Paper Example: The Mortality Transition in Western Culture

From the 19th century, the rates of mortality in Western culture have significantly dropped while life expectancy is rising, the situation is known as mortality transition. There are two main features that characterize the mortality transition. The first one is associated with infectious diseases and diseases of childhood and infancy. Second, is attributed to urban settings around the 20th century considered to have unsanitary havens of pestilence. In the year of 1940, the rates of mortality in rural areas and urban areas were comparable. Based on the arguments by traditional economists, better nutrition, rising incomes, and overall economic growth are the main attributes of the mortality transition. As authored by the recent magazines, the emphasis is focused on public health efforts particularly the sector for water treatment. Cutler and Miller argued that the efforts of public health have resulted in food and water-borne diseases in the phase of 21st century.

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From the literature review, the efforts of filtration and chlorination of drinking water resulted in a decline in infant mortality associated with typhoid mortality These measures instilled include; designing of project for delivery of potable water; sewage treatment before discharging into the water bodies such as streams, lakes and rivers; selling the milk within the city perimeters and ensuring that it comply with state bacteriological standards; and also the source of milk shouldn’t be from a cow diagnosed with tuberculosis. The urban mortality transition gradually reduced considering that breastfeeding was not a norm when the measure to keep the quality of milk was introduced hence attracting more research on the milk quality.

The results provided little evidence that municipal-level interventions such as chlorination, the building of sewage treatment plants and efforts to clean the milk supply were effective. On contrary, there is strong evidence clearly showing that treatment of municipal water before suppling would reduce the infant mortality.

Americans experienced an unprecedented improvement in health and longevity in the late 19th and early 20th century this was accompanied by radical changes in the U.S disease profile. before this the leading cause of death were food-and water-borne diseases for instance diarrhea, enteritis and typhoid alongside respiratory diseases such as influenza and pulmonary TB.by 1940 deaths from these diseases were on the wane; chronic conditions such as heart disease and cancer had become the leading cause of death

Efforts to Supply Clean Water

Water filtration: Chicago did not begin to filter its water supply 1947 but filtration plants were built by most other major U.s cities during the period of study. The main aim was to reduce discoloration and turbidity of water. Water filtration gained support at the field of bacteriology advanced and city governments came under increasing political pressure to protect their citizens from infectious diseases Public health experts armed with studies showing dramatic decreases in typhoid mortality after filtration systems were put in place.

Chlorination: in 1908, Jersey City famously became the first municipality in the United States to disinfect its water supply by continuously treating it with chlorine. The process of chlorination was simple and inexpensive, water was added to bleaching powder (Calcium hypochlorite) to make a thick paste, which was then mixed with the water supply before delivery (Hooker 1913) in part because chlorination was inexpensive, it quickly gained popularity (Hill 1911)

Clean water projects: Chicago drew its water from lake Michigan, but the city also dumped its sewage, which carried disease-causing pathogens, directly into the lake, in 1867, Chicago constructed a two-mile tunnel under lake Michigan, enabling it to extend its later crib well beyond its heavily polluted shoreline; several American cities went to even greater lengths to deliver clean water , building aqueducts and tunnels that connected distant reservoirs with their water distribution systems.

Sewage treatment plants: effects of extending sewer systems and treating sewage that is by using chemical or biological processes to remove contaminants from wastewater before being discharged into lakes, rivers, and streams. It was found that the interaction of clean water and sewerage accounted for approximately one-third of the observed decline in child mortality among children under the age of 5.

Efforts to Supply Clean Milk

Bacteriological standards for milk: Boston was the first U.S. city to require that milk sold within its limits meet a bacteriological standard (specifically, a maximum of 500,000 bacteria per cubic centimeter). Though it was not enforced with vigor health officials were employed alongside bacteriologists and lab assistants to ensure that they were adhered to by dairy farmers and milk vendors.

TB testing of dairy cows: approximately 10 percent of dairy cows in the United States were infected with Bovine TB in 1917, the year in which federal efforts to control the disease were begun. Bovine TB can be transmitted to humans through the consumption of raw milk and represents a particularly serious threat to the health of children and infants because they have lower resistance to the disease.

Baseline Results

By contrast, Cutler and Miller whose empirical strategy and data are closest to ours, find that filtration is associated with a 15% reduction in total mortality. The estimated coefficients of chlorination and clean-water-project indicators are also small and statistically significant at conventional levels.

We turn our attention to infant mortality at Table 7. Across all specifications, there is strong evidence of a negative relationship between water filtration and infant mortality. For instance, filtration is associated with a 12% percent reduction in the infant mortality rate if we do not include the sewage–and–milk–related intervention indicators; by contrast, Cutler and Miller (2005) find that filtration was associated with a 35% reduction in infant mortality rate.

Comparing Estimates to Those of Cutler and Miller

C&M’s empirical strategy is similar to ours and their mortality data comes from mortality statistics. They find that water filtration is associated with a reduction in total mortality of 16 log points (15%), and a reduction in infant mortality C&M’s estimates on infant and total mortality estimates are considerably larger.

In this section, ACR2020 explores by beginning to reproduce C&M’s estimates of the effects of filtration and chlorination on total mortality using their specification and original data. The estimates are reported in column (1) of table 11. While C&M’s specification is similar to ours, they control for 5 lags of the total mortality rate.”

In column (2) of table 11, C&M interpret the positive and significant coefficient of the interaction between chlorination and filtration whereas ACR2020 corrects their standard errors for clustering at the municipal level with this correction the filtration coefficient remains significant at 5%level, but the coefficient of the interaction between chlorination and filtration is no longer statistically significant.

In the 3rd column of table 11, ACR2020, corrects a minor transcription error, Memphis did not provide mortality data to the U.S Census Bureau in 1916, so C&M assign Memphis a mortality rate of zero for this year. For the years 1900-1917, C&M, rely on total mortality rates published in Mortality statistics. By contrast for the post-1917 period, C&M calculate total mortality rates using mortality counts from mortality statistics and U.S Bureau of the census estimates.

In the 4th column ACR2020 use this later method to consistently calculate total mortality rates for the entire period under study, which reduces the estimated impact of filtration from -13 log points to -8 log points

In the 5th column of table 11, ACR corrects C&M ‘s chlorination and filtration dates. These corrections reduce the filtration estimate further, to -4.3 log points, which is than the a third the size of C&M’s original estimate.

In the last column of table 11, ACR2020, switch from C&M’s specifications to theirs but restricted the sample to their years that is (1905-1936) and cities. Filtration is associated with a statistically insignificant reduction in total mortality of 4.2 log points, which is still considerably larger than the estimate reported in the last column of table 6, suggesting that that the effect of filtration on total mortality in the 13 cities analyzed by C&M may have been larger than its effect in ACR 2020 expanded sample of 25 cities.

Conclusion

The mortality transition is of obvious importance to policymakers and economic historians but the causes are not well understood. Prominent economists such as Fogle and McKeon argued that rising incomes and better nutrition were the primary drivers of the morality transition. Leaning on the results of Cuter and Miller (2005), argue that municipal public health efforts were important drivers of the mortality transition at the turn of the 20th century.