Mormon mortality in Manti, Utah, 1849-1977 : the epidemiologic transition in a frontier town

Information contained in the Cemetery Records of Manti, Utah, 1849 to 1977, is analyzed, using aggregative techniques, to investigate mortality and to examine the effects of the frontier and Mormonism on patterns of death. The first phase of this study involves the analysis of differentials and trends in mortality by age, sex, cause, and season to determine whether the risks by dying in Manti during the l26-year interval follow those predicted in epidemiologic transition theory (Omran, 1971a). In the second phase of this study, the effects of public health and the Mormon religion on mortality differentials in frontier, rural, and urban settings are explored.

Mortality levels in Manti during the period of frontier settlement from 1849 to 1889, are predicted to be intermediate to the higher levels in the cities and the lower levels in the countryside. Manti became an established rural town from 1890 to 1929, and mortality rates are expected to drop from frontier to rural levels. From 1930 to 1977, there was a reversal in rural-urban mortality rates. The high concentration of Mormons in Manti, with their lifestyle proscriptions against tobacco, alcohol, and caffeine which result in proven reductions in the incidence of death cardiovascular disorders and cancer (Enstrom, 1975; Jarvis, 1977; Lyon, et al., 1976), however, is predicted to be one factor which may lower mortality in Manti after 1930.

Mortality in Manti clearly follows the patterns specified in epidemiologic transition theory. During the first forty years, 1849 to 1889, air- and water-borne infectious diseases predominated, and, as a consequence, so did infant and childhood mortality and marked seasonal fluctuations of death. From 1890 to 1929, advancements in public health began to control mortality from water-borne infectious diseases. Chronic diseases were included among the leading causes of death, but air-borne infections continued to predominate, as did infant and childhood mortality and seasonal rhythms of death. Infectious diseases declined after 1930, as did infant and childhood mortality, and, subsequently, degenerative diseases increased. Seasonality of death was reduced to a smooth yearly pattern by the predominance of chronic diseases which display little seasonal fluctuation. More importantly, the Mormon lifestyle contributed to reductions in the incidence of death from chronic diseases in Manti.

The first phase of the epidemiologic transition in Manti, the control of infectious diseases, took place during the first sixty years. Biological factors and public health measures had a significant impact on mortality levels at that time. After 19l0, the second phase of the epidemiologic transition in Manti, the rise of chronic degenerative diseases, took place. Environmental factors, lifestyle and religion were most influential during the last sixty years in effecting reductions in mortality. Continued monitoring of morbidity and mortality in Mormon populations, as well as further specification of the variables related

According to Omran, the first stage of the Epidemiologic Transition consisted of the "Age of Pestilence and Famine" (Omran, 1971a: 516), which occurred in the United States prior to 1850. As a consequence of the time span covered by the Burial Records in Manti, from settlement in 1849 to 1977, the residents of Manti experienced only the second and third phases of Omran's scheme. For the sake of clarity in this study, therefore, the second and third phases of Omran's scheme correspond to the first and second phases, respectively, of the Epidemiologic Transition in Manti.

to Mormon levels of health, will afford vital information concerning the control of chronic degenerative diseases which will constitute the third phase of the epidemiologic transition.