Work in progress

Disease Exposure in Early Life Affects Female Reproduction: Evidence From Southern Sweden 1896 – 2015. Paper, with Nilsson and Quaranta.

Early-life adversity negatively affects health in late life, but much less is known about if and how early-life conditions affect survival and morbidity in mid-life. We study the reproductive health of women to address their health in mid-life and further our understanding of the long-term consequences of exposure to epidemic disease. Using the Scanian Economic Demographic Database and data on local infant disease load exposure in the year of birth, we follow women’s reproductive careers over a period of almost 100 years (1905-2000). We study several outcome measures: the likelihood of giving birth, birth intervals, offspring sex ratio, twinning and the risk of a stillbirth, and separately analyse first-born and later-born children. Using purposively digitized obstetric records, we also examine offspring’s birthweight and birth length for a sub-sample of individuals. The findings indicate that contextual characteristics at the time of birth, in particular early-life disease exposure, have a continuing impact on reproduction and health across the female life course, and even translate to the early-life health of the next generation. 

Find the preprint here.

A Healthy Marriage? Emerging Marital Status Differences in Mortality in Scania, 1815 – 2015. Chapter, with Martin Dribe.

Married people tend to have better health and live longer than the single and the widowed. When they do fall ill, they are more likely to recover and do so more quickly. Differences in health and mortality by marital status are not exclusively a modern phenomenon, but existed also in historical societies, including Sweden. However, the long-term change in the mortality differentials by marital status, and its interaction with gender and social class, has not been systematically addressed in the literature. In this chapter, we explore these issues for the city of Landskrona and the rural parishes in its hinterland. We focus on period changes and the different patterns by gender and social class. The development in marital status differences in mortality are related to societal transformation and the changing marriage patterns, especially increased frequency of divorce and the postponement of widowhood to later ages.

The development of maternal and infant health 1905-2000. Chapter, with Lazuka & Quaranta.

In this chapter, we analyse the development of maternal and infant health in five rural parishes and the city of Landskrona in Scania, Sweden, in the last 110 years. We address the overall development of maternal and infant health using a range of indicators. We take a closer look at changes in care for pregnant women and infants, and developments in medical developments available to women around childbirth in Sweden and in the town of Landskrona specifically. Around the turn of the 20th century, maternal and infant mortality were very low in Scania from an international perspective. Yet, a dramatic further reduction took place in the 20th century. Before 1930, most women were assisted in childbirth by midwives, whereas later birth increasingly took place in maternity wards and, later, in hospitals. Medical interventions around childbirth became more feasible with time as infections could be treated using antibiotics from the 1930ies onwards. Similarly, bacterial infections among infants became less deadly with the arrival of antibiotics. We relate the development of maternal and infant health to the institutions and medical innovations available in the area, such as the expansion of hospital facilities, availability of antibiotics and the opening of maternity wards and neonatal intensive care units. We estimate the magnitude of the impact of these interventions on health using time series analysis.

Find the preprint here.

Intergenerational Inequality in Child Mortality in the Netherlands, 1833-1913.

In historical the Netherlands, child mortality was distributed unequally between families and this inequality persisted across generations. Using family reconstitution data for the province of Zeeland (LINKS) we show that parents with elevated sibling child mortality had increased risk of stillbirth and deaths among their own children. Intergenerationally high risk of child death can partially be attributed to SES. Inequalities accumulate as parents that grew up in high mortality, low-SES families with low adulthood SES had the highest under-five mortality among their children. Intergenerational transmission is found even for a period when child mortality had declined strongly.