Vögele J P
Institut für Geschichte der Medizin, Universität Düsseldorf.
Ann Demogr Hist (Paris). 1996:249-68.
Traditionally cities and towns in historical Europe were perceived as being particularly unhealthy. Terms like 'le handicap urbain' or 'urban penalty' have been introduced in order to emphasize the high death rates in the fast-growing industrial towns of nineteenth century Europe, which significantly exceeded the average rates for rural areas or the whole country. A rising population density was ideal for the transmission of the prevailing infectious diseases. This paper assesses urban and rural mortality change in Imperial Germany, when the country was going through a process of accelerated industrialization and urbanization. It provides an analysis of changes in age-, sex- and disease-specific mortality in urban and rural Prussia. In general, urban mortality in Germany reached its peak after the middle of the century, thereafter urban mortality improved substantially in relative as well as in absolute terms, the gap between urban and rural mortality narrowed and finally disappeared entirely. The largest cities registered the strongest decline in mortality. Obviously they had the potential to overcome the threats of disease or death, and became forerunners of improved health conditions in modern industrialized societies. An analysis of the mechanisms of mortality change in an urban environment during industrialization in the late nineteenth and early twentieth centuries can therefore serve as a paradigm for conditions in highly urbanized industrial societies.
传统上，历史时期的欧洲城镇被认为特别不健康。“城市劣势”或“城市惩罚”等术语被引入，以强调19世纪欧洲快速发展的工业城镇中的高死亡率，这些死亡率显著超过农村地区或全国的平均水平。不断上升的人口密度为当时流行的传染病传播提供了理想条件。本文评估了德意志帝国在经历加速工业化和城市化进程时城乡死亡率的变化。它分析了普鲁士城乡在年龄、性别和疾病特异性死亡率方面的变化。总体而言，德国的城市死亡率在世纪中叶后达到峰值，此后城市死亡率在相对和绝对水平上都有显著改善，城乡死亡率差距缩小并最终完全消失。最大的城市死亡率下降最为明显。显然，它们有能力克服疾病或死亡的威胁，并成为现代工业化社会健康状况改善的先驱。因此，对19世纪末20世纪初工业化时期城市环境中死亡率变化机制的分析可以作为高度城市化工业社会状况的范例。
