Scarlet Fever and nineteenth-century mortality trends. A Reply to Romola Davenport

by Simon Szreter (University of Cambridge) and Graham Mooney (Johns Hopkins University)

The full article from this blog post will be published in The Economic History Review and is available now on Early View.

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In 1998 we published in the Economic History Review an analysis showing that all the available robust demographic evidence testified to a deterioration of mortality conditions in fast-growing industrial towns and cities in the second quarter of the nineteenth century. We also demonstrated that although there was some alleviation in the 1850s from the terrible death rates experienced in the 1830s and 1840s, sustained and continuous improvement in the life expectancies of the larger British urban populations did not begin to occur until the 1870s. In other publications, we have each shown how it is most likely that an increasing range and density of politically-initiated public health interventions in the urban environments, starting in earnest in the late 1860s and 1870s and gaining depth and sophistication through to the 1900s, was primarily responsible for the observed demographic and epidemiological patterns.

In a new article in Economic History Review in 2020, Romola Davenport has argued that a single disease, scarlet fever, should be attributed primary significance as the cause of major urban mortality trends of the period, not only in Britain but across  Europe, Russia and North America.

In this response we critically examine the evidence adduced by Davenport for this hypothesis and find it entirely unconvincing. While scarlet fever was undoubtedly an important killer of young children, focusing on the chronology of the incidence of scarlet fever in Britain shows that it lags behind by a clear decade or more the major turning points in urban mortality trends. Scarlet fever did not make any significant recorded impact until the 1840s and it did not exert its most deadly effects until the 1850s. Its severe depredations then continued unabated in the 1860s and 1870s, thereafter declining sharply in the period 1880-85.

We therefore maintain that our original findings and interpretation of the main causes of Britain’s urban mortality patterns during the course of the nineteenth century remain entirely valid.