Wealth, health and frailty in industrial-era London

Abstract

Background: Socioeconomic status is a powerful predictor of mortality in living populations, as status affects exposure or access to a variety of factors that impact health and survival, such as diet, healthcare, infectious disease and pollution.Aim: This study examines the effect of socioeconomic status on mortality and survival in London during a period spanning the early 18th through mid-19th centuries. During this period, London experienced rapid industrialization and heightened class distinctions. This study examines whether low-socioeconomic status was associated with reduced survival at a time when the distinctions between social strata were peaking.Subjects and methods: The samples for this study are drawn from three skeletal assemblages in London that represent lower and higher social strata. The upper socioeconomic status sample (n = 394) is from Chelsea Old Church and St Bride’s Fleet Street (crypt assemblage). The low socioeconomic status sample (n = 474) is from St. Bride’s Lower Churchyard (also known as St Bride’s Farringdon Street). The effect of status on mortality and survival is assessed using hazard analysis and Kaplan–Meier analysis.Results: The results reveal elevated mortality and reduced survival for lower socioeconomic status children, but no strong effect of status on adult mortality or survival.Conclusion: These results might indicate strong selective mortality operating during childhood or the effects of migration in the industrial-era population of London.