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Mortality in the Victorian asylum: was it so high? Standardised Mortality Rate compared with historical methods
Charlotte Richardson1, Alastair Robson2, Loopinder Sood3
1East London Foundation Trust, UK.
History of Psychiatry
|August 9, 2024
Summary
Standardised Mortality Rates (SMR) provide a clearer picture of institutional mortality by accounting for age, sex, and historical context. This study found SMR in an asylum was 2.5 times higher than the general population, unlike crude rates.
Area of Science:
- Demography
- Medical History
- Public Health
Background:
- Mortality rates are influenced by age, sex, and socio-historical factors.
- Crude mortality rates can be misleading when comparing institutionalized populations to the general population.
- Standardised Mortality Rates (SMR) adjust for demographic and temporal variations.
Purpose of the Study:
- To calculate and analyze SMR for the Hatton Asylum population.
- To compare SMR with crude mortality rates in the asylum.
- To evaluate the utility of SMR for understanding institutional mortality.
Main Methods:
- Utilized historical records from the Hatton Asylum.
- Incorporated contemporaneous census data for comparison.
- Calculated SMR by comparing asylum mortality to age- and sex-matched general population rates for the same period.
Main Results:
- Asylum SMR were approximately 2.5 times higher than the general population.
- Crude mortality rates for the asylum were over 7 times higher than the general population.
- SMR provided a more nuanced understanding of mortality risk within the asylum.
Conclusions:
- SMR offers a more accurate assessment of mortality in institutional settings compared to crude rates.
- The SMR method can reveal significant differences in mortality risk, even when crude rates appear high.
- This approach enhances the historical and epidemiological understanding of institutional populations.
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