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Can’t Boil, Won’t Boil: Material Inequality, Information, and Disease Avoidance during a Typhoid Epidemic in Tampere, Finland, in 1916

Published online by Cambridge University Press:  14 December 2023

Jarmo Peltola Open the ORCID record for Jarmo Peltola [Opens in a new window] ,
Sakari Saaritsa Open the ORCID record for Sakari Saaritsa [Opens in a new window]  and
Henri Mikkola
Jarmo Peltola
Affiliation:
University of Helsinki, Helsinki, Finland
Sakari Saaritsa*
Affiliation:
University of Helsinki, Helsinki, Finland
Henri Mikkola
Affiliation:
Urban Research and Statistics Unit of the City of Helsinki, Helsinki, Finland
*
Corresponding author: Sakari Saaritsa; Email: sakari.saaritsa@helsinki.fi
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Abstract

Historical research on urban epidemics has focused on the interaction of diseases with social and spatial gradients, such as class, ethnicity, or neighborhood. Even sophisticated historical studies usually lack data on health-related behavior or health-related perceptions, which modern analysts tend to emphasize. With detailed source material from the Finnish city of Tampere during a typhoid epidemic in 1916, we are able to combine both dimensions and look at how material and social constraints interacted with behavior and knowledge to produce unequal outcomes. We use data on socioeconomic status, location, and physical habitat as well as the self-reported behavior and expressed understandings of transmission mechanisms of the infected people to identify the determinants of some falling ill earlier or later than others. Applying survival analysis to approximately 2,500 cases, we show that disease avoidance behavior was deficient and constrained by physical habitat, regardless of considerable public health campaigning. Behavioral guidelines issued by authorities were sub-optimally communicated, unrealistic, and inadequately followed. Boiling water was hampered by shared kitchens, and access to laundry houses for additional hygiene was uneven. Centralized chemical water purification finally leveled the playing field by socializing the cost of prevention and eliminating key sources of unequal risk.

Keywords

Typhoidepidemicshealth behaviorhousingsanitationwaterpublic healthhealth inequalityurban historyFinland
Type
Research Article
Information
Social Science History , Volume 48 , Issue 2 , Summer 2024 , pp. 203 - 232
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Social Science History Association

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