
including careful efforts to distinguish infant from child and other forms of
mortality, have only resulted in negative or contradictory statistical findings.
5
In
this chapter, therefore, separate treatments of the history of changing urban
mortality and fertility have been offered, reflecting the two distinct bodies of
historiography.
(ii)
Two principal features dominate urban mortality patterns in the period to
: initially high death rates (extremely high in many industrial towns), which
began to decline from about ; and a gradual shift in the main causes of death
from infectious to chronic and degenerative diseases.
6
The high death rate/high
infectious disease rate regime, especially marked in the second and third quar-
ters of the nineteenth century, was the result of unregulated industrial and urban
growth, which reduced many residential areas in towns and cities across Britain
to squalid, stinking dormitories. Whereas eighteenth-century citizens had often
made successful efforts to clean up their towns and stave off the ravages of infec-
tious disease, such efforts seem to have been insufficiently maintained during the
first half of the nineteenth century.
7
By , urban Britain was highly insani-
tary, as Edwin Chadwick’s great Sanitary Report of graphically docu-
mented and as the ensuing Health of Towns Commission confirmed.
8
These urban environments formed a perfect breeding ground for endemic
infectious diseases, as well as for that terrifying visitor, cholera. Badly ventilated
and overcrowded houses, where families too often lived each to a room, with
as many families in the house as there were rooms, encouraged the spread of
diseases transmitted by droplet infection and close contact: whooping cough,
measles, scarlet fever, smallpox and tuberculosis. Thousands of children died
Urban fertility and mortality patterns
5
M. Kabir, ‘Multivariate study of reduction in child mortality in England and Wales as a factor
influencing the fall in fertility’ (PhD thesis, University of London, ); R. Woods, P. A.
Watterson and J. H. Woodward, ‘The causes of rapid infant mortality decline in England and
Wales, –’, Population Studies, Part , (), –, part , (), –.
6
For important recent historical epidemiological studies, see A. Mercer, Disease, Mortality and
Population (Leicester, ); R. Woods and N. Shelton, An Atlas of Victorian Mortality (Liverpool,
); J. Vogele, Urban Mortality Change in England and Germany, – (Liverpool, ); A.
Cliff, P. Haggett and M. Smallman-Raynor, Deciphering Global Epidemics.Analytical Approaches to the
Disease Records of World Cities, – (Cambridge, ); R. Woods, The Demography of
Victorian England and Wales (Cambridge, ).
7
For eighteenth-century reforms and renovations see C. W. Chalklin,The Provincial Towns of Georgian
England (London, ); P. J. Corfield, The Impact of English Towns – (Oxford, ), ch.
; James Riley, The Eighteenth-Century Campaign to Avoid Disease (London and Basingstoke, );
P. Borsay, The English Urban Renaissance: Culture and Society in the Provincial Town, –
(Oxford, ); Roy Porter, ‘Cleaning up the Great Wen’, in W. F. Bynum and R. S. Porter, eds.,
Living and Dying in London, Medical History (Supplement, ).
8
M. W. Flinn, ed., Report on the Sanitary Condition of the Labouring Classes of Great Britain (Edinburgh,
).
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