Mortality in late nineteenth-century Montreal: geographic pathways of contagion.

In the City of Montreal, 1881, the presence of three cultural communities with different profiles of economic status makes it possible to observe the way social settings affected survival over a lifetime. Regression models show culturally determined maternal factors dominant for infants, and persistent throughout childhood. For post-neonates, children aged 1-4, and adults aged 15-59 household poverty has a comparable effect. Among adults, a gender penalty differs among the three communities. Models are improved when differentiated by cause of death. Locating households using a GIS reveals high levels of residential segregation by ethnicity and income, spatial correlation of environmental hazards, and constraints on exit from zones of risk, which together produce neighbourhood effects as large as household effects. Attention to groups excluded (foundlings and inmates of institutions) confirms that models limited to full household-level information significantly underestimate the impacts of poverty and exclusion.