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But in fact people die for a reason, and those dying at any given age are demonstrably not a random sample of the living population at risk of death at that age (10, 11).

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If this were true, Black Death cemeteries would provide unbiased cross-sections of demographic and epidemiological conditions in 14th-century Europe.

Using skeletal remains from medieval England and Denmark, new methods of paleodemographic age estimation, and a recent multistate model of selective mortality, we test the assumption that the mid-14th-century Black Death killed indiscriminately.

The dying, on average, are less healthy than the rest of the living. But several researchers hope that it can be circumvented by examining so-called “catastrophic” skeletal samples.

Such samples are produced at more or less one point in time by massive, population-wide die-offs, caused, for example, by natural disasters, famines, epidemics, or war (15, 16).

One such special-purpose burial ground, the East Smithfield cemetery in London, was established in late 1348 or early 1349 for the express purpose of burying Black Death victims, and there is no evidence that it was used after the epidemic ended in 1350 (23, 24).

East Smithfield is one of very few excavated mass burial grounds in Europe that has clear documentary and archaeological evidence linking it to the mid-14th century Black Death (24).Skeletons from the East Smithfield Black Death cemetery in London are compared with normal, nonepidemic cemetery samples from two medieval Danish towns (Viborg and Odense).The results suggest that the Black Death did not kill indiscriminately—that it was, in fact, selective with respect to frailty, although probably not as strongly selective as normal mortality.To answer this question, we need to compare the East Smithfield skeletal sample to a nonepidemic, attritional control sample.The control sample should come from an urban community as similar as possible to London 1345, i.e., just before the epidemic.Denmark's medieval urban cemeteries are likely to provide as close an approximation to the ideal control group for East Smithfield as can be hoped for.