Tommy Bengtsson

Childhood misery and disease in later life: the effects on mortality in old age of hazards experienced in early life, southern Sweden, 1760-1894.

This paper assesses the importance of early-life conditions relative to the prevailing conditions for mortality by cause of death in later life using historical data for four rural parishes in southern Sweden for which both demographic and economic data are very good. Longitudinal demographic data for individuals are combined with household socio-economic data and community data on food costs and the disease load using a Cox regression framework. We find strong support for the hypothesis that the disease load experienced during the first year of life has a strong impact on mortality in later life, in particular on the outcome of airborne infectious diseases. Hypotheses about the effects of the disease load on mothers during pregnancy and access to nutrition during first years of life are not supported. Contemporary short-term economic stress on the elderly was generally of limited importance although mortality varied by socio-economic group.

Deliberate Control in a Natural Fertility Population: Southern Sweden, 1766-1864

In this article, we analyze fertility control in a rural population characterized by natural fertility, using survival analysis on a longitudinal data set at the individual level combined with food prices. Landless and semilandless families responded strongly to short-term economic stress stemming from changes in prices. The fertility response, both to moderate and large changes in food prices, was the strongest within six months after prices changed in the fall, which means that the response was deliberate. People foresaw bad times and planned their fertility accordingly. The result highlights the importance of deliberate control of the timing of childbirth before the fertility transition, not in order to achieve a certain family size but, as in this case, to reduce the negative impacts of short-term economic stress.

The Ageing Population

The Ageing Population.- In This World Nothing Is Certain but Death and Taxes: Financing the Elderly.- A Stable Pension System: The Eighth Wonder.- Ways of Funding and Organising Elderly Care in Sweden.- Financing Healthcare: A Gordian Knot Waiting to Be Cut.- Towards a New Swedish Model?.Ageing, with increases in the old-age dependency ratio, puts a strain on pension systems organised as a pay-as-you-go system. The question asked is whether the Swedish system will be politically as weill as financially stable in the future. The design is described and analysed with resspect to sustainability.

Living Standards in the Past

Why did Europe experience industrialisation and modern economic growth before China, India or Japan? This is one of the most fundamental questions in Economic History and one that has provoked intense debate. The main concern of this book is to determine when the gap in living standards between the East and the West emerged. The established view, dating back to Adam Smith, is that the gap emerged long before the Industrial Revolution, perhaps thousands of years ago. While this view has been called into question - and many of the explanations for it greatly undermined - the issue demands much more empirical research than has yet been undertaken. How did the standard of living in Europe and Asia compare in the seventeenth and eighteenth centuries? The present book proposes an answer by considering evidence of three sorts. The first is economic, focusing on income, food production, wages, and prices. The second is demographic, comparing heights, life expectancy and other demographic indicators. The third combines the economic and demographic by investigating the demographic vulnerability to short-term economic stress. The contributions show the highly complex and diverse pattern of the standard of living in the pre-industrial period. The general picture emerging is not one of a great divergence between East and West, but instead one of considerable similarities. These similarities not only pertain to economic aspects of standard of living but also to demography and the sensitivity to economic fluctuations. In addition to these similarities, there were also pronounced regional differences within the East and within the West - regional differences that in many cases were larger than the average differences between Europe and Asia. This clearly highlights the importance of analysing several dimensions of the standard of living, as well as the danger of neglecting regional, social, and household specific differences when assessing the level of well-being in the past. Contributors to this volume - Kenneth Pomeranz, University of California, Irvine Li Bozhong, Tsinghua University Osamu Saito, Hitotsubashi University Prasannan Parthasarathi, Boston College Robert C. Allen, Oxford University P. Hoffman, D. Jacks, P. Levin and P. Lindert, California Institute of Technology and University of California, Davis Jan Luiten van Zanden, IISG Jaime Reis, University of Lisbon Richard Steckel, Ohio State University Boris Mironov, St. Petersburg State University E. Hammel and A. Gullickson, University of California, Berkley and Columbia University Hans Christian Johansen, University of Southern Denmark M. Breschi, A. Fornasin, and G. Gonano, University of Udine T. Bengtsson and M. Dribe, Lund University M. Oris, G. Alter and M. Neven, University of Geneva, Indiana University and University of Liege C. Campbell and J. Lee, UCLA and University of Michigan N.Tsuya and S. Kurosu, Keio University and Keitaku University

Do conditions in early life affect old-age mortality directly and indirectly? Evidence from 19th-century rural Sweden

Previous research has shown that the disease load experienced during the birth year, measured as the infant mortality rate, had a significant influence on old-age mortality in nineteenth-century rural Sweden. We know that children born in years with very high rates of infant mortality, due to outbreaks of smallpox or whooping cough, and who still survived to adulthood and married, faced a life length several years shorter than others. We do not know, however, whether this is a direct effect, caused by permanent physical damage leading to fatal outcomes later in life, or an indirect effect, via its influence on accumulation of wealth and obtained socio-economic status. The Scanian Demographic Database, with information on five rural parishes in southern Sweden between 1813 and 1894, contains the data needed to distinguish between the two mechanisms. First, the effects of conditions in childhood on obtained socio-economic status as an adult are analyzed, then the effects of both early-life conditions and socio-economic status at various stages of life on old-age mortality. By including random effects, we take into account possible dependencies in the data due to kinship and marriage. We find that a high disease load during the first year of life had a strong negative impact on a persons ability to acquire wealth, never before shown for a historical setting. This means that it is indeed possible that the effects of disease load in the first year of life indirectly affect mortality in old age through obtained socio-economic status. We find, however, no effects of obtained socio-economic status on old-age mortality. While the result is interesting per se, constituting a debatable issue, it means that the argument that early-life conditions indirectly affect old-age mortality is not supported. Instead, we find support for the conclusion that the effect of the disease load in early-life is direct or, in other words, that physiological damage from severe infections at the start of life leads to higher mortality at older ages. Taking random effects at family level into account did not alter this conclusion.

Early-life effects on socio-economic performance and mortality in later life: A full life-course approach using contemporary and historical sources.

Evidence has shown that conditions early in life can influence the development of cardiovascular diseases, respiratory and allergic diseases, diabetes, hypertension and obesity, breast and testicular cancers, neuropsychiatric and some other disorders (Ben-Shlomo & Kuh, 2004). Three specific diseases, respiratory tuberculosis, haemorrhagic stroke, and bronchitis, which have accounted for twothirds of the total decline in mortality in ages 15–64 years from the mid-nineteenth century to the first decade of the 20th century in Britain, reflect demonstrable responses from conditions in infancy and childhood (Lindström & Davey Smith, 2007). This is not to deny the influence of adult factors, such as life style, education and income, but merely to state that factors over the entire life course need to be taken into account when analyzing adult mortality. A fundamental question that arises is ‘‘what is the importance of early risk factors over the entire life course and to what extent do later life factors mitigate or intervene?’’ The overall aim of this Special Issue is to contribute to our understanding of the importance of early-life factors for health deficits or resilience and address whether early-life factors affect mortality at older ages directly or indirectly through education and attained socio-economic position. This aim includes the need to identify certain life-course factors that potentially mitigate the influence of early-life factors and health in later life. Contemporary prospective studies that have been developed to address these questions include the Medical Research Council’s National Survey of Health and Development which sampled all births that took place in England, Scotland and Wales during the week 3–9 March 1946 (Wadsworth et al., 2003) and the National Child Development Study (Ferri, 1993) which includes nearly all children born in the week of March 3–9, 1958 in Great Britain. The age-depth in these studies is presently 50–60 years, which means that they do not cover older ages in which most deaths today occur. Prospective studies based on register data, generally available from around 1970 onwards, include all age-spans but here the age-depth is even shorter, only about 40 years. Studies of oldage mortality in contemporary populations are therefore, partly or entirely, retrospective. This is problematic regarding the exclusion of details about socio-economic and other factors at individual and family level early in life. It is also problematic regarding selectivity since studies also lack information about those migrating or dying before they enter into the sample. Taken together, it makes it difficult to use a full life-course approach in analyzing old-age mortality in contemporary populations. Studies based on historical data bases often contain full life courses and thus are more useful for analyzing conditions over the entire life course. One important

Population, Economy, and Welfare in Sweden

1. Introduction.- 2. The Demographic Transition Revised.- 3. Combining Market Work and Family.- 4. Internal Migration.- 5. Immigration and Economic Change.- 6. The Pension System.- 7. Social Care and the Elderly.- 8. Health care and the Elderly.

Quantifying the Family Frailty Effect in Infant and Child Mortality by Using Median Hazard Ratio (MHR)

Abstract Most microlevel studies in the social sciences have focused on the impact of different measured variables. While some studies have also dealt with unobserved variation, it has usually only been controlled for to perfect the estimates of the observables. In this article, the authors applied a modified version of a recently developed method designed to quantify the effect of unobserved variation in continuous time multilevel models, called a median hazard ratio. It allows a direct comparison of the effect of unobserved heterogeneity with standard relative risks. The method is used in an analysis of infant and child mortality in southern Sweden during the period 1766–1895. The empirical findings indicate that unmeasured differences between families were more important than either socioeconomic status or gender throughout this period.

Kinship and Demographic Behavior in the Past

Acknowledgements: Tommy Bengtsson and Geraldine P. Mineau,-Introduction: Tommy Bengtsson and Geraldine P. Mineau,- Part I: Family and kin as immediate providers of well-being for its members,- 1: Marriage and the kin network: Evidence from a 19th-century Italian community: Matteo Manfredini and Marco Breschi,- 2: Mortality in the family of origin and its effects on marriage partner selection in a Flemish village, 18th-20th centuries: Bart Van de Putte, Koen Matthijs, and Robert Vlietinck,- 3: Villages, descent groups, households, and individual outcomes in rural Liaoning, 1789-1909: Cameron Campbell and James Lee,- Part II: The importance of family and kin over the life-course,- 4: The presence of parents and childhood survival: The passage of social time and differences by social class: Frans Van Poppel and Ruben Van Gallen,- 5: When do kinsmen really help? Examination of cohort and parity-specific kin effects on fertility behavior. Case of the Bejsce parish register reconstitution study, 17-20th centuries, Poland: Krzysztof Tymicki,- 6: Places of life events as bequestable wealth. Familial territory and migration in France, 19th and 20th centuries: Lionel Kesztenbaum,- 7: Family effects on mortality in older ages, Southern Sweden, 1829-1894: Tommy Bengtsson and Goeran Brostroem,- Part III: Kinship as a marker of genetic proximity,- 8: The influence of consanguineous marriage on reproductive behavior and early mortality in northern coastal Sweden, 1780-1899: Inez Egerbladh and Alan Bittles,- 9: Post-reproductive longevity in a natural fertility population: Alain Gagnon et al,- 10: Familial aggregation of elderly cause-specific mortality: Analysis of extended pedigrees in Utah, 1904-2002: Richard Kerber et al,- 11: Distant kinship and founder effects in the Quebec population: Marc Tremblay et al.

The Vulnerable Child. Economic Insecurity and Child Mortality in Pre-Industrial Sweden: A Case Study of Västanfors, 1757--1850

By using macro-economic time series as time-varying community variables in a life event analysis framework for micro data on individuals, we have found that mortality among children over the age of one year in pre-industrial Sweden was directly dependent upon economic fluctuations, a fact which has not been demonstrated before. The impact is stronger among the lower classes than the well-to-do. It is particularly strong in years following an extremely poor harvest. Another new finding is that smallpox mortality among children is determined by economic fluctuations. However, infant mortality seems to follow its own rhythms independently of changes in economic conditions.