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1. Calculus and survivorship in medieval London: The association between dental disease and a demographic measure of general health

   https://doi.org/10.1002/ajpa.23772  

   Yaussy, Samantha L. ; DeWitte, Sharon N. ( January 2019 , American Journal of Physical Anthropology)

   Dental plaque is associated with a variety of systemic diseases and mortality risks in living populations. However, bioarchaeologists have not fully investigated the mortality risks associated with plaque (or its mineralized form, calculus) in the past. This study examines the relationship between survivorship and calculus in a medieval skeletal sample.

   Our sample (n = 1,098) from four medieval London cemeteries,c. 1000–1540 CE, includes people who died under attritional (normal) and catastrophic (famine and plague) conditions. The associations between age and the presence of dental calculus on the permanent left first mandibular molar are assessed using binary logistic regression and Kaplan–Meier survival analysis.

   The regression results indicate a significant negative relationship between age and calculus presence for individuals of all ages who died under normal mortality conditions and for adults who died under both normal and catastrophic conditions. Survival analysis reveals decreased survivorship for people of all ages with calculus under normal mortality conditions. Similarly, during conditions of catastrophic mortality, adult males with calculus suffered reduced survivorship compared to males without it, though there was no difference in survivorship between adult females with and without calculus.

   These results suggest that, as in modern populations, calculus accumulation in the inhabitants of medieval London reflects a greater risk of premature death. The evaluation of calculus, a potential measure of underlying frailty, in the context of a demographic measure of general health suggests that it might provide insights into health in past populations.

    

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2. Survivorship and the second epidemiological transition in industrial‐era London

   https://doi.org/10.1002/ajpa.24797  

   Yaussy, Samantha L. ; DeWitte, Sharon N. ; Hughes‐Morey, Gail ( June 2023 , American Journal of Biological Anthropology)

   The second epidemiological transition describes a shift in predominant causes of death from infectious to degenerative (non‐communicable) diseases associated with the demographic transition from high to low levels of mortality and fertility. In England, the epidemiological transition followed the Industrial Revolution, but there is little reliable historical data on cause of death beforehand. Because of the association between the demographic and epidemiological transitions, skeletal data can potentially be used to examine demographic trends as a proxy for the latter. This study uses skeletal data to examine differences in survivorship in London, England in the decades preceding and following initial industrialization and the second epidemiological transition.

   We use data (fromn = 924 adults) from London cemeteries (New Churchyard, New Bunhill Fields, St. Bride's Lower Churchyard, and St. Bride's Church Fleet Street) in use prior to and during industrialization (c.1569–1853 CE). We assess associations between estimated adult age at death and time period (pre‐industrial vs. industrial) using Kaplan–Meier survival analysis.

   We find evidence of significantly lower adult survivorship prior to industrialization (c.1569–1669 and 1670–1739 CE) compared to the industrial period (c.1740–1853 CE) (p < 0.001).

   Our results are consistent with historical evidence that, in London, survivorship was improving in the later 18th century, prior to the recognized beginning of the second epidemiological transition. These findings support the use of skeletal demographic data to examine the context of the second epidemiological transition in past populations.

    

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3. The intersections of industrialization: Variation in skeletal indicators of frailty by age, sex, and socioeconomic status in 18th‐ and 19th‐century England

   https://doi.org/10.1002/ajpa.23881  

   Yaussy, Samantha L. ( June 2019 , American Journal of Physical Anthropology)

   Intersectionality theory argues that various categories of identity and forms of systemic oppression interact and produce inequalities in resource access, economic opportunities, and health outcomes. However, there has been little explicit engagement with this theory by bioarchaeologists examining disparate health outcomes in the past. This study examines the associations among frailty, age at death, sex, and socioeconomic status (SES) in 18th‐ and 19th‐century England.

   The sample for this study comes from four industrial‐era cemeteries from England, ca. 1711–1857. The associations among adult age (18+ years), SES, sex, and three skeletal indicators of stress (dental enamel hypoplasia [DEH,n= 293], cribra orbitalia [CO,n= 457], periosteal lesions [PNB,n= 436]) are examined using hierarchical log‐linear analysis.

   Significant interactions existed among the variables examined for two skeletal indicators: high SES females had lower frequencies of CO relative to other groups and males between ages 30–45 years exhibited higher frequencies of PNB compared to females or males of older or younger ages, regardless of SES. Additionally, sex and SES were consistently associated with age at death.

   These results suggest that patterns of stress indicators cannot be examined solely across unilateral axes of age, SES, or sex. Intersecting axes of privilege, marginalization, and structural oppression may have buffered high SES females from some negative health outcomes (CO) while predisposing them to others (risk of maternal mortality). Likewise, the hazardous working conditions relegated to adult males may have heightened the risk of injury, infection, and death for middle‐aged men in industrial‐era England.

    

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4. Assessment of nutritional stress in famine burials using stable isotope analysis

   https://doi.org/10.1002/ajpa.24054  

   Walter, Brittany S. ; DeWitte, Sharon N. ; Dupras, Tosha ; Beaumont, Julia ( April 2020 , American Journal of Physical Anthropology)

   We compared δ¹⁵N and δ¹³C values from bone and dentine collagen profiles of individuals interred in famine‐related and attritional burials to evaluate whether individuals in medieval London who experienced nutritional stress exhibit enriched nitrogen in bone and tooth tissue. Dentine profiles were evaluated to identify patterns that may be indicative of famine during childhood and were compared with the age of enamel hypoplasia (EH) formation to assess whether isotopic patterns of undernutrition coincide with the timing of physiological stress.

   δ¹⁵N and δ¹³C isotope ratios of bone collagen were obtained from individuals (n= 128) interred in attritional and famine burials from a medieval London cemetery (c. 1120–1539). Temporal sequences of δ¹⁵N and δ¹³C isotope profiles for incrementally forming dentine collagen were obtained from a subset of these individuals (n= 21).

   Results indicate that individuals from attritional graves exhibit significantly higher δ¹⁵N values but no significant differences were found between burial types for the sexes. Analyses of dentine profiles reveal that a lower proportion of famine burials exhibit stable dentine profiles and that several exhibit a pattern of opposing covariance between δ¹⁵N and δ¹³C. EH were also observed to have formed during or after the opposing covariance pattern for some individuals.

   The results of this study may reflect differences in diet between burial types rather than nutritional stress. Though nutritional stress could not be definitively identified using bone and dentine collagen, the results from dentine analysis support previous observations of biochemical patterns associated with nutritional stress during childhood.

    

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5. Using craniofacial fluctuating asymmetry to examine the effects of sex, socioeconomic status, and early life experiences on adult age at death in industrial England

   https://doi.org/10.1002/ajpa.24907  

   Yaussy, Samantha L. ( February 2024 , American Journal of Biological Anthropology)

   Historical evidence from 18th‐ and 19th‐century England suggests that industrialization's impacts on health were largely negative, especially among marginalized groups. However, available documentary evidence is often biased toward adult men and rarely sheds light on the experiences of other members of the population, such as women and children. Craniofacial fluctuating asymmetry (FA) can serve as a proxy measurement of developmental instability and stress during development. This study examines the associations among age, sex, socioeconomic status (SES), and FA in skeletal samples from industrial‐era England.

   The sample for this study comes from four industrial‐era cemeteries from England (A.D. 1711–1857). Geometric morphometric analyses of three‐dimensional landmark coordinate data were used to generate a measure of FA for each individual (Mahalanobis distance). A three‐way ANOVA was used to evaluate the impacts of sex, SES, and FA scores on adult age at death (n = 168).

   Significant associations existed between age at death and SES (p = 0.004) and FA scores (p = 0.094). Comparisons of the estimated means indicated that age at death was consistently higher among high SES individuals and individuals with FA scores less than one standard deviation from the mean.

   This study supports findings from previous studies that have suggested that the differences in resource access and environmental buffering generated by socioeconomic inequality can impact longevity and patterns of mortality among socioeconomic status groups. Likewise, stress in early life—evinced by craniofacial fluctuating asymmetry—can influence observed patterns of longevity in adults decades later.

    

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