Social Determinants of Spinal Pathology in Adolescents From Urban Centers in the Post‐Medieval Netherlands (1650–1850  <scp>CE</scp> )

ABSTRACT The study of trauma in individuals undergoing growth and development remains an understudied area of research but can provide unique insights into the lived experiences and social identities of young people in the past. This study examines vertebral compression fractures and Schmorl's nodes in children and adolescents (1–20 years at death) from four post‐medieval Dutch urban centers (1650–1850 CE ) to explore how age, socioeconomic status (SES), and occupation influenced spinal trauma. A total of 55 individuals were analyzed macroscopically, with select vertebrae examined using micro‐CT imaging. Compression fractures and Schmorl's nodes were each identified in seven individuals (12.7%), all in early to middle adolescents (10–17 years) from low‐SES burial contexts. A Fisher's Exact test showed that the association between fractures and middle adolescence was statistically significant ( p = 0.0137), suggesting increased vulnerability during this developmental stage. Co‐occurrence with Schmorl's nodes occurred in five individuals and was statistically significant ( p = 0.00013) using a Fisher's Exact test, suggesting shared causative mechanisms such as repetitive spinal loading and hyperflexion. These patterns support historical accounts of widespread wage labor beginning in early life in urban environments, where adolescents often engaged in physically demanding tasks. While metabolic and developmental factors may have contributed to fracture risk, the evidence indicates occupational strain is likely the primary cause. By applying a social determinants of health framework, this study contributes to understanding how social identity, labor, and inequality shaped the health and lived experiences of adolescents in post‐medieval Dutch communities and provides insight into socioeconomic activities during adolescence.