Men and women in the Middle Ages suffered from the same diseases and risked death | Science

Women in modern society live about five years longer than men. Even in extreme conditions, girls cope better than boys. The so-called gender survival paradox ends when statistics show that women tend to get sick more than men, but they have a longer life expectancy. Although the paradox is not resolved, science is beginning to point to genetics and biology. It wasn’t always like this. A study of the bones of hundreds of people who lived in medieval London has been published in a scientific journal. Achievements of scienceshows that in those times, also harsh, with famine and several plagues, both women and men had the same risk of morbidity and mortality. The authors of this work find only one possible explanation: in a patriarchal society, cultural factors that favored men in London society took precedence over biology.

In the bones and teeth there remained a trace of the illnesses and deprivations through which this body went, including mental ones. A study published several years ago showed how it permanently constricted the brains of those children who had the misfortune of passing through the orphanages of the Romanian regime of dictator Ceausescu. The malnutrition, neglect and abuse suffered by exploited children during the Industrial Revolution can also be detected by the grooves that open up on teeth during poor enamel formation (hypoplasia). Marks on the skull tell stories of cancer operations that occurred thousands of years ago, or of the first wars, of injuries to bones caused by arrows or spears. But interpreting these bone scars is not always easy. Wear and tear on the head of limb bones can be a sign of fragility. However, osteoporosis is a condition that usually appears later in life, so it may also indicate greater resilience.

Based on this complexity, a team of bioarchaeologists analyzed the remains of 1,658 people buried in London cemeteries between the 11th and 15th centuries. They looked for the presence of up to ten biomarkers, ranging from hypoplasia to abnormal length of the femur, through the formation of new bone tissue (an indicator of traumatic injury, but also its healing) or the presence of cavities. As Sharon DeWitt, an anthropologist at the University of Colorado Boulder (USA) and co-author of this study, recalls, tooth decay is associated with general health: “They may reflect an inadequate immune response and are associated with malnutrition; dental caries can also be a contributing factor to poor health; for example, causing a systemic inflammatory response that can have negative consequences, and the tooth decay infection can spread from the mouth to other parts of the body.”

Based on the results of these biomarkers, they formed indices of fragility and stability, seeing which side the bones fell on depending on whether they belonged to a woman or a man. In the conclusions of their work we read: “Our comparison of frailty and resilience rates between men and women does not reveal significant differences… These data suggest that the paradox of morbidity and mortality between men and women observed in various modern populations may not have existed in the medieval period. London.

Although this work does not detail the results for specific biomarkers, using indices that combine them, DeWitt links what they found (in previous work) to the specific case of differential impact of plague. “Our main finding was that men were at significantly lower mortality risk compared to women after the Black Death (14th to 16th centuries) under normal mortality conditions and during famines,” he details in an email. “This suggests that the female survival advantage (due to large body fat reserves and the protective effects of estrogen) that was observed during later famines did not exist in the medieval period,” he adds. The reason, although they cannot articulate it definitively, must have been social: “Perhaps because cultural practices that benefited men in a society that valued them more outweighed any inherent biological advantages to women.”

The first author of the study, a researcher at James Madison University (USA), Samantha Yaussi, gives another example – the length of the femur. “Short femur length is often associated with resource constraints during growth and development, such as food shortages or poor living conditions,” he says. When they looked at differences in the femur between men and women, they saw that “femur length was more variable and contributed more to weakness in women compared to men.” All of the bones studied were from adults, suggesting that “the most fragile men, those with short femurs, died in childhood, resulting in less variation in femur length among the surviving cohort of adult men analyzed in our study. with women.” – Jaussi concludes.

According to the authors of the paper, their results would demonstrate that the higher life expectancy of women observed today is a relatively recent phenomenon, likely due to less cultural marginalization today. “Long-term female survival (i.e., the morbidity-mortality paradox) did not emerge until recently,” says Jaussi. For most of history, she adds, “women have been culturally marginalized, which has impacted their survival.”

This would result in societies such as medieval London, through some cultural artefact, “minimizing or negating any biological advantage they possessed, resulting in a woman’s risk of death being about the same as and the risk of death of a man,” he develops the researcher. However, there is another possibility that Jaussi does not rule out: the most fragile men died in childhood, and the adult sample is biased in favor of survivors with lower levels of fragility and higher levels of resilience.