Infant and early childhood mortality in a historical context

Evelien Walhout, Tilburg University
Jornt Mandemakers, University of Groningen

The objective of this paper is to test, in a historical setting, whether and how social class influences the level of infant mortality and how this may be related to or explained by breastfeeding practices. What social groups are affected most with high infant mortality in a high mortality regime and how does it evolve along with overall mortality decline. Socioeconomic variation in infant mortality can be explained by the uneven distribution of risk and protective factors between social groups. Infants are exposed to different health risks because socioeconomic status is highly correlated with housing, sanitary conditions, proper nourishment, and medical treatment. We expect therefore that infant mortality was higher among the poorer classes. In addition to analyzing infant mortality according to social group, we test – using individual level data including causes of death regarding the population of the Dutch town of Roosendaal – several hypotheses in order to explain social differentials and its mechanisms regarding infant mortality. The explanations for the findings are considered in the context of different social and environmental conditions, disease environment, and infant feeding practices. Besides socioeconomic determinants, previous research on infant mortality in past and present has discussed the role of breastfeeding and its direct effect on infant survival. In order to connect social differences with distinct feeding practices and related health risks we will particularly focus on: 1. timing (or occurrence) of death within the first two years of life (related to the incidence of weaning); 2. the distribution of infant death throughout the year (the practice of artificial feeding accompanied by poor sanitary standards will result in excess summer mortality); 3. the main causes of infant death (the practice of bottle feeding will result in high numbers of deaths because of gastro-enteritis or diarrhea); and 4. differences/changes in historical time.