On Illnesses Among Norwegian Emigrants, 1825–1925

The emigrants who boarded sailing ships between 1830 and 1870 on their way to the promised land across the sea—America—would come to face many different health challenges along the way, both during the voyage and especially after arriving at their destination in the Midwest. This applied to women, men, and children alike. They quickly learned that access to medical advice and care was almost nonexistent, at least during the first few decades, and for the most part, they were left to fend for themselves.

The crossing could take two to three months, but from the mid-1860s, steamships gradually began to replace sailing ships. This made travel time shorter and conditions on board significantly better, and marked the beginning of large-scale mass emigration.

The early emigrant ships were often converted cargo vessels fitted with an extra deck—a so-called “between deck”—lined with double-tiered bunks filled with straw and intended to accommodate several people in each. A long table ran down the center with benches on either side. The ceiling was low and space was cramped. In storms or bad weather, everyone had to remain below deck, and the hatches had to be sealed to keep the sea from pouring in. Conditions were unhealthy, ventilation poor, and daylight scarce. The toilets were filthy and rarely cleaned. Most Norwegians on board had never been to sea before, so seasickness quickly set in. Contagious diseases spread rapidly, there was no medical assistance to be found on board, and deaths were not uncommon. The voyage—often lasting 10 to 12 weeks—was a serious ordeal for nearly everyone.

Emigrants had to bring food for ten weeks themselves, and on the upper deck, there was usually a separate cooking area where meals could be prepared. Drinking water was distributed daily—each person received three liters—but it quickly became stale and contaminated, often causing illness. Dysentery, a severe disease involving fever, painful stomach cramps, and bloody, mucus-filled diarrhea, is caused by shigella bacteria in contaminated water and is highly infectious. Without treatment, it often leads to death. Another serious and contagious disease stemming from polluted drinking water is typhoid fever—also called “nervous fever”—caused by salmonella bacteria. In adults, it shares many symptoms with dysentery. It spreads through the consumption of food or water contaminated by the urine or feces of infected animals or people. Children often experience a milder version. With so many people packed together for long periods, respiratory infections were common and often fatal. Eye infections and skin conditions caused by lice, fleas, and scabies were also widespread.

These diseases often followed the emigrants further inland as they traveled to the Midwest, where most eventually settled. Many still carried the infection, though often without obvious symptoms. At first, they found land in Wisconsin and Illinois, and later, further west. In many areas, clean drinking water remained hard to come by. Dysentery and typhoid fever reappeared in the early years in several pioneer settlements, such as Beaver Creek, Illinois, in 1838.

Cholera, another highly contagious and deadly intestinal infection marked by vomiting and severe, watery diarrhea, is caused by the Vibrio cholerae bacterium found in contaminated food and water. The disease was first reported in the U.S. in 1832 in the region around the Great Lakes Ontario and Erie. From 1849, it spread westward with emigrants who had been infected in New York. At the same time, it traveled north on riverboats along the Mississippi from New Orleans, and in the same year, reached Chicago. In the years that followed, there were several serious cholera epidemics in the Midwest, including in the pioneer communities of Fox River and Koshkonong in Wisconsin. The death tolls were extremely high. These epidemics were likely responsible for the greatest number of deaths among Norwegian settlers.

Many Settlers Chose Land in Damp and Marshy Areas, Where Mosquitoes Were Plentiful.
Here, they were exposed to another serious disease—malaria (also called "climate fever," "swamp fever," or often simply "the ague"). It was transmitted through mosquito bites and caused great suffering for those infected. Symptoms often resembled mild flu, with recurring cycles of fever lasting 6 to 24 hours. Fatigue, general weakness, and a significantly reduced ability to work often persisted for weeks or months—something that severely impacted the settlers’ ability to establish themselves. Over time, various organs could be affected, especially the liver, often leading to jaundice. Many died as a result. Those who moved from the marshlands to higher, drier ground usually recovered and escaped further infection.

During their first years, settlers typically lived in small, cramped sod houses or log cabins, often shared by multiple families. These crowded and unsanitary living conditions made the spread of infectious diseases highly likely. Diarrheal diseases and respiratory infections were common, and pneumonia frequently proved fatal. Tuberculosis was also widespread.

Women typically gave birth at home in these unhealthy, cramped spaces, often with no more assistance than an untrained neighbor woman. Professional midwives were rare, and most women had to manage on their own. One feared complication was puerperal (childbed) fever. Many were afflicted by it, and it claimed the lives of numerous women. Infant mortality rates were high across the various settler communities.

In 19th-century Norway, alcohol abuse was a serious issue. Sociologist Eilert Sundt found that by 1857, more than one-third of all married men were dependent on alcohol. Many carried these drinking habits with them to the new country, and alcoholism became a well-known problem among Norwegian immigrants. Countless families were destroyed because of it.

Mental health issues among settlers are rarely mentioned, but they were likely widespread—especially among women. During the initial emigration period, up to around 1870, most emigrants were families with spouses and children, often traveling together with relatives. Traditionally, men held dominant roles and were usually the driving force behind the decision to start anew in America. Wives were often more hesitant and followed reluctantly. Back in Norway, they had clear roles: tending the farm, caring for children and livestock, and enjoying summers spent in the mountain pastures—a cherished highlight for many. But in the Midwestern settlements, things were different. Livestock was uncommon, farming was focused on grain and crop production—tasks women rarely took part in—and the tradition of summer farming didn’t exist.

Aside from domestic chores, there was little else for women to do, and many spent their days idle. With neighbors far apart, the loneliness became overwhelming. Many felt unhappy and without purpose and suffered from deep homesickness. Quite a few regretted leaving Norway, and some never truly settled into their new lives. Many were gripped by despair and depression. Especially for a woman who had grown up in a narrow valley in Western Norway, surrounded by steep mountain cliffs, the transition to the vast, flat prairie—where there was nothing to rest the eye on—was frightening. “Nowhere to hide,” they would say, and it was hard to cope with. The boundless sky and the absence of any visual anchor points made them feel uneasy and anxious. Many became mentally ill, and it has been reported that Norwegian immigrant women were overrepresented in American mental institutions at the time.

It is primarily the first 40–50 years of the 100-year period from 1825 to 1925 that are of particular interest when it comes to the health challenges faced by settlers after leaving their homeland. Little was known about the causes of disease, how infections spread, or the consequences of cramped and unsanitary living conditions. There was little to no access to professional medical care, and people had to manage on their own as best they could. Over time, as the social conditions of settlers improved, houses became larger and more sanitary, and better services became available, the diseases afflicting Norwegian immigrants in the latter part of the period gradually began to resemble those of typical Americans.

_{Cover Image from "Det løfterike landet» by Odd S. Lovoll (1997) page 27}