MedHeal600 seeks to generate new empirical knowledge and methods essential to understanding how and why health and sickness developed from an individual concern to a public responsibility. The main hypothesis is that the principle of public health care and governance in Norway comes from a number of specific practices and interventions to prevent diseases and debility influenced by a) the particular physical environment that constituted the medieval urbanscape and b) the dependence on the ecological conditions surrounding medieval towns.

This will be investigated by comparing a diverse set of archaeological, palaeobotanical and osteoarchaeological sources with aDNA and stable isotopic data, in cooperation with national and international interdisciplinary expertise in molecular biology, medical history, archaeology, palaeobotany, osteoarchaeology, dendrochrology and engineering. For this purpose, the importance of comparative material studies has been carefully considered: Because of the project´s pioneering character, priority has been given to the collection and processing of a high quality and reliable data set from one medieval urban environment, Trondheim, Norway.

Extensive archaeological excavations were carried out in the medieval town center between 1970-1995 and the results have been processed and extensively published in books and articles.  Knowledge of how health developed, in a long term perspective, in ecological and built urban environments different from those seen today will provide a deeper understanding of the processes and consequences relevant to organizations planning and implementing public health management in modern low-resource, urbanized areas.

Research topics (RT1-3)

RT1: If the present public health policy in Norway is founded on the development of practices and environmental conditions in medieval urban communities, in which way did the surrounding ecology influence the health of the urban population?

RT2: How did the frequency of infectious diseases vary in time and how did it relate to the urban environment?

RT3: If the public health evolved from individual health practices to public health strategies, what factors caused this ground-breaking development?

Methods

The basic research design is based on a complex interdiciplinary cooperation representing a diverse set of scholarly competences and a varied set of data, sources and methods never previously assembled in the systematic manner proposed by MedHeal600.

The overarching methodological principle of MedHeal600 is to compare both the natural environment and health interventions visible in the built environment in medieval Trondheim with the development of infectious diseases, varying diet and mobility. The basic “health-data” will be gathered from a representative and well preserved collection of human skeletons from the medieval churches of St. Olav and St. Gregorius and the Christ Church (Cathedral) in Trondheim. The skeletons will be divided into three chronological divisions (AD 1000-1200, AD 1200-1400, AD 1400-1600) and grouped, as reliably as possible, by social status. Biomolecular analysis will identify the character and volume of infectious diseases in the population. Protein sequencing will identify the infectious diseases that each individual has been either a carrier of, or from which he/she died. Stable isotope analysis will be used to identify mobility and diet.

Work packages

WP 1: Nutrition and environment around a medieval urban settlement

The research carried out in WP1 relates to RT1 and will focus on both how the environment affects people´s standard of living, and how people affect the environment. WP 1 addresses four main questions:

1. What were the environmental/climatic conditions in medieval Trondheim and how did this affect nutrition and health?
2. What kind of nutrition was available for the urban settlers and who got access to these resources?
3. How and when is it possible to trace changes in dietary practice?
4. How did the combination of nutrition and climate affect people´s lives?

WP2: Water, waste and infectious diseases

The research carried out in WP2 relates to RT2 and will focus on how the built environment facilitated the spread of infection and how the frequency of infectious diseases varied over time. The research will draw on the extensive, well-preserved and well-documented material from the Library Site in Trondheim (AD1000-1600) and will address the following main questions:

1. What were the potential sources of contagion and infection?
2. What were the mechanisms of infection in the physical environment?
3. How can the mechanisms of infection be traced in the physical environment?
4. Is there any significant correspondence between mobility and change in frequency of infectious diseases?

WP3 Public health development and social practices

The research carried out in WP3 relates to RT3 and will focus on a long-term historical analysis of health conditions, standards of living and social hygiene in Trondheim in the period AD 1000–1600, based on a thorough scrutiny of available primary written sources, and investigating whether living conditions in a medieval town could have been improved through the of implementation of preventive measures addressing alleged threats to public health. Living conditions will be assessed with emphasis on social stratification or differentiation – poor-rich, profane-clerical, as well as on development over time. The research will address four main questions:

1. How were possible threats to health and living conditions perceived?
2. How and to what extent did changes in standards of living take place during the long time-span under investigation?
3. What was the nature of assumed improvements in public health and in which periods did significant advances occur?
4. What kind of practices  aimed towards the improvement of health conditions were carried out?