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Urban mortality change and the workhouse: St. Martin-in-the-Fields 1725-1824

Urban mortality change and the workhouse: St. Martin-in-the-Fields 1725-1824. Romola Davenport Cambridge Group for the History of Population and Social Structure Jeremy Boulton University of Newcastle. Funded by the ESRC and the Wellcome Trust.

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Urban mortality change and the workhouse: St. Martin-in-the-Fields 1725-1824

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  1. Urban mortality change and the workhouse: St. Martin-in-the-Fields 1725-1824 Romola Davenport Cambridge Group for the History of Population and Social Structure Jeremy Boulton University of Newcastle Funded by the ESRC and the Wellcome Trust

  2. Infant mortality fell dramatically in London in the last quarter of the eighteenth century London Bills London Quakers England & Wales

  3. St. Martin’s workhouse in 1871

  4. The workhouse accounted for 20% of all burials in the parish (10% of infant burials)* *Based on burials of residents buried in parish

  5. Workhouse records give date of and age at entry, and date of discharge. Burial books give address and cause. Jan 1 1750 Bastard born in WH {smallpox} 0 0.5 Settlement right. Sent to Hospital 17 No admission reason given {Old Age} 65 64 64.5 Entered with mother and siblings. Discharged. 4.25 4.3 5 4.75

  6. Young women dominated admissions, but not the workhouse population female admissions female population at risk

  7. The medical functionof the workhouse produced strange age-patterns of mortality

  8. The medical function of the workhouse is evident in the excessive mortality rates upon entry Mortality rates by length of stay in the workhouse, ages 20-49 (patterns were similar at all ages). Note semi-log scale

  9. But even for those who survived the extreme mortality upon entry, mortality in the workhouse was much higher than in the national population

  10. Large apparent improvements in survival at all ages over the century 1725-1824 females males Death rates in first 6 months of residence improved at all ages

  11. But death rates of long-stay inmates only improved at ages under 15,consistent with reductions in acute infectious disease rates survival after 6 months’ residence in workhouse (females)

  12. Smallpox declined in adults but not children in the workhouse. No evidence for inoculation in the workhouse. Smallpox rates, after two months in the workhouse (rate per 1000 person years, and % of burials) age 1752-68 1775-1805 0 107 (2.6%) 126 (4.7%) 1-9 4 (15.2%) 10 (11.4 %)

  13. Infant survival improved across the first year of life, but especially in the first month of life

  14. The workhouse accounted for 3-8 % of baptisms, and 5-15 % of infant burials 1783 new labour ward 1772 rebuild

  15. Did the workhouse ‘murder’ infants? Risk factors for neonatal mortality: illegitimacy (70-85% of births) high risk pregnancies? (excess multiple births, high maternal mortality) poverty? medicalisation of delivery workhouse environment

  16. Cox regression analysis of neonatal mortality 1-6 days 7-29 days Variable% risk P % risk P Illegitimate 100 100 Legitimate 90 .822 53 .073 No info 80 .321 77 .073 1725-49 100 100 1750-74 52 .006 44 .000 1775-99 69 .137 54 .000 1800-24 50 .055 20 .000 Winter 100 100 Summer 47 .001 114 .377 Mixed ward 100 100 Labour ward 88 .541 88 .351 New labour ward 59 .081 44 .000

  17. Neonatal tetanus may have been a major cause of neonatal mortality in the workhouse No similar pattern in the parish

  18. Seasonality of neonatal mortality in the parish (and amongst foundlings) suggests hand-feeding Neonatal burials (days 1-29, adjusted for birth seasonality), St. Martin-in-the-Fields

  19. No evidence of changes in seasonality that might indicate changes in breastfeeding practices Seasonality of burials, St. Martin-in-the-Fields

  20. Did the workhouse murder mothers? Childbed burials Period WH non-WH 1747-71 52.5 (686) 8.2 (18810) 1772-89 19.8 (910) 10.1 (13388) 1790- 2.0 (500) 7.3 (26134) 1805/24

  21. Mortality and urban workhouses • Survivorship improved amongst infants and children in the workhouse 1725-1824 • Reductions in acute infectious disease mortality may have contributed. Improvements in workhouse management (eg. hygiene or segregation of infectious cases)? No evidence of smallpox inoculation • The workhouse may have contributed to infant mortality through neonatal tetanus. Dramatic improvements in neonatal (and possibly maternal) mortality followed reorganisation of wards.

  22. Supported by the Wellcome Trust and The ESRC

  23. Foul disease ‘Foul disease’ burials exclusively a pauper, and mainly a workhouse, phenomenon Paupers with foul disease were sent to hospitals and/or treated in the parish before the 1770s, but seem to have been treated in-house subsequently (3-6% of female burials aged 10-39, 1770-1805)

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