A lesson from history? Worsening mortality and the rise of the Nazi Party in 1930s Germany.

OBJECTIVES: The aim of the study was to test the hypothesis that worsening mortality rates in the early 1930s were associated with increasing votes for the Nazi Party. STUDY DESIGN: The study consist of panel data with fixed effects. METHODS: We used district- and city-level regression models of Nazi vote shares on changes in all-cause mortality rates in 866 districts and 214 cities during federal elections from 1930 to 1933, adjusting for election and district/city-level fixed effects and sociodemographic factors. As a falsification test, we used a subset of deaths less susceptible to sociopolitical factors. RESULTS: Historical downward trends in mortality rates reversed in the early 1930s in Germany. At the district/city level, these increases were positively associated with a rising Nazi vote share. Each increase of 10 deaths per 1000 population was associated with a 6.51-percentage-point increase in Nazi vote share (95% confidence interval = 1.17-11.8). The strongest associations were with deaths due to infectious and communicable diseases, suicides, and alcohol-related deaths. Worsening mortality had no association with votes for the Communist Party or for other contemporary political parties. Greater welfare payments were associated with smaller increases in both mortality and Nazi vote share, and adjusting for welfare generosity mitigated the association by approximately one-third. CONCLUSIONS: Worsening mortality rates were positively associated with the rise of the Nazi Party in 1930s Germany. Social security mitigated the association between mortality and Nazi vote share. Our findings add to the growing evidence that population health declines can be a 'canary in the coal mine' for the health of democracies

Living on the edge: precariousness and why it matters for health

The post-war period in Europe, between the late 1940s and the 1970s, was characterised by an expansion of the role of by the state, protecting its citizens from risks of unemployment, poverty, homelessness, and food insecurity. This security began to erode in the 1980s as a result of privatisation and deregulation. The withdrawal of the state further accelerated after the 2008 financial crisis, as countries began pursuing deep austerity. The result has been a rise in what has been termed ‘precariousness’. Here we review the development of the concept of precariousness and related phenomena of vulnerability and resilience, before reviewing evidence of growing precariousness in European countries. It describes a series of studies of the impact on precariousness on health in domains of employment, housing, and food, as well as natural experiments of policies that either alleviate or worsen these impacts. It concludes with a warning, drawn from the history of the 1930s, of the political consequences of increasing precariousness in Europe and North America

Heights across the last 200 years in England

This paper uses a dataset of heights calculated from the femurs of skeletal remains to explore the development of stature in England across the last two millennia. We find that heights increased during the Roman period and then steadily fell during the 'Dark Ages' in the early medieval period. At the turn of the first millennium heights grew rapidly, but after 1200 they started to decline coinciding with the agricultural depression, the Great Famine and the Black Death. Then they recovered to reach a plateau which they maintained for almost 300 years, before falling on the eve of industrialisation. The data show that average heights in England in the early nineteenth century were shorter than those in Roman times, and that average heights reported between 1400 and 1700 were similar to those of the twentieth century. The paper also discusses the association of heights across time with some potential determinants and correlates (real wages, inequality, food supply, climate change and expectation of life), showing that in the long run heights change with these variables, and that in certain periods, notably the thirteenth and fourteenth centuries, the associations are observable over the shorter run as well. We also examine potential biases surrounding the use of skeletal remains

Heights across the Last 2,000 Years in England

This chapter uses a dataset of heights calculated from the femurs of skeletal remains to explore the development of stature in England across the last two millennia. We find that heights increased during the Roman period and then steadily fell during the “Dark Ages” in the early medieval period. At the turn of the first millennium, heights grew rapidly, but after 1200 they started to decline coinciding with the agricultural depression, the Great Famine, and the Black Death. Then they recovered to reach a plateau which they maintained for almost 300 years, before falling on the eve of industrialization. The data show that average heights in England in the early nineteenth century were comparable to those in Roman times, and that average heights reported between 1400 and 1700 were similar to those of the twentieth century. This chapter also discusses the association of heights across time with some potential determinants and correlates (real wages, inequality, food supply, climate change, and expectation of life), showing that in the long run heights change with these variables, and that in certain periods, notably the thirteenth and fourteenth centuries, the associations are observable over the shorter run as well. We also examine potential biases surrounding the use of skeletal remains