black death essay conclusion

Impact of the Black Death Essay

Introduction, social impacts of the black death, economic impacts of the black death, political impacts of the black death, reference list.

The Black Death was, no doubt, the greatest population disaster that has ever occurred in the history of Europe. The name is given to the bubonic plaque that occurred in the fourteenth century in Europe killing millions of people. The plaque began in the year 1348, and by the year 1359, it had killed an approximate 1.5 million people, out of an estimated total population of about 4 million people.

So terrifying was the Black Death that peasants were blaming themselves for its occurrence, and thus some of them resulted to punishing themselves as a way of seeking God’s forgiveness. The bubonic plaque was caused by fleas that were hosted by rats, a common phenomenon in the cities and towns. The presence of rats in the cities and towns was due to the fact that the towns were littered, and they were poorly managed.

The worst part of it is the fact that the medieval peasants did not know that the plaque was caused by the pleas hosted by the rats. They actually believed that the plague was caused by the rats themselves. As more and more people died from the Black Death, the impacts of the plague became more profound.

The plague affected the demographic composition of the society, and thus it had far-reaching effects on the social, economic, political and even cultural realms of the medieval society. To this day, the Black Death is remembered as the worst demographic disaster to be ever experienced in European history (Robin, 2011). This paper is an in-depth analysis of the impacts of the Black Death.

The Black Death had far reaching social impacts on the people who lived during the fourteenth century. An obvious social impact of the plague is the fact that the Black Death led to a significant reduction in the human population of the affected areas. This had extensive effects on all aspects of life, including the social and political structure of the affected areas.

Before the plague, feudalism, the European social structure in medieval times, had created a society in which inequality was rife, with many poor peasants, and rich lords. This fuelled overpopulation, which was a catalyst for the mortality of the plaque. After the plaque, a large number of the overpopulated peasants became victims of the plaque, and thus the lords lacked labourers in their farms. This also led to a significant reduction in the population (Bryrne, 2011).

The people who were spared by the plague lived full lives. They regarded themselves as the next victims of the bubonic plague. This led to immoral behaviour that saw societal codes like the sexual codes broken. People did not care about having virtues anymore because they knew that death was approaching fast. As people lost their partners to the plague, the marriage market grew, fuelling more sexual immorality (Carol, 1996).

Also among the immediate social impacts is the fact that at one point, the number of people who were dying from the bubonic plague was seemingly more than the number of the living. This made it virtually impossible for the living to take care of the ailing, or even for the living to bury the deceased. This was a social crisis that has remained in the books of history as a remarkable impact of the bubonic plague.

Immediately after the occurrence of the Black Death, all economic activities were paralysed. The first economic activity to suffer substantially from the plaque was trade. Although people were not aware that it was the infectiousness of the plaque that was making it to kill more people, they were afraid to travel to plagued areas for fear of coming into contact with rats, which they believed was the source of the disease. This substantially affected trade ties between villages and communities in the medieval European society.

After the occurrence of the Black Death, other impacts of the plague started affecting the community. The population of the European parts affected by the plaque reduced drastically, leading to a severe shortage of labour for the farms. The demand of peasant farmers increased, with the lords competing for them by relocating them from their villages to the farms of the latter. This made the peasants have a competitive economic edge, as they were able to negotiate for better salaries.

As the Black Death claimed more lives, farms were left unattended because the peasants who were responsible for ploughing had fallen victims of the plague. Where the lords were lucky to have had some harvest, it was challenging to bring it home due to a serious shortage of manpower.

Some harvest got destroyed in the field as there were no men to bring it home. Some animals got lost because the people who used to look after them had also fallen victims of the plague. These problems led to a number of other impacts in the medieval society of the fourteenth century (Bridbury, 1973).

As farms went unploughed and some harvest remained in the fields, people in the villages starved for food. Cities and towns also faced severe shortages of food since the farming villages around the towns did not have sufficient foodstuffs. Lords had to strategize economically in order to survive, and thus most of them resulted to keeping sheep since it was easier without the manpower.

Economic activities that required the presence of large numbers of peasants like the farming of grains lost their popularity. This, in turn, led to serious shortage of basic commodities like bread. This, coupled with the fact that the production of all kinds of foodstuffs had decreases, led to inflationary prices on commodities (“The Black Death And Its Effects”, 1935). The poor were left thriving in an environment full of hardships as the prices of foods skyrocketed.

The Black Death had a number of political impacts. First of all, the feudal social system of the fourteen-century European population demanded that peasants could not relocate from their villages at will. For a peasant to relocate from his/her village, he/she had to seek the permission of his/her lord.

After the Black Death, it became increasingly difficult for lords to get the number of peasants they required to provide them with the labour for their farms. This made lords to disregard the law, and relocate peasants to their villages so that they could work in their farms. Most of the times, the lords even declined to return the latter to their rightful villages in a bid to get maximum benefit from their labour.

Another political impact of the Black Death also stems from the reduced population of the affected areas. This is because after the number of peasants reduced, and they were able to negotiate salaries and even relocate from their villages, contrary to feudal law, the government imposed stricter rules to regulate the way peasants offer their manpower to the lords.

This was done by the introduction of the 1351 “statute for labourers” (Bridbury, 1973). The statute provided that payments to peasants were to be made with reference to the payments that were made in 1346. This meant that peasants would receive payments using the terms that were prevailing before the plague occurred.

The statute was structures such that both the lord and the peasant could be accused of breaking the law by either the peasant receiving a higher payment, or the lord giving the same. The effect of this statute was that a good number of peasants disobeyed it, leading to, arguably inhumane punishment. This fuelled revolt among the peasants who sought to fight for their rights in the 1381 Peasants Revolt (Bentley et al., 2008).

After oppressive statutes like the statute for labourers came into force, peasants started to be resistant. They therefore organized a number of revolts in a bid to attract the attention of legislators to their plea of fairness. The most serious of these revolts was the aforementioned 1381 peasant revolt. The peasants had gathered in huge numbers and marched to London. They killed senior officials of the King and took control over the tower of London.

Among their main grievances was the fact that, thirty-five years after the occurrence of the Black Death, the population had reasonably grown and the pre-existent demand for labour had substantially reduced. The lords were therefore threatening to withdraw the privileges they had given to peasants since their demand was no more. This led to the revolt as the peasants sought to fight for their privileges.

From the discussion above, it is evident that the Black Death had a lot of impacts on the European medieval society. It changed the demographic set-up of the community and thus it substantially affected the social activities of the peasants. This can be evidenced by the aforementioned increase in cases of sexual immorality as people had lost their partners in the plague.

The Black Death also had a number of economic impacts which resulted from the drastic decrease in the population of peasants. This can be evidenced by the aforementioned change by lords from grain farming to sheep farming. Lastly, the Black Death had a number of political impacts which can be exemplified by the development of the aforementioned statute for labourers.

Studies of the impacts of the bubonic plague are still ongoing. This is despite the fact that most of the impacts were realized immediately after the plague and their effects on the society analyzed. Political activists during the time, who were mostly lords, had observed the effects of the plague and made societal changes that were bound to benefit them.

However, scientists still believe that the European society still suffers significant effects of the bubonic plague. For instance, it has been established that England, where the greatest effects of the bubonic plague were perhaps felt, has significantly lower genetic diversity than it is suspected to have had in the eleventh century. Geneticists explain this by the argument that the deaths that resulted from the Black Deaths were the cause of the low genetic variation in Europe.

Bentley, Jerry H., Ziegler, Herbert F., Streets, Heather E. (2008) Traditions and

Encounters: A Brief Global History, ch9,15,19, McGraw-Hill, Inc.

Bridbury, A. (1973). The Black Death. The Economic History Review, 26: 577 – 592.

Bryrne, J. (2011). Black Death. World Book Advanced. Web.

Carol, B. (1996). Bubonic Plague in the nineteenth-century China.

Robin, N. (2011). Apocalypse Then: A History of Plague. Special Report. World Book Advanced. Web.

The Black Death And Its Effects. (1935). Readings in English History Drawn from the Original Sources: Intended to Illustrate a Short History of England. Boston: Ginn.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2018, August 22). Impact of the Black Death. https://ivypanda.com/essays/impact-of-the-black-death/

"Impact of the Black Death." IvyPanda , 22 Aug. 2018, ivypanda.com/essays/impact-of-the-black-death/.

IvyPanda . (2018) 'Impact of the Black Death'. 22 August.

IvyPanda . 2018. "Impact of the Black Death." August 22, 2018. https://ivypanda.com/essays/impact-of-the-black-death/.

1. IvyPanda . "Impact of the Black Death." August 22, 2018. https://ivypanda.com/essays/impact-of-the-black-death/.

Bibliography

IvyPanda . "Impact of the Black Death." August 22, 2018. https://ivypanda.com/essays/impact-of-the-black-death/.

• The Black Death in Europe: Spread and Causes
• Stress and Strains in the Renaissance Society
• The Black Death Disease' History
• What Factors Contributed to the Dissolution of the Roman Empire?
• Chivalry in the First Crusade
• The Knights Templar: The Warrior Monks
• The Catholic Church and the Black Death in the 14th Century
• The Year 1000’ by Robert Lacey and Danny Danziger

• History Classics
• Your Profile
• Find History on Facebook (Opens in a new window)
• Find History on Twitter (Opens in a new window)
• Find History on YouTube (Opens in a new window)
• Find History on Instagram (Opens in a new window)
• Find History on TikTok (Opens in a new window)
• This Day In History
• History Podcasts
• History Vault

Black Death

By: History.com Editors

Updated: March 28, 2023 | Original: September 17, 2010

The Black Death was a devastating global epidemic of bubonic plague that struck Europe and Asia in the mid-1300s. The plague arrived in Europe in October 1347, when 12 ships from the Black Sea docked at the Sicilian port of Messina. People gathered on the docks were met with a horrifying surprise: Most sailors aboard the ships were dead, and those still alive were gravely ill and covered in black boils that oozed blood and pus. Sicilian authorities hastily ordered the fleet of “death ships” out of the harbor, but it was too late: Over the next five years, the Black Death would kill more than 20 million people in Europe—almost one-third of the continent’s population.

How Did the Black Plague Start?

Even before the “death ships” pulled into port at Messina, many Europeans had heard rumors about a “Great Pestilence” that was carving a deadly path across the trade routes of the Near and Far East. Indeed, in the early 1340s, the disease had struck China, India, Persia, Syria and Egypt.

The plague is thought to have originated in Asia over 2,000 years ago and was likely spread by trading ships , though recent research has indicated the pathogen responsible for the Black Death may have existed in Europe as early as 3000 B.C.

Symptoms of the Black Plague

Europeans were scarcely equipped for the horrible reality of the Black Death. “In men and women alike,” the Italian poet Giovanni Boccaccio wrote, “at the beginning of the malady, certain swellings, either on the groin or under the armpits…waxed to the bigness of a common apple, others to the size of an egg, some more and some less, and these the vulgar named plague-boils.”

Blood and pus seeped out of these strange swellings, which were followed by a host of other unpleasant symptoms—fever, chills, vomiting, diarrhea, terrible aches and pains—and then, in short order, death.

The Bubonic Plague attacks the lymphatic system, causing swelling in the lymph nodes. If untreated, the infection can spread to the blood or lungs.

How Did the Black Death Spread?

The Black Death was terrifyingly, indiscriminately contagious: “the mere touching of the clothes,” wrote Boccaccio, “appeared to itself to communicate the malady to the toucher.” The disease was also terrifyingly efficient. People who were perfectly healthy when they went to bed at night could be dead by morning.

Did you know? Many scholars think that the nursery rhyme “Ring around the Rosy” was written about the symptoms of the Black Death.

Understanding the Black Death

Today, scientists understand that the Black Death, now known as the plague, is spread by a bacillus called Yersinia  pestis . (The French biologist Alexandre Yersin discovered this germ at the end of the 19th century.)

They know that the bacillus travels from person to person through the air , as well as through the bite of infected fleas and rats. Both of these pests could be found almost everywhere in medieval Europe, but they were particularly at home aboard ships of all kinds—which is how the deadly plague made its way through one European port city after another.

Not long after it struck Messina, the Black Death spread to the port of Marseilles in France and the port of Tunis in North Africa. Then it reached Rome and Florence, two cities at the center of an elaborate web of trade routes. By the middle of 1348, the Black Death had struck Paris, Bordeaux, Lyon and London.

Today, this grim sequence of events is terrifying but comprehensible. In the middle of the 14th century, however, there seemed to be no rational explanation for it.

No one knew exactly how the Black Death was transmitted from one patient to another, and no one knew how to prevent or treat it. According to one doctor, for example, “instantaneous death occurs when the aerial spirit escaping from the eyes of the sick man strikes the healthy person standing near and looking at the sick.”

How Do You Treat the Black Death?

Physicians relied on crude and unsophisticated techniques such as bloodletting and boil-lancing (practices that were dangerous as well as unsanitary) and superstitious practices such as burning aromatic herbs and bathing in rosewater or vinegar.

Meanwhile, in a panic, healthy people did all they could to avoid the sick. Doctors refused to see patients; priests refused to administer last rites; and shopkeepers closed their stores. Many people fled the cities for the countryside, but even there they could not escape the disease: It affected cows, sheep, goats, pigs and chickens as well as people.

In fact, so many sheep died that one of the consequences of the Black Death was a European wool shortage. And many people, desperate to save themselves, even abandoned their sick and dying loved ones. “Thus doing,” Boccaccio wrote, “each thought to secure immunity for himself.”

Black Plague: God’s Punishment?

Because they did not understand the biology of the disease, many people believed that the Black Death was a kind of divine punishment—retribution for sins against God such as greed, blasphemy, heresy, fornication and worldliness.

By this logic, the only way to overcome the plague was to win God’s forgiveness. Some people believed that the way to do this was to purge their communities of heretics and other troublemakers—so, for example, many thousands of Jews were massacred in 1348 and 1349. (Thousands more fled to the sparsely populated regions of Eastern Europe, where they could be relatively safe from the rampaging mobs in the cities.)

Some people coped with the terror and uncertainty of the Black Death epidemic by lashing out at their neighbors; others coped by turning inward and fretting about the condition of their own souls.

Flagellants

Some upper-class men joined processions of flagellants that traveled from town to town and engaged in public displays of penance and punishment: They would beat themselves and one another with heavy leather straps studded with sharp pieces of metal while the townspeople looked on. For 33 1/2 days, the flagellants repeated this ritual three times a day. Then they would move on to the next town and begin the process over again.

Though the flagellant movement did provide some comfort to people who felt powerless in the face of inexplicable tragedy, it soon began to worry the Pope, whose authority the flagellants had begun to usurp. In the face of this papal resistance, the movement disintegrated.

How Did the Black Death End?

The plague never really ended and it returned with a vengeance years later. But officials in the port city of Ragusa were able to slow its spread by keeping arriving sailors in isolation until it was clear they were not carrying the disease—creating social distancing that relied on isolation to slow the spread of the disease.

The sailors were initially held on their ships for 30 days (a trentino ), a period that was later increased to 40 days, or a quarantine — the origin of the term “quarantine” and a practice still used today. 

Does the Black Plague Still Exist?

The Black Death epidemic had run its course by the early 1350s, but the plague reappeared every few generations for centuries. Modern sanitation and public-health practices have greatly mitigated the impact of the disease but have not eliminated it. While antibiotics are available to treat the Black Death, according to The World Health Organization, there are still 1,000 to 3,000 cases of plague every year.

Gallery: Pandemics That Changed History

HISTORY Vault

Stream thousands of hours of acclaimed series, probing documentaries and captivating specials commercial-free in HISTORY Vault

Sign up for Inside History

Get HISTORY’s most fascinating stories delivered to your inbox three times a week.

By submitting your information, you agree to receive emails from HISTORY and A+E Networks. You can opt out at any time. You must be 16 years or older and a resident of the United States.

More details : Privacy Notice | Terms of Use | Contact Us

The Black Death: A Personal History Essay Questions

By john hatcher, essay questions.

These notes were contributed by members of the GradeSaver community. We are thankful for their contributions and encourage you to make your own.

Written by people who wish to remain anonymous

The black death plague was not a health issue but rather a religious issue Show how the writer presents the plague as a religious crisis rather than a health crisis in The Black Death: A Personal History

Written employing the point of view of the local priest, Master John, the book follows the happenings as a result of the black death plague. Through the priest’s eyes and those of the other people, the book examines the question of whether the crisis is a health one as opposed to being a religious one. Throughout the pages, Master John and the other priests struggle in an attempt to find the reason and religious meaning behind the plague. In this sense, these characters are of the idea that the plague is a religious issue. There is a hovering assertion that the plague was sent by God as a punishment. The assertion of the disease being religious-related is thus valid as an argument as it clearly presents the politics affecting the Catholic church.

Show the role that the black death epidemic plays in resulting in economic inequality as presented in John Hatcher’s The Black Death: A Personal History .

The black death as an epidemic spread quickly and widely being transferred from one individual to another and across villages. In so doing, the disease is presented as being responsible for wiping out and eradicating fairly large proportions of people a situation that results into the introduction of unfairness in the distribution of economic resources in the society in which the story is set. This resulted in a different way of doing things. Upon its climax, the poor became poorer and class struggles are implicit. Europe thus required rebuilding as the system was essentially broken.

What role do the historical account at the beginning of chapters in The Black Death: A Personal History play?

In this work, the black death epidemic is brought out quite vividly through the writer’s employment of the perception of Master John as well as other characters. However, the writer also includes a historical account and explanation of events as they were, which plays the role of being the backdrop to the unfolding events through the book.

Update this section!

You can help us out by revising, improving and updating this section.

After you claim a section you’ll have 24 hours to send in a draft. An editor will review the submission and either publish your submission or provide feedback.

The Black Death: A Personal History Questions and Answers

The Question and Answer section for The Black Death: A Personal History is a great resource to ask questions, find answers, and discuss the novel.

Study Guide for The Black Death: A Personal History

The Black Death: A Personal History study guide contains a biography of John Hatcher, literature essays, quiz questions, major themes, characters, and a full summary and analysis.

• About The Black Death: A Personal History
• The Black Death: A Personal History Summary
• Character List

Essays for The Black Death: A Personal History

The Black Death: A Personal History essays are academic essays for citation. These papers were written primarily by students and provide critical analysis of The Black Death: A Personal History by John Hatcher.

• The Black Death and the Modernization of Europe: A Critique of Hatcher's Account

• Search Menu
• Browse content in Arts and Humanities
• Browse content in Archaeology
• Anglo-Saxon and Medieval Archaeology
• Archaeological Methodology and Techniques
• Archaeology by Region
• Archaeology of Religion
• Archaeology of Trade and Exchange
• Biblical Archaeology
• Contemporary and Public Archaeology
• Environmental Archaeology
• Historical Archaeology
• History and Theory of Archaeology
• Industrial Archaeology
• Landscape Archaeology
• Mortuary Archaeology
• Prehistoric Archaeology
• Underwater Archaeology
• Urban Archaeology
• Zooarchaeology
• Browse content in Architecture
• Architectural Structure and Design
• History of Architecture
• Residential and Domestic Buildings
• Theory of Architecture
• Browse content in Art
• Art Subjects and Themes
• History of Art
• Industrial and Commercial Art
• Theory of Art
• Biographical Studies
• Byzantine Studies
• Browse content in Classical Studies
• Classical History
• Classical Philosophy
• Classical Mythology
• Classical Literature
• Classical Reception
• Classical Art and Architecture
• Classical Oratory and Rhetoric
• Greek and Roman Epigraphy
• Greek and Roman Law
• Greek and Roman Papyrology
• Greek and Roman Archaeology
• Late Antiquity
• Religion in the Ancient World
• Digital Humanities
• Browse content in History
• Colonialism and Imperialism
• Diplomatic History
• Environmental History
• Genealogy, Heraldry, Names, and Honours
• Genocide and Ethnic Cleansing
• Historical Geography
• History by Period
• History of Emotions
• History of Agriculture
• History of Education
• History of Gender and Sexuality
• Industrial History
• Intellectual History
• International History
• Labour History
• Legal and Constitutional History
• Local and Family History
• Maritime History
• Military History
• National Liberation and Post-Colonialism
• Oral History
• Political History
• Public History
• Regional and National History
• Revolutions and Rebellions
• Slavery and Abolition of Slavery
• Social and Cultural History
• Theory, Methods, and Historiography
• Urban History
• World History
• Browse content in Language Teaching and Learning
• Language Learning (Specific Skills)
• Language Teaching Theory and Methods
• Browse content in Linguistics
• Applied Linguistics
• Cognitive Linguistics
• Computational Linguistics
• Forensic Linguistics
• Grammar, Syntax and Morphology
• Historical and Diachronic Linguistics
• History of English
• Language Acquisition
• Language Evolution
• Language Reference
• Language Variation
• Language Families
• Lexicography
• Linguistic Anthropology
• Linguistic Theories
• Linguistic Typology
• Phonetics and Phonology
• Psycholinguistics
• Sociolinguistics
• Translation and Interpretation
• Writing Systems
• Browse content in Literature
• Bibliography
• Children's Literature Studies
• Literary Studies (Asian)
• Literary Studies (European)
• Literary Studies (Eco-criticism)
• Literary Studies (Romanticism)
• Literary Studies (American)
• Literary Studies (Modernism)
• Literary Studies - World
• Literary Studies (1500 to 1800)
• Literary Studies (19th Century)
• Literary Studies (20th Century onwards)
• Literary Studies (African American Literature)
• Literary Studies (British and Irish)
• Literary Studies (Early and Medieval)
• Literary Studies (Fiction, Novelists, and Prose Writers)
• Literary Studies (Gender Studies)
• Literary Studies (Graphic Novels)
• Literary Studies (History of the Book)
• Literary Studies (Plays and Playwrights)
• Literary Studies (Poetry and Poets)
• Literary Studies (Postcolonial Literature)
• Literary Studies (Queer Studies)
• Literary Studies (Science Fiction)
• Literary Studies (Travel Literature)
• Literary Studies (War Literature)
• Literary Studies (Women's Writing)
• Literary Theory and Cultural Studies
• Mythology and Folklore
• Shakespeare Studies and Criticism
• Browse content in Media Studies
• Browse content in Music
• Applied Music
• Dance and Music
• Ethics in Music
• Ethnomusicology
• Gender and Sexuality in Music
• Medicine and Music
• Music Cultures
• Music and Religion
• Music and Media
• Music and Culture
• Music Education and Pedagogy
• Music Theory and Analysis
• Musical Scores, Lyrics, and Libretti
• Musical Structures, Styles, and Techniques
• Musicology and Music History
• Performance Practice and Studies
• Race and Ethnicity in Music
• Sound Studies
• Browse content in Performing Arts
• Browse content in Philosophy
• Aesthetics and Philosophy of Art
• Epistemology
• Feminist Philosophy
• History of Western Philosophy
• Metaphysics
• Moral Philosophy
• Non-Western Philosophy
• Philosophy of Science
• Philosophy of Language
• Philosophy of Mind
• Philosophy of Perception
• Philosophy of Action
• Philosophy of Law
• Philosophy of Religion
• Philosophy of Mathematics and Logic
• Practical Ethics
• Social and Political Philosophy
• Browse content in Religion
• Biblical Studies
• Christianity
• East Asian Religions
• History of Religion
• Judaism and Jewish Studies
• Qumran Studies
• Religion and Education
• Religion and Health
• Religion and Politics
• Religion and Science
• Religion and Law
• Religion and Art, Literature, and Music
• Religious Studies
• Browse content in Society and Culture
• Cookery, Food, and Drink
• Cultural Studies
• Customs and Traditions
• Ethical Issues and Debates
• Hobbies, Games, Arts and Crafts
• Lifestyle, Home, and Garden
• Natural world, Country Life, and Pets
• Popular Beliefs and Controversial Knowledge
• Sports and Outdoor Recreation
• Technology and Society
• Travel and Holiday
• Visual Culture
• Browse content in Law
• Arbitration
• Browse content in Company and Commercial Law
• Commercial Law
• Company Law
• Browse content in Comparative Law
• Systems of Law
• Competition Law
• Browse content in Constitutional and Administrative Law
• Government Powers
• Judicial Review
• Local Government Law
• Military and Defence Law
• Parliamentary and Legislative Practice
• Construction Law
• Contract Law
• Browse content in Criminal Law
• Criminal Procedure
• Criminal Evidence Law
• Sentencing and Punishment
• Employment and Labour Law
• Environment and Energy Law
• Browse content in Financial Law
• Banking Law
• Insolvency Law
• History of Law
• Human Rights and Immigration
• Intellectual Property Law
• Browse content in International Law
• Private International Law and Conflict of Laws
• Public International Law
• IT and Communications Law
• Jurisprudence and Philosophy of Law
• Law and Politics
• Law and Society
• Browse content in Legal System and Practice
• Courts and Procedure
• Legal Skills and Practice
• Primary Sources of Law
• Regulation of Legal Profession
• Medical and Healthcare Law
• Browse content in Policing
• Criminal Investigation and Detection
• Police and Security Services
• Police Procedure and Law
• Police Regional Planning
• Browse content in Property Law
• Personal Property Law
• Study and Revision
• Terrorism and National Security Law
• Browse content in Trusts Law
• Wills and Probate or Succession
• Browse content in Medicine and Health
• Browse content in Allied Health Professions
• Arts Therapies
• Clinical Science
• Dietetics and Nutrition
• Occupational Therapy
• Operating Department Practice
• Physiotherapy
• Radiography
• Speech and Language Therapy
• Browse content in Anaesthetics
• General Anaesthesia
• Neuroanaesthesia
• Browse content in Clinical Medicine
• Acute Medicine
• Cardiovascular Medicine
• Clinical Genetics
• Clinical Pharmacology and Therapeutics
• Dermatology
• Endocrinology and Diabetes
• Gastroenterology
• Genito-urinary Medicine
• Geriatric Medicine
• Infectious Diseases
• Medical Toxicology
• Medical Oncology
• Pain Medicine
• Palliative Medicine
• Rehabilitation Medicine
• Respiratory Medicine and Pulmonology
• Rheumatology
• Sleep Medicine
• Sports and Exercise Medicine
• Clinical Neuroscience
• Community Medical Services
• Critical Care
• Emergency Medicine
• Forensic Medicine
• Haematology
• History of Medicine
• Browse content in Medical Dentistry
• Oral and Maxillofacial Surgery
• Paediatric Dentistry
• Restorative Dentistry and Orthodontics
• Surgical Dentistry
• Browse content in Medical Skills
• Clinical Skills
• Communication Skills
• Nursing Skills
• Surgical Skills
• Medical Ethics
• Medical Statistics and Methodology
• Browse content in Neurology
• Clinical Neurophysiology
• Neuropathology
• Nursing Studies
• Browse content in Obstetrics and Gynaecology
• Gynaecology
• Occupational Medicine
• Ophthalmology
• Otolaryngology (ENT)
• Browse content in Paediatrics
• Neonatology
• Browse content in Pathology
• Chemical Pathology
• Clinical Cytogenetics and Molecular Genetics
• Histopathology
• Medical Microbiology and Virology
• Patient Education and Information
• Browse content in Pharmacology
• Psychopharmacology
• Browse content in Popular Health
• Caring for Others
• Complementary and Alternative Medicine
• Self-help and Personal Development
• Browse content in Preclinical Medicine
• Cell Biology
• Molecular Biology and Genetics
• Reproduction, Growth and Development
• Primary Care
• Professional Development in Medicine
• Browse content in Psychiatry
• Addiction Medicine
• Child and Adolescent Psychiatry
• Forensic Psychiatry
• Learning Disabilities
• Old Age Psychiatry
• Psychotherapy
• Browse content in Public Health and Epidemiology
• Epidemiology
• Public Health
• Browse content in Radiology
• Clinical Radiology
• Interventional Radiology
• Nuclear Medicine
• Radiation Oncology
• Reproductive Medicine
• Browse content in Surgery
• Cardiothoracic Surgery
• Gastro-intestinal and Colorectal Surgery
• General Surgery
• Neurosurgery
• Paediatric Surgery
• Peri-operative Care
• Plastic and Reconstructive Surgery
• Surgical Oncology
• Transplant Surgery
• Trauma and Orthopaedic Surgery
• Vascular Surgery
• Browse content in Science and Mathematics
• Browse content in Biological Sciences
• Aquatic Biology
• Biochemistry
• Bioinformatics and Computational Biology
• Developmental Biology
• Ecology and Conservation
• Evolutionary Biology
• Genetics and Genomics
• Microbiology
• Molecular and Cell Biology
• Natural History
• Plant Sciences and Forestry
• Research Methods in Life Sciences
• Structural Biology
• Systems Biology
• Zoology and Animal Sciences
• Browse content in Chemistry
• Analytical Chemistry
• Computational Chemistry
• Crystallography
• Environmental Chemistry
• Industrial Chemistry
• Inorganic Chemistry
• Materials Chemistry
• Medicinal Chemistry
• Mineralogy and Gems
• Organic Chemistry
• Physical Chemistry
• Polymer Chemistry
• Study and Communication Skills in Chemistry
• Theoretical Chemistry
• Browse content in Computer Science
• Artificial Intelligence
• Computer Architecture and Logic Design
• Game Studies
• Human-Computer Interaction
• Mathematical Theory of Computation
• Programming Languages
• Software Engineering
• Systems Analysis and Design
• Virtual Reality
• Browse content in Computing
• Business Applications
• Computer Security
• Computer Games
• Computer Networking and Communications
• Digital Lifestyle
• Graphical and Digital Media Applications
• Operating Systems
• Browse content in Earth Sciences and Geography
• Atmospheric Sciences
• Environmental Geography
• Geology and the Lithosphere
• Maps and Map-making
• Meteorology and Climatology
• Oceanography and Hydrology
• Palaeontology
• Physical Geography and Topography
• Regional Geography
• Soil Science
• Urban Geography
• Browse content in Engineering and Technology
• Agriculture and Farming
• Biological Engineering
• Civil Engineering, Surveying, and Building
• Electronics and Communications Engineering
• Energy Technology
• Engineering (General)
• Environmental Science, Engineering, and Technology
• History of Engineering and Technology
• Mechanical Engineering and Materials
• Technology of Industrial Chemistry
• Transport Technology and Trades
• Browse content in Environmental Science
• Applied Ecology (Environmental Science)
• Conservation of the Environment (Environmental Science)
• Environmental Sustainability
• Environmentalist Thought and Ideology (Environmental Science)
• Management of Land and Natural Resources (Environmental Science)
• Natural Disasters (Environmental Science)
• Nuclear Issues (Environmental Science)
• Pollution and Threats to the Environment (Environmental Science)
• Social Impact of Environmental Issues (Environmental Science)
• History of Science and Technology
• Browse content in Materials Science
• Ceramics and Glasses
• Composite Materials
• Metals, Alloying, and Corrosion
• Nanotechnology
• Browse content in Mathematics
• Applied Mathematics
• Biomathematics and Statistics
• History of Mathematics
• Mathematical Education
• Mathematical Finance
• Mathematical Analysis
• Numerical and Computational Mathematics
• Probability and Statistics
• Pure Mathematics
• Browse content in Neuroscience
• Cognition and Behavioural Neuroscience
• Development of the Nervous System
• Disorders of the Nervous System
• History of Neuroscience
• Invertebrate Neurobiology
• Molecular and Cellular Systems
• Neuroendocrinology and Autonomic Nervous System
• Neuroscientific Techniques
• Sensory and Motor Systems
• Browse content in Physics
• Astronomy and Astrophysics
• Atomic, Molecular, and Optical Physics
• Biological and Medical Physics
• Classical Mechanics
• Computational Physics
• Condensed Matter Physics
• Electromagnetism, Optics, and Acoustics
• History of Physics
• Mathematical and Statistical Physics
• Measurement Science
• Nuclear Physics
• Particles and Fields
• Plasma Physics
• Quantum Physics
• Relativity and Gravitation
• Semiconductor and Mesoscopic Physics
• Browse content in Psychology
• Affective Sciences
• Clinical Psychology
• Cognitive Psychology
• Cognitive Neuroscience
• Criminal and Forensic Psychology
• Developmental Psychology
• Educational Psychology
• Evolutionary Psychology
• Health Psychology
• History and Systems in Psychology
• Music Psychology
• Neuropsychology
• Organizational Psychology
• Psychological Assessment and Testing
• Psychology of Human-Technology Interaction
• Psychology Professional Development and Training
• Research Methods in Psychology
• Social Psychology
• Browse content in Social Sciences
• Browse content in Anthropology
• Anthropology of Religion
• Human Evolution
• Medical Anthropology
• Physical Anthropology
• Regional Anthropology
• Social and Cultural Anthropology
• Theory and Practice of Anthropology
• Browse content in Business and Management
• Business Strategy
• Business Ethics
• Business History
• Business and Government
• Business and Technology
• Business and the Environment
• Comparative Management
• Corporate Governance
• Corporate Social Responsibility
• Entrepreneurship
• Health Management
• Human Resource Management
• Industrial and Employment Relations
• Industry Studies
• Information and Communication Technologies
• International Business
• Knowledge Management
• Management and Management Techniques
• Operations Management
• Organizational Theory and Behaviour
• Pensions and Pension Management
• Public and Nonprofit Management
• Strategic Management
• Supply Chain Management
• Browse content in Criminology and Criminal Justice
• Criminal Justice
• Criminology
• Forms of Crime
• International and Comparative Criminology
• Youth Violence and Juvenile Justice
• Development Studies
• Browse content in Economics
• Agricultural, Environmental, and Natural Resource Economics
• Asian Economics
• Behavioural Finance
• Behavioural Economics and Neuroeconomics
• Econometrics and Mathematical Economics
• Economic Systems
• Economic History
• Economic Methodology
• Economic Development and Growth
• Financial Markets
• Financial Institutions and Services
• General Economics and Teaching
• Health, Education, and Welfare
• History of Economic Thought
• International Economics
• Labour and Demographic Economics
• Law and Economics
• Macroeconomics and Monetary Economics
• Microeconomics
• Public Economics
• Urban, Rural, and Regional Economics
• Welfare Economics
• Browse content in Education
• Adult Education and Continuous Learning
• Care and Counselling of Students
• Early Childhood and Elementary Education
• Educational Equipment and Technology
• Educational Strategies and Policy
• Higher and Further Education
• Organization and Management of Education
• Philosophy and Theory of Education
• Schools Studies
• Secondary Education
• Teaching of a Specific Subject
• Teaching of Specific Groups and Special Educational Needs
• Teaching Skills and Techniques
• Browse content in Environment
• Applied Ecology (Social Science)
• Climate Change
• Conservation of the Environment (Social Science)
• Environmentalist Thought and Ideology (Social Science)
• Natural Disasters (Environment)
• Social Impact of Environmental Issues (Social Science)
• Browse content in Human Geography
• Cultural Geography
• Economic Geography
• Political Geography
• Browse content in Interdisciplinary Studies
• Communication Studies
• Museums, Libraries, and Information Sciences
• Browse content in Politics
• African Politics
• Asian Politics
• Chinese Politics
• Comparative Politics
• Conflict Politics
• Elections and Electoral Studies
• Environmental Politics
• European Union
• Foreign Policy
• Gender and Politics
• Human Rights and Politics
• Indian Politics
• International Relations
• International Organization (Politics)
• International Political Economy
• Irish Politics
• Latin American Politics
• Middle Eastern Politics
• Political Methodology
• Political Communication
• Political Philosophy
• Political Sociology
• Political Behaviour
• Political Economy
• Political Institutions
• Political Theory
• Politics and Law
• Public Administration
• Public Policy
• Quantitative Political Methodology
• Regional Political Studies
• Russian Politics
• Security Studies
• State and Local Government
• UK Politics
• US Politics
• Browse content in Regional and Area Studies
• African Studies
• Asian Studies
• East Asian Studies
• Japanese Studies
• Latin American Studies
• Middle Eastern Studies
• Native American Studies
• Scottish Studies
• Browse content in Research and Information
• Research Methods
• Browse content in Social Work
• Addictions and Substance Misuse
• Adoption and Fostering
• Care of the Elderly
• Child and Adolescent Social Work
• Couple and Family Social Work
• Developmental and Physical Disabilities Social Work
• Direct Practice and Clinical Social Work
• Emergency Services
• Human Behaviour and the Social Environment
• International and Global Issues in Social Work
• Mental and Behavioural Health
• Social Justice and Human Rights
• Social Policy and Advocacy
• Social Work and Crime and Justice
• Social Work Macro Practice
• Social Work Practice Settings
• Social Work Research and Evidence-based Practice
• Welfare and Benefit Systems
• Browse content in Sociology
• Childhood Studies
• Community Development
• Comparative and Historical Sociology
• Economic Sociology
• Gender and Sexuality
• Gerontology and Ageing
• Health, Illness, and Medicine
• Marriage and the Family
• Migration Studies
• Occupations, Professions, and Work
• Organizations
• Population and Demography
• Race and Ethnicity
• Social Theory
• Social Movements and Social Change
• Social Research and Statistics
• Social Stratification, Inequality, and Mobility
• Sociology of Religion
• Sociology of Education
• Sport and Leisure
• Urban and Rural Studies
• Browse content in Warfare and Defence
• Defence Strategy, Planning, and Research
• Land Forces and Warfare
• Military Administration
• Military Life and Institutions
• Naval Forces and Warfare
• Other Warfare and Defence Issues
• Peace Studies and Conflict Resolution
• Weapons and Equipment

• < Previous chapter
• Next chapter >

24 Conclusion

• Published: April 2018
• Cite Icon Cite
• Permissions Icon Permissions

The conclusion summarizes the findings of the book’s investigation of the hypothesis that epidemics which were mysterious and without known cures were the most likely to provoke hatred, blame, and violence towards ‘the other’ and the disease’s victims. These assumptions are based on a handful of examples, such as the Black Death, cholera riots of the 1830s, and the US experience of AIDS. In a brief survey of the book’s descriptions of epidemics across time, the conclusion highlights several key insights into their socio-psychological consequences, which are richer than the dominant hypothesis would lead us to expect. Epidemics could possess the power to negate class, race, ethnic, and religious differences by spurring compassion and self-sacrifice. Despite the laboratory revolution, collective violence provoked by disease appears overwhelmingly to have been a modern phenomenon but has never constituted the general rule.

This book challenges a dominant hypothesis in the study of epidemics across time: that mysterious diseases with no preventive measures or cures to hand were the ones to provoke ‘sinister connotations’, spurring hatred and blame towards ‘the other’ and victims of disease. If this were true, then why were such incidents so rare before the spread of cholera through Europe in the 1830s? As we have shown, these violent reactions hardly appeared in antiquity, and for the Middle Ages the Black Death has cast a long shadow that needs contesting. Recurrences of plague after 1348 into the sixteenth century did not rekindle the horrors of the Black Death, which pervaded social relations and brought about not only the burning of Jews but also the more diffused cruelty of abandoning loved ones in their moment of need. Even with resurging fears of plague spreaders in the sixteenth century, neither Jews nor other minorities were then the butts of prejudice and persecution; rather, insiders from solid artisans to bankers were the usual suspects. Moreover, those tried, tortured, and executed did not amount to thousands; nor were entire communities exterminated as in 1348–50. In the most studied case, the torture and execution of alleged plague carriers in Milan in 1630, only ten executions are recorded. The Black Death was a colossal exception, not the rule for a pre-‘laboratory-revolution’ past when almost all diseases were without cures to hand.

Should we then suppose that a socio-psychological immunity developed, with epidemics losing their capacity to terrorize and spark widespread violence after their first mysterious appearances? The answer was usually no. Sometimes we forget that cholera first struck parts of Europe in the early 1820s, not the 1830s, and first spread through Russia’s Volga basin without traces of social violence. 1 But it returned there for the next five cholera waves with deadly socio-psychological effects, as in the 1890s, when crowds of 10,000 killed a governor, physicians, and soldiers and destroyed an important industrial town, present-day Donetsk. Such recurrences were not limited to authoritarian regimes that brutally enforced sanitary controls. In Italy, cholera’s social violence, instead of declining or disappearing with successive bouts of the disease, expanded geographically. With its first attack in 1836–7, riots were confined almost exclusively to Sicily. By its last major wave, 1910–11, riots had advanced through Puglia, Calabria, and Abruzzi, invading towns in the centre-north, such as seaside resorts north of Rome, and by some accounts, Venice. With the same fantasies and fears of the 1830s, crowds attacked town halls and hospitals, killed doctors and mayors, and ‘liberated’ afflicted neighbours, whom they triumphantly carried on their shoulders back to their homes.

Cholera was not the only epidemic disease that failed to acquire immunity to attacks of blame and violence. While rioting accompanied the first spread of plague in Mumbai in 1896, social violence mounted with successive strikes of the disease and peaked with its largest, most deadly revolt in March 1898, joined by shopkeepers who closed their businesses and workers who went on strike. The same holds for plague in the Middle East, where social violence was not triggered by the first appearance of the disease but after four plague seasons had passed.

Smallpox’s trajectory of violence was more striking. If the Antonine pandemic of the 160s ce was smallpox, as historians now believe, it provoked no known cases of blame, persecution, or violence. Quite the opposite: tensions along Rome’s bellicose borders eased. Nor did the Middle Ages record any smallpox riots or persecution, and the same appears to have been the case when it arrived in the New World and later in colonial Latin America. Instead, sustained smallpox violence that blamed outsiders—the tramp, ‘Negro’, ‘Chinaman’, and ‘Bohemian’—came late in the day with the pandemic of 1881–2 in the US and mounted in frequency and cruelty into the twentieth century, that is, after it had become a familiar disease both epidemically and endemically, and after an effective means of prevention had been discovered.

Aggressors and Targets

Smallpox highlights a second theme running through this book. The violence spawned by various epidemic diseases was not all alike, nor was it what historians have supposed. People perceived as the ‘other’—ethnic and racial minorities, the outsider, the foreigner, the Jew—were not predominantly the victims. Rather, aggressors and their targets assumed different sides, depending on the epidemic. Although officials, intellectuals, and physicians may have decried the ignorance and filth of the labouring classes, seeing them as cholera’s cause, elites were the victims of this disease’s rage. As René Baehrel claimed sixty-six years ago, these were matters of class struggle, but one to which neither Marx nor Engels paid any heed. Across a wide range of political regimes from Czarist Russia to liberal Manchester, the poor and marginal—recent Irish Catholic immigrants in English, Scottish, and North American cities; Asiatic Sarts in Tashkent, impoverished women and children in Glasgow and Edinburgh, fig-growers and fishermen in Sicily and southern Italy—produced similar fantasies that accused elites of plotting to cull populations of the poor. Here, the ‘others’, instead of being the butts of blame, were the perpetrators, who attacked physicians, pharmacists, mayors, and police.

On first impression, plague riots, mostly in India in the years 1896 to 1902, may appear to have followed cholera’s suit. These riots, however, rarely divided communities. Instead, they unified castes and classes, bridging differences even between Hindus and Muslims in common cause against colonial and municipal abuses, military searches, destruction to temples and homes, and disrespect for local customs. In contrast to the bulk of cholera riots, which show few signs of prior organization, planning, or leadership, plague riots usually began with open meetings, resolutions, newspaper editorials, and letters to colonial commissioners. Despite initial criticisms of violence or lower-class ‘superstitions’, intellectuals and indigenous elites often ended up supporting the demands of the lower classes against abuses, incompetence, and notions of plague control that dated back to the Middle Ages, but by 1898 had been discovered to be counterproductive.

Plague protest as a force for unity was not exclusive to the subcontinent. The national Public Health Service’s discriminatory quarantine on San Francisco’s Chinatown and coercive vaccination of the Chinese alone not only united the city’s Chinese community across class, it moved white merchants to support their Chinese neighbours with demonstrations, business closures, and legal actions in marked contrast to their earlier attitudes and actions during outbreaks of smallpox, tuberculosis, and syphilis. Similarly, Honolulu’s plague experience ultimately was a force for unity, despite white citizens’ initial fears and armed quarantine entrapment of Chinese, Japanese, and native Hawaiians, while their homes and businesses burnt to the ground. No class or ethnic massacre ensued. Instead, white elites succoured the afflicted: charity and compassion were the upshots.

The epidemic disease that best fits the present view that diseases inspired hatred with the victims of the disease often being victimized was smallpox in America, which historians have yet to realize. This disease’s social violence was also one of class struggle, but the perpetrators and victims of violence now switched sides. Smallpox ‘mobs’ were mostly comprised of small-town white citizens, businessmen, or propertied farmers and were led (unlike cholera protesters) by adult males. In such cases, the victims were doubly victimized, first by the disease, then by elite violence. Smallpox violence differed in another respect. Although these crowds could number in the thousands, more characteristically, gangs or small vigilante groups greeted those seeking help with double-barrel shotguns, or worse, burnt their pesthouses to the ground, sometimes with the incumbents cremated inside. Other epidemics showed more complex alignments, as in Milan in 1630. Those who perpetuated myths of plague spreaders and persecuted those who were accused by means of brutal legal procedures participated in an unspoken alliance between the poor—often women—and elites, comprised of physicians, senators, and the Cardinal-Archbishop. The alleged untori on the other hand were not outsiders or the lowest of plague cleaners, as historians now assume, but insiders, native Milanese, who proudly announced it when summoned before the authorities who interrogated and tortured them.

Across the wide sweep of recorded epidemics, blame and persecution were not the usual outcomes. As Livy and authors in antiquity highlight, epidemics often interrupted the course of human events, ending, at least temporarily, conflict between tribes and nations, such as between Rome and Velitrae or the Volscians during the fifth century bce , or internal battles, such as the ongoing strife between senatorial classes and plebeians. When epidemics were particularly mysterious, oracles or sacred books were consulted. Instead of casting out beggars or persecuting ‘others’, ancients heeded oracles’ calls by opening their doors to strangers, breaking the manacles binding prisoners, granting work-free holidays, providing grain for the poor, and inventing new forms of hospitality. Similarly, with the two great pandemics of late antiquity, the Antonine Plague of 165–180 ce and the Justinianic Plague beginning in 541, unity and charity, not division and hatred, were the outcome. Emperor Marcus Aurelius was praised for his charitable offerings to the afflicted, and despite war with the Germanic tribes, his previous persecution of Christians, and the fact that this pestilence was new, mysterious, and originated beyond the Empire’s borders, no blame or persecution ensued. Instead, new opportunities and privileges were extended to ‘barbarian’ outsiders.

The depiction of the Justinianic Plague once it reached Constantinople was more extraordinary, especially given the disposition of its principal historian, Procopius, towards Emperor Justinian. Before the pandemic, Procopius depicted Justinian’s greed, corruption, and cruelty that divided the city through factional strife, sponsoring the circus of the Blues and murdering their rivals. Yet with the coming of the plague, Procopius heaps praise on Justinian’s charity, which through his minister, Theodorus, rallied public assistance to the poor and afflicted, and buried the mounds of plague corpses threatening the city’s survival. The circuses’ perennial divisions temporarily ended. Those who before the plague despised one another now united to honour the dead.

The late Middle Ages also experienced these moments of unity in the midst of pestilence. Not only was the Black Death unique in its horrific socially inflicted carnage, half a century later, a flagellant movement was born from a plague that was the polar opposite of the previous movement in 1349. Instead of re-enacting Black-Death division and hate, the Bianchi was a peace movement that united elites and commoners, crossed city walls into the countryside, and brought men, women, and children together to end social conflict from everyday litigation to factional strife among aristocratic clans and war between territorial states.

Even if the Black Death was not a turning point in epidemics’ power to fuel hatred, it awakened a new awareness of the transmission of diseases, inspiring new regulations and organizations to protect communities in plague time by evicting suspected carriers and undesirables. Yet it was the birth of a new disease in Europe at the end of the fifteenth century—the Great Pox—that launched endeavours to track the movement of disease, as physicians turned from their reliance on antique and Arabic sources, to chart Columbus’s voyages and the possible routes by which the new disease progressed to Naples, then across Europe and beyond. With this disease, however, tracking of contacts did not lead to blaming and certainly not to persecution. Instead, the leading edge of hate-fuelled disease in early modernity was Europe’s old companion, known now for two centuries—plague. The sixteenth- and early seventeenth-century accusations, tortures, and executions did not hinge on ignorance or a sudden unleashing of folkloric superstition previously locked in mountain hollows. Instead, those at the forefront of medicine and science were the ones to justify the state’s onslaught on innocents. Yet these injustices did not amount to massacres, certainly not on a scale comparable to the Black Death slaughter or to cholera and plague riots in the nineteenth and twentieth centuries.

Even with modernity and new notions that diseases were carried by people (although miasmas continued to figure), few epidemic diseases ignited collective violence against victims of disease, outsiders, insiders, or elites. Instead, some of the most feared and deadly diseases, whose causative agents remained mysterious into the twentieth century, provoked waves of compassion and volunteerism rather than division and hate. Like Livy’s ancient plagues, yellow fever in America and the Great Influenza of 1918–20 globally eased class, ethnic, sectional, and racial tensions and extended care and charity through the donation of resources and relief provided by priests, nuns, doctors, nurses, and others who often journeyed from distant places and died as a consequence of their charity. The mass evacuation of Philadelphia in 1793, New Orleans in 1853, Memphis in 1878, and many smaller towns across the Deep South throughout the nineteenth century suggests that yellow fever sparked greater fear and panic than any disease in US history. Fear and panic did not, however, spell blame and violence. Instead, it cut in the opposite direction, spurring clubs and business to assist the afflicted, with people from the North volunteering in the South and blacks sacrificing their lives for the white afflicted. These waves of abnegation, moreover, sprouted in historical contexts not conducive to such sentiments, such as the South’s epidemic of 1853, when sectional tensions between North and South were on the rise, or in 1878, during a racist backlash against the advances of post-Civil War reconstruction.

Charitable outpouring and self-sacrifice were more widespread during the Great Influenza and differed from earlier waves of disease-inspired volunteerism. Women now played the principal role, at least across much of Canada, the US, and Australia. No doubt, the war played its part in the shift. But here too the general contexts—war-spun xenophobia, worldwide industrial strife, red-scare hysteria, the longest, most violent race riots in US history, and rising anti-Mexican hatred, even warfare, along the Texan–Mexican border—ran counter to humanitarian urges. But in El Paso, middle-class women and debutant girls crossed into the city’s most impoverished and afflicted Mexican neighbourhoods to sweep floors, make meals, care for children, and nurse the dangerously ill. Such sentiments flourished across the country against advice from government bulletins and municipal decrees pillorying spitters, sneezers, coughers, and big talkers, and urging ‘patriots’ to blame them for flu’s fatal spread. No collective violence, however, ensued against sufferers or any other ‘others’.

The Importance of Disease

This book has argued that local and national contexts are insufficient to explain how a disease such as cholera could have produced such similar and distinctive fantasies of blame and patterns of collective violence across radically different political and cultural regimes from Asiatic Russia to New York City. Moreover, other epidemic diseases struck some of these places at the same moments without stirring blame or igniting mass violence, such as an influenza pandemic in Paris, other places in France, and Europe in 1831 that caused more deaths than cholera did a year later. Similarly, a wave of typhus raged through Britain and Ireland in 1826, felling 20,000 in London alone, and again in the 1830s with no ramifications of social violence, and attacks of plague and typhus spread through the Volga in 1892, when cholera and the riots associated with it were rife, but here neither plague nor typhus spawned a single disturbance. In addition, many disastrous epidemics fill modern European history, such as typhus which accompanied the ‘Great Hunger’ in Ireland in the 1840s or that spread from Siberia in 1920–2 through parts of Russia and into Eastern Europe, but did not stir up violence.

Of course, neither cholera nor smallpox spread hate and blame everywhere. As we have seen, smallpox’s social violence was situated mostly in the US and before 1881–2 had been extremely rare. Cholera also showed peculiar patterns. So far, only one major cholera riot has appeared in its birthplace, India, although cholera was rife at moments when plague protest neared its peak in May 1897 on the eve of the ‘Tragedy of Poona’ and with mass plague violence in Kolkata, Mumbai, and elsewhere. On the other side of the hate–compassion divide, an epidemic of poliomyelitis erupted in New York City in 1916. However, unlike influenza two years later, elite ladies, instead of risking their lives to clean, feed, and nurse the poor, blamed the poor for the disease and patrolled impoverished neighbourhoods to report habits they judged unsavoury to the police.

As shown in the chapter on smallpox and collective violence, pundits in the nineteenth century thought cholera was the disease most likely to provoke social violence in America. International news, however, and not their own history, fixed their views. In places such as Ireland, Britain, America, and to a large extent France, waves of cholera after the 1830s failed to spark mass social violence; whereas in Russia, Spain, Portugal, Persia, and places in the Middle East, the riots persisted throughout the nineteenth century, and, in Italy, may have reached their zenith during its last major wave in 1910–11. Moreover, in North America, cholera crowds in the thousands appeared only once. Even in the 1830s, when cholera pushed westward, devastating cities such as New Orleans and St Louis, no rioting or fantasies of doctors culling populations arose.

Certainly, such differences depended on multiple factors, which can be uncovered only through new comparative research, investigating attitudes and practices of ruling elites and medical authorities along with those of the poor, especially on sensitive matters of ritual and religion, such as the burial and handling the dead. In places, authorities appear to have learnt lessons, such as the reforms made by the British for the provisioning of cadavers to anatomy colleges. In other places, such as Russia from the 1830s to at least the 1890s, elites instead stood fast to the same accusations, blaming the disease on the poor, castigating their supposed ‘ignorance’ and ‘superstitions’, and creating their own mythologies that labelled any cholera disturbance the work of outside agitators, while the state imposed heavier controls and harsher repression.

Similar measures by local and national authorities continued to provoke distrust and cholera unrest in Italy. From the first cholera wave in Italy in 1836–7 to the last major one in 1910–11, local authorities prohibited non-elites from performing their traditional burial rites, visiting afflicted friends and relations, and viewing the bodies of loved ones before burial, while elites were allowed to bury theirs in traditional church grounds. Such class-based impositions supported fears that doctors and the state were murdering the poor. Seeing their relatives unceremoniously ‘thrown into ditches’ of newly created cholera grounds, the popolo of Ostuni rioted in 1837. In 1910, the state’s class-based burial restrictions remained in place, and fears of poisoning and burials alive resurfaced. In mid-November, Ostuni’s collective violence exploded beyond any of its previous incidents: 3000 in a town of 18,500 wrecked the cholera hospital, ‘liberated the patients’, burnt down the town hall and health department, took possession of the town square, attacking health workers, stoning carabinieri , and destroying doctors’ homes.

On the other hand, other places succeeded in quelling fears and distrust, which could have sparked social violence among populations unaccustomed to hospital care and where mythologies of doctors plotting to poison the poor already existed. Such was the experience during yellow fever’s 1905 finale in Louisiana’s bayous. Recently arrived Sicilian peasants, working the sugar plantations and imbued with cholera fantasies from their homeland of little more than a decade earlier, initially resisted doctors and fumigators entering their homes. In Old World fashion, they accused them of spreading the disease to cull their numbers. Through door-to-door canvassing by Italian-speaking neighbours and priests, and letters and lectures from trusted community leaders, their fears, however, faded: threats of collective violence turned to disease prevention.

A Model for Epidemic Diseases?

Few scholars have pointed to which diseases in the past or which of their characteristics were likely to spark social violence. Margaret Humphreys has delved deeper than others, arguing that childhood diseases and those that were endemic, despite being big killers—diphtheria, scarlatina, whooping cough, dysentery, typhoid, tuberculosis, and influenza—were not prone to ignite blame or hatred. Instead, those that struck suddenly and disappeared quickly were the socially dangerous ones. At times, this was certainly the case. However, America’s socially most toxic disease—smallpox—was an endemic disease with epidemic outbreaks, and children more than adults were the victims. The same goes for poliomyelitis, which in 1916 was blamed on the poor, ethnic minorities, and victims of the disease, or their mothers. As for diseases that struck fast and vanished rapidly, this theory only partially works with cholera and plague: plague after 1348 and into the sixteenth century provoked no riots and rarely social loathing. Moreover, with modern plague, collective violence was confined mostly to India and the years 1896 to 1902, well before the disease reached its heights in the subcontinent. Other epidemic diseases also rose and disappeared quickly, such as yellow fever and the Great Influenza, which in many places wreaked its havoc within a month. Yet, these failed to spark mass violence or social victimization of the diseased victim.

Three further characteristics may have influenced epidemics’ potential for hate and social violence. First, diseases that kill quickly such as cholera (in a day or two), plague in medieval and early modern Europe (in two to three days), and modern plague (around a week in bubonic form, twenty-four hours in pneumonic form, and less with septicaemia) could all provoke hatred, blame, and rioting. Yet fast killers, such as yellow fever (within a week) or influenza in 1918–20 (often within forty-eight hours) did not rouse violent recriminations. By contrast, smallpox, whose record of hatred and violence arose only in the late nineteenth century, was usually a slow killer. Second, diseases with signs and symptoms that produced reactions of disgust also could spread hate and blame. Here, the prime candidates were smallpox, leprosy, and syphilis and other venereal diseases that engulfed early modern Europe. But as we have observed, leprosy during the Middle Ages until the mid-nineteenth century rarely ignited hatred and sparked mass slaughter only once, in 1321, when no epidemic of it raged. Similarly, neither syphilis nor other venereal diseases spread blame or persecution of their victims until late into the sixteenth century and then it was limited mostly to England. Of the diseases renowned for disgust, only smallpox engendered popular hatred or rioting and this occurred principally in the US and only by the late nineteenth century.

Finally, lethality (and certainly not mortality) was a key variable. Lethality rates of medieval and early modern plague were high. As calculated from lazaretti records, they could range between 50 and 90 per cent and remained as high with modern plague until the diffusion of antibiotics. Cholera’s rates were also high, usually over 50 per cent into the twentieth century, as were Ebola’s in West Africa in 2014–15. 2 With both diseases, this lethality sparked repeated claims by victims’ friends and families: ‘Here, if the people come into the hospital, they don’t leave alive.’ And for both, these suspicions led to deadly consequences for doctors, health workers, and police. In addition, with cholera and Ebola, as well as plague in India, anger arose when health workers tried to disrupt traditional rituals of dressing and burying the afflicted. Yet as the recent history of Ebola in West Africa has shown, along with examples in this book stretching from Mumbai’s slums to Louisiana’s bayous, relations between governors and health boards and the communities of victims were crucial. When the latter were permitted to negotiate and participate in measures such as search parties, the rioting and assassinations ended. While this book knows no easy answers, it has uncovered parallels and stark differences over the long history of epidemics. Just as different diseases affect our bodies differently, so too they have affected differently our collective mentalities.

I know of only one riot during cholera’s first wave. In Manila, 9 October 1820, thirty to forty Europeans and eighty Chinese were massacred; Peckham, ‘Symptoms of Empire’, 192.

By contrast, lethality rates of yellow fever and especially influenza, even the Great One, were much lower. In places with repeated strikes of yellow fever, mild cases arise that often go undetected. Even in severe epidemics like Philadelphia’s in 1793, estimates of lethality are less than 20 per cent.

• About Oxford Academic
• Publish journals with us
• University press partners
• What we publish
• New features  
• Open access
• Institutional account management
• Rights and permissions
• Get help with access
• Accessibility
• Advertising
• Media enquiries
• Oxford University Press
• Oxford Languages
• University of Oxford

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide

• Copyright © 2024 Oxford University Press
• Cookie settings
• Cookie policy
• Privacy policy
• Legal notice

This Feature Is Available To Subscribers Only

Sign In or Create an Account

This PDF is available to Subscribers Only

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

• Undergraduate
• High School
• Architecture
• American History
• Asian History
• Antique Literature
• American Literature
• Asian Literature
• Classic English Literature
• World Literature
• Creative Writing
• Linguistics
• Criminal Justice
• Legal Issues
• Anthropology
• Archaeology
• Political Science
• World Affairs
• African-American Studies
• East European Studies
• Latin-American Studies
• Native-American Studies
• West European Studies
• Family and Consumer Science
• Social Issues
• Women and Gender Studies
• Social Work
• Natural Sciences
• Pharmacology
• Earth science
• Agriculture
• Agricultural Studies
• Computer Science
• IT Management
• Mathematics
• Investments
• Engineering and Technology
• Engineering
• Aeronautics
• Medicine and Health
• Alternative Medicine
• Communications and Media
• Advertising
• Communication Strategies
• Public Relations
• Educational Theories
• Teacher's Career
• Chicago/Turabian
• Company Analysis
• Education Theories
• Shakespeare
• Canadian Studies
• Food Safety
• Relation of Global Warming and Extreme Weather Condition
• Movie Review
• Admission Essay
• Annotated Bibliography
• Application Essay
• Article Critique
• Article Review
• Article Writing
• Book Review
• Business Plan
• Business Proposal
• Capstone Project
• Cover Letter
• Creative Essay
• Dissertation
• Dissertation - Abstract
• Dissertation - Conclusion
• Dissertation - Discussion
• Dissertation - Hypothesis
• Dissertation - Introduction
• Dissertation - Literature
• Dissertation - Methodology
• Dissertation - Results
• GCSE Coursework
• Grant Proposal
• Marketing Plan
• Multiple Choice Quiz
• Personal Statement
• Power Point Presentation
• Power Point Presentation With Speaker Notes
• Questionnaire
• Reaction Paper

Research Paper

• Research Proposal
• SWOT analysis
• Thesis Paper
• Online Quiz
• Literature Review
• Movie Analysis
• Statistics problem
• Math Problem
• All papers examples
• How It Works
• Money Back Policy
• Terms of Use
• Privacy Policy
• We Are Hiring

The Black Death, Essay Example

Pages: 1

Words: 408

Hire a Writer for Custom Essay

Use 10% Off Discount: "custom10" in 1 Click 👇

You are free to use it as an inspiration or a source for your own work.

The Black Death, or Bubonic Plague, was an epidemic that drastically changed society in Medieval Europe. Outbreaks occurred from 1348 to the 1600s and killed approximately one third of the population. The Bubonic Plague’s brutal nature impacted the way people treated each other, their customs, and basic political structure.

Transmission was due to lice, rats, and unsanitary living conditions. The plague’s distinguishing symptoms were buboes, or painful and swollen lymph nodes in the axilla or groin. Other symptoms included headache, seizures, fever, and muscle aches. Once onset began, the disease could kill within a few hours.

Fear of the disease caused people to radically change their behavior and customs. Some isolated themselves, restricting both their diet and social interaction. Others over-indulged in food, drinking, and debauchery. People abandoned not only their cities and homes, but also their friends and family. The sick were often neglected and left to die on their own. Many physicians and clergy refused to see the sick for fear of contracting the plague. Prior to the outbreak, it was custom to die surrounded by friends and family and receive a proper funeral and mourning. During the period of the Black Death, funeral processions were discontinued. Sextons would carry the bodies to the nearest open tomb for disposal. No ceremony was given and many times the dead were thrown onto the streets.

Religious fanaticism heightened during the Black Death. Flagellates would travel throughout Europe, beating themselves to repent for sin. Witch hunts and persecution against Jews intensified.

The extreme drop in population altered the economy and class structure. As the wealth was redistributed, standards of living improved for the survivors. Due to a shortage of workers, peasants were able to demand higher wages. Many nobles were forced to free serfs, as they could no longer afford to keep them. Taxes were increased due to depleted finances and to increase funding for projects such as the Hundred Year War. The tax increases and the lack of desire to pay workers higher wages led to peasant uprisings, weakening the strength of the nobility. As the nobility weakened, the merchant class grew stronger and European society began to transform from feudalism to more of a capitalistic economy.

The severe nature of the Black Death inspired mass fear, which led to changes in the economy, government, and customs of Medieval Europe. Though pestilence took the lives of many and caused people to abandon civilized behavior, after a time, positive changes were able to develop.

Stuck with your Essay?

Get in touch with one of our experts for instant help!

The Evolution of Resources, Case Study Example

Food & Drug Administration Agency, Research Paper Example

Time is precious

don’t waste it!

Plagiarism-free guarantee

Privacy guarantee

Secure checkout

Money back guarantee

Related Essay Samples & Examples

Voting as a civic responsibility, essay example.

Words: 287

Utilitarianism and Its Applications, Essay Example

Words: 356

The Age-Related Changes of the Older Person, Essay Example

Pages: 2

Words: 448

The Problems ESOL Teachers Face, Essay Example

Pages: 8

Words: 2293

Should English Be the Primary Language? Essay Example

Pages: 4

Words: 999

The Term “Social Construction of Reality”, Essay Example

Words: 371

Home — Essay Samples — History — Medieval Europe — Black Death

Essays on Black Death

When it comes to writing an essay on the Black Death, also known as the Bubonic Plague, it’s crucial to choose a topic that is not only interesting but also relevant and impactful. The Black Death was one of the most devastating pandemics in human history, and its impact on society, culture, and economy was immense. Therefore, selecting the right essay topic is essential to ensure that you can delve deeper into this historical event and provide valuable insights to your readers.

The Black Death had a profound and lasting impact on European society. It led to widespread death and suffering, economic collapse, and significant shifts in religious and cultural practices. As a result, studying the Black Death is crucial for understanding the broader historical context of the period and its long-term consequences. By choosing the right essay topic, you can contribute to the ongoing scholarly conversation about the Black Death and its impact on human history.

When selecting a Black Death essay topic, it’s important to consider your interests, the available research material, and the specific angle or perspective you want to explore. Whether you’re interested in the medical, social, economic, or cultural aspects of the Black Death, there are plenty of thought-provoking essay topics to choose from.

Recommended Black Death Essay Topics

There are numerous topics to consider in the Black Death essays. Whether you are interested in the history, social impact, or scientific aspects of this devastating pandemic, there is a wide range of topics to explore. Below is a list of Black Death essay topics categorized by different themes.

Medical Aspects

• The spread of the Black Death: causes and transmission
• The impact of the Black Death on medieval medicine
• The role of physicians and healers during the Black Death
• Comparing the Black Death to modern-day pandemics

Social and Economic Impact

• The demographic consequences of the Black Death
• The economic repercussions of the Black Death
• Changes in labor and land ownership after the Black Death
• The Black Death and the decline of feudalism

Religious and Cultural Effects

• Religious responses to the Black Death
• The portrayal of the Black Death in art and literature
• The Black Death and the development of public health measures
• The impact of the Black Death on social and cultural norms

Global and Comparative Perspectives

• The Black Death and its impact beyond Europe
• Comparing the Black Death to other historical pandemics
• The Black Death in the context of global trade and travel
• The Black Death and its legacy in different regions of the world

These are just a few examples of the wide range of essay topics that you can explore when writing about the Black Death. By choosing a topic that resonates with your interests and expertise, you can produce an engaging and insightful essay that contributes to our understanding of this pivotal moment in history.

Black Death: Humanity's Grim Catalyst

Essay on the black death, made-to-order essay as fast as you need it.

Each essay is customized to cater to your unique preferences

+ experts online

Black Plague – The Deadliest Epidemic in History

The black plague in medieval europe, the black plague: causes, symptoms, and spread, black death and its impact on economic, cultural and social structures of european society, let us write you an essay from scratch.

• 450+ experts on 30 subjects ready to help
• Custom essay delivered in as few as 3 hours

A Research Paper on Bubonic Plague

The black death of 1348 as the greatest biomedical disaster in world history, a report on plague: hostory, forms, and prevention, the impact of the black death on family relations, get a personalized essay in under 3 hours.

Expert-written essays crafted with your exact needs in mind

The Horror of Black Death in The Medieval Era

How the black death pandemic affected the lifes of people, impact of black death on england, perception of black death in the world, the bubonic plague pandemic and its impact on the world, social effects of the black plague, the biggest pandemics in history and how they affected people’s lifes, major sources for the black deaths, microbial disease report: the plague, black death vs. covid-19: a comparative analysis, the profound impact of the black death.

75,000,000–200,000,000

1346 - 1353

Eurasia, North Africa

The Pestilence, the Great Mortality, the Plague.

The Black Death was a bubonic plague pandemic occurring in Afro-Eurasia, and became the most fatal pandemic recorded in human history. The Black Death had profound effects on the course of European history.

The Black Death is believed to have been the result of plague, caused by the bacterium Yersinia pestis, but it may also cause septicaemic or pneumonic plagues. The disease was likely transmitted from rodents to humans by the bite of infected fleas. The Definitive appearance of the Black Death was in Crimea in 1347 and reached southern England in 1348.

Yersinia pestis causes three types of plague in humans: bubonic, pneumonic, and septicemic, and it is likely that all three played some role in the pandemic. The Bubonic Plague causes fever, chills, vomiting, diarrhea, terrible aches and pains. Also, it attacks the lymphatic system, causing swelling in the lymph nodes. The disease was also terrifyingly progressive, people who went to bed at night could be dead by morning. The bacillus travels from person to person through the air.

The Black Death estimated to have killed 30 percent to 60 percent of the European population. The bacterial infection still occurs but can be treated with antibiotics. The Black Death had profound effects on the course of European history.

Relevant topics

• Imperialism
• Middle Ages
• Scientific Revolution
• French Revolution
• Romanticism
• Renaissance
• Frederick Douglass
• Civil Rights Movement

By clicking “Check Writers’ Offers”, you agree to our terms of service and privacy policy . We’ll occasionally send you promo and account related email

No need to pay just yet!

We use cookies to personalyze your web-site experience. By continuing we’ll assume you board with our cookie policy .

• Instructions Followed To The Letter
• Deadlines Met At Every Stage
• Unique And Plagiarism Free

Study reveals staggering toll of being Black in America: 1.6 million excess deaths over 22 years

Research has long shown that Black people live sicker lives and die younger than white people.

Now a new study, published Tuesday in JAMA , casts the nation’s racial inequities in stark relief, finding that the higher mortality rate among Black Americans resulted in 1.63 million excess deaths relative to white Americans over more than two decades.

Because so many Black people die young — with many years of life ahead of them — their higher mortality rate from 1999 to 2020 resulted in a cumulative loss of more than 80 million years of life compared with the white population, the study showed.

Although the nation made progress in closing the gap between white and Black mortality rates from 1999 to 2011, that advance stalled from 2011 to 2019. In 2020, the enormous number of deaths from Covid-19 — which hit Black Americans particularly hard — erased two decades of progress.

Authors of the study describe it as a call to action to improve the health of Black Americans, whose early deaths are fueled by higher rates of heart disease, cancer, and infant mortality.

“The study is hugely important for about 1.63 million reasons,” said Herman Taylor, an author of the study and director of the cardiovascular research institute at the Morehouse School of Medicine.

“Real lives are being lost. Real families are missing parents and grandparents,” Taylor said. “Babies and their mothers are dying. We have been screaming this message for decades.”

High mortality rates among Black people have less to do with genetics than with the country’s long history of discrimination, which has undermined educational, housing, and job opportunities for generations of Black people, said Clyde Yancy, an author of the study and chief of cardiology at Northwestern University’s Feinberg School of Medicine.

Black neighborhoods that were redlined in the 1930s — designated too “high risk” for mortgages and other investments — remain poorer and sicker today , Yancy said. Formerly redlined ZIP codes also had higher rates of Covid infection and death . “It’s very clear that we have an uneven distribution of health,” Yancy said. “We’re talking about the freedom to be healthy.”

A companion study estimates that racial and ethnic inequities cost the U.S. at least $421 billion in 2018, based on medical expenses, lost productivity, and premature death.

In 2021, non-Hispanic white Americans had a life expectancy at birth of 76 years, while non-Hispanic Black Americans could expect to live only to 71 . Much of that disparity is explained by the fact that non-Hispanic Black newborns are 2½ times as likely to die before their first birthdays as non-Hispanic whites. Non-Hispanic Black mothers are more than 3 times as likely as non-Hispanic white mothers to die from a pregnancy-related complication. (Hispanic people can be of any race or combination of races.)

Racial disparities in health are so entrenched that even education and wealth don’t fully erase them, said Tonia Branche, a neonatal-perinatal medicine fellow at Lurie Children’s Hospital of Chicago who was not involved in the JAMA study.

Black women with a college degree are more likely to die from pregnancy complications than white women without a high school diploma. Although researchers can’t fully explain this disparity, Branche said it’s possible that stress, including from systemic racism, takes a greater toll on the health of Black mothers than previously recognized.

Death creates ripples of grief throughout communities. Research has found that every death leaves an average of nine people in mourning.

Black people shoulder a great burden of grief, which can undermine their mental and physical health, said Khaliah Johnson, chief of pediatric palliative care at Children’s Healthcare of Atlanta. Given the high mortality rates throughout the life span, Black people are more likely than white people to be grieving the death of a close family member at any point in their lives.

“We as Black people all have some legacy of unjust, unwarranted loss and death that compounds with each new loss,” said Johnson, who was not involved with the new study. “It affects not only how we move through the world, but how we live in relationship with others and how we endure future losses.”

Johnson’s parents lost two sons — one who died a few days after birth and another who died as a toddler. In an essay published last year , Johnson recalled, “My parents asked themselves on numerous occasions, ‘Would the outcomes for our sons have been different, might they have received different care and lived, had they not been Black?’”

Johnson said she hopes the new study gives people greater understanding of all that’s lost when Black people die prematurely. “When we lose these lives young, when we lose that potential, that has an impact on all of society,” she said.

And in the Black community, “our pain is real and deep and profound, and it deserves attention and validation,” Johnson said. “It often feels like people just pass it over, telling you to stop complaining. But the expectation can’t be that we just endure these things and bounce back.”

Teleah Scott-Moore said she struggles with the death of her 16-year-old son, Timothy, an athlete who hoped to attend Boston College and study sports medicine. He died of sudden cardiac arrest in 2011, a rare condition that kills about 100 young athletes a year. Research shows that an underlying heart condition that can lead to sudden cardiac death, hypertrophic cardiomyopathy, often goes unrecognized in Black patients.

Scott-Moore still wonders if she should have recognized warning signs. She also has blamed herself for failing to protect her two younger sons, who found Timothy’s body after he collapsed.

At times, Scott-Moore said, she wanted to give up.

Instead, she said, the family created a foundation to promote education and health screenings to prevent such deaths. She hears from families all over the world, and supporting them has helped heal her pain.

“My grief comes back in waves, it comes back when I least expect it,” said Scott-Moore, of Baltimore County, Maryland. “Life goes on, but it’s a pain that never goes away.”

KFF Health News , formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

Follow  NBC HEALTH  on  Twitter  &  Facebook .