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 ...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
Research master thesis | Archaeology (research) (MA/MSc)
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This thesis analysed orthopaedic treatment in three infirmary collections from Late Medieval and Early Modern period, The Netherlands; Delft Old and New Infirmary, Haarlem st. Gangolf Infirmary and...Show moreThis thesis analysed orthopaedic treatment in three infirmary collections from Late Medieval and Early Modern period, The Netherlands; Delft Old and New Infirmary, Haarlem st. Gangolf Infirmary and Breda Vlaszak Infirmary. Macroscopic, radiologic, and handheld x-ray fluorescence (hhXRF) analysis were applied to cases of fractures, dislocations, kyphosis, scoliosis, rickets and poliomyelitis (in total n=88) to understand the nature, access and quality of treatment provided to individuals from a lower segment of society. Treatment was most abundantly detected in the fracture sample (n=25). Stable fracture types appeared well healed consistently throughout the Late Medieval and Early Modern period. More complicated, unstable fractures, carried a poor prognosis. Deformations of the spine and ribs suggested active treatment through orthopaedic corseting for one individual suffering from kyphosis in the Delft infirmary. Metal staining on the affected limb of an individual with poliomyelitis suggested active treatment with a metal artefact, possibly an orthopaedic brace of an individual from the Breda collection. Handheld XRF analysis identified the metal as brass. The distribution of the conditions suggests that the Breda infirmary was perhaps more focussed on the medical component of the infirmary than the Delft and Haarlem infirmary. However, similar relative frequencies of actively treated individuals of the Delft and Breda collection suggest access to care would have been comparable. Analysis of the conditions grouped by period showed that stable fractures, such as the Colles’ and parry fractures, were treated proficiently from the Late Medieval period onwards. In addition, the individual with active kyphosis treatment from the Delft collection predates historical references to orthopaedic corsets. The findings of this study suggest that orthopaedic healthcare was of good quality and, in contrast to historical sources, accessible to individuals of all layers of society. The importance of osteoarchaeology in creating a more holistic narrative on the past is underlined by the detection of complicated forms of treatment predating historical sources.Show less
Beemster was a rural municipality in the Netherlands which was founded in the 17th century on drained land. The cemetery of Middenbeemster lies in the central village of Beemster and was used from...Show moreBeemster was a rural municipality in the Netherlands which was founded in the 17th century on drained land. The cemetery of Middenbeemster lies in the central village of Beemster and was used from the 17th to 19th century and 450 skeletons were excavated in 2011. Forty nine subadults from the ages of one to fifteen years were examined for rickets. In the 19th century, rickets had become epidemic in most industrialised cities throughout Northern Europe. Crude rickets prevalence in contemporaneous urban populations from the Netherlands varied from 1% to 7%. To identify this disease in the sample of Middenbeemster ten features as described by Ortner and Mays (1998) were scored. Bending deformities of the lower limbs or at least three non-bending features had to be present in order to diagnose rickets. Five individuals displayed evidence of rickets, which is 10.2% of the entire sample. This alone is a high rickets prevalence, but even more for a rural community. In addition, all the affected individuals belonged to the same age category, one to three years (n=25), so the age-specific prevalence becomes much higher at 20.0%. This is an unexpectedly high prevalence of rickets in a community where sunlight was readily available. Specific practices and activities associated with the young age of affected individuals must have diminished sunlight exposure to such a degree that their diet was not sufficient enough to replenish required vitamin D levels to prevent rickets development. Cultural practices including the swaddling of older infants, occlusive clothing for infants and children, keeping the young indoors, and the famine of 1845-1847 likely have contributed to this high rickets prevalence.Show less
