Sickness experience in England, 1870-1949

Using data from the Hampshire Friendly Society, a sickness insurance institution in southern England, we examine morbidity trends in England between 1870 and 1949. Morbidity prevalence increased between 1870 and around 1890, mainly because of a rise in the average duration of sickness episodes, but after 1890 average durations fell markedly even though the incidence of sickness rose. During the first two decades of the twentieth century, sickness prevalence increased gradually but this rise was entirely due to the greatly increased duration of claims made by men aged 65 years and over. After the early 1920s both the incidence and the average duration of sickness claims declined. These trends seem to be measuring ‘objective morbidity’: they vary closely with year-on-year changes in the mortality of men of working age, but do not show any clear relationship with real wages or unemployment. Our conclusions are different from those of earlier research using English sickness insurance data. We believe that one reason for this was a methodological problem with the analysis performed by nineteenth-century actuaries.