Compared to other regions of North America, there have been relatively few paleopathological studies of arctic populations to date, particularly those aimed at elucidating patterns of health and disease prior to contact, and assessing temporal changes in disease patterns. In the present study, four Aleut skeletal samples representing one pre-contact population from Umnak Island in the eastern Aleutian Islands (N=65), and three late pre-contact/early contact period populations from Umnak, Kagamil, and Shiprock Islands (N=227), were examined macroscopically for indicators of health status. The analysis revealed some evidence of declining health in the late pre-contact/early contact period. Statistical comparisons of the earlier and later samples indicated a significantly higher frequency of cribra orbitalia and cranial infection in the later sample compared to the earlier one. Archaeological, epidemiological, and historical data point to several possible explanations for these findings, including the introduction of new pathogens by Europeans.