VoxEU Column Health Economics COVID-19 Economic history

City autonomy reduced the incidence of the Black Death

Variation in the incidence of pandemics among cities has often been attributed to luck, rather than to institutional factors. This column examines how the Black Death – the deadliest of pandemics – differently impacted European cities in the 14th century. City autonomy, which allowed the independent introduction of counter-measures, reduced the plague’s death toll, on average, by almost 10%. Being a capital city, hosting a parliament, or having a bishop or an archbishop did not produce similar benefits. Improving the quality of local institutions can be an efficient mechanism to fight pandemics, even today.

It has traditionally been assumed that the impact of the initial outbreaks of epidemics is mostly random. COVID-19’s incidence in the north of Italy could be put down to sheer bad luck (Sanfelici 2020), as it was the main entry point of the pandemic in Europe. Andrew Cuomo, governor of New York, also attributed New York City’s bad first wave of COVID-19 to population density (Badger 2020). 

But are city variations in the short-term incidence of pandemics completely random? Do differences in local institutional capacity matter in determining disparities in the incidence and duration of pandemics?

Our new research (Wang and Rodríguez-Pose 2021) looks into the variations in incidence and duration of the initial outbreak of the Black Death (1347–1352) at the urban level in Europe. 

The Black Death is the deadliest pandemic on record. It wiped between one- and two-thirds of the European population in the 14th century (Ziegler 2013). It also represented a turning point in European history. The recovery after the Black Death has been connected to a significant reduction in wealth inequality (Alfani 2020) and to the onset of a high-income Malthusian equilibrium that resulted in a relatively rapid economic recovery (Clark 2008). 

However, the Black Death left a different mark in different parts of Europe. According to Christakos et al. (2005), the average mortality rate in European cities was approximately 42.57%, with the average duration of a wave of the plague lasting 6.3 months. Some cities, such as Leuven (in Belgium), Arras, and Douai (both in France), reported mortality rates lower than 10%. In contrast, mortality rates in Yarmouth (in England), Scicli (in Sicily) and Ciudad Real (in Spain) exceeded 70% of the city population.

What factors explain such large variations in mortality? One potential explanation is variations in urban autonomy in mediaeval times. A greater degree of autonomy could have allowed cities to rapidly react and swiftly introduce quarantines and lockdowns shortly after the arrival of the plague (Alfani and Murphy 2017, Geltner 2020). Non-autonomous cities, by contrast, did not have the luxury of adopting their independent measures. They had to wait for decisions taken by distant, and often aloof, kings in, say, Paris, London, Toledo, Lisbon, or Zaragoza or by the Pope in Rome (Hohenberg and Lees 1995). 

It is not always the case that autonomous cities adopted rapid and suitable decisions against a pandemic everyone knew little about, but they at least showed more initiative relative to cities with no or a far lower degree of autonomy.

Mapping the Black Death and urban autonomy in mediaeval times

Figure 1 identifies the hotspots of the first wave of the Black Death. The highest incidence was found in eastern Sicily, central Italy, southern France, Catalonia, and southern England. The incidence was considerably lower in southern Germany, Belgium, and most of central and northern France.

Figure 1 Mortality rate of the Black Death


In terms of duration, the Black Death lasted longer in Belgium, northern France, central Germany, Andalusia, and in isolated cities such as Toledo, Barcelona, and Naples (Figure 2). 

Figure 2 Duration of the Black Death


When comparing Figures 1 and 2, there seems to be no correlation between reported mortality rates in cities and the duration of the plague. Naples, for example, suffered the plague for a long time, but its mortality rate was low. In the Sicilian cities of Scicli and Syracuse, the pandemic was shorter but its impact was far more devastating.

Figure 3 maps the location of autonomous cities in the 14th century. Cities are classified as autonomous if, at the time of the first wave of the plague, they had institutions for self-governance and the members of these institutions were chosen by the inhabitants of the city, not by outside rulers – i.e. if there was a local urban participative organisation that made decisions about local urban affairs. Evidence of the presence of consuls, official documents like notarial acts signed by the representatives of cities, and the presence of imperial charters to grant self-governance to cities were used as criteria to consider a city as autonomous. 

Figure 3 The location of autonomous and non-autonomous cities


Urban autonomy was more frequently the norm in small city-states in central Italy or Germany than in larger and more consolidated kingdoms, such as Aragon, Castile, England, or France. There were, however, exceptions such as cities in southern and north-eastern France or most cities in Portugal.

Local institutions matter for mortality rates, but not for duration

How much did the capacity of autonomous cities to react earlier to the Black Death limit its incidence? Our analysis finds that city autonomy is strongly correlated to lower Black Death mortality, even when other factors that affected variations in mortality in mediaeval times – including a rich gamut of geographic, social, and political conditions – are taken into account.

In autonomous cities the mortality rate linked to the Black Death was, on average, 9.29% lower than in cities without a significant degree of self-rule. During the Black Death, the adoption of swifter and more efficient measures against the plague somewhat lessened the pandemic’s horrific death toll, particularly in cities governed by remote princes, kings and emperors. 

City autonomy was, moreover, a far stronger tool in mitigating the effects of the plague than nearly all other geographical and political characteristics of the cities considered. Being a capital city, hosting a parliament, or having a bishop or an archbishop at the beginning of the 14th century did not reduce the incidence of the plague. In other words, among various political factors at the time, only city autonomy and the powers it granted to local citizens provided some protection against the deadliest of pandemics.

While city autonomy significantly influenced Black Death mortality rates, it had less of an impact on the average lengths of the plague in different cities.

Overall, self-governing local institutions played a crucial role in trimming down the impact of the Black Death. When confronted with the worst pandemic ever recorded, autonomous city governments were more effective in adopting better prevention measures. 

Self-government may also be contributing to reducing excess mortality in the current COVID-19 pandemic (Rodríguez-Pose and Burlina 2021). Thus, improving the quality of local institutions was and can still be today an efficient mechanism to fight pandemics. When greater local autonomy is matched with competent and resourceful local institutions that implement adequate policies (Bricongne and Meunier 2021), the chances of being able to fight current and future pandemics more efficiently are likely to increase.


Alfani, G, and T E Murphy (2017), “Plague and lethal epidemics in the pre-industrial world”, Journal of Economic History 77(1): 314–43.

Alfani, G (2020), “Pandemics and inequality: A historical overview”,, 15 October.

Badger, E (2020), “Density is normally good for us. That will be true after coronavirus, too”, New York Times, 24 March.

Bricongne, J C, and B Meunier (2021), “The best policies to fight pandemics: Five lessons from the literature so far”,, 10 August.

Christakos, G, R A Olea, M L Serre, L L Wang and H L Yu (2005), Interdisciplinary public health reasoning and epidemic modelling: The case of Black Death, New York: Springer.

Clark, G (2008), A farewell to alms: A brief economic history of the world, Princeton: Princeton University Press.

Geltner, G (2020), “The path to Pistoia: Urban hygiene before the Black Death”, Past and Present 246(1): 3–33.

Hohenberg, P M, and L H Lees (1995), The making of urban Europe, 1000–1994, Cambridge MA: Harvard University Press.

Rodríguez-Pose, A, and C Burlina (2021), “Institutions and the uneven geography of the first wave of the Covid-19 pandemic”, Journal of Regional Science 61: 728–52.

Sanfelici, M (2020), “The Italian response to the COVID-19 crisis: Lessons learned and future direction in social development”, International Journal of Community and Social Development 2(2): 191–210.

Wang, H, and A Rodríguez-Pose (2021), “Local institutions and pandemics: City autonomy and the Black Death”, Applied Geography 136: 102582.

Ziegler, P (2013), The Black Death, Faber and Faber.

1,155 Reads