Collaborative Research: Socioeconomic and Kinship Factors in Infant and Child Mortality in Historical Slavonia

在占世界人口80%的发展中国家，婴儿和儿童的死亡率是一个巨大的社会、心理和经济负担。投资于婴儿从受孕到死亡的所有资源，包括母亲参与经济生产，如自给农业和/或有偿工作，都失去了。用于医疗保健或教育的任何政府资源也会丢失。发展中国家1岁以下儿童的死亡率是发达国家的10倍。利比里亚（15%）是芬兰（0.3%）的50倍。同样，发展中国家5岁以下儿童的总死亡率高出10倍。在撒哈拉以南非洲的一些国家，这一比例接近25%，但在许多欧洲和一些亚洲国家，这一比例约为5%。这种情况的经济和医疗方面相当明显。由于贫穷、无知以及政府缺乏对保健或基础设施的投资而造成的不卫生条件导致了胃肠道疾病和疟疾，这些疾病对婴儿和儿童来说尤其致命。但是，虽然我们对死亡率与平均人口水平的经济和流行病学情况之间的广泛相关性有所了解，但在这些国家，我们对单个家庭的情况几乎一无所知；因此，我们无法解释种群内的变异。必要的资料很难获得。从人种学观察中可以得到非常详细的信息，但样本量有限，而且观察结果往往是轶事。特别是，我们对家庭和大家庭的组成如何影响儿童的生存几乎一无所知。这类信息几乎从未记录在健康调查中。因此，我们求助于历史，特别是教区的洗礼、婚姻和葬礼记录，这些记录允许重建家庭和大家庭。它们提供的信息几乎不可能从现代调查中获得。本项目分析了18世纪和19世纪克罗地亚部分地区农民的一组特别好的此类数据。这些农民生活在与今天发展中国家相似的经济和政治条件下。以前关于产妇死亡率的研究表明，经济和政治条件对分娩死亡的几率有很大的影响，因为它使男性劳动力离开家庭农场，使妇女承担劳动负担，并影响到对新母亲的照顾水平。先前的研究也表明，大家庭的组成是一个重要因素。这个支持团体越大，死亡的风险就越低。然而，在家庭制度中，兄弟的妻子处于激烈的竞争之中，数据显示，考虑到家庭网络的整体规模，新母亲的嫂子越多，她的死亡风险就越高。同样，哥哥的级别越高，他妻子的生存机会就越大。因此，家庭内部政治对母亲生存的影响与整体经济实力和生产力的影响一样大。在这项关于婴儿和儿童死亡率的研究中，研究人员将利用同样的人口数据库和同样的统计技术，应用从产妇死亡率分析中得到的教训。它们将考虑到不断变化的经济和政治条件（如农奴制的废除、战争和征兵、现金越来越多地进入农民经济），以及家庭规模和结构。他们还将能够考虑到个别母亲及其亲属网络中其他母亲以前的儿童死亡率历史。他们希望在更广泛的条件和家庭网络组成的细节中找到类似的结果。从科学的角度来看，这种分析应鼓励更好地收集更详细的数据，并注意当代健康调查中的人种学相关性。增加一些关于家庭和大家庭组成的问题会很简单，但可能非常有成效。这项研究的更广泛影响是明确的：从历史分析中吸取的教训应该有助于解决现代世界的婴儿和儿童死亡率问题。在发展中国家，越来越多的男子作为雇佣劳工离开家乡，而妇女则生活在大家庭中，往往是一夫多妻制的环境中，竞争是预料之中的。这些条件与这个历史数据库中的条件相似。联合国儿童基金会（UNICEF）、美国国际开发署（USAID）和非政府组织（ngo）等组织目前为降低婴儿和儿童死亡率所做的努力，将有助于更深入地了解经常被忽视的因素，比如亲属群体内部的生存政治。

In the developing countries that account for 80 percent of the world population, the mortality of infants and children is a great social, psychological, and economic burden. All of the resources invested in infants from conception to their deaths, including the participation of mothers in economic production, such as subsistence farming and/or paid work, is lost. Any governmental resources devoted to health care or education are also lost. The mortality of children under age 1 is 10 times higher in developing countries than in developed ones. It is 50 times higher in Liberia (15 percent) than in Finland (0.3 percent). Similarly, the total mortality of children under age 5 is 10 times higher in developing countries. It is close to 25 percent in some countries of sub-Saharan Africa but around five percent in many European and some Asian countries.The economic and medical aspects of this situation are fairly clear. Unsanitary conditions attributable to poverty, ignorance, and lack of government investment in health or infrastructure result in gastrointestinal and malarial disease, which are particularly deadly to infants and children. But while we know something about broad correlations between mortality rates and economic and epidemiological circumstances on average at the population level, we know almost nothing in such countries about the circumstances of individual families; thus we cannot account for variation within populations. The necessary data are very difficult to obtain. There is excellent detailed information from ethnographic observation, but the sample sizes are limited, and the observations are often anecdotal. In particular, we know almost nothing about the way in which the composition of families and extended families affects the survival of children. That kind of information is almost never recorded in health surveys.Therefore we turn to history and particularly parish records of baptism, marriage, and burial, which allow the reconstitution of families and extended families. They give information almost impossible to obtain from modern surveys. This project analyzes a particularly good set of such data for the peasants of part of Croatia in the 18th and 19th centuries. These peasants lived under economic and political conditions similar to those of developing countries today. Previous research on maternal mortality showed that economic and political conditions had strong effects on the chance of death in childbirth, by drawing male labor away from the family farm, putting labor burdens on the women, and affecting the level of care that could be devoted to new mothers. Previous research also showed that composition of the extended family was an important factor. The larger was this support group, the lower was the risk of death. However, the family system was one in which the wives of brothers were in strong competition, and the data show that the more sisters-in-law a new mother had, the higher was her risk of death, given the overall size of the family network. Similarly, the more senior a brother was, the better were his wife's survival chances. Thus internal family politics affected survival of mothers as much as overall economic power and productivity.In this research on infant and child mortality, the researchers will apply the lessons from the analysis of maternal mortality, using the same population database and the same statistical techniques. They will take account of changing economic and political conditions (such as the abolition of serfdom, warfare and military recruitment, increasing intrusion of cash into the peasant economy), as well as family size and structure. They will also be able to take into account the prior child mortality history of individual mothers, and of other mothers in their kinship network. They expect to find similar results of broader conditions and of details of family network composition. From a scientific perspective, this analysis should encourage better collection of more detailed data and attention to ethnographic relevance in contemporary health surveys. Adding a few questions on the composition of households and extended families would be simple, but potentially very productive.The broader impacts of the research are clear: the lessons learned from the historical analysis should be useful in attacking problems of infant and child mortality in the modern world. In developing countries, men are increasingly drawn away from home as wage labor, and women live in an extended family context, often in a polygamous context where rivalry is to be expected. These conditions are similar to those in this historical database. Current efforts by organizations such as UNICEF, USAID, and NGOs to cut rates of infant and child mortality would be aided by closer understanding of factors often ignored, such as the politics of survival within kinship groups.