New study confirms that Roman urbanism was bad for health

Tuesday 16th December 2025

Analysis of skeletal remains from England before and during Roman occupation confirms theories that the population’s health declined under Roman occupation, but only in the urban centres, suggesting pre-Roman traditions continued in rural parts of Roman Britain whilst those in cities suffered long-term consequences.

The Roman occupation of Britain in AD 43 brought with it great social upheaval. Although the Romans wrote of bringing ‘civilisation’ to the people of Britannia, the increased urbanisation of the country under Roman influence exposed people to new diseases and introduced class divides that restricted access to resources, so has widely been viewed as having a negative impact on the overall health of the population.

Despite this being the prevailing belief, health in the preceding Iron Age has been comparatively overlooked, meaning our understanding of the Roman impact on health is limited.

“Iron Age funerary rites are very different to the organised cemeteries we often associate with the dead, instead their customs largely demonstrate that they believed fragmenting the body was required to release the soul into the afterlife”, states author of the research, Rebecca Pitt from the University of Reading. “This complicates analysis of this period as there are comparatively fewer human remains available for study, and examination of the complete skeleton cannot always take place.”

In contrast to adults, infants in Iron Age Britain were frequently inhumed intact rather than being cremated or disarticulated. To take advantage of this, Pitt takes a new approach, applying the DOHaD hypothesis.

“The DOHaD hypothesis suggests that what a child below the age of two years experiences will have an impact on their health and development throughout their lifetime”, Pitt explains. “This means that factors which we refer to as ‘stressors’, essentially disease, malnutrition, or maybe even a traumatic event, can influence an individual’s epigenetic signatures, which in turn can result in health issues later in life and even impact subsequent generations.”

By viewing non-adult experiences alongside the health of reproductive (biologically female) adults, an impression of the stressors affecting different generations can be gained, giving a more representative view of the long-term socioeconomic changes associated with the Roman occupation.

“Mothers and infants are underrepresented in historical accounts,” adds Pitt. “By looking at mother-infant experiences together, we can observe the long-lasting impact urbanisation has on the health of individuals, with negative health signatures passed from mothers to their children.”

Pitt studied 646 skeletons, 372 of which were non-adults and 274 adult females, from urban and rural Iron Age and Romano-British sites across south and central England.

Pitt identified the skeletons’ ages at death and health indicators such as skeletal lesions, then analysed them statistically to assess differences between Iron Age, rural Roman and urban Roman populations.

She found that, whilst there was a statistically significant rise in negative health markers during the Roman Period, this was only in urban contexts such as civitas capitals. Rural skeletons did show slightly increased pathogen exposure, but there was no statistical difference between Iron Age and Roman health in rural contexts.

It is likely that urbanisation resulted in limited access to resources, overcrowded, polluted living situations, and exposure to lead, which was a key part of urban Roman infrastructure. This had a harsh, long-term impact on health.

In contrast, rural communities did not similarly experience any of these stressors. It is even possible that regional Iron Age traditions were preserved in rural areas, questioning the prevailing idea that the Roman administration forced drastic cultural change on Iron Age communities.

Overall, whilst the negative health impacts of the Roman occupation were largely limited to the polluted and overcrowded urban centres, Pitt’s findings reveal a narrative of hardship caused by Roman urbanisation that spanned generations.

“I believe this has major connotations to the health of modern communities,” Pitt concludes. “Currently, children are being born into an increasingly polluted world, and a growing number of families are struggling with the cost of living. This can severely impact the development of young children, and result in a major impact to their health and wellbeing which will last throughout their lifetime and possibly into future generations.”