Rural Penalty in Morbidity: Cause-Specific Morbidity among Working-Class Men and Women in Early Twentieth Century Sweden

This paper uses data from a nationwide Swedish health insurance society (1912–1914) to explore how gendered rural and urban living conditions shaped morbidity during a period characterized by the epidemiological transition and an urban penalty in mortality. Infectious diseases were more common in rural areas, driving the urban–rural morbidity gap. Urban regions experienced less sickness episodes due to lower fertility and pregnancy-related illnesses among women and safer workplaces for men. The findings suggest that urban areas led the epidemiological transition, with urban populations benefiting from more favorable living conditions, while rural populations experienced a rural penalty in morbidity.