Health, Medicine and Cultural Interaction in Rural Spain 1875–1936

This article considers changing perceptions of health conditions in rural Spain and how these might have improved over the late nineteenth and early twentieth centuries, using particularly the case of provincial Valencia. The issue attracted attention at levels from the local to the international. To begin with, Spain was overwhelmingly still a lural society. According to the census of 1920, 17.3 million people lived in rural areas cOlnpared with 4 lnillions in the main cities.2 However, official statistics restricted definitions of the urban to provincial capitals, thereby exaggerating this in1balance and Inaking still1nore problelnatic the differentiation of urban and lural populations. Second, the process of health transition seen in Inany European countries over the second half of the nineteenth century was delayed in Spain, where cholera, smallpox and other infectious diseases were often prevalent and rates of general and child Inortality were high.3 Subject to considerable local diversity, the experience in Spain broadly coincided with the MeditelTanean lnodel, with trends in vital rates intennediate between Italy and POliugal, for exan1ple. Third, late-nineteenth century presumptions about rural health and its evident advantages, in ten11Sof life expectancy and n10rtality, eroded with the virtual disappearance of 'the urban penalty' by the early 1930s.