目的:本研究旨在确定中世纪伦敦男性-女性健康-生存悖论的信号。
方法:本研究使用有关年龄的骨骼数据,性别,中世纪伦敦公墓的成年人患龋齿(n=592)和死前牙齿脱落(n=819)(c。1200-1540CE)。使用二元逻辑回归评估年龄与龋齿之间的关联。年龄之间的关联,时间段(前与黑死病后),口腔生物标志物(龋齿或死前牙齿脱落),和性别使用分层对数线性分析进行检验。
结果:分析显示,随着成年年龄的增加,龋齿的几率显着增加,黑死病后更多的老年人,不同性别之间龋齿的年龄分布,黑死病后女性龋齿患病率下降幅度更大。这些结果似乎不是AMTL趋势的产物。然而,这项研究没有证据表明女性在黑死病后的成年后期相对于男性而言,其生存优势和口腔健康状况均有所下降.
结论:这些结果没有提供存在男性-女性健康-生存悖论的证据,但他们确实证实了黑死病后健康状况总体改善的现有证据。黑死病后龋齿患病率下降可能反映了饮食改善或流行期间选择性死亡率的影响。
OBJECTIVE: This study seeks to identify signals of the male-female health-survival paradox in medieval London.
METHODS: This study uses skeletal data on age, sex, dental caries (n = 592) and antemortem tooth loss (n = 819) from adult individuals from medieval London cemeteries (c. 1200-1540 CE). The association between age and dental caries was assessed using binary logistic regression. The associations among age, time period (pre- vs. post-Black Death), oral biomarker (dental caries or antemortem tooth loss), and sex were tested using hierarchical log-linear analysis.
RESULTS: The analyses reveal significantly higher odds of dental caries with increasing adult ages, more older adults after the Black Death, different age distributions of dental caries between the sexes, and a greater decrease in the prevalence of dental caries for females after the Black Death. These results appear not to be an artifact of trends in AMTL. However, this study does not yield evidence suggesting that females experienced both a survival advantage and a decline in oral health at late adult ages after the Black Death relative to males.
CONCLUSIONS: These results do not provide evidence of the existence of a male-female health-survival paradox, but they do corroborate existing evidence of improvements in health in general in the aftermath of the Black Death. The decreased prevalence of dental caries after the Black Death may reflect dietary improvements or the effects of selective mortality during the epidemic.