Selectivity of Black Death with Respect to Preexisting Health Presentation

Outcomes

• Black Death no longer thought to be an unselective, unbiased, virulent scourge
• Additional studies were completed on The Black Death such as femur length and, sex (Male vs. Female) to determine the depth of selectivity

Opinions

• There is a correlation with likelihood of death and skeletal lesions
• If the Black Death was completely unbiased, the -2LLR values would be zero, showing no increased risk
• The specific cause of Black Death was not specified either in this study, thought to be Yersinia pestis
• It was lacking historical data on what the Black Death was
• They overgeneralized the term frailty

References Cited

• Sharon N. EDeWitte., Wood, W James

2008 Selectivity of Black Death Mortality with Respect to Preexisting Health. Proceedings of the National Academy of Sciences 105(5): 1436-1441.

• Gottfried, Robert S.

2010 The Black Death: Natural and Human Disaster in Medieval Europe. Simon and Schuster Inc., New York.

Purpose

• "The Purpose here was to test whether the Black Death killed people indiscriminately - i.e., regardless of frailty as indicated by the presence of skeletal lesions - or whether Black Death mortality behaved like normal,epidemic mortality in which individuals with the highest frailty were at highest risk of death" (DeWitte and Wood 2008: 1436)

Methods

• A multistate model was used
• Involved using 3 states:

Presence of Lesions, No Lesions and Death

• Used to show distribution of ages and lesion status
• Model is applied separately to the control and sample sites

Selectivity of Black Death with Respect to Preexisting Health

Results

• Data shows that having skeletal lesions during the black death era causes for a decrease in likelihood of mortality
• Graphs show that having skeletal lesions in non-epidemic Denmark had increased likelihood of mortality
• East Smithfield risk of curve greatly resembles regular mortality

Denmark

Methods

• Paleodemography- age at death
• Age determination using dental eruption and epiphyseal union
• Rostock protocol.
• Dating using hand positions of skeletons

Results

East Smithfield

• When comparing likelihood mortality ratio (-2LLR) there is a significant difference between Denmark and East Smithfield
• The proportionality risk of death (K2) is higher in Denmark in comparison to East Smithfield.
• With the exception of Maxilliary Canine LEH and Femur length, data shows more of lower likelihood of mortality as a result of Lesions in East Smithfield

In Conclusion: The Black Death was slightly selective in mortality when compared to prexisting health conditions

Introduction

• Time period - mid 14th Century
• Location- Europe
• East Smithfield - London (established 1348-1349)
• 490 skeletal samples
• St. Albani (Odense) and St. Mikkel Church (Viborg) - Denmark (1100-1500's)
• 291 skeletal samples

Background

• Natural Hazard
• Epidemics
• 30-50% mortality in Europe
• Three Strain
• Septicaemic
• Pneumonic
• Bubonic
• Origins from China by land and sea trade networks
• Spread as a result of poor sanitation

Arguments

• If Black Death killed indiscriminately the people with poor health to begin with should not have been at a higher risk of dying when Black Death hit

Conclusions

By: DeWitte, Sharon N. & James W. Wood

• The Black Death was as slightly selective in mortality, as there is less of a risk of death with skeletal lesions present in East Smithfield

Biases

Presentation By: Brenna Ardiel, Cole Reed and Nerusha Suthaskaran

Discussion and Biases

• Selectivity during the Black Death suggests that those with preexisting diseases increase their risk of death compared to the large population
• However the risk was very minimal
• The study of paleodemography and paleoepidemiology are biased with the death population because the dead can not represent the living population
• This is indicative of one population not all of Europe
• Bias within the Usher model