Abstract In the later decades of the nineteenth century, the United Kingdom experienced a shift in the causes of mortality, from infectious diseases to those more associated with ageing. This epidemiological transition from acute to chronic conditions was accompanied by an increase in longevity and a corresponding increase in morbidity, measured by rising rates of sickness absence. As longevity improved, the period between the onset of ill health and death lengthened. If we are to understand the daily lived experiences of health in different places during the epidemiological transition, it is necessary to explore the complex causes of morbidity rather than just focus on mortality. We argue that other reasons need to be considered alongside age as important influences on the incidence and duration of ill health, including urbanisation, occupational risks and cultural and institutional factors. Using evidence drawn from a sample of pension records of postal workers, we examine a variety of different factors that could have accounted for the changing pattern of morbidity observed in other studies. We conclude that age alone cannot account for the greater incidence of sickness absence and ill health and that other factors relating to the residential and working environment, as well as institutional arrangements for sick pay, need to be taken into account.

中文翻译：

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系统跳动的心脏：维多利亚时代伦敦邮政工人的健康

摘要 在 19 世纪后期，英国经历了死亡原因的转变，从传染病到与老龄化更相关的疾病。这种从急性病到慢性病的流行病学转变伴随着寿命的延长和发病率的相应增加，以病假率的上升来衡量。随着寿命的延长，疾病发作和死亡之间的时间延长了。如果我们要了解流行病学转变期间不同地方的日常生活经历，就必须探索发病率的复杂原因，而不仅仅是关注死亡率。我们认为，除了年龄之外，还需要考虑其他原因作为对健康不良的发生率和持续时间的重要影响，包括城市化、职业风险以及文化和制度因素。使用从邮政工人养老金记录样本中提取的证据，我们检查了各种不同的因素，这些因素可能解释了其他研究中观察到的发病率变化模式。我们得出的结论是，仅凭年龄并不能说明病假和健康不佳的发生率更高，还需要考虑与居住和工作环境以及病假工资制度安排有关的其他因素。