Factors influencing infant mortality in western Europe during the eighteenth and nineteenth centurie
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Factors influencing infant mortality in western Europe during the eighteenth and nineteenth centurie "Twenty years ago our knowledge of the decline in western mortality was fairly rudimentary" (Tedebrand, 1988, p7). Since then historical demographers have religiously reconstructed families from pre-1837 parish registers and collected post-1837 data from the census/civil registration to examine population characteristics for a variety of western countries. The results have shown that up until the end of the nineteenth century mortality throughout the whole of Europe was extremely high. They have also highlighted the enormous contribution infant deaths have made to this total. Consequently, much research has been done into the determinants of infant mortality as an important mechanism in demographic theory. This essay attempts to review some of the influential factors identified in the infant mortality literature. No attempt is made to distinguish between those that explain inter- and intra-regional trends or those that supposedly initiate widespread change. Instead, all are included on the basis that they have had some effect on infant mortality. It is hoped that approaching the subject in this way will allow the diversity and interrelationships that exist between them to shine through and that, in the process, monocausal explanations will be proved deficient. One of the most influential, and controversial, theories regarding infant mortality was posited by Thomas McKeown, an eminent British historical demographer, in 1976 with his book 'The Modern Rise of Population'.
notes that contradictory patterns can also be found in some areas of Sweden. A similar pattern is described by Kintner (1987) using 1910 data for Germany. In this instance, as with Brändström (1993), a high degree of correlation was found between low levels of infant mortality and high levels of breastfeeding in some cases. Kintner (1987) cites the examples of Bavaria in southern Germany where infants were never breastfed or weaned early and infant mortality was extremely high (sometimes 276 per 1000) and rural areas of north-west Germany where the prevalence of breastfeeding was high and infant mortality was low (78 per 1000). Once again however, significant exceptions to the pattern existed. Large urban centres such as Hamburg, Bremen and Berlin with substantial proportions of their population never having been breastfed had only low to moderate levels of infant mortality (Kintner, 1987). The existence of such exceptions in both studies thus suggests that other variables also have an important part to play in infant mortality rates. Fertility is one of the variables generally regarded as having an important effect on infant mortality, though it is widely appreciated that the precise relationship is very difficult to quantify. Hobcraft et al. (1983) in a study of the deleterious effects of rapid childbearing make reference to Jelliffe's (1966)
the prevalence of infanticide and abortion (Sauer, 1978); the proportion of the population who is Catholic (Kintner, 1987, Kintner, 1988); society/a community's psychological attitude to births, deaths and life in general (Imhof see Williams, 1995); and varying climatic conditions affecting the spread of disease and 'quality of life' (see for instance Woods' et al. (1988) 'urban-sanitary-diarrhoeal-effect', Kytir and Münz, 1993, Woods et al., 1993). Many of these factors and there interrelationships are shown in figure 3. In conclusion, the vast array of literature on factors affecting infant mortality is evidence in itself that any monocausal explanation must be an inadequate answer to what is an inherently complex issue. It has been shown that infant feeding practices and female labour obligations, the two most widely quoted causal factors, are interrelated and also dependent on a host of other determining factors that have only been mentioned here. One way to grasp the complex nature of infant mortality rates is via an appreciation of the susceptibility and sensitivity of infants to their new world, something that mothers from around the world realise and try to protect their children from even today (note responsible parents' obsession with cleaning and sterilisation!). Small wonder then that, "studies...aimed at monocausal explanations of trends in infant mortality have fast proven unsatisfactory: infant mortality is clearly conditioned by a [complex] combination of social, cultural, biological, economic and psychological factors [that interplay with each other]" (Brändström, 1993, p24).
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