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

Conclusion and suggestions for further studies Summarizing the overview of the proximal, intermediate and distal factors of the IMR we can conclude that the proximal factors like nursing habits and the mothers'situation are strongly influenced by the distal determinants like health campaigns, education and tradition. The destiny of the children born out of wedlock could have been fatal 100 years ago. The view of single mothers in society was problematic and legislations did not ameliorate their lives either. We speculate that when the commitment of the state appears more explicitly, e.g. in terms of laws providing equal handling for children born out of wedlock, the situation of this risk group improves like it did in Sweden. Since in a democracy only measures with wide support from society are legislated, changes in public opinion were necessary beside government policies. In the 19

th century it was a major challenge for single mothers to raise a healthy child alone. A nations tradition and political system are strongly driving the redistribution issue and other influential factors like general education, midwives education, breastfeeding campaigns. We suggest a further study on the political systems and the information systems of the two countries, as well as the confounders and death causes issue for a better understanding. The different traditions of democracy and independence might also strongly influence the framework of the populations health behaviour. Comparison of the two countries shows, that of all studied influential factors of IMR (the role of midwifes, breast feeding, smallpox vaccination, quality of households, state economy, general education, etc.) most plausible causes of a lower IMR in Sweden are the following: • role of midwifes - however only when the antiseptic methods were introduced in 1881 and not before. • compulsory smallpox vaccination - but without analyzing the death causes. • more improved water and sanitation system. All these measures were introduced through laws and the results suggest that there was considerable support for these measures on all levels of society. Passing these laws seems to be a result of consensus built through a long dialogue involving most segments of society. Such laws could not be effective without the support of people and local governments. There is need for further study with more accurate analysis regarding the role of the economic status of a country and the role of the redistribution, as Sundbärg, (1898-99) suggested that is one of the differences between the Western and Eastern European countries in our study period. The opposite ratio regarding the urban-rural differences in the IMR in these two countries suggest that Hungarian peasants might have had a more difficult situation than the Swedish peasants. A possible hypothesis for this could be the Hungarian peasants lower status in society, as the lack of interest representation in political decision-making and their bad economic situation. Meanwhile in Sweden peasants had representation on all levels of local and country politics. These differences in the representation can explain their lack of influence.