via HeritageDaily: 17th- and 18th-century risk of disease through Migration

17th- and 18th-century risk of disease through Migration

HERITAGE March 3, 2014 – No comments
smallpox

The fate of migrants moving to cities in 17th- and 18th-century England demonstrates how a single pathogen could dramatically alter the risks associated with migration and migratory patterns today.

Cities have always been a magnet to migrants. In 2010, a tipping point was reached for the first time when, according to the World Health Organization, the majority of the world’s population lived in cities. By 2050, seven out of 10 people will have been born in – or migrated to – a city. One hundred years ago, that figure was two out of 10.

Today, cities are generally the safest places to live. If you live in one, you’re likely to be richer than someone living in a rural environment. If you’re richer, you’re likely to live longer. If you live in a city, you have better access to hospitals and healthcare, and you’re more likely to be immunised.

But that was not always the case. In 17th- and 18th-century England, city life was lethal – disproportionately so for those migrating from the countryside.

Dr Romola Davenport is studying the effects of migration on the health of those living in London and Manchester from 1750 to 1850, with a particular focus on the lethality of smallpox – the single most deadly disease in 18th-century England. In the century before 1750, England’s population had failed to grow. Cities and towns sucked in tens of thousands of migratory men, women and children – then killed them. It’s estimated that half of the natural growth of the English population was consumed by London deaths during this period. Burials often outstripped baptisms.

In 2013, cities are no longer the death traps they once were, even accounting for the millions of migrants who live in poor, often slum-like conditions. But will cities always be better places to live? What could eliminate the ‘urban advantage’ and what might the future of our cities look like if antibiotics stop working?

By looking at the past – and trying to make sense of the sudden, vast improvement in survival rates after 1750 – Davenport and the University of Newcastle’s Professor Jeremy Boulton hope to understand more about city life and mortality.

“For modern migrants to urban areas there is no necessary trade-off of health for wealth,” said Davenport. “Historically, however, migrants often took substantial risks in moving from rural to urban areas because cities were characterised by substantially higher death rates than rural areas, and wealth appears to have conferred little survival advantage.”

The intensity of the infectious disease environment overwhelmed any advantages of the wealthy – such as better housing, food and heating. Although cities and towns offered unparalleled economic opportunities for migrants, wealth could not compensate for the higher health risks exacted by urban living.

“Urban populations are large and dense, which facilitates the transmission of infectious diseases from person to person or via animals or sewage. Towns functioned as trading posts not only for ideas and goods but also for pathogens. Therefore, growing an urban population relied upon substantial immigration from rural areas,” explained Davenport.

“After 1750, cities no longer functioned as ‘demographic sinks’ because there was a rapid improvement in urban mortality rates in Britain. By the mid-19th century, even the most notorious industrial cities such as Liverpool and Manchester were capable of a natural increase, with the number of births exceeding deaths.”

Davenport has been studying the processes of urban mortality improvement and changing migrant risks using extremely rich source material from the large London parish of St Martin-in-the-Fields. The research, funded by the Wellcome Trust and the Economic and Social Research Council, is now being augmented with abundant demographic archives from Manchester, funded by the Leverhulme Trust.

For both cities, Davenport and colleagues have access to detailed records of the individual burials underlying the Bills of Mortality, which were the main source of urban mortality statistics from the 17th to the 18th century. These give age at death, cause of death, street address and the fee paid for burial, which enables them to study the age and sex distribution of deaths by disease. In addition, baptismal data allow them to ‘reconstitute’ families as well as to measure the mortality rates of infants by social status.

“The records themselves give only a bald account of death,” said Davenport. “But sometimes we can link them to workhouse records and personal accounts, especially among the migrant poor, which really bring home the realities of life and death in early modern London.

“Smallpox was deadly. At its height, it accounted for 10% of all burials in London and an astonishing 20% in Manchester. Children were worst affected, but 20% of London’s smallpox victims were adults – likely to be migrants who had never been exposed to, and survived, the disease in childhood. However in Manchester – a town that grew from 20,000 to 250,000 in a century – 95% of smallpox burials were children in the mid-18th century, implying a high level of endemicity not only in Manchester but also in the rural areas that supplied migrants to the city.

“So studying urban populations can tell us not only about conditions in cities but also about the circulation of diseases in the rest of the population.”

The greater lethality of smallpox in Manchester is, for the moment, still a mystery to researchers; but evidence suggests the potential importance of transmission via clothing or other means – as opposed to the person-to-person transmission assumed in mathematical models of smallpox transmission in bioterrorism scenarios. Although smallpox was eradicated in the late 1970s, both the USA and Russia have stockpiles of the virus – which has led to fears of their use by terrorists should the virus ever fall into the wrong hands. Data on smallpox epidemics before the introduction of vaccination in the late 1790s are very valuable to bioterrorism researchers because they provide insights into how the virus might spread in an unvaccinated population (only a small proportion of the world’s population is vaccinated against smallpox).

From 1770 onwards, there was a rapid decline in adult smallpox victims in both London and Manchester, which Davenport believes could be attributable to a rapid upsurge in the use of smallpox inoculation (a precursor of vaccination) by would-be migrants or a change in the transmissibility and potency of the disease. By the mid-19th century, towns and cities appear to have been relatively healthy destinations for young adult migrants, although still deadly for children.

“Smallpox was probably the major cause of the peculiar lethality of even small urban settlements in the 17th and 18th centuries,” said Davenport, “and this highlights how a single pathogen, like plague or HIV, can dramatically alter the risks associated with migration and migratory patterns.”

“The close relationship between wealth and health that explains much of the current ‘urban advantage’ is not a constant but emerged in England in the 19th century,” added Davenport. “While wealth can now buy better access to medical treatment, as well as better food and housing, it remains an open question as to whether this relationship will persist indefinitely in the face of emerging threats such as microbial drug resistance.”

Header Image : An 1802 cartoon of the early controversy surrounding Edward Jenner’s vaccination theory, showing using hiscowpox-derived smallpox vaccine causing cattle to emerge from patients. WikiPedia

Contributing Source : University of Cambridge

© Copyright 2014 HeritageDaily – Heritage & Archaeology News

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via National Geographic: Behind the Headlines: History and Geography Help Explain Ukraine Crisis

A woman cries near a memorial for the people killed in clashes in Kiev.

A woman wipes away tears as she walks away from a memorial in Independence Square in Kiev, Ukraine.

PHOTOGRAPH BY DARKO BANDIC, AP

Eve Conant

for National Geographic

PUBLISHED FEBRUARY 24, 2014

Charged with the mass killings of civilians, Ukraine’s recently ousted president, Viktor Yanukovych, is now on the lam.

Last November Yanukovych touched off months of deadly protests in the capital of Kiev and other cities by caving into pressure from the country’s former overlords in Moscow and shelving a landmark trade deal with the European Union. Dozens of citizens died last week in clashes with police and security forces in Kiev.

On Saturday evening, the Ukrainian parliament voted to remove Yanukovych from his post as president.

The new government has now issued a warrant for the president’s arrest, but his exact whereabouts are unknown.

Yanukovych left Kiev by helicopter on Friday after signing an agreement to end the protests. On Saturday, he arrived in the eastern city of Donetsk, where he was prevented from leaving the country on a private jet. He then drove to Ukraine’s pro-Russian Crimean Peninsula and was most recently rumored to be in Sevastopol, the home port of both the Ukrainian navy and Russia’s Black Sea fleet.

The Fault Lines of History

A look back into the country’s history and geography helps explain why Yanukovych would flee eastward, and how the passions and upheaval in the recent news stem from centuries of battles over Ukraine’s precarious position between East and West.

A map of Ukraine.

It was a history that created fault lines. Eastern Ukraine fell under Russian imperial rule by the late 17th century, much earlier than western Ukraine. This helps to explain why, after the fall of the Soviet Union, people in the east have generally supported more Russian-leaning politicians. Western Ukraine spent centuries under the shifting control of European powers like Poland and the Austro-Hungarian Empire. The western third of Ukraine was even part of Poland for several years leading up to World War II. That, to some degree, helps explain why people in the west have tended to support more Western-leaning politicians. The east tends to be more Russian-speaking and Orthodox, with parts of the west more Ukrainian-speaking and with heavier Roman Catholic influences.

But it’s not just about geography or religion. “The biggest divide,” saysAdrian Karatnycky, a Ukraine expert at the Atlantic Council of the United States, “is between those who view the Russian imperial and Soviet rule more sympathetically versus those who see them as a tragedy.”

 

At first there were no such divisions. In the ninth century, Ukraine, known as Kievan Rus, was becoming the early seat of Slavic power and of the newly adopted Orthodox religion. But Mongol invasions in the 13th century curtailed Kiev’s rise, with power eventually shifting north into Russia, to present-day St. Petersburg and Moscow.

(Related video: Ukraine at the Crossroads)

East and West

Over the centuries, Ukraine—with its rich black soil that would help it become a major grain producer—was continually carved up by competing powers. In the 16th century, major swaths of the country were under the control of Poland and Lithuania, with Cossack fighters patrolling Ukraine’s frontier with Poland.

In the 17th century, war between the Tsardom of Russia and the Polish-Lithuanian Commonwealth resulted in more internal divisions. Lands to the east of the Dnieper River fell under Russian imperial control much earlier than Ukrainian lands to the west of the Dnieper. The east became known as “Left Bank” Ukraine and as a center of industry and coal. Lands to the west of the Dnieper, or “Right Bank,” were to be ruled by Poland. A small part in the west, called Galicia, was allotted to the Austro-Hungarian Empire in the late 19th century. The Austro-Hungarian Empire ended at the conclusion of World War I, and Galicia remained outside the Russian Empire, becoming incorporated into the U.S.S.R. only as a result of the World War II.

Under the reign of Catherine the Great, the steppe areas of eastern Ukraine became major economic centers of coal and iron. The Ukrainian language—spoken in rural areas—was twice banned by decree of the tsar, says Karatnycky (and today both Ukrainian and Russian are spoken in the country). But peace did not last for long. After the communist revolution of 1917, Ukraine was one of the many countries to suffer a brutal civil war before becoming a Soviet republic in 1920.

Ukrainian Identity

In the early 1930s, to force peasants into joining collective farms, Soviet leader Joseph Stalin orchestrated a famine that resulted in the starvation and death of millions of Ukrainians. Afterward, Stalin imported large numbers of Russians and other Soviet citizens—many with no ability to speak Ukrainian and with few ties to the region—to help repopulate the east.

This, says former ambassador to Ukraine Steven Pifer, is just one of the historic reasons that helps explain why “the sense of Ukrainian nationalism is not as deep in the east as it is in west.”

On some maps you can even see the divide between the southern and eastern parts of Ukraine—known as the steppes—with their fertile farming soil, and the northern and western regions, which are more forested, says Serhii Plokhii, a history professor at Harvard and director of the university’s Ukrainian Research Institute. The institute has created a map depicting the demarcations between the steppe and the forest, a diagonal line between east and west, that bears a “striking resemblance” to political maps of the Ukrainian presidential elections in 2004 and 2010.

As the protests spread east, the conflict “metamorphosed into much more,” says Pifer. It was initially about Europe but in the end turned to the issues of democracy and the end of corruption. There also appeared to be political divisions based on demographics, between younger and older generations, not just geography and a turbulent history.