AbstractThe effect of extreme temperatures on infant mortality in the Umeå and Skellefteå regions 1895–1950 is studied. More precisely, the effect of climate and weather, measured by temperature, average and extremes, on infant mortality is investigated. The main question is to what extent temperature, directly or indirectly via humidity, affect the survival of infants and to what extent it depends on the resources of the family. It turns out that the normal seasonality (the average temperature) is generally more important than the extremes (the deviations), low average temperatures are more important than temporary dips in temperature, but effects are different in neonatal and postneonatal settings. It is at normal temperatures that we expect the resources of the family to be of most importance, and this is also what we find. In extremely cold winters, also the children of the higher classes suffered from increased postneonatal mortality.
The impact of ambient temperature variations on infant mortality is studied for two northern Sweden areas, the Umeå coastal region and Skellefteå coastal and inland regions, during the first half of the twentieth century. Two recent papers (Junkka et al. 2021; Karlsson et al. 2021) studied neonatal mortality and temperature variations in this geographical area during the years 1880–1950. Rocklöv et al. (2014) studies associations between temperature and age-stratified mortality, Skellefteå 1749–1859. Effects of temperature on mortality in general is a research area that has generated great interest over the last years, partly due to new weather conditions related to climate change.
In our previous study, we analysed the role of climate for mortality in different ages in southern Sweden 1766–1860 combining time-series data on temperature and longitudinal individual level data (T. Bengtsson and Broström 2010). We found that low winter temperatures led to an increase in mortality among adults but not children in ages 1-15 years (T. Bengtsson and Broström 2010). To understand how hard winters and warm summers affected different parts of the population, we used methods similar to the ones we have developed for our analyses of the impact of food prices. This means that the focus was on annual variations on temperature and mortality. The main focus was on demographic vulnerability to changes in external factors, such as food process and temperature, as a measurement of living standards. Well-off groups could afford buying food and firewood even of prices went up, while those living close to their margins suffered to such an extent that family members might die (T. Bengtsson 2004). Still, child mortality was fairly equal between social classes until the latter part of the nineteenth century to widen in the beginning of the twentieth century, for both post-neonatal infant and child mortality (Dribe and Karlsson 2021). For neonatal mortality, no systematic class differences existed in any period. While infant was equal between social classes up until the end of the nineteenth century, it differed between urban and rural areas. In fact, in 1850, infant mortality in urban areas was 50 percent higher than in rural areas and it was not until the 1920s that mortality rates converged (Vinge and Kihlbom 1969).
Periods with low temperature might not only cause problems of keeping body heat, indoors and outdoors, but also lead to an increase in the spread of virus. The reason is that low temperature is associated with low humidity. A study of England and Wales in 1921–27, for example, shows the close connections between seasonality in temperature, humidity, and diagnosed cases of smallpox, which was a mild disease by then (Rogers 1928). This means that you are more likely to be infected by viral diseases, such as measles, whooping-cough, and influenza, in low temperatures. Since the outcome of such diseases are not dependent on the nutritional status of the host (Rothberg and Rabb 1983), we anticipate that they will not have a social gradient. Other diseases that are nutritionally dependent, such as pneumonia, TB, and gastro-intestinal diseases, might, however, have such a gradient. It means that low winter temperatures might give rise to a social gradient in mortality, but it may as well be socially neutral.
In this study, we differentiate between neonatal and postneonatal mortality in an effort to understand the role of resources to protect infants rom both normal and extreme ambient temperatures. We analyse the effects of seasonal variation and the occurrence of extreme weekly temperatures and its interaction with social class and time period. Analyses are performed separately for neonatal and post neonatal mortality, and for winter and summer seasons. The reason is that mortality in the first four weeks of life is associate with different factors than mortality later in infancy. For this reason, Bourgeois-Pichat differentiate between endogenous and exogenous factors, arguing that mortality shortly after birth is due to the maternal health, fetal factors, and the delivery itself, whereas it afterwards is due to exposure to external factors following the birth-weight development (Bourgeois-Pichat 1951a, 1951b). The main question is to what extent temperature, directly or indirectly via humidity, affect the survival of infants and to what extent it depends on the resources of the family.
Figure 1.1 shows the study area within Sweden, with the weather stations marked. The map is taken (with permission) from the paper by Junkka et al. (2021).