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New research examining the transition between the Iron Age and Romano-British period has shed new light on the detrimental impact of Roman occupation and urbanisation on population health.
Previous studies had already highlighted the likely health consequences of ‘Romanisation’ in Britain, with signs of poor health noted among a number of non-elite burials. With relatively few Iron Age examples to compare them to, however, the actual impact of imperial influence proved hard to determine. Now Rebecca Pitt, a PhD student from the University of Reading, has analysed 646 skeletons from 24 Iron Age and Roman sites in south-east England (choosing this region specifically as it was more-or-less continually under Roman control for the entirety of the Romano-British period).
During her study (recently published in Antiquity: https://doi.org/10.15184/aqy.2025.10263), Rebecca specifically focused on women of child-bearing age and infants aged 3.5 years and younger, as she was interested in applying the Developmental Origins of Health and Disease (DOHaD) hypothesis, which suggests that an individual’s experiences during the first 1,000 days after conception (up until around two years of age) have an enormous impact on their health in adulthood. Infant health, she notes, is also a good proxy for a community’s overall wellbeing, as the diseases and socio-economic conditions affecting a mother often have a direct impact on the outcomes for her offspring.
As for the infants studied in this research, 146 out of 372 (39.2%) had at least one sign of disease preserved on their skeleton, with enamel hypoplasia (when enamel doesn’t form properly during tooth development due to ill-health or lack of nutrients) and bone infection being the most common conditions. Within this group, 26% of Iron Age infants showed signs of poor health, compared to 41% of Roman-period infants in rural settings and 61.5% of those in urban environments. This indicates a significant increase from the Iron Age to the Roman period, with infants from urban Roman contexts particularly affected.
The adult women followed a similar pattern. Overall, 81.1% of women from urban Roman cemeteries had evidence of ill-health affecting their bones, compared to 63.5% from rural Roman burials and 62.1% of Iron Age ones. The biggest difference was seen in metabolic conditions that signify nutritional deficiencies, such as osteomalacia and Paget’s disease, with 28.8% of urban Romano-British women affected compared to 4.3% of rural Romano-British women and only 1.1% of Iron Age women.
From these results, it appears that living in an urban Roman centre was not conducive to good health. One of the explanations put forward by Rebecca for the observed disparities, particularly regarding metabolic disease, might be exposure to lead, which was used in Roman plumbing systems, tableware, cookware, and children’s toys. Lead disrupts metabolic pathways, and exposure can lead to increased rates of nutritional deficiencies, particularly among infants (who tend to absorb more). The very low rates of metabolic diseases in rural populations might suggest that they did not use as many Roman-style lead objects; might this hint at a degree of resistance to adopting ‘Romanised’ practices? Diet may have played a part too, Rebecca suggests: previous studies have shown that infants in Roman London were weaned on a primarily cereal-rich diet (as recommended by the 2nd-century Greek physician Soranus, who wrote an influential treatise on gynaecology), while infants in rural Oxfordshire appear to have had a higher intake of protein.
Text: Kathryn Krakowka / Photo: R Pitt (2026) Antiquity, https://doi.org/10.15184/aqy.2025.10263
