Published online by Cambridge University Press: 13 August 2007
This article examines aspects of infant mortality in a discrete part of Kingston upon Thames – the Canbury area – in the late nineteenth and early twentieth centuries. It highlights the concentration of infant mortality in this area, which was characterized – especially in the 1890s – by an increasingly overcrowded and unhealthy environment, made worse by the proximity of animals to living space. Animal manure attracted flies which, particularly during hot summer months, transmitted disease to infant foodstuffs, especially milk, increasing the incidence of summer diarrhoea. Poor feeding and child-care practices contributed to high levels of infant mortality, a situation acknowledged by Kingston's Medical Officer of Health.
1 For comprehensive bibliographies covering infant mortality in the late nineteenth and early twentieth centuries see those in J. Vogele, Urban mortality change in England and Germany, 1870–1913 (Liverpool, 1998); R. Woods, The demography of Victorian England and Wales (Cambridge, 2000); and E. Garrett, A. Reid, K. Schurer and S. Szreter, Changing family size in England and Wales: place, class and demography, 1891–1911 (Cambridge, 2001). Among the many recent contributions to the debates over the locality, the extent and the causes of infant mortality see, for example, Williams, N. and Mooney, G., ‘Infant mortality in an “Age of Great Cities”: London and the English provincial cities compared, c. 1840–1910’, Continuity and Change 9 (1994), 185–212CrossRefGoogle Scholar; Williams, N. and Galley, C., ‘Urban–rural differentials in infant mortality in Victorian England’, Population Studies 49 (1995), 401–20CrossRefGoogle Scholar; R. Woods and N. Shelton, An atlas of Victorian mortality (Liverpool, 1997), chapter 5; B. Thompson, ‘Infant mortality in nineteenth-century Bradford’, in R. Woods and J. Woodward eds., Urban disease and mortality in nineteenth-century England (London, 1984), 120–47; Watterson, P. A., ‘Infant mortality by father's occupation from the 1911 census of England and Wales’, Demography 25 (1988), 289–306CrossRefGoogle ScholarPubMed; Atkins, P. J., ‘White poison? The social consequences of milk consumption, 1850–1930’, Social History of Medicine 5 (1992), 207–27CrossRefGoogle Scholar; Millward, R. and Bell, F., ‘Infant mortality in Victorian Britain: the mother as medium’, Economic History Review 54 (2001), 699–733CrossRefGoogle Scholar; Morgan, N., ‘Infant mortality, flies and horses in later-nineteenth-century towns: a case study of Preston’, Continuity and Change 17 (2002), 97–132CrossRefGoogle Scholar; Cage, R. and Foster, J., ‘Overcrowding and infant mortality: a tale of two cities’, Scottish Journal of Political Economy 49 (2002), 129–49.CrossRefGoogle Scholar
2 For example, in the two articles already cited by Millward and Bell and by Cage and Foster; in two articles by R. Woods, P. Watterson and J. Woodward, ‘The causes of rapid infant mortality decline in England and Wales, 1861–1921’, ‘Part I’, Population Studies 42 (1988), 343–66; ‘Part II’, Population Studies 43 (1989), 113–32; and in Lee, C., ‘Regional inequalities in infant mortality in Britain, 1861–1971: patterns and hypotheses’, Population Studies 45 (1991), 55–65CrossRefGoogle ScholarPubMed.
3 On the need for studies of infant mortality to move from the aggregate to the individual level see Williams and Galley, ‘Urban–rural differentials’, 416–17; P. Laxton and N. Williams, ‘Urbanization and infant mortality in England: a long term perspective and review’, in M. C. Nelson and J. Rogers eds., Urbanisation and the epidemiologic transition (Uppsala, 1989), 109; and Reid, A., ‘Infant feeding and post-neonatal mortality in Derbyshire, England, in the early twentieth century’, Population Studies 56 (2002), especially pp. 151–12.CrossRefGoogle Scholar The work and influence of the General Register Office are fully discussed in E. Higgs, Life, death and statistics: civil registration, censuses and the work of the General Register Office, 1836–1952 (Hatfield, 2004).
4 For a number of other micro-studies of infant mortality see the symposium in Family and Community History 6 (2003), 107–50. As Michael Drake argues in his introduction to this symposium, such studies have ‘made it possible to devolve the analysis to the level of the family, household, street and neighbourhood’ (p. 109).
5 French, C., ‘“Death in Kingston upon Thames”: analysis of the Bonner Hill Cemetery burial records, 1855–1911’, Archives 28 (2003), 36–47Google Scholar; French, C. and Warren, J., ‘Medical Officers of Health and infant mortality: the case of Kingston upon Thames in the late nineteenth and early twentieth centuries’, Local Population Studies 73 (2004), 61–72Google Scholar; French, C., ‘Infant mortality in Asylum Road, Kingston upon Thames, 1872–1911: an exercise in microhistory’, Family and Community History 7 (2004), 141–55.CrossRefGoogle Scholar
6 A comprehensive guide to the census returns (kept at The National Archives, London, hereafter TNA) as historical sources is provided in E. Higgs, Making sense of the census – revisited: census records for England and Wales 1801–1901, a handbook for historical researchers (London, 2005).
7 The burial registers (located at Bonner Hill Cemetery, Kingston upon Thames) give both the date of burial and the date of death. Throughout this analysis (unless indicated otherwise) when years or months are specified, they refer to the years or months of infant deaths and not burials.
8 For further details of the Bonner Hill burial registers and their value for research into local mortality see French, ‘“Death in Kingston upon Thames”’. A very small number of infants were also buried in outlying parish churchyards.
9 This valuable source for historians (now kept in The National Archives) is fully discussed in B. Short, Land and society in Edwardian Britain (Cambridge, 1997). An example of how the source can be used is Anderton, P., ‘Milking the sources: Cheshire dairy farming and the field notebooks of the 1910 “Domesday” Survey’, The Local Historian 34 (2004), 2–16Google Scholar.
10 Henry Beale Collins (MRCS Eng. and LSA, 1873) was a retired surgeon from the Royal Navy and formerly an Assistant Instructor in Naval Hygiene at Gosport in Hampshire. In 1891 he was Resident Medical Officer at St George's Hanover Square Provident Dispensary, and Public Vaccinator for the Mayfair District. He published articles in the British Medical Journal on such subjects as influenza, rashes and eruptions in relation to the spread of infectious diseases, and on the prevention of diphtheria. We are grateful to Pamela Reading – a research student attached to the Centre for Local History Studies at Kingston University – for providing us with this information from Black's Medical Directory for 1891. On the role of MOHs in tackling the problem of infant mortality in other localities see Galley, C., ‘Social intervention and the decline of infant mortality: Birmingham and Sheffield, c.1870–1910’, Local Population Studies 73 (2004), 29–50Google Scholar; and N. Shelton, ‘The role of local Medical Officers of Health in influencing the levels of childhood mortality in late Victorian Devon and Cornwall’, in M. Breschi and L. Pozzi eds., The determinants of infant and child mortality in past European populations (Udine, 2004), 175–90.
11 TNA, MH 12/12448.
12 Registrar-General of Births, Deaths and Marriages in England and Wales, 1905, Registrar-General's Decennial Supplement for 1891–1900, British Parliamentary Papers, XVIII, cxxxi.
13 Kingston Museum and Heritage Services, Local History Room, North Kingston Centre, Kingston upon Thames, Annual Report of the Medical Officer of Health for 1895 (S1 (614) KIN), 16 (hereafter these reports are referred to as Annual Report MOH). ‘Numbers’ in this quote presumably refers to the numbers of children living in the roads.
14 The development of the Canbury area is discussed further in J. Sampson, All change: Kingston, Surbiton and New Malden in the nineteenth century, revised edn (Surbiton, 1991), 54–8. The roads included are listed in Table 3.
15 These are the proportions of the borough population living in the Canbury area and not of the whole census area. Although this proportion dropped between 1891 and 1901 this was largely because the Canbury population was virtually at its maximum for the area and housing available in 1891. Canbury's population could not continue to increase, whereas Kingston's population did continue to increase.
16 The presence of so many domestic servants could indicate an area of greater wealth than implied by the other evidence. However, the majority of these servants (118) did not have a servant relationship to the head of household (i.e. they were not live-in servants). Of those who did have a servant relationship to the head of household, 55 lived and worked in King's Road, parts of which were slightly superior to the rest of the Canbury area and, as can be seen in Figure 1, were really outside of the Canbury area.
17 Annual Report MOH 1895, 17. The three other groups of streets that were identified by the MOH were the Hogg's Mill Group, the Norbiton Group and the Town Group.
18 It is necessary, of course, to consider also the number of infants who were at risk in the Canbury area, and this will be done in the next section.
19 The numbers for individual roads are inevitably rather small, especially as buildings in some roads were not completed, or even started, until after the 1881 census. For the roads included in the Elm Road (etc.) group and the Canbury Park Road (etc.) group, see Table 3.
20 On the connection between social class and infant mortality see Watterson, P., ‘Infant mortality by father's occupation from the 1911 census of England and Wales’, Demography 25 (1988), 289–306CrossRefGoogle ScholarPubMed, and A. Reid, ‘Locality or class? Spatial and social differentials in infant and child mortality in England and Wales, 1895–1911’, in C. Corsini and P. Viazzo eds., The decline of infant and child mortality: the European experience, 1750–1990 (The Hague, 1997), 129–54. The influence of socio-economic differentials on infant and child mortality in the Netherlands is also analysed in Van Poppel, F., Jonker, M. and Mandemakers, K., ‘Differential infant and child mortality in three Dutch regions, 1812–1909’, Economic History Review 58 (2005), 272–309CrossRefGoogle Scholar. Social status as a factor in differentiating between infant mortality levels among Jews and Catholics is also discussed in Derosas, R., ‘Watch out for the children! Differential infant mortality of Jews and Catholics in nineteenth-century Venice’, Historical Methods 36 (2003), 109–30CrossRefGoogle Scholar. The role of socio-economic factors in infant mortality is one of the main themes discussed in a number of the contributions to Breschi and Prozzi eds., Determinants of infant and child mortality.
21 In Table 7 heads of household have been assigned to one of the social classes I to V according to the criteria set out by W. A. Armstrong, and based on the Registrar General's 1951 Classification of occupations. For arguments in favour of the 1951 classification and for the criteria adopted in this analysis see W. A. Armstrong, ‘The use of information about occupation’, in E. A Wrigley ed., Nineteenth-century society: essays in the use of quantitative methods for the study of social data (Cambridge, 1972), chapter 6. The numbers in each social class for Kingston are different from those reported in French,‘“Death in Kingston upon Thames”’, when, as was noted, research into social class was still at an early stage (p. 45). This research has now advanced and is reflected in the revised figures. The relative size of each class, however, is not that different, except in the case of social class I.
22 Garrett, Reid, Schurer and Szreter, Changing family size in England and Wales, 198.
23 Morgan, ‘Infant mortality, flies and horses’, 129–49.
24 North Kingston Local History Room, ‘Sanitary and Drainage Committee Minute Book, 1897–1904’, 10 February 1898, 42, KB5/6/3.
25 Valuation Field Books for Acre Road: TNA, IR 58/45289, 45311, 45312, 45330, 45331. Although at the time of the survey, just before the First World War, a number of stables and so on may no longer have been in use as the use of the horse declined locally, the important point to note is that they almost certainly had been in use in the closing decades of the nineteenth century when the employment of horses was at its peak. This, as will be argued, had important consequences for the level of infant mortality in the Canbury area. Although the stabling was not distributed evenly along each street, the very presence of stabling and animals (and therefore flies) had a potential impact on infant mortality throughout the whole area – however it was distributed.
26 Valuation Field Books for Elm Road: TNA, IR 58/45298, 45299, 45319.
27 Valuation Field Books for Canbury Park Road: TNA, IR 58/45292, 45293, 45315.
28 TNA, IR 58/45314; 45326 and 45315.
29 Valuation Field Books for King's Road: TNA, IR 58/45321, 45322, 45323; Valuation Field Books for Shortlands Road: TNA, IR 58/45307, 45327.
30 Valuation Field Books for Richmond Road: TNA, IR 58/45326, 45327.
31 TNA, IR 58/45314, Survey Number 7162; TNA, IR 58/45331, Survey Number 8813.
32 TNA, IR 58/45314, Survey Number 7177; TNA, IR 58/45315, Survey Number 7203; TNA, IR 58/45330, Survey Number 8742.
33 TNA, IR 58/45330, Survey Number 8720.
34 TNA, IR 58/45330, Survey Number 8783 and Survey Number 8775. The second of these descriptions was applied to a terrace of six cottages – 99 to 109 Acre Road (odd numbers only).
35 Annual Report MOH 1899, 13.
36 Details of the 44 infant deaths from summer diarrhoea in August and September 1899 were given in a table attached to page 11 of the Annual Report MOH 1899. The profiles of these infants and a number of the socio-economic conditions in which they lived – and died – are discussed in French and Warren, ‘Medical Officers of Health and infant mortality’, 63–70.
37 Similar conclusions were reached by Buchanan in his analysis of infant mortality in six mining communities between 1880 and 1911. He found that: (1) during the hot summers of the 1890s, the increase in infant mortality from the diarrhoeal group of diseases was due to ‘a complex interaction involving urban insanitation and the method of infant feeding adopted, and that the common house fly was an important infective agent’ (p. 148); (2) ‘Artificially-fed infants were more likely to die from an enteric infection than breast-fed infants’ (p. 159); and (3) ‘artificial feeding did not itself cause diarrhoea but … it made infection easier.’ (p. 160). See I. Buchanan, ‘Infant feeding, sanitation and diarrhoea in colliery communities 1880–1911’, in D. Oddy and D. Miller eds., Diet and health in modern Britain (Beckenham, 1985), 148–77. A recent analysis of mortality among young children in New York, Chicago and New Orleans between 1870 and 1920 also highlighted the peaking of infant mortality in the hot summer months. It concluded in similar vein to this analysis of the Canbury area, although the geographical areas covered were much larger, ‘that contaminated food and/or milk was a major source of high infant and early childhood summer mortality’ and ‘that the mortality of infants and young children was influenced not only by the macro-environment of large cities but also by the child-care practices of their inhabitants and the complex intersections of the two’. See Condran, Gretchen A. and Lentzner, Harold R., ‘Early death: mortality among young children in New York, Chicago and New Orleans’, Journal of Interdisciplinary History 34 (2004), 315–54CrossRefGoogle Scholar; the quotes are on pages 326 and 336–7.
38 Annual Report MOH 1898, 17–18. Similarly, a recent study with the aim of explaining the ‘differential infant mortality of Jews and Catholics in nineteenth-century Venice’ hypothesized that differences in favour of the Jewish community were determined by ‘cultural attitudes towards life, death, health and well-being [which were] reflected in childcare or child neglect’. The Jewish infants ‘were less vulnerable because they enjoyed a certain careful attention, even dedication, to their health and well-being to a degree that was unusual in Catholic families.’ See Derosas, ‘Watch out for the children!’, 109–30; the quotes are on pages 109 (Abstract) and 125. Lara Marks has also argued that the Jewish community in the East End of London at the end of the nineteenth century experienced unusually low rates of infant mortality because ‘certain religious requirements and cultural behaviour would have influenced the health of young infants at the turn of the century, particularly the stress laid by Jewish teaching on personal hygiene and cleanliness as well as the intricate preparations around food. This was especially important in the context of infantile diarrhoea, which is strongly linked to the type of food an infant receives and the conditions under which it is prepared.’ See L. Marks, Model mothers: Jewish mothers and maternity provision in east London, 1870–1939 (Oxford, 1994), especially 45–87; the quote is on pages 66–7.
39 Infant deaths recorded in the burial registers also peaked (at 194) in 1904.
40 Annual Report MOH 1904, 14.
41 Annual Report MOH 1904, 14. See also Fildes, V., ‘Infant feeding and infant mortality in England, 1900–1919’, Continuity and Change 13 (1998), 251–80.CrossRefGoogle Scholar
42 Annual Report MOH 1904, 15–16.
43 Annual Report MOH 1906, 5.
44 This concern and the evidence for it are discussed in D. Dwork, War is good for babies and other young children: a history of the infant and child welfare movement in England 1898–1918 (London, 1987), chapter I.
45 For examples see Dwork, War is good for babies, chapter II.
46 Annual Report MOH 1906, 5.
47 Annual Report MOH 1906, 6–7. See also the case study discussed in Marland, H., ‘A pioneer in infant welfare: the Huddersfield Scheme 1903–1920’, Social History of Medicine 5 (1993), 25–49Google Scholar.
48 For details of the measures taken see Dwork, War is good for babies; Marland, ‘A pioneer in infant welfare’; and the debate between Drake, M. and Galley, C., ‘Health visitors and infant mortality in the 1900s’, Local Population Studies 76 (2006), 63–75Google Scholar.