Dances of death: Macabre mirrors of an unequal society

textabstractObjectives Between 1400 and 1800, Dances of Death were a popular art form depicting a metaphorical encounter between Death and representatives of a stratified human society. We review the thematic development of Dances of Death and study the development of social critique. Methods We first assembled a full catalogue of all Dances of Death created between 1400 and 1800. We then analyzed patterns of spatiotemporal diffusion and made an in-depth hermeneutic study of the combined texts and images of a carefully selected set of 20 Dances of Death, comparing four distinct periods (1425-1525, 1525-1600, 1600-1650, and 1650-1800). Results We identified more than 500 Dances of Death. It was only in its first stage of development, coinciding with the Pre-Reformation (1425-1525), that social critique was very prominent. This was represented in four forms: explicit references to social (in) equality, to failures of the authorities, and to emancipated farmers, and a general social realism. In later phases social critique largely disappeared and was replaced by religious themes. Conclusions Dances of Death provide historical context to current analyses and debates of social inequalities in health. They remind us of the stubbornness of these inequalities, which despite progress in material well-being are still very much with us today