Social Determinants of Head Trauma? Skull Fractures in Nineteenth-Century Male Prisoners in Graz, Austria-Hungary

This study investigates whether social factors influence patterns of head trauma in a bioarchaeological population sample of known identity. By examining the relationship between individual-level social variables and head trauma, it is hypothesized that social determinants shape behaviors leading to injury. Skulls and crania of 135 males who died in Karlau Prison, Graz, Austria-Hungary, between 1858 and 1908 were analyzed. Head trauma was quantified statistically by region (cranial base, vault, and face) and type. Social variables were defined from historical records and included age, legitimacy status at birth, language, and occupation. Head trauma was present in 23.0% of all individuals, with 2.2% to cranial bases, 20.5% to vaults, and 5.9% to faces. The social variables considered have a limited impact on the occurrence and patterns of head injuries in this group. The only significant patterns observed related to legitimacy status in individuals older than 40 years. Individuals born to married parents displayed a higher trauma rate, as well as Slovenian speakers classified as unskilled laborers. A logistic regression analysis revealed that social variables poorly predicted trauma outcomes, despite the well-contextualized sample. The random pattern of head trauma could possibly be linked to the social dynamics within the prison system, rather than life outside the institution that the variables considered in this study reflect. This study highlights how social complexity, which is evident from the historical records pertaining to these individuals, does not necessarily manifest as patterns of health and injury in bioarchaeological population samples.