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The urban environment can affect the health of a population in various ways. Cities can expose their inhabitants to unhealthy conditions including overcrowding, air pollution, inadequate housing and sanitation, and difficult working conditions. However, cities can also offer health-enhancing benefits such as higher real incomes, better health facilities, and more social support systems. Although historical research has primarily emphasized the adverse effects of urbanization, linked with industrialization, studies for the twentieth century have also recognized the advantages cities can provide (Szreter and Mooney 1998; Woods 2003; Oris and Farinas 2016; Davenport 2020). Historical research for Belgium has shown that urban living affected the mortality of men, women, and children in cities differently (Eggerickx, Debuisson and Sanderson 2013; Oris 1998; Van Rossem, Deboosere and Devos 2018). Analyses of age- and sex-specific mortality risks for the late 19th century for instance have revealed that urban hazards were particularly severe for infants in Ghent, for girls in Bruges, for adult males in Antwerp and Brussels, and for elderly men in Liège and Seraing. Differences in the urban labour market appear at least partly responsible: we can refer to the female factory workers in Ghent unable to breastfeed, the girls employed in the Bruges lace industry, and the men working in hazardous conditions in Antwerp's port, Brussels' industries, and the mines of Wallonia (Devos and Van Rossem 2015; Van Rossem, Deboosere and Devos 2018). A detailed analysis of the causes of death is the critical next step, as this will enable a more systematic comparison of the urban labour markets and the associated health risks. In this article, we look at eleven urban areas with distinct demographic and occupational structures (port, capital, mining, textile and rural cities) between 1890 and 2019. Using aggregate population and cause-of-death data by age and sex, we examine how the epidemiological transition unfolded in these cities since the late nineteenth century, compared to the rest of the country. We examine whether there were substantial disparities in cause-specific mortality among them, how these disparities evolved over time, and varied with age and sex. How did mortality by cause-of-death group change in these cities in the context of industrialization, tertiarization, rising living standards, improved social security and medical progress? By focusing on the causes of death of urban men, women, and children between the late nineteenth and early twenty-first centuries, we aim to deliver an important contribution to the debate on the relationship between urban change and cause-of-death mortality, and provide a better insight into the mechanisms at play.
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Devos, I., Bourguignon, M., Eggerickx, T., Sanderson, J.-P., & Vrielinck, S. (2025). Urban health penalties. The epidemiological transition in Belgian cities, 1890-2019. European Social Science History Conference 2025, Leiden, The Netherlands. https://hdl.handle.net/2078.5/268656