Exploring Macro-Micro Dialogues Through Analysis of Mortality Patterns in Soho, London During the 1854 Cholera Outbreak

Abstract

The macro-scale demographic and epidemiological transition models were first established to describe changing population patterns. Over time, researchers from many academic fields have examined how well these macro transitions play out at the micro level in various settings. This has led to allegations that the macro-scale transition models are oversimplified and do not sufficiently represent the heterogeneity within populations. To explore these claims, I analyse the micro-level mortality patterns during the 1854 cholera outbreak in Soho, London. Using a biocultural framework, I investigate the following three questions: 1) What are the patterns of mortality observed during the 1854 cholera outbreak in Soho, and in what ways do they diverge from the wider pattern observed in London during the 1853-1854 epidemic? 2) How does variation in the population composition during this period influence mortality patterns? 3) To what extent do the social and public health responses shape these patterns? By using an extensive range of historical archival records and secondary sources, I gather both quantitative and qualitative data. From this, I collate sociodemographic variables to allow for examination, comparison, and statistical analyses of the cholera mortality patterns in Soho and London, plus the potential factors which shape these patterns. I find that in addition to broad similarities between the cholera mortality experiences in Soho and London, there are significant differences. These include higher cholera mortality rates in Soho than in London as a whole across all areas when examining age and sex, occupation, social class, marital status, and country of birth. The disproportionate mortality experiences of Soho women aged 40-44 and 50-64 years and lower skilled workers within Soho are of particular interest. I also discover that in comparison to London as a whole, Soho cholera victims more commonly died in hospitals. In contrast, a smaller percentage died in workhouses compared to London. Lastly, I uncover that most of the social and public health responses to the outbreak in Soho occur at the micro level (individual and local), where individuals with specific ideas about disease causation and health made purposeful choices and carried out particular actions with specific consequences.