Dying in Hospital in Early 20th-Century Madrid. Social Inequality and Place of Death

Michel Oris, Consejo Superior de Investigaciones Científicas (csic)
Stanislao Mazzoni, Consejo Superior de Investigaciones Científicas (CSIC)
Mélanie Bourguignon, UCLouvain
Diego Ramiro Fariñas, Spanish National Research Council (CSIC)

Background: In 1905, life expectancy in Madrid was only 28 years, and the city deserved its nickname as the ‘city of death’. However, the situation improved in the following years. Data and preliminary results: To study the mortality, epidemiological and sanitary transitions, we have created a database of 366,220 death certificates covering the entire Spanish capital from 1905 to 1927. This data source systematically mentions the place and cause of death. 14.9% (n=56,601) occurred in hospitals. Compared to deaths at home, deaths in hospital involved slightly more men than women, and many more adolescents and young adults aged 15 to 24, as well as adults aged 25 to 49. A preliminary descriptive analysis shows that deaths due to external causes (41.5%), neoplasms (31.3%), digestive diseases (28.8%), childbirth (25.2%), genitourinary disorders (24.6%) and tuberculosis (24.5%) were more frequent than average in hospitals. The death certificates also document the place (province) of birth of the deceased, as well as the profession (of the parent(s) if the dead was a child). Our objective is to further analyze these data, using logistic regressions, in order to address the interactions between socioeconomic inequality and place of death. The combination of causes of death and SES of those dying at home or in hospital, and its evolution across time, will be instructive. This approach will document the interactions between the epidemiological transition and the social history of medicine, the transformation of hospitals from dangerous places reserved for marginalized people into temples of a new medicine treating emerging social and chronic diseases, making them a welcoming place for the middle and upper classes as well.

See extended abstract

 Presented in Session 14. Mortality: The Aftermath of Disease