The Urban Penalty Meets the SES Gradient: A Full-Population Study of Child Mortality in Sweden at the Turn of the Twentieth Century.

Marcos Castillo, Lund University
Martin Dribe, Lund University

In both historical and modern contexts, child mortality has differed significantly between rural and urban areas, reflecting contrasting living conditions and public health challenges. This study explores these rural-urban disparities in Sweden from the late 19th to the mid-20th century—a period of steady decline in child mortality. As Sweden industrialized, cities expanded rapidly, transforming daily life. Urbanization brought both benefits—such as improved healthcare access, sanitation, and economic opportunities—and risks, including overcrowding, pollution, and higher exposure to infectious diseases. It remains uncertain whether city life provided better chances of survival or exposed children to greater risks during this period. Importantly, child mortality patterns may have differed from adult mortality trends, as infants and young children remained highly vulnerable to environmental and socioeconomic conditions. Using individual-level data from the full-count Swedish censuses of 1880, 1890, 1900, 1910, and 1950, along with a sample from the 1930 census, we link individuals to the Swedish Death Index, which covers nearly all deaths happening in the country, through either an automated matching algorithm or by personal identifier. By analyzing both infant mortality (death within the first year) and under-five mortality, we provide a better picture of how survival differed across environments and evolved over time. We further analyze these patterns by sex, as male and female children may have faced different mortality risks. With the inclusion of detailed demographic and socioeconomic data, we assess whether urban-rural mortality differences primarily reflected broader social class inequalities. By controlling for parental social class, household structure, and regional variations, our study disentangles the complex relationships between urbanization and child survival. In doing so, we contribute to a deeper understanding of the mechanisms that shaped early-life mortality during a period of rapid societal transformation in Sweden.

No extended abstract or paper available

 Presented in Session 53. Historical Change in Fertility Timing and Quantum