The greatest health problem of the Middle Ages? Estimating the burden of disease in medieval England.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101562474 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-9825 (Electronic) Linking ISSN: 18799817 NLM ISO Abbreviation: Int J Paleopathol Subsets: MEDLINE
    • Publication Information:
      Publication: : Amsterdam : Elsevier
      Original Publication: [New York, NY] : Elsevier
    • Subject Terms:
      Disabled Persons* ; Plague*/epidemiology; Child ; Cost of Illness ; England/epidemiology ; Humans ; Infant ; Middle Aged ; Quality-Adjusted Life Years
    • Abstract:
      Objective: To identify the major health problems of the Middle Ages. Bubonic plague is often considered the greatest health disaster in medieval history, but this has never been systematically investigated.
      Materials: We triangulate upon the problem using (i) modern WHO data on disease in the modern developing world, (ii) historical evidence for England such as post-medieval Bills of Mortality, and (iii) prevalences derived from original and published palaeopathological studies.
      Methods: Systematic analysis of the consequences of these health conditions using Disability Adjusted Life Years (DALYs) according to the Global Burden of Disease methodology.
      Results: Infant and child death due to varied causes had the greatest impact upon population and health, followed by a range of chronic/infectious diseases, with tuberculosis probably being the next most significant one.
      Conclusions: Among medieval health problems, we estimate that plague was probably 7th-10th in overall importance. Although lethal and disruptive, it struck only periodically and had less cumulative long-term human consequences than chronically endemic conditions (e.g. bacterial and viral infections causing infant and child death, tuberculosis, and other pathogens).
      Significance: In contrast to modern health regimes, medieval health was above all an ecological struggle against a diverse host of infectious pathogens; social inequality was probably also an important contributing factor.
      Limitations: Methodological assumptions and use of proxy data mean that only approximate modelling of prevalences is possible.
      Suggestions for Further Research: Progress in understanding medieval health really depends upon understanding ancient infectious disease through further development of biomolecular methods.
      (Copyright © 2021 Elsevier Inc. All rights reserved.)
    • Grant Information:
      200368/Z/15/Z United Kingdom WT_ Wellcome Trust; 2000368/Z/15/Z United Kingdom WT_ Wellcome Trust
    • Contributed Indexing:
      Keywords: DALYs; Global Burden of Disease; Infant death; Infectious disease; Medieval health; Plague; Tuberculosis
    • Publication Date:
      Date Created: 20210708 Date Completed: 20211025 Latest Revision: 20220907
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.ijpp.2021.06.011
    • Accession Number:
      34237609