Princeton/Stanford Working Papers in Classics Age and health in Roman Egypt Version 1.0 February 2010 Walter Scheidel Stanford University Abstract: Prepared for a forthcoming handbook of Roman Egypt, this paper surveys ancient and comparative evidence and modern interpretations of life expectancy, mortality patterns, and disease in ancient Egypt. © Walter Scheidel. [email protected] Age structure and life expectancy Roman Egypt is the only part of the ancient world where documentary evidence for the age composition of the general population has survived. Pertinent information is provided by extant census returns from the first three centuries of Roman rule. Gathered every fourteen years, these documents list the members of individual households with their names, familial status, and ages. Some 850 records have become known to date (Bagnall, Frier and Rutherford 1997: 57-88; Bagnall and Frier 2006: 179-325). Knowledge of the age distribution enables us to track mortality rates and infer average life expectancy, which is a critical measure of overall wellbeing. In practice, however, the raw data reveal numerous deficiencies that interfere with straightforward demographic analysis (Fig. 1). 65+ 60-64 55-59 Female 50-54 Male 45-49 40-44 35-39 30-34 Age group Age 25-29 20-24 15-19 10--14 5--9 0-4 Fig. 1 Distribution of ages recorded in census documents from Roman Egypt (n=847) Source: Bagnall and Frier 2006: 314-23, 348-50; Bagnall, Frier and Rutherford 1997: 100 In 1994, Roger Bagnall and Bruce Frier’s study of this material transformed our understanding of Roman Egyptian population history by exploiting the census data with the help of modern demographic techniques. Drawing on 710 age records available at the time, they reconstructed the age distributions of the male and female populations and estimated mean life expectancy at birth. This procedure entailed several assumptions. Because urban data are overrepresented in the record, the raw data had to be adjusted to give due weight to evidence from the countryside. Gender rather than location was considered to be the crucial variable in accounting for differences in survival rates. Moreover, owing to the relative paucity of records for small children, average life expectancy at birth could not be directly measured and had to be derived by fitting the weighted and smoothed data to modern life tables (Bagnall and Frier 1994 = 2006: 75-110). Implied life expectancy at birth was very low, in the low to mid-twenties for women and in the mid- to late twenties for men. These values resemble those documented for China in the first millennium CE, in eighteenth-century France, in nineteenth-century Spain and Russia, and in India in the late nineteenth and early twentieth centuries (Scheidel in press a). * This paper will be published in Christina Riggs (ed.), The Oxford handbook of Roman Egypt . 2 Despite their ostensible plausibility, these findings are open to a number of criticisms. One is that modern life tables, which are primarily based on fairly recent census data, may not capture the full range of the mortality experience of pre-modern populations (Scheidel 2001a: 123-42; 2001b). More specifically, they tend to overstate deaths in childhood relative to those among adults. Alternative models have been developed to address this problem (Woods 2007). This raises the question with which, if any, modern model the Egyptian census data might best be compared. Another problem concerns the nature of the data: It has been argued that records for many male villagers are too corrupted by selective underreporting to be of much demographic value (Scheidel 2001a: 156-60). A third issue is that location may be a more significant determinant of mortality than gender. Urban census data fall into a pattern that differs from standard models by showing elevated rates of attrition among young and middle-aged adults (Fig. 2). If this divergence reflects reality, it may be interpreted as evidence of urban excess mortality driven by density-dependent disease (Scheidel 2001a: 144-56). A similar pattern is visible in a data set from an unknown city, probably Lykopolis, that was not initially available to Bagnall and Frier ( P.Oxy 984A in Bagnall, Frier and Rutherford 1997). Census records for female villagers appear to be largely free from systematic distortions but remain insufficiently numerous to support firm estimates beyond a fairly wide range from 20 to more than 30 years of mean life expectancy at birth (Fig. 3; Scheidel 2001a: 160-2, 174-5). 100 Census population 90 Model West 80 Females (e0=20) Model South 70 Europe (e0=20) 60 50 40 30 20 10 0 Proportion surviving to age x (ages 15-19=100) 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75- 19 24 29 34 39 44 49 54 59 64 69 74 79 Age group Fig. 2 Smoothed age distribution of the adult urban metropolitan census population of Roman Egypt (excluding lodgers and slaves) compared to model life tables Source: Coale and Demeny 1983: 55; Scheidel 2001a: 155; Woods 2007: 379 3 14 Census population 12 Model West Females (e0=22.5) 10 Model South Europe (e0=25) 8 6 4 Proportion (in per cent) 2 0 5--9 10-- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75- 80+ 14 19 24 29 34 39 44 49 54 59 64 69 74 79 Age group Fig. 3 Smoothed age distribution of the female census population of villages in Roman Egypt compared to model life tables Source: Coale and Demeny 1983: 56; Scheidel 2001a: 161; Woods 2007: 379 Due to commemorative biases, the numerous ages recorded on tombstones and mummy labels do not provided usable information on life expectancy (Boyaval 1975, 1976). Yet even if reconstructions built on the census records are not as robust as initially surmised, they nevertheless point to very high mortality rates overall (Scheidel in press c). This notion is consistent with conditions in Egypt in the early twentieth century and may be explained with reference to environmental factors and unusually high population densities (Scheidel 2001a: 178, and see above, Chapter 9). Mortality patterns Dates of death recorded on tombstones and mummy labels help us gauge monthly variation in mortality. Most of this evidence comes from the Nile Valley south of the Delta, both in Egypt and in Nubia farther south. Greek epitaphs from the period of Roman rule as well as later Coptic records reveal a strong concentration of deaths in the spring. Months mentioned on mummy labels fall into a very similar pattern: Previously misunderstood as dates of death, they refer to the completion of mummification ten weeks later (Scheidel 1998). Adjusted accordingly, these records match the epigraphic profile (Fig. 4; Scheidel 2001a: 4-19). 4 200 Greek epitaphs (n=353) 175 Coptic epitaphs (n=585) 150 Mummy labels (n=113) 125 100 75 50 Seasonality index (mean = 100) 25 0 Ty Me Ph Ph Pa Pa Ep Me Th Ph Ha Ch Egyptian months (approximating modern western months) Fig. 4 Seasonal mortality in Upper Egypt and Nubia according to Greek and Coptic funerary inscriptions and adjusted dates on Greek mummy labels Source: Scheidel 2001a: 6, 13 By contrast, Greek epitaphs from several sites in Lower Egypt and from the coast reveal substantially different distributions. Thus, data from Terenouthis and other sites in or near the Delta region show an increase in mortality in the fall and winter but a comparatively low incidence in the spring. Data from Alexandria are scarce but do not suggest any significant seasonal concentrations (Scheidel 2001a: 19-25). Surviving death declarations also frequently list dates of death but fail to contribute reliable information (Scheidel 1999). Causes of death The observed regional variations in seasonal mortality patterns indicate regional differences in the dominant causes of death. As in pre-modern societies more generally, infectious diseases can be expected to have accounted for the majority of deaths at most ages. Different infections flourished and affected people at different times of the year. The connection between the disease environment and seasonal mortality is visible in epitaphs from the city of Rome in late antiquity. They show a surge in the death rate during the late summer and early fall, at a time when malaria, which appears to have been endemic, used to flare up and exacerbate other diseases (Scheidel in press b). In Roman Egypt, by contrast, it is more difficult to establish a clear connection between seasonality profiles and particular diseases. Nevertheless, comparative data support the notion that the pattern documented for the Nile Valley reflected actual health conditions. Travelers’ accounts from the sixteenth to the early nineteenth centuries consistently point to a concentration of fatal infections in the spring, variously reporting diarrhea, dysentery, typhus, typhoid, relapsing fever, jaundice, malaria, tuberculosis, smallpox, plague, and cholera, as well as severe conditions that cannot be properly identified (Scheidel 2001a: 110). With only few exceptions – cholera and perhaps smallpox and typhus – these diseases were already present in antiquity. Acting 5 concurrently, they would have been powerful enough to skew mortality patterns in the observed fashion. As recently as in Cairo in 1859/60, “typhoid fevers” peaked at that time of the year (Schnepp 1862: 552-3). It is also worth noting that funerary inscriptions from late Roman Palestine show a comparable spike in deaths during the spring (Patlagean 1977: 92-4). In Lower Egypt, by contrast, elevated death rates in the late fall and early winter may have been boosted by respiratory diseases precipitated by a somewhat cooler and wetter climate. If a large sample of seasonal mortality data from Terenouthis in Lower Egypt is disaggregated according to age, we find that the elderly were particularly vulnerable during the winter months, in much the same way as they were in the late antique city of Rome (Scheidel 2001a: 29; in press b).