Infection and malnutrition interaction effects on child mortality in Scania, Sweden, 1766-1894

Kent Johansson, Lund University

Before 1900, food production was so low that most European populations were chronically malnutritioned, and any short-term food scarcity must have affected mortality, especially for those suffering from any illness and especially for children, since low nutritional status makes an individual more susceptible to infectious disease. Infections on the other hand worsen the nutritional status and the body is easier to infect in the first place if malnourished. Thus, the interaction of disease and malnutrition should be an important determinant for mortality. The age-group analysed here is children since the consequences are more serious than for adults, and data comes from five parish populations in Southern Sweden, 1766-1894. The multilevel Cox regressions show that current nutrition and disease load affected mortality, and that there is a relative risk increase by up to 22% caused by their interaction; thus this interaction is important and should be used when explaining child mortality.