Urban mortality in Greece: Hermoupolis (1859–1940)

The paper examines mortality patterns in the city of Hermoupolis, on the Greek island of Syros, from 1859 to 1940. It produces important new insights into Mediterranean urban historical demography and is the first comprehensive study of urban mortality in Greece, utilising the largest and one of the longest time series at the individual level yet calculated from civil registration and census data. Abridged life tables were constructed for the first time for a Greek urban settlement, enabling the calculation of age-specific mortality rates and life expectancies. Hermoupolis experienced much higher mortality levels than the national average. The findings suggest that early childhood mortality started to decline rapidly from the late nineteenth century onwards, with declines in early adulthood and infancy following. The paper reinforces and confirms our limited knowledge about the timing of the mortality transition in Greece. It proposes that an urban penalty was clearly operating in the country even during the early twentieth century. Finally, this paper suggests that a combination of factors was responsible for the mortality decline in Hermoupolis, including wider access to water, which even when it was not clean enough to drink, nevertheless enabled improvements in personal hygiene among the residents of the city.     

Child mortality under Chinese reforms

This paper looks at the impact of China's economic reforms on its health performance. Based on an appropriate health outcomes indicator, the logit of infant survival, it appears that while still out-performing most countries, China's relative advance decreased during the reform period. Consistent with the fact that the health system had to rely increasingly on private expenditures, we find an increasing impact of income on infant survival. We also show that relative prices at the provincial level matter for infant survival: for a given increase in income per capita, a real currency depreciation lowers survival. Focusing on poverty reduction still seems to be a major means to significantly improve infant survival in China.     

Mortality in South Africa: Socio-economic profile and association with self-reported health

This paper exploits the first two waves of the National Income Dynamics Study (NIDS) to describe the socio-economic profile of mortality and to assess whether self-rated health status is predictive of mortality between waves. Mortality rates in NIDS are in line with estimates from official death notification data and display the expected hump of excess mortality in early and middle adulthood due to AIDS, with the excess peaking earlier for women than for men. We find evidence of a socio-economic gradient in mortality, with higher rates of mortality for individuals from asset-poor households and with lower levels of education. Consistent with evidence from many industrialised countries and a few developing countries, we find self-rated health to be a significant predictor of two-year mortality, an association that remains after controlling for socio-economic status and several other subjective and objective measures of health.     

煤炭资源型城市经济发展对健康的影响

文章在Grossman健康需求模型以及实践研究的基础上,运用来自中国24个煤炭资源型城市的经济数据和死亡率数据进行实证分析,结果表明经济发展和人口死亡率之间存在着显著关系,并且部分城市死亡率随着经济发展呈现出先增长后下降的倒U趋势.文章还对煤炭资源型城市安徽省淮北市进行个案研究,以实地发放问卷为数据来源,以健康自评为衡量健康指标,考察各因素对居民健康影响,发现性别、教育和职业地位对健康影响显著.     

Social inequalities in famine mortality in the manorial system of the tsarist Russian province of Livland in the mid-1840s

By relying on longitudinal data on two rural parishes in the Russian Baltic province of Livland, the article analyses two questions concerning famine's short-run effects on mortality in a manorial system: (1) whether there is evidence of a social gradient in mortality during the famine of 1844–6 and (2) whether the manors could protect the peasants against the hardships. The analysis reveals that neither the status of a farmer peasant nor the landlord saved the local inhabitants from an increased risk of dying during the famine of 1844–6. The conventional assumptions about the protective effect of the higher socio-economic status or type of manor against subsistence crisis found very little support in the study.     

From home to hospital: The evolution of childbirth in the United States, 1928-1940

This paper examines the shift in childbirth from home to hospital that occurred in the United States in the early 20th century. Using a panel of city-level data over the period 1928-1940, we examine the impact on maternal mortality resulting from the shift of childbirth from home to hospital. Results suggest that until the late 1930s when sulfa drugs were developed, medical intervention had a limited impact on maternal mortality. Post-sulfa, the medicalization of childbirth reduced maternal mortality. Regressions estimated separately by race provide mixed evidence as to whether blacks and whites benefited differentially from medical intervention.     

Ethnic-specific infant care practices and infant mortality in late Imperial Russia

The Russian Empire had the highest infant mortality rate in Europe at the beginning of the twentieth century. Using a variety of official statistical sources and qualitative evidence, this paper documents uniquely high infant mortality among ethnic Russians. In contrast, among other ethnic groups of the empire, infant mortality rates did not exceed those of the European countries by much. The evidence suggests that the explanation for the Russian infant mortality pattern was ethnic-specific infant care practices, such as the early introduction of solid food, which increased the incidence of lethal gastrointestinal diseases. Our findings highlight the importance of traditional infant feeding practices in mortality in pre-industrial societies.     

Status and mortality: Is there a Whitehall effect in the United States?

The influential Whitehall studies found that top-ranking civil servants in Britain experienced lower mortality than civil servants below them in the organizational hierarchy due to differential exposure to workplace stress. I test for a Whitehall effect in the United States using a 1930 cohort of white-collar employees at a leading firm – General Electric (GE). All had access to a corporate health and welfare program during a critical period associated with the health transition. I measure status using position in the managerial hierarchy, attendance at prestigious management training camps and promotions, none of which is associated with a Whitehall-like rank-mortality gradient. Instead, senior managers and executives experienced a 3–5-year decrease in lifespan relative to those in lower levels, with the largest mortality penalty experienced by individuals in the second level of the hierarchy. I discuss generalizability and potential explanations for this reversal of the Whitehall phenomenon using additional data on the status and lifespan of top business executives and US senators.     

Chasing Success: Health Sector Aid and Mortality

As many cases studies show, successful public health measures are being implemented in many places around the globe, and country-level mortality has fallen significantly in recent decades in all but a few countries. Are the two linked? Does development assistance for health (DAH) improve, on balance, recipient countries’ mortality trajectory? Using a new data source containing DAH on 96 high mortality countries, the regression analysis shows no effect of DAH on mortality. Other types of aid, including water development, also have no effect. Economic growth, on the other hand, has a strong negative effect on mortality. These findings confirm and build upon recent work by Williamson (2008) and are shown to be robust to a variety of sensitivity analyses and alternative model specifications and estimation methods.This analysis also shows that the effectiveness of DAH has not increased over time, even as the level of that funding has increased fourfold, though spending on infectious diseases and family planning may have caused small reductions in mortality. Furthermore, even though it is encouraging that DAH has tended to go where the need is highest, it also goes to states that have experienced the greatest mortality reductions in the recent past. In other words, DAH appears to be following success, rather than causing it.     

Mortality and voyage length in the middle passage revisited

Using a newly published database on the transatlantic slave trade prepared at Harvard University's W. E. B. Du Bois Institute and a new methodology, this article reevaluates the relationship between slave mortality and the length of the middle passage on nine routes during the 18th and 19th centuries. For each route, interactive regressions are used to estimate the influence of factors such as crowding on-board, season of departure, and whether stopovers were made on a voyage. Death rates that track the average time pattern of deaths on the voyages of each route are calculated. These rates indicate whether deaths mainly occurred in the early part, middle section, or latter part of a voyage. Hence we are now closer to understanding whether deaths on individual routes largely resulted from preboarding or on-board conditions or an interaction between preboarding and on-board conditions. The relationships between mortality during three phases of the voyage, the coasting period, the middle passage, and the postarrival period, are also assessed as are the connections between slave and crew deaths.     

The Demography of Indonesia in Comparative Perspective

Having reduced its fertility rate over the past 40 years, Indonesia has reached a new demographic crossroad. Its fertility rate is now around 2.5 births per woman, which, if sustained, would add substantial numbers to Indonesia's population in the future. There are concerns within Indonesia that the present level of population growth is an obstacle to continued economic development and, accordingly, that fertility should be reduced to the replacement level of 2.1 births per woman as soon as possible. Yet a comparative perspective indicates that countries such as Singapore, Japan, and Thailand are concerned about the effects that their very low rates of fertility are having on their labour forces and their rates of population ageing. This article suggests that with the right policy settings Indonesia can avoid this outcome yet continue to reduce its fertility. It discusses the implications of Indonesia's population growth and distribution for its economy, as well as the poor quality of demographic data.     

The fiscal cost of child grants in the context of high adult mortality in South Africa: A simulation to 2015

This paper investigates the expected costs of cash transfers to children in South Africa up to 2015. The child population is not expected to grow between 2008 and 2015 and thus the fiscal cost of the Child Support Grant is expected to stabilise in the near future. The other major child grant, the Foster Care Grant, is far less predictable – while it is not intended to be an orphan grant, three quarters of its beneficiaries are orphans. Because of the HIV/AIDS pandemic, the number of dual orphans is expected to double between 2008 and 2015, reaching 1.3 million, and the overall number of orphans (maternal, paternal and dual) to reach 4.8 million by 2015. If the Foster Care Grant were to become a de facto orphan grant, its costs would escalate rapidly. The paper does not argue in favour of an orphan grant, but rather for greater effort in ensuring that the Child Support Grant reaches the neediest children, especially maternal orphans.     

Water and Chicago’s mortality transition, 1850-1925

Between 1850 and 1925, the crude death rate in the City of Chicago fell by 60 percent. We estimate that 30-50 percent of this reduction can be attributed water purification measures and the subsequent eradication of diarrheal diseases and typhoid fever and its sequella. Our findings are consistent with a proposition that early public-health scholars referred to as the Mills-Reincke phenomenon. According to advocates of the Mills-Reincke phenomenon, for every one death from typhoid fever that was prevented by water purification, there were three or more deaths from other causes (not usually considered waterborne) that were also prevented. At least part of this phenomenon appears to have driven by the fact that typhoid had a low case fatality rate but so weakened its survivors that they were vulnerable to later infections from tuberculosis and pneumonia. There is also evidence that typhoid survivors eventually developed kidney problems from which they later succumbed. These findings have implications for public health policies in developing countries.