Disease, Mortality and Public Health, Hamilton, Ontario, 1900-1914

Abstract

<p>One of the recent concerns of social and medical historians has been the problem of public health reform as one of the many social reform movements characteristic of North American society, and urban society, in particular, in the late nineteenth and early twentieth centuries. The historiography of public health and its reform has focused on two issues. Medical historians, epidemiologists, and demographers have questioned whether specific social or ecological reforms have played any verifiable role in altering historical patterns of mortality in western society. On the other hand, social and urban historians have tended toward the assumption that urban reformers, and, more particularly, professionals in various fields were able, by improving social environments, to better the quality of urban life, as measured by many factors, including lower mortality rates. This thesis focuses on this conundrum and brings to bear on it two types of historical evidence drawn from the city of Hamilton, 1900-1914 . Data are presented to describe the changes in general mortality rates and rates from specific causes, annually, 1900-1914. More traditional evidence is used to assess the impact of the activities of the Hamilton Department of Health, during the same time period, on the incidence of disease and mortality in the city.</p> <p>After an extended examination of the historiographical issues involved, the thesis proceeds, in Chapter II, to an analysis of mortality patterns within the wider region of which Hamilton is a part. The evidence supports the argument that urban mortality rates, particularly from contagious diseases and among infants, were generally higher than for the province as a whole, and that Hamilton's rates were at least as high as, or higher than, the average rates for urban Ontario. Chapter III then provides a detailed microanalysis of mortality patterns by ward and age cohort in Hamilton for 1910, a year in which an upward trend in mortality rates finally peaked. The analysis suggests that social and economic variables (housing density , occupation, assessed wealth) account for differential mortality rates within the city. With these data as background, Chapter IV traces the activities of Hamilton's Department of Health, and, in particular of Dr. James Roberts who became M.H.O. i n 1905. It is argued that in the absence of a broadly based reform movement in Hamilton, Roberts' actions and efforts, though not always successful, were particularly important, especially in terms of identifying for the public the ecological problems created by rapid industrialization and urbanization and manifested as threats to public health.</p> <p>The thesis is intended as a contribution to urban history, the history of social reform in Canada, and especially as a contribution to the so far undeveloped area of public health as an object of historical inquiry in Canadian historical scholarship.</p>