Now there is some evidence that this may not have been the case. Osteoarchaeologist Rachel Schats examined three deposits of well-preserved bones from medieval Holland. One of these was for townspeople, from Alkmaar (1448 -- 1572 AD). Two were from rural settlements, the West-Frisian community of Blokhuizen (1000 -- 1200 AD) and the flooded village of Klaaskinderkerke (1286 -- 1570 AD) in Zeeland. Schats found no more evidence of disease in the urban sample. The number of what archaeologists call "stress markers" was the same in the two samples:
These stress markers indicate the degree of malnutrition or disease. Although it is not immediately clear what the diseases are, we do see that these stress markers are equally distributed among the city and country dwellers.This is not definitive because of the usual caveat about all archaeological bone collections, which is that we have no idea what portion of the inhabitants ended up in graveyards; archaeologists pretty much never find enough skeletons to represent everyone in the community. But this is the data we have. If this turns out to be true, then we will have to come with another theory of why town dwellers did not reproduce themselves. Late marriage due to housing shortages? or due to a need to accumulate larger dowries?
Schat's study showed that the town dwellers of Alkmaar, a port, ate much more seafood than the rural people. They also had more tooth decay, which indicates they were eating more sugar, possibly in the form of beer.
Picture shows the Battle of Alkmaar in 1573.