Water determines health, skeleton research shows

Water determines health, skeleton research shows

VUB research shows that living close to wetlands increases risk of diseases such as malaria or pulmonary infections such as possible Tuberculosis

For her PhD at the Vrije Universiteit Brussel and the University of Sheffield, Dr. Marit Van Cant studied medieval to early modern skeletal populations from six archaeological sites in Flanders. Her research shows that social status was not always a decisive factor in better health.

Dr Van Cant: “The research shows that independent of urban or rural context, social origin, age or gender, environmental factors were crucial, especially the effect of water.”


The disease patterns at the six sites – Deinze, Moorsel, Oosterweel, Slijpe, Vichte and Zottegem – suggest that the inhabitants’ natural habitat played a crucial role in the development of diseases. The places with the most recorded infectious diseases – Deinze, Slijpe and Vichte – are also those with polluted water, a marshy environment or high exposure to flooding. Van Cant did not find any significant differences in the occurrence of infectious diseases between men and women, which shows that both sexes were equally affected by the consequences of living in the vicinity of water.

On the coast: malaria

Van Cant found a high presence of cribra orbitalia in both adult and child skeletons from the coastal village of Slijpe. Cribra orbitalia is a condition characterised by porosity or holes in the eye sockets, associated with iron deficiency and anaemia, which can be linked to malaria. Populations in the interior did not have this condition, or only minimally.

Van Cant: “Malaria is related to brackish water and therefore occurred mainly in coastal areas and wetlands. It was a common disease in our region, especially between 1500 and 1750, and probably also between 1200 and 1500, the time of the coastal inhabitants of Slijpe.”

The same is true in Oosterweel. Historical sources point to malaria or polder fever in the area, but Van Cant could not find any instances of cribra orbitalia among these inhabitants of higher social status. The adults did have a milder form of enamel hypoplasia on their teeth, indicating malnutrition or exposure to disease during childhood.

Van Cant: “Here the richer background may have been important. So it is possible that the children from Oosterweel’s upper class were affected by disease, but survived thanks to their wealthy background.”

By the river: tuberculosis

The greatest incidences of respiratory diseases and indications of tuberculosis were found in Deinze. A higher susceptibility to developing lung disease and tuberculosis is more common in the city than in the countryside and is often attributed to poor sanitation and overcrowding. In the small urban context of Deinze, pulmonary diseases are linked to the town’s industrial activities. The textile industry there caused numerous unhealthy situations: leather processing, dyeing fabrics in poorly ventilated rooms, and the retting of flax, which caused the death of cattle and fish in the polluted Leie river, which crosses the town. A high frequency of enamel hypoplasia was also found among the inhabitants of Deinze.

Traces of respiratory diseases and ear infections were also found in the skeleton population of Vichte. Typhoid and cholera broke out here in the 19th century, and sanitary conditions in the village were poor. The nearby Vichte or Kasselrij stream was used to power the local mill and became an open sewer in the landscape, so the pollution of this water was recorded as extremely high.

Inland: fewer infections, more joint disorders

In rural Moorsel, mortality was on average higher than in the other case studies. No enamel hypoplasia or indications of infections or other specific disorders were found.

Van Cant: “This suggests that there were no long-term malnutrition or infections present during childhood.”

She was able to identify the effects of hard labour, typical of the agricultural industry, in rural areas.

“With younger women, wear and tear of the hip joint is more common, which indicates employment at a very young age. For Zottegem, we see similar data with the other rural villages where joint disorders in the shoulder and upper arm are especially common among both men and women in the younger age groups.”

The research

The skeleton populations from the six archaeological sites contain between 50 and 100 skeletons per collection. These skeletons have been excavated and are stored in various depots across Flanders. They are from the late-medieval village of Slijpe and the small town of Deinze, the early modern villages of Moorsel, Oosterweel and Zottegem and the 19th-century village of Vichte.

With the exception of the polder village of Oosterweel, the collections consist of people who mainly worked in agriculture and the textile industry, and who were excavated from churchyards around the village. The skeletons from Oosterweel were the only ones excavated inside the church, which means these were mainly people from the upper class and priests.

The skeletons were examined macroscopically for demographic factors such as age at death, height and gender, entheseal changes and for chronic diseases and trauma that can be observed on human bone.

Van Cant: “Modern research techniques such as the application of chemical analyses on bone material, via stable isotopes and ancient DNA, now make it possible to investigate the genetic origin and evolution of diseases as well as dietary reconstructions, and to link these to socio-economic class differences.”

Van Cant’s research is a joint PhD between the VUB research group HARP and the University of Sheffield. She worked with Flemish provincial heritage centres and archaeological agencies such as SOLVA in Erembodegem and PEC Ename. During her postdoctoral research via a Belgian American Educational Foundation grant at Stanford University and in collaboration with the Center for Bioarchaeological Research at Arizona State University, she carried out further aDNA analyses on a subsample (Deinze) of the skeleton group.


Marit Van Cant


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