Comparison of natural and non-natural deaths in medieval (1452-1485) and contemporary Milan
AI Summary
Homicide was markedly more frequent in late medieval Milan than today, with 35.2% versus 1.5% of non-natural deaths; age-adjusted PMR 7.6.
Accidental deaths comprised a smaller share in medieval registers than today: 61.1% versus 79.9% of non-natural deaths with determined intent.
Female representation among homicide victims rose sharply from 5.9% in the 15th century to 31.5% recently; female-to-male ratio increased from 0.06 to 0.46.
J Epidemiol Community Health. 2026 Jul 20:jech-2025-225065. doi: 10.1136/jech-2025-225065. Online ahead of print.
ABSTRACT
BACKGROUND: Long-term historical trajectory of violence remains insufficiently understood.
METHODS: This study examines long-term changes in natural/non-natural mortality by comparing cause-of-death data from late medieval and contemporary Milan. It aims to reconstruct medieval patterns and assess changes in age-specific and sex-specific distributions of violent and accidental deaths. Causes of death recorded in the Liber Mortuorum (LM), a civil death register in use in Milan since at least 1451, were compared with 21st-century mortality data from the Milan province. Causes of death in the LM were translated from Latin and classified as natural or non-natural (accidents, homicides or suicides). Comparisons were made using the age-adjusted proportional mortality ratio (PMR) and the female-to-male ratio.
RESULTS: The LM recorded 16 288 deaths over 8 non-consecutive years between 1452 and 1485, 15 861 with age at death available. These included 217 deaths from non-natural causes: 118 accidents, 68 homicides, 7 suicides and 24 deaths of undetermined intent. Accidental deaths accounted for 61.1% of non-natural deaths with determined intent in the LM compared with 79.9% in contemporary data. Among non-natural causes, deaths from homicides were more frequent in the medieval period than in contemporary times (35.2% vs 1.5%, age-adjusted PMR: 7.6). In the medieval period, 5.9% of homicide victims were female compared with 31.5% in recent data, with the female-to-male mortality ratio increasing from 0.06 to 0.46. Suicides were rarely reported in the LM.
CONCLUSIONS: Homicide was more frequent in general in medieval times, even though female homicide appears proportionally more represented in contemporary data than in the 15th-century records and represents a key finding of the study.
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