In medieval Denmark, burial location often reflected wealth and status: graves closer to church walls—or even inside the church—cost more and signaled prestige. But how were the sick treated, especially those with visible diseases like leprosy or tuberculosis? A new study in Frontiers in Environmental Archaeology shows the answer is more nuanced than expected.
Researchers examined 939 adult skeletons from five Danish cemeteries, including three urban sites and two rural ones, looking for skeletal evidence of leprosy (which affects the face, hands, and feet) and tuberculosis (which can impact bones near the lungs and joints, sometimes without obvious outward signs).
Surprisingly, illness did not consistently lead to exclusion from high-status burial areas. Many individuals with leprosy or tuberculosis were buried alongside their neighbors near churches and monasteries, just like healthy individuals. In several urban cemeteries, a large proportion of tuberculosis cases were found in prestigious plots. At one site, over half of those in high-status graves showed signs of tuberculosis.
The only exception was the town of Ribe, where fewer sick individuals were found in church or monastery plots. Researchers suggest this may reflect differences in exposure and survival: wealthier individuals could afford better housing and nutrition, which may have allowed them to live long enough for tuberculosis to leave detectable marks on their bones, ironically making them more visible in the archaeological record.
“Medieval communities were variable in their responses,” said Saige Kelmelis, lead author of the study. “For several communities, those who were sick were buried alongside their neighbors and given the same treatment as anyone else.”
The study challenges the stereotype of medieval society as uniformly harsh toward the ill. While wealth could influence burial location, illness alone did not automatically erase status, even in death. Kelmelis notes that genomic analyses could reveal more about disease prevalence, but for now, Danish cemeteries suggest a more inclusive approach to the sick than previously assumed.
