Can the dead speak? - This is a discussion on the health status of prehistoric populations in South East Asia at the time of the transition to agriculture. - Anthropology - http://maxpages.com/mikeparsons/Biological

Review and discussion of the literature concerning the health of Neolithic populations
during the ‘agricultural transition’ in South Asia.

One of the most significant changes that human activity has experienced during the last
10,000 years was the transition to agriculture during the period known as the Neolithic.
During this period, at different times and in different parts of the world many populations
changed from food gatherers to food producers, significantly altering their way of life.
In many places the organisation of societies, population levels and their relationship with
the environment changed in accordance with new subsistence strategies. These changes
have been the focus of many hypotheses regarding the cause and effect of this transition,
Gebauer and Price (1992) outlined 38 suggested possible causes ranging from climatic
fluctuations and the Oasis theory to xenophobia or aliens. Despite the absurdity of the
latter idea, such diversity of discussion highlights the range and intensity of debate over
this subject and the implications for our understanding of this important aspect of
prehistoric human activity.

The remains of humans from the Neolithic period can exhibit signs of change in activity
in relation to stress, pathologies and trauma associated with various cultural activities.
Patterns of types of stress can show an archaeologist how cultural activities have affected
the health of a population. It is the interpretation of these human remains that can help us
understand how the transition to agriculture affected the health of past populations.

The health of past populations has been misinterpreted in the past. Larsen (1995) points
out that previously, western scholars such as G.V.Childe believed that the Neolithic
transition was one of “deprivation to plenty and sickness to health”. It was generally
assumed that there was a continuum from hunter-gatherer to agriculturalist that was
parallelled by an increase in health, stability and longevity.(Larsen 1995.p186).
Larsen points out that since the late 1960’s these assumptions have been challenged by
new information that shows that the change from hunter-gatherer was accompanied by a
general decrease in health. This information was derived from examination of skeletal
material from a variety of Neolithic sites, if the data is analysed in the correct manner
changes in the health of a population can be documented. A global survey on the health
effects of this transition was compiled by Cohen and Armelagos(1984) using evidence
from various regions . This was undertaken to gather a set of data with which a pattern of
global or localised trends could be documented using skeletal information.

The types of evidence that can be used to enquire into the health status of an individual
ranges from Harris lines in long bones, to dental caries and other abnormalities, changes
and patterns of growth evident in skeletal material. Information from these skeletal
markers can be used on a populational basis to allow for a larger sample and comparative
analysis.

It is at this junction that there has been intense debate in anthropology, many scholars
(Cohen and Armelagos 1984, Goodman 1993, and Larsen 1995) believe that the evidence
gained from prehistoric skeletal samples represents a general decline in the health of
Neolithic populations. (Cohen,1994)

Some academics eg.(Wood, Milner,Harpending,Weiss.1992), do not have faith in the use
of lesions and trauma to assign health status to a whole population as well as questioning
the statistical validity of using small skeletal samples, such as a battle site or graveyard.
(Wood et.al. 1992)

For Wood, the controversy is whether or not skeletal evidence from archaeological sites
represents the lower health status of a sick individual, or a healthy person capable of
fighting an infection or pathology.Supporters of Wood propose that because a person
exhibiting a lesion or trauma is able to fight the pathology, they are healthier than other
populations who would succumb to it, or other causes. This means in regards to the
interpretation of osteological features such as lesions, trauma, stature averages etc, as
well as ensuring an adequate statistical sample.The problems and advantages associated
with this data will be examined as they are outlined later.

Buikstra and Konigsberg (1985) comment on interobserver error and statistical problems
concerning paleodemography, a related subject that relies on composing life-tables from
osteological evidence from a particular population. Facing criticism that we can not make
inferences from skeletal evidence, they state that once problems with standardising
techniques and sampling strategies are addressed it is possible to use this information.
They also point out that their work is able to show “demographic changes apparently
associated with the shift from hunting and gathering to agriculture” (Buikstra and
Konigsberg,1985.p318)

The problem of bias (statistical or other) in paleodemography is paralleled in our
attempts to study the health status of past populations. Waldron calls this “the bane of
the modern epidemiologist” (Waldron,1994.p11) To solve this problem or to lessen the
effects of it, Waldron highlights the need for an adequate sampling strategy that allows
for extrinsic and intrinsic factors that affect the appearance of human remains. These
factors are those which would change the status of a sample from a random sample of a
whole population, to an incomplete or biased sample.(a member of an elite caste at a
burial ground for example) If the nature of the sample is understood it is possible to
account for any statistical bias that is present and relate this to any interpretations.

Goodman(1993) comments on the need for multifactorial analysis using “various
indicators of health” to understand the health status of an individual.This means utilising
as many reliable factors as possible to account for any bias on one factor.On a wider
basis, patterns in the data from an adequate sample of a population can show any
changes in the overall health of a group of people. Due to the low preservation rate of
food remains in the archaeological matrix, information gained from the osteological
evidence is usually the most reliable data available if interpreted with biases in mind.
.
I will discuss the range of osteological evidence relevant to paleodemography, as well as
the statistical problems that have been noted by Wood. I will also relate this information
to Neolithic populations in South Asia, an area defined by Kennedy (1984) as including
India, Burma, Pakistan, Bangladesh, Afghanistan, Nepal, Sikham, Buthan, Sri Lanka and
other Islands of the Indian Ocean and Bay of Bengal.

In order to explore the health of a past population from their skeletal remains we must
look at any indicators of stress, pathologies, or growth patterns.The dentition has been
used for this in many populations, in New Zealand Taylor(1963) showed evidence for the
inclusion of fern root in the diet of prehistoric Maori. By looking at the rate and patterns
of wear he found a particular type of attrition specific to this type of food. Cultural
factors are important here, if two populations are eating the same food it does not
necessarily mean rates of wear are the same. Factors such as the use of different grinding
stones for grain may mean more grit in the diet of one population than another. Cultural
practices can also play a major role, Lukacs (1992) found different tooth size and rates of
wear between males and females in the bronze age site of Harappa.Females at this site
showed a higher incidence of dental caries and pathology as well as signs of childhood
growth disruption resulting in enamal hypoplasia.This evidence Lukacs attributed to the
way females focused on agriculture while males ate more meat, he also points towards
the preferential treatment of male children that is still evident in South Asia today. Also
used by Lukacs (1983) are the tooth crown dimensions of a population, he used this
information to compare between two prehistoric and one living population in western
India.Lukacs found that differences between the sizes of teeth in these populations could
be attributed to “ differences in technology, diet,and subsistence”.Lukacs,(1983.p386)

Kennedy (1984) states that tooth size reduction is evident in South Asia between
agricultural and preagricultural societies and also in a north/south distribution.This
reduction has to do with the relaxation of selection pressures associated with masticatory
stress.Preagriculturalists exhibited larger teeth due to the stress that later technology
would diminish.

Evaluating the stature of past populations by measuring long bones can show if a person
has reached their full growth potential. This is also related to skeletal robusticity,
Kennedy shows both of these to be greater in preagricultural societies than in later
populations. Kennedy highlights the point that because the transition to agriculture put
stress on people in Neolithic South Asia they are generally shorter and less robust than
preagriculturalists.Kennedy,(1984,p174). Kennedy also points to environmental factors
that affect stature as well as dietary factors which could combine to produce trends in a
population.

Also useful to an anthropologist is the appearance of signs of growth arrest which can
give an idea of the general health history of an individual. The most widely used
indicators are Harris lines and enamel hypoplasia. Harris lines are an indication that
growth has been disrupted in long bones while an individual has still been growing.
Enamel hypoplasia is associated with disruption of growth in childhood evident in pits
and lines in the teeth of an individual. Kennedy states that in South Asia these forms of
evidence are more prevalent in agriculturalists showing that food strategies could have
been disrupted creating stress due to an inadequate diet.

The use of pathological indicators to assign health status has problems due to the non
specifity of some lesions. This is an area that has been the subject of criticism from
Wood et al. outlined above. Despite problems with the interpretation of paleopathologies
much work has been done in the area and a wide range of literature is available, one
bibliography (Tyson,ed.1997) contains thousands of relevant articles.Aufderhide and
Rodriguez-Martin (1998) provide an excellent reference on the history and description of
various diseases and their relationship with bone.Capasso, Kennedy and Wilczak (1999)
have compiled an atlas of pathologies related to markers of occupational stress and show
how paleopathology can be used to explore the cultural activities of a population.

Dental pathologies have been documented in South Asia in relation to the appearance of
“caries, malocclusion, agenisis of teeth and crowding”(Kennedy,1984.p177). These
forms of evidence can give an idea of the effect of diet on the teeth of a population, a diet
that has more sugar, grit(eg.shellfish) or other factor will show up in analysis. Kennedy
states that Lukacs(1981) noted an increase in dental pathologies such as caries with the
transition to agriculture.(Kennedy,1984.p177). Lukacs and Pastor(1988) described an
increase in the appearance of interproximal grooves between Bronze age Harappa and
Neolithic Mehrgarh. These interproximal grooves were the result of dental probing, a
practice associated with dental caries and a subsequent indicator of a decrease in dental
health.(Capasso.et al.199,p153)

Kennedy (1984) alludes to the fact that many forms of pathologies studied in South Asia
have been misinterpreted in the past. It is the nonspecifity of many lesions that can lead
to misinterpretation of them, some pathologies however do leave clues as to the health of
an individual. Diseases such as porotic hyperostosis and cribra orbitalia can be identified
as resulting from iron deficiencies in childhood as can osteoarthiritis and general
infection be identified to their causes.Kennedy points out that thalassemia, an adaptation
to cope with malaria that is evident in cranial bones, is prevalent in Asian populations.
The appearance of porotic hyperostosis in farming communities is seen by Kennedy as
evidence of a decline in the nutrition and health of farmers in South Asia.
(Kennedy,1984.p182)

The work of Kennedy and Lukacs show that the study of the health of past populations
from the South Asian region leads to an idea of the fluctuations in their general health
status.The indicators that Kennedy uses show that there has been a general decrease in
the health of those adopting farming as the main means of subsistence.The appearence of
lesions shown to be porotic hyperostosis in many people gives Kennedy reason to assert
that the ability for farming to provide a stable and varied diet.Lukacs also beleives in the
decline in health associated with the Neolithic transition to agriculture, his work shows
how the dental health of those changing from hunter-gatherers has deteriorated over time.
Similar trends have been identified from around the world although there are always
specific adaptations to particular environments.Even particular segments of societies can
exhibit change in health status(South Asian female children for example) while some
may remain stable.Larsen (1995) points out that many factors contribute to the biological
changes seen in populations changing to agriculture and that these can tell us a great deal
about how a major change in subsistence can affect our health status.(Larsen,1995.p204)

Larsen also highlights the fact that a more holistic attitude to the investigations into the
health of neolithic farmers is needed.There is a need to have relevant information from a
wide range of sites with statistically valid samples to get an idea of how a greater
proportion of the worlds population coped with any stresses they may have encountered.
Mark Nathan Cohen and George Armelagos (1984) brought together information from
eight regions around the world and related them to the transition to agriculture in the
Neolithic. They found seven ‘general trends’ that were gained from the study these
showed a general decrease in the health of hunter-gatherers as they made the transition to
intensive agriculture.

These are; 1. a higher frequency of non-specific chronic infections among farmers; 2.a
higher frequency of specific infections eg. yaws, tuberculosis and T.B-like infections
related to increased sedintism; 3. more intestinal infections and parasites (in mummies or
faeces) in tandem with group size and sedintism; 4. a higher incidence of porotic
hyperostosis linked to (childhood?) anaemia in most farmers; 5.other signs of
malnutrition (retarded growth and osteoporosis in children, premature adult osteoporosis
reduced tooth size etc.) were more common in farmers; 6. the average stature of
measured adults declined in the old world from the Palaeolithic through the Neolithic; 7.
the signs of systemic stress visible in teeth, including macroscopic enamel hypoplasia
and microscopic Wilson bands were more frequent and pronounced in farmers than
earlier hunter-gatherers. (Cohen,1994.p 629)

Cohen believes that if (and he says that they are) skeletal samples are representative of
the greater population in an area , this information proves that farming increased
biological stress on Neolithic populations. This overturns previously held notions of a
general progression from sick to healthy accompanying the development of agriculture.

This was commented on by Larsen(1995) who agrees, stating that the “shift from
foraging to farming led to a reduction in health status and well being, an increase in
physiological stress, a decline in nutrition, an increase in birth rate and population
growth, and an alteration of activity types and workloads.”(Larsen,1995.p204)This
reduction in the health of farming communities was also found by Lukacs in comparison
to earlier communities in the same area at an earlier time.

All this information leads to the point where we are able to say that although there are
problems with the statistical nature of some of our samples and interpretation of data
such as non-specific lesions, health in many Neolithic farmers changed. There have been
several trends noted by Larsen(1995) and Cohen(1984) that show that there are indicators
of health status that point towards a general decline in the health of neolithic people who change their main subsistence strategy from hunting-gathering to a reliance on a
sedintary agricultural lifestyle

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