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Deposited in DRO: 02 July 2018 Version of attached le: Accepted Version Peer-review status of attached le: Peer-reviewed Citation for published item: Redfern, Rebecca and DeWitte, Sharon and Montgomery, Janet and Gowland, Rebecca (2018) 'A novel investigation into migrant and local health-statuses in the past : a case study from Roman Britain.', Bioarchaeology international., 2 (1). pp. 20-43. Further information on publisher's website: https://doi.org/10.5744/bi.2018.1014
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A novel investigation into migrant and local health-statuses in the past: a case study from Roman Britain
Journal: Bioarchaeology International ManuscriptFor ID bai-2017-0016.R2 Review Only Manuscript Type: Research Article
Date Submitted by the Author: n/a
Complete List of Authors: Redfern, Rebecca; Museum of London, Centre for Human Bioarchaeology DeWitte, Sharon; University of South Carolina, Anthropology Montgomery, Janet; Durham University, Archaeology Gowland, Rebecca; Durham University, Archaeology
Keywords: Migration, Stable isotope, Disease
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1 2 3 Title: A novel investigation into migrant and local health statuses in the past: a case study 4 5 from Roman Britain 6 7 8 Key words: mobility, cultural change, disease 9 10 1* 2 3 3 11 Authors: Rebecca Redfern , Sharon DeWitte , Janet Montgomery , Rebecca Gowland 12 13 1 14 Centre for Human Bioarchaeology, Museum of London, London, United Kingdom 15 16 2 17 Department of Anthropology, University of South Carolina, Columbia, South Carolina, 18 19 United States of AmericaFor Review Only 20 21 3 22 Department of Archaeology, Durham University, Durham, United Kingdom 23 24 25 * Corresponding author 26 27 28 E mail: [email protected] (RR) 29 30 31 Tel: (+44) 20 7814 5649 32 33 34 35 36 37 38 39 40 41 42 43 44 45
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1 2 3 Abstract 4 5 6 Migration continues to be a central theme in archaeology, and bioarchaeology has made 7 8 significant contributions towards understanding the disease and demographic consequences 9 10 of migration in different periods and places. These studies have been enhanced by stable 11 12 isotope studies of mobility and diet, which have revealed further complexities. 13 14 15 This study integrates osteological, palaeopathological and stable isotope evidence to 16 17 investigate the interrelationship between migrant and local population disease frequencies in 18 19 For Review Only 20 Roman Britain. Previous analyses have identified migrants from across the Roman Empire, 21 22 along with increases in the prevalence rates of infectious and metabolic diseases, poor dental 23 24 health and non specific indicators of stress. This study aims to explore the extent to which 25 26 migrants and people born in Britain differed in terms of mortality risk and the frequencies of 27 28 disease variables. Osteological and dental data from 151 individuals excavated from 24 29 30 Romano British cemetery sites with mobility isotope data were statistically analysed. The 31 32 results reveal significant differences between migrant and local populations for periosteal 33 34 35 new bone formation, rib lesions, residual rickets, and dental health variables. When data were 36 37 pooled for both sexes, a statistically significant difference in mortality between the two 38 39 groups was also observed. 40 41 42 Overall, the results of this study suggest that migrants transformed patterns of disease 43 44 in the Romano British period, and combined with the changes to settlement patterns and 45 46 environment, created new disease risks for both groups. The results also show that many of 47 48 the key bioarchaeological indicators of change following the Roman conquest may actually 49 50 51 reveal more about disease and health experienced in the wider Empire. 52 53 54 55 56 57 58 2 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 3 of 67 Bioarchaeology International
1 2 3 4 5 6 Migration remains a prominent theme in archaeology, and human skeletal remains have 7 8 proven fundamental to such studies (Baker and Tsuda 2015:3; Burmeister 2000; Hakenbeck 9 10 2008; Murphy and Klaus 2017). Clinical and epidemiological studies have shown that the 11 12 interaction between migrant and local (also known as host) populations can result in profound 13 14 and sometimes devastating impacts in terms of disease frequency (Ahonen et al. 2007; 15 16 17 Bhopal 2014; Mascie Taylor and Krzyżanowska 2017). Recent advances in biomolecular 18 19 techniques have revolutionisedFor ourReview understanding of Onlymigration in the past (Baker and Tsuda 20 21 2015: 4 5; van Dommelen 2014) (e.g. Stantis et al. 2015). Stable isotope data from teeth have 22 23 provided important information concerning childhood origin, as well as dietary staples, which 24 25 may point to an ‘exotic’ provenance (Eckardt 2010). This study integrates the osteological, 26 27 palaeopathological and stable isotope evidence to examine the differences in disease and 28 29 30 mortality risk between incomers and the local population during the Roman occupation of 31 32 Britain in AD 43 410. 33 34 35 The Roman conquest of Britain resulted in a distinct and transformative shift in the 36 37 archaeological record, including new settlement patterns, material culture and funerary rites 38 39 (Mattingly 2006). Migration in Roman military and urban populations has been explored 40 41 extensively using mobility isotope studies by a number of authors (e.g., Eckardt 2010; 42 43 Eckardt et al. 2014), resulting in a substantial published dataset (see also, Martiniano et al. 44 45 2016). Bioarchaeological studies have observed disease differences between pre Roman (late 46 47 48 Iron Age) and Roman populations, and also between urban and rural communities (Bonsall 49 50 2013; Redfern and DeWitte 2011a; Redfern et al. 2015; Rohnbogner 2015). Regional and 51 52 national datasets have established that mortality risk increases for males and subadults, with 53 54 increases in the frequency of infectious and metabolic diseases, dental disease and indicators 55 56 of stress post Conquest (Redfern and DeWitte 2011b; Redfern et al. 2012). 57 58 3 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 4 of 67
1 2 3 Using Roman Britain as a case study, our research builds on these studies by 4 5 investigating the extent to which these patterns of disease (see Temple and Goodman 2014) 6 7 and mortality risks were created and shaped by people who had travelled within the region or 8 9 country where they died, and those who came to Britain from abroad. It also examines 10 11 whether the clinical trend for differences in health patterns, particularly disease frequencies 12 13 14 and mortality rates between migrant and non migrant (or host) populations can be established 15 16 in an archaeologically derived sample of human remains. 17 18 19 For Review Only 20 21 22 Materials and Methods 23 24 25 Osteological data 26 27 28 The sample comprised a total of 24 cemetery sites from Dorset, Hampshire, Yorkshire, and 29 30 the Greater London area (Figure 1) for which isotope values had been published, and a 31 32 human bone report or archived data were accessible (Tables 1 and 2); the dataset used in the 33 34 study is published as a Supplementary Table 1). These sites were predominantly urban and/or 35 36 military in nature, as many sites, such as York and Gloucester were urban settlements 37 38 established by the military, who also had a permanent base there (see Wacher 2016). The 39 40 41 archaeological and stable isotope evidence revealed that these settlements had been inhabited 42 43 by both migrants and people whose childhoods were spent in Britain. Ancestry evidence for 44 45 the Roman period, gleaned from ancient DNA and forensic methods, suggests that, in some 46 47 instances, British born people had non White European heritage (Leach et al. 2009; Redfern 48 49 et al. 2016, 2017). Only a portion of each of the cemetery sites had been sampled for stable 50 51 isotope ratios (e.g. Chenery et al. 2011). 52 53 54 55 56 57 58 4 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 5 of 67 Bioarchaeology International
1 2 3 Demographic analyses of these cemeteries revealed a male bias, which is often the 4 5 case in Roman cemeteries, particularly those with a military connection (Pearce 2011), and 6 7 this has influenced the sex ratio of the overall sample (Table 3). A total of 151 individuals 8 9 were included, ranging in age from infancy to older adult. Eighty one were adult male (≥15 10 11 years old), 47 adult female, 3 adults of unknown sex, and 20 subadults aged between 10 12 13 14 months and 15 years old (Table 3, see also Supplementary Table 1). The decision to lower 15 16 the subadult/adult threshold to 15 years old was undertaken because in a Roman life course 17 18 perspective, this was the age when girls and some boys were recognised as being socially 19 For Review Only 20 adult (Harlow and Laurence 2002: 54 78). 21 22 23 Using previously published isotope data, an inventory of context numbers was created 24 25 and cross referenced to the human bone reports. The majority of skeletons had been analysed 26 27 after the introduction of recording standards (Brickley and McKinley 2004; Buikstra and 28 29 30 Ubelaker 1994) meaning that, for the most part, the same methods to determine sex, estimate 31 32 age at death and identify diseases had been used. However, we recognise that inter observer 33 34 error in observations and differences in recording methods presents an inescapable bias (see, 35 36 Roberts and Cox 2003: 26 30). For the older reports, individuals were included only when the 37 38 methods used to record the human remains were described and considered to be adequate. 39 40 Additionally, the osteological recording had to be sufficiently detailed to establish the 41 42 43 presence/absence of bones in order to accurately calculate prevalence rates. Bone 44 45 completeness and preservation varied greatly between cemetery sites due to a variety of 46 47 taphonomic factors, including differences in soil types across Britain (UK Soil Observatory 48 49 2016). 50 51 52 A re evaluation of diagnoses of pathological lesions was undertaken for each 53 54 individual based on the descriptions of the bone and dental lesions present in the reports. This 55 56 was deemed necessary because of recent developments in the diagnostic criteria relating to a 57 58 5 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 6 of 67
1 2 3 range of metabolic and infectious diseases. The selected conditions (Table 4) were only 4 5 recorded if the requisite bones or teeth necessary for a diagnosis were present, and were 6 7 scored as present (1) or absent (0). If the requisite bones or teeth were not present or 8 9 unobservable due to taphonomic damage this was scored as a (9); for example, rickets and 10 11 osteomalacia were scored as (9) if long bones were absent due to post mortem taphonomic 12 13 14 damage or truncation, as these bones are critical to making a diagnosis (Brickley and Ives 15 16 2008: 97 100, 109 111) (See Supplementary Table 1). Each individual had been previously 17 18 assessed for age and sex, and for age at death a mid point value was produced from the age 19 For Review Only 20 range provided in order to facilitate statistical analyses (See Supplementary Table 1); for 21 22 those individuals with open ended age estimates of >45 or >60, the values 50.5 and 60, 23 24 respectively, were used. 25 26 27 28 29 30 Stable and radiogenic isotope evidence for mobility 31 32 33 The study’s dataset had been published from 1998 onwards, with lead, oxygen and strontium 34 35 isotopes from dental enamel used to explore mobility (Richards and Montgomery 2012). 36 37 38 These isotope systems represent different environmental parameters to which an individual 39 40 was exposed, and specifically in the Roman period, anthropogenic pollutants (lead), thus 41 42 providing information about childhood residential origins (Evans et al. 2012; Montgomery 43 44 2002). By comparing data from an individual with the values prevailing in the burial 45 46 location, it is possible to reliably assert that the person had migrated to that locale before 47 48 death (Montgomery 2010). 49 50 51 As the field of stable isotope analysis has witnessed rapid development since the 52 53 54 1990s, it was imperative that the published values were scrutinised and re evaluated to 55 56 establish a person’s origin. The isotope values were interrogated by the third author who then 57 58 6 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 7 of 67 Bioarchaeology International
1 2 3 assigned the individual to one of three groups: regional local (values consistent with the 4 5 region where the person was buried), British (excludes regional locals, values consistent with 6 7 the British Isles), and non British (values not consistent with the British Isles) (Table 2; see 8 9 also Supplementary Table 1). Individuals were assigned local status if both their strontium 10 11 and oxygen isotope ratios were consistent with origins in the biosphere overlying the geology 12 13 14 of the cemetery according to the strontium isotope tables in Evans et al. (2012) and with the 15 16 2sd oxygen isotope range of humans from either western (Winchester, Gloucester and 17 18 Poundbury Camp) or eastern (London and Yorkshire) England. If one of these isotope ratios 19 For Review Only 20 precluded local origins but did not preclude origins in Britain these individuals were deemed 21 22 to be consistent with origins in Britain. If either the strontium or oxygen isotope ratio fell 23 24 outside the ranges for Britain, or the individual had previously been convincingly identified 25 26 27 as of non British origin based on published isotope evidence for exposure to non British lead 28 29 (Montgomery et al. 2010; Shaw et al. 2016), or carbon isotope evidence for the consumption 30 31 of a C4 diet (Müldner et al. 2011; Eckardt et al. 2015), the individual was deemed to be of 32 33 non British origin. This method may return false positives, i.e. some individuals may be 34 35 assigned local status when they were not, but should not produce false negatives, i.e. it was 36 37 highly unlikely that individuals were incorrectly assigned non local status. For some 38 39 40 individuals (see Table 2), their borderline/undiagnostic values meant that it was not 41 42 absolutely clear cut which group individuals belonged to, and these were identified as 43 44 ‘possible’ locals (regional or British) or ‘possible’ non British. 45 46 47 48 49 50 Statistical analyses 51 52 53 Differences between the three groups (regional local, British, and non British) with respect to 54 55 the frequencies of a range of disease variables (cribra orbitalia, porotic hyperostosis, 56 57 58 7 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 8 of 67
1 2 3 periosteal new bone formation, rib lesions, enamel hypopolastic defects, periodontal disease, 4 5 dental caries, and calculus) were assessed using Chi square analyses. The second author ran 6 7 the statistical analyses excluding the ‘possible’ isotope groupings for cribra orbitalia, porotic 8 9 hyperostosis, periosteal new bone formation and rib lesions. These results were found to be 10 11 similar to those obtained by including ‘possible’ individuals. Therefore, these individuals 12 13 14 were included where appropriate in the three groupings for all statistical analyses (e.g. all 15 16 those scored as “possibly not British” were included in the “not British” group). Residual 17 18 rickets and tuberculosis were both rarely observed pathologies; thus, we used Fisher's exact 19 For Review Only 20 tests to assess differences in the presence of these diseases. Chi square tests were also used to 21 22 assess differences in the sex distributions between the three groups. These statistical tests are 23 24 appropriate given that we are assessing the associations among and between categorical 25 26 27 variables (most of which are binary, i.e. the sex and disease variables). 28 29 30 Differences in survival among the three groups were assessed using Kaplan Meier 31 32 survival analysis with a log rank test and using pooled data on age from all three groups. 33 34 Analysis was performed using SPSS version 23. Kaplan Meier analyses were performed 35 36 separately for samples including: individuals of all ages; adults only (≥15 years old); female 37 38 adults; and male adults. 39 40 41 The differences in risks of mortality between all paired combinations of groups 42 43 (regional local vs. British; regional local vs. non British; British vs. non British) were 44 45 assessed by pooling the adult (≥15 years old) data to estimate the Gompertz hazard of adult 46 47 48 mortality and by modeling group as a covariate affecting the baseline Gompertz hazard. The 49 50 Gompertz hazard is a two parameter, parsimonious model of adult mortality: h(a) = αeβa . For 51 52 each paired combination of groups, all individuals in one group were assigned a covariate 53 54 55 score of 0, and all members of the other group were assigned a score of 1, and the group 56 57 58 8 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 9 of 67 Bioarchaeology International
1 2 3 covariate was modeled using a proportional hazards specification. Table 6 specifies which 4 5 group, from each pair, was assigned the covariate value of 1 for analysis. For example, to 6 7 evaluate differences in mortality between regional locals and non British people, the regional 8 9 locals were coded as “0” and the non British individuals were coded as “1”; in this case, a 10 11 positive estimate for the parameter representing the effect of the covariate would suggest 12 13 14 non British people were at an increased risk of death compared to regional locals, while a 15 16 negative estimate would suggest that non British people were at a decreased risk of death. 17 18 Hazards models such as this can be applied to relatively small samples, as they smooth 19 For Review Only 20 random variation in mortality data (Gage 1988). Parameters were estimated using maximum 21 22 likelihood analysis with the program mle (Holman 2005). The fit of the full model with the 23 24 regional group covariate compared to a reduced model in which the value of the parameter 25 26 27 representing the regional covariate is set equal to 0 was assessed using a likelihood ratio test 28 29 (LRT). The LRT tests the null hypothesis that the regional group was not associated with 30 31 elevated nor decreased risks of death. The LRT was computed as follows: LRT = 32 2 33 2[ln(Lreduced) – ln(Lfull)], where LRT approximates a χ distribution with df=1. Similarly to the 34 35 survival analyses described above, the hazards model was applied separately to samples 36 37 including: all adults; adult females, and adult males. 38 39 40 Though we are wary of relying too heavily on p-values to evaluate our findings, given 41 42 43 the problems associated with conventional null hypothesis significance testing (see for 44 45 example, Lang et al. 1998; Rothman 1998; Goodman 1999; Cohen 2011; Trafimow and 46 47 Marks 2015) and our relatively small sample sizes, we do consider p values equal to or less 48 49 than 0.05 to suggest a significant difference and values of 0.1 or less to indicate a trend 50 51 worthy of discussion and potential future study. 52 53 54 55 56 57 58 9 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 10 of 67
1 2 3 Results 4 5 6 The results of the survival and hazards analyses are provided in Tables 5 and 6. Kaplan 7 8 Meier survival analyses (Table 5) using a sample that includes subadults (<15 years old) does 9 10 not reveal significant differences among the three groups. However, using a sample that 11 12 includes just the adults (males, females, and adults of "indeterminate" sex ≥15 years old), 13 14 reveals a difference in survivorship between those from Britain and people who had migrated 15 16 17 to it (P=0.088). The estimated mean survival age is lowest for the non British people, though 18 19 there is considerable For overlap inReview the 95% confidence Only intervals for all groups. When adult 20 21 males and females are assessed separately, the results are not statistically significant. Mean 22 23 survival age for males is similar across all three groups. For females, regional locals had the 24 25 highest mean survival age, and non Britons had the lowest; however, the 95% confidence 26 27 intervals for all groups overlap considerably. 28 29 30 For the comparison of regional local vs. non British using a pooled sex sample 31 32 (regional local = 0, non British = 1), the positive value of the group covariate indicates higher 33 34 35 risks of mortality for non British people compared to the regional locals (P=0.03). A similar 36 37 pattern was observed when analyses were restricted to females (P= 0.06), but no differences 38 39 in mortality among the groups were found for males (Table 6). No significant differences in 40 41 any of the samples were observed between regional locals and British, or between British and 42 43 non British people for disease variables and indicators of stress. Overall, these results suggest 44 45 that, at least among females, non British people fared relatively poorly with respect to risk of 46 47 48 mortality compared to regional locals (Table 6). We note that the small sample sizes might be 49 50 influencing these analyses to an unknown degree. 51 52 53 Statistically significant differences in disease variables among the regional locals, 54 55 British, or non British people were observed for periosteal new bone formation, rib lesions, 56 57 58 10 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 11 of 67 Bioarchaeology International
1 2 3 and residual rickets (frequencies are shown in Tables 7 and 8, and the results of statistical 4 5 analyses are shown in Table 9). For each of these variables, regional locals have the lowest 6 7 frequencies of palaeopathology. For residual rickets, regional and British individuals have 8 9 similarly low frequencies. However, for periosteal new bone formation and rib lesions, the 10 11 British are similar to non Britons in having relatively high frequencies compared to regional 12 13 14 locals. No significant differences in tuberculosis frequencies are observed, though we note 15 16 that very few people in general had signs of this disease in their skeleton (Table 7 and 8). 17 18 However, it is interesting to note that non British people were more likely to show evidence 19 For Review Only 20 for tuberculosis (Table 8). 21 22 23 Substantial differences among the regional groups are also observed for dental health 24 25 pathologies (periodontal disease, carious lesions, and dental calculus) (Table 10). In general, 26 27 Britons had the highest frequencies of all dental health pathologies. Periodontal disease 28 29 30 frequencies were lowest among non Britons, but for both carious lesions and dental calculus, 31 32 regional locals and non Britons had similar relatively low frequencies (compared to British 33 34 locals). 35 36 37 As expected, the sex distributions varied across the three groups (Tables 3 and 9, P= 38 39 0.075). The non British sample contains the highest proportion of females and the British 40 41 sample has the lowest. As shown in Table 9, the difference in sex distribution between the 42 43 British and non British samples is statistically significant (P = 0.03). 44 45 46 47 48 49 Discussion 50 51 52 The most important finding of this analysis is that the disparity between late Iron Age 53 54 and Romano British patterns of disease, particularly for periosteal new bone formation, rib 55 56 57 58 11 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 12 of 67
1 2 3 lesions and residual rickets appears to be primarily driven by migrants from elsewhere in the 4 5 Empire. This explanation has been one of several alternatives posited within the literature 6 7 (amongst others, Redfern and DeWitte 2011a; Roberts and Cox 2003), and our research has 8 9 demonstrated that this hypothesis should come to the fore in future interpretations. This result 10 11 has implications for how living environments (e.g. urban centres) and the consequences of 12 13 14 Roman colonisation are interpreted and understood (Gowland and Redfern 2010), and 15 16 prompts us to re evaluate the conclusion that Roman colonisation saw a general increase in 17 18 disease. The result is not a cause and effect outcome of conquest and colonisation; instead, 19 For Review Only 20 these data reflect greater variation in disease states in correlation with the increasingly 21 22 diverse population composition. This is not to say that the urban centres did not negatively 23 24 impact their inhabitants, but rather that these centres altered disease patterns bi directionally 25 26 27 between different communities. The results indicate a mixture of time spent in Britain and 28 29 elsewhere in the Empire, with the negative long term consequences of people's childhood 30 31 environments being 'seen' in Britain, because this is where these migrants died. 32 33 34 Each new community and settlement created by migrants from within and outside of 35 36 Britain, as well as local indigenous people, would have created heterogeneous disease 37 38 environments, because each person would have had a unique migration experience and 39 40 individual history of disease. The ability for an individual to create changes at the population 41 42 43 level is frequently seen in migrant health studies; for example, it only takes one person 44 45 carrying an infectious disease for many thousands to become infected (Ahonen et al. 2007; 46 47 Mascie Taylor and Krzyżanowska 2017; Odone et al. 2015). Such a situation may explain 48 49 why patterns of disease in Roman Britain have been found to substantially differ between 50 51 settlement types, but also between those supposedly of the ‘same’ type, such as urban 52 53 settlements (Bonsall 2013; Rohnbogner and Lewis 2016; Redfern et al. 2015). 54 55 56 57 58 12 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 13 of 67 Bioarchaeology International
1 2 3 Differences in disease frequencies between people whose childhoods were spent in 4 5 Britain versus those who grew up elsewhere may be evidenced by variations in the frequency 6 7 of non specific indicators of stress (e.g., enamel hypoplastic defects ) (Goodman and Martin 8 9 2002). Our finding that non British migrants had the highest rates of enamel hypoplastic 10 11 defects (though not statistically significant in our analyses), is notable as this is one of the 12 13 14 most frequently observed differences between pre and post Conquest populations (e.g. Peck 15 16 2009; Redfern 2007; Roberts and Cox 2003). It is problematic to interpret this disease 17 18 variable as evidence of the detrimental impact of new settlement types and increased 19 For Review Only 20 childhood adversity in Britain (Redfern 2007; Redfern and DeWitte 2011a; Redfern et al. 21 22 2012, 2015; Redfern and Roberts 2005; Rohnbogner 2015). Instead, as Gowland and 23 24 Redfern (2010; Redfern and Gowland 2011) proposed, enamel hypoplastic defects record 25 26 27 childhood insults to health experienced elsewhere in the Empire, compounded by different 28 29 living environments and childcare practices, the negative impacts of which are seen in the 30 31 high frequencies of enamel hypoplastic defects reported from other locales in the Empire, 32 33 especially Italy (amongst others, Caldarini et al. 2006; Henneberg and Henneberg 2005; 34 35 Paine et al. 2009; Gowland and Garnsey 2010). Crucially, these findings underline the point 36 37 that the Roman Empire encompassed great diversity in terms of economic development, 38 39 40 compounded by stark environmental and sociocultural differences between the Mediterranean 41 42 heartland, which had large established urban settlements for many hundreds of years 43 44 compared to the peripheral territories (Garnsey and Saller 1987; Laurence and Berry 1998; 45 46 Mattingly 2010; Nevett and Perkins 2000; Woolf 1998). 47 48 49 The higher frequency of periosteal new bone formation in migrants compared to 50 51 regional local and British individuals may reflect a response to being confronted with new 52 53 environmental conditions. The transformation of Britain’s wider and local living 54 55 environments, food ways and population under Roman rule may also explain why a high 56 57 58 13 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 14 of 67
1 2 3 frequency of periosteal new bone formation was observed in British locals. For example, the 4 5 increase in rib lesions hints at a higher prevalence of specific infectious disease, exposure to 6 7 pollution through work, and greater indoor pollution, probably exacerbated by a decreased 8 9 local air quality due to people living in larger communities than ever before (Roberts et al. 10 11 1994, 1998; Roberts and Lewis 2002). 12 13 14 Each disease variable studied provides its own perspective on migrant health and the 15 16 17 impact on the indigenous population through the creation of these new communities and 18 19 living environments. ForOne of the Review key changes post conquest Only is the decline in dental health for 20 21 both sexes and all age groups (Redfern 2007; Roberts and Cox 2003). The marked increase 22 23 in carious lesions and dental calculus follows a post Conquest shift in dietary patterns from 24 25 the over whelming terrestrial and low sugar food ways of the late Iron Age communities, 26 27 which display little intra or inter community variation, to the post Conquest diet with 28 29 30 increased levels of marine resources, more sugar (e.g. dried fruits, with honey frequently used 31 32 as a sweetener) and greater variation between age, sex and status groups, as well as between 33 34 settlement types (e.g. rural urban diets Cool 2006) (Bonsall 2014; King 1999a, 1999b, 2001; 35 36 Locker 2007; Peck 2009; Redfern et al. 2012; van der Veen et al. 2008). 37 38 39 Another interesting finding is the relationship between migrant status and residual 40 41 rickets. This metabolic disease is caused by a deficiency of vitamin D, usually sustained 42 43 because of a lack of exposure to sunlight (Brickley and Ives 2008; Brickley et al. 2010: 78 44 45 81). Research has demonstrated that being vitamin D deficient increases the likelihood of 46 47 48 developing poor general health, as it negatively impacts on a person’s immune system 49 50 (Brickley et al. 2014; Snoddy et al. 2016). The clinical literature has also associated high 51 52 lead exposure with the development of rickets in children (Caffey 1938; Gordon and 53 54 Whitehead 1949), and this period saw an increase in the use of lead (e.g. water pipes and 55 56 especially the consumption of bio available lead compounds), a trend evidenced by a rise in 57 58 14 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 15 of 67 Bioarchaeology International
1 2 3 lead levels in human remains (Aufderheide et al. 1992; Budd et al. 2004; Lessler 1983; 4 5 Montgomery et al. 2010; Nriuagu 1983; Retief 2005; Scarborough 1984). 6 7 8 The limb and spinal deformities caused by vitamin D deficiency were known to the 9 10 Romans, being described in two medical texts (e.g. Soranus 1991: Book II) (Rajakumar 11 12 2003). Ancient historians have proposed that even sun rich cities such as Rome were prime 13 14 centres for the conditions which create rickets, because of dietary insufficiencies produced by 15 16 17 the population’s over reliance on cereals and cultural practices such as sun avoidance and 18 19 clothing (Gowland andFor Redfern Review2010; Minozzi et al. 2012;Only Molto 2000; Soliman El Banna et 20 21 al. 2014). 22 23 24 Prior to this study, the presence of rickets in Roman Britain was understood to be 25 26 another indicator of significant post Conquest change, and the rare cases of this disease 27 28 suggest that cultural buffering may have influenced this result (Gowland and Redfern 2010; 29 30 Redfern and DeWitte 2011a, 2011b; Redfern and Gowland 2011; Roberts and Cox 2003; 31 32 Rohnbogner 2015). However, our results suggest that the increase in prevalence of rickets 33 34 35 reflects childhoods spent elsewhere in the Empire. For example, the burial of a 14 year old 36 37 girl from Roman London whose isotope results were consistent with a childhood spent in the 38 39 southern Mediterranean, and who had lived in London for at least four years before her death 40 41 (Arthur et al. 2016; Redfern et al. 2016), exhibited mild bowing deformities consistent with 42 43 rickets in younger childhood (Brickley and Ives 2008: 97 100; Brickley et al. 2010; Redfern 44 45 et al. 2017). 46 47 48 There is a marked increase in the number of individuals with tuberculosis from the 49 50 51 late Iron Age (Redfern and DeWitte 2011a; Roberts and Cox 2003: 120), but there was no 52 53 statistical difference between the groups for tuberculosis, although non British people 54 55 showed a greater prevalence of the disease along with rib lesions (Kelley and Micozzi 1984; 56 57 58 15 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 16 of 67
1 2 3 Mariotti et al. 2015; Roberts et al. 1994; Santos and Roberts 2001). There are many reported 4 5 cases of tuberculosis from across the Roman Empire, including Rome (amongst others, Canci 6 7 et al. 2006; Hajdu et al. 2012; Hlavenková et al. 2015; Rubini et al. 2014). The Empire 8 9 produced and enabled multiple causes and pathways of infection: urban settlements, many of 10 11 which had poor sanitation, with homes densely packed together; long and short distance 12 13 14 population movement (e.g. trade), including the forced or free migration of vulnerable people 15 16 (e.g. migrants and the enslaved) to new environments, many of which were experiencing 17 18 socio economic stress (i.e. structural violence); and congenital infection due to maternal 19 For Review Only 20 infection during pregnancy (Eddy 2015; Farmer 2004a, 2004b; Mittal et al. 2014). 21 22 23 One of the more surprising findings of our study was that female migrants had a 24 25 higher mortality risk, despite having the biological advantage of an enhanced immune system 26 27 (Gubbels Bupp 2015; Jaillon et al. 2017). Earlier work in Dorset, demonstrated that it was 28 29 30 adult males rather than females who had a higher mortality risk (Redfern and DeWitte 31 32 2011b), but this work was unable to distinguish between migrants and locals, as only a few 33 34 individuals in the region had been analysed for mobility (Richards et al. 1998). We suggest 35 36 that our new result provides a more nuanced insight into intra sex differences in health, 37 38 because only female migrants show a higher prevalence of pathologies. There is increasing 39 40 evidence for female mobility in the Roman Empire, as part of the military community, as 41 42 43 slaves, or due to family circumstances, occupations, and economic activities (e.g. merchants) 44 45 (Allason Jones 2005; Allison 2006; Becker 2006; Greene 2012, 2013; Hemelrijk 2015; 46 47 Kleijwegt 2012; Saller 1998). Within Roman society, females were seen as 'less' than males 48 49 and their social, economic and political freedoms were curtailed, resulted in embedded 50 51 structural inequalities (Redfern forthcoming). For many females (free or enslaved) their lives 52 53 were tied to the domestic sphere (Allason Jones 2005; Dixon 2001; Evans Grubb 2002; 54 55 Hemelrijk 2015; Saller 1998), which increased the likelihood of developing diseases 56 57 58 16 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 17 of 67 Bioarchaeology International
1 2 3 associated with pollution (i.e. rib lesions), because of living and working in homes with poor 4 5 ventilation (Roberts and Lewis 2002). Such a life style could also limit their access to 6 7 sunlight, thus increasing their risk of developing vitamin D deficiency (Brickley and Ives 8 9 2008: 77 82; Brickley et al. 2014), particularly in Britain where during the autumn and winter 10 11 months, the sunlight is not strong enough for the body to metabolise the necessary quantities 12 13 14 of vitamin D to ensure good health (Diffey 2013). This would have been a greater risk for 15 16 those individuals from the Mediterranean and the near East with darker skin pigmentation 17 18 (Chandler 2001; Eckardt et al. 2014; Leach et al. 2009). Isotopic data from across the Empire 19 For Review Only 20 have established that in many locales, including Britain, female diets were less diverse and 21 22 more cereal based than adult males (Powell et al. 2014) (see also, Prowse et al. 2004, 2005). 23 24 Such a diet would additionally increase the risk of females developing an iron deficiency, 25 26 27 because of the iron inhibiting chelates found in cereals (Stuart Macadam and Kent 1992: 83, 28 29 137). 30 31 32 Unfortunately, due to the small sample size and because the majority of these 33 34 samples have not been precisely dated (either stratigraphically or using radiocarbon), we are 35 36 unable to test whether there are temporal changes throughout the Roman period in Britain. 37 38 The predominance of cremation burial during the earlier period of Roman occupation also 39 40 creates a bias towards skeletal samples dating to later Roman Britain. Nor were we able to 41 42 43 investigate detailed differences in health between rural and urban settlements due to a current 44 45 dearth in isotopically tested samples from rural sites. It is likely that this situation will 46 47 improve in the near future with an increasing research focus on Roman rural settlements 48 49 (Smith et al. 2016). 50 51 52 53 54 55 Conclusions 56 57 58 17 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 18 of 67
1 2 3 This analysis is the first bioarchaeological study to unite osteological and isotope data to 4 5 investigate how migrant and local population influenced each other’s patterns of disease. For 6 7 Roman Britain, the changes in disease frequencies traditionally used as evidence for the 8 9 transformation in living environment and culture instead relate to childhoods and lives spent 10 11 outside of the province. Childhoods across the Empire were often compromised by disease, 12 13 14 and in some instances by childcare practices. 15 16 17 Although urban centres must have played an important role in changing patterns of 18 19 disease in Roman Britain,For it was Review the composition of theOnly people living within these and other 20 21 settlements across Britain which really produced a transformation in the bioarchaeological 22 23 record. The unique, heterogeneous life ways of migrants, fundamentally altered disease 24 25 transmission and frequencies, changed mortality rates and in conjunction with the 26 27 introduction of new food and life ways, transformed disease patterns from the late Iron Age. 28 29 30 The development of new settlements, inhabited by internal migrants and those from overseas, 31 32 created new environments which posed health challenges for all, despite many growing up in 33 34 some of the most urbanised places in Europe. Therefore, many of the key indicators of 35 36 changing disease frequencies associated with the Roman conquest and colonisation of Britain 37 38 actually reveal more about the increased heterogeneity of communities in Britain. 39 40 41 42 43 44 45 46 47 Acknowledgements 48 49 50 RR is most grateful to Sally Brooks (MoL), Greg Speed (Northern Archaeological 51 52 Associates), Malin Holst and Anwen Caffell (York Osteoarchaeology Ltd), Louise Loe, 53 54 Sharon Clough, Ceri Boston, Angela Boyle and Nicholas Márquez Grant (current and former 55 56 57 58 18 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 19 of 67 Bioarchaeology International
1 2 3 staff at Oxford Archaeology), and Simon Mays (Historic England) for all their help in 4 5 sourcing many of the site reports and osteological data used in this study; Heather Bonney 6 7 (NHM) for providing access to the Poundbury Camp and Trentholme Drive populations, 8 9 Verity Anthony (Bath and North East Somerset County Council) for sharing the information 10 11 from Bath, Emma Jayne Graham (Open University) for her advice about the swaddling of 12 13 14 infants, and the MoL donors who supported much of the work undertaken on the London 15 16 material. Finally, we are very grateful for the constructive comments provided by anonymous 17 18 reviewers. 19 For Review Only 20 21 22 23 24 25 26 References cited 27 28 Ahonen, E. Q., F. G. Benavides and J. Benach. 2007. Immigrant populations, work and 29 health a systematic literature review. Scand J Work Environ Health 33 (2):96 104. 30 DOI: 10.5271/sjweh.1112. 31 32 Allason Jones, Lindsay. 2005. Women in Roman Britain. 2nd Edition ed. Council for British 33 Archaeology, York. 34 35 Allison, Penelope M. 2006. Mapping for gender. Interpreting artefact distribution inside 1st 36 37 and 2nd century A.D. forts in Roman Germany. Archaeological Dialogues 13 (1):1 38 20. DOI: https://doi.org/10.1017/S1380203806211851. 39 40 Arthur, Nichola A., Rebecca Gowland and Rebecca C. Redfern. 2016. Coming of age in 41 Roman Britain: osteological evidence for pubertal timing. American Journal of 42 Physical Anthropology 159:698 713. DOI: 10.1002/ajpa.22929. 43 44 Aufderheide, A., G. Rapp Jr, L.E. Wittmers Jr, J.E. Wallgren, R. Macchiarelli, G. Fornaciari, 45 F. Mallengi and R.S. Corruccini. 1992. Lead exposure in Italy: 800BC 700AD. 46 International Journal of Anthropology 7 (2):9 15. DOI: 10.1007/BF02444992. 47 48 Baker, Brenda J., and Takeyuki Tsuda. 2015. Introduction: Bridging the past and present in 49 50 assessing migration. In Migration and disruption. Toward a unifying theory of 51 ancient and contemporary migrations, edited by Brenda J. Baker and Takeyuki 52 Tsuda. University of Florida Press, Florida. pp. 3 14. 53 54 Barber, Bruno, and David Bowsher, eds. 2000. The eastern cemetery of Roman London. 55 Excavations 1983-1990. MoLAS Monograph 4. Museum of London, London. 56 57 58 19 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 20 of 67
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1 2 3 4 Redfern, Rebecca C. and Rebecca L. Gowland. 2011. A bioarchaeological perspective on the 5 pre adult stages of the life course: implications for the care and health of children in 6 the Roman Empire. In Families in the Roman and Late Antique Roman World, edited 7 by Mary L. Harlow and Lena L. Lovén. Continuum International Publishing Group, 8 London. pp. 111 140. 9 10 Redfern, Rebecca C., Darren R. Gröcke, Andrew R. Millard, Victoria Ridgeway, Lucie 11 Johnson and Joseph T. Hefner. 2016. Going south of the river: a multidisciplinary 12 13 analysis of ancestry, mobility and diet in a population from Roman Southwark, 14 London. Journal of Archaeological Science 74:11 22. DOI: 15 https://doi.org/10.1016/j.jas.2016.07.016. 16 17 Redfern, Rebecca C., Christine Hamlin and Andrew Millard. 2012. A regional investigation 18 of subadult dietary patterns and health in late Iron Age and Roman Dorset, England. 19 Journal For of ArchaeologicalReview ScienceOnly 39:1249 1259. DOI: 20 https://doi.org/10.1016/j.jas.2011.12.023. 21 22 Redfern, Rebecca C., Michael Marshall, Katherine Eaton and Hendrik Poinar. 2017. 'Written 23 in Bone': new discoveries about the lives of Roman Londoners Britannia 48: 253 277. 24
25 26 Redfern, Rebecca C. and Charlotte A. Roberts. 2005. Health in Romano British urban 27 communities: reflections from the cemeteries. In Fertile ground: papers in honour of 28 Susan Limbrey, edited by David N. Smith, Megan B Brickley and Wendy Smith. 29 Oxbow Books, Oxford. pp. 115 129. 30 31 Retief, F.P. 2005. Lead poisoning in ancient Rome. Acta Theologica Suppplementum 7:147 32 164. 33 34 Richards, Michael P, Robert E M Hedges, Theya I Molleson and Joseph C Vogel. 1998. 35 Stable isotope analysis reveals variations in human diet at the Poundbury Camp 36 Cemetery site. Journal of Archaeological Science 25:1247 1252. DOI: 37 https://doi.org/10.1006/jasc.1998.0307. 38
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1 2 3 Roberts, Charlotte A., and Margaret Cox. 2003. Health and disease in Britain: from 4 prehistory to the present day. Sutton Publishing Ltd, Stroud. 5 6 Roberts, Charlotte A., and Mary E. Lewis. 2002. Ecology and infectious disease in Britain 7 from prehistory to the present: the case of respiratory infection. In Ecological aspects 8 of past human settlements in Europe, edited by P. Bennike, E. Bodzsar and C. 9 Susanne. Eotvos University Press, Budapest. pp. 179 192. 10 11 Roberts, Charlotte A., David Lucy and Keith Manchester. 1994. Inflammatory lesions of ribs: 12 13 an analysis of the Terry Collection. American Journal of Physical Anthropology 14 95:169 182. DOI: 10.1002/ajpa.1330950205. 15 16 Rohnbogner, Anna. 2015. Exploring concepts of Romanisation and its impact on child health 17 in late Roman Britain. Ph.D. thesis, University of Reading. Reading. 18 19 Rohnbogner, Anna, andFor Mary Lewis.Review 2016. Dental cariesOnly as a measure of diet, health, and 20 difference in non adults from urban and rural Roman Britain. Dental Anthropology 21 29(1): 16 31. 22 23 Rothman, K.J. 1999. Writing for epidemiology. Epidemiology 9: 333 337. 24
25 26 Rubini, M., P. Zaio and C. Roberts. 2014. Tuberculosis and leprosy in Italy: new skeletal 27 evidence. Homo 65 (1):13 32. DOI: 10.1016/j.jchb.2013.07.006. 28 29 Saller, Richard P. 1998. Symbols of gender and status hierarchies in the Roman household. In 30 Women and slaves in Greco-Roman culture: differential equations, edited by Sandra 31 R. Joshel and Sheila Murnaghan. Routledge, London. pp. 85 91. 32 33 Sandgren, A., M.S., Schepisis, G. Sotgiu, E. Huitric, G.B. Migliori, D. Manissero, M.J. van 34 der Werf and E. Girardi. 2014. Tuberculosis transmission between foreign and 35 native born populations in the EU/EEA: a systematic review. The European 36 Respiratory Journal 43 (4): 1159 1171. DOI: 10.1183/09031936.00117213. 37 38 Santos, Ana Luísa, and Charlotte A Roberts. 2001. A picture of tuberculosis in young 39 40 Portuguese people in the early 20th century: a multidisciplinary study of the skeletal 41 and historical evidence. American Journal of Physical Anthropology 115:38 49. DOI: 42 10.1183/09031936.00117213. 43 44 Scarborough, J. 1984. The myth of lead poisoning among the Romans: an essay review. 45 Journal of the History of Medicine and Allied Sciences 39 (4):469 475. 46 47 Shaw, Heidi, Janet Montgomery, Rebecca Redfern, Rebecca Gowland and Jane Evans. 2016. 48 Identifying migrants in Roman London using lead and strontium stable isotopes. 49 Journal of Archaeological Science 66:57 68. DOI: 50 https://doi.org/10.1016/j.jas.2015.12.001. 51
52 53 Simmonds, Andrew, Nicholas Marquéz Grant and Louise Loe. 2008. Life and death in a 54 Roman city: excavations of a Roman cemetery with a mass grave at 120-122 London 55 Road, Gloucester. Oxford: Oxford Archaeology Monograph No 6. 56 57 58 28 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 29 of 67 Bioarchaeology International
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12 13 Soranus. 1991. Gynecology. edited by Owsei Temkin. The Johns Hopkins Press, Baltimore. 14 15 Stantis, C., R.L. Kinaston, M.P. Richards, J.M. Davidson and H.R. Buckley. 2015. Assessing 16 human diet and movement in the Tongan maritime chiefdom using isotopic analyses. 17 PLoS One 10 (3):e 0123156. DOI:10.1371/journal.pone.0123156. 18 19 Stuart Macadam, Patricia,For and Review Susan Kent, eds. 1992.Only Diet, demography and disease. 20 Changing perspectives on anemia. Aldine de Gruyter, New York. 21 22 Temple, Daniel H. and Alan H. Goodman. 2014. Bioarchaeology has a ‘health’ problem: 23 conceptualizing ‘stress’ and ‘health’ in bioarchaeological research. American Journal 24 of Physical Anthropology 155: 186 191. 25 26 27 Trafimow, David and Michael Marks. 2015. Editorial. Basic and Applied Social Psychology 28 37: 1 2. 29 30 UK Soil Observatory. 2016. Soils of England and Wales. 31 http://www.ukso.org/SoilsofEnglandandWales/home.html. Accessed 31st October 32 2016. 33 34 van der Veen, M., A. Livarda and A. Hill. 2008. New plant foods in Roman Britain: dispersal 35 and social access. Environmental Archaeology 13 (1):11 36. DOI: 36 http://dx.doi.org/10.1179/174963108X279193. 37 38 van Dommelen, P. 2014. Moving on: archaeological perspectives on mobility and migration. 39 40 World Archaeology 46 (4):477 483. DOI: 10.1080/00438243.2014.933359. 41 42 Wacher, John. 2016. The towns of Roman Britain. Abingdon: Routledge. 43 44 Walker, Philip, Rhonda R Bathhurst, Rebecca Richman, Thor Gjerdrum and Valerie A 45 Andrushko. 2009. The causes of porotic hyperostosis and cribra orbitalia: a 46 reappraisal of the iron deficiency anemia hypothesis. American Journal of Physical 47 Anthropology 139: 109 125. DOI: 10.1002/ajpa.21031. 48 49 Weston, Darlene. 2008. Investigating the specificity of periosteal reactions in pathology 50 museum specimens. American Journal of Physical Anthropology 137:48 59. DOI: 51 10.1002/ajpa.20839. 52 53 54 2012. Non specific infection in palaeopathology: interpreting periosteal reactions. In 55 Companion to Paleopathology, edited by Anne L Grauer. Wiley Blackwell, New 56 York. pp. 492 512. 57 58 29 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 30 of 67
1 2 3 4 Woolf, Greg. 1998. Becoming Roman: the origins of provincial civilization in Gaul. 5 Cambridge University Press, Cambridge. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 For Review Only 20 21 22 23 24 25 Figure captions 26 27 28 Figure 1. Map showing the location of the towns selected for analysis in Roman Britain. 29 Each site report listed in Table 1 has a detailed location map. Drawn by J. Davis from a base 30 map made available at http://www.d maps.com/carte.php?num_car=5585&lang=en 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 30 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Reference Reference Leach (2009) al. et Leach Leach et al. (2009); Montgomery (2011) al. et Montgomery (2009); al. et Leach Leach (2009) al. et Leach Chenery et al. (2011) al. et Chenery Chenery et al. (2011) al. et Chenery Chenery et al. (2011) al. et Chenery
Shaw et al. (2016) (2016) al. et Shaw Bell, pers comm; Montgomery (2010) al. et Montgomery pers comm; Bell, Redfern et et (2016) al. Redfern Shaw et al. (2016) (2016) al. et Shaw Shaw et al. (2016) (2016) al. et Shaw Shaw et al. (2016) (2016) al. et Shaw Shaw et al. (2016) (2016) al. et Shaw Shaw et al. (2016) (2016) al. et Shaw Shaw et al. (2016) (2016) al. et Shaw Shaw et al. (2016) (2016) al. et Shaw Shaw et al. (2016) (2016) al. et Shaw Shaw et al. (2016) (2016) al. et Shaw
Eckardt et et (2015) al. Eckardt
Booth et al. (2010); Eckardt et al. (2009) (2009) Eckardt al. et (2010); al. et Booth
Simmonds et al. (2008) (2008) al. Simmonds et
Richards et al. (1998) (1998) al. et Richards
4 4 9 9 2 2 2 2 1 1 5 5 4 4 1 1 2 2 1 1 1 1 2 2 1 1 3 3 2 2 3 3 18 18 20 20 19 19 10 10 40 40 13 13 Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only 6 Driffield Terrace, York Terrace, Driffield 6 Trentholme Drive, York Drive, Trentholme 3 Driffield Terrace, York Terrace, Driffield 3 Honeypot Road, Catterick Catterick Road, Honeypot Dere Street, Catterick Street, Catterick Dere
St Bartholomew's Hospital Hospital St Bartholomew's Spitalfields Market Market Spitalfields Lant Street Lant Hooper Street Hooper Harper Road Harper Great Dover Street Dover Great Cotts House Cotts House Broadgate Broadgate 60 London Wall 60 London 65-73 Mansell Street Mansell 65-73 49-55 Mansell Street Mansell 49-55 1-4 Giltspur Street Street Giltspur 1-4
Poundbury Camp, Dorchester Camp, Poundbury
Yorkshire Yorkshire Catterick Farm, Bainesse
London London
Lancashire Lancashire Scorton Banks, Hollow
Hampshire Hampshire Winchester
Gloucestershire Gloucestershire Gloucester Road, London Dorset Dorset
City/ County County City/ name Site size Sample
Table 1. List of sites used in the study study used sites in the of 1. List Table Page 31 of 67 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Page 32 of 67 British (1 (1 British to local = or region 2 Britain, non-= British) 1 1 1 2 2 1 1 1 2 2 1 1 1 1 1 1 1 2 2 1 2 2 1 1 1 1 2 2 2 1 1 1 1 Regional Regional = (1 local to local 2 region, British = and non- local) 3.5 3.5 2 2 Local status status Local no = data, (9 regional = 1 = 1.5 local, possible regional = 2 local, = 3 British, inconsistent with Britain, = 3.5 possible inconsistent with Britain)
Male Male 1 Male Male 2 Male Male 2 Male Male 1 Male Male 2 Male Male Male 2 1 Female Female 1 Female Female Female 2 1 Female Female 2 Female Female 1 Female Female 3.5 2 2 Female Female 3.5 2 2
235 235 862 862 1103 1103 1127 1127 1131 1131 1181 1216 1238 1238 1328 1328 1364 1364 1518 1539 1539 1541 1544 1255 1255 Subadult number number Sex Context (or grave) (or grave) Context Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only
County County andcity/town modern name Site Gloucestershire Gloucester Road, London
Dorset Dorset Dorchester Camp, Poundbury
1) in Table listed sources from (data location, by individual and site data organised isotope Stable 2. Table 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 2 2 2 1 1 2 1 1 1 1 1 1 1 1 1 1 1 2 2 1 2 1 2 2 2 1 1 1 1 1 1 2 2 1 2 2 2 2 1 2 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Male Male 1 Male Male 1 Male Male 3 Male Male Male 1 2 Male Male Male Male 2 2 2 Male Male Male 2 2 Male Male Male Male 1 2 1 Male Male 1 Female Female 1 Female Female 1 Female Female Female Female 1 2 1 Female Female Female 1 2 Female Female Female 1 1 Female Female 3 Female Female Female 1 3 Female Female 1 Female 1 Female Female 1.5 1 1 Subadult Subadult 1 Subadult Subadult 1 Subadult Subadult 1
12 12 84 84 118 118 119 119 212 212 271 281 281 435 489 566 661 683 683 776 806 812 812 861 862 874 926 926 932 932 1553 1553 1026 1026 1084 Subadult 1 1091 1091 1094 1114 1119 1119 1133 1134 1197 Subadult 1 1207 1207 1227 1244 1271 1277 Subadult 1 Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only
Winchester Winchester
Hampshire Hampshire
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1 1 1 1 1 1 2 2 2 2 2 1 2 2 1 2 2 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 1 1 1 2 2 1 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 2 2 2 1 1 1 1 1 1
3 3 3 3
Male Male 1 Male Male 9 Male Male 2 Male Male 1 Male Male Male Male 1 1 Male 1 2 Male Male 1 Male Male 1 Male Male 1 Female Female 1 Female Female 2 Female Female Female 1 1 Female Female 1 Female Female 1 Female Female 2 Female Female 1 Female Female 1 Female Female 3 Subadult Subadult 3 Subadult Subadult 1
37 37 27 27 13 13 30 30 518 518 163 163 709 709 390 390 724 400 400 652 652 311 311 599 599 150 150 325 1407 1407 1673 1289 1289 1517 1697 1761 1870 1894 Subadult Subadult 1 1 695.5 695.5 803.6 803.6 535 (grave 6) (grave 535 Male 3 523 (grave 2) (grave 523 Male 3 600 (grave 7) (grave 600 Male 3 529 (grave 5) (grave 529 Unknown 502 (grave 1) (grave 502 Unknown 541 (grave 10) (grave 541 Unknown 511 (grave 13) (grave 511 Male 11) (grave 565 1 Female 3 594 (grave 12) (grave 594 Male 1 Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only 49-55 Mansell Street Mansell 49-55 60 London Wall 60 London
Street Mansell 65-73 Broadgate Great Dover Street Dover Great Street Dover Great Cotts House Cotts House Harper Road Harper Street Hooper
Street Lant 1-4 Giltspur Street Street Giltspur 1-4
Hollow Banks, Scorton Banks, Hollow
London London
Lancashire Lancashire 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
2 2 1 2 2 2 1 1 1 1 1 1 2 2 2 1 1 1 2 2 2 1 1 1 2 2 1 2 2 1 2 2 2 2 2 1 2 2 1 1 1 1 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 2 2 1 2 2 2 1 1 1 2 2 2 1 1 1
Male Male 9 Male Male 3.5 2 2 Male Male 3.5 2 2 Male Male 9 Male Male 2 Male Male 9 Male Male 9 Male Male 3.5 2 2 Male Male Male 2 2 Male Male 1 Male Male 1 Male Male 1 Male Male 1 Male Male 1 Male Male 3 Female Female 2 Female Female 3 Female Female 1 Female Female 1 Female Female Female 3.5 3 2 2 Female Female 9 Female Female 3.5 2 2 Female Female 1 Female Female Female 1 2 Subadult Subadult 3 Subadult Subadult 3 Subadult Subadult 9 Subadult Subadult 3 Subadult Subadult 1 Subadult Subadult 2
58 58 182 182 255 255 103 103 128 128 154 154 157 157 208 253 253 321 321 339 358 358 369 379 379 385 407 407 434 434 440 465 465 277 277 324 422 422 475 475 632 678 678 679 709 709 746 746 756 801 1988 1988 15903 15903 Female 3 23873 23873 34209 Subadult 1 34245 34245 Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only
Market Spitalfields
St Bartholomew's Hospital Hospital St Bartholomew's
Bainesse Catterick Farm, Bainesse
Yorkshire
Page 35 of 67 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Page 36 of 67 1 1 1 1 1 1 1 1 1 2 2 1 2 2 1 1 1 1 1 1 1 2 2 2 1 1 2 2 2 1 1 1 1 1 2 2 1 1 1 1 1 1 1 1 2 2 2 1 2 1 1 1 1 1 1 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 1 1 1 1 1 1 1 1 Male Male 1 Male Male 1 Male Male 2 Male Male 1 Male Male 2 Male Male 1 Male Male 2 Male Male 2 Male Male 2 Male Male 2 Male Male 1 Male Male Male 2 1 Male Male 3 Male Male Male Male 1 1 2 Male Male 1 Male Male 1 Male Male Male 1 1 Male Male 1 Male Male 1 Male Male Male Male Male 1 1 2 1 Male Male Male 2 2 Male Male 1 Female Female 1 Female Female 1 Female Female 2 Subadult Subadult 1 Subadult Subadult 1 Subadult Subadult 1 2 2 4 9 9 6 6 7 8 1 1 4 4 77 77 37 37 12 12 14 14 16 16 15 15 17 17 18 18 19 19 20 20 21 21 37 37 941 941 812 812 136 136 166 389 484 484 942 942 153 153 157 157 173 411 466 513 513 608 708 P IV 9 P IV Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only Honeypot Road, Catterick Catterick Road, Honeypot York Drive, Trentholme 3 Driffield Terrace, York Terrace, Driffield 3 6 Driffield Terrace, York Terrace, Driffield 6
Catterick Bridge, Catterick Catterick Bridge, Catterick
Dere Street, Catterick Street, Catterick Dere
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 2 2 1 2 2 1 2 2 2 Male Male 2 Male Male 2 Male Male 3 22 22 23 23 24 24 Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only
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5 5 1 1 14 14 Bioarchaeology International (2.56%) (2.56%) (17.24%) (17.24%) (16.87%) (16.87%) Subadult https://mc04.manuscriptcentral.com/bioarchaeolint 0 0 3 0 0 Sex Sex (0%) (0%) (0%) (0%) Adult (10.34%) (10.34%) For Review Only Indeterminate Indeterminate 9 9 11 11 27 27 Adult Female Female (23.08%) (23.08%) (37.93%) (32.53%) (32.53%) 42 42 29 10 (50.6%) (50.6%) (74.36%) (74.36%) (34.48%) Adult Male Adult Male Table 3: Sample sizes for each group. The ‘regional local ‘sample includes ’possible’ regional locals, and the ‘non-British’ sample includes those with with those sample includes ‘non-British’ the locals, and regional ’possible’ includes ‘sample ‘regional local The group. each sizes for 3: Sample Table inconsistent Britain. with possibly are that values Regional Local British Non- British 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Reference Reference Hillson (2005) (2005) Hillson Lewis (2011); Mariotti et al. (2015); et (2015); Mariotti al. (2011); Lewis Kelley and Micozzi (1984); Roberts et et Roberts Micozziand (1984); Kelley Brickley and Ives (2008); Brickley al. et (2008); Brickley and Ives Brickley 2014) (2010, Goodman and Martin (2002); Hillson (2002); Hillson Martin and Goodman (2000); King and Humphrey (2005); and Stuart-Macadam et (2005); al. King and Rivera Mirazón Lahr (1992); Kent (2009); Weston al. et Walker (2017); (2008) Roberts and Buikstra (2008); Sandgren (2008); Sandgren Buikstra and Roberts (2014) al. et al. (1994, 1998); Weston (2008, 2012) (2008, Weston 1998); (1994, al.
Diseases Diseases Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint calculus calculus Tuberculosis Tuberculosis Rib lesions Rib lesions rickets rickets hypoplastic defects and periosteal new bone new periosteal defects and hypoplastic formation Periodontal disease, carious lesions, dental carious dental lesions, disease, Periodontal
Cribra orbitalia, porotic hyperostosis, enamel enamel hyperostosis, porotic orbitalia, Cribra
Scurvy, osteomalacia, rickets and residual residual and rickets osteomalacia, Scurvy, For Review Only Category Category
disease infectious Specific disease infectious Non-specific health Dental in the study. included of diseases categories 4: The Table Metabolic diseases diseases Metabolic Indicators of Stress of Indicators Page 39 of 67 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Page 40 of 67
value 0.25 0.25 0.088 0.088 0.925 0.435 p- Mantel-Cox Mantel-Cox
Bioarchaeology International 95% CI
https://mc04.manuscriptcentral.com/bioarchaeolint 35.1 35.1 39.24 - 30.96 time 30.58 30.58 34.40 34.40 - 26.77 29.23 38.63 - 30.17 36.93 33.57 - 24.89 39.92 - 33.93 31.46 36.23 35.49 - 27.42 35.23 39.98 - 32.47 39.68 - 30.78 38.08 34.58 43.12 - 33.03 32.36 46.11 - 23.06 37.51 - 27.22 35.39 35.39 42.71 - 28.07 Mean Mean survival survival
For Review Only
British (n = 31) 31) = (n British 28) = (n Non-British 53) = (n local Regional 30) = (n British 25) = (n Non-British 24) = (n British 9) = (n Non-British 6) = (n British 11) = (n Non-British Regional local (n = 67) = (n local Regional 33) = (n local Regional 20) = (n local Regional
Samples results. survival analysis 5: Kaplan-Meier Table ages All Adults (includes "indeterminate") Males Females 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 p p 3.52 3.52 0.06 4.57 4.57 2.10 0.03 0.15 0.08 0.78 1.31 0.25 0.21 0.21 0.65 0.06 0.81 0.007 0.007 0.93 0.043 0.043 0.84 -2LLR -2LLR 0.55 0.55 0.41 0.11 0.79 0.64 0.033 0.033 0.105 0.105 0.066 0.097 (0.25) (0.25) (0.28) (0.41) (0.83) (0.39) (0.39) (0.21) (0.21) (0.25) (0.39) Effect Effect (0.41) (0.41) Covariate Covariate Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only Samples Samples Regional local (n = 53) vs. non-British* (n = 25) = (n vs. 53) non-British* = local (n Regional 25) = non-British* vs. (n 30) = (n British 9) = (n vs. 33) non-British* = local (n Regional 9) = (n vs. 24) (n non-British* = local Britain 11) = (n vs. 20) non-British* = local (n Regional non-British* vs. 11) 6) = = (n (n British Regional local (n = 53) vs. British* (n = 30) = (n vs. 53) British* = local (n Regional 24) = (n vs. 33) British* = local (n Regional 6) = (n vs. 20) British* = local (n Regional
* an with in indicated group in the (individuals covariate the of effect the of in parentheses) error standard (with estimates 6: Maximum likelihood Table tests. the ratio of likelihood results the and Gompertz model the of on score 1) covariate a assigned were column first the Pooled sexes Males Females Page 41 of 67 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Page 42 of 67
25 25 12 13 (31.6%) (31.6%) (44.8%)
defects defects Enamel Enamel hypoplastic hypoplastic 26 26 16 54 54 Absent Absent Present (68.4%) (55.2%) (68.4%)
3 3 9 7 (4.3%) (4.3%) (27.3%) (24.1%)
Rib lesions lesions 67 67 24 22 Absent Absent Present (95.7%) (72.7%) (75.9%)
22 22 18 14 (28.6%) (48.6%) (48.3%) Bioarchaeology International
55 55 19 15 Periosteal new Periosteal bone formation bone formation (71.4%) (51.4%) (51.7%) Absent Absent Present https://mc04.manuscriptcentral.com/bioarchaeolint
5 5 5 For 11 Review Only (14.3%) (18.5%) (15.3%)
Porotic Porotic 61 61 30 22 22 hyperostosis hyperostosis (84.7%) (85.7%) (81.5%) Absent Absent Present
6 6 19 19 11 (40%) (40%) (51.4%) (42.3%)
Cribra Cribra orbitalia orbitalia 9 9 18 18 15 (60%) (60%) Absent Absent Present (48.6%) (57.7%)
disease/lesion. a without or with of samples regional Percentage = % grouping. by isotope stable frequencies dental health and 7: Disease Table Regional Local British Non- British 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint
1 1 1 0 0
For (0%) Review Only (1.2%) (1.2%) (3.6%)
27 27 80 80 39 Tuberculosis Tuberculosis (100%) (100%) (96.4%) (98.8%) Absent Absent Present
1 1 1 4 (1.3%) (1.3%) (2.9%) (13.8%)
Rickets Rickets Residual Residual 74 74 34 25 Absent Absent Present (98.7%) (97.1%) (86.2%) isotope grouping stable diseases by 8: Specific Table Regional Local British Non- British Page 43 of 67 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Page 44 of 67 value value p- 0.08 0.08 0.04 0.04 0.017* 0.017* 0.41 0.41 0.096 0.187 0.075 0.18 0.18 0.05 0.28 0.89 0.89 0.002 0.002 0.45* 0.45* 0.01 0.01 0.03 0.28 0.28 0.1 0.67 0.67 0.05 0.05 Bioarchaeology International Comparison Comparison https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only Regional × British × non-British × × British Regional Regional × British × non-British × × British Regional non-British × × British Regional non-British × × British Regional 0.028 non-British × × British Regional non-British × × British Regional Regional/British × non-British × Regional/British × British Regional non-British × Regional non-British × British × British Regional × British Regional × British Regional non-British × Regional non-British × British Regional × British × non-British × × British Regional Regional × British × non-British × × British Regional Regional × non-British × Regional Regional × British × non-British × × British Regional Variable Variable for p-values The shown. are tests Chi-square for p-values indicated, otherwise sex Unless and diseases distributions. of comparisons of 9: Results Table *. an by asterisk indicated are observed) rarely were tuberculosis, which of and both rickets residual (for tests exact Fisher's orbitalia Cribra hyperostosis Porotic bone formation new Periosteal Rib lesions defects hypoplastic Enamel rickets Residual non-British × × British Regional Tuberculosis disease Periodontal lesions Carious calculus Dental Sex 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
31 31 52 52 19 (81.6%) (65.8%) (65.5%) Bioarchaeology International 7 7 27 27 10 (18.4%) (18.4%) (34.2%) (34.2%) (34.5%) Absent Absent Present https://mc04.manuscriptcentral.com/bioarchaeolint
36 36 25 For 13 Review Only (45.6%) (65.8%) (44.8%)
43 43 13 16 16 Carious lesions lesions Carious calculus Dental (54.5%) (34.2%) (55.2%) Absent Absent Present
42 42 26 13 13 (52%) (52%) (73.7%) (83.9%)
disease disease 5 5 Periodontal Periodontal 15 15 12 (48%) (48%) (16.1%) Absent Absent Present (26.3%) groupings stable by isotope given health frequencies : Dental 10 Table Regional Local British Non- British Page 45 of 67 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Page 46 of 67 Bioarchaeology International https://mc04.manuscriptcentral.com/bioarchaeolint For Review Only
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Page 47 of 67 Bioarchaeology International
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 For Review Only 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 Map of Britain showing the location of the sites used in the study. Drawn by J. Davis based on http://d- 46 maps.com ©Museum of London 47 48 189x234mm (300 x 300 DPI) 49 50 51 52 53 54 55 56 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 48 of 67
1 2 3 City/ County Site name Context (or grave) number 4 5 Dorset Poundbury Camp, Dorchester 235 6 862 7 8 1255 9 10 Gloucestershire London Road, Gloucester 1103 11 1127 12 1131 13 1181 14 1216 15 16 1238 17 1328 18 1364 19 For Review Only1518 20 1539 21 1541 22 1544 23 24 1553 25 26 Hampshire Winchester 12 27 84 28 118 29 119 30 31 212 32 271 33 281 34 435 35 489 36 566 37 661 38 39 683 40 776 41 806 42 812 43 861 44 862 45 874 46 47 926 48 932 49 1026 50 1084 51 1091 52 1094 53 54 1114 55 1119 56 1133 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 49 of 67 Bioarchaeology International
1 2 1134 3 1197 4 1207 5 1227 6 1244 7 8 1271 9 1277 10 1289 11 1517 12 1697 13 1761 14 1870 15 16 1894 17 18 Lancashire Hollow Banks, Scorton 502 (grave 1) 19 For Review 511Only (grave 13) 20 523 (grave 2) 21 529 (grave 5) 22 535 (grave 6) 23 24 541 (grave 10) 25 565 (grave 11) 26 594 (grave 12) 27 600 (grave 7) 28 29 London 1-4 Giltspur Street 599 30 31 1-4 Giltspur Street 709 32 49-55 Mansell Street 163 33 49-55 Mansell Street 390 34 49-55 Mansell Street 724 35 60 London Wall 695.5 36 60 London Wall 803.6 37 65-73 Mansell Street 37 38 39 Broadgate 400 40 Cotts House 30 41 Great Dover Street 150 42 Great Dover Street 325 43 Harper Road 311 44 Hooper Street 518 45 Hooper Street 652 46 47 Hooper Street 1407 48 Hooper Street 1673 49 Lant Street 13 50 Lant Street 27 51 Lant Street 58 52 Lant Street 103 53 54 Lant Street 128 55 Lant Street 154 56 Lant Street 157 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 50 of 67
1 2 Lant Street 208 3 Lant Street 253 4 Lant Street 321 5 Lant Street 339 6 Lant Street 358 7 8 Lant Street 369 9 Lant Street 379 10 Lant Street 385 11 Lant Street 407 12 Lant Street 434 13 Lant Street 440 14 Lant Street 465 15 16 Spitalfields Market 1988 17 Spitalfields Market 15903 18 Spitalfields Market 23873 19 SpitalfieldsFor Market Review Only34209 20 Spitalfields Market 34245 21 St Bartholomew's Hospital 182 22 23 24 Yorkshire Bainesse Farm, Catterick 255 25 277 26 324 27 422 28 475 29 632 30 31 678 32 679 33 709 34 746 35 756 36 801 37 812 38 39 Catterick Bridge, Catterick 37 40 77 41 136 42 166 43 389 44 484 45 Dere Street, Catterick P IV 9 46 47 Honeypot Road, Catterick 941 48 942 49 Yorkshire Trentholme Drive, York 4 50 153 51 157 52 173 53 54 411 55 466 56 513 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 51 of 67 Bioarchaeology International
1 2 608 3 708 4 3 Driffield Terrace, York 16 5 37 6 6 Driffield Terrace, York 1 7 8 2 9 4 10 6 11 7 12 8 13 9 14 12 15 16 14 17 15 18 17 19 For Review Only18 20 19 21 20 22 21 23 24 22 25 23 26 24 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 52 of 67
1 2 Sex 3 Age midpoint Cribra orbitalia 4 (F: female; M: Male; S: subadult; U: unknown) 5 F 40.5 0 6 F 40.5 9 7 8 S 10 1 9 10 F 30.5 9 11 M 21.5 0 12 F 21.5 9 13 F 30.5 0 14 M 40.5 1 15 16 M 40.5 9 17 M 21.5 1 18 F 21.5 0 19 ForM Review Only 30.5 0 20 F 30.5 1 21 M 21.5 1 22 M 30.5 0 23 24 M 30.5 0 25 26 M 50.5 0 27 F adult 1 28 S 0.9 9 29 F 30.5 9 30 31 F 60 9 32 F 30.5 9 33 M 50.5 9 34 F 50.5 9 35 M 50.5 9 36 M 30.5 9 37 F 50.5 9 38 39 M 50.5 0 40 M adult 0 41 F 60 9 42 M 50.5 9 43 M 60 9 44 M 40.5 9 45 S 9 9 46 47 S 13 9 48 M 21.5 0 49 S 5.5 1 50 F 30.5 9 51 F 21.5 9 52 F adult 1 53 54 F 30.5 9 55 M 50.5 9 56 S 6.5 9 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 53 of 67 Bioarchaeology International
1 2 F 40.5 9 3 F 60 9 4 F adult 9 5 F 40.5 9 6 S 13 1 7 8 M 50.5 9 9 M 40.5 9 10 M 40.5 1 11 M 60 9 12 M 40.5 9 13 S 6 9 14 S 9.5 9 15 16 M 21.5 9 17 18 U 21 9 19 ForM Review Only30 9 20 Male 30 9 21 U 30 9 22 M 30 0 23 24 U 30 9 25 F 21 9 26 M 30 9 27 M 30 0 28 29 F 40.5 1 30 31 F 40.5 9 32 F adult 0 33 F 40.5 0 34 M 50.5 1 35 M 40.5 1 36 M 30.5 1 37 M 50.5 9 38 39 S 8 1 40 M 21.5 1 41 S 7 9 42 F 21.5 9 43 F x 1 44 F 40.5 1 45 M adult 0 46 47 F adult 9 48 F adult 1 49 F 32 0 50 M 40.5 0 51 F 32 1 52 S 16 1 53 54 M 37 1 55 M 22 1 56 F 27 0 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 54 of 67
1 2 F 42 9 3 F 37 1 4 M 42 0 5 S 15 9 6 M Adult 0 7 8 S 15 0 9 M Adult 0 10 S 14 9 11 M 27 9 12 F 40.5 0 13 M 37 1 14 M 42 1 15 16 F 40.5 9 17 F 21.5 0 18 S 5 9 19 ForM Review Only30.5 0 20 M 50.5 1 21 F 21.5 9 22 23 24 F 37 9 25 M 40 9 26 M 22.5 9 27 F 50.5 9 28 M 22.5 9 29 S 5 9 30 31 M 42.5 9 32 S 13.5 9 33 M 45 9 34 M 50.5 9 35 F 27.5 9 36 F adult 9 37 S 5 9 38 39 M Adult 9 40 F 27.5 9 41 M 22.5 1 42 M 25 9 43 S 4.5 9 44 S 2.25 9 45 M 40 9 46 47 M 22.5 0 48 M adult 0 49 M Adult 1 50 F Adult 1 51 M Adult 0 52 M Adult 1 53 54 M Adult 1 55 M Adult 1 56 F Adult 1 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 55 of 67 Bioarchaeology International
1 2 M Adult 0 3 M Adult 1 4 M 40.5 0 5 M 30.5 0 6 M x 9 7 8 M 40.5 0 9 M 40.5 1 10 M 30.5 0 11 M 40.5 0 12 M 40.5 0 13 M Adult 0 14 M Adult 0 15 16 M 30.5 1 17 M 21.5 0 18 M 40.5 0 19 ForM Review Only19 1 20 M 30.5 0 21 M 30.5 0 22 M 40.5 1 23 24 M 30.5 1 25 M 21.5 0 26 M 21.5 0 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 56 of 67
1 2 3 Porotic hyperostosis Periosteal new bone formation Rib lesions Scurvy Osteomalacia 4 5 9 1 1 0 0 6 0 1 1 0 0 7 8 0 0 1 0 9 9 10 0 1 0 0 0 11 0 0 0 0 0 12 0 1 0 0 0 13 0 1 1 0 0 14 0 1 1 0 0 15 16 0 0 0 0 0 17 0 1 0 0 0 18 0 0 0 0 0 19 0 For Review1 Only0 0 0 20 0 1 0 0 0 21 0 1 0 0 0 22 0 1 0 0 0 23 24 0 1 0 0 0 25 26 0 1 0 0 0 27 0 1 9 0 0 28 0 0 0 0 0 29 0 1 0 0 0 30 31 0 0 0 0 0 32 0 0 0 0 0 33 0 0 0 0 0 34 0 0 0 0 0 35 0 1 0 0 0 36 0 0 0 0 0 37 0 0 0 0 0 38 39 0 0 0 0 0 40 0 0 9 0 0 41 0 0 0 0 0 42 0 1 9 0 0 43 0 0 0 0 0 44 9 1 0 0 0 45 0 0 0 0 0 46 47 0 0 9 0 0 48 0 0 0 0 0 49 0 0 0 0 0 50 0 0 0 0 0 51 0 0 0 0 0 52 0 0 9 0 0 53 54 0 0 0 0 0 55 0 0 0 0 0 56 0 0 0 0 0 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 57 of 67 Bioarchaeology International
1 2 1 1 1 0 0 3 0 0 0 0 0 4 0 0 9 0 0 5 0 0 0 0 0 6 0 0 0 0 0 7 8 0 0 0 0 0 9 0 0 9 0 0 10 1 0 0 0 0 11 0 1 0 0 0 12 0 0 0 0 0 13 0 0 9 0 0 14 0 0 0 0 0 15 16 0 0 0 0 0 17 18 0 0 0 0 0 19 0 For Review0 Only0 0 0 20 0 1 0 0 0 21 9 0 0 0 9 22 0 1 0 0 0 23 24 0 0 0 0 0 25 0 0 0 0 0 26 0 1 0 0 0 27 0 1 0 0 0 28 29 1 1 0 0 0 30 31 0 0 0 0 0 32 0 0 0 0 0 33 0 1 0 0 0 34 0 0 0 0 0 35 1 0 9 0 9 36 1 0 9 0 9 37 0 0 0 0 0 38 39 1 0 0 0 0 40 1 1 0 0 0 41 0 0 0 0 0 42 0 0 0 0 0 43 0 0 0 0 0 44 1 0 0 0 0 45 0 0 0 0 0 46 47 0 0 0 0 0 48 0 0 0 0 0 49 0 1 0 0 0 50 1 1 1 0 0 51 0 1 1 0 0 52 1 1 1 0 9 53 54 0 0 1 0 0 55 1 1 0 0 0 56 0 0 0 0 0 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 58 of 67
1 2 0 0 1 0 0 3 1 1 1 0 0 4 0 1 0 0 0 5 0 0 0 0 9 6 1 1 0 0 0 7 8 0 0 0 0 9 9 0 0 0 0 0 10 0 1 0 0 9 11 0 0 0 0 0 12 1 1 1 0 0 13 1 1 0 0 0 14 1 1 0 0 0 15 16 0 0 0 0 0 17 0 0 0 0 0 18 0 0 0 0 0 19 0 For Review0 Only0 0 0 20 0 0 0 0 0 21 0 0 0 0 0 22 23 24 9 0 0 0 0 25 9 0 0 0 0 26 9 0 0 0 0 27 9 0 0 0 0 28 9 0 0 0 0 29 9 0 0 0 0 30 31 9 0 0 0 0 32 9 0 0 0 0 33 9 0 0 0 0 34 9 0 0 0 0 35 9 0 0 0 0 36 9 0 0 0 0 37 9 0 0 0 0 38 39 0 0 0 0 0 40 0 0 0 0 0 41 0 0 0 0 0 42 0 0 0 0 0 43 0 0 0 0 0 44 0 0 0 0 0 45 0 1 9 0 9 46 47 0 0 0 0 0 48 0 0 0 0 0 49 1 9 9 9 0 50 1 9 9 9 0 51 1 9 9 9 0 52 1 9 9 9 0 53 54 1 1 9 9 0 55 1 9 9 9 0 56 1 1 1 9 0 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 59 of 67 Bioarchaeology International
1 2 1 9 9 9 0 3 1 9 9 9 0 4 0 1 0 0 0 5 0 1 1 0 0 6 9 9 9 9 9 7 8 0 1 0 0 0 9 0 1 0 0 0 10 0 1 0 0 0 11 0 1 0 0 0 12 0 1 1 0 0 13 0 1 0 0 0 14 0 0 0 0 0 15 16 0 1 1 0 0 17 0 1 1 0 0 18 0 1 0 0 0 19 0 For Review0 Only0 0 0 20 0 1 0 0 0 21 0 0 1 0 0 22 0 1 1 0 0 23 24 0 1 0 0 0 25 0 0 0 0 0 26 0 1 1 0 0 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 60 of 67
1 2 3 Rickets Residual rickets Tuberculosis Periodontal disease Carious lesions Calculus 4 5 9 0 0 1 0 1 6 9 1 0 9 0 0 7 8 0 0 0 0 0 0 9 10 0 0 0 1 1 1 11 0 0 0 0 1 1 12 0 0 0 1 1 1 13 0 0 0 1 1 1 14 0 0 0 1 1 1 15 16 0 0 0 1 1 1 17 0 0 0 1 1 1 18 0 0 0 1 1 1 19 0 0 For Review0 1 Only 1 1 20 0 0 0 0 1 1 21 0 0 0 0 1 1 22 0 0 0 1 1 1 23 24 0 0 0 1 1 1 25 26 0 0 0 9 1 1 27 0 0 0 1 1 1 28 0 0 0 9 0 0 29 0 0 0 9 0 1 30 31 0 0 0 1 1 1 32 0 0 0 1 1 1 33 0 0 0 1 0 1 34 0 0 0 1 1 1 35 0 0 0 1 1 1 36 0 0 0 9 1 1 37 0 0 0 9 0 1 38 39 0 0 0 1 1 1 40 0 0 0 0 1 1 41 0 0 0 1 0 1 42 0 0 0 9 0 1 43 0 0 0 1 0 1 44 0 0 0 9 0 0 45 0 0 0 9 0 1 46 47 0 0 0 9 0 0 48 0 0 0 1 0 1 49 0 0 0 0 0 0 50 0 0 0 1 1 1 51 0 0 0 1 1 0 52 0 0 0 9 1 0 53 54 0 0 0 1 1 1 55 0 0 0 1 1 1 56 0 0 0 9 0 0 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 61 of 67 Bioarchaeology International
1 2 0 0 1 1 1 0 3 0 0 0 1 1 0 4 0 0 0 9 0 0 5 0 0 0 9 1 1 6 0 0 0 9 1 0 7 8 0 0 0 9 1 1 9 0 0 0 9 0 0 10 0 0 0 1 0 1 11 0 0 0 0 1 1 12 0 0 0 9 0 0 13 0 0 0 9 0 0 14 0 0 0 9 0 0 15 16 0 0 0 9 0 1 17 18 0 0 0 0 1 0 19 0 0 For Review0 0 Only 0 1 20 0 0 0 0 1 0 21 0 0 0 9 0 0 22 0 0 0 0 0 0 23 24 0 0 9 9 0 0 25 0 0 0 0 0 0 26 0 0 0 0 1 0 27 0 0 0 0 0 0 28 29 0 0 0 1 0 1 30 31 0 0 0 0 0 1 32 0 0 0 0 1 1 33 0 0 0 1 1 0 34 0 0 0 0 0 1 35 9 9 0 1 1 1 36 9 9 0 1 0 1 37 0 0 0 1 1 1 38 39 0 0 1 0 0 1 40 0 0 0 1 1 1 41 1 0 0 1 0 1 42 0 0 0 0 1 1 43 0 0 0 1 0 1 44 0 0 0 1 0 1 45 0 0 0 1 1 1 46 47 0 0 0 1 1 1 48 0 0 0 0 1 1 49 9 0 0 1 1 1 50 9 0 0 1 1 1 51 9 0 0 1 0 1 52 0 0 0 0 0 1 53 54 9 0 0 1 1 1 55 9 0 0 1 0 1 56 9 0 0 1 1 1 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 62 of 67
1 2 9 1 0 1 0 1 3 9 0 0 1 1 1 4 9 1 0 1 1 1 5 0 0 0 1 0 1 6 9 0 0 1 1 1 7 8 0 0 0 0 0 1 9 9 0 0 1 1 1 10 0 1 0 1 0 1 11 9 0 0 9 1 1 12 9 0 0 1 1 1 13 9 0 0 1 0 1 14 9 0 0 1 1 1 15 16 0 0 0 0 1 0 17 0 0 0 0 1 1 18 0 0 0 9 9 9 19 0 0 For Review0 0 Only 1 1 20 0 0 0 1 1 1 21 0 0 0 1 1 0 22 23 24 0 0 0 9 0 0 25 0 0 0 9 1 0 26 0 0 0 9 0 0 27 0 0 0 9 0 0 28 0 0 0 9 0 0 29 0 0 0 9 9 9 30 31 0 0 0 9 0 0 32 0 0 0 9 9 9 33 0 0 0 9 0 0 34 0 0 0 9 0 0 35 0 0 0 9 0 0 36 0 0 0 9 0 0 37 0 0 0 9 9 9 38 39 0 0 0 1 0 0 40 0 0 0 0 0 0 41 0 0 0 1 0 0 42 0 0 0 1 1 0 43 0 0 0 0 0 0 44 0 0 0 0 0 0 45 9 9 9 1 0 1 46 47 0 0 0 0 0 1 48 0 0 0 1 1 1 49 9 9 0 1 0 1 50 9 9 0 1 0 1 51 9 9 0 1 0 1 52 9 9 0 1 0 1 53 54 9 9 0 1 1 1 55 9 9 0 1 0 1 56 0 9 0 1 0 1 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 63 of 67 Bioarchaeology International
1 2 0 9 0 1 0 1 3 9 9 0 1 0 1 4 0 0 0 1 1 1 5 0 0 0 1 1 1 6 9 9 9 9 9 9 7 8 0 0 0 1 1 1 9 0 0 0 1 1 1 10 0 1 0 1 0 1 11 0 0 0 1 1 1 12 0 0 0 1 1 1 13 0 0 0 0 0 1 14 0 0 0 1 1 1 15 16 0 1 0 0 0 1 17 0 0 0 1 1 1 18 0 0 0 1 1 1 19 0 0 For Review0 0 Only 0 1 20 0 0 0 1 1 1 21 0 0 0 0 1 1 22 0 0 0 1 1 1 23 24 0 0 0 1 1 1 25 0 0 0 1 0 1 26 0 0 0 1 1 1 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 64 of 67
1 2 3 Enamel hypoplastic defects 4 5 0 6 0 7 8 0 9 10 0 11 0 12 0 13 0 14 0 15 16 0 17 0 18 0 19 0 For Review Only 20 1 21 1 22 1 23 24 1 25 26 0 27 0 28 0 29 0 30 31 0 32 1 33 0 34 0 35 0 36 0 37 0 38 39 0 40 0 41 0 42 1 43 0 44 1 45 0 46 47 0 48 0 49 0 50 0 51 0 52 0 53 54 0 55 0 56 0 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 65 of 67 Bioarchaeology International
1 2 0 3 0 4 0 5 0 6 0 7 8 0 9 0 10 0 11 0 12 0 13 0 14 0 15 16 0 17 18 1 19 1 For Review Only 20 0 21 0 22 1 23 24 1 25 0 26 0 27 0 28 29 1 30 31 1 32 1 33 0 34 1 35 1 36 0 37 0 38 39 0 40 1 41 1 42 1 43 0 44 1 45 1 46 47 1 48 1 49 0 50 0 51 1 52 1 53 54 0 55 1 56 1 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Bioarchaeology International Page 66 of 67
1 2 0 3 1 4 1 5 0 6 1 7 8 0 9 0 10 1 11 0 12 0 13 0 14 1 15 16 0 17 1 18 9 19 0 For Review Only 20 0 21 1 22 23 24 0 25 0 26 0 27 0 28 0 29 9 30 31 0 32 9 33 0 34 0 35 0 36 0 37 9 38 39 0 40 0 41 0 42 0 43 0 44 0 45 0 46 47 0 48 0 49 0 50 1 51 1 52 1 53 54 1 55 0 56 1 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint Page 67 of 67 Bioarchaeology International
1 2 0 3 0 4 1 5 1 6 9 7 8 1 9 1 10 0 11 0 12 1 13 1 14 1 15 16 0 17 1 18 1 19 1 For Review Only 20 1 21 1 22 1 23 24 1 25 0 26 0 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 https://mc04.manuscriptcentral.com/bioarchaeolint