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Sweden has a long-standing tradition of recording causes of death, dating back to the establishment of Tabellverket, in 1749. At that time, parish ministers were responsible for documenting causes of death in parish registers and compiling related statistics, which were then used for national population data. This article explores the various agents involved in the development and maintenance of this reporting system. These include government officials (including medical scientists), practising physicians, clergy and the close social networks of the deceased. Each group played a vital role in shaping how causes of death were recorded and understood. The reporting system functioned as an information network, influenced by the differing levels of knowledge and perspectives on disease and mortality held by these agents. While the clergy initially occupied a central position in this system, the role of physicians — limited at first — gradually expanded as medical expertise and authority grew over time. Despite the limitations of the early reporting system, the preserved cause-of-death data offers invaluable insights into the changing landscape of public health, disease patterns and mortality in Sweden from the mid-18th to the mid-20th century.

In this article, we analyse infant mortality in Sundsvall 1860–1892. The focus is on the pattern and development of causes of death with separate analyses of neonatal and post-neonatal mortality. Furthermore, we discuss the development of infant mortality in relation to possible determinants in the historical context in Sundsvall. The results show substantial differences between neonatal and post-neonatal mortality when it comes to causes of death as well as their seasonal pattern. For deaths in the first 28 days, a large proportion of the deaths were diagnosed as unknown disease or given vague and symptom-descriptive diagnoses. For post-neonatal mortality on the other hand, the dominant cause of death categories were water-and food-borne infections and air-borne infections. Water-and food-borne diseases had a very strong seasonal pattern with the peak in late summer — July and August. There is no indication that sanitary improvements in the 1880's led to fewer cases of diarrhoea. Mortality from air-borne diseases on the other hand was lowest during summer, instead peaking in the winter months.

While there is strong evidence that maternal smallpox infection can cause foetal loss, it is not clear whether smallpox infections were a demographically important cause of stillbirths historically. In this paper, we use parish-level data from the Swedish Tabellverket data set for 1780–1839 to test the effect of smallpox on stillbirths quantitatively, analysing periods before and after the introduction of vaccination in 1802. We find that smallpox infection was not a major cause of stillbirths before 1820, because most women contracted smallpox as children and were therefore not susceptible during pregnancy. We do find a small, statistically significant effect of smallpox on stillbirths from 1820 to 1839, when waning immunity from vaccination put a greater share of pregnant women at risk of contracting smallpox. However, the reduced prevalence of smallpox in this period limited its impact on stillbirths. Thus, smallpox was not an important driver of historical stillbirth trends.

Over the last 60 years several major historical databases with reconstructed life courses of large populations spanning decades have been launched. The development of these databases is indicative of considerable investments that have greatly expanded the possibilities for new research within the fields of history, demography, sociology, as well as other disciplines. In this volume spanning seven articles, eight databases are included that have had a wide impact on research in various disciplines. Each database had its own unique genesis that is well described in the articles assembled in this volume. They inform readers about how these databases have changed the course of research in historical demography and related disciplines, how settled findings were challenged or confirmed, and how innovative investigations were launched and implemented. In the end we explore how research with this kind of databases will develop in future.

The Demographic Data Base (DDB) at the Centre for Demographic and Ageing Research (CEDAR) at Umeå University has since the 1970s been building longitudinal population databases and disseminating data for research. The databases were built to serve as national research infrastructures, useful for addressing an indefinite number of research questions within a broad range of scientific fields, and open to all academic researchers who wanted to use the data. A countless number of customized datasets have been prepared and distributed to researchers in Sweden and abroad and to date, the research has resulted in more than a thousand published scientific reports, books, and articles within a broad range of academic fields. This article will focus on the development of techniques and methods used to store and structure the data at DDB from the beginning in 1973 until today. This includes digitization methods, database design and methods for linkage. The different systems developed for implementing these methods are also described and to some extent, the hardware used.

Our study aims to find how disability affected human health in historical time through an examination of individuals' mortality risks and death causes. Swedish parish registers digitized by the Demographic Data Base (DDB) enable us to account for a relatively high number of persons reported to have disabilities, and to compare them with a group of non-disabled cases. The findings concern a 19th-century population of 35,610 individuals in the Sundsvall region, Sweden, and show that disability increased the premature mortality risk substantially. Disability seems to have jeopardized men’s survival in particular, and perhaps due to gendered expectations concerning the type of work men and women became less able to perform when disabled. Our study of death causes indicates that their deaths were less characterized by infectious diseases than among the non-disabled group, as a possible consequence of lower exposure to infections due to the way in which disability could impede opportunities for interaction with peers in the community. In all, our mortality findings suggest that disability was associated with poor living conditions and limited possibilities to participate in work and social life, which further tend to have accumulated across life and resulted in ill health indicated by premature death.

In the present report, we investigate the patterns and trends of inequality in disposable income in the working-age population in Swedish municipalities 1986-2013. This period coincided with when Sweden changed from very lowlevels of inequality to one with substantially increasing inequality. Incomes has increased in all parts of Sweden, but differences in incomes between municipalities have widened. Asa result, large parts of Sweden have become poorer in a relative, although not in a nominative sense. At the same time, income inequality has increased substantially within as well as between municipalities. Present-day Swedes live in much more unequal environments, both at the national level and in the municipalities. The large city areas, or at least part of them, have had a much more advantageous economic development, but they also became more unequal. We see a division between parts of Sweden; there are clear differentiation tendencies between urban and rural parts, centre and periphery. Another finding is that the relation between mean income and income inequality has changed from the 1980s to the present. This association was negative a couple of decades ago, meaning that inequality was somewhat higher in poorer municipalities. From the 1990s onwards, the association is instead positive – affluent municipalities are more unequal.

Long QT Syndrome (LQTS) is an autosomal dominant inherited cardiac disorder associated with life-threatening arrhythmias. In northern Sweden, a LQTS founder mutation (p.Y111C, KCNQ1 gene) was verified by genetic haplotype analysis and genealogical studies, and a common ancestor couple was identified. Clinical studies of this population revealed an apparent mild phenotype. However, due to early commencement of prophylactic treatment, the natural history of this disorder cannot be properly assessed based only on clinical data. By using the family tree mortality ratio method (FTMR), we assessed the natural history of the untreated LQTS founder population. The principle of FTMR is to compare the age-specific mortality rates in a historic population harboring an inherited disorder with the corresponding mortality rates in an unaffected control population.

Initially, we used the general Swedish population during the same period for comparison and observed an apparent increased longevity in the p.Y111C study population. However, when using a control population born in the same area, we observed no differences regarding overall mortality. Moreover, patterns suggesting age- and sex-stratified excess mortality, in accordance with previous LQTS studies, were evident.

This study shows the importance of being aware of historical demographic patterns to avoid misinterpreting when comparing historical data.

The Demographic Data Base (DDB) at the Centre for Demographic and Ageing Research (CEDAR) at Umeå University has since the 1970s been building longitudinal population databases and disseminating data for research. The databases were built to serve as national research infrastructures, useful for addressing an indefinite number of research questions within a broad range of scientific fields, and open to all academic researchers who wanted to use the data. A countless number of customised datasets have been prepared and distributed to researchers in Sweden and abroad and to date, the research has resulted in more than a thousand published scientific reports, books, and articles within a broad range of academic fields. While there has long been a clear predominance of research within the humanities and social sciences, it has always been used for research in other fields as well, for example medicine. In this article, we first give a brief presentation of the DDB and its history, characteristics, and development from the 1970s to the present. It includes an overview of the research based on the DDB databases, with a focus on the databases POPUM and POPLINK with individual-level data. A number of major traits of the research from 1973 to now have been outlined, showing the breadth of the research and highlighting some major contributions, with a focus on work that would have been very difficult to perform without data from the DDB.

We designed a retrospective cohort study for exploring the impact of municipality-level income inequality, based on the Gini 1986, 2004 indices, on all-cause old-age mortality among the older Swedish population during 2005-2009. We controlled for the confounding effects of individual and regional correlates and the lag effects of inequality by using multilevel logistic regression. The effects of income inequality were not consistent across age cohorts and, among the youngest cohorts, were negligible. This study reiterates that individual-level economics rather than the immediate or lagged effects of income inequality matter more for old-age mortality, even after controlling for individual and regional factors.