Author response: Debating mortality trends in 19th century Britain

Abstract

The commentary by Davey Smith and Lynch is of a different kind from the others and requires a separate response, from Simon Szreter alone, since it is almost entirely devoted to a critique of Szreter's historical work on the chronology of mortality and health change in 19th century Britain. The key claim, which Davey Smith and Lynch wish to advance, is that it is wrong to place the primary emphasis on the 1870s and on the political and social events associated with that decade as comprising the most important causes of the modern mortality decline in Britain. They assert that it is the decade of the 1850s, instead, which saw the true origins of a continuous secular fall in the nation's mortality and that we should therefore examine the political and social events associated with that decade as being of primary significance in causing the modern mortality decline. Closely associated with their claims for this revized chronology, they believe that a dynamic process of cohort-improvement in health should be given much greater prominence. They claim that the historical evidence indicates that this process of cohort improvement commenced in England and Wales with the birth cohort of the 1850s.1

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