Grammars of Death

Abstract

Historical mortality analysis is often confounded by changing disease environments, diagnostic criteria, and terminology. Recorded causes of death are shaped by these local and historical contexts. We analyze changing literal causes of death during the shift from miasmatic to germ theories of disease using death records from two Massachusetts towns for selected years spanning 1850 to 1912. This analysis demonstrates that (1) International Classification of Diseases (ICD) classifications are more stable, yet potentially less informative, than the literal causes recorded in death accounts, (2) recorded causes of death often include additional qualifications and elaborations beyond basic literal causes of death, and the use of such qualifiers rose dramatically during the late nineteenth century, (3) social biases are clearly evident in the extent to which causes of death were further described or qualified, and (4) the additional descriptive qualification of deaths during this period of often ambiguous historical causes of death can potentially aid in efforts to classify causes of death and derive robust estimates of cause-specific mortality trends.

Immigration, wealth and the ‘mortality plateau’ in emergent industrial cities of nineteenth-century Massachusetts

“…4 In previous work, we have argued that high overall regional mortality was sustained by the strains of significant population growth within newly emerging urban-industrial communities. 5 These strains were ultimately relieved as population growth stabilised and urban infrastructures developed, notably with the introduction of filtered water supplies and sewage systems. 6 Although such improvements began after mid-century, their widespread penetration into emerging industrial cities was not completed until near the turn of the century or later, when regional mortality finally began to fall.…”

Defining and Managing Infant Mortality: A Case Study of Philadelphia, 1870-1920

“…16 There is a large literature on the reporting of causes of death and nosological schemes used in the nineteenth and early twentieth centuries. For example, Douglas L. Anderton and Susan Hautaniemi Leonard (2004) examine changing causes of death records in Massachusetts from 1850 to 1912; Naomi Williams (1996) examines the same for mid-nineteenth-century England; and Jan Sundin (1996) studies the specific problems of recording the causes of child mortality in Sweden from 1750 to 1860. 17 Both the ages of the children and the seasonal patterns of diarrheal diseases and fevers have been useful in identifying reported causes of death as belonging in one or the other category.…”