A World of (In)difference? Social Inequalities Among Infants' Causes of Death in Mid-nineteenth-Century Amsterdam

The relationship between mortality and socioeconomic status is among the most debated topics within historical demography. This article scrutinises social disparities in infant mortality and its underlying mechanisms in mid-nineteenth-century Amsterdam. We apply two methods of survival analysis (Cox proportional hazard models and Fine-Grey competing risk models) on newly digitised individual-level cause-of-death data for infants born in 1856 combined with civil certificates and population register data. Through a comparison of all-cause and cause-specific mortality, we bring to light important social differences in infants' mortality risks; hazard ratios for congenital and birth disorders during early post-neonatal infancy were over 50 per cent lower for Amsterdam's middle class than for unskilled workers. We argue that the social differentiation in infant mortality reflects stark intra-urban disparities in maternal health across social groups as well as a degree of medical ineffectiveness or even indifference structured along the same socioeconomic lines.