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

signs. The Hungarian capital had similar situation as Stockholm had but it also had to cope with two world wars as well and it had to face a more heterogeneous society with different ethnic- and religious groups. Determinants of infant and child mortality in Hungary and Sweden We begin the presentation of some detenmnants of infant and child mortality with a brief enumeration of many factors showing the relationship between them. Then we describe these determinants starting from the proximate up to the distal, that is, from the role of nursing to that of the political system. One of the first connections with the outside world of a newborn baby is nutrition. Nursing habits are one of the most influential factors of the IMR which were earlier studied. We also think that the condition of the infant is influenced by the housing environment, the family's economy, the parents education and traditions, the geographical location and the political system. Breastfeeding During the eighteenth century consequences of urbanization were negative. Cities were built very compactly unable to provide sufficient air and light, the sewage system and the water supply were not hygienic. Higher mortality rates used to be attributed to insufficient nursing. Several studies showed that the (grade of) mothers employment rate was proportional to the IMR; the fewer mothers worked at factories and on the field the lower the mortality rate among infants (Holt, 1913). Luling (1900) showed a strong inverse correlation between breastfeeding and mortality. Among those children who had been breast-fed by their mothers and who got information about breastfeeding the mortality rate was half compared to that of the children who were fed by artificial milk by a stranger. A similar study was also conducted in Sweden. In a Swedish review, Bengtsson and Lundh (1999) cite Lithell who has also found in her study on Swedish and Finnish parishes that breastfeeding explains variations between different groups to a greater degree. Nursing compensated for poor living conditions and artificial nursing led to higher mortality. The Hungarian Weszelovszky (1882) also cites Berg, a Swedish physician, who had written about an increase in IMR in an earlier period due to less nursing. To stop the increase in IMR due to lack of nursing authorities stated in a royal decree which said that it is punishable to deprive the breast-milk from the children. We also have data about breastfeeding campaigns in Nedertorneâ in 1830. (Hógberg, 1983) In Hungary Kapronczay (2001) also observed a lower IMR among children fed with breast-milk than among children whose mothers were industrial workers without any possibilities to breast-feed the infants. Weszelovszky (1882) tried to explain why the Flungarian U5MR was double the Swedish. He found that children born out of wedlock, those who are not fed with breast-milk and those who are not looked after properly died in higher ratio. He also found that the country's climate is not a risk factor. Generally speaking, Weszelovszky also found a lower IMR among Israelites in Baden and Bavaria, an observation valid in Hungary as well which shows the significance of the familys' background that we pointed out earlier.