Frailty among non-survivors: Investigating rural-urban health inequalities in children and mothers through oral stress indicators: Frailty among non-survivors: Investigating rural-urban health inequalities in children and mothers through oral stress indicators

Substantial research has been done assessing health inequalities between rural and urban contexts; however, fewer studies have considered the effect of rural/urban living on non-adults. Because dental enamel does not remodel, analyzing the time of dental stress insult in both deciduous and permanent teeth allows for the analysis of infant-maternal stress during specific periods of time. By investigating dental stress markers, we can overcome some of the limitations of the osteological paradox, providing information about maternal and infant health inequalities between rural and urban contexts from a perspective of frailty and survivorship. This research focuses on assessing the effects of rural/urban living in infant and maternal health during the post-medieval period (1600-1800 A.D.) in the Netherlands through the comparison of linear enamel hypoplasia from a rural (Middenbeemster) and an urban (Arnhem) collection of non-adults and adults. To do so, frequencies and age-at-formation of linear enamel hypoplasia were recorded and analyzed for permanent and deciduous teeth using age-categorical data to compare them between rural and urban individuals. The results from this research demonstrates that urban living had a negative impact on infants likely due to maternal stress in-utero, as indicated by significantly higher rates of linear enamel hypoplasia in deciduous teeth. In addition, higher prevalences of linear enamel hypoplasia in deciduous teeth are related to frailty, rather than resiliency, since individuals who died as infants were clearly more vulnerable than those who died in later stages of childhood.