Frailty and Mortality in Historic Americans: The Relationship Between Sex, Social Race, Health, and Survival

The study of human skeletal remains from historic contexts is uniquely positioned to explore inequality over time by linking the underlying sociocultural factors that enforce marginalization with lived experiences and health outcomes. We analyzed mortality rates among historic individuals of low socioeconomic status from a documented human skeletal collection, to examine how culture and identity become biologically embodied. Because pre-existing health conditions affect mortality risk, we examined whether individuals with short stature experienced earlier mortality. Kaplan–Meier analyses and log rank tests indicated significant differences in survivorship over time and among social race groups, indicating that African American individuals showed significantly higher mortality, but no sex differences were observed within population groups. Logistic regressions tested for the effects of age-at-death, combined sex and population group, and birthdate on the outcome of bone length. Age and birthdate were not significant, suggesting no relationship between short stature and age-at-death, which also did not change over time. However, odds ratios indicated fewer African Americans were surviving up to adulthood. While many individuals in the collection likely suffered some poverty and marginalization, survivorship was significantly worse for African Americans. The likely effects of systematic racism resulting in further socioeconomic marginalization significantly affected the health of the African American community.