Post on 04-Jan-2016
Urban mortality change and the workhouse:
St. Martin-in-the-Fields 1725-1824
Romola DavenportCambridge Group for the History of Population and Social Structure
Jeremy Boulton University of Newcastle
Funded by the ESRC and the Wellcome Trust
Infant mortality fell dramatically in London in the last quarter of the eighteenth century
London Quakers
London Bills
England & Wales
St. Martin’s workhouse in 1871
The workhouse accounted for 20% of all burials in the parish (10% of infant burials)*
*Based on burials of residents buried in parish
0 10 20 30 40 50 60 70 80 900
10
20
30
40
50
malefemale
age
% o
f re
side
nce
time
Workhouse records give date of and age at entry, and date of discharge. Burial books give address and cause.
Jan 1 1750
0 0.5
17
64 64.5 65
4.25 4.3 4.75 5
Bastard born in WH{smallpox}
Settlement right. Sent to Hospital
No admission reason given {Old Age}
Entered with mother and siblings. Discharged.
Young women dominated admissions, but not the workhouse population
female admissions female population at risk
The medical function of the workhouse produced strange age-patterns of mortality
Mortality rates by length of stay in the workhouse, ages 20-49 (patterns were similar at all ages). Note semi-log scale
The medical function of the workhouse is evident in the excessive mortality rates upon entry
But even for those who survived the extreme mortality upon entry, mortality in the workhouse was
much higher than in the national population
0 10 20 30 40 50 60 70 800
200
400
600
800
1000
St. Martin's workhouse(long-stayers)
English reconstitutionsample (married adult women)
comparison of female mortality rates in the second half of the C18th
age (years)
risk
of
dyin
gin
age
inte
rval
x 1
000
Large apparent improvements in survival at all ages over the century 1725-1824
males females
Death rates in first 6 months of residence improved at all ages
But death rates of long-stay inmates only improved at ages under 15,consistent with reductions in acute
infectious disease rates
1720 1740 1760 1780 1800 18200
200
400
600
800
1000
1-4
5-14
15-3940-59
60-79
year
prob
abili
ty o
f dy
ing
(x10
00)
survival after 6 months’ residence in workhouse (females)
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 %)
Infant survival improved across the first year of life, but especially in the first month of life
1720 1740 1760 1780 1800 18200
200
400
600
800
1000
1-6 days
182-365 days
1-365 days
7-28 days
29-181 days
year
pro
babili
ty o
f dyi
ng
(x1000)
The workhouse accounted for 3-8 % of baptisms, and 5-15 % of infant burials
1720 1740 1760 1780 1800 18200
50
100
150
workhouse birthsworkhouse % of births
0
5
10
15
workhouse % ofinfant burials
year
# of
birt
hs
% of births,burials
in the workhouse
1772 rebuild 1783 new labour ward
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
Cox regression analysis of neonatal mortality
1-6 days 7-29 daysVariable % risk P % risk PIllegitimate 100 100Legitimate 90 .822 53 .073No info 80 .321 77 .073
1725-49 100 1001750-74 52 .006 44 .0001775-99 69 .137 54 .0001800-24 50 .055 20 .000
Winter 100 100Summer 47 .001 114 .377
Mixed ward 100 100Labour ward 88 .541 88 .351New labour ward 59 .081 44 .000
Neonatal tetanus may have been a major cause of neonatal mortality in the workhouse
0 5 10 15 20 25 300
10
20
30
40
1783-18241750-821725-49
age (days)
risk
of
dyin
g, p
er d
ay
No similar pattern in the parish
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
No evidence of changes in seasonality that might indicate changes in breastfeeding practices
Seasonality of burials, St. Martin-in-the-Fields
Did the workhouse murder mothers?
1740 1750 1760 1770 1780 1790 1800 1810 18200
5
10
15
20 non-workhouseworkhouse
age (days)
risk
of
dyin
g, p
er d
ay
Period WH non-WH1747-71 52.5 (686) 8.2 (18810)1772-89 19.8 (910) 10.1 (13388)1790- 2.0 (500) 7.3 (26134)1805/24
Childbed burials
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.
Supported by the Wellcome Trust and The ESRC
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)
0 10 20 30 40 50 60 70 80 900
5
10
15
20
femalemale
age
buri
als