LAUSR

During the first half of the 20th century, infant mortality in the general population fell by more than 50% in higher income countries. Despite accounting for a disproportionately high share of deaths in these countries during this period, few quantitative studies have examined the experiences of infants who were born or raised in an institutional context. In this paper, we quantify mortality rates in Mother and Baby Homes in Ireland, institutions that were aimed primarily at unmarried mothers and their infants. Using information on over 40,000 infants born in the 6 largest of these insitutions in Ireland, we assess how this risk of mortality changed over the course of the 20th century relative to the general population, and assess variation in death rates by observed characteristics. The mortality penalty for these institutions was greatly elevated, reaching four times the national mortality rate in the 1930s and 1940s. By comparing the outcomes of infants from the Mother and Baby Homes with the rest of the population using large-scale quantitative data, this study documents the scale of the disadvantage faced by marginalised communities born outside public hospital systems, and highlights the potential role of nutrition-related causes in these disparities.