Kapronczay Károly szerk.: Orvostörténeti Közlemények 202-205. (Budapest, 2008)

TANULMÁNYOK — ARTICLES - VARGA, Gabriella: A comparative study of the social-political determinants of infant and child mortality in Sweden and Hungary 1850-1945. - Összehasonlító tanulmány a svéd és a magyar csecsemőhalandóság szociálpolitikai tényezőiről 1850 és 1945 között

To sum up this overview the evolution of the IMR showed the same trend in Hungary as in Sweden. The exceptions are the results of World War I. We noticed that the decline of the differences happened earlier in the Swedish IMR of the different areas in the countries and in the capitals, and also between different groups than in Hungary. This delay is constant in the decline of the IMR which consider even the introduction of the potential influential factors, such as the compulsory smallpox vaccination. This proves that good examples can be followed in other circumstances too. Stockholm Industrialization and mass immigration to the big cities made big changes in the societies' lives. Changes in the traditional family models and employment pattern just like overcrowding had a huge pressure on inhabitants most vulnerable groups, namely upon women mostly those who raised their children alone - and upon infants. Stockholms population increased threefold during the second half of the 19

lh century. In the same period, nativity decreased by 25% and IMR declined by 40%. According to Edin quoted in an article written by N. Bin (as the authors name was mentioned by the Statistsk mânadsskrift, 1932), decline of IMR among children born out of wedlock could have occurred faster could be explained by the fact, that mothers moved from the capital after delivery. So, births would leave a trace only in birth statistics, while deaths wouldn't registered when occurring death on the countryside. Mortality differences by the mothers' marital status and socio-economic status of the head of the family in the population of Stockholm was studied by Burström and Bernhardt (2001). Their study analysing child mortality (0-14 years old) in Stockholm showed that the relative risk (RR) to die for children under 14 born out of wedlock compared with the others was 2,4 in 1885 and 2 in 1910. Proportion of children born out of wedlock to those born in families increased in the 19

th century, from 35% to 45% during the period 1821-1858. (Statistiska tidskrift Band 1, 1860-62) Evolution of IMR followed almost the same pattern. The ten-year average of IMR among infants born out of wedlock decreased from 283 in 1891-1900 to 78 in 1921-1930 whereas the IMR for the infants born in wedlock went down from 122 to 46 during the same period. (St. m.krift, 1932) A law that protected children born out of wedlock was legislated in 1917 in Sweden (Höjer, 1934). A lower socio-economic status meant also an elevated risk to die in early childhood. Relative risk (RR) to die before the age of 15 for a child from the manual workers group compared with the upper-middle class was 1,6 in 1885, 2,6 in 1891 and 2,2 in 1910. (Bur

ström, Bernhardt, 2001) The biggest decrease in infant mortality (80%) in Stockholm occurred among cases of diarrhoea. From 1876 to 1904 it decreased from 100 per 1000 to 20 per 1000, a fact which can be related to the improvements in water and sanitation. (Burström, Bernhardt, 2001) As a result this decrease continued and the average became 2 per 1000 between 1918-1925. (Burström et al. 2005) Infant mortality rate varied also between areas. The highest IMR in a district of Stockholm was found to be almost 100% higher than in the district with the lowest mortality. While 117 per 1000 live-birth infants died in Klara parish, in "Katarina and Sofia" parish