Article ID: CBB476408525

Can’t Boil, Won’t Boil: Material Inequality, Information, and Disease Avoidance during a Typhoid Epidemic in Tampere, Finland, in 1916 (2024)

unapi

Historical research on urban epidemics has focused on the interaction of diseases with social and spatial gradients, such as class, ethnicity, or neighborhood. Even sophisticated historical studies usually lack data on health-related behavior or health-related perceptions, which modern analysts tend to emphasize. With detailed source material from the Finnish city of Tampere during a typhoid epidemic in 1916, we are able to combine both dimensions and look at how material and social constraints interacted with behavior and knowledge to produce unequal outcomes. We use data on socioeconomic status, location, and physical habitat as well as the self-reported behavior and expressed understandings of transmission mechanisms of the infected people to identify the determinants of some falling ill earlier or later than others. Applying survival analysis to approximately 2,500 cases, we show that disease avoidance behavior was deficient and constrained by physical habitat, regardless of considerable public health campaigning. Behavioral guidelines issued by authorities were sub-optimally communicated, unrealistic, and inadequately followed. Boiling water was hampered by shared kitchens, and access to laundry houses for additional hygiene was uneven. Centralized chemical water purification finally leveled the playing field by socializing the cost of prevention and eliminating key sources of unequal risk.

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Authors & Contributors
Richardson, Nigel
Steere-Williams, Jacob
Abril, Fred Gustavo Manrique
Álvarez, Bernardo Francisco Meléndez
Armiero, Marco
Bernabeu Mestre, Josep
Journals
Journal of the History of Medicine and Allied Sciences
Asclepio: Archivo Iberoamericano de Historia de la Medicina
Canadian Bulletin of Medical History/Bulletin Canadienne d'Histoire de la Medecine
Canadian Historical Review
Dynamis: Acta Hispanica ad Medicinae Scientiarumque Historiam Illustrandam
Journal of Medical Biography
Publishers
Columbia University
Carocci Editore
Croydon Natural History and Scientific Society
MIT Press
Steiner
University of Chicago Press
Concepts
Public health
Epidemics
Sanitation
Typhoid fever
Disease and diseases
Medicine and government
People
Doyle, Arthur Conan
Time Periods
19th century
20th century, early
20th century
Qajar dynasty, Iran (1794-1925)
Places
Great Britain
United States
England
Iran
Canada
Italy
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