OBJECTIVE:We assess the current use and future potential of micro-computed tomography (micro-CT) in bioarchaeology and paleopathology, identifying areas of underuse and offering recommendations for effective, standardized application. MATERIALS:We reviewed articles published 2015-2025 in the International Journal of Paleopathology and International Journal of Osteoarchaeology, supplemented by the Journal of Archaeological Science and Journal of Archaeological Science: Reports (2015-2025) and five frequently cited mummy studies (2010-2025). METHODS:Articles were categorized by how micro-CT was used (active use versus referencing or recommending it) and by anatomical and pathological focus; reporting of acquisition and reconstruction parameters was also evaluated. RESULTS:Across all journals, micro-CT was used predominantly to image bone, with little application to soft tissue, infectious disease, or malignancy, and parameter reporting was inconsistent across studies. CONCLUSIONS:Micro-CT is underused for soft-tissue, infectious, and neoplastic pathologies; its diagnostic value would expand with standardized parameter reporting and closer collaboration with radiologists. SIGNIFICANCE:This review maps current micro-CT use in paleopathology and offers practical guidance, a reporting checklist, and parameter recommendations to support broader, more reproducible adoption of this potentially diagnostic imaging modality. LIMITATIONS:The review focused on a defined set of journals and a non-exhaustive selection of mummy studies. SUGGESTIONS FOR FURTHER RESEARCH:Future work should develop consensus reporting protocols by tissue type and explore AI-assisted analysis of micro-CT data.
OBJECTIVE:This study evaluates osseous changes suggestive of ear inflammation in three individuals from a Classic Period (250-900 CE) Maya skeletal assemblage. MATERIALS:Isolated left temporal bones from two adults and one juvenile from the Cueva de Sangre, Dos Pilas, Guatemala were examined. METHODS:The temporal bones were inspected macroscopically, microscopically, and radiographically. RESULTS:Each individual presented with pathological bone remodeling on the tympanic part, mastoid region, sigmoid sulcus, and temporomandibular joint, and altered pneumatization in the mastoid process. CONCLUSIONS:The bony modifications observed in each individual are consistent with chronic or recurrent inflammatory processes affecting the temporal bone. Possible etiologies include otitis externa, otitis media, and mastoid involvement. The presence of remodeled bone and the severity and intratemporal extent of osseous changes suggest recurrent infection and inflammation. SIGNIFICANCE:Otopathology may have been more common in ancient Maya populations than currently recognized. The individuals described here contribute to our understanding of health challenges faced by the ancient Maya. LIMITATIONS:Because these conditions primarily affect soft tissues, the osseous changes observed here are not pathognomonic and must be interpreted within a broad differential diagnosis. The commingled and fragmentary nature of the assemblage precluded attempts to estimate a biological profile, assess bilaterality, and identify comorbidities. SUGGESTIONS FOR FUTURE RESEARCH:Paleo-otopathological investigations have the potential to inform reconstructions of health, sensory impairment, and lived experience. Temporal bones from Maya assemblages should be carefully examined to better understand the health challenges the ancient Maya faced and their resilience to such health stressors.
OBJECTIVE:To compare the prevalence and frequency of activity-related spinal pathologies in non-adults and young adults from three post-medieval (1650-1850 CE) Dutch populations with documented histories of child labour. MATERIALS:Well preserved human remains of 143 children and early young adults (4 years ± 1 year to 25 years ± 2 years) from three osteoarchaeological assemblages. METHODS:Macroscopic palaeopathological analysis was conducted to observe the presence and distribution of spinal pathologies, including facet joint osteoarthritis, Schmorl's nodes, and body margin modifications. RESULTS:Significant differences were found between the three sites across all age categories, with non-adults from the assemblages with historically documented child labour practices having the highest rate of spinal lesions, particularly in the rural population. The distribution of lesions throughout the spinal column also varied notably between sites. CONCLUSIONS:The type and intensity of historically documented child labour practices are visible in the distribution of activity-related pathological lesions throughout the spinal column and indicate a clear impact of manual labour on the growing skeleton. SIGNIFICANCE:Through the analysis of the distribution of activity-related spinal joint disease alongside historical contexts, a better understanding of the biomechanical impact of documented child labour practices can be achieved. LIMITATIONS:As is the nature of juvenile osteology, this study worked with limited sample sizes across all three assemblages. This is reflected both in the number of individuals assessed as well as in the number of vertebrae analysed, as recovery of the complete spinal column was not possible for every individual included in this study.
OBJECTIVE:To evaluate axial and peripheral joint lesions in a late adolescent/young adult skeleton and assess whether they support a diagnosis of juvenile-onset ankylosing spondylitis. MATERIALS:Individual M55, a possible male aged 16.5-20 years, recovered from a Ming-Qing period tomb (14th-20th century CE) at the Dabuzi cemetery, Shaanxi, China. METHODS:Macroscopic observation was used to record skeletal pathologies. Differential diagnosis focused on inflammatory spondyloarthropathies and related arthropathies. RESULTS:The preserved thoracic and lumbar vertebrae show multi-level posterior ankylosis of the zygapophyseal joints, with fusion of the costovertebral and costotransverse joints. Erosive and irregular lesions affect the shoulders, hips, knees, and other peripheral joints. Ossified ligamentous tissue occurs superior to the right auricular surface, although the sacroiliac joints are poorly preserved. Manubriosternal fusion and active periosteal reactions are also present. CONCLUSIONS:The lesion distribution is most consistent with possible juvenile-onset ankylosing spondylitis, but incomplete preservation prevents a definitive diagnosis. SIGNIFICANCE:This case provides a diagnostic model for evaluating juvenile inflammatory spondyloarthropathy in incomplete archaeological remains, especially when the sacroiliac joints, hands, and feet are absent or poorly preserved. LIMITATIONS:Observations are macroscopic and lack radiographic, CT, or biomolecular confirmation. SUGGESTIONS FOR FURTHER RESEARCH:Imaging, comparative screening, and biomolecular analysis may clarify disease attribution and broader patterns of inflammatory joint disease.
OBJECTIVE:Investigate whether deformational plagiocephaly, a common pediatric cranial condition, often linked to limited infant head mobility, occurred in an ancient population and its implications for infant care practices. MATERIALS:Twenty-six Early Iron Age adult crania from Matelica, Italy (mid-9th-8th c. BCE). METHODS:All crania underwent macroscopic assessment. Computed tomography was performed on those with posterior cranial asymmetry (n = 11) to support differential diagnosis. Severity was classified using the oblique cranial length ratio from standardized vertex images. RESULTS:Eleven crania (42.3%) showed posterior asymmetry, with a male predominance (63.6%) and more common right-sided flattening (72.7%). Differential diagnosis excluded post-depositional changes, intentional modification, and craniosynostosis. In several cases, CT revealed occipital base flattening with ipsilateral mastoid anterior displacement - features vertex-based oblique cranial length ratio may underestimate. Seven individuals exhibited postcranial markers possibly consistent with congenital muscular torticollis, a condition clinically correlated with deformational plagiocephaly. CONCLUSIONS:The pattern is consistent with prolonged infant head immobility, plausibly linked to caregiving behaviors. SIGNIFICANCE:These represent the earliest known Italian examples of deformational plagiocephaly, placing the condition in deep historical and evolutionary context. These findings suggest that deformational plagiocephaly may not be solely modern, supporting its interpretation as both a pediatric condition and cultural marker. LIMITATIONS:The small sample size and preservation-dependent skeletal markers limit interpretations. Infant care practices are inferred indirectly; oblique cranial length ratio may underestimate basal deformity. SUGGESTIONS FOR FURTHER RESEARCH:Future comparative studies are needed to determine whether the high deformational plagiocephaly prevalence at Matelica is localized or represents a broader Iron Age pattern in central Italy.
Objective: To examine the prevalence of lower respiratory tract diseases (LRTDs) in post-medieval non-adult skeletal assemblages from the Low Countries and to assess whether their occurrence was influenced by socioeconomic status. Materials: We analyzed 146 non-adult individuals from eight urban sites dating between 1492 and 1850 CE, representing populations from diverse socioeconomic groups. Methods: New bone formation on visceral surfaces of ribs was assessed macroscopically as a proxy for LRTDs. Firth logistic regression and Fisher's Exact test were used to analyze associations between lesions, socioeconomic status, and age-at-death. Results: 15.8% (23/146) of the analyzed individuals showed evidence of new bone formation. Lesions were distributed evenly across age groups and socioeconomic strata (low: 15.6%, 12/77; middle: 15.6%, 5/32; high: 16.2%, 6/37) with no significant associations observed. Conclusions: Despite well-documented historical inequalities in living conditions and access to healthcare, no socioeconomic gradient was observed in rib lesion frequency. This may reflect a widespread exposure of children to risk factors for respiratory disease. Significance: This study adds to the growing body of literature on historical health in the Low Countries and provides important insights into the challenges of using new bone formation on visceral surfaces of ribs as an indicator of past health. Limitations: Small sample sizes, only moderate inter-observer agreement, and the inherent complexity of new bone formation on ribs as a diagnostic marker for respiratory health. Suggestions for further research: Broader comparative studies are needed to clarify the role of LRTDs in shaping childhood health outcomes in past populations.
Objective Lacunar lesions at the anterior medial collateral ligament (MCL) bundle attachment on the humeral medial epicondyle may represent partial avulsion fractures. This study developed and validated a quantitative approach to assess their morphology. Materials Two Neolithic samples were studied: Parisian Basin (France, N = 45) and Meuse Valley (Belgium, N = 25). Methods Lesions were extracted using a 3D protocol with ambient occlusion and curvature filters, then screened and analyzed using size, shape and surface metrics. Reproducibility was assessed using Lin’s concordance correlation coefficient. Results The protocol was successfully validated with excellent intra-observer agreement. Lesions occurred exclusively on right humeri at the anterior MCL bundle footprint, while showing uniform shape but variable size, flattening and surface characteristics. Conclusions The protocol provides an objective, reproducible method for lesion characterization and, when applied, revealed cortical-confined depths and surface areas smaller than the anterior MCL bundle footprint, suggesting specific fiber involvement. Right-side bias indicates a potential link with handedness, while morphological patterns align with clinical descriptions of proximal MCL partial avulsion fractures common in youth throwing athletes. Significance Findings support an activity-related etiology and demonstrate potential for reconstructing past behaviors from skeletal remains while complementing clinical studies on long-term injury outcomes. Limitations Limitations include small sample size, reliance on absolute measurements, dependence on imaging resolution, and lack of direct clinical validation. Suggestions for Further Research Studies should apply this protocol to larger, diverse samples, confirm the clinical association, and adapt it to additional imaging modalities for broader archaeological and clinical applications.
Objective This study seeks to evaluate morphological changes in a skeleton recovered from San Marcial de Rubicón, the earliest permanent European settlement in the Canary Islands. Materials The individual derives from a primary inhumation dated to the early fifteenth century. Methods Macroscopic observation was combined with conventional radiography, computed tomography, and mitochondrial DNA analysis. A systematic differential diagnosis considered metabolic, infectious, inflammatory, neoplastic, and degenerative conditions. Results The individual under investigation is an adult male with evidence of diffuse cortical thickening, periosteal new bone formation, heterogeneous radiodensity, cranial diploic expansion, long-bone bowing, severe degenerative joint disease, sacroiliac ankylosis, and elongated thoracic vertebral defects. Mitochondrial DNA analysis identified haplogroup X2c1, consistent with European maternal ancestry. Conclusions The overall pattern is most consistent with polyostotic Paget disease of bone, although coexisting axial ankylosis and vertebral defects complicate the interpretation. These additional lesions are insufficient to support an alternative primary diagnosis. Significance This case provides an early extra-European archaeological example of Paget disease in the context of Atlantic colonial expansion. Rather than simply extending the geographic record of the disease, it shows how chronic skeletal conditions with strong European clinical and archaeological associations may be identified in frontier populations formed through mobility, settlement and colonial interaction. Limitations The diagnosis is based on a single individual, and nuclear DNA data were insufficient to assess genetic susceptibility. Suggestions for further research Further radiological, genomic, and isotopic analyses of early colonial skeletal assemblages are needed to evaluate chronic disease, mobility, and biological diversity in Atlantic frontier populations.
Objective: To assess the etiology of cranial variation noted in domestic geese from a 17th-century archaeological site in Flecken Zechlin, Brandenburg, Germany. Materials: Four skulls from domestic geese. Methods: Macroscopic analysis and review of relevant literature. Results: Defects in the goose crania are similar to those occurring in crested ducks but differ from those associated with crested chicken in location and appearance. There are no indications that the defects are taphonomic or result from infection or nutritional disease. Conclusions: The cranial defects are consistent with a crested phenotype and display variability in severity of defects associated with crestedness. Significance: This work highlights the importance of evaluating cranial lesions in archaeologically recovered fowl and shows the variability in severity of defects associated with a crested phenotype. Pathology associated with distinct phenotypes of domestic species has implications for understanding the cultural impact on animal breeding and the deliberate maintenance of deleterious defects in domestic animals. Limitations: The number of goose crania inspected is small. Suggestions for further research: Look specifically for further archaeological cases to give more insight into the chronological and geographic distribution of crested geese and other birds, which will complement evidence from paintings and written sources.
Objective: Disturbances in the structure of the sella turcica are recognised markers of pituitary pathology in clinical diagnostics but remain rarely evaluated in archaeological human remains. This study aims to provide a morphometric and morphological analysis of an enlarged sella turcica in an individual recovered from an 18th-century crypt. Materials: 45-55-year-old male from the burial crypts of the Church of St Francis of Assisi in Cracow, Poland Methods: The skull was examined using high-resolution computed tomography (CT) and endoscopic inspection. Linear dimensions were obtained following established radiological protocols and compared with modern reference data. Results: CT imaging revealed pronounced enlargement of the sella turcica in all dimensions and a full-thickness erosive defect of the dorsum sellae with smooth, scalloped margins, consistent with chronic pressure-induced remodelling. No additional skeletal changes indicative of hormonally active pituitary disease were observed. Conclusions: The findings are most compatible with a long-standing benign non-functioning pituitary macro-adenoma and demonstrate that subtle endocranial changes can be reliably identified using advanced imaging techniques in archaeological material. Significance: This study addresses a clear gap in palaeopathological research by providing rare, imaging-based evidence of pituitary-region pathology in archaeological remains. It demonstrates the diagnostic potential of systematic sella turcica assessment and supports the integration of clinical radiological criteria into palaeopathological practice, with broader implications for identifying endocrine disorders in past populations. Suggestions for further research: Future studies should integrate biomolecular and histological approaches and investigate larger skeletal series to establish the prevalence and variability of pituitary-related changes in past populations.
Objective Ancient dental calculus (DC) serves as a critical biomolecular repository, preserving dietary and extra-dietary residues related to past health and disease. This review examines DC as a potential ‘One Paleopathology’ resource, highlighting the interconnectedness of past human-animal-environmental health. Through a One Health lens, it critically assesses current research and opportunities for the next 50 years of study. Results By synthesizing the available literature and the current state of the art, we critically evaluate how DC research bridges paleopathology, bioarchaeology, and modern health sciences, providing a unique lens for assessing health and disease within ecological and evolutionary contexts. We highlight methodological advances and limitations, while identifying critical gaps and opportunities for interdisciplinary integration, standardization, and forward-looking research to expand the field over the next 50 years. Conclusions DC research effectively integrates paleopathology, bioarchaeology, and modern health sciences enabling the reconstruction of health and disease within ecological and evolutionary contexts and highlights the interdependence of humans, animals, and the environment. Significance From a One Health perspective, dental calculus analysis provides a long-term perspective on interactions among humans, animals, microbes, and environments, informing past and contemporary health research. Limitations Interpretation is constrained by preservation biases, variability in analytical methods, and the destructive nature of sampling dental calculus. Further Research Future investigations should prioritize sustainable sampling, methodological standardization, and interdisciplinary collaboration. Emerging technologies and integrative approaches will place DC research at the forefront of ‘One Paleopathology’.
OBJECTIVES:To investigate whether the presence of interglobular dentine (IGD), reflecting periods of suboptimal vitamin D levels, affects serial carbon (δ13C) and nitrogen (δ15N) isotope values in incremental dentine profiles. MATERIAL:Nine individuals, represented by eight 1st molars and one canine from Hattem, Beemster (Netherlands), and Koekelberg (Belgium) cemeteries (17th-19th cent. CE). Eight teeth had IGD previously identified via microscopy, and one displayed no IGD. METHODS:The two common sequential dentine methodologies, micro-slicing and micro-punching, were applied to measure serial δ13C and δ15N variation within each tooth. RESULTS:Incremental δ13C ranged from -21.4‰ to -18.8‰, and δ15N from 9.3‰ to 18.2‰. Comparisons between increments with and without IGD revealed minimal isotopic differences, with IGD increments showing slight δ13C (0.1‰) and δ15N (0.2‰) depletion. CONCLUSIONS:IGD, and accordingly vitamin D deficiency, had a minimal effect on δ13C and δ15N values from human dentine and did not affect the incremental sampling conclusions on diet and weaning. SIGNIFICANCE:This pilot study suggests that there seems to be no clear link between periods of vitamin D deficiency and serial δ13C and δ15N variations. LIMITATIONS:The limited sequential δ13C and δ15N analysis of more 'control' individuals with no detected IGD from the three cemeteries, due to the high prevalence of vitamin D deficiency at the time. SUGGESTIONS FOR FURTHER RESEARCH:Continued sequential analysis of populations with IGD, from different periods and/or geographic locations, to confirm the findings of this case report.
Objective This project is designed to estimate the prevalence of osteoarthrosis in avian remains from the site of UNL-050, Unalaska Island, Alaska as a means of contextualizing past environmental conditions. Materials A subsample of 9667 well-preserved archaeological avian remains. Methods All remains were visually identified morphologically to the lowest taxonomic level with the aid of reference collections from the Boston University Zooarchaeology Laboratory, the American Museum of Natural History, and Harvard Museum of Comparative Zoology. Results Fifty-one post-cranial instances of pathology were identified, including forty-five instances of osteoarthrosis. Conclusions Degenerative joint changes are concentrated on the shoulder joint and are consistent with sustained mechanical stress associated with flight and foraging behaviors. Environmental variability during the Neoglacial may have contributed to these stresses, although multiple factors are likely involved. Significance Examination of archaeological avian bones for pathology can suggest climatic impacts on past bird populations. Limitations Research was conducted during the Covid-19 pandemic, when physical access to museum reference collections was not possible, and reference specimen loans were limited. Time and budgetary constraints also did not allow for examination of the full avifaunal assemblage. Suggestions for Further Research Examining the entire avian assemblage to see if other shoulder girdle elements were impacted and examining nearby sites from the Neoglacial to understand climatic changes and potential sea ice extent and impacts.
Objective This study aims to document and contextualize cranial trauma attributable to interpersonal violence in one Langobard individual from the Ferrovia necropolis in Cividale del Friuli (NE Italy). Materials The study examines one human skeleton: a middle-aged female dated between 590 and 630 CE. Methods Osteological and palaeopathological analyses were conducted to assess trauma, age-at-death, and activity-related markers. Sex estimation was confirmed through amelogenin analysis. Results The individual presents healed antemortem cranial lesions consistent with interpersonal violence: one sharp-force and one blunt-force. Conclusions This case represents documented paleopathological evidence of interpersonal violence affecting a Langobard female. Significance The finding challenges assumptions regarding the exclusively male nature of interpersonal violence in Langobard society and provides a rare bioarchaeological correlate to legal and historical sources acknowledging female involvement in violent contexts. Limitations The identification of interpersonal violence is constrained by preservation biases and the limited visibility of soft-tissue injuries in the skeletal record. Moreover, the interpretation of interpersonal violence from the cranium only is limiting. Suggestions for further research Future studies integrating palaeopathological, biomolecular, and contextual archaeological data across larger samples are needed to refine interpretations of violence and gender roles in Langobard populations.
OBJECTIVE:To evaluate pathological changes identified in a skeleton of a horse from Roman-period Gerulata, Slovakia. MATERIALS:The remains consist of a partially preserved, articulated skeleton of an adult horse from today's southern urban district of Bratislava-Rusovce in southwestern Slovakia. METHODS:The specimen underwent macroscopic analysis to assess taxonomic identification, biological profile, and pathological changes. Thoracolumbar lesions were further evaluated using computed tomography (CT). Radiocarbon dating determined the absolute age of the remains. RESULTS:Species determination indicates that the remains, radiocarbon dated to 21-133 cal CE (90.1% probability), belonged to a male domestic horse that died between 9-10 years of age. Key pathological features include flowing ossification corresponding to the ventral longitudinal ligament, as well as signs of active bone remodeling. Complete bridging was observed between T11-T12, and near-complete bridging in the T10-T11 and T12-T14 segments. CONCLUSIONS:Recorded changes at T10-T14 are most consistent with diffuse idiopathic skeletal hyperostosis (DISH). The interpretation of lesions in non-contiguous segments (T16-T17, L3-L4) remains ambiguous. SIGNIFICANCE:This case highlights diagnostic challenges in distinguishing DISH from spondylosis in horses and demonstrates structural limitations of current criteria derived from human and veterinary medicine. LIMITATIONS:The skeleton was incompletely preserved due to post-depositional disturbance, and the vertebral arches in the affected segments (T10-T13, and partially T14) were not recovered. SUGGESTIONS FOR FURTHER RESEARCH:Future work should focus on standardizing diagnostic criteria for equine spinal pathologies, aligning them more closely with current human medicine standards.
Objectives This study hypothesizes that the co-occurrence of porous skeletal lesions (PSL) and respiratory infection-related changes influenced non-adult morbidity in prehistoric communities. Materials All articulated non-adult skeletons (n = 48) from the Chalcolithic (3rd millennium BCE) burial site of Camino del Molino, SE Iberia. Methods The presence/absence of PSL (cribra orbitalia, cribra cranii, and cribra femoralis) and infection-related changes (serpens endocrania symmetrica, granular impressions, new bone formation, hypervascularisation of vertebral bodies, ischium, and sacrum) were recorded macroscopically. Lesion co-occurrence was examined in relation to age-at-death and biological sex. Results Overall, 91.7% of individuals exhibited at least one skeletal alteration. PSL were observed in 89.6% (43/48) of the sample and respiratory infection-related changes in 68.8% (33/48). Co-occurrence of both conditions was identified in 66.7% (32/48) of individuals. Subjects with PSL showed increased risk of respiratory infection-related changes (OR=11.64). Lesions were observed across all age groups, peaking in infants and early adolescents, with no sex-based differences detected. Conclusion The co-occurrence of PSL and respiratory infection-related changes points to prolonged or recurrent infections as a key factor in childhood morbidity. The predominance of lesions in infants and early adolescents aligns with periods of increased vulnerability to respiratory disease. The presence of these lesions suggests that respiratory infections, likely including TB, were already affecting non-adults during the Copper Age. Significance This study underscores the complexity of interpreting porous and respiratory infection-related skeletal changes and demonstrates the necessity of holistic, population-level approaches in palaeopathology. Suggestions for further research Future biomolecular analyses will be essential to verify whether pathogenic agents, particularly those causing tuberculosis or other respiratory diseases, are present in the population.
Objective A finding in a fossil mysticete rib is used to get insights into biomechanical limits of extinct whales. Materials The investigated specimen from the Miocene (Serravallian/Tortonian boundary) of Groß Pampau, North Germany, comprises a 252 mm distal fragment of a right posterior rib exhibiting distinctive pathological features including extensive periosteal new bone formation and a prominent 69 mm bony spur. Methods The internal morphology was analysed with a clinical CT-scanner. Results Morphological examination and computed tomography analysis revealed irregular cortical thickening, excentric bone proliferation with a 17° anterior deviation, and trabecular bone continuity at the spur base, consistent with a healed stress fracture. Differential diagnoses including acute trauma, osteomyelitis, neoplasia, and dysbaric osteonecrosis were systematically excluded based on morphological criteria and the absence of associated lesions throughout the skeleton. Conclusions The combination of an isolated rib fracture with periosteal reaction and the presence of an adaptive bony spur strongly suggests a stress fracture etiology resulting from repetitive biomechanical overload, analogous to stress injuries observed in human athletes, e.g., intensive swimming activities. Significance Stress fractures are underreported in cetaceans. Our findings enhance our understanding of bone remodeling processes providing evidence for chronic, repetitive mechanical overload and highlight that fossil bone can be used to demonstrate long-term physiological strain in deep-time. Limitations To date, there have been few comparable studies on marine mammals. Suggestions for Further Research Further research into the locomotory behavior and biomechanical stress patterns of Miocene cetaceans is needed.
OBJECTIVE:There is interest across many fields, government agencies, and health organizations in the health of urban dwellers in the past and present. Research on the topic often ignores variation across and within the urban-rural spectrum. To improve understanding of heterogeneity in outcomes, we examine the possible effect of childhood stressors on later life health in medieval Denmark in an array of settlements across the urban-rural spectrum. MATERIALS:We use data on age and stress markers (linear enamel hypoplasia (LEH) and cribra orbitalia (CO) from n = 755 individuals from six skeletal collections (ca. 1050-1400 CE). METHODS:We use Kaplan-Meier survival and Cox regression analyses to test differences in mortality hazards and survivorship between individuals in rural villages, middle-level towns, and developed towns, between those with and without stress markers, and whether those associations were consistent across age. RESULTS:Individuals of all ages in developed towns experienced the highest mortality hazards. LEH and CO significantly affected nonadult survivorship and mortality hazards, but not that of adults. CO was associated with survival and mortality disadvantages in rural and developed-town contexts (p < 0.0001). CONCLUSIONS:Variation in early life conditions across the urban-rural spectrum shaped health outcomes in ways obscured by strict urban-rural binaries. SIGNIFICANCE:Adopting statistical approaches that account for age-specific lesion formation processes in bioarchaeological analyses improve our understandings of the impact of urbanization on past health. LIMITATIONS:Middle-level town sample was small. SUGGESTIONS FOR FUTURE RESEARCH:Development of more highly specified models of mortality that accommodate data on lesion formation timing and healing status.
OBJECTIVE:This paper presents the Social Determinants of Health (SDoH) as a framework to explain health patterns in past populations and to evaluate how social factors shaped differential health outcomes. MATERIALS:Primary data derive from a case study of Deir el-Medina, Egypt, New Kingdom (1550-1080 BCE) comprised of at least 134 individuals and 1725 skeletal elements. Comparative case studies from published research across ancient and historical contexts are also discussed. METHODS:The Deir el-Medina case study compares data from skeletal stress indicators such as enamel hypoplasias and cranial porosities with historical records. Additional examples illustrate similar integrations of bioarchaeological and historical data. RESULTS:Case studies demonstrate that food security, social support, and healthcare access likely impacted health patterns. The SDoH framework provides a systematic approach to identifying social factors that influenced health outcomes. CONCLUSIONS:The SDoH framework is a valuable tool for systematically investigating social impacts on health in past populations. It addresses how social structures-not just biology or ecology-produced health disparities across communities. SIGNIFICANCE:Applying the SDoH allows bioarchaeologists to reveal social sources of heterogeneous frailty. It also contributes historical perspectives to modern public health discussions. LIMITATIONS:The SDoH framework is most suitable for community-based populations with historical data and is less useful in prehistoric or poorly contextualized sites. SUGGESTIONS FOR FURTHER RESEARCH:Future research could apply the SDoH framework to identify when the social health gradient emerged and the broader applicability of the SDoH across varied archaeological contexts.
OBJECTIVE:Granular impressions (GIs) on the endocranial surface have been regarded as evidence of tuberculous meningitis. However, recent studies suggest that these subtle lesions more likely reflect disseminated tuberculosis. This study examines the frequency of GIs in an epidemic skeletal assemblage from Lucca (Italy) dating to the 17th century CE. MATERIALS:Excavations at the convent of St Francesco uncovered a cemetery archaeologically and historically linked to an epidemic outbreak, likely the plague of 1630-31. The assemblage comprises 98 individuals of poor preservation. METHODS:Endocranial surfaces of 73 crania (25 preadults and 48 adults) were examined macroscopically and microscopically, and frequencies were calculated per individual and cranial bone. RESULTS:GIs were observed in 53.4% of individuals, with adults showing a significantly higher frequency (66.6%) than preadults (28.0%). Overall, 30.2% (125/413) of cranial bones exhibited GIs. Adult cranial bones presented GIs (40.4%) more frequently than preadult (8.4%). CONCLUSIONS:The high frequency of GIs in this skeletal assemblage is consistent with the hypothesis that these lesions represent a marker of tuberculous infection during bacteraemic spread, rather than the rare and rapidly fatal form of tuberculous meningitis. SIGNIFICANCE:This study demonstrates that GIs can serve as markers of TB infection and, when found alongside other diagnostic skeletal lesions, may indicate active TB disease. LIMITATIONS:The skeletal assemblage is relatively small, and the poor preservation of some bones limited the number of crania available. SUGGESTIONS FOR FURTHER RESEARCH:Future research should expand the assessment of GIs in archaeological skeletal assemblages from different spatiotemporal contexts.
