Highs and lows of frailty: skeletal frailty differentials among socioeconomic groups in Postmedieval London

Abstract

In this paper, we apply a skeletal frailty index (SFI) to a skeletal series representing two distinct socioeconomic (high and low) statuses living in London during the Postmedieval period and evaluate the biological impacts of social stratification considering the secularization hypothesis. In living populations, socioeconomic status (SES) is associated inversely with physiological and psychosomatic stress. While comparable links between SES and physiological stress are observed in archeological samples, bioarcheological research across Europe indicates skeletal “health” and frailty do not always adhere to this pattern. We compare 11-biomarker SFIs between ascribed high (Chelsea Old Church, N = 66; St. Bride’s Crypt, N = 111) and low (St. Bride’s Lower, N = 174) SES contexts. Results show significant differences in SFIs between socioeconomic groups in Postmedieval London, differences explained in part by both status and age. SFIs increase monotonically and significantly from the youngest to oldest age groups with males demonstrating significantly higher frailty scores than females overall, but not within SES groups. Between status groups, intrasexual disparities in frailty were significant only in male subgroups, with low-SES males exhibiting significantly higher SFI than high-SES males. Significantly higher skeletal frailty was observed in the low-SES St. Bride’s Lower sample, with notably higher frequencies of periosteal new bone, fractures, and osteoarthritis relative to high-SES samples. However, frailty disparities within the high-SES sample demonstrate how variability in health and mortality exists even within socioeconomic strata. Results allude to complex, multifactorial relationships among status, age, sex, and frailty across Postmedieval London’s socioeconomic settings, challenging frailty expectations of the secularization hypothesis.