By Michail Raftakis (University of Sassari)
This blog post is based upon the author’s article forthcoming in the Economic History Review.
Mortality started to decline among some populations in northern Europe as early as the eighteenth century. Mediterranean Europe, on the other hand, still exhibited high mortality levels until the beginning of the twentieth century, as a result of the very high infant and/or early childhood mortality, as well as the high prevalence of infectious diseases. A main characteristic of the mortality regime in the nineteenth century were the great discrepancies between rural and urban populations. Cities faced an ‘urban penalty’ which reduced survival probabilities for their inhabitants and resulted in a great number of deaths, most significantly among infants. The main conditions responsible for excess urban mortality included the high population density leading to the rapid spread of infectious diseases and the lack of sanitary reforms. This urban-rural mortality gap seems to have narrowed significantly by the early twentieth century in most European populations and was then followed by an urban advantage.
Figure 1. View of Hermoupolis and Ano Syros
Source: D. Baud-Bovy and F. Boissonnas, 1919.
Only little evidence is available about changes in mortality in modern Greece prior to the 1960s. Apart from a few studies which have attempted to estimate national mortality levels (though on the basis of indirect techniques and extensive assumptions) and several studies that refer to non-urban populations, cover short periods of time, or employ rather superficial demographic methods, there remains a significant lack of studies focusing solely on urban mortality patterns in Greece with a long-term perspective.
My forthcoming study in the Economic History Review examines the patterns of mortality decline in the Greek urban centre of Hermoupolis on the Greek island of Syros, and, by employing a variety of sources (i.e., death records, census data, local press, public health reports, and oral interviews), it investigates the pathways that facilitated such decline. Hermoupolis, in particular, was chosen not only because it was one of the most important nineteenth-century Greek cities experiencing very high mortality, but also because of the unique civil registration sources which it possesses at the individual level. A series of abridged life tables is constructed for the first time for a Greek urban settlement, enabling the calculation of age- and sex-specific mortality rates and life expectancies. The main contributions of this study reinforce, confirm, and expand our limited knowledge regarding the timing and the reasons for the decline in mortality in Greece. Moreover, the study contributes to the urban-rural debate within Europe.
Mortality in Hermoupolis is found to have been much higher than the national average and, moreover, the highest rate calculated for Greece in almost every census year from the mid-nineteenth century until 1940; see figure 2. Comparisons of Hermoupolis with other semi-urban and rural Greek populations suggest that an ‘urban penalty’ was clearly operating in Greece even during the first decades of the twentieth century, most likely as a result of insufficient sanitary infrastructure, high population density, bad housing, low living standards, unhealthy working conditions, and in-migration. Life expectancy at birth in Hermoupolis is significantly lower than any other available rate that has been calculated for Greek populations. When age-specific death rates are plotted, the generally expected U-shaped curve is clearly visible in every census year for which life tables are constructed; see figure 3. Mortality among men is also found to be consistently higher than that of women, as greater gains in life expectancy occurred among women.
Figure 2. Annual and five-year moving average of the crude death rate, Hermoupolis, 1859-1940
Note: Crude death rate = annual number of deaths/ mid-year population* 1,000. Source: Hermoupolis Mortality Database.
Figure 3. Age-specific death rates (nMx) and life expectancy at all ages, Hermoupolis, 1861-1928 (census years)
Source: Hermoupolis Mortality Database and Greek censuses.
Confirming the assumptions made by others about the timing of the mortality decline, time series for Hermoupolis show that a declining trend was underway by the beginning of the twentieth century or even the late nineteenth century: young children benefited initially, adults and infants followed. Life expectancy at birth had increased from 36 years in 1861 to almost 46 years of age in 1928; see figure 3. The mortality decline was only interrupted in the years around the 1918/19 influenza pandemic and the arrival of the Asia Minor refugees around 1922, which has been associated with increases in mortality throughout the country; see figure 2.
A combination of factors was found to be responsible for the mortality decline in Hermoupolis, including changes in the registration system; mass immunisation; improvements in living standards and nutrition among lower strata infants; improvements in maternal literacy; the mortality-fertility interaction during the demographic transition; and wider access to water, as an underground water supply system was introduced in the mid-1920s, and although not expanded across the whole city, it may have enabled improvements in personal hygiene among the residents of the city. The study therefore supports the idea that cultural factors may have played a crucial role in the changes in mortality in Hermoupolis during the period under study. This aspect has been under-examined, or at least underestimated, in previous demographic studies, but it seems to be of very special importance in Greece.
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