Was shoemaking bad for babies? A vaccination register study of the impact of shoemaking on neonatal mortality in Northamptonshire 1880-1910

In Northamptonshire shoemaking was a cottage industry in which the whole family participated until the last two decades of the 19th century when industrialisation took place. As a result of mechanisation of the process, towns where land was readily available for factory building became focal points for shoemaking. The environment and living conditions within these towns suffered a concomitant deterioration as overcrowding, poor sanitation and a lack of an adequate supply of clean water led to an increase in infections accompanied by a rise in infant mortality. The newly appointed Medical Officer of Health, Dr John Crew, indicated in 1883, that the rate of infant mortality was high ‘especially for a rural sub-district’ but added ‘that it should be borne in mind that in the large villages where the people work in factories, the conditions of life are much what they are in the factory towns’. Using the smallpox vaccination registers for the Higham Ferrers registration sub-district in Northamptonshire it was seen that infant mortality rose, especially during the period of proto-industrialisation. It was also found that compared with men in other occupations living and working in Rushden, (the main town within the sub-district), the infant mortality rate for shoemakers’ offspring was significantly higher. Further examination revealed this to be true only during the neonatal period: the infants of shoemakers who survived the first month had a much greater chance of survival than their counterparts born into non-shoemaking families. This paper explores possible reasons for this anomaly.