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Bulletin of the History of Medicine 78.1 (2004) 206-208

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Richard H. Steckel and Jerome C. Rose, eds. The Backbone of History: Health and Nutrition in the Western Hemisphere. Revised papers from a second conference sponsored by the National Science Foundation, 7-10 March 1996, Columbus, Ohio. Cambridge: Cambridge University Press, 2002. xx + 633 pp. Ill. $75.00 (0-521-80167-2).

This work represents something of an introduction to macrobioarchaeology, where the fields of paleonutrition, paleopathology, and paleodemography intersect and overlap. It features the skills of some fifty noted anthropologists, anatomists, biologists, economists, geographers, and historians in interpreting findings from the skeletal remains of 12,520 individuals who died in the Western Hemisphere between 5,000 BC and the late nineteenth century. Around 80% of the remains were of Native Americans (66% of these were North Americans, 12% were Middle Americans, and 22% were South Americans), with the other 20% split evenly between those of European and those of African descent. Slightly [End Page 206] more than half of the Native Americans died in pre-Columbian times, and a significant number of them (14%) were born and died more than two thousand years ago.

One problem with past bioarchaeological investigations has been skeletal samples so small as to discourage generalization. Another has been a lack of criteria for comparing such findings. Obviously, in this case the first problem has no relevance, and fortunately neither does the second. One of the major contributions of this study is the development of an index that permits a comparative analysis of the physical health of these remains using (1) anthropometric measurement (height); (2) linear enamel hypoplasias (dental indications of childhood malnutrition); (3) porotic hyperostosis (cranial lesions associated with anemia); (4) infectious disease (bony signs of infectious lesions); (5) trauma (injuries); (6) osteoarthritis and degenerative bone disease; and (7) dental caries. This health index will doubtless be refined, modified, and extended; nonetheless, as it stands now, it represents a considerable methodological breakthrough that will make subsequent bioarchaeological analysis substantially more meaningful.

Following an introduction, the work devotes three chapters to methodological considerations; five chapters to "Euro-Americans and African-Americans in North America"; two chapters to "Native Americans in Central America"; two chapters to "Native Americans and Euro-Americans in South America"; and five chapters to "Native Americans in North America." It concludes with two chapters by the editors reviewing the findings, and two more epilogue chapters that discuss the significance of the study.

Part of the significance of this collection of studies is that, taken together, they call into question the assumptions upon which numerous historical and anthropological studies rest. These include prominent books that assert that the New World was a Garden of Eden until the Europeans showed up to spoil it; that U.S. slave populations were well fed, not because of a master's kindness, but because they resourcefully foraged for themselves; or that the Mayas, who built a great civilization, must have been a healthy lot to do all that building. There are even books insisting that hunter-gatherers who domesticated fire as well as the dog, who spread out to all corners of the globe and launched a technological revolution around forty thousand years ago with a flurry of inventions including the atlatl, the sling, and the bow and arrow, were nonetheless physical wrecks, living brutish lives, hard pressed even to feed themselves until they finally invented agriculture.

The data generated in this work tell a different story. Native Americans were both the healthiest and the unhealthiest in the sample. South American hunter-gatherers were the healthiest; the Maya and other agricultural civilizations were the unhealthiest. African Americans also occupied places on the scale ranging from best to worst health, with the slaves at the bottom and free blacks near the top—even healthier than whites. Indeed, Euro-Americans tended to cluster toward the middle of the health index despite their sometimes-assumed advantage over the other groups in access to good nutrition. [End Page 207]

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