The Late Decline of Seasonal Diarrhoeal Mortality: Temperature and Urban Sanitation in England and Wales, 1891-1930

Hannaliis Jaadla , University of Cambridge
Romola Davenport, University of Cambridge

During the late nineteenth century, England and Wales witnessed a significant decline in mortality from faecal–oral diseases such as typhoid, cholera, and dysentery. However, infant diarrhoeal mortality showed a more complex trajectory and later disappearance, with a particularly strong seasonal component. This paper investigates the late decline in diarrhoeal deaths that mostly occurred in infancy in England and Wales. We examine how the relationship between hot summer temperatures and mortality evolved from the 1890s to the 1930s, and explore the key factors contributing to this change—including improvements in sanitary infrastructure, developments in transport, and changes in infant feeding practices. Our analysis relies on Registrar General’s weekly returns of cause-specific deaths in large towns from 1891 to 1930. We combine this mortality data with daily temperature data and information on sanitary infrastructure (share of flush toilets) and demographic and occupational indicators to estimate two-way fixed effects models (Barreca et al. 2016). Our preliminary results indicate that the decline in infant diarrhoeal mortality in England and Wales between 1890 and 1930 reflects a complex interplay of environmental, infrastructural, and behavioural factors. While changes in sanitary infrastructure improved baseline conditions, they cannot by themselves explain the abrupt weakening of the summer temperature–mortality relationship after the First World War. Alternative mechanisms for the decisive decline in diarrhoeal mortality may lie in changes in infant feeding practices and the growing availability of new infant food products, such as dried milk.

See extended abstract

 Presented in Session 24. Mortality, Inequality and Population Dynamics in Historical Perspective