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The transformation of the urban epidemiological regime, 1750-1850

The transformation of the urban epidemiological regime, 1750-1850

Half the world's population now lives in urban settlements. However before c.1800 it is improbable that any society in the world could have sustained such high levels of urbanisation because the population attrition associated with urban living would have caused national depopulation. In the seventeenth and early eighteenth centuries European cities operated as 'urban graveyards', with death rates so high as to require a net flow of in-migrants even to maintain their population size. Wrigley famously estimated that half the natural growth of the English population (births in excess of deaths) was consumed by London's mortality regime in this period. Kuznets and de Vries have argued that excessive urban mortality rates precluded modern economic growth, with its concomitant rapid urbanisation, because no population could produce a rural population surplus sufficient to maintain a very large urban component.

However in the last half of the eighteenth century a dramatic change occurred, and baptisms began to exceed burials from around 1770 in a large number of towns and cities in north-western Europe. It is likely that most of the relatively modest improvement in life expectancy over the eighteenth century in the English population is attributable to improvements in mortality in urban populations, in contrast to the braking function of urban death rates on life expectancy gains in both the seventeenth and nineteenth centuries. In London improvements in survival were particularly spectacular, and infant mortality fell from a peak of around 300-350 deaths per thousand births in the mid-eighteenth century to the national average of c.160/1000 by 1825. However very little is known of mortality trends in other urban populations.

This transformation of the urban epidemiological regime is the subject of a long-run research project which uses a variety of sources to investigate mortality change in northwest Europe from the seventeenth to the twentieth centuries. For London we are using the very detailed records of the parish of St. Martin-in-the-Fields to investigate the timing and causes of improvements in infant and child mortality and the extent to which these improvements were shared by different social status groups (see, and Infant mortality by social status in Georgian London). To test whether mortality improvements were possible in the context of rapid industrialisation and laissez-faire urbanisation we are using the hitherto unexploited sources for Manchester, Britain's second city in the Victorian period (see Future work in collaboration with Prof. Richard Smith will involve analyses of mortality patterns throughout the settlement hierarchy and for a range of types of urban centre 1600-1945. Results from these projects will be compared with existing evidence for urban centres across Europe.

Publications/work in progress