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Social History of Medicine 1994 7(1):89-113; doi:10.1093/shm/7.1.89
© 1994 by Society for the Social History of Medicine
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Discussion Point

The Importance of Social Intervention in England's Mortality Decline: The Evidence Reviewed

SUMIT GUHA*

* Fellow, Centre for Contemporary Studies, Nehru Memorial Museum and Library New Delhi, India.

This paper examines the first phase of England's mortality decline, which commenced in the middle of the eighteenth century, and proceeded fitfully down to the end of the nineteenth. It finds that recent research in population history has weakened the explanation known as the McKeown thesis, but that the alternative synthesis, developed by Szreter, does not stand up well to a scrutiny of the evidence for London in the eighteenth, and England in the nineteenth century, especially the evidence on infant mortality and morbidity. It concludes by pointing out that, contrary to the received version, diarrhoeal diseases continued in defiance of late-Victorian public health measures, but appear to have become less lethal, sharing in the general decline in the lethality of illness found by J. C. Riley for the second half of the nineteenth century.

Keywords: mortality decline; sanitary measures; nutritional status; morbidity; infant mortality; diarrhoeal diseases


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