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Introduction: COVID-19 has challenged governments, healthcare systems, and individuals, drawing attention to the limits of modern technology and the extent of social inequity. Such challenges have directed attention to historical epidemics as repositories of data that could contribute to effective public health strategies and prognostic modeling. In light of the well-established correlation between frailty and mortality from COVID-19, this paper investigates the relationship between frailty, inequity, and mortality in the setting of the Black Death of 1346 – 1353, in order to identify trends over time in populations at the greatest risk of mortality during pandemics.

Methods: A comparative review examining relationships between frailty and mortality during the fourteenth century Black Death and the current COVID-19 pandemic was conducted. Data related to the Black Death are derived from osteological analyses of remains from mass plague graves in the United Kingdom, and data related to COVID-19 are derived from the United States, Italy, and China. Results: Nutrition – often a consequence of socioeconomic status – plays a crucial role in pandemic mortality. During the Black Death, people with pathological indicators that can reflect undernourishment due to inadequate caloric intake were more likely to die of plague. In the COVID-19 pandemic, higher obesity rates among populations of lower socioeconomic status in the United States reveal similar relationships among nutrition, frailty, inequity, and pandemic mortality.

Conclusion: Nutrition – often a consequence of socioeconomic status – has a crucial role in risks of mortality. Our analysis underscores the importance of addressing nutrition and frailty in present and future discussions of the prevention and mitigation of pandemics.

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APA Citation

van Schaik, K., & DeWitte, S. (2020). COVID-19 and the Black Death: Nutrition, Frailty, Inequity, and Mortality. Journal of Health and Social Sciences, 5(4), 471–484.

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