Fatal Places? Contextual Effects on Infant and Child Mortality in Early Twentieth Century England and Wales
Fatal Places? Contextual Effects on Infant and Child Mortality in Early Twentieth Century England and Wales
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DOI：
10.1017/ssh.2023.5
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发表时间：
2023-07-10
影响因子：
0.8
通讯作者：
Rafferty，Sarah
中科院分区：
文献类型：
--
作者：
Reid，Alice;Garrett，Eilidh;Rafferty，Sarah
本文以普雷斯顿和海恩斯在《致命的岁月》中观察到的社会阶层是20世纪初英格兰和威尔士婴儿和儿童死亡率的最重要影响因素作为出发点。随后的一项研究表明，这在一定程度上可能是由于不同阶层在不同类型的地方的空间分布，而社会阶层的一些死亡率差异实际上可能反映了健康和不健康地区的环境影响。尽管这一论点在卫生地理学文献中得到了相当多的关注，但很少对特定的历史时期进行研究，而且只在特定的城市地区进行研究。在本文中，我们对1911年英格兰和威尔士人口普查的完整的个人水平数据集应用了多层次模型，比较了个体夫妇水平和两个空间水平对婴儿和儿童死亡率的影响。我们发现，尽管婴儿和儿童死亡率的大部分变化是在个体层面上发生的，但在两个空间层面上也存在重要的变化，社会阶层之间的死亡率差异的部分原因是人们生活的地区，而不是他们的社会阶层。对所有三个层次上的自变量的考虑表明，不同的空间尺度反映了对幼儿死亡率的不同类型的影响。
This paper takes, as its starting point, Preston and Haines’ observation in Fatal Years that social class was the most important influence on infant and child mortality in England and Wales in the early twentieth century. A subsequent study suggested that this could in part be due to the spatial distribution of the different classes across different types of place, and that some of the mortality differences by social class might actually reflect the contextual effects of healthy and unhealthy places. Although this line of argument has received a considerable amount of attention in health geography literature, it has rarely been examined for a specific historic period, and then only within particular urban areas. In this paper, we apply multi-level models to a complete count individual-level dataset of the 1911 census of England and Wales, comparing influences on infant and child mortality at the level of the individual couple and for two spatial levels. We find that although most variation in infant and child mortality operates at the individual level, there is also important variation at the two spatial levels and part of the mortality differences between social classes is better explained by the areas in which people lived rather than by their social class. A consideration of independent variables at all three levels suggests that different spatial scales capture different sorts of influences on early age mortality.