SUMMARY

Secular variations in the mortality of populations before the late nineteenth century cannot generally be explained in terms of changing real incomes, a finding which has contributed to the development of a historical epidemiology concerned particularly with the factors influencing levels of exposure to infection in the past. In this context an important role has been attributed to large metropolitan centres which are likely to have acted as endemic foci of infection and as points of entry for new pathogens into national populations.

The results of earlier aggregative studies of London's mortality over the ‘Long Eighteenth Century’ (c. 1675–1825) were consistent with such a role, and the present study applies family reconstitution methods to London Quaker vital registers in order to investigate age-specific mortality patterns. The results reveal levels of infant mortality which were substantially higher than those found in other English family reconstitution studies for much of the period, but a major decline is visible from the later eighteenth century and is particularly associated with a reduction in neonatal deaths.

In accordance with expectation, childhood mortality was even more in excess of that found elsewhere in England, and was associated particularly with deaths from smallpox. Estimates were made of the age-distribution both of smallpox deaths and of the underlying risk of mortality from this cause. Levels of mortality in adulthood, however, appear to have been closer to those prevailing in the country at large, a fact reflecting the high levels of acquired immunity in the older age-groups.

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