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Urban mortality change and the workhouse: St. Martin-in-the-Fields 1725-1824 Romola Davenport Cambridge Group for the History of Population and Social.

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Presentation on theme: "Urban mortality change and the workhouse: St. Martin-in-the-Fields 1725-1824 Romola Davenport Cambridge Group for the History of Population and Social."— Presentation transcript:

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 Quakers London Bills 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 0 0.5 17 6464.5 65 4.254.3 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.

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

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

8 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

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 males females 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) age1752-681775-1805 0107 (2.6%)126 (4.7%) 1-94 (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 1772 rebuild 1783 new labour ward

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 days7-29 days Variable% riskP% riskP Illegitimate100100 Legitimate90.82253.073 No info80.32177.073 1725-49100100 1750-7452.00644.000 1775-9969.13754.000 1800-2450.05520.000 Winter100100 Summer47.001114.377 Mixed ward100100 Labour ward88.54188.351 New labour ward59.08144.000

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? Period WHnon-WH 1747-7152.5 (686) 8.2 (18810) 1772-8919.8 (910)10.1 (13388) 1790- 2.0 (500) 7.3 (26134) 1805/24 Childbed burials

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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