Rural industry, disease, and the struggle for health in nineteenth-century Prussia and Sweden: A comparative study of Iserlohn County and the Sundsvall area

Rural industrialisation in Iserlohn County and the Sundsvall area produced a new medical landscape demanding greater efforts to improve the population's health. On the one hand, Prussian and Swedish officials attempted to combat high smallpox and infant mortality, and improve the supply of trained medical personnel. On the other hand, the growth of industry changed the disease panorama while simultaneously presenting workers with the need, financial means, and desire to assume greater responsibility for their own health. Only by examining the entire medical landscape can we make sense of the ways people responded to disease.; This dissertation questions the ability of even the most centralised states to deal effectively with major threats to demographic growth. The introduction of compulsory vaccination in 1816 and the greater autonomy and skills of Swedish midwives ensured that Sweden was more successful than Prussia in reducing smallpox and infant mortality. However, the ratios of inhabitants to physicians, midwives, or hospitals did not improve markedly in either state. This was particularly true in these two industrialising areas.; Rising mortality from infectious diseases, particularly scarlet fever and diphtheria characterised the disease panorama that emerged during the peak of industrial growth. While these diseases were particularly deadly among very young children, the health of young adults dependent upon industrial labour also suffered because of respiratory diseases and tuberculosis.; Occupational dangers and increased vulnerability because of changes in business organisation forced workers to become more involved in their own health care. This involved the founding of numerous sickness insurance funds. In Sweden, it also entailed a change in behaviour and the creation of a more disciplined workforce. As industrial workers generally were more highly paid than those engaged in handicrafts and farming they also could become consumers of the various medical Products advertised in local newspapers.; It was neither solely the power of the Prussian or Swedish states, nor the authority of doctors that eventually led to the dominance of academic medicine. Rather we must look to the merging of political, social, economic, and cultural forces that produced a climate in which this process could occur.