Frailty, Survivorship, and Stress in Medieval Poland: A Comparison of Urban and Rural Populations

Medieval Poland (tenth-thirteenth centuries CE) experienced substantial change, including increasing urbanization, which has been associated with detrimental health effects, such as higher rates of infectious disease due to population crowding. This may have led to higher rates of mortality and lower survivorship in urban compared to rural populations, as the latter were presumably buffered from those effects due to their lower population density. Skeletal samples from medieval urban and rural Polish populations provide an opportunity to investigate whether the urban inhabitants experienced lower survivorship and higher rates of pathological conditions, both of which are viewed as proxies for health, than their rural counterparts (though we note that many of the acute crowd diseases in urban areas would not have affected the skeleton). To test this hypothesis, demographic data from urban Poznan (n = 98) and from rural Giecz (n = 246) were analyzed using Kaplan-Meier survival analysis. No differences in survivorship between urban and rural inhabitants were found for the entire sample, for all adults, and for adult males and adult females. However, analysis of nonadults (<18 years), suggests that rural children had higher survivorship than urban children. These results suggest that rural versus urban dwellings did not impact the overall survivorship and risk of mortality once people reached adulthood. For nonadults, living in urban centers apparently reduced survivorship, perhaps because of increased exposure to and easier spread of infectious disease. Analysis of skeletal stress indicators revealed two distinct patterns. In the urban sample, significantly higher rates of periosteal reaction were observed compared to the rural sample, which is likely a function of the higher pathogen load in urban environments. By contrast, the rural sample had a higher prevalence of porotic hyperostosis and cribra orbitalia, which may be related to meat consumption patterns in Giecz. Collectively, the results indicate that settlement pattern does affect indicators of health, including stress markers and survivorship.