Statistics Predicted a Healthier Medieval London Following the Black Death



By Samantha Wallace


The Black Death, a pandemic at its height in Europe during the mid-14th century, was a virulent killer. It was so effective that it wiped out approximately one third of Europe’s population. Recent studies have shown that the elderly and the sick were most susceptible. But was the Black Death a “smart” killer?

A recent PLOS ONE study indicates that the Black Death’s virulence might have affected genetic variation in the surviving human population by reducing frailty, resulting in less virulent subsequent outbreaks of the plague. By examining the differences in survival rates and mortality risks in both pre-Black Death and post-Black Death samples of a London population—in combination with other, extrinsic factors, like differences in diet between the two groups—the researcher found that in London, on average, people lived longer following the plague than they did before it, despite repeated plague outbreaks. In other words, in terms of genetic variation, the Black Death positively affected the health of the surviving population.

To uncover differences in the health of medieval Londoners, Dr. Sharon DeWitte of the University of South Carolina examined 464 pre-Black Death individuals from three cemeteries and 133 post-Black Death individuals from one. She chose a diverse range of samples for a comprehensive view of the population, including both the rich and the poor, and women and children, but targeted one geographic location: London.

The ages-at-death of the samples were determined by calculating best estimates—in statistics these are called point estimates—based on particular indicators of age found on the skeletons’ hip and skull bones. Individuals’ ages were then evaluated against those in the Anthropological Database of Odense University, a pre-existing database comprising the Smithsonian’s Terry Collection and prior age-at-death data from 17th-century Danish parish records.

After estimating how old these individuals were when they died and comparing the age indicators against the Odense reference tool, the author conducted statistical analyses on the data to examine what the ages-at-death could tell us about the proportion of pre- and post- Black Death medieval Londoners who lived to a ripe old age, as well as the likelihood of death.

Survivorship was estimated using the Kaplan-Meier Estimator, a function used to indicate a quantity based on known data; in this case the function evaluated how long people lived in a given time period (pre-Black Death or post-Black Death). The calculated differences were significant: In particular, the proportion of adults who lived beyond the age of 50 from the post-Black Death group was much greater than those from the pre-Black Death group.


Age-at-death Distributions

In the pre-Black Death group, death was most likely to occur between the ages of 10 and 19, as seen above.

The Kaplan-Meier survival plot shows how the chances of survival, which decrease with age, differ for Pre-Black Death and Post-Black Death groups, as seen below.


Survival Functions

As the survival plot indicates, post-Black Death Londoners lived longer than there Pre-Black Death predecessors.

Finally, Dr. DeWitte estimated the risk of mortality by applying the age data to the statistical model known as the Gompertz hazard, which shows the typical pattern of increased risk in mortality with age. She found that overall post-Black Death Londoners faced lower risks of mortality than their pre-Black Death counterparts.

To make long and complicated methodology short, these analyses indicate that post-Black Death Londoners appear to have lived longer than pre-Black Death Londoners. The author estimates that the general population of London enjoyed a period of about 200 years of improved survivorship, based on these results.

The virulent killer, the Black Death, may have helped select for a healthier London by influencing genetic variation, at least in the short term. However, to better understand the improved quality of life of post-Black Death London, the author suggests further study to disentangle two major factors: the selectivity of the Black Death, coupled with improvements in lifestyle for post-Black Death individuals. For example, the massive depopulation in Europe resulted in increased wages for workers and improvements to diet following the plague, which also likely improved health for medieval Londoners. By unraveling intrinsic, biological changes in genetic variation from outside extrinsic factors like improvements in diet, it may be possible to better understand the aftermath of one of the most devastating killers in infectious disease history.