abstract
- OBJECTIVE: There is interest across many fields, government agencies, and health organizations in the health of urban dwellers in the past and present. Research on the topic often ignores variation across and within the urban-rural spectrum. To improve understanding of heterogeneity in outcomes, we examine the possible effect of childhood stressors on later life health in medieval Denmark in an array of settlements across the urban-rural spectrum. MATERIALS: We use data on age and stress markers (linear enamel hypoplasia (LEH) and cribra orbitalia (CO) from n = 755 individuals from six skeletal collections (ca. 1050-1400 CE). METHODS: We use Kaplan-Meier survival and Cox regression analyses to test differences in mortality hazards and survivorship between individuals in rural villages, middle-level towns, and developed towns, between those with and without stress markers, and whether those associations were consistent across age. RESULTS: Individuals of all ages in developed towns experienced the highest mortality hazards. LEH and CO significantly affected nonadult survivorship and mortality hazards, but not that of adults. CO was associated with survival and mortality disadvantages in rural and developed-town contexts (p < 0.0001). CONCLUSIONS: Variation in early life conditions across the urban-rural spectrum shaped health outcomes in ways obscured by strict urban-rural binaries. SIGNIFICANCE: Adopting statistical approaches that account for age-specific lesion formation processes in bioarchaeological analyses improve our understandings of the impact of urbanization on past health. LIMITATIONS: Middle-level town sample was small. SUGGESTIONS FOR FUTURE RESEARCH: Development of more highly specified models of mortality that accommodate data on lesion formation timing and healing status.