Stress markers and survivorship over the last 2,000 years in Milanese females and males

This study combines paleopathological data and paleoepidemiological analyses, specifically survival analyses, to investigate the impact of eight physiological and mechanical stress markers on survivorship in a sample of 492 adult Milanese males and females across five historical periods. Pearson's Chi-squared, post-hoc tests, and survival analyses were performed on the entire dataset. The findings reveal that certain stress markers, such as cribra orbitalia, cribra femoralis and/or humeralis, porotic hyperostosis, and linear enamel hypoplasia, were associated with decreased survivorship, while osteoarthrosis and Schmorl's nodes were associated with increased survivorship. Harris lines and antemortem trauma did not significantly affect longevity. Analysis across historical periods indicated that living conditions deteriorated through the Modern era but improved in recent times. Despite lower survival among females in the Roman period, the low prevalence of skeletal stress markers in females suggests that other factors or hazards, such as childbirth, influenced female frailty to a greater degree. In the Modern era, post-cranial cribriotic lesions, porotic hyperostosis, and Harris lines were associated with decreased survival in females, reflecting greater exposure to environmental stressors, whereas cribriotic lesions and porotic hyperostosis were associated with decreased survival among males in the Roman, Early Medieval, and Modern eras. These findings offer robust insights into the historical impact of stress markers on survivorship and mortality in Milan and improve our understanding of the quality of life of males and females in Milan over the last 2000 years.