Health and Mortality in the 19th-Century Rural United States: The Second Epidemiological Transition in Madison County, New York.

objectivesA number of studies have examined changes in mortality and health during industrialization in both the United States and Western Europe; however, most of this work has focused on urban communities. Despite theories regarding differences between rural and urban patterns of mortality at this time, few analyses of data from rural communities have been done. Our goal is to examine trends in mortality, c. 1850-1880, for a rural county in central New York State at a time when farming, the economic base of this county, was becoming commercialized and industrialization was impacting the wider region. MATERIALS AND

methodsUsing census mortality records from Madison County, NY (1850-1880), we examine trends in hazards of death, survivorship, and cause of death. In order to contribute a rural perspective to this area of study, we examine trends from the mortality records at several scales: town-specific, groups of towns based on population density, and the county as a whole.

resultsOur results suggest that the hazards of death decreased and survivorship increased at the county level across this 30-year period. In general, the rates of communicable diseases decreased and the rates of non-communicable diseases increased. Individual towns had variable outcomes, and higher population density towns had better apparent outcomes than those with medium and lower densities.

conclusionsOverall, mortality patterns changed noticeably during this period. These changes were likely at least partially a result of changing economic conditions, but may also have been affected by socio-spatial factors and access to healthcare, both of which continue to impact rural communities today.