Differential Mortality Trends at the Intersection of Climate Change and Urban Growth From 13th to 18th Century Berlin.

objectivesThe purpose of this study is to evaluate differences in adult mortality risk at the intersection of climate change and urbanization between late medieval (c. 1200-1500) and early modern (c. 1500-1800) Berlin. After the founding of the city in c. 1200, the early modern period saw increased population density and the advent of the Little Ice Age (LIA), whose long winters and wet summers destroyed crop yields. MATERIALS AND

methodsTo test the hypothesis that mortality risk increased in the early modern period, this study examined Gompertz and Gompertz-Makeham mortality curves for adult individuals (n = 274) dated from c. 1200 to 1717 Berlin. To evaluate the magnitude of differences in mortality by time period and estimated sex, a Cox Proportional Hazards analysis was used.

resultsAll adults faced a decreased risk of mortality in the early modern period compared to the late medieval period. In both time periods, estimated females faced a higher risk of mortality compared to estimated males, though this difference was only statistically significant in the early modern period. DISCUSSION: Decreased risk of mortality may indicate protective effects of urban life, even with the climatic variability of the LIA. The early modern period saw the proliferation of public hospitals and an increase in medical publications. Higher mortality risks for estimated females at this time may be a result of differential education and heightened religious tensions that resulted in witchcraft persecutions, possibly affecting social determinants of health for women at the time.