Urban health inequalities and socioeconomic conditions in Glasgow, Manchester and Nancy, 1850-1950

This thesis examines the impact of socioeconomic conditions on inequalities in mortality, mortality dynamics and health choices in the cities of Glasgow, Manchester and Nancy in the late nineteenth and early twentieth centuries. To undertake this analysis, I created new datasets from historical administrative records. Those for Glasgow and Manchester and their constituent areas were sourced principally from contemporaneous Medical Officer of Health reports. The Nancy dataset consists of individual-level data from death registers and annual censuses, with sampling focusing on the death of the male head of household in the period 1895-1897.
In my first results chapters, Chapters 2 and 3, I focus on mortality differentials between small areas of Glasgow and Manchester. In Chapter 2, I use descriptive and regression analysis to show that inequalities in mortality are closely associated with initial socioeconomic conditions, with this influence lasting for forty years or more. Chapter 3 focuses on the dynamics of mortality reductions, and I find that reductions follow sigmoid dynamics, with higher socioeconomic areas benefitting earlier from mortality gains. In Chapter 4, I examine vaccination decisions in early twentieth century Glasgow and find a persistent association between high levels of vaccine refusal and lower socioeconomic conditions.
In Chapters 5 and 6, I study families who suffered the loss of the male head of household in Nancy in the 1890s. In Chapter 5, I find that occupation had an influence on age at death, but that for these prime age individuals, most of the variation in age at death was driven by random factors. In Chapter 6, I use regression analysis and find that, following the death of the head of household, the accommodation position of the families became less stable, but that socioeconomic conditions did not play a significant role.
Taken together, my findings indicate a clear and long-lasting association between socioeconomic conditions and mortality outcomes and health decisions in three large cities in northern Europe during the late nineteenth and early twentieth centuries. Focusing on the period which saw the first sustained falls in mortality rates, my findings add to the considerable literature on socioeconomic influences on health inequalities.