Abstract/Summary

The Black Death was a pandemic that spread through Africa, Asia, and Europe. It was caused by a zoonotic disease known as the bubonic plague. This disease is transmitted by the bacterium Yersinia pestis. In England, the Black Death was an unprecedented catastrophic event dated between the years AD 1348-1350. There are multiple debates in relation to the exact mortality of the plague. However, it was estimated to have been between 30% and 60% of the population. Although traditionally it was considered that the plague had started a period of crisis, further studies indicate that the outbreak was part of a longer period of hardship that started in the 12th century. More recent studies have tackled analysing the period leading to the Black Death. However, these studies have focused exclusively on individuals living in London. This investigation aimed to evaluate childhood health in the period leading to the Black Death and its possible influence on the outbreak within and outside London to assess whether population human health was failing before the pandemic. The study sample comprised primary and secondary data from individuals from five sites outside of London (n=1341) and five sites from the London region (n=724). Individuals were examined for multiple indicators of physiological stress (cribra orbitalia, DEH), dietary indicators (vitamin C and D deficiency, folic acid), infections related to immunosuppression (tuberculosis), and estimates of disrupted growth and development (puberty stage estimation, VNC dimensions, and long bone osteometrics). Results showed evidence of stress during the late pre-Black Death period. However, when compared to the early pre- and post-Black Death periods, few statistically significant differences were found. The London region showed a significant decline in health during the Black Death period which represented not only the catastrophic outbreak but also a decline in health in the period immediately before the pandemic. This decline was followed by an improvement in health, especially for men, which reflected an increase in access to resources and higher wages after the plague. Changes in the health of females were less clear. Comparisons between regions showed different patterns, especially between males and females. These differences show the variability existing in the extra-London region concerning how the plague developed and affected rural populations. This study highlights the importance of studying health status not only after but also before a pandemic, as well as analysing regions outside London to create a more comprehensive image of health in medieval England.