The Biologically Vulnerable Boy

Framing Sex Differences in Childhood Infectious Disease Mortality

in Boyhood Studies
Author:
Heather T. Battles University of Auckland h.battles@auckland.ac.nz

Search for other papers by Heather T. Battles in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT

Demographers have noticed longer adult female life expectancies and higher rates of male infant mortality in Europe as early as the seventeenth and eighteenth centuries. During the Western demographic and epidemiologic transition of the late nineteenth and early twentieth centuries, infant and childhood mortality rates became increasingly male-skewed. I examine the changing awareness and understanding of sex differentials in childhood infectious disease mortality and the discourse surrounding them in the medical and epidemiological literature, with particular focus on discussions surrounding diphtheria. I identify the emergence of the concept of males as the weaker sex (the “biological hypothesis”) and the framing of boys as biologically vulnerable, and argue that these are products of this historical period, linked not only to observed epidemiological patterns but also to changing ideas of children and childhood and the shift in science and medicine toward the laboratory as the source of knowledge.

Contributor Notes

Heather T. Battles is a Lecturer in biological anthropology in the School of Social Sciences at the University of Auckland in Auckland, New Zealand. Her research examines historical patterns of infectious disease in the context of demographic and epidemiological transition, with a focus on children and childhood. Recent and current projects examine diphtheria and polio mortality in Canada and New Zealand. Email: h.battles@auckland.ac.nz

  • Collapse
  • Expand

Boyhood Studies

An Interdisciplinary Journal

  • Aaby, Peter. 1998. “Are Men Weaker or Do Their Sisters Talk Too Much? Sex Differences in Childhood Mortality and the Construction of ‘Biological’ Differences.” Pp. 223245 in The Methods and Uses of Anthropological Demography, ed. Alaka Malwade Basu and Peter Aaby. Oxford: Clarendon Press.

    • Search Google Scholar
    • Export Citation
  • Abramowicz, Mark, and Henry L. Barnett. 1970. “Sex Ratio of Infant Mortality: Trends of Change.” American Journal of Diseases of Children 119, no. 4: 314315.

    • Search Google Scholar
    • Export Citation
  • Ainbender, Eugene, Ruth Berger Weisinger, Magda Hevizy, and Horace L. Hodes. 1968. “Difference in the Immunoglobulin Class of Polioantibody in the Serum of Men and Women.” Journal of Immunology 101, no. 1: 9298.

    • Search Google Scholar
    • Export Citation
  • Allen, Edgar V. 1934. “The Relationship of Sex to Disease.” Annals of Internal Medicine 7, no. 8: 10001012.

  • Ariès, Philippe. [1960] 1962. Centuries of Childhood: A Social History of Family Life, trans. Robert Baldick. New York: Vintage Books.

  • Armstrong, David. 1986. “The Invention of Infant Mortality.” Sociology of Health and Illness 8, no. 3: 211232.

  • Austad, Steven N. 2006. “Why Women Live Longer Than Men: Sex Differences in Longevity.” Gender Medicine 3, no. 2: 7992.

  • Bakwin, Harry. 1929. “The Sex Factor in Infant Mortality.” Human Biology 1, no. 1; 90116.

  • Balsara, Sheri L., Jennifer A. Faerber, Nancy B. Spinner, and Chris Feudtner. 2013. “Pediatric Mortality in Males Versus Females in the United States, 1999–2008.” Pediatrics 132, no. 4: 631638.

    • Search Google Scholar
    • Export Citation
  • Basu, Alaka Malwade, and Peter Aaby. 1998. “Introduction: Approaches to Anthropological Demography.” Pp. 121 in The Methods and Uses of Anthropological Demography, ed. Alaka Malwade Basu and Peter Aaby. Oxford: Clarendon Press.

    • Search Google Scholar
    • Export Citation
  • Beltrán-Sánchez, Hiram, Caleb E. Finch, and Eileen M. Crimmins. 2015. “Twentieth-Century Surge of Excess Adult Male Mortality.” PNAS 112, no. 29: 89938998.

    • Search Google Scholar
    • Export Citation
  • Brosco, Jeffrey P. 1999. “The Early History of the Infant Mortality Rate in America: ‘A Reflection Upon the Past and a Prophecy of the Future.’Pediatrics 103: 478485.

    • Search Google Scholar
    • Export Citation
  • Ciocco, Antonio. 1940. “Sex Differences in Morbidity and Mortality (Concluded).” The Quarterly Review of Biology 15, no. 2, 192210.

    • Search Google Scholar
    • Export Citation
  • Clarke, Joseph, and Richard Price. 1786. “Observations on Some Causes of the Excess Mortality of Males Above That of Females.” Philosophical Transactions of the Royal Society of London 76: 349354.

    • Search Google Scholar
    • Export Citation
  • Crum, Frederick S. 1917. “A Statistical Study of Diphtheria.” American Journal of Public Health 7, no. 5: 445477.

  • Cullen, Mark R., Michael Baiocchi, Karen Eggleston, Pooja Loftus, and Victor Fuchs. 2015. “The Weaker Sex? Vulnerable Men, Resilient Women, and Variations in Sex Differences in Mortality since 1900.” NBER Working Paper No. 21114. www.nber.org/papers/w21114 (accessed 20 April 2016).

    • Search Google Scholar
    • Export Citation
  • Cunningham, Hugh. 1995. Children and Childhood in Western Society since 1500. 2nd ed. New York: Longman.

  • Deacon, W.J.V. 1924. “A Study of the Incidence, Mortality and Fatality of Diphtheria.” American Journal of Public Health 14, no. 5: 404408.

    • Search Google Scholar
    • Export Citation
  • Dewitte, Sharon N. 2014. “Modeling the Second Epidemiologic Transition in London: Patterns of Mortality and Frailty During Industrialization.” Pp. 3553 in Modern Environments and Human Health: Revisiting the Second Epidemiologic Transition, ed. Molly K. Zuckerman. Hoboken, NJ: Wiley-Blackwell.

    • Search Google Scholar
    • Export Citation
  • Doull, J.A. 1930. “Factors Influencing Selective Distribution in Diphtheria.” Journal of Preventive Medicine 4: 371404.

  • Drevenstedt, Greg L., Eileen M. Crimmins, Sarinnapha Vasunilashorn, and Caleb E. Finch. 2008. “The Rise and Fall of Excess Male Infant Mortality.” PNAS 105, no. 13: 50165021.

    • Search Google Scholar
    • Export Citation
  • Dyson, Tim. 2012. “Causes and Consequences of Skewed Sex Ratios.” Annual Review of Sociology 38: 443461.

  • Fausto-Sterling, Anne. 1985. Myths of Gender: Biological Theories about Women and Men. New York: Basic Books.

  • Fischer, Julia, Norma Jung, Nirmal Robinson, and Clara Lehmann. 2015. “Sex Differences in Immune Responses to Infectious Disease.” Infection 43: 399403.

    • Search Google Scholar
    • Export Citation
  • Gage, Timothy B. 1994. “Population Variation in Cause of Death: Level, Gender, and Period Effects.” Demography 31, no. 2: 271296.

    • Search Google Scholar
    • Export Citation
  • Garenne, Michel, and Monique Lafon. 1998. “Sexist Diseases.” Perspectives in Biology and Medicine 41, no. 2, 176190.

  • Hill, Kenneth, and Dawn M. Upchurch. 1995. “Gender Differences in Child Health: Evidence from the Demographic and Health Surveys.” Population and Development Review 21, no. 1: 127151.

    • Search Google Scholar
    • Export Citation
  • Ingold, Tim, and Gisli Palsson, eds. 2013. Biosocial Becomings: Integrating Social and Biological Anthropology. Cambridge: Cambridge University Press.

    • Search Google Scholar
    • Export Citation
  • Johansson, S. Ryan. 1991. “Welfare, Mortality, and Gender. Continuity and Change in Explanations for Male/Female Mortality Differences over Three Centuries.” Continuity and Change 6: 135177.

    • Search Google Scholar
    • Export Citation
  • Latour, Bruno, and Steve Woolgar. 1979. Laboratory Life: The Social Construction of Scientific Facts. Beverly Hills: Sage.

  • le Pecq de la Clôture, Louis. 1778. Collection d’observations sur les maladies et constitutions épidémiques, années 1763 à 1770, et 1771 à 1773 [Collection of observations on epidemic diseases and constitutions, years 1763 to 1770, and 1771 to 1773]. Rouen: Imprimerie Privilégiée.

    • Search Google Scholar
    • Export Citation
  • Lock, Margaret M. 1993. Encounters with Aging: Mythologies of Menopause in Japan and North America. Berkeley: University of California Press.

    • Search Google Scholar
    • Export Citation
  • Lock, Margaret, and Patricia Kaufert. 2001. “Menopause, Local Biologies, and Cultures of Aging.” American Journal of Human Biology 13: 494504.

    • Search Google Scholar
    • Export Citation
  • Lopez, Alan D. 1983. “The Sex Mortality Differential in Developed Countries.” Pp. 53120 in Sex Differentials in Mortality: Trends, Determinants and Consequences, ed. Alan D. Lopez and Lado T. Ruzicka. Miscellaneous Series No. 4. Canberra: Australian National University.

    • Search Google Scholar
    • Export Citation
  • Lopez, Alan D., and Lado T. Ruzicka. 1983. “Introduction.” Pp. 15 in Sex Differentials in Mortality: Trends, Determinants and Consequences, ed. Alan D. Lopez and Lado T. Ruzicka. Miscellaneous Series No. 4. Canberra: Australian National University.

    • Search Google Scholar
    • Export Citation
  • McMichael, A.J. 1999. “Prisoners of the Proximate: Loosening the Constraints on Epidemiology in an Age of Change.” American Journal of Epidemiology 149, no. 10: 887897.

    • Search Google Scholar
    • Export Citation
  • Meckel, Richard A. 1990. Save the Babies: American Public Health Reform and the Prevention of Infant Mortality 1850–1929. Baltimore: Johns Hopkins University Press.

    • Search Google Scholar
    • Export Citation
  • Moogk, Peter N. 2003. “Les Petits Sauvages: The Children of Eighteenth-Century France.” Pp. 3656 in Histories of Canadian Children and Youth, ed. Nancy Janovicek and Joy Parr. Toronto: Oxford University Press.

    • Search Google Scholar
    • Export Citation
  • Mooney, Graham. 2002. “Shifting Sex Differentials in Mortality During Urban Epidemiological Transition: The Case of Victorian London.” International Journal of Population Geography 8: 1747.

    • Search Google Scholar
    • Export Citation
  • Muenchhoff, Maximilian, and Philip J.R. Goulder. 2014. “Sex Differences in Pediatric Infectious Diseases.” Journal of Infectious Diseases 209, no. S3: S120S126.

    • Search Google Scholar
    • Export Citation
  • Nathanson, C.A. 1984. “Sex Differences in Mortality.” Annual Review of Sociology 10: 191213.

  • Omran, Abdel R. 1971. “The Epidemiologic Transition: A Theory of the Epidemiology of Population Change.” The Milbank Memorial Fund Quarterly 49, no. 4: 509538.

    • Search Google Scholar
    • Export Citation
  • Ortner, Donald J. 1998. “Male–Female Immune Reactivity and Its Implications for Interpreting Evidence in Human Skeletal Paleopathology.” Pp. 7992 in Sex and Gender in Paleopathological Perspective, ed. Anne L. Grauer and Patricia Stuart-Macadam. Cambridge: Cambridge University Press.

    • Search Google Scholar
    • Export Citation
  • Pennell, Leesa M., Carole L. Galligan, and Eleanor N. Fish. 2012. “Sex Affects Immunity.” Journal of Autoimmunity 38, no. 2–3: J282J291.

    • Search Google Scholar
    • Export Citation
  • Pongou, Roland. 2013. “Why Is Infant Mortality Higher in Boys Than in Girls? A New Hypothesis Based on Preconception Environment and Evidence from a Large Sample of Twins.” Demography 50, no. 2: 421444.

    • Search Google Scholar
    • Export Citation
  • Pongou, Roland. 2015. “Sex Differences in Early-Age Mortality: The Preconception Origins Hypothesis.” Demography 52, no. 6: 20532056.

    • Search Google Scholar
    • Export Citation
  • Preston, Samuel H. 1976. Mortality Patterns in National Populations: With Special Reference to Recorded Causes of Death. New York: Academic Press.

    • Search Google Scholar
    • Export Citation
  • Quirke, Viviane, and Jean-Paul Gaudillière. 2008. “The Era of Biomedicine: Science, Medicine, and Public Health in Britain and France after the Second World War.” Medical History 52: 441452.

    • Search Google Scholar
    • Export Citation
  • Smith, W.R. 1896. Report to the School Board of London. London: Straker and Sons.

  • Sommerville, C. John. 1992. The Discovery of Childhood in Puritan England. Athens: University of Georgia Press.

  • Stern, Alexandra Minna, and Howard Markel. 2002. “Introduction.” Pp. 120 in Formative Years: Children’s Health in the United States, 1880–2000, ed. Alexandra Minna Stern and Howard Markel. Ann Arbor: University of Michigan Press.

    • Search Google Scholar
    • Export Citation
  • Stinson, Sara. 1985. “Sex Differences in Environmental Sensitivity During Growth and Development.” Yearbook of Physical Anthropology S6: 123147.

    • Search Google Scholar
    • Export Citation
  • Süssmilch, Johann Peter. 1761. Die göttliche Ordnung in den Veränderungen des manchlichen Geschlechts, aus der Geburt, dem Tode, und Fortpflanzung desselben erwiesen [The divine order in the changes of the human species, proven by its birth, death, and propagation]. Berlin: J. C. Spencer.

    • Search Google Scholar
    • Export Citation
  • Tabutin, Dominique. 1978. “La surmortalité féminine en Europe avant 1940 [Excess female mortality in Europe before 1940].” Population 33, no. 1: 121148.

    • Search Google Scholar
    • Export Citation
  • Théré, Christine. 2003. “L’analyse de la mortalité différentielle selon le sexe au dix-huitième siècle [Analysis of differential mortality by sex in the eighteenth century].” SVEC 2003, no. 1: 185219.

    • Search Google Scholar
    • Export Citation
  • Théré, Christine, and Jean-Marc Rohrbasser. 2006. “Facing Death in the Early Days of Life: Inequality Between the Sexes in Enlightenment Demographic Thought.” History of the Family 11: 199210.

    • Search Google Scholar
    • Export Citation
  • Thorne, R. Thorne. 1894. “The Etiology, Spread and Prevention of Diphtheria.” Journal of the Royal Society for the Promotion of Health 15, no. 1: 720.

    • Search Google Scholar
    • Export Citation
  • Trivers, Robert L., and D.E. Willard. 1973. “Natural Selection of Parental Ability to Vary the Sex Ratio of Offspring.” Science 179: 9092.

    • Search Google Scholar
    • Export Citation
  • Vallin, Jacques. 1991. “Mortality in Europe from 1720–1914: Long-Term Trends and Changes in Patterns by Age and Sex.” Pp. 3867 in The Decline of Mortality in Europe, ed. Roger Schofield, David Reher, and Alan Bideau. Oxford: Clarendon Press.

    • Search Google Scholar
    • Export Citation
  • Vallin, Jacques. 2006. “Mortality, Sex, and Gender.” Pp. 177194 in Demography: Analysis and Synthesis, vol. 2, ed. Graziella Caselli, Jacques Vallin, and Guillaume Wunsch. Boston: Academic Press.

    • Search Google Scholar
    • Export Citation
  • van de Walle, Etienne, and Francine van de Walle. 1990. “The Private and Public Child.” Pp. 150164 in What We Know About Health Transition: Cultural, Social and Behavioural Determinants of Health, ed. J.C. Caldwell, S. Findley, P. Caldwell, G. Santow, W. Cosford, J. Braid, and D. Broers-Freeman. Canberra: Australian National University Press.

    • Search Google Scholar
    • Export Citation
  • Waldron, Ingrid. 1998. “Sex Differences in Infant and Early Childhood Mortality: Major Causes of Death and Possible Biological Causes.” Pp. 6483 in Too Young to Die: Genes or Gender? New York: United Nations.

    • Search Google Scholar
    • Export Citation
  • Washburn, Thomas C., Donald N. Medearis, and Barton Childs. 1965. “Sex Differences in Susceptibility to Infection.” Pediatrics 35: 5764.

    • Search Google Scholar
    • Export Citation
  • Weden, Margaret M., and Ryan A. Brown. 2010. “Historical and Life Course Timing of the Male Mortality Disadvantage in Europe: Epidemiological Transitions, Evolution, and Behaviour.” Social Biology 53: 6180.

    • Search Google Scholar
    • Export Citation
  • Wells, Jonathan C.K. 2000. “Natural Selection and Sex Differences in Morbidity and Mortality in Early Life.” Journal of Theoretical Biology 202: 6576.

    • Search Google Scholar
    • Export Citation
  • Wolfenden, R. Norris. 1896. “School Boards and Diphtheria.” Journal of Laryngology, Rhinology, and Otology 11, no. 1: 15.

  • Worthman, Carol M., and Brandon Kohrt. 2005. “Receding Horizons on Health: Biocultural Approaches to Public Health Paradoxes.” Social Science and Medicine 61, no. 4: 861878.

    • Search Google Scholar
    • Export Citation
  • Wright, Peter W.G. 1988. “Babyhood: The Social Construction of Infant Care as a Medical Problem in England in the Years around 1900.” Pp. 299329 in Biomedicine Examined, ed. Margaret Lock and Deborah R. Gordon. Boston: Kluwer.

    • Search Google Scholar
    • Export Citation
  • Zelizer, Viviana A. 1985. Pricing the Priceless Child: The Changing Social Value of Children. New York: Basic Books.

Metrics

All Time Past Year Past 30 Days
Abstract Views 2699 1835 388
Full Text Views 31 6 0
PDF Downloads 25 5 0