Researchers examining 939 adult skeletons from five medieval Danish cemeteries found no consistent evidence that people with leprosy or tuberculosis were relegated to lower-status graves. Instead, individuals showing signs of these diseases were often buried in prominent locations, suggesting that responses to illness varied across communities rather than following a uniform pattern of exclusion.
In medieval Denmark, burial location often reflected a person’s wealth and status. Christians could pay for more prestigious graves, and plots closer to a church were typically more expensive.
A study highlighted by Frontiers and summarized by ScienceDaily examined whether disease affected where people were buried, focusing on leprosy—long associated with stigma and ideas of sin—and tuberculosis.
The research was led by Dr. Saige Kelmelis of the University of South Dakota in collaboration with Vicki Kristensen and Dr. Dorthe Pedersen of the University of Southern Denmark. The team examined 939 adult skeletons from five medieval Danish cemeteries—three urban and two rural—to compare possible differences between town and countryside populations.
“When we started this work, I was immediately reminded of the film Monty Python and the Holy Grail, specifically the scene with the plague cart,” Kelmelis said. “I think this image depicts our ideas of how people in the past -- and in some cases today -- respond to debilitating diseases. However, our study reveals that medieval communities were variable in their responses and in their makeup. For several communities, those who were sick were buried alongside their neighbors and given the same treatment as anyone else.”
To identify disease in the remains, researchers looked for skeletal changes linked to infection. Leprosy can leave clear traces on bones, including facial damage and deterioration of the hands and feet caused by secondary infections. Tuberculosis tends to affect joints and bones near the lungs.
The team mapped each cemetery and used boundaries and features—including burials inside religious buildings—to compare higher-status and lower-status burial areas. Overall, the researchers did not find a consistent link between illness and burial status.
Only one location, the urban cemetery of Ribe, showed a notable pattern: about one third of individuals buried in lower-status areas had tuberculosis, compared with 12% of those buried in the monastery or church. Because people with leprosy or tuberculosis still appeared in prestigious burial areas, the researchers said the Ribe difference most likely reflects varying levels of exposure to tuberculosis rather than social stigma.
Tuberculosis appeared frequently across the five cemeteries. The urban burial site at Drotten stood out: nearly half of the graves were in higher-status areas, and 51% of the skeletons showed evidence of tuberculosis. Researchers suggested that wealthier individuals may have survived tuberculosis longer, increasing the likelihood that the infection left visible skeletal changes.
“Tuberculosis is one of those chronic infections that people can live with for a very long time without symptoms,” Kelmelis said.
The researchers said further excavations and genomic methods could clarify how widespread these infections were, noting that skeletal evidence can miss cases. “Individuals may have been carrying the bacteria but died before it could show up in the skeleton,” Kelmelis cautioned.
