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The association between population change and mortality has been investigated for over a century. In theSupplement to the 35th Annual Report of the Registrar-General (1861–1870) it was evident that rapidly urbanising areas, with increasing populations, experienced relatively adverse mortality trends, while districts with declining populations did rather better.1 In 1930 Lewis-Faning1showed that between 1860 and 1910 more rapid population growth was associated adversely with relative mortality, albeit weakly. These data were taken to suggest that rapid industrialisation and urbanisation had unfavourable health effects during a period when infectious diseases were the most important cause of morbidity and mortality. Conversely Hoffman2 examined the trend in death rates in large US cities between 1871 and 1904 and demonstrated that the cities with the greater population growth had the lower mortality rate. Thus the …
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