The effect of sex on risk of mortality during the Black Death in London, A.D. 1349-1350

The Black Death of 1347-1351 was one of the most devastating epidemics in human history, and though it is frequently assumed that the epidemic killed indiscriminately, recent research suggests that the disease was selective, at least with respect to frailty. The purpose of this study is to determine whether the Black Death was similarly selective with respect to biological sex-that is, did either sex face an elevated risk during the epidemic or were men and women at equal risk of dying? A sample of 298 victims of the Black Death, from the East Smithfield cemetery in London, is compared to a pre-Black Death normal mortality sample of 194 individuals from two Danish urban cemeteries, St Mikkel Church (Viborg) and St Albani Church (Odense). To assess the effect of sex on risk of death, sex is modeled as a covariate affecting the Gompertz-Makeham model of adult mortality. The results suggest that sex did not strongly affect risk of death in either the normal mortality or Black Death samples. These results are important for improving our understanding of Black Death mortality patterns. This is essential for understanding the effects the Black Death had on European populations, and the methods used here can potentially be informatively applied to investigations of other episodes of epidemic diseases in past populations.