Infant and childhood death in the medical profession. Evidence from nineteenth- and early twentieth-century Netherlands

Abstract

Abstract This paper shows the effect that the medical expertise of medical practitioners had on the life chances of their children. We focus on infant and early childhood mortality. We reconstructed the life histories of the offspring of a group of around 2800 medical practitioners who were practicing in a high-mortality region in the Netherlands between 1850 and 1922, the period during which infant and child mortality in the Netherlands underwent the largest changes. The survival of their offspring is compared with that of a random sample of children from the Historical Sample of the Netherlands. Multilevel hazard analysis, using Cox proportional hazards models with shared frailty, is applied to study the effect of belonging to the medical profession on survival, in relation to the level of infant mortality in the regions where children were born. Within the group of medical practitioners, attention is paid to differences in children’s survival according to the level of medical knowledge of the fathers. Our statistical analyses show that the offspring of medical practitioners as a whole did have better survival prospects than children born to families without a father with a medical background. When medical practitioners had effective medical knowledge, measured by the period of graduation and the highest level of medical training reached, the positive effects on the survival of their children were even stronger.