HISTORICAL POPULATION HEALTH: SPATIOTEMPORAL MORTALITY PATTERNS OF HAMILTON, ONTARIO 1880–1882 AND 1910–1912
This dissertation empirically investigates multifaceted causes of health inequity by exploring historical connections between shifting economic activity, urban development, population change, and mortality. The purpose is to reveal the impact of changing socioeconomics on population structure and urban development, and the association of this impact on spatiotemporal mortality patterns. This research advances knowledge on the complex ecological interplay of population, behaviour, habitat, and subsequent health inequities, revealing a link between health disparities and economic transitions. Examining Hamilton, Ontario, at two cross-sections (1880–1882 and 1910–1912), using purposive working-age and infant samples provides a snapshot of life and death before and during heavy industrial activity. Mixed-methods use data from census and death records, health reports, photographs, and maps to construct a profile of demography, epidemiology, and the urban environment (physical, built, and social). Two major findings are identified: 1) industrialization played a major role in emerging human health ecology risks correlating to the mortality patterns; and 2) industrialization tended to increase health inequities amongst the population and across the city. The onset of predominately industrial economic activity caused further class divide, uneven urban development, and inequitable health outcomes. Statistical inquiry (multiple logistic regression) of the working-age mortality sample revealed an increased association between age at death and dying of tuberculosis, and an increased association between accidental death with biological sex, age at death, and birthplace. The infant mortality sample revealed a temporal shift with an increased association between diarrhoeal mortality and infant age, and between infectious respiratory mortality and infant age. Results from Historical GIS inquiry indicate residential working-class sections were more unhealthy environments than other areas of the city. Historical documentation and photographs supported these results, presenting the likelihood of a social disparity to health outcomes. The interplay between population, environment, and behaviour manifests into a spatiotemporal pattern of stressors related to socioeconomic status, urban development, and health disparity. Industrialization brought new stressors to Hamilton creating unequal opportunities for the rapidly growing working classes. Thus, without careful planning in urban development, concentrations of health risks lead to inequitable population health outcomes, especially those undergoing an economic transition, such as industrialization.
Canadian Industrialization, Health Inequity, Economic Transition, Human Health Ecology, Urban Health, Historical Epidemiology, Infectious Diseases, Mixed Methods
Doctor of Philosophy (Ph.D.)
Geography and Planning