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The beating heart of the system: the health of postal workers in Victorian LondonIn the later decades of the nineteenth century, the United Kingdom experienced a shift in the causes of mortality, from infectious diseases to those more associated with ageing. This epidemiological transition from acute to chronic conditions was accompanied by an increase in longevity and a corresponding increase in morbidity, measured by rising rates of sickness absence. As longevity improved, the period between the onset of ill health and death lengthened. If we are to understand the daily lived experiences of health in different places during the epidemiological transition, it is necessary to explore the complex causes of morbidity rather than just focus on mortality. We argue that other reasons need to be considered alongside age as important influences on the incidence and duration of ill health, including urbanisation, occupational risks and cultural and institutional factors. Using evidence drawn from a sample of pension records of postal workers, we examine a variety of different factors that could have accounted for the changing pattern of morbidity observed in other studies. We conclude that age alone cannot account for the greater incidence of sickness absence and ill health and that other factors relating to the residential and working environment, as well as institutional arrangements for sick pay, need to be taken into account.