Catherine Cox Cultures of Care in Irish Medical History, 1750 1970 (2011)

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.69 Kennedy notes that the years of greatest excess female mor-tality in Ireland were the time of changing land laws; he suggests apossible link with land succession and property transfers,70 implyingthat farmers privileged their sons and may have disadvantaged theirdaughters in order to secure a male heir, and may have been less con-cerned about the survival of female children, who would have had tobe dowered, which was considered to be a drain on family resources.He also concludes that males were dominant in Irish society, and thatthey controlled many of the resources needed for good health in ruralareas.71 Among the evidence of male dominance that Kennedy cites isArensberg and Kimball s description of women waiting on men whilethey ate, and then eating later.Can we be certain that there was alwayssufficient food left for them, or that the men had not eaten all the bacon,eggs or whatever protein was available? There is substantial evidence thatin Dublin tenement households c.1909, men got most of the proteinavailable, and children got most of what was left, leaving women tosurvive on bread and tea.72 Did a similar, or even worse, division of food244 Death and Disease in Independent Irelandapply in rural Ireland? We have no evidence, since the National NutritionSurvey collected data on meals per household; it made no effort to look athow the food was distributed.One indirect source of evidence regarding the inferior treatment offemale children in rural Ireland comes from statistics on admissions toindustrial schools.Most children committed to industrial schools werecommitted because their families (nuclear or extended) were no longerable or willing to care for them, or were perceived as unable to care forthem.Girls always constituted a majority of those committed becauseof poverty and related factors; they were committed at an earlier agethan boys, and they stayed longer in these institutions.This suggeststhat when a family came under pressure, boys were more likely to be keptwithin the family than girls.However, the gender ratio for Dublin childrencommitted to industrial schools was significantly different to the nationalpicture; in July 1950, for example, 988 boys and 817 girls from DublinCity were inmates of industrial schools and reformatories, compared with1,831 boys and 2,348 girls with addresses outside Dublin.73Economic factors cannot be excluded from the analysis of femalehealth and mortality.The heavy manual work carried out by women infarming and associated jobs has been suggested as one factor in therelatively worse mortality of rural women, but Irish women did notcarry out much heavy outdoor work except in the remote areas alongthe western seaboard.Indeed the dearth of work for women on Irishfarms may have been a more critical factor.There was very little paidwork for women in rural Ireland, and many rural women may havebeen regarded as surplus to requirements.Every farm needed one womanto cook, clean and mind the hens but one was probably sufficient,whereas there was often work for two or more men.Rural men could sup-plement their income by claiming unemployment assistance, whereaswomen were generally denied this form of income supplement, with theexception of widows, who were better treated than widowers in terms ofstate support.By the mid-twentieth century, there were many diatribesabout the flight of the girls from rural Ireland; available information oncomparative mortality suggests that migration from rural Ireland to citiesand towns in Ireland or overseas would have been a rational decision forIrish women.In 1841, on the eve of the famine, women accounted forprecisely 50 per cent of the rural population but, by 1901, there were only961 women for every 1,000 men and, by 1951, the ratio had fallen to868, compared with 1,120 : 1,000 in urban areas.The gender imbalancewas even more pronounced among younger adults with 1,165 womenper thousand men in the age group 20 29.But the diatribes against theMary E.Daly 245lack of women in rural Ireland rarely took account of the fact that,whereas life expectancy for men was greater in the countryside thanin the cities, the reverse applied for women.Again these statistics werenot hidden; they were readily available, but they were not seen as amatter for concern.At this stage the best that we can do is flag this as a topic that urgentlyrequires further research.Some possible areas for investigation includemilk-borne diseases, such as TB and typhoid, because women were tradi-tionally responsible for milking cows, and bovine tuberculosis remainedrife in Irish herds until the 1960s.We also need to identify factors thatmight make women more susceptible to acute respiratory diseases andrheumatic fever.There is evidence that many Irish women were sent backfrom the US in the 1920s because they suffered from heart disease causedby rheumatic fever.74 However the explanation may lie deeper in Irishsociety.With an average of six children per farming family, surplusdaughters may have rated very low in the allocation of food, medical careand general nurturing.Alternatively, we should conclude that life in thecountryside was good for men.Future researchAn understanding of the underlying factors in the three issues that I haveoutlined will require a more detailed and much more rigorous analysis ofthe statistical information, from both Irish and comparative sources.With regard to female advantage (or lack thereof), a detailed analysis ofmortality by gender might prove illuminating.But the answers to thesequestions, even partial answers, will not be found in medical statisticsor in the history of medical institutions, but through the integrationof medical knowledge with our knowledge of the state and society [ Pobierz całość w formacie PDF ]

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