Social and Environmental Factors of Mortality by Tuberculosis in 1905 Madrid

Michel Oris, Consejo Superior de Investigaciones Científicas (csic)
Stanislao Mazzoni, Consejo Superior de Investigaciones Científicas (CSIC)
Dariya Ordanovich, IEGD-CCHS Spanish National Research Council (CSIC)
Diego Ramiro, Consejo Superior de Investigaciones Científicas (CSIC)

Tuberculosis, especially pulmonary tuberculosis, heavily affected past populations. The "white death" played an important role in the early stages of the epidemiological transition, still as a contagious disease, but without the brutality of, for example, the cholera epidemics. In this communication we work on the city of Madrid which was one of the Spanish areas with the highest incidence of tuberculosis. Moreover, the capital of Spain was growing, largely populated by immigrants, characterized by social inequalities and spatial segregation. More specifically, we work on a large sample of the 150'000 inhabitants of three districts, Congreso in the wealthy center, Hospital and Hospicio in the disfavored southern periphery. Our database is based on the 1905 padron (census). In a second step, births and deaths certificates from 1905 and 1906 have been linked. Death certificates include the cause of death. Early twentieth century is a particularly interesting moment because located not only in the middle of the mortality decline, but also in the middle of the transitions from urban penalty to urban advantage and from female to male over-mortality. And tuberculosis was important in all those processes. We will present a critical assessment of the Madrid data. Then multivariate models of the risk of dying from pulmonary tuberculosis will be estimated, using as explanatory variables individual (age, sex, place of birth), household (SES of the household head, household size, position in the household and link to the household head), and environmental factors (crowding of the lodging, of the building, of the street, of the neighborhood; global level of mortality in the neighborhood). Because contemporary medical doctors reported some issues in the report of a cause of death like tuberculosis, we will estimate the same models for the risk of dying from respiratory diseases and compare the results.

No extended abstract or paper available

 Presented in Session 150. Environmental and Social Dimensions of Infectious Disease Mortality: Historical Perspectives