Physical Impairment or Disability? Three Cases of Developmental Dysplasia of the Hip from Grote Kerk, Alkmaar, the Netherlands (A.D. 1716–1830)

Abstract

Disability is part of the human experience, yet until recently, the lived experiences of individuals affected by physical impairment have been overlooked in bioarchaeological studies. Disability is a social construct; how we define disability is culturally specific, which makes identifying disability in archaeological contexts difficult. However, by defining disability as the inability to function within expected lifeways, it is possible to examine the effects of physical impairment on lived experiences and explore the construction of disability in historic contexts. Using a biocultural lens and robust cultural contextualization, this study examines the ability to function of three middle- to upper-class adult females from Grote Kerk, Alkmaar, the Netherlands (A.D. 1716–1830), with diagnoses of permanent, bilateral developmental dysplasia of the hip (DDH). DDH results from an abnormality in the hip joint’s size, shape, or orientation and, when untreated, leads to loss of normal joint function and deteriorating quality of life. While DDH probably resulted in limited mobility and pain for all three individuals analyzed in the present study, there is little evidence to support disablement in the form of social restrictions. The findings add to the ongoing discussion of historic disability by examining the intersection of socioeconomic status, sex, and physical impairment in a post-medieval Dutch population and add data that can be used in estimating historic prevalence rates of DDH, which are variable across modern populations.