Medical, economic and population factors in areas of high mortality: the case of Glasgow

Abstract

Regional inequalities in British mortality, though longstanding, also show important patterns of historical change. The case of Glasgow is particularly striking, since its mortality was converging with England's until the 1820s. It then experienced a surge in the death rate between 1831 and 1871, after which relatively high mortality has persisted to the present day. This patterns is not explain by changes in age structure, particular causes of death, or general urban conditions. It has only limited connections with time lags in the diffusion of sanitary or medical developments. It is associated with industrial development only in its early stage, and is not related to consumption of alcohol. However it is strongly associated with poverty and overcrowding, and probably also with inadequate diet. It is also closely associated with the period of heavy immigration from Ireland and the Highlands, though this is not explicable in terms of Irish or Highland mortality in the place of origin. Hypotheses are presented linking the Irish and Highland immigration with still‐enduring features of regional housing and labour markets, and with two nineteenth‐century lags in the development of sanitary measures and poor relief; and an agenda of research questions is outlined, which relate historical to contemporary regional inequalities. Copyright © 1994, Wiley Blackwell. All rights reserved