Louis-René Villermé (1782-1863), a pioneer in social epidemiology: Re-analysis of his data on comparative mortality in Paris in the early 19th century
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- Received 29 January 2009
- Accepted 18 July 2009
- Published Online First 18 September 2009
Background: During the early 19th century, contagionists’ and anti-contagionists’ explanations of disease causes opposed one another, and the Hippocratic miasma theory still predominated. According to that theory, geographic health disparities could be explained by topographical factors: differences in altitude, population density or proximity to a river. This paper summarizes the life of Louis-René Villermé (1782–1863) and his major contributions to social epidemiology that proved the association between poverty and mortality.
Methods: We present and reanalyze the data reported by Villermé to study the mortality-rate variations across the 12 districts (arrondissements) of Paris, i.e., 1817–1826 Parisian death rates by district, population density and income indicators.
Results: Results obtained with today’s statistical techniques (correlation analysis) support Villermé’s claims of a direct poverty–high death-rate link: the three income indicators that he chose were significantly correlated with at-home mortality: taxation index (r= –0.83, p<0.002), average rent (r= –0.83, p<0.002), trade taxation index (r= –0.67, p<0.05), while population-density variables were not associated with mortality.
Conclusion: Villermé was not only a forerunner of social epidemiology, he was also a scientific pioneer by relying on data, not opinions, to challenge or support medical hypotheses.