De Jure and De Facto Deaths. The Impact of Unregistered Attendees and Absentees on Urban Death Rates in Early Twentieth-Century Belgium

Excess mortality in European cities in the nineteenth century, before the development of appropriate health infrastructures, is explained by poor living conditions and inadequate urban sanitation. However, the indicators measured are not always an accurate reflection of urban mortality conditions. First, they take account of recent immigrants whose risk of dying may be different from that of the local population. In particular, they may have moved to the city to receive hospital treatment. Second, mortality measures may be biased if the deaths and the populations at risk are not defined in a consistent manner. Deaths used in the numerator to calculate mortality rates are sometimes counted by place of death, while population estimates in the denominator are based on the place of habitual residence. Tina Van Rossem, Patrick Deboosere and Isabelle Devos examine the impact of this inconsistency by recalculating mortality levels in three Belgian cities in the early twentieth century on the basis of the habitual residence of the deceased.