Public health measures against neonatal tetanus on the island of Vestmannaeyjar (Iceland) during the 19th century

The article presents a study of neonatal tetanus on the tiny island of Vestmannaeyjar (Iceland) during the 18th and 19th centuries. At an early date, Vestmannaeyjar was known for its high levels of mortality from neonatal tetanus. This appalling mortality is analysed, inter alia, on the basis of parish registers at the individual family level. During the late 18th and early 19th centuries, more than three out of four newborns on the island died during the first 2 weeks of life. At the beginning of the 19th century, Icelandic and Danish authorities had already showed great interest in improving infant survival on Vestmannaeyjar. In 1827 a physician was appointed to the island and by the late 1840s the disease was successfully fought on the island. The achievement on Vestmannaeyjar is a good example of how the sanitary movement was able to bring about important improvements in infant survival long before the breakthrough of the bacteriological revolution.     

Infant mortality in Bremen in the 19th century

This article analyses the development of infant mortality in the port city of Bremen within a disaggregated framework, using the available material from civil birth and death registers, as well as the census returns for 1862, 1871, 1885, 1895, and 1905. The analysis focuses on a number of factors that affected infant mortality, including breast-feeding, female labor-force participation, social class, and migrant status. Particular attention is paid to the age structure of infant mortality in relation to stillbirths and reproductive mortality, as well as registered trends in neonatal and postneonatal mortality. The Bremen data also provide a basis for analyzing infant mortality by cause of death and seasonality. By incorporating disaggregated demographic and socioeconomic data, the authors are able to offer some new insights into the determinants of urban infant mortality trends in the 19th century.     

Highlights from a low-level area: infant mortality and social structure in eight East Frisian parishes, 1740–1839

Considerable variations in infant mortality rates have occurred within the low-lying region of northern Germany's East Frisia. Individual parishes can be assigned to three specific groups by registered mortality levels for the period 1740–1839. Differences also existed between parishes containing Geest (heathland), bogs, and marshland reflecting specific geographical and environment factors, as well as the structure of the local economy. In both Geest and bog parishes, the level of infant mortality and its trend over time were not homogeneous. In the two marshy river parishes, only environmental factors were significant; both registered the lowest rates of infant mortality. They had fertile soil, extensive grazing land, an exceptionally high number of large agricultural holdings, and households that were above average in size. By contrast, the highest rates of infant mortality were found in one bog and two Geest parishes, but these communities remained heterogeneous in terms of geographical size and population growth and density.     

Infant mortality in town and countryside: northern Germany, ca. 1750–1850

The discussion still continues among researchers about the causes for the decline in infant mortality in widespread parts of Europe at the turn of the 19th century. This article is based on sources such as unpublished statistical material from Prussia, parish registers, and lineage and village genealogies. As these sources are broken down by town and countryside and into various phases of infant mortality, they provide evidence for further reflection that may be fruitful. Thus, several causes for the decrease in infant mortality and ways of diffusion can be excluded and the impact of others delimited. The present study concludes that research should pay more attention to changes in infant care than it usually does.     

Highlights from a low-level area: infant mortality and social structure in eight East Frisian parishes, 1740–1839

Considerable variations in infant mortality rates have occurred within the low-lying region of northern Germany's East Frisia. Individual parishes can be assigned to three specific groups by registered mortality levels for the period 1740–1839. Differences also existed between parishes containing Geest (heathland), bogs, and marshland reflecting specific geographical and environment factors, as well as the structure of the local economy. In both Geest and bog parishes, the level of infant mortality and its trend over time were not homogeneous. In the two marshy river parishes, only environmental factors were significant; both registered the lowest rates of infant mortality. They had fertile soil, extensive grazing land, an exceptionally high number of large agricultural holdings, and households that were above average in size. By contrast, the highest rates of infant mortality were found in one bog and two Geest parishes, but these communities remained heterogeneous in terms of geographical size and population growth and density.     

Differential infant mortality viewed from an evolutionary biological perspective

Evidence from family reconstitution studies suggests that variations in infant mortality may reflect differences in parental solicitude. For various proximate reasons that might originate from emotional, material or social interests, parents may be inclined to invest differently in the survival of their offspring. Evolutionary theory holds that the behavior-regulating mechanisms that cause differential parental care operate in a biologically functional manner. They obey the biological imperative of striving to propagate one's own genetic material in the gene pool of the population to the best possible degree, in view of prevailing socioecological constraints. From a Darwinian point of view, differential parental investment can be best understood as a socioecologically contingent tactical measure within an adaptive, i.e., genetic fitness enhancing strategy. Therefore, human reproductive decisions remain poorly understood unless their biological function in the Darwinian fitness competition is taken into consideration.     

Is breast best? Evaluating breastfeeding patterns and causes of infant death in a Dutch province in the period 1875–1900

In the Dutch province of Noord-Brabant, infants experienced extremely high mortality risks towards the final decades of the nineteenth century. It has been stated that infant survival in the past highly depended upon the fact whether a child was breastfed or not. In this article we will reflect on this perceived importance of infant diet in order to explain the high mortality risks of Brabant infants in the period 1875–1900. Using local aggregated cause of death data, a change in breastfeeding practices can indeed be detected. Between 1875/79 and 1895/99 there was an increase in the relative and absolute number of infants deaths as a result of diarrhoea and other digestive disorders indicating deficient hygiene and that fewer infants were breastfed frequently. By discussing differences between urban and rural settings, and between Catholic and Protestant regions, we will shed more light on possible mechanisms for this change in breastfeeding practices.     

Differentials in overall and cause-specific mortality among infants born in and out of wedlock,Stockholm 1878–1925

This study investigates differentials in the decline of cause-specific infant mortality by marital status of the mother in Stockholm (1878–1925) and factors contributing to the explanation of these differentials using computerized records of individual entries from the Roteman Archives. Included in the analysis were 120,094 children less than 1 year of age who lived in Södermalm during this period. Cause-specific mortality rates were calculated for three time periods. Cox's regression analysis was used to study the relationship between overall and cause-specific risk of infant death and of being born in and out of wedlock in relation to a set of variables. Infant mortality rates and mortality risks were higher among children born out of rather than in wedlock. The most pronounced differentials in cause-specific mortality rates between these groups of children were seen in cases of diarrhea. The socioeconomic status of the household head and number of children in the household were statistically significant with infant mortality, but explain only part of the excess mortality risk of children born out of wedlock. In Stockholm at the turn of the 19th century being born out of wedlock was strongly associated with poor health outcomes, particularly in diarrheal diseases, pneumonia/bronchitis, and immaturity/congenital causes.     

Urban infant mortality and religion at the end of the nineteenth and in the early twentieth century: the case of Ekaterinburg,Russia

Modern demographers analyse regional and other infant mortality differentials as important factors behind the current life expectancy of Russian citizens. Historically, however, the Russian Empire is simply displayed as one block with high infant mortality rates. Also with respect to cultural background factors, Russia is often perceived as religiously homogeneous with the Orthodox Church dominating the country. In reality, Russia has a long history of coexisting religious traditions. This includes both provinces with a majority of Catholics, Muslims, Buddhists or shamanistic populations as well as territories characterized by religious diversity and significant minority religions. Our project studies minority religious groups in the Urals, a province by the Ural Mountains stretching into Asia. While no territory can claim to be truly representative of this mega-country, we believe that this centrally located province is well suited to show some of the Russian variety, including differential infant mortality among the followers of minority religions, which is the topic of this article. We employ church record microdata to study Catholics, Jews and Old Believers in the main metal-producing city of Ekaterinburg.     

Correlates of Mortality in a U.S. Cohort of Youth, 1980–98: Implications for Social Justice

This paper reports results of a study based on a nationally representative sample of U.S. youth (N = 11,549) that asked two questions: (1) How does family structure affect the likelihood of adolescent death beyond that of race/ethnicity, sex, socioeconomic status, personal behavior, and other structural factors and (2) under what conditions might appeals for social justice be warranted for relative mortality statuses and for absolute gains in mortality? The study found that marital instability increases the likelihood of dying when controlling for a variety of other factors including class, race/ethnicity, sex, and unemployment rate in area of residence. The author argues that this finding lends support to social justice arguments to redistribute resources in such a way as to ensure the likelihood of absolute gains in mortality. The study also found, however, that race/ethnicity/sex also accounted for the likelihood of dying independently of family structure when controlling for socioeconomic and other factors. The author argues that this finding lends support to social justice arguments to redistribute resources on the basis of relative mortality statuses.     

公共卫生框架下的卫生监督及其法制工作内涵简

卫生监督工作是公共卫生事业的一个组成部分,在实现公共卫生目标的同时,应当具备＂自我进化＂的能力。这种能力是公共卫生事业不断向高水平发展的重要因素,其动力来源在很大程度上依赖于卫生监督法制工作在正确的方向上有效运转。传统视角下对卫生监督法制工作内涵的解读有其局限性,本文在把握卫生监督与公共卫生之间的关系,以及重述、分析卫生监督过程的基础上,从解读立法、审视立法、反馈立法三个新的视角尝试探讨卫生监督法制工作的内涵。     

公共卫生与人权

本文是置人权于中国公共卫生场域中的阐释。起因是2004年后——2004年,人权在中国入宪——当人们试图以人权作为转型中中国公共卫生的基础理念时,却发现从旧体制（计划经济体制）走出来的中国公共卫生很难在实际上接受人权：是同样地保护每一个人,还是保护大多数人;是首先着眼于管理,还是强调国家对每一个人的健康权的积极责任,是在中国,公共卫生必须面对的问题。     

Legislating for Your Own Good: Criminalising Moral Choice. The Modern Echoes of the Victorian Vaccination Acts

Victorian vaccination legislation has important echoes for the present age in the dilemma over how to promote compliance with government-endorsed scientific and medical public health strategies for the welfare of the community in a context of growing popular mistrust of such initiatives, in terms of their likelihood to confer benefits as well as their possible negative impacts on individuals. Victorian experience of dealing with the issue of ‘conscientious objection’ to policy initiatives seen as intruding into the area of individual moral choice, especially parental choice for children, is invoked to suggest better ways of comprehending the present resistance to take-up of the MMR vaccine, and its wider implications; as well as commenting on the role of the media.