Frailty, Famine, and Plague: Crisis Mortality in Medieval London

Date of Award


Document Type

Open Access Thesis



First Advisor

Sharon DeWitte


Famine can broadly be defined as a shortage of accessible foodstuffs that instigates widespread excess mortality due to starvation, infectious disease, and social disruption. Like other causes of catastrophic mortality, famine has the potential to be selective—it can primarily target biologically- and culturally-determined population subgroups that differ in their frailty, or risk of death compared to others. This study examines famine burials from medieval London and compares them to nonfamine (attritional) burials from the same time periods. The data analyzed come from St. Mary Spital cemetery (SRP98, c. 1120-1540), particularly burials from the 12th – 16th centuries A.D. Using data previously collected by Museum of London Archaeology researchers, this study uses hazard modeling and hierarchical log linear analysis to examine the associations between age, sex, and four skeletal indicators of stress (porotic hyperostosis, cribra orbitalia, linear enamel hypoplasia, and periosteal new bone formation). The results of this project indicate that age, sex, and previous stress affected the selectivity of famine mortality in the past. However, the results also highlight the importance of considering the Osteological Paradox in bioarchaeological studies and incorporating it into our interpretations of the past. Lastly, this project encourages reflection upon the ways that famine mortality has been selective in the past and continues to be selective today.

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