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.
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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.
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Childhood neighborhoods and cause-specific adult mortality in Sweden 1939-2015. Paper, Hedefalk, Van Dijk & Dribe.
The socioeconomic health gradient has widened since the mid-21st century, but the role of childhood neighborhoods remains underexplored. We analyze longitudinally how socioeconomic neighborhood conditions in childhood influence cause-specific deaths in adulthood for the town of Landskrona. Children are followed in the town 1939-1967, and we observe their moves through the city as well as other children living nearby. We then follow them as adults in the Swedish national registers, 1968-2015.
The social class of the nearby, same-age, childhood neighbors had a lasting effect on male all-cause and preventable, but not non-preventable, mortality. Men who grew up with having 10% more children from white-collar families as close-proximity neighbors had an 8% lower mortality risk due to preventable causes of death in adulthood. The mortality for women was not affected by their childhood neighbors, although both a lower adult class and class origin increased their mortality. Because preventable causes of death are linked to lifestyle factors, this study suggests that childhood neighborhood peers had a strong and lasting influence on the health behavior of men growing up before the health gradient was fully established.Childhood neighborhoods can thus help to better understand the mortality differentials by SES.
Find the preprint here.