Comparison of natural and non-natural deaths in medieval (1452–1485) and contemporary Milan

Background Long-­ term historical trajectory of violence
remains insufficiently understood.
Methods This study examines long-­ term changes in
natural/non-­ natural mortality by comparing cause-­ of-death
data from late medieval and contemporary Milan.
It aims to reconstruct medieval patterns and assess
changes in age-­ specific and sex-­ specific distributions of
violent and accidental deaths. Causes of death recorded
in the Liber Mortuorum (LM), a civil death register in
use in Milan since at least 1451, were compared with
21st-­ century mortality data from the Milan province.
Causes of death in the LM were translated from Latin
and classified as natural or non-­ natural (accidents,
homicides or suicides). Comparisons were made using
the age-­ adjusted proportional mortality ratio (PMR) and
the female-­ to-­ male ratio.
Results The LM recorded 16 288 deaths over 8 non-consecutive
years between 1452 and 1485, 15 861
with age at death available. These included 217 deaths
from non-­ natural causes: 118 accidents, 68 homicides,
7 suicides and 24 deaths of undetermined intent.
Accidental deaths accounted for 61.1% of non-­ natural
deaths with determined intent in the LM compared
with 79.9% in contemporary data. Among non-­ natural
causes, deaths from homicides were more frequent in the
medieval period than in contemporary times (35.2% vs
1.5%, age-­ adjusted PMR: 7.6). In the medieval period,
5.9% of homicide victims were female compared with
31.5% in recent data, with the female-­ to-­ male mortality
ratio increasing from 0.06 to 0.46. Suicides were rarely
reported in the LM.
Conclusions Homicide was more frequent in general
in medieval times, even though female homicide appears
proportionally more represented in contemporary data
than in the 15th-­ century records and represents a key
finding of the study.