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

A COMPARATIVE STUDY OF THE SOCIAL-POLITCAL DETERMINANTS OF INFANT AND CHILD MORTALITY IN SWEDEN AND HUNGARY 1850-1945 GABRIELLA VARGA Introduction The fight against poverty and illness crosses country borders. One of UN millennium goals is to reduce child mortality by two-thirds by 2015. The importance of comparative studies lies in their practical, useful results. Two hundred years ago the risk to die before the age of 1 year was a hundred times greater in Europe than it is today. The value of infant's lives has been changing throughout history. In ancient Sparta and Roman times a new-born's destiny was decided by a committee or by the father. At the end of the 4

th century infanticide was punished by death in Rome. They have also designated places for abandoned children in churches. The care for foundlings has been practiced by civil organisations from the sixteenth century and during the reign of Louis XIV they got some provision from the state. (Holt, 1913) The IMR however in early times cant be analysed. In this paper we use infant mortality, measured with infant mortality rate (IMR: deaths per 1000 live born children), as the main comparative factor. Looking at national averages in the studied centuries there has always been a major IMR difference between these two countries to the advantage of Sweden, but the speed of IMR declination was quite similar. The situation of the capitals however was different than the country average. It is important to mention, that in the late 1890s the two capitals, Stockholm and Budapest, had almost similar (less than 3% difference) IMR. At that time IMR differences in rural and urban areas were each other's opposites in the two countries: Sweden had lower IMR in rural areas, while in Hungary the capital had lower infant mortality. IMR stagnated in Budapest during the first decades of the 20

th century while in the Swedish capital it decreased to one third of the 1890s level until the beginning of the 1920s. The fact that the IMR value graphs of the two capitals meet each other in the 1890s, make it even more interesting to investigate factors that generally might have slowed down the IMR progress in Hungary. The topic of the most important factors behind the mortality decline is long debated. Szreter (2002) and Colgrove (2002) summarised the polemics around one of the most debated scientist McKeown whose arguments emphasize the "invisible hand" as the most important factor. In his theory this consists of the economic growth, improving living conditions and improved nutrition. On the one hand it can not be denied that these are important factors, but they have their effect in a bigger context of public health intervention. The crit-