Scarlet fever and nineteenth-century mortality trends: a reply to Romola Davenport

Romola Davenport's recent article is presented as a significant revision of the interpretation of the reasons for rising and then falling urban mortality in Britain in the nineteenth century put forward by Szreter and Mooney, which emphasized the importance of the politics of public health. Davenport's claims that mortality patterns c. 1830–70 were driven by a synchronized rise and fall of scarlet fever across Europe and North America, as well as in rural locations in Britain, are based on frail and inconclusive forms of evidence. The epidemiological evidence presented by Davenport in fact indicates a chronologically lagging—not leading—role for scarlet fever in contributing to the rise in urban death rates before 1850 and the subsequent fall in urban mortality after c. 1870 in Britain.