The Decline of Infant and Child Mortality: The European Experience, 1750-1990 (review)

In retrospect, what confuses me about this book is only the subtitle: The European Experience, 1750–1990. Apart from implying that the decline of infant and child mortality was basically similar all over Europe, the term “experience” additionally leads to the impression that Corsini and Viazzo’s volume binds together such a comprehensive knowledge of the very complex causes and processes under discussion that the book may even be useful for contemporary politicians in their effort to lower the high infant and child mortality rates in non-European countries.

Actually, neither the editors nor the authors of the twelve papers (J. Bernabeu-Mestre, M. Bortolotto, P. Bourdelais, A. Brändström, M. Demonet, Ch. Galley, V. Hionidou, J. Kok, E. Kruse, P. Mancini, G. Masuy-Stroobant, V. Pérez-Moreda, A. Pinnelli, F. van Poppel, D. S. Reher, A. Reid, C. Rollet, P. P. Viazzo, J. Vögele, N. Williams, R. Woods, and A. Zanotto) ever claim to have arrived at hard truths. On the contrary: spurred by the knowledge that our understanding of the causes and timing of age-specific mortality changes is still tenuous, all the contributors—and especially the introducing editors—agree in their demand for “better data, more subtle indicators and more astute analytical and comparative strategies” (p. xiv).

Years of experience with official state statistics have shown that trends varied widely before the end of the nineteenth century. Since this was true on both the European and the national levels, the presumed uniformity of the so-called secular decline of infant mortality in Europe is revealed as an “illusion” (p. xix). Changes in mortality very often occurred simultaneously with those in a variety of factors—demographic, social, economic, cultural, political, and climatic—and with changes in the health sector.

This volume is the second publication resulting from the so-called Innocenti Project, a European research project initiated in 1992 at the Istituto degli Innocenti in Florence with the “threefold aim of reviewing the state of art in the study of infant mortality in the various European countries, surveying the available sources and, rather more ambitiously, laying foundations for a coordinated research enterprise” (p. xvii). However, a promising international comparison cannot be made without facing the different methodological difficulties inherent in both macro- and micro-studies of mortality development. Whether those studies are based on national time series or on vital statistics from church registers, whether they deal with large national or small regional samples, or whether they analyze age-specific mortality in the eighteenth, nineteenth, or twentieth century—in any case, geographical and temporal comparison has to take severe data problems into account. As G. Masuy-Stroobant points out in the opening chapter of the volume, there are still definition differences for the registration of live births and stillbirths all over Europe, “and their impact on the comparability of the infant mortality figures derived from them is rising” (p. 27). Therefore, in addition to the often very detailed glimpses into the state of infant mortality research in the early 1990s, it is above all the pinpointing of a general, growing lack of comparison that European scientists owe to the Innocenti Project.

Unfortunately, eleven of the twelve contributions to the reviewed volume fail to meet this particular requirement. They provide a remarkable demonstration of the variety of themes, sources, methods, and “styles” of mortality analysis. Their results are substantial and very interesting, but they do not refer to each other; in fact, they deal with national, regional, and/or subregional developments of infant and/or child mortality within eight different (Western) European states: France, Germany, Great Britain, Greece, Italy, Spain, Sweden, and the Netherlands. The questions addressed by the above-named specialists from different countries and disciplines range from geographical, age-specific, and gender differences to class related patterns of mortality. Five of the studies are based on published...