Mortality change in Hermoupolis, Greece (1859-1940)

Abstract

This thesis examines mortality decline from 1859 to 1940 in the city of Hermoupolis, on the Greek island of Syros. A demographic approach is employed to understand the mechanisms of mortality decline at both local and national levels. This study produces important new insights into Greek and Mediterranean urban historical demography and is the first comprehensive study of urban mortality in Greece, utilizing the largest and one of the longest time-series yet calculated from civil registration and census data. Standard historical demographic methods were employed in this study along with the technique of nominal record linkage. A series of abridged life tables was constructed for the very first time for a Greek urban settlement, enabling the calculation of age-specific mortality rates and life expectancy. Cause-specific mortality analysis for the years 1916–1940 provided a deeper insight into the epidemiological profile of the city. Hermoupolis experienced much higher mortality levels than the national average. The findings presented here suggest that early childhood mortality started to decline rapidly as a result of mass immunisations from the late nineteenth century onwards, with declines in early adulthood and infancy following. This thesis has found that the second stage of Omran’s epidemiological transition theory was still ongoing in the 1930s, with high prevalence of infectious diseases, especially of tuberculosis among young adults and diarrhoeal diseases among infants and young children. Exceptionally high mortality levels were also recorded during the 1918 influenza pandemic. This thesis reinforces and confirms our limited knowledge about the timing of the mortality transition in Greece. It proposes that an urban penalty was clearly operating in the country even during the first decades of the twentieth century. Finally, this thesis suggests that a combination of factors was responsible for the mortality decline in Hermoupolis, including wider access to water, which even when it was not clean enough to drink, it nevertheless enabled improvements in personal hygiene among the residents of the city.