Dr Alice Reid  (St John's College and The Cambridge Group for the History of Population and Social Structure)

" 'Defective vitality': Cause of death reporting in England in the early
twentieth century".

The reporting of causes of death for those dying during infancy during the demographic transition in England and ales is notoriously bad. Non-certified deaths were the most unreliable, and although levels of certification rose during the late nineteenth and early twentieth centuries, a higher proportion of infant deaths remained uncertified. Even the causes of deaths certified by registered doctors were apt to be vague and frequently failed to distinguish between causes and symptoms. Changing knowledge and the vagaries of fashion produced changes in the recording of different causes over the course of time, confusing the analysis of time-trends in causes of deaths. Duality of cause provides another source of error and inconsistency: although there were procedures recommended for the consistent recording of primary and secondary causes, it is not clear that these were always followed.

This paper the records made by health visitors who visited every child born in the English county of Derbyshire between 1917 and 1922, which include the age and cause of deaths for individual infants and children, to examine patterns of cause of death recording. Multiple causes are examined to assess the extent to which recommendations for recording of deaths were followed. Multiple causes, with the aid of analysis of the influences on particular causes (using hazards modeling) are also used to examine the validity of theories that some causes were used as proxies for others (such as convulsions and teething for diarrhea). Finally implications for the use of cause of death information over the course of the demographic transition are examined.