The impact of socioeconomic status on rickets prevalence in the post-medieval Netherlands

Rickets, a disease caused by vitamin D deficiency in subadults, has known a long research history. The primary causes of a deficiency are a lack of exposure to UVB radiation and an inadequate diet (Veselka et al., 2015, p. 665). While biophysical factors (e.g., latitude and skin color) play a role, recently more attention has been paid to sociocultural factors that may have contributed to the development of the disease (Brickley et al., 2014, p. 48). Socioeconomic status, cultural and religious practices could have impacted an individual’s exposure to sunlight. In this study, the possible impact of socioeconomic status on the prevalence of rickets in two post-medieval Dutch populations from Arnhem and Zwolle will be examined. The Netherlands underwent significant social and economic changes during the 17th to 19th centuries that may have influenced the health of its population. To explore this, a paleopathological analysis was conducted on skeletal remains from two urban populations...Show moreRickets, a disease caused by vitamin D deficiency in subadults, has known a long research history. The primary causes of a deficiency are a lack of exposure to UVB radiation and an inadequate diet (Veselka et al., 2015, p. 665). While biophysical factors (e.g., latitude and skin color) play a role, recently more attention has been paid to sociocultural factors that may have contributed to the development of the disease (Brickley et al., 2014, p. 48). Socioeconomic status, cultural and religious practices could have impacted an individual’s exposure to sunlight. In this study, the possible impact of socioeconomic status on the prevalence of rickets in two post-medieval Dutch populations from Arnhem and Zwolle will be examined. The Netherlands underwent significant social and economic changes during the 17th to 19th centuries that may have influenced the health of its population. To explore this, a paleopathological analysis was conducted on skeletal remains from two urban populations: Arnhem, representing a low-status population, and Zwolle, representing a higher-status population. The study seeks to answer the research question: "Does socioeconomic status impact the prevalence of rickets in post-medieval Dutch populations?" Additionally, it explores which socioeconomic factors might have influenced the development of rickets and how these findings fit within the broader context of the Netherlands In total 83 subadults were analyzed for rickets based on 14 macroscopic features. The results show a crude rickets prevalence of 7.6% in Arnhem and 16.7% in Zwolle. While the relationship between socioeconomic status and rickets prevalence was not statistically significant, rickets was more than twice as common in the higher-status population of Zwolle than in the lower-status population of Arnhem. This was particularly evident in infants. It is possible that factors influenced by socioeconomic status such as reduced outdoor activities for women, clothing practices and diet, contributed to this difference between both populations. Additionally, the effects of the urban environment like density of buildings, pollution, overcrowding and more indoor occupations likely influenced rickets prevalence in both populations. It can be concluded that socioeconomic status is not a determinant of rickets prevalence in Arnhem and Zwolle, however it can influence the amount of sunlight exposure an individual gets. A confluence of different biocultural factors impacts the prevalence of rickets of which socioeconomic status can be one.Show less

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The impact of socioeconomic status on rickets prevalence in the post-medieval Netherlands