title: The impact of water supply and sanitation on infant mortality: Individual-level evidence from Tartu, Estonia, 1897-1900.
abstract: Evidence from a number of historical studies has demonstrated a strong impact of the provision of clean water on mortality risks, while no clear effect has been reported in others. We investigated the relationship between water supply, sanitation, and infant survival in Tartu, a university town in Estonia, 1897-1900. Based on data from parish registers, which were linked to the first census of the Russian Empire, the analysis reveals a clear disadvantage for infants in households using surface water, compared with families that acquired water from groundwater or artesian wells. The impact is stronger in the later stages of infancy. Competing-risk analysis shows that the effect is more pronounced for deaths caused by diseases of the digestive system. Our findings suggest that it may have been possible to improve the water supply, and consequently reduce infant mortality, before the introduction of piped water and sewage systems.
authors.affiliation: a Tallinn University.
authors.forename: Hannaliis
authors.initials: H
authors.lastname: Jaadla
authors.affiliation: a Tallinn University.
authors.forename: Allan
authors.initials: A
authors.lastname: Puur
mesh_terms: D004957:Estonia / Q000453:epidemiology; D005260:Female; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000266:history; D007231:Infant, Newborn; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors; D012499:Sanitation / Q000266:history / Q000706:statistics & numerical data*; D014881:Water Supply / Q000266:history / Q000706:statistics & numerical data*
keywords: Estonia; infant mortality; nineteenth century; sanitation; water supply