Health Is not always written in bone

Using a modern comorbidity index to assess disease load in paleopathology

Bibliographic Data

ID8313003
AuthorsKatherine D Van Schaik (0000-0002-7600-5233, Harvard University, corresponding author), Katherine Van Schaik (Harvard Medical School and Harvard Department of the Classics Cambridge MA), Dmitry Vinichenko (Department of Chemistry and Chemical Biology Harvard University Cambridge MA), Frank Rühli (Center for Evolutionary Medicine, Institute of Anatomy University of Zürich Switzerland), F J Rühli (0000-0001-7937-001X, University of Zurich, corresponding author)
Year2014
Volume154
Issue2
Pages215-221
Publication date2014-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAmerican Journal of Physical Anthropology (JOURNAL)
Journal identifiersISSN: 0002-9483 • E-ISSN: 1096-8644
PublisherWiley (PUBLISHER • GB)
DOI10.1002/ajpa.22494
PMID24936606
OpenAlexW1482567947
LanguageEN
Citations received16
References cited11

Paleopathology has revealed much about disease in the past but is usually limited to conditions with osteological manifestations; this often excludes acute soft tissue infections and causes of death for most individuals in the past and present. Our understanding of the evolution of disease is essential for contextualizing and predicting the epidemiological shifts that are happening in modern society, as high rates of infectious disease coexist alongside high rates of chronic disease in rates unlike those observed previously in human history. Moreover, many physiological states not previously classified as “disease” (obesity) have become pathologized, influencing our conception of disease and what defines health. By using the Galler Collection, a pre‐antibiotic and pre‐chemotherapeutic osteological series with modern autopsy records, our research quantifies disease burden of the past using the Charlson Index (CI), a modern comorbidity index of disease severity. Galler Collection remains and autopsy records were scored with the Charlson Index to correlate bone findings with soft tissue findings, and statistical analysis was performed for cumulative scores and absolute diagnosis counts, with patients stratified by sex and cause of death (pneumonia or cancer). Osteological diagnosis counts were more predictive of soft‐tissue autopsy disease counts than were associated cumulative CI scores. Diagnosis counts and CI scores for osteological data were more closely related to associated soft tissue data for cancer patients than for pneumonia patients. This research indicates how interdisciplinary paleopathological analysis assists in making more reliable assessments of health and mortality in the past, with implications for trending and predicting future epidemiological shifts. Am J Phys Anthropol 154:215–221, 2014. © 2014 Wiley Periodicals, Inc

Autopsy · Comorbidity · Disease · Osteology · Paleopathology · Pathology · Pneumonia · Rochester Epidemiology Project · Epidemiology · Forensic Anthropology and Bioarchaeology Studies · Historical and modern epidemiology studies · Internal Medicine · Medicine · Paleopathology and ancient diseases

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