The effects of wealth, occupation, and immigration on epidemic mortality from selected infectious diseases and epidemics in Holyoke township, Massachusetts, 1850−1912

1. IntroductionSocial, economic, and environmental factors all impacted mortality in 19th century Europe and the United States. The type of place (rural or urban, industrial or non-industrial area, stable or growing population) was a powerful predictor of mortality, especially for children, even when socioeconomic status (SES) is taken into account (e.g., Preston and Haines 1991; Vinovskis 1981; Preston and Van de Walle 1978). The effects of structural and social environmental mechanisms (sanitation, overcrowding, occupational structure, population stability) also varied within geographic regions (e.g., Preston and Van de Walle 1978; Melosi 1999). Yet individual-level socioeconomic circumstances influenced mortality across the wider disparities and inequalities of geographic circumstance in 19th century society (e.g., Condran 1995; Garrett et al. 2001; Preston and Haines 1991), and may have even been most salient where other circumstances were most dire (Reid 1997). We sought to expand on our own previous work in 19th century Massachusetts towns, by asking whether individual-level socioeconomic factors influenced mortality from infectious diseases characterized by epidemics in emerging urban, often stressful and harsh, environments.Holyoke, Massachusetts is located on the Connecticut River in the western portion of the state. The township was a planned industrial community and experienced rapid growth from the 1850s through 1910s, fueled primarily by immigration from Ireland, Canada, and Eastern Europe. Structural issues related to sanitation and overcrowding were continual problems in Holyoke during the last half of the 19th century and led to numerous recorded epidemic outbreaks (Green 1939). The industrial structure of the township created a high level of economic and social inequality, with immigrants entering primarily to work in low-paying mill jobs. The constant influx of new workers further impacted the township's demography by maintaining a relatively young population (Leonard, Beemer, and Anderton 2012). Immigrants of Irish and Canadian origin then experienced an accumulation in both personal and real estate wealth at a fast rate, eventually bringing their level of wealth close to that of the native-born. We argue that this accumulation of wealth over time represents a maturation effect, whereby later immigrants from a specific country of origin benefit from established social connections and resources of prior co-nationals. Overall mortality was high during periods of rapid growth, and only recent immigration significantly lowered the likelihood of death.2. Data and methodsWe utilized two datasets for this analysis. The first dataset includes records of all deaths in Holyoke between 1850 and 1912. The second dataset is an urban-based geographic sample of Federal census records, linked to property tax information and death records in the year following the census, allowing us to analyze personal and family characteristics not available from the death records. Gutman (1956) demonstrates the extraordinary completeness of Massachusetts death reporting and previous research (e.g., Leonard, Beemer, and Anderton 2012) demonstrates representation of the impoverished within the tax-linked dataset. We looked at trends in mortality rates for the entire population using the first dataset, and modeled mortality rates for the sampled census population using Poisson rate regression. Cause-specific counts of deaths are the numerators of the rates, with interpolated census population counts as the denominators. The model presented here was developed in prior research and applied to overall adult and child mortality (Leonard, Beemer, and Anderton 2012). In this note we replicate the same model, limited to mortality from the important infectious diseases of the time in this place.We focused on infectious diseases that caused significant epidemics in the 19th century United States (Condran and Murphy 2008) and were continually present in Holyoke between 1850 and 1912. …