© 2004 by Society for the Social History of Medicine
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Nutrition and Scarlet Fever Mortality during the Epidemics of 1860–90: The Sundsvall Region
1 Department of History, Memorial University of Newfoundland, St John’s, NL, A1C5S7 Canada. E-mail: stephanc{at}mun.ca
This article examines the social and economic contexts in which three scarlet fever epidemics appeared in rural parishes surrounding the Swedish town of Sundsvall during the later nineteenth century. This preliminary investigation challenges studies that have discounted a possible relationship between nutrition and scarlet fever. It suggests that poor nutrition during pregnancy may have caused women to give birth to children who were particularly susceptible to scarlet fever. It is also possible that years of food shortages may have made it difficult for some mothers to nurse their infants and that this increased the likelihood that they would fall victim to the disease when the next epidemic occurred. Food shortages, brought about by a rapidly increasing population, below average harvests, the extraordinary development of the sawmill industry, and severe winters, often hampered the most determined efforts of local inhabitants to find sufficient amounts of nutritional food. Frequently, this compromised the immuno-competence of young children. This study uses patterns in crop yields, annual wages, and various demographic indicators to identify those years in which it would have been most difficult to maintain adequate levels of nutrition. District physicians’ reports and computerized parish records provide the mortality data used to identify patterns of scarlet fever mortality.
Keywords: scarlet fever, Sweden, nutrition, neonatal mortality, fertility, food budgets