An intersectional and Bayesian investigation of pleural disease in industrializing England (1700-1857CE)

This study used an intersectional lens to investigate pleural disease burden in adults from industrial-era England.

Demographic (age-at-death and biological sex) and paleopathological data (periosteal new bone on the visceral rib) were collected from the skeletal remains of 478 adults from Barton-upon-Humber (St. Peter's Church), London (New Bunhill Fields and St. Bride's Fleet Street), and North Shields (Coach Lane).

A Bayesian logistic model with priors informed by historical respiratory mortality trends was fitted to the skeletal data to estimate the posterior probability of presenting rib lesions among social strata defined by biological sex, socioeconomic status (SES), and region of burial.

The model identified an association between SES, region, and rib lesion probability, which translated into three stratum-level clusters: higher SES Londoners (lowest), lower SES Londoners (highest), and the remaining strata (intermediate). Median age-at-death was substantially lower for individuals with than without lesions.

Variation in pleural disease burden was attributed to environmental privilege among affluent Londoners, differences in the pace of urbanization, and the sociohistorical contexts of the skeletal samples.

This study used Bayesian inference to quantify the health effects of intersectionality in a historical population, providing a theory-driven approach that incorporates archival, mortuary, and skeletal data.

The impact of selective mortality within strata is unclear due to sample size issues.

Research is needed to locate additional identities hidden within the archaeological record that may have interacted multiplicatively with class and gender to influence respiratory health in the past.