Article

Medieval Monastic Mortality: Hazard Analysis of Mortality Differences Between Monastic and Nonmonastic Cemeteries in England

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  • Museum of London
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Abstract

Scholarship on life in medieval European monasteries has revealed a variety of factors that potentially affected mortality in these communities. Though there is some evidence based on age-at-death distributions from England that monastic males lived longer than members of the general public, what is missing from the literature is an explicit examination of how the risks of mortality within medieval monastic settings differed from those within contemporaneous lay populations. This study examines differences in the hazard of mortality for adult males between monastic cemeteries (n = 528) and non-monastic cemeteries (n = 368) from London, all of which date to between AD 1050 and 1540. Age-at-death data from all cemeteries are pooled to estimate the Gompertz hazard of mortality, and "monastic" (i.e., buried in a monastic cemetery) is modeled as a covariate affecting this baseline hazard. The estimated effect of the monastic covariate is negative, suggesting that individuals in the monastic communities faced reduced risks of dying compared to their peers in the lay communities. These results suggest better diets, the positive health benefits of religious behavior, better living conditions in general in monasteries, or selective recruitment of healthy or higher socioeconomic status individuals. Am J Phys Anthropol, 2013. © 2013 Wiley Periodicals, Inc.

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... tools available for navigating the osteological paradox has grown with the inclusion of additional lines of evidence on nutrition, physiology, fertility parameters, and modern epidemiology (McFadden & Oxenham, 2020). Advances in statistical approaches, such as those that compare the distribution of skeletal lesions by age-at-death (DeWitte et al., 2013;O'Donnell, 2019;Wright & Yoder, 2003), have also augmented our ability to evaluate how skeletal stress indicators co-vary with demographic factors. Together, these advances provide viable means for dealing with the osteological paradox to reveal salient information on ancient stress and disease. ...
... (3) hazard models, and (4) stable isotope biochemistry. Each of these methods has proven successful for navigating aspects of the osteological paradox in previous research (DeWitte et al., 2013;DeWitte & Bekvalac, 2010DeWitte & Hughes-Morey, 2012;McFadden & Oxenham, 2020;Temple, 2019;Wilson, 2010Wilson, , 2014Wright & Yoder, 2003). ...
... Hazard models can compare a broad suite of demographic phenomena on a population level. Hazard models that exclude subadults have been shown to effectively track both age-dependent and ageindependent adult mortality within and between populations (Dewitte et al., 2013;Wilson, 2010Wilson, , 2014Wood et al., 2002). Analyses that include subadults in the models can crudely track changes in fertility, as long as subadults are well represented in skeletal series (Buikstra et al., 1986;Milner et al., 2008;Paine, 1989). ...
Article
Objectives We leverage recent bioarchaeological approaches and life history theory to address the implications of the osteological paradox in a study population. The goal of this article is to evaluate morbidity and mortality patterns as well as variability in the risk of disease and death during the Late Intermediate period (LIP; 950–1450 C.E.) in the Nasca highlands of Peru. We demonstrate how the concurrent use of multiple analytical techniques and life history theory can engage the osteological paradox and provide salient insights into the study of stress, frailty, and resilience in past populations. Materials and methods Crania from LIP burial contexts in the Nasca highlands were examined for cribra orbitalia (n = 325) and porotic hyperostosis (n = 270). All age groups and both sexes are represented in the sample. Survivor/nonsurvivor analysis assessed demographic differences in lesion frequency and severity. Hazard models were generated to assess differences in survivorship. The relationship between dietary diversity and heterogeneity in morbidity was assessed using stable δ¹⁵N and δ¹³C isotope values for bone collagen and carbonate. One hundred and twenty‐four crania were directly AMS radiocarbon dated, allowing for a diachronic analysis of morbidity and mortality. Results The frequency and expression of both orbital and vault lesions increases significantly during the LIP. Survivor/nonsurvivor analysis indicates cranial lesions co‐vary with frailty rather than robusticity or longevity. Hazard models show (1) decreasing survivorship with the transition into the LIP, (2) significantly lower adult life expectancy for females compared to males, and (3) individuals with cranial lesions have lower survivorship across the life course. Stable isotope results show very little dietary diversity. Mortality risk and frequency of pathological skeletal lesions were highest during Phase III (1300–1450 C.E.) of the LIP. Conclusion Results provide compelling evidence of increasing physiological stress and mortality in the Nasca highlands during the LIP, but also reveal substantial heterogeneity in frailty and the risk of death. Certain members of society experienced a heavier disease burden and higher mortality compared to their contemporaries. Elevated levels of disease and lethal trauma among females account for some of the sex differences in survivorship but cannot explain the large degree of female‐biased mortality. We hypothesize that parental investment in males or increased female fertility rates may explain these differences.
... Expanding SFI applicability, maintaining explanatory power As originally proposed and applied, the SFI comprised a suite of 13 metric and non-metric skeletal biomarkers of lifetime stress. In our original analysis of monastic and nonmonastic Medieval London cemetery samples, the 13-biomarker index criteria reduced the number of skeletons for which SFI could be determined (N = 134) to less than 12% of the original skeletons (N = 976), and only 23% of the sample (N = 558) examined earlier by DeWitte and colleagues [48]. This reduced sample size was a concern, as the 134 skeletons retained for analysis of skeletal frailty may not have been fully representative of the total population. ...
... Similarly, although individuals of all groups were exposed to comparable ecological and epidemiological climates, their abilities and resources to mitigate and buffer exposures were not equal [49,51]. Analyzing human skeletal remains from six Medieval cemeteries, DeWitte and colleagues [48] demonstrated how these disparities between strata translated into differential mortality risks between, specifically, the monastic and nonmonastic communities in London. According to their findings, nonmonastic adults were at significantly higher risk of mortality than their monastic contemporaries. ...
... We use them to test comparability between the original 13-biomarker SFI and the 2-11 biomarker SFI constructs. These monastic and nonmonastic samples were based on the same cemeteries included in DeWitte and colleagues' [48] . With this larger sample we estimated the nonmetric 6-and 4-biomarker SFIs. ...
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To broaden bioarchaeological applicability of skeletal frailty indices (SFIs) and increase sample size, we propose indices with fewer biomarkers (2–11 non-metric biomarkers) and compare these reduced biomarker SFIs to the original metric/non-metric 13-biomarker SFI. From the 2-11-biomarker SFIs, we choose the index with the fewest biomarkers (6-biomarker SFI), which still maintains the statistical robusticity of a 13-biomarker SFI, and apply this index to the same Medieval monastic and nonmonastic populations, albeit with an increased sample size. For this increased monastic and nonmonastic sample, we also propose and implement a 4-biomarker SFI, comprised of biomarkers from each of four stressor categories, and compare these SFI distributions with those of the non-metric biomarker SFIs. From the Museum of London WORD database, we tabulate multiple SFIs (2- to 13-biomarkers) for Medieval monastic and nonmonastic samples (N = 134). We evaluate associations between these ten non-metric SFIs and the 13-biomarker SFI using Spearman’s correlation coefficients. Subsequently, we test non-metric 6-biomarker and 4-biomarker SFI distributions for associations with cemetery, age, and sex using Analysis of Variance/Covariance (ANOVA/ANCOVA) on larger samples from the monastic and nonmonastic cemeteries (N = 517). For Medieval samples, Spearman’s correlation coefficients show a significant association between the 13-biomarker SFI and all non-metric SFIs. Utilizing a 6-biomarker and parsimonious 4-biomarker SFI, we increase the nonmonastic and monastic samples and demonstrate significant lifestyle and sex differences in frailty that were not observed in the original, smaller sample. Results from the 6-biomarker and parsimonious 4-biomarker SFIs generally indicate similarities in means, explained variation (R²), and associated P-values (ANOVA/ANCOVA) within and between nonmonastic and monastic samples. We show that non-metric reduced biomarker SFIs provide alternative indices for application to other bioarchaeological collections. These findings suggest that a SFI, comprised of six or more non-metric biomarkers available for the specific sample, may have greater applicability than, but comparable statistical characteristics to, the originally proposed 13-biomarker SFI.
... However, age-at-death distributions do not measure the relationship between mortality patterns of multiple groups (Wilson, 2014). This relationship is commonly identified through studies of survivorship (probability of surviving) and/or mortality risk (risk of dying) patterns (Betsinger et al., 2020;Boldsen, 2007;Dewitte et al., 2013;Godde et al., 2020;Kelmelis and Dangvard Pedersen, 2019;Redfern et al., 2015;Redfern and Dewitte, 2011;Wilson, 2014). Many studies of survivorship and mortality risk patterns in England predominantly focus on London (DeWitte, 2017(DeWitte, , 2015(DeWitte, , 2014(DeWitte, , 2010Dewitte et al., 2013;Godde et al., 2020;Godde and Hens, 2021;Yaussy et al., 2016;Yaussy and DeWitte, 2018) which leads to less understanding of other areas in England. ...
... This relationship is commonly identified through studies of survivorship (probability of surviving) and/or mortality risk (risk of dying) patterns (Betsinger et al., 2020;Boldsen, 2007;Dewitte et al., 2013;Godde et al., 2020;Kelmelis and Dangvard Pedersen, 2019;Redfern et al., 2015;Redfern and Dewitte, 2011;Wilson, 2014). Many studies of survivorship and mortality risk patterns in England predominantly focus on London (DeWitte, 2017(DeWitte, , 2015(DeWitte, , 2014(DeWitte, , 2010Dewitte et al., 2013;Godde et al., 2020;Godde and Hens, 2021;Yaussy et al., 2016;Yaussy and DeWitte, 2018) which leads to less understanding of other areas in England. ...
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The adverse urban environment of medieval Canterbury possibly influenced poor health conditions and diseases which ultimately led to death. Individuals of low socioeconomic status may have been more at risk of death than those of higher socioeconomic status due to dense living conditions, consistently encountering unhygienic waste management, and less access to resources during famines and disease outbreaks. This study evaluates survivorship and mortality risk patterns of high- and low-status groups to determine the effect of socioeconomic status on survival and mortality in medieval Canterbury. A sample of 796 low- and 74 high-status individuals were examined from St. Gregory’s Priory. Kaplan-Meier analysis and Cox Regression were used to assess mortality and survival between the socioeconomic status groups. The results reveal lower survivorship for high-status than low-status non-adults, and lower survivorship and high mortality risk for high-status adult females compared to low-status adult males. Meanwhile there were no significant differences found in mortality risks and survivorship between low- and high-status adult males, low- and high-status adult females, and low-status adult females and high-status adult males. High risk of mortality and decreased survivorship of high-status adult females may reflect decreased survivorship of high-status non-adults due to poor nutritional intake during and after pregnancy as well as rationing food. In comparison, low-status adult males would have benefited from the pilgrimage culture that allowed them abundant access to nutritious foods.
... Wood et al. (1992) exposed the inherent paradox of these statistical interpretations, which apparently overlooked concerns of demographic non-stationarity, selective mortality, and individual heterogeneity (see Goodman, 1993 for response). Since publication of the osteological paradox, alternative methods for dealing with these inescapable issues in bioarchaeology have been proposed: hazard models (Boldsen, 2007;DeWitte, 2010;DeWitte & Wood, 2008;DeWitte, Boulware, & Redfern, 2013;Wilson, 2014) and life-history studies (Wright & Yoder, 2003). Both approaches enable bioarchaeologists to study health among individuals rather than overall population proportions and ratios, which tend to mute population variability. ...
... Comparison of frailty indices for Medieval London populations demonstrates significant differences between monastic and nonmonastic populations ( Figure 1). Despite increased access to higher quality foods and living amenities (e.g., sanitation and medical care) (Hatcher et al., 2006), these conditions did not buffer the monastic community from cumulative stress, although increased resources seem to have extended the years of life for individuals residing in a monastic setting relative to a nonmonastic setting (DeWitte et al., 2013). In fact, the individuals associated with monastic environments apparently exhibited higher morbidity with lower mortality. ...
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Stress plays an important role in the etiology of multiple morbid and mortal outcomes among the living. Drawing on health paradigms constructed among the living augments our evolving knowledge of relationships between stress and health. Therefore, elucidating relationships between stress and both chronic and acute skeletal lesions may help clarify our understanding of long-term health trends in the past. In this study, we propose an index of "skeletal frailty," based on models of frailty used to evaluate the life-long effects of stress on health among living populations. Here, we assess the possible applicability of frailty to archaeological populations. The skeletal frailty index (SFI) is proposed as a methodological liaison between advances made by biological anthropologists studying relationships between stress and health among the living and bioarchaeologists studying stress and health among the dead. In a case study examining skeletal stress in Medieval London, the SFI is applied to nonmonastic (N = 60) and monastic (N = 74) samples. We used analysis of variance/analysis of covariance to compare SFI values between nonmonastic-monastic groups, sexes, and age cohorts. Results indicate higher lifetime morbidity among monastic groups. These results complement previous bioarchaeological findings on the same London populations, wherein lower risks of mortality and longer lifespans were observed for monastic populations. SFI data reflect the morbidity-mortality paradox observed in modern populations and accompany recent findings in bioarchaeology of variation in Medieval monastic and nonmonastic "health." Ultimately, this study demonstrates the SFI's utility in bioarchaeology, through its application of commonly assessed skeletal biomarkers, its ease of applicability, and its potential usefulness for assessing changes in skeletal health over time and across specific geographies.
... The innovations implemented in BIF ensure the applicability of this index to a larger segment of the population, expanding the survey to include those skeletons that would be discarded due to their fragmentary condition. Marklein et al. (2016) also stressed the importance of having a larger number of individuals, by proposing in a subsequent study an SFI with a reduced number of biomarkers (Marklein & Crews, 2017 It was previously observed by DeWitte et al. (Dewitte et al., 2013) that Monastic individuals from medieval times lived longer than Non-Monastic people, an observation that has been confirmed by our mortality table (Table S2). The Monastic population was composed of clerical men and women, yet also noble individuals were sometimes buried with the clericals (Dewitte et al., 2013). ...
... Marklein et al. (2016) also stressed the importance of having a larger number of individuals, by proposing in a subsequent study an SFI with a reduced number of biomarkers (Marklein & Crews, 2017 It was previously observed by DeWitte et al. (Dewitte et al., 2013) that Monastic individuals from medieval times lived longer than Non-Monastic people, an observation that has been confirmed by our mortality table (Table S2). The Monastic population was composed of clerical men and women, yet also noble individuals were sometimes buried with the clericals (Dewitte et al., 2013). Moreover, during the Middle Ages, those who joined the clergy were mostly people from noble families, usually second children who could not inherit the assets of their family. ...
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Objective Frailty is the physiological stress that individuals suffer during their life. In past populations, frailty is conventionally assessed through the occurrence of different biomarkers of biological stress. Some efforts have been made to propose indexes that combine all biomarkers. However, these indices have some critical limitations: they cannot be used on incomplete skeletons, do not consider the severity and/or healing of lesions, and assign equal importance to different biomarkers. To address these limitations, we propose a new index to assess frailty in skeletal individuals. Material and Methods By statistically analyzing a large amount of osteological data available from the Museum of London, and using a Logit model, we were able to define a different weight for each reported biomarker of frailty, based on their importance in increasing the risk of premature death for the individuals. Results The biological index of frailty (BIF) is the weighted mean of all biomarkers scored on the individuals, according to a different degree of importance assigned to each one. It also considers the severity and healing of the biomarkers when this is relevant to diagnose frailty. We applied BIF on a sample of Monastics and Non-Monastics from medieval England and compared it with the skeletal index of frailty (SFI). Discussion BIF is the first frailty index that gives a different weight to each skeletal biomarker of stress, considers both severity and healing of the lesions, and can be applied on partial skeletal remains. The comparison with SFI showed that BIF is applicable to a larger number of skeletal individuals, revealing new differences between the Monastic and the Non-Monastic groups.
... Hospital samples introduce bias as they may represent a more frail subset of the greater population, and in the case of St Mary Spital, it is confirmed through the description of (Thomas, 1997) who states, "The hospital was founded to look after the sick, the poor, women in childbirth, and the children of women who died in childbirth up to the age of 8" (117). Monastic cemeteries can be selective for males, and those interred in monastic cemeteries likely also had improved health compared with the greater population, possibly through healthier diets, spiritual beliefs, living quarters, and/or selection of healthier individuals (Dewitte, Boulware, & Redfern, 2013). Although we did not include special-use cemeteries in our analyses, the cemeteries we selected likely contain individuals who died after or due to an illness, as well as those who could be interred at religious houses, such as monasteries (see description of St Mary Graces, below). ...
Article
Objectives Described as an indiscriminate killer by many chroniclers, the Black Death descended on London during the 14th century. To best understand the pattern of transmission among demographic groups, models should include multiple demographic and health covariates concurrently, something rarely done when examining Black Death, but implemented in this study to identify which demographic groups had a higher susceptibility. Female predisposition to the Black Death was also explored, focusing on whether social inequality added to vulnerability. Materials and methods Three attritional cemeteries from the Wellcome Osteological Research Database were compared with the Black Death cemetery, East Smithfield. A Cox proportional hazards regression estimated hazards ratios of dying of the Black Death, using transition analysis ages‐at‐death as the time variable, and sex and frailty as covariates. Additionally, a binomial logistic regression generated odds ratios for age‐at‐death, sex, and frailty. Results The Cox model produced a significant hazards ratio for individuals deemed frail. Similarly, the logit model calculated significantly increased odds ratios for frail individuals, and decreased odds for individuals aged 65+. Discussion The older individuals were not undergoing growth during times of great stress in London pre‐dating the Black Death epidemic, which may explain the decreased odds of contracting the Black Death. Further, although women dealt with social inequality, which partially led to the demographic puzzle of the Medieval “missing” women, women's susceptibility to infection by the Black Death was not increased. The phenomenon of the missing women may be due to a combination of factors, including infant and child mortality and preservation.
... V C 2014 In the 20 years since Wood et al. (1992) published the "Osteological Paradox," bioarcheology has made substantial analytical and methodological advances reflecting its commitment to a truly inter-and multidisciplinary framework (Paine, 1997;Wright and Yoder, 2003;Larsen, 2006). While scholars continue to reference this paradox and ponder the theoretical implications (e.g., Goodman and Martin, 2002;Lambert, 2009), the methodological challenges associated with analyzing death assemblages have been largely overlooked with several notable exceptions (Boldsen, 1997(Boldsen, , 2005(Boldsen, , 2007Usher, 2000;DeWitte and Wood, 2008;DeWitte, 2010;Bekvalac, 2010, 2011;Redfern and DeWitte, 2011;DeWitte and Hughes-Morey, 2012;DeWitte et al., 2013). An unfortunate result has been the fragmented conceptual and operational definitions tied to such terms as stress, health, adaptive success, and morbidity, among others. ...
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Bioarcheology has made tremendous strides since the subdiscipline's inception, subsequent syntheses, the standardization of data collection methods, and analytical advances ranging from molecular analyses through age-estimation and biodistance. Concurrently, health and the adaptive success of past populations have remained primary concerns. However, questions are routinely raised about lesions and whether or not changing frequencies are synonymous with increases or decreases in stress, morbidity, and overall health. These include how and why healed lesions can simultaneously represent stress and survival, demanding that researchers understand how population dynamics influence skeletal sample formation. In this study, methods to analyze age- and sex-specific mortality patterns prior to, and in conjunction with, the analysis of linear enamel hypoplasias are demonstrated. Paleodemographic and paleoepidemiological models are presented for late Pre-Columbian skeletal samples from the Eastern Woodlands. Results of hazard modeling demonstrate that elevated mortality rates were commonplace during the latter half of the Mississippian period (AD 1200–1450) with reproductive-age females experiencing high age-specific risk of death attributed to the development of fortified villages and novel environments for increased pathogen loads. Corollary results are presented for the age-specificity of linear enamel hypoplasias in the central Illinois River valley. The epidemiological models demonstrate that the relationship between adult mortality and early childhood stress varied through space, culture, and time. These findings highlight the need to effectively operationalize measurements related to health and stress in past populations and support the adoption of selective mortality and heterogeneity in frailty as key concepts in bioarcheological research. Am J Phys Anthropol, 2014. © 2014 Wiley Periodicals, Inc.
... He finds different associations between the presence of skeletal lesions and mortality between the sexes for some lesions, demonstrating the presence of heterogeneity in frailty between males and females. Other scholars have used similar hazards approaches to investigate the interrelationships among stature, body mass, skeletal stress markers, mortality, and socioeconomic status in 18-19th-century London (Hughes-Morey 2012); frailty in the context of the Romanization of Britain (Redfern and DeWitte 2011a, b); demographic patterns in the aftermath of the Black Death in London (DeWitte 2014); and mortality in medieval monastic communities (DeWitte et al. 2013). ...
Article
More than 20 years ago, Wood et al. (Curr Anthropol 33:343–370, 1992) published ‘‘The Osteological Paradox: Problems of Inferring Prehistoric Health from Skeletal Samples,’’ in which they challenged bioarchaeologists to consider the effects of heterogeneous frailty and selective mortality on health inferences in past populations. Here, we review the paper’s impact on bioarchaeology and paleopathology, focusing on recent advancements in studies of ancient health. We find the paper is often cited but infrequently engaged in a meaningful way. Despite an initial decade of limited progress, numerous researchers are now addressing components of the Paradox in more informed ways. We identify four areas of fruitful research: (1) intrasite, contextual perspectives, (2) subadults, (3) associating stress markers with demographic phenomena, and (4) skeletal lesion-formation processes. Although often seen as a problematic assumption, understanding the sources of heterogeneous frailty within human populations is a worthy research question in and of itself, and one that clearly links past and present health research within a global framework.
... It is possible that the interval age-estimates and particu- larly the open terminal age category 46+ have resulted in an under-estimation of the differences between high and low status adults. However, a recent analysis of mortality differences between monastic and non-monastic commu- nities in London (1050-1540) used these same age categories and sample sizes comparable to those used in our study (DeWitte et al., 2013). That study found a substantial difference in adult mortality between the monas- tic and non-monastic communities using a hazards approach like that used here. ...
Article
Background: Socioeconomic status is a powerful predictor of mortality in living populations, as status affects exposure or access to a variety of factors that impact health and survival, such as diet, healthcare, infectious disease and pollution. Aim: This study examines the effect of socioeconomic status on mortality and survival in London during a period spanning the early 18th through mid-19th centuries. During this period, London experienced rapid industrialization and heightened class distinctions. This study examines whether low-socioeconomic status was associated with reduced survival at a time when the distinctions between social strata were peaking. Subjects and methods: The samples for this study are drawn from three skeletal assemblages in London that represent lower and higher social strata. The upper socioeconomic status sample (n = 394) is from Chelsea Old Church and St Bride’s Fleet Street (crypt assemblage). The low socioeconomic status sample (n = 474) is from St. Bride’s Lower Churchyard (also known as St Bride’s Farringdon Street). The effect of status on mortality and survival is assessed using hazard analysis and Kaplan–Meier analysis. Results: The results reveal elevated mortality and reduced survival for lower socioeconomic status children, but no strong effect of status on adult mortality or survival. Conclusion: These results might indicate strong selective mortality operating during childhood or the effects of migration in the industrial-era population of London. Read More: http://informahealthcare.com/eprint/CXTkrgpCpwffUVFZKpgg/full
... We propose that the association between DISH and high socioeconomic status or a monastic way of life could be explained by sample bias. The onset of DISH has largely been associated with advanced age (e.g., Forestier & Rotes-Querol, 1950;Holton et al., 2011;Resnick et al., 1975;Vidal, 2000), and monastic communities usually have more advanced age-at-death than nonmonastic communities (DeWitte, Boulware, & Redfern, 2013). Therefore, the higher presence of DISH reported in the literature for monastic burials (Waldron, 1985;Rogers & Waldron, 2001) may be related to the over-representation of advanced age groups. ...
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Diffuse idiopathic skeletal hyperostosis (DISH) has largely been associated with high socioeconomic status rather than lower social status in paleopathological studies. This difference has been explained as a consequence of a high intake of fats and sedentary lifestyle that could be related to metabolic syndrome and obesity, associated risk factors in DISH by some clinical authors. This association is also known as the ‘monastic way of life’. In this work, we present a DISH case corresponding to a male individual exhumed from a civil burial site of the necropolis of the Trinitarian Monastery of Avinganya, in the North-East of Iberian Peninsula. In this case, DISH coexists with some evidences of occupational stress markers (back lesions and traumas) that indicate a non-sedentary lifestyle, despite the individuals overweight. Therefore, the present case of DISH seems to contradict the ‘monastic way of life’ association. The previous relationship can be explained as a bias in the sample analysed, where high status individuals have longer survival ratios, so more probabilities to develop DISH, because age is a proved risk factor. In this way, mechanical stress is proposed as another risk factor of DISH, which is more accurate to explain this case.
... The Rostock Manifesto (Hoppa and Vaupel, 2002) argued for a Bayesian approach to the data. Many researchers have thus adopted probabilistic approaches to these data, including transition analysis (Boldsen et al., 2002), an increasingly popular and relatively easily employed approach that effectively alleviates some of the problems we have outlined (DeWitte, 2010;DeWitte et al., 2013). Taking a probabilistic approach to age-at-death smooths-over the lack of precision inherent to evaluating morphological changes and improves population-level comparisons Boldsen, http://dx.doi.org/10.1016/j.ijpp.2014.04.001 1879-9817/© 2014 Elsevier Inc. ...
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Bioarchaeologists rely on accurate estimations of age-at-death. Clearly, some pathological conditions are associated with gross morphological changes in the skeleton that could impact the effectiveness of age-at-death estimation (i.e. methods based on the pelvis, fourth rib, dental attrition, and cranial stenosis). The magnitude of this problem has not been widely studied due to a paucity of pathological skeletons of known age. We assessed age-at death for three individuals affected by bone dysplasias (achondroplasia, residual rickets, osteogenesis imperfecta) using cementum annulations and several osseous age indicators. We predicted osseous indicators that are based on gross morphological changes would yield age estimates discrepant from the cementochronology. Results demonstrated considerable differences in age estimates between morphological and histological techniques suggesting a need for additional research on the effects of pathology on the accuracy of morphological methods. Conversely, we addressed the proposition that cementum annulations will be inappropriate for age estimation in cases of chronic and severe rhino-maxillary infection and periodontitis. We assessed age-at-death for one individual with leprosy and found no indication the disease process affected cementum formation or preservation. The results of this research indicate the potential value of cementochronology in cases where skeletal pathological conditions constrain the usefulness of traditional age estimation approaches.
... Religious people were also deeply involved in the economic and social history. Human remains from convents and cathedrals, being important osteological and anthropological records, are also predominantly used in studies to address differences between ecclesiastical and lay people (e.g., DeWitte et al., 2013;Mays, 1997;Müldner & Richards, 2007;Quintelier et al., 2014), diseases (e.g., Judd, 2020;Rogers & Waldron, 2001;Väre et al., 2020), or diet and mobility (e.g., Ahlin Sundman, 2018;Müldner et al., 2009;Sarkic et al., 2019). ...
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This study aims to reconstruct the biological histories of the people buried at the Royal chapel of Lugo Cathedral, an important religious centre of NW Spain, by using anthropological, geochemical and historical perspectives. We conducted a macroscopic and radiographic study on 955 skeletal elements; a multi-isotope (δ¹³Ccol, δ¹⁵N, δ³⁴Scol, δ¹³Cap, δ¹⁸Oap) analysis of human (n=12) and animal (n=4) samples; and the study of 1407 documents from the Cathedral archives. There was a minimum of 15 individuals, including six subadults (<7 years), seven mature males and one possible female. Several traumatic healed injuries, a pelvis osteochondroma and a case of DISH have been detected. Males were enriched in ¹⁵N (up to 15.7‰, Δhuman-animal avg=5.1‰) suggesting consumption of animal protein including freshwater fish. Cathedral documents reflect fora payments in the form of rye, eggs, poultry, sheep, pigs and eels as well as the hiring of two physicians. All individuals, except one, lived between the 14th and the early 15th centuries and show characteristics of high standard of living. Males were likely members of the Cathedral - chaplains, administrators, sacristans, but not bishops - or noblemen relatives of the former according to preserved documents. Isotopic and paleopathological study suggest that they had an active and travelling life and at least one of them had connections with Central Spain. Children were local and possibly connected to the nobility. Lugo Cathedral is a prime example about the possibilities of transdisciplinary research in the identification of lifestyle in past populations.
... The Medieval period cemeteries are largely monastic cemeteries, which tend to contain individuals of greater socioeconomic status than nonmonastic cemeteries (WORD database 2017) and who often benefit from greater overall health (DeWitte et al. 2013). Males are most common in both Medieval and Post-Medieval combined groups ( Table 2). ...
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The Medieval-Post-Medieval transition in England was an important shift in the human biocultural environment. With urbanization and industrialization came resultant changes in living and working conditions and subsequent effects on the skeleton. In addition, the Post-Medieval period ushered in changes in footwear and activity patterns, with potential consequences on foot bone morphology. The objective of this study is to compare calcaneal and talar lengths between the Medieval and Post-Medieval periods to determine whether there are quantifiable differences that correspond to shifting footwear and activity patterns. T-tests and ANCOVAs (and their non-parametric equivalents) were used to compare calcaneal and talar lengths of 1086 adults from 14 London cemeteries (Medieval n = 8, Post-Medieval n = 6), available in the Oracle Wellcome Osteological Research Database (WORD) curated by the Museum of London. Males and females were also analyzed separately. In the total sample, tali and calcanei are longer in the Medieval period (p < 0.001 for both tarsals). When males and females are analyzed separately, male talar length is greater in the Post-Medieval period (p < 0.001). The difference in talar length between periods is not statistically significant for females (p = 0.093). These differences in talar and calcaneal lengths between periods likely reflect differences in footwear between the Medieval and Post-Medieval periods. The magnitude of these differences varies according to sex, indicating that the change in footwear had differential impacts on men and women. Together, these results suggest that Medieval and Post-Medieval tarsals physically incorporated their respective cultural environments and gendered differences in cultural practice, particularly related to the footwear characteristic of each period.
... Misziewicz (2015), for example, observed significantly higher prevalence of linear enamel hypoplasias (LEH), irreversible enamel growth arrest lines from childhood, among higher SES individuals at St. Gregory's Priory than lower SES individuals interred at the lay cemetery in Canterbury, England (eleventh-sixteenth centuries CE). Within Medieval monastic and nonmonastic communities, individuals associated with the former high-SES group exhibited lower risk of mortality and higher frailty scores, associated with their prolonged lives, relative to their lower status contemporaries (DeWitte et al. 2013;Marklein et al. 2016). However, the pattern observed often in contemporary populations, wherein SES and both mortality and indices/measures of stress inversely correlate, is not universal across human history. ...
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In this paper, we apply a skeletal frailty index (SFI) to a skeletal series representing two distinct socioeconomic (high and low) statuses living in London during the Postmedieval period and evaluate the biological impacts of social stratification considering the secularization hypothesis. In living populations, socioeconomic status (SES) is associated inversely with physiological and psychosomatic stress. While comparable links between SES and physiological stress are observed in archeological samples, bioarcheological research across Europe indicates skeletal “health” and frailty do not always adhere to this pattern. We compare 11-biomarker SFIs between ascribed high (Chelsea Old Church, N = 66; St. Bride’s Crypt, N = 111) and low (St. Bride’s Lower, N = 174) SES contexts. Results show significant differences in SFIs between socioeconomic groups in Postmedieval London, differences explained in part by both status and age. SFIs increase monotonically and significantly from the youngest to oldest age groups with males demonstrating significantly higher frailty scores than females overall, but not within SES groups. Between status groups, intrasexual disparities in frailty were significant only in male subgroups, with low-SES males exhibiting significantly higher SFI than high-SES males. Significantly higher skeletal frailty was observed in the low-SES St. Bride’s Lower sample, with notably higher frequencies of periosteal new bone, fractures, and osteoarthritis relative to high-SES samples. However, frailty disparities within the high-SES sample demonstrate how variability in health and mortality exists even within socioeconomic strata. Results allude to complex, multifactorial relationships among status, age, sex, and frailty across Postmedieval London’s socioeconomic settings, challenging frailty expectations of the secularization hypothesis.
... Gompertz and Gompertz-Makeham models, and others that are used Wood et al., 2002), have also been employed to approximate adult age-at-death in archaeological samples (DeWitte, 2015;DeWitte et al., 2013;DeWitte & Yaussy, 2020;Konigsberg & Frankenberg, 2002;Milner & Ferrell, 2011;Redfern & DeWitte, 2011a, 2011bSasaki & Kondo, 2016b;Stanton & Hefner, 2016;Wilson, 2014). The emphasis on adults accommodates three issues; two are practical, while the third is of more interest. ...
Article
Much of paleodemography, an interdisciplinary field with strong ties to archaeology, among other disciplines, is oriented toward clarifying the life experiences of past people and why they changed over time. We focus on how human skeletons contribute to our understanding of preindustrial demographic regimes, including when changes took place that led to the world as we know it today. Problems with existing paleodemographic practices are highlighted, as are promising directions for future work. The latter requires both better age estimates and innovative methods to handle data appropriately. Age-at-death estimates for adult skeletons are a particular problem, especially for adults over 50 years that undoubtedly are mistakenly underrepresented in published studies of archaeological skeletons. Better age estimates for the entirety of the lifespan are essential to generate realistic distributions of age at death. There are currently encouraging signs that after about a half-century of intensive, and sometimes contentious, research, paleodemography is poised to contribute much to understandings of evolutionary processes, the structure of past populations, and human-disease interaction, among other topics.
Article
In modern populations, inequalities in oral health have been observed between urban and rural communities, but to date the impact of the place of residence on oral health in archaeological populations has received only limited attention. This meta-study analyses dental palaeopathological data to examine the relationship between place of residence and oral health in Roman, early medieval, and late medieval Britain. Published data on ante-mortem tooth loss, calculus, caries, dental abscesses, and periodontal disease were analysed from cemeteries in urban and rural locations from each period. The results indicate that the place of residence influenced oral health in Roman and late medieval times, with urban populations enjoying better oral health than rural populations in Roman Britain, but poorer oral health in the late Middle Ages. These findings may reflect changes in the nature of urban settlements and in their relationship with their rural hinterlands over time.
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WHAT WAS IT LIKE to be a teenager in medieval England? Despite the fact that medieval society often singled young apprentices and workers out for comment, their study has been largely neglected in medieval archaeology. The skeletal remains of 4940 children and adolescents (6.6–25 years) from 151 sites in medieval England were compiled from a combination of primary data collection and secondary data from published and unpublished skeletal reports and online databases. The aim was to explore whether apprentices could be identified in the archaeological record and, if so, at what age they started work and what impact occupation had on their health. The data were divided into urban and rural groups, dating from before and after the Black Death of ad 1348–49, and before the Industrial Revolution. A shift in the demographic pattern of urban and rural adolescents was identified after the Black Death, with a greater number of young females residing in urban contexts after 14 years. The average age of males in urban contexts increased from 12 years to 14 years after the plague years, contrary to what we might expect with the greater opportunities for work after the Black Death. There were higher rates of spinal and joint disease in the urban adolescents, and before the age of 18 years, their injuries were more widespread than their rural counterparts. Domestic service was the potential cause of greater strain on the knees and backs of urban females, with interpersonal violence evident in young urban males. Overall, it was the urban females that carried the burden of respiratory and infectious diseases, suggesting they may have been the most vulnerable group. This study has demonstrated the value of adolescent skeletal remains in revealing information about their health and working life, before and after the Black Death.
Article
Objectives The current research explores survivorship differences in the Middle Cumberland Region of Tennessee during the Mississippian period (ca. 1000–1500 AD). Using updated paleodemographic methods, this study investigates whether individuals from the Late Mississippian period had lower survivorship compared to individuals from the Early Mississippian period, foreshadowing groups on the brink of abandonment. Additionally, this study examines whether there were sex disparities in survivorship. Materials and Methods Adult age-at-death estimates from human skeletal remains (n = 545) were calculated using Transition Analysis, a Bayesian maximum likelihood method. Survivorship was reconstructed using Gompertz and Gompertz-Makeham hazards models, with Akaike Information Criterion compared to determine the best fitting model. Results For individuals surviving into adulthood, mean age-at-death decreased by 7 years from the Early Mississippian to Late Mississippian period. Marked differences between the sexes indicate lower survivorship of females compared to males. Male survivorship decreased sharply from the Early Mississippian to Late Mississippian period, from a mean age-at-death of 57.99 years to 44.45 years. Female survivorship remained constant throughout the Mississippian period (41 years). Discussion Temporal differences in male survivorship may be the result of interactions between climate change, decreased maize harvests, and sociopolitical strife. Sustained maternal mortality may have destabilized small-scale communities that characterized the Mississippian MCR, thereby precipitating population decline.
Article
Objectives: Many individuals living in medieval and post-medieval London suffered issues with sanitation, food insecurity, infectious disease, and widespread exposure to parasites from a multitude of sources, causing increased risk of death for many inhabitants. We examine this stressful environment and its relationship with various demographic and temporal dimensions, using cribra orbitalia (CO) as an indicator of stress, to model an increased risk of dying under the expectations of our proposed parasitic model of infection. Materials and methods: We analyze the relationship between CO and mortality across seven medieval and post-medieval cemeteries from London by the covariates of sex, status, and age-at-death. A survival analysis (Cox regression) and a binomial logit estimated hazard and odds ratios of dying with CO across age-at-death, sex, status, and time-period within single statistical models. In addition, we provide new Bayesian age-at-death estimates for post-medieval samples. Results: The models show the rate of CO decreased over time and age-at-death, regardless of sex or status; post-medieval individuals were ~72% less likely to die with lesions than their medieval counterparts. Further, individuals with CO had ~1% decrease in risk of dying with CO per year of age. Discussion: These results suggest increased mortality risk for those with lesions indicative of anemia (CO), and selective mortality of younger individuals during the medieval period. Despite sex-specific nutritional and occupational hazards, and status-based access to resources, the prevalence of CO was similar across sex and status, which suggests living with parasitic infection that caused anemia was an everyday reality for medieval and post-medieval Londoners.
Article
Objective: Research situated within the Developmental Origins of Health and Disease demonstrates that stressors are correlated with future mortality risk, especially if experienced frequently and during early periods of postnatal life. This study examines if the developmental timing and frequency of early life stressors influenced mortality risk for Indigenous Guale in Spanish Florida during the 17th century. Materials and methods: The present study examines internal enamel microgrowth disruptions (accentuated lines-AL) from Guale individuals (n = 52) interred at Mission Santa Catalina de Guale on St. Catherines Island, Georgia (AD 1605-1680). Teeth were thin-sectioned and microscopically analyzed to document AL variables as predictors of age-at-death. Results: Individuals with AL died earlier than those without AL. This difference, however, was not significant. Individuals who exhibit AL formed during their first year of life died on average three times earlier than those who did not. The frequency of AL and age-at-first-AL are significantly correlated with age-at-death, and Cox hazard analyses indicates that individuals with early forming and frequent AL had increased risks of early death. Discussion: This study emphasizes how the lived experiences of Guale children shaped demographic patterns during the 17th century. The survival of early life stressors resulted in life history trade-offs and increased risks for early death. Mortality risks were exacerbated for individuals who experienced frequent stressors during the earliest periods of life. This underscores a role for bioarchaeology in understanding of how accumulative stress burdens during the earliest years of postnatal life may influence mortality risk.
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Pasaulyje vykdomi vienuolynų bioarcheologiniai tyrinėjimai atskleidžia esminius skirtumus tarp pasaulietinio ir vienuolinio gyvenimo būdo, tačiau traumų analizės nepateikia didelių staigmenų – sužalotų vienuolių skaičius yra santykinai mažas. Todėl daromos prielaidos, kad vienuoliai nepriklauso rizikos grupei dėl specifinio gyvenimo būdo. 2015‒2016 m. vykdytų Vilniaus unitų Švč. Trejybės cerkvės kriptos tyrimų metu atidengti XVII‒XVIII a. bazilijonų vienuolių palaidojimai leido tyrinėti ir rašytiniuose šaltiniuose menkai atsispindinčią vienuolių gyvenimo pusę ‒ bendrą jų sveikatos būklę, patologijas ir patirtas traumas. Straipsnyje, pasiremiant osteologine medžiaga ir istoriniais šaltiniais, analizuojamos vienuolių patirtos traumos, jų mechanizmas ir galimas poveikis sveikatai. Tyrimas atskleidė vienuolių traumatizmo tendencijas, kurioms būdingi dažni šonkaulių lūžiai, smurtinės žaizdos ir didelės energijos sužalojimai. Gauti rezultatai patvirtina, kad vienuoliai nebuvo labiau nei kitos visuomenės grupės ap­saugoti nuo rizikos patirti įvairaus pobūdžio traumas.
Article
Objectives: This study aims to identify the patterns and prevalence of violence-related skull trauma (including the cranium and mandible) among a large sample of skeletons from medieval London (1050-1550 AD). Materials and methods: In total, data from 399 skulls, representing six different sites from across medieval London, were analyzed for evidence of trauma and assessed for the likelihood that it was caused by violence. The sites include the three parish cemeteries of St Nicholas Shambles (GPO75), St Lawrence Jewry (GYE92), and St Benet Sherehog (ONE94); the two monastic houses of London Blackfriars (PIC87) and St Mary Graces (MIN86); and the early inmate cemetery from the medieval hospital of St Mary Spital (NRT85). Results: The overall findings suggest that violence affected all aspects of medieval London society, but how that violence was characterized largely depended on sex and burial location. Specifically, males from the lay cemeteries appear to have been the demographic most affected by violence-related skull injuries, particularly blunt force trauma to the cranial vault. Discussion: Using both archaeological and historical evidence, the results suggest that violence in medieval London may have been more prevalent than in other parts of medieval England, particularly rural environments, but similar to other parts of medieval Europe. However, more studies focusing on medieval trauma, and violence specifically, need to be carried out to further strengthen these results. In particular, males from the lay cemeteries were disproportionately affected by violence-related trauma, especially blunt force trauma. It perhaps indicates a means of informal conflict resolution as those of lower status did not always have the newly established medieval legal system available to them.
Article
Objectives: The southern Brazilian shellmounds provide archaeological evidence of prolonged human activity in the coast from approximately 6000 to 1000 BP. Shellmound building populations exploited the rich coastal estuarine zones, and the human remains recovered from them are important sources of information on health and overall lifestyle of these mid-Holocene groups. Therefore, they were included in the Western Hemisphere Global History of Health project. The shellmounds contribute the highest Health Index in the Western Hemisphere, but these conclusions are based on collections that exclude postcranial remains. Here, we reconstruct the Health Index for one specific shellmound using both cranial and postcranial remains to determine whether the initial studies might misrepresent the relative health of the Brazilian shellmound builders. Materials and methods: The Health Index was calculated for a sample of 18 complete skeletons recovered from the shellmound Porto do Rio Vermelho 02 (Santa Catarina Island, Brazil). The Heath Index was calculated with and without postcranial markers and the results are compared with the Western Hemisphere Global History of Health data. Results: The Health Index for Porto do Rio Vermelho 02 is lower than the reported average for American series in the Western Hemisphere Global History of Health Project and considerably lower than the original index reported for Brazilian shellmounds. This discrepancy is due to an increased prevalence of infectious disease and low stature. Conclusions: Although the Health Index remains a useful comparison statistic, re-evaluation of fragmentary skeletal remains demonstrates the need for caution when applying it to incomplete skeletal series.
Article
Urbanization is one of the most important settlement shifts in human history and has been the focus of research within bioarchaeology for decades. However, there have been limited attempts to synthesize the results of these studies in order to gain a broader perspective on whether or how urbanization affects the biology, demography, and behavior of humans, and how these potential effects are embodied in the human skeleton. This paper outlines how bioarchaeology is well‐suited to examine urbanization in the past, and we provide an overview and examples of three main ways in which urbanization is studied in bioarchaeological research: comparison of (often contemporaneous) urban and rural sites, synchronic studies of the variation that exists within and between urban sites, and investigations of changes that occur within urban sites over time. Studies of urbanization, both within bioarchaeology and in other fields of study, face a number of limitations, including a lack of a consensus regarding what urban and urbanization mean, the assumed dichotomous nature of urban versus rural settlements, the supposition that urbanization is universally bad for people, and the assumption (at least in practice) of homogeneity within urban and rural populations. Bioarchaeologists can address these limitations by utilizing a wide array of data and methods, and the studies described here collectively demonstrate the complex, nuanced, and highly variable effects of urbanization.
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Objective To investigate how lifestyle may have impacted the risk of contracting intestinal parasites in medieval England . Regular clergy (such as those living in monasteries) and the lay population form interesting groups for comparison as diet and lifestyle varied significantly. Monasteries were built with latrine blocks and hand washing facilities, unlike houses of the poor. Materials Sediment samples from the pelvis, along with control samples from feet and skull, of 19 burials of Augustinian Friars (13th-16th century), and 25 burials from All Saints by the Castle parish cemetery (10th-14th century), Cambridge. Methods We analysed the sediment using micro-sieving and digital light microscopy to identify the eggs of intestinal parasites. Results Parasite prevalence (roundworm and whipworm) in the Augustinian friars was 58%, and in the All Saints by the Castle parishioners just 32% (Barnards Test score statistic 1.7176, p-value 0.092). Conclusions It is interesting that the friars had nearly double the infection rate of parasites spread by poor hygiene, compared with the general population. We consider options that might explain this apparent difference, and discuss descriptions and treatment of intestinal worms in medical texts circulating in Cambridge during the medieval period. Significance This is the first study to compare prevalence of parasite infection between groups with different socioeconomic status from the same location. Limitations Quality of egg preservation was suboptimal, so our data may under-represent the true prevalence. Suggestions for further research Larger studies with greater statistical power, covering different time periods and regions.
Article
Objectives: Early Byzantine (A.D. 330-842) monastic rules stipulated that entrants relinquished familial connections, personal belongings and secular relationships to become part of the ascetic collective that continued in death, resulting in bioarchaeological marginalization, as was the case of the monastics excavated from the Chapel of Robebus at Mount Nebo, Jordan (ca. A.D. 491-640). It was hypothesized that compared to contemporary monastic groups, the Mount Nebo monastics experienced poorer health and gravitated to Mount Nebo, owing to its association with the Prophet Moses and proximity to the Dead Sea, Livias baths and Jordan River, all associated with curative benefits, especially for those suffering from leprosy. Materials and methods: The commingled remains of 73 adult males from Mount Nebo and the articulated skeletons (n = 27) from the Sanctuary of Agios Lot at Deir 'Ain 'Abata (Jordan) were assessed for paleopathology, then compared with a contemporary commingled group from the Monastery of Saint Euthymius at Khan-el-Ahmar (Judean Desert) (n = 117). Results: No skeletal evidence of leprosy was observed among the groups. Most Mount Nebo individuals did not reach an older age, yet injuries, severe osteoarthritis, lower leg osteoperiostitis and antemortem tooth loss were common. The paleopathological profile was similar at Deir 'Ain 'Abata, but paleopathology was negligible at Khan-el-Ahmar. Conclusions: The similar paleopathological profiles of the Jordanian monastic groups suggest that the proximity to the Dead Sea may have attracted monastics to both sites, in addition to spirituality, but leprosy was not a factor based on the skeletal evidence.
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Much of our knowledge of Early Medieval monastic economies is based on contemporary documentary sources. Until recently, this literary record has had little in the way of useful archaeo-environmental data to support it. This paper examines the unusually rich environmental remains recovered from the excavations at two early island monasteries – Iona, in the Inner Hebrides, and Illaunloughan, Co. Kerry. The assemblages present a key opportunity to compare and contrast the literary accounts of the monastic diet with the physical evidence, and offer new insights into the economy of early monasteries. We conclude that the archaeological record indicates a much wider food base than previously documented, demonstrating the importance of integrating both strands of evidence.
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Research from the United States shows a possible relationship between religious attendance (RA) and blood pressure (BP). The religious context in the United States differs widely from Scandinavia. The aim was, therefore, to test whether the relationship between RA and BP is specific to the religious culture in the United States or whether a similar relationship exists between RA and BP in a Norwegian context. Data from the Nord-Trøndelag Health Study's third wave, HUNT 3 (2006-08), was used. The associations between RA and diastolic (DBP) and systolic (SBP) blood pressure in women (n = 20,066) and men (n = 15,898) were investigated in a cross-sectional study using multiple regression analyses. Mean DBP for women/men was 71.0 mmHg/76.7 mmHg. Mean SBP was 128.5 mmHg/134.0 mmHg; 39.1%/42.8% of women/men never attended religious services, 3.8%/3.4% attended more than 3x/month. The bivariate associations were statistically significant between RA and SBP in both genders and women's DBP but not men's DBP. After adjustment, inverse associations between RA and DBP/SBP for both genders were found. The RA-DBP relationship (p < 0.001) demonstrated a gradient in effect for both genders, with increasing RA associated with decreasing DBP, with 1.50/1.67 mmHg lower in women/men respectively in those attending more than 3x/month, 0.87/1.16 mmHg lower in those attending 1-3x/month, and 0.49/0.10 mmHg less in those attending 1-6x/6 months. Differences in RA-SBP (p < 0.05) were 2.12/1.71 mmHg, 0.30/0.11 mmHg, and 0.58/0.63 mmHg, respectively. In a large population-based survey in Norway, RA was associated with lower DBP and SBP after adjusting for relevant variables.
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A vast literature has documented the inverse association between educational attainment and U.S. adult mortality risk but given little attention to identifying the optimal functional form of the association. A theoretical explanation of the association hinges on our ability to describe it empirically. Using the 1979-1998 National Longitudinal Mortality Study for non-Hispanic white and black adults aged 25-100 years during the mortality follow-up period (N = 1,008,215), we evaluated 13 functional forms across race-gender-age subgroups to determine which form(s) best captured the association. Results revealed that the preferred functional form includes a linear decline in mortality risk from 0 to 11 years of education, followed by a step-change reduction in mortality risk upon attainment of a high school diploma, at which point mortality risk resumes a linear decline but with a steeper slope than that prior to a high school diploma. The findings provide important clues for theoretical development of explanatory mechanisms: an explanation for the selected functional form may require integrating a credentialist perspective to explain the step-change reduction in mortality risk upon attainment of a high school diploma, with a human capital perspective to explain the linear declines before and after a high school diploma.
Book
In historical accounts of the circumstances of ordinary people's lives, nutrition has been the great unknown. Nearly impossible to measure or assess directly, it has nonetheless been held responsible for the declining mortality rates of the nineteenth century as well as being a major factor in the gap in living standards, morbidity and mortality between rich and poor. The measurement of height is a means of the direct assessment of nutritional status. This important and innovative study uses a wealth of military and philanthropic data to establish the changing heights of Britons during the period of industrialization, and thus establishes an important dimension to the long-standing controversy about living standards during the Industrial Revolution. Sophisticated quantitative analysis enables the authors to present some striking conclusions about the actual physical status of the British people during a period of profound social and economic upheaval, and Height, Health and History will provide an invigorating statistical edge to many debates about the history of the human body itself.
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In the three hundred years covered by this study, the city of London, in partnership with its near neighbour the town of Westminster, developed as the economic, social, administrative, and political capital of the expanding English kingdom. This book charts the halting process whereby the Londoners struggled to forge viable systems of self-government under the ever-watchful eyes of the royal officials at Westminster. This book examines the symbiotic relationship between the Crown and the City, and charts the ways in which the Londoners created the wealth that made them so indispensable to the Crown. It was during these years that the Londoners developed the systems of self-government, welfare provision, and control of the urban environment which were to able to withstand the pressures of massive population expansion, endemic plague, and the extremes of poverty and wealth in the Tudor period. The remarkable survival of the city's own records makes it possible to trace, for the first time and in unexpected detail, the inner workings of civic politics and government over three hundred formative years.
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Paleodemography is the field of enquiry that attempts to identify demographic parameters from past populations (usually skeletal samples) derived from archaeological contexts, and then to make interpretations regarding the health and well-being of those populations. However, paleodemographic theory relies on several assumptions that cannot easily be validated by the researcher, and if incorrect, can lead to large errors or biases. In this book, physical anthropologists, mathematical demographers and statisticians tackle these methodological issues for reconstructing demographic structure for skeletal samples. Topics discussed include how skeletal morphology is linked to chronological age, assessment of age from the skeleton, demographic models of mortality and their interpretation, and biostatistical approaches to age structure estimation from archaeological samples. This work will be of immense importance to anyone interested in paleodemography, including biological and physical anthropologists, demographers, geographers, evolutionary biologists and statisticians.
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This impressive volume presents a thorough examination of all aspects of physical impairment and disability in medieval Europe. Examining a popular era that is of great interest to many historians and researchers, Irene Metzler presents a theoretical framework of disability and explores key areas such as: medieval theoretical concepts theology and natural philosophy notions of the physical body medical theory and practice. Bringing into play the modern day implications of medieval thought on the issue, this is a fascinating and informative addition to the research studies of medieval history, history of medicine and disability studies scholars the English-speaking world over.
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This book, the first of its kind, reviews and discusses the full range of research on religion and a variety of mental and physical health outcomes. Based on this research, the authors build theoretical models illustrating the various behavioural, psychological, and physiological pathways by which religion might affect health. They also review research that has explored the impact of religious affiliation, belief, and practice one use of health services and compliance with medical treatment. Finally, they discuss the implications of these findings, examine a number of possible clinical applications, and make recommendations for future research in this area
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The goal of this research is to explore status-based differences in diet of the peasants, monks and elites interred at the medieval Cistercian monastery of Øm Kloster. In order to accomplish this task bone samples were taken from 98 individuals from the monastery for the stable isotopic analysis of carbon and nitrogen found in both bone collagen and apatite. Significant differences were found in the diet of these three groups. Elites demonstrated significantly enriched δ15N and δ13C values and had the smallest δ13Ccoll–ap spacing in comparison to the peasant and monastic population. Although there were no changes in the diet of the elite or peasant population through time, the monastic diet shifted from resembling the diet of the peasant population early in the period to more closely matching that of the elites at the close of the period, although small sample size precluded the significance testing of this shift. This research suggests that social status played a considerable role in the types and quantity of food resources available to a given individual in society and that there were some socially based differences in the medieval Danish diet.
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,The study of the relationship between religion and health has grown substantially in the past decade. There is little doubt that religion plays an important role in many people’s lives and that this has an impact on their health. The question is how researchers and clinicians can best evaluate the available information and how we can improve upon the current findings. In this essay we review the cur- rent knowledge,regarding religion and health and also critically re- view issues pertaining to methodology, findings, and interpretation ofthese studies. It is important to maintain,a rigorous perspective with regard to such studies and also to recognize inherent limitations and suggest constructive ways in which to advance this field of study. In the end, such an approach can provide new information that will improve our understanding of the overall relationship between reli- gion and health. Keywords:,health; methodology; religion; spirituality. The relationship between religion and health care has cycled between co-
Article
Activity patterns in an assemblage of medieval skeletons from York, England, are investigated using analyses of biomechanical properties of the humeral diaphyses. Evidence is found for differences in activity patterns between males and females and between male layfolk and members of a male monastic community. Copyright © 1999 John Wiley & Sons, Ltd.
Article
Paleodemography and paleopathology presuppose that direct relationships exist between statistics calculated from archaeological skeletal series (e.g., skeletal lesion frequencies and mean age at death) and the health status of the past populations that gave rise to the series. However, three fundamental conceptual problems confound the interpretation of such statistics: demographic non-stationarity, selective mortality, and unmeasured, individual-level heterogeneity in the risks of disease and death. Using simple models of the relationship between individual "frailty" and the hazard of death at each age, this paper explores the implications of these problems for archaeological interpretation. One conclusion is that the skeletal evidence pertaining to the transition from hunting-and-gathering to settled agriculture is equally consistent with an improvement in health and a deterioration in health resulting from the transition.
Article
Diffuse idiopathic skeletal hyperostosis (DISH) is common condition and its prevalence increases markedly with age. This paper describes the pathology and aetiology of the condition; DISH seems to be related to obesity and type II diabetes and is probably a multisystem hormonal disorder. DISH occurs frequently in human skeletal remains, particularly in those recovered from monastic sites. Evidence is presented to confirm this association and the causes are discussed. We also present criteria for the diagnosis of DISH in human remains, which we suggest would permit valid inter-study comparisons. Copyright
Article
This article presents reliable data on the life expectancy of the monks of Durham Priory between 1395 and 1529. The number of years that monks survived in this northern monastery plunged precipitously in the second half of the fifteenth century before staging a partial recovery in the early sixteenth. The experience of Durham monks mirrors the scale, direction, and timing of the data already produced for the monks of Canterbury and Westminster. While the precise relationship between monastic mortality and that of the population at large remains difficult to determine, there can be no doubt that the symmetry that has been established between mortality in three monasteries located in different parts of the country has important implications for our understanding of the demographic history of late medieval England.
Article
ABSTRACT In this article, we use a combination of ethnographic data and empirical methods to identify a process called “absorption,” which may be involved in contemporary Christian evangelical prayer practice (and in the practices of other religions). The ethnographer worked with an interdisciplinary team to identify people with a proclivity for “absorption.” Those who seemed to have this proclivity were more likely to report sharper mental images, greater focus, and more unusual spiritual experience. The more they prayed, the more likely they were to have these experiences and to embrace fully the local representation of God. Our results emphasize learning, a social process to which individuals respond in variable ways, and they suggest that interpretation, proclivity, and practice are all important in understanding religious experience. This approach builds on but differs from the approach to religion within the culture-and-cognition school.
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IntroductionPoint-CounterpointThe Stories Skeletons can TellSkeletons as a Sample of DeathsMeasurement ConcernsAnalytical ConcernsConclusion AcknowledgmentsReferences
Article
The arduous nature of monastic life could impact on the monks’ physical and mental well-being, causing minor injuries but also fatalities. Back problems might develop from ringing the heavy monastery bells, digestive disorders could result from years of fasting, and those holding important offices invariably suffered from stress and strain. There has been significant discussion of healthcare in the monastery – of disease and illness, the treatment of the sick, the infirmary, and the role of professional practitioners within the monastery. Less consideration has been given to the various hazards that might affect the monks on a daily basis, from the obstacles that caused them to trip and tumble to the injuries and fatalities that could result from natural disasters, outbreaks of fire and faulty repair work. This article seeks to explore more fully the perils and pitfalls that the religious community might face, but includes a brief discussion of the general impact of monastic observance on the monks’ well-being, and the spiritual and physical recourse they sought to prevent mishaps and to treat casualties. Analysis centres on the monastic houses of Britain in the high middle ages, but refers to later and continental examples for comparative purposes and where they are likely to be indicative of conditions in Britain in the twelfth and thirteenth centuries.
Article
A comparison between secular hospitals and monastic infirmaries introduces a discussion of the duration and seasonality of the illnesses of the monks of Westminster in two periods: 1297/8 to 1354/5 and 1381/2 to 1416/17. A change in the duration of illnesses is related to change in the conventions of treatment after the Black Death of 1348/9. The resemblance between the seasonal pattern of morbidity in this sample and that of mortality among male adults in the early modern period is discussed. It is suggested that the latter pattern may extend into the late middle ages.
Article
This exploratory study examined relationships between spirituality and immune function in 112 women with metastatic breast cancer. Spirituality was assessed by patient reports of frequency of attendance at religious services and importance of religious or spiritual expression. White blood cell counts, absolute numbers of lymphocytes, T-lymphocyte subsets, and natural killer cells were assessed by flow cytometry. Assessments of natural killer cell activity and delayed-type hypersensitivity responses to skin test antigens provided two measures of functional immunity. In analyses controlling for demographic, disease status, and treatment variables, women who rated spiritual expression as more important had greater numbers of circulating white blood cells and total lymphocyte counts. Upon examination of relationships with lymphocyte subsets, both helper and cytotoxic T-cell counts were greater among women reporting greater spirituality.
This is the first full account of the evolution of the government of London from the tempestuous days of the Commune in the late twelfth century to the calmer waters of Tudor England. In this three-hundred-year period Londoners learnt how to construct, and to manage, 'self-government at the king's command'. They had to develop ways of negotiating with demanding and very different kings and to devise ways of raising money from citizens which were seen to be fair. London's elected rulers had also to resolve conflicting economic interests, to administer common resources and to protect and enhance the health and well-being of all those who lived in the city. London was by far the most populous and wealthy city in the kingdom, and its practices were widely copied throughout England. It was, as the Londoners claimed in 1339, the 'mirror and example to the whole land'. Available in OSO: http://www.oxfordscholarship.com/oso/public/content/history/9780199257775/toc.html Contributors to this volume - Anne Lancashire
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Between 1200 and 1520 medieval English society went through a series of upheavals: this was an age of war, pestilence and rebellion. This book explores the realities of life of the people who lived through those stirring times. It looks in turn at aristocrats, peasants, townsmen, wage-earners and paupers, and examines how they obtained their incomes and how they spent them. This revised edition (1998) includes a substantial new concluding chapter and an updated bibliography.
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Eastern forms of meditation have been widely studied for their effectiveness in stress management (Walsh and Shapiro American Psychologist 61:227–239, 2006). Yet few empirical studies have been conducted on the health effects of Judeo-Christian contemplative prayer practices. This study contributes to research in this underdeveloped area by exploring the outcome of a contemporary form of Christian meditation called Centering Prayer (Keating 1986) on everyday stress and on Christians’ approach to communicating with God. The impact of 10 weekly 2-hour group sessions and individual practice of Centering Prayer 2-times daily by 15 Roman Catholic congregants was hypothesized to decrease participants’ stress and increase their collaborative relationship with God (Pargament et al. Journal for the Scientific Study of Religion 27:90–104, 1988). Pre-post quantitative and qualitative data on Centering Prayer versus comparison groups supported the hypothesis. KeywordsCentering prayer-Contemplative prayer-Meditation-Stress-Unconscious
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After reviewing various systems of age determination based on analysis of the pubic bone, the discussion concentrates on the collection and preparation of an extensive autopsy sample (n=1225) of pubic bones from modern individuals with legal documentation of age at death (death and/or birth certificates). TheSuchey-Brooks method derived from this sample is described. TheAcsádi-Nemeskéri system is evaluated in terms of the documented collection and it is seen that their five stage method focuses only on the early and late morphological changes. The intermediate stages, in which the ventral rampart is in process of completion, are not described. Their suggested age ranges do not correspond with the documented modern sample. Based on these limitations of theAcsádi-Nemeskéri method, applications of theSuchey-Brooks system are discussed.
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Research suggests that attending religious services could provide small yet important protective benefits against coronary heart disease (CHD) and CHD risk factors (e.g., diabetes, hypertension). The extent to which these benefits apply to Canada deserves study because approximately one-third of adult Canadians attend religious services at least monthly. Therefore, the objective of this study is to examine the association between frequency of religious service attendance and prevalence of (1) CHD, (2) diabetes, and (3) hypertension in Canada. We used the Saskatchewan sample (n = 5,442) of the Canadian Community Health Survey (CCHS-4.1) and built multivariable logistic regression models to evaluate associations between religious service attendance and self-reported CHD, diabetes, and hypertension. After controlling for demographic, socioeconomic and health behavior variables, the association between religious service attendance and prevalence of CHD was not significant (OR = 0.82; 95 % CI 0.61-1.11). However, persons who attended religious services more than once a week exhibited lower prevalence odds of diabetes (OR = 0.60; 95 % CI 0.45-0.80) and hypertension (OR = 0.82; 95 % CI 0.68-0.99) compared to persons who attended less than once a year. The findings of this study are the first to suggest religious service attendance may be associated with a lower prevalence of CHD risk factors in Canada.
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The Black Death of 1348-9 is thought to have killed a third to a half of the population of Europe. More exact measurements of the plague mortality are hard to come by, but the ten episcopal registers of England which survived the great pestilence provide some of the most complete and reliable information about the number of deaths on a yearly basis. Although there are qualifications to be made before using this information, the defects in the bishops' registers are not so great that the historian can afford to neglect this valuable source. In addition, there is sometimes anecdotal evidence in the registers which speaks of the human drama of the plague, in contrast to the impassive testimony of numbers.This paper will examine the evidence of the register of Thomas de Lisle, bishop of Ely from 1345 until 1361, as it relates to the Black Death. The first half of the paper will address the statistical evidence, to be followed by a discussion of the anecdotal material. De Lisle's register has not been extensively studied since J. Lunn's 1930 thesis on The Black Death in the Bishops' Registers, which is now lost. A re-evaluation of this evidence will reveal that the inhabitants of East Anglia, and of Cambridgeshire in particular, were among the greatest sufferers of the plague.
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This study examines the relationship between religiosity and the affective and immune status of 106 HIV-seropositive mildly symptomatic gay men (CDC stage B). All men completed an intake interview, a set of psychosocial questionnaires, and provided a venous blood sample. Factor analysis of 12 religiously oriented response items revealed two distinct aspects to religiosity: religious coping and religious behavior. Religious coping (e.g., placing trust in God, seeking comfort in religion) was significantly associated with lower scores on the Beck Depression Inventory, but not with specific immune markers. On the other hand, religious behavior (e.g., service attendance, prayer, spiritual discussion, reading religious literature) was significantly associated with higher T-helper-inducer cell (CD4+) counts and higher CD4+ percentages, but not with depression. Regression analyses indicated that religiosity’s associations with affective and immune status was not mediated by the subjects’ sense of self-efficacy or ability to actively cope with their health situation. The associations between religiosity and affective and immune status also appear to be independent of symptom status. Self-efficacy, however, did appear to contribute uniquely and significantly to lower depression scores. Our results show that an examination considering both subject religiosity as well as sense of self-efficacy may predict depressive symptoms in HIV-infected gay men better than an examination that considers either variable in isolation.