Comparative social research
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The author tests McKeown's hypothesis that socioeconomic improvement was the most important cause of mortality decline in England and Wales. First, McKeown's basic work is replicated using data on childhood mortality in Rhode Island between 1860 and 1970. "Then the effect of socioeconomic change on mortality change is examined in ways that differentiate it from other effects. Next, socioeconomic and public health effects on disease are differentiated by computing case-fatality and incidence rates." The results provide support for McKeown's argument.