The Roman invasion of England in 43 AD led to a profound social and environmental upheaval, which has generally been assumed to have been detrimental to the local population, who faced exposure to novel pathogens and restricted access to resources. Archaeological investigations have suggested that the people of Roman-occupied England were significantly less healthy than those of either the preceding Iron Age of following Early Medieval periods. However, data on Iron Age England is notoriously sparse, with only a few known burial sites, compared to the large number of Romano British cemeteries, potentially creating a biased perception of the health of Iron Age Britons.
The Iron Age itself was a period of profound change, with new methods of land management, social structures, and production technologies were introduced to Britain. However, this was not an even process, with fluctuations in the rate of change across the country. Burials from this period are rare, with most known burials being of individuals, which may not be representative of the population as a whole, and only a small number of burial grounds.
The rate of change in ancient England accelerated sharply after the Roman occupation, with the introduction of new technologies and ideas from the continent, and a single administration governing the entire population. For the first time a significant difference between the upper and lower social classes appears in the archaeological record. However, research on this period has tended to concentrate on the wealthier Roman or Romanised sections of the community, which may lead to a distorted perception of its society.
The impact of the Roman occupation itself appears to have varied across the country, but the general trend appears to have been to place a strain upon the local population which did not lift until the fifth century. This was driven not just by exposure to new diseases and additional strains upon resources, but also by the imposing of a new system of social division which caused the greatest hardship to marginalised communities. Recent studies have shed light on the rates of infection,metabolic deficiencies, and growth disruption in Roman Britain, but similar studies on the population of Iron Age Britain, which would enable comparison, are missing.
Current models in anthropology and biomedical science suggest that the period between conception and the second birthday is crucial to healthy development, and that the environment of a child during this period can affect not just the health of the individual as an adult, but also that of subsequent generations. Thus, in archaeology, studying the remains of children can significantly increase our understanding of the pressures that a population faced, improving our understanding of the health of the community.
In a paper published in the journal Antiquity on 11 December 2025, Rebecca Pitt of the Department of Archaeology at the University of Reading presents the results of a study in which she compared the skeletons of children and women of maternal age (approximately 18-45) from rural and urban settlements in England from the fourth century BC till the fourth century AD.
Pitt selected 646 skeletons (274 women and 372 children) from 24 Iron Age and Roman sites. These included 116 women and 150 children from Iron Age sites, 63 women and 144 children from rural Roman sites, and 95 women and 78 children from urban Roman sites.
The Iron Age sites were chosen from across England, to give a full scope of life in this period. However, because the Roman occupation of England is known not to have been similar everywhere, with a heavier military presence in the west and north. To try to ensure similarity of conditions at different Roman sites, Pitt selected remains only from sites in the south and central part of England, including Hampshire, Oxfordshire, Dorset, Northamptonshire, and Peterborough. These remains were additionally from the later part of the Roman occupation, to ensure that any developmental disorders detected were caused by the strain of living under Roman rule, not the initial disruption of the Roman invasion. Skeletons deemed to be from high status graves, as determined by the presence of stone sarcophagi or lavish grave goods, or by their placement in family mausoleums, were excluded.
Each skeleton was analysed to determine its age at death and health status. Adult skeletons were also examined to determine their sex, though this was not done for child skeletons as there are no reliable markers before puberty. Skeletons were only included in the study if the cranial vault, thoracic spine and long bones were preserved.
For the juvenile skeletons, priority was given to age determination by the formation, development, mineralisation and eruption of each tooth. If this was not possible, long bone diaphyseal lengths were used. Only skeletons deemed to be younger than 3.5-years-old (including foetal remains) were included in the study.
Child skeletons were assessed for growth disruption, which is indicative of impaired health prompted by environmental stress, by comparing the expected diaphyseal long bone length to the age-at-death as determined by dental development.
Both adult and child skeletons were analysed for dental and skeletal lesions, their locations, and whether they were healed or active at the time of death. The prevalence of such lesions within each community was determined by comparing the number of skeletons with a lesson on a skeletal element to the number of skeletons within which that element was present, for each population.
Six different types of lesion were included in the study: Dental enamel hypoplasia, defined as linear enamel defects across two or more bilateral teeth, cribra orbitalia, which presents as pores in the roofs of he eye sockets, dental disease such as caries or periodontal disease, bone infection, which manifests as layers of woven or dense lamellar bone, respiratory infections, such as sinusitis, visceral rib lesions, or tuberculosis, and metabolic conditions such as vitamin C deficiency, or vitamin D deficiency, which manifest as diagnostic modifications of the long bones, teeth, and other skeletal elements.
Of the 372 child skeletons included in the study, 146 of them (39.3%) were found to display some form of palaeopathological lesion, with dental enamel hypoplasia and bone infections being the most abundant. The proportion of children showing such symptoms varied from group-to-group, with 26% of Iron Age children (39 of 150 individuals) showing lesions, compared to 41% of rural Roman children (59 of 144 children) and 61.5% of urban Roman children (48 of 78 children). The most common pathologies were bone infections, found in 15.3% of Iron Age children, 21.8% of urban Roman children, and 28.5% of rural Roman children. Urban Roman children also showed high rates of metabolic conditions, which were found in 19.2% of these skeletons, and cribula orbata, found in 19.4% of urban Roman children. Dental enamel hypoplasia was found in 34.5% of urban Roman children, and 18.1% of rural Roman children, but only 4.5% of Iron Age children.
It was possible to calculate whether growth has been disrupted in 142 of the individuals, with only 3.1% of Iron Age children showing such developmental issues, compared to 25.5% of rural Roman children and 51.9% of urban Roman children. This was most common in children over six months old, suggesting that children were protected by 'maternal buffering' before being born and while being breast fed, but began to falter as they were weaned.
Of the 274 adult women included in the study, 189 (69%) showed symptoms of some form of health issue, with dental pathologies being the most common. Other conditions found included lesions with complex aetiologies, including congenital changes, osteochondroma, button osteomas and hyperostosis frontalis interna.
This was much more common in the urban Roman women (81.1%) than Iron Age women (62.1%) or rural Roman women (63.5%). Although dental pathologies were the most common overall, the prevalence of these did not vary greatly between populations. The majority of the difference between the groups appeared to be driven by metabolic conditions, which were found in 28.8% of urban Roman women, but only 4,3% of rural Roman women and 1.1% of Iron Age women. Respiratory infections were also much more common in urban Roman women, being found in 10.5% of individuals, compared to 0.9% of Iron Age women, and 3.2% of rural Roman women. Dental enamel hypoplasia, considered to be a sympton of stress, was also more common in urban Roman women, affecting 45.0% of individuals, compared to 19.0% of Iron Age women and 23.9% of rural Roman women.
Pitt's study reveals a marked decline in the health of both infants and maternal aged women during the Roman period, something which was particularly marked in urban areas. Previous studies on the health of fourth century urban populations in the UK have produced similar results, suggesting that this was not so much a Roman 'Golden Age' as it has traditionally been seen, but a time of fluctuating populations, with periodic overcrowding and nutritional stress.
The rise in pathologies in Roman populations, and in particular in urban Roman populations, may have been caused by exposure to lead. Romans made extensive use of lead, using it to make everything from pipes to cooking utensils to toys, as well as using it as an additive in wines and foods. Because it was used in piping, even the poorest sections of urban Roman society are likely to have been ingesting lead, which can disrupt metabolic pathways leading to nutritional deficiencies even in people with good diets. Young children are known to be particularly vulnerable to this form of poisoning.
Previous studies have suggested similar rates of metabolic problems in rural and urban populations, but Pitt found a significant difference between the two for both adult women and children. Children in rural Roman England appeared to be suffering higher rates of stress related pathologies and infectious diseases than their Iron Age predecessors, but there was little difference between rural Roman and Iron Age women. This may indicate that Roman occupation changed the lives of rural English populations less than is generally assumed, with local customs and ways of life persisting away from urban centres.
Iron Age Britain is often perceived as very regionalised, with communities in different parts of the country living very different lives, while the Romans are seen as having imposed a colonial administration with a centralised bureaucracy which imposed their version of civilisation throughout the land. However, recent studies have suggested that even under Roman occupation, the country remained quite diverse, with the adoption of Roman customs differing from area to area.
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