Child Mortality and Causes-of-Death in Madrid, 1905-1928 Inequalities across the Urban Environment during the Epidemiological Transition

Diego Ramiro Fariñas, Spanish National Research Council (CSIC)
Michel Oris, Consejo Superior de Investigaciones Científicas (csic)
Stanislao Mazzoni, Consejo Superior de Investigaciones Científicas (CSIC)
Mélanie Bourguignon, UCLouvain
Dariya Ordanovich, IEGD-CCHS Spanish National Research Council (CSIC)

While at the beginning of the 20th century, Madrid was nicknamed “the city of death”, the capital of Spain went through a rapid mortality decline and epidemiological transition during the following 30 years. Child mortality, which was initially as high as infant mortality, played a leading role. We analyze those crucial evolutions which have already been studied in several cities with aggregate statistics. We work on individual nominal data covering all Madrid. For 95% of the 104’000 children who died before 5, we have linked death and birth certificates. With such a massive database, we confront two classifications of causes of death, study the diseases that decreased the most (water-and-food borne causes of death), but also the persistent ones (airborne causes of death) and isolate diseases that reflected acute symptoms of malnutrition. To understand those divergent evolutions, we use semi-parametric Fine-Gray models for competitive risks. For the main groups of causes of death and for a few specific ones, we test the impact on child survival of the inscription of social inequalities in the urban space, but also of an important and relatively under-studied dimension, the vulnerability to climatic hazards, and we consider the interrelations between those two environmental dimensions.

Keywords: Mortality and Longevity, Historical Demography, Linked data sets , Children, Adolescents, and Youth

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