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So curious about the few years in those graphs where scarlet fever and diphtheria have a big dip, at the same time that measles and whooping cough spike. Is it possible that there's a cause/effect thing going on there-- like, isn't measles the one that erases your immune memory and makes you vulnerable to diseases you've already had? Wouldn't explain what's going on with scarlet fever there, unless there's some strep-- uh.... most cases of strep don't turn into scarlet fever. Are you *less* likely to get scarlet fever with strep if your immune system is underreacting to it?

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Wouldn't read anything into those patterns without knowing any local yearly rates. What goes on in NYC in one year may have nothing to do with what goes on in Boston the next, etc.

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Dec 13, 2023Liked by Brian Mowrey

Fair enough.

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Dec 12, 2023Liked by Brian Mowrey

I think it’s due to Climate Change 😀

Kids diseases look to be inversely proportional to CO2. All that extra CO2 in the atmosphere must have changed the pH of the kids mucosal layer or blood or carbonated the water supply or something. Maybe, warmer weather is good for kids.🤷‍♂️

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It is now little remembered that from 1830 to 1914, the main cause of childhood illness was evil looks from kelpies. These were all drowned by raising the sea level.

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Dec 12, 2023Liked by Brian Mowrey

I believe it. I seem to remember you having a hazardous encounter by the seaside with one of their surviving offspring.

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Dec 11, 2023Liked by Brian Mowrey

Thanks for this. As someone who works in municipal services (drinking water, wastewater treatment) I do suspect that improvements to these services helped health in general, and reduced spread. But I also suspect nutrition improvements play a role too.

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Naturally - but a lot of that would have already been "baked in" by 1900, except in urban neighborhoods where landlords might have preferred their buildings free of piped water or just didn't bother one way or the other when things broke. Generally the problem is that sanitation happens, you get big reductions in adult infectious disease deaths, not as much movement in childhood diseases aside from scarlet fever. E.g. in England respiratory tuberculosis and typhus decline 48 and 79% from 1850s to 1890s, but measles, whooping cough and diphtheria combined go up 14% in the same time (McKeown 1965). Infant mortality doesn't decline in England until after 1900 (though childhood mortality is dropping), and while small cities take longer to modernize their water systems, London has had decades of progress by then. Of course, I haven't laid out a convincing thesis here. But my hunch is that reduced urban migration did a lot of lifting after 1914.

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