A Competing Risks Analysis of Victims and Survivors: The Impact of Different Socioeconomic Factors on Cause-specific Early Childhood Mortality risks in Amsterdam, 1856-1865

Mayra Murkens , Radboud University
Tim Riswick, Radboud University
Jeanine Houwing-Duistermaat, Radbou

Socioeconomic disparities in health in modern day society are high on the research agenda, as they appear to be omnipresent. The historical roots of health inequalities along the lines of class are however still highly debated. Young children have often been overlooked, while they were the ones who predominantly succumbed to a variety of infectious diseases before the epidemiological transition started. Moreover, the few historical studies that were conducted into socioeconomic inequalities in health for this age category remain inconclusive as they find contradicting results. This study examines what determined cause-specific early childhood mortality in mid-nineteenth century Amsterdam (1856-1865). By doing so, it addresses how different socioeconomic factors played a role in determining who died and who survived from age one to age five before the start of the health transition. We employ a unique individual-level dataset which contains all children born in Amsterdam during the period 1856-1860, and for the ones who die, their specific cause of death. The result of our competing risks models demonstrate that socioeconomic inequalities existed. However, some of these are expressed mainly in particular diseases. For instance, tuberculosis, diphtheria and measles were causing the overall social gradient among airborne diseases. In addition, among the unknown causes of death an even stronger social gradient existed, implying that medical consumption of the lower classes was lower compared to the higher classes. Thus, socioeconomic inequality in early childhood mortality was present in nineteenth-century Amsterdam, but the underlying causes were different from those of infant mortality.

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 Presented in Session 117. Flash Session - Changing Mortality Patterns over Time and Space