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This study analyzed skeletal health disparities among African American and Euro-American males of low socioeconomic status born between 1825 and 1877. A total of 651 skeletons from the Cobb, Hamann-Todd, and Terry anatomical collections were macroscopically examined for skeletal pathologies related to dietary deficiencies and disease. Individuals were separated into age, ancestry, birth (Antebellum, Civil War, Pre-Reconstruction, and Reconstruction), combined ancestry/birth, enslaved versus liberated, and collection cohorts. These groups were statistically evaluated using ANOVA and χ(2) analyses to determine if age, ethnic, and temporal differences existed. Results indicated that African Americans, especially those born during Reconstruction, had significantly higher frequencies of tuberculosis (P = 0.004) and treponematosis (P = 0.006) than Euro-Americans. Historical sources are important in contextualizing why these different ethnic and temporal patterns were present, pointing to environmental conditions related to enslavement, postliberation migration to the industrialized North, crowded urban living conditions, and poor sanitation.
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Race, Health, and Disease in 19th-Century-Born Males
Carlina de la Cova*
Anthropology Department, University of North Carolina at Greensboro, Greensboro, NC 27412
KEY WORDS paleopathology; 19th century; African American history; tuberculosis;
treponematosis
ABSTRACT This study analyzed skeletal health
disparities among African American and Euro-Ameri-
can males of low socioeconomic status born between
1825 and 1877. A total of 651 skeletons from the
Cobb, Hamann-Todd, and Terry anatomical collections
were macroscopically examined for skeletal pathologies
related to dietary deficiencies and disease. Individuals
were separated into age, ancestry, birth (Antebellum,
Civil War, Pre-Reconstruction, and Reconstruction),
combined ancestry/birth, enslaved versus liberated, and
collection cohorts. These groups were statistically eval-
uated using ANOVA and v
2
analyses to determine if
age, ethnic, and temporal differences existed. Results
indicated that African Americans, especially those
born during Reconstruction, had significantly higher
frequencies of tuberculosis (P50.004) and treponema-
tosis (P50.006) than Euro-Americans. Historical
sources are important in contextualizing why these diff-
erent ethnic and temporal patterns were present, pointing
to environmental conditions related to enslavement,
postliberation migration to the industrialized North,
crowded urban living conditions, and poor sanitation.
Am J Phys Anthropol 144:526–537, 2011. V
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Wiley-Liss, Inc.
The skeletal health of 19th century Americans has
been a topic of recent interest to biological anthropolo-
gists (Kelly and Angel, 1987; Owsley et al., 1987; Rath-
bun, 1987; Lanphear, 1990; Rathbun and Scurry, 1991;
Owsley, 1994; Blakely and Harrington, 1997; Rankin-
Hill, 1997; Rathbun and Smith, 1997; Higgins, 2001;
Sledzik and Sandberg, 2002; Steckel and Rose, 2002;
Wols and Baker, 2004). This scholarship has mainly
focused on the skeletal health of African Americans or
Euro-Americans. Few studies have compared 19th-cen-
tury-born African Americans and Euro-Americans
(Rathbun and Scurry, 1991; Blakely and Harrington,
1997; Rathbun and Steckel, 2002; Watkins, unpublished
data). This article expands on previous research by
examining skeletal health disparities in 651 African
Americans and Euro-Americans of low socioeconomic
status born between 1825 and 1877 from the Hamann-
Todd, Robert J. Terry, and William Montague Cobb
collections. It was hypothesized, based on existing his-
torical and anthropological scholarship, that African
Americans and persons born during the Reconstruction
era (1866–1877) would have the highest rates of infec-
tious diseases, nutritional deficiencies, and biological
stress. Historical data indicate that African American
mortality increased and fertility declined after the Civil
War and remained low through the early 20th century
(Farley, 1970; Giffin, 2005). Census data supports this
trend, illustrating that African Americans had higher
death rates and larger frequencies of tuberculosis,
malaria, measles, pneumonia, scrofula, and venereal
diseases between 1880 and 1900 (Billings, 1885, 1896;
King, 1902).
Several historical events also coalesced to decrease
longevity and increase disease frequencies and biological
stress among African Americans. These included the
treatment of runaway slaves in Union-run contraband
camps, the postwar economy, migration from the South
to densely populated Northern cities, and job competi-
tion. The transition from enslavement to freedom for
Black Southerners would have been stressful. Many
slaves fled their masters during the Civil War, seeking
refuge in Union army encampments. The Confiscation Act
of 1861 also dictated that any Confederate property,
including human chattel used for insurrectionary activ-
ities, was subject to confiscation by the U.S. military.
Slaves, now contrabands of war, flocked daily to Union
lines in increasing numbers. Army officers initially placed
them in contraband camps on the periphery of Federal
encampments and assigned the men to work as laborers,
cooks, launderers, servants, and eventually soldiers
(Nolen, 2001; Reid, 2002). Females, children, and the
elderly remained in the designated areas, where crowding
was constant, food and supplies were lacking, white sol-
diers were condescending, and diseases spread rapidly.
Many succumbed to illness and malnutrition, perishing
before attaining freedom (Reid, 2002). In late 1862, these
poor conditions forced the army to organize the refugees
into established settlements and provide some rations,
clothing, and medicine. However, mortality rates, crowd-
ing, and malnutrition still plagued the camps (Click, 2001;
Reid, 2002). The army lacked the resources to support
hundreds of thousands of contrabands.
Soldiers also met with hardships during the war.
Camp life was grueling with bad sanitation, frequent
Grant sponsors: Smithsonian Institution and Indiana University
Department of Anthropology, and Indiana University Graduate Stu-
dent and Professional Organization.
*Correspondence to: Dr. Carlina de la Cova, Anthropology Depart-
ment, University of North Carolina at Greensboro, Greensboro,
North Carolina 27412. E-mail: cmdelaco@uncg.edu
Received 29 March 2010; accepted 5 October 2010
DOI 10.1002/ajpa.21434
Published online 1 December 2010 in Wiley Online Library
(wileyonlinelibrary.com).
V
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AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 144:526–537 (2011)
illnesses, harsh exposure to the elements, and a poor
diet. Disease was responsible for two-thirds of the
600,000 war-related deaths (Bollet, 2002). Measles,
mumps, chickenpox, and whooping cough infected regi-
ments and recruits never exposed to these illnesses in
epidemic proportions. Unsanitary camp conditions
prompted numerous cases of dysentery, typhoid fever,
jaundice, and typhus. Warm weather exposed soldiers to
unwanted intermittent fevers, malaria, and sunstrokes.
Colds, coughs, pneumonia, bronchitis, and tuberculosis
were also common.
The end of the Civil War ushered in the Reconstruc-
tion era (1866–1877) and the Gilded Age (1878–1900).
The Southern infrastructure and economy remained
stagnated throughout these periods. Many Southern
African Americans and poor Euro-Americans turned to
sharecropping to survive, which left them permanently
indebted to landowners. Blacks fared worse with dis-
crimination, Jim Crow laws, and persecution from the
Ku Klux Klan (Phillips, 1999). These proved to be major
factors that pushed Black Southerners to migrate to
Northern states.
As the South languished, the North advanced economi-
cally. The post-Civil War years saw increasing job oppor-
tunities and further industrialization. Urban areas grew
denser and transportation advancements allowed for the
rapid mobility of people and their pathogens across
the American landscape. Southern African Americans,
fleeing the sharecropping system and oppressive discrim-
ination, chose to relocate to industrialized cities like
Cleveland, Ohio, and St. Louis, Missouri, in search of
better lives (Phillips, 1999; Giffin, 2005). This in-migra-
tion of over one million Southern Blacks to the North,
Midwest, and West, known as the Great Migration,
began in 1910 and continued until 1930 (Giffin, 2005).
Poor Euro-Americans in these regions did not eagerly
welcome the new arrivals. They saw their job prospects
narrowing in an economy where they already competed
with European immigrants (Bonacich, 1972, 1975). The
population influx prompted housing shortages and fur-
ther crowding of the lower classes into tenements, sub-
standard rooms with poor ventilation, and bad sanita-
tion. Tensions between Blacks and whites over access to
jobs and housing eventually exploded when numerous
race riots erupted across the U.S. during the summers of
1917 and 1919.
Bioanthropological studies of 19th century African
Americans have shed light on how the above historical
factors impacted health. Scholarship has mainly focused
on the Antebellum era due to salvage archaeology proj-
ects (Kelly and Angel, 1987; Rathbun, 1987; Rathbun
and Scurry, 1991; Blakely and Harrington, 1997). These
analyses indicated that enslaved Blacks suffered from
malnutrition, enamel hypoplasia, growth disruption, dis-
ease, anemia, infection, bone hypertrophy, arthritis, and
high mortality rates (Kelly and Angel, 1987; Martin et
al., 1987; Rathbun, 1987; Rathbun and Scurry, 1991;
Rankin-Hill, 1997; Blakey, 2001). Post-Reconstruction
African Americans from Arkansas had higher rates of
nutritional stress, growth disturbances, and infectious
diseases when compared with their Antebellum breth-
ren, suggesting that health declined after liberation
(Rose, 1985, 1989). Watkins (2003; in press) examination
of late-19th and early 20th century African Americans
from the Cobb and Terry anatomical collections also indi-
cated that Blacks had high rates of infectious disease
and arthritis.
Studies of Euro-Americans have examined diverse
samples, including soldiers, indigents from almshouses,
and wealthy plantation owners (Lanphear, 1990; Rath-
bun and Scurry, 1991; Rathbun and Smith, 1997; Hig-
gins, 2001; Rathbun and Steckel, 2002). Despite their
social differences, many of these Euro-Americans also
suffered from periosteal reactions, growth disruption, po-
rotic hyperostosis, enamel hypoplasia, caries, osteoar-
thritis, trauma, and disease (Lanphear, 1990; Rathbun
and Scurry, 1991; Higgins et al., 2002; Rathbun and
Steckel, 2002; Saunders et al., 2002; Sledzik and Sand-
berg, 2002).
Few studies have compared 19th century African
Americans and Euro-Americans. Rathbun and Scurry
(1991) examined white South Carolinian Croft family
elites and their slaves, but sample sizes were too small
for any cogent findings. Analyses of human remains dis-
covered in the Georgia Medical College’s basement in
1989 could only assess ancestry for twenty-four persons
and focused on African Americans, who had slightly
higher rates of infectious lesions, but shared low calcium
levels with Euro-Americans (Blakely and Harrington,
1997). The Global History of Health Project compared
the skeletal health of 19th century Euro-Americans and
African Americans using a complied sample of various
individuals (Steckel and Rose, 2002). Whites included
middle class Canadians, almshouse inmates from Roch-
ester, New York, wealthy Southern plantation owners,
and U.S. Army soldiers. African Americans were also
diverse with slaves from Antebellum Charleston, mem-
bers of the 55th Massachusetts Regiment, post-Recon-
struction African Americans living in the Southwest,
and free Antebellum Blacks residing in Philadelphia. Af-
ter these samples were combined into ancestry cohorts
and analyzed, results revealed that Euro-Americans
were healthier than African Americans (Rathbun and
Steckel, 2002; Steckel et al., 2002). However, when
examined independently, free Antebellum Philadelphia
Blacks were the ‘‘healthiest.’’ Regardless of their limita-
tions, these studies have provided important insights
into 19th century American health, indicating that both
African Americans and Euro-Americans suffered from bi-
ological stress and infectious diseases.
Destitution and dissection
in 19th century America
The samples analyzed for this project come from three
major American anatomical collections: Hamann-Todd,
Robert J. Terry, and William Montague Cobb. The 19th-
century-born subjects associated with these collections
died in almshouses, charity institutions, and municipal
hospitals without anyone claiming their remains (Cobb,
1935; Watkins, 2003; Hunt and Albanese, 2004). This
was common in the late 19th and early 20th centuries
when anatomical laws dictated that unclaimed bodies be
given to medical schools for dissection (Blakely and Har-
rington, 1997; Richardson, 2001; Sappol, 2002).
Previous studies have compared 19th century Blacks
and whites but few have examined large sample sizes.
Rathbun and Steckel (2002) admitted their combined
sample of Euro-Americans and African Americans was
small, limited, and heterogeneous, since it was pooled
from various sites and time periods. Combining individu-
als from different socioeconomic contexts to represent an
ethnic group can be problematic and lead to misrepre-
527DISEASE IN 19TH CENTURY MALES
American Journal of Physical Anthropology
sentations of health as salubrity is tied to access to
health care, environmental stressors, nutrition, and soci-
oeconomic status.
The current project builds on these previous studies of
19th century health by examining a larger sample of
individuals (n5651) from the same socioeconomic back-
ground with shared occupations that lived in similar
environments. The subjects studied were indigent at
death and, according to morgue records, were unskilled
laborers in Cleveland, Ohio, St. Louis, Missouri, and
Washington, D.C.
In addition to examining persons of the same socioe-
conomic status with similar occupations, this project
focused on males born during the Antebellum (1800–
1860), Civil War (1861–1865), and Reconstruction
(1866–1877) eras. As discussed earlier, these epochs
were associated with political, social, and cultural
upheavals that impacted all Americans including the
lower socioeconomic classes. By examining these impor-
tant periods, a better understanding of the relationship
between environmental stressors and changes in skele-
tal health among African Americans and Euro-Ameri-
cans of low socioeconomic status can be ascertained.
Blacks born during the Antebellum period would have
grown and matured whilst enslaved and lived through
Reconstruction. Euro-Americans born in the Antebel-
lum era would have lived through the stressful period
of the Civil War. Civil War-born persons would have
undergone growth and development during Reconstruc-
tion but lived their adult lives in post-Reconstruction.
Those born in Reconstruction matured during the post-
Reconstruction eras, weathering the financial panics of
1873 and 1893 and the Influenza Pandemic of 1918. It
is expected, based on historical evidence, that African
Americans and Reconstruction-born individuals will
have the highest rates of infectious diseases and nutri-
tional deficiencies.
MATERIALS AND METHODS
A total of 651 male skeletons from the Hamann-Todd,
Robert J. Terry, and William Montague Cobb anatomical
collections were analyzed for skeletal markers of disease
and dietary deficiencies (Tables 1 and 2). The Hamann-
Todd Collection contains more than 3,000 persons born
between 1825 and 1910 that died in Cleveland, Ohio, or
neighboring cities. The Robert J. Terry Collection is com-
prised of 1,728 individuals that lived between 1837 and
1943 and expired in St. Louis. The William Montague
Cobb Collection at Howard University includes 987 per-
sons that lived from the mid-19th century until the
1960s and died in Washington D.C. Each collection has
morgue documentation for most individuals that include,
age, ancestry, occupation, cause of and place of death,
and source of donation (Cobb, 1935; Rankin-Hill and Bla-
key, 1994; Watkins, 2003; Hunt and Albanese, 2004).
This research focused on the earlier parts of these collec-
tions and excluded body donors. Morgue records were
consulted to confirm this. All three anatomical samples
are also biased towards older individuals and African
Americans. Therefore, all available Euro-Americans
were included in this study.
Persons were placed in age, ancestry, birth, pre-Recon-
struction versus Reconstruction, combined ethnicity/
birth, enslaved versus liberated, and collection cohorts to
determine if ethnic and temporal differences existed
between African Americans and Euro-Americans born
during the Antebellum, Civil War, and Reconstruction
time periods (Table 1). The enslaved versus liberated
cohorts were constructed to test for significant differen-
ces between African Americans born before and after
emancipation, and contemporary Euro-Americans. Age
cohorts comprised of 10-year intervals were examined to
see if pathologies were concentrated in certain age
groups. Age was based on morgue records and the U.S.
Census. If discrepancies existed between these reports,
then recorded age in the census was relied upon as it
was taken while the person was living.
Remains were macroscopically studied for the patholo-
gies listed in Table 2. All were recorded as present or
absent and statistically analyzed by the cohorts defined
in Table 1 using v
2
analyses. Morgue records were used
TABLE 1. Cohorts used in data analysis and sample size
Ancestry cohorts
African American
Euro-American
a
Collection cohorts (location)
Terry (St. Louis, Missouri)
Hamann-Todd (Cleveland, Ohio)
Cobb (Washington, D.C.)
Birth cohorts
Antebellum
Civil War
Reconstruction
Pre-Reconstruction vs.
reconstruction
Prereconstruction
Reconstruction
Ancestry/birth cohorts
Antebellum White
Antebellum Black
Civil War White
Civil War Black
Reconstruction White
Reconstruction Black
Enslaved vs. liberated ancestry/birth cohorts
Enslaved Black
Pre-Reconstruction White
Liberated/Reconstruction Black
Reconstruction White
Age cohorts
29–39
40–49
50–59
60–100
Sample size by ancestry and collection
Hamann-Todd Terry Cobb
African American 171 117 73
Euro-American
a
19 258 13
Total 190 375 86
a
This was all available Euro-Americans for the time periods
examined.
TABLE 2. Diseases, dietary deficiencies, and pathologies
examined
Dietary deficiencies (present/absent)
Rickets (Ortner, 2002)
Porotic hyperostosis (Stuart-Macadam, 1989)
Infectious diseases (present/absent)
Treponematosis (Ortner, 2002)
Tuberculosis (Kelley and El-Najjar, 1980; Kelley and Micozzi,
1984; Roberts et al., 1994; Ortner, 2002)
Osteomyelitis (Ortner, 2002)
528 C. DE LA COVA
American Journal of Physical Anthropology
to ensure the diagnosis was accurate. Age was examined
using ANOVA tests.
Historical research
Rankin-Hill (1997, p 14) has indicated that informa-
tion ‘‘generated from skeletal biological analyses must be
placed within the context of a population’s lifeways and
history to explain the conditions that produced the dis-
ruptions.’’ Therefore, historical methodology was
employed by analyzing primary sources such as newspa-
pers, letters, manuscripts, and pamphlets, to reconstruct
the socioeconomic and cultural contexts of the shifting
environments in which the individuals being studied
lived. Basic demographic data on all persons came from
morgue records accompanying the remains. Further in-
formation on the subjects, including birthplace, resi-
dence, and occupation, was acquired by searching the
U.S. Census. Individuals were searched in the census by
name, location, and birth date. Additional data from
morgue records, including the hospital in which the per-
son expired, parent’s birthplace, or occupation was also
utilized to ensure that the proper subjects were located
in the census. For example, an individual from the Terry
Collection was traced through the census for the last
thirty years of his life. He had spent them in the City
Sanitarium, where he died. Morgue data regarding his
date and place of birth matched the census data. Previ-
ous demographic studies done on these collections were
also consulted (Cobb, 1935, Watkins, 2003; Hunt and
Albanese, 2004). Primary sources that provided insights
into life among the working-class of Cleveland, Ohio, St.
Louis, Missouri, and Washington, D.C. were examined at
the National Archives and the Library of Congress in
Washington, D.C. Contemporary newspapers were also
reviewed using several online databases including
‘‘America’s Historical Newspapers’’ and ‘‘19th Century
Newspapers.’’
RESULTS
The average age at death was 65.51 years (Tables 3
and 4 and Fig. 1). African Americans and Euro-Ameri-
cans were of similar ages for all time periods. The birth
and combined ancestry/birth cohorts revealed a signifi-
cant decline in age at death through time (Table 4).
Antebellum persons lived 7 years longer than Civil
War-born individuals and 15.3 years longer than those
born during Reconstruction (F5183.63; P50.000).
Combined ancestry/birth cohorts further illustrated
these differences. Collection cohorts (Table 4) were also
significant with Hamann-Todd having the youngest indi-
viduals (F567.004, P50.000).
Chi-squared and frequency analyses of porotic hyper-
ostosis (PH), rickets, treponematosis, skeletal tubercu-
losis (TB), and osteomyelitis are reported in Tables 5
and 6 by cohorts. Cohorts are bordered in Table 5 to
illustrate which were analyzed together. Approximately
85.6% of the sample had PH, with Euro-Americans and
Civil War-born persons having the highest rates but
these observations were not statistically significant.
However, Hamann-Todd had significantly more cases of
PH when compared to the other collections (Table 5).
Rickets was present in 4% (n526) of the individuals
examined; no statistical differences existed among the
cohorts (Table 5; Figs. 2 and 3). Skeletal manifestations
of treponematosis were observed in 2.2% of the sample
(Table 5) with African Americans having significantly
higher frequencies when compared with Euro-Americans
(P50.004). Furthermore, Reconstruction-born Blacks
were significantly different, but the expected cell counts
were low. An analysis of the Enslaved versus Liberated
Ancestry/Birth cohorts (Table 5) clarified these findings
indicating that Liberated/Reconstruction Blacks had sig-
nificantly higher rates of treponematosis when compared
with Pre-Reconstruction Whites, Enslaved Blacks, and
Reconstruction Whites (P50.046). Tests on skeletal tu-
berculosis (TB) mirrored these results (Table 5). Approxi-
TABLE 3. Average ages of cohorts
Cohort NMean
Entire sample 651 65.515
African American 360 65.019
Euro-American 291 64.127
Antebellum 175 75.029
Civil War 133 68.000
Reconstruction 343 59.697
Antebellum White 91 75.077
Antebellum Black 84 74.976
Civil War White 60 67.917
Civil War Black 73 68.068
Reconstruction White 140 59.543
Reconstruction Black 203 59.803
Terry 375 67.149
Hamann-Todd 189 58.545
Cobb 87 73.609
TABLE 4. ANOVA analysis of birth cohorts and age
NMean Std. deviation FSig.
Antebellum 175 75.03 7.19 183.63 0.000
Civil War 133 68.00 7.29
Reconstruction 343 59.70 9.95
Total 651 65.51 10.97
Antebellum White 91 75.08 5.51 73.141 0.000
Antebellum Black 84 74.98 8.68
Civil War White 60 67.92 4.07
Civil War Black 73 68.07 9.15
Reconstruction
White
140 59.54 10.79
Reconstruction
Black
203 59.80 9.36
Total 651 65.51 10.97
Terry 370 67.19 9.13 67.044 0.000
Hamann-Todd 169 60.30 10.11
Cobb 82 74.50 9.22
Total 621 66.28 10.37
Bonferroni Post hoc test
(I) Birth era (J) Birth era
Mean
difference (I2J) Sig.
Antebellum Civil War 7.03 (*) 0.000
Reconstruction 15.33 (*) 0.000
Civil War Antebellum 27.03 (*) 0.000
Reconstruction 8.30 (*) 0.000
Antebellum
White
Antebellum Black 0.10073 1.000
Civil War White 7.16026 (*) 0.000
Civil War Black 7.00843 (*) 0.000
Reconstruction White 15.53407 (*) 0.000
Reconstruction Black 15.27397 (*) 0.000
Terry Hamann-Todd 6.89012 (*) 0.000
Cobb 27.30811 (*) 0.000
Hamann-
Todd
Terry 26.89012 (*) 0.000
Cobb 214.19822 (*) 0.000
* Denotes statistical significance.
529DISEASE IN 19TH CENTURY MALES
American Journal of Physical Anthropology
mately 4.4% of the sample suffered from TB but African
Americans (4.5%) had significantly higher rates (P5
0.004). While there was a temporal increase in disease
prevalence among the birth cohorts, only the combined
ancestry/birth cohorts were significant, with Reconstruc-
tion-born African Americans having higher rates of TB
(P50.015). Again, the cells had low counts, but an ex-
amination of the Enslaved versus Liberated Ancestry/
Birth cohorts revealed that Liberated/Reconstruction
Blacks were significantly more afflicted with TB (P5
0.007) when compared with their enslaved brethren,
Pre-Reconstruction Whites, and Reconstruction-born
Whites (Figs. 4 and 5). Collection analyses for both trep-
onematosis and TB were not statistically significant, but
Hamann-Todd had the most cases.
Statistical analyses of the age cohorts and pathologies
indicated there were no differences, with the exception
of TB (Table 6).The youngest cohorts had significantly
higher rates of TB (P50.002). These findings suggest
that, in regard to most paleopathological conditions, the
birth cohorts are comparable as they have similar fre-
quencies of pathologies.
DISCUSSION
Based on previous historical and bioanthropological
scholarship, it was hypothesized that African Americans
would have higher frequencies of biological stress, nutri-
tional deficiencies, and disease when compared to Euro-
Americans. It was also surmised that health would
decrease through time and the Reconstruction era would
be the least salubrious. The results partially supported
these research hypotheses. There were no significant dif-
ferences among the cohorts and the prevalence of PH
and rickets. However, African Americans, especially
those born during Reconstruction, had significantly
higher rates of treponematosis and TB when compared
to Euro-Americans. This suggests that Blacks suffered
more from these infectious diseases than whites, espe-
cially after emancipation. The lack of differences
between African Americans and Euro-Americans in
regard to PH and rickets indicates that both groups in
this sample shared similar rates of nutritional deficien-
cies and biological stress.
Compared with other 19th and early 20th century
African American skeletal series, Blacks in this study
had higher rates of TB than their Antebellum brethren
from Philadelphia’s First African Baptist Church (3%),
but not as high as the 6% frequency associated with
Post-Reconstruction Cedar Grove (Rose, 1985, 1989;
Rankin-Hill, 1997). In contrast, this research had low
frequencies of treponemal disease that differed from the
16.1% observed in 40 individuals from the New York
African Burial Ground, of which 28 (31.5%) were male
(Null et al., 2004). High rates of periostitis at Cedar
Grove among subadults and premature infants (81.8%)
Fig. 1. Distribution of age at death.
530 C. DE LA COVA
American Journal of Physical Anthropology
led Rose (1985, 1989) to conclude that congenital and ve-
nereal syphilis was present.
Age and socioeconomic status at death
African Americans and Euro-Americans were not sig-
nificantly different with regard to age at death. However,
persons born during the Antebellum period lived 15
years longer than those born during Reconstruction.
This does not mean Antebellum individuals had
extended life spans. This is probably an artifact of
cadaver acquisition procedures. Carl Hamann started
gathering skeletons for his collection in 1893. Robert
Terry began in 1910. William Montague Cobb collected
his sample in the 1930s. The gap between the Antebel-
lum era and body acquisition for the collections best
explains the large age difference.
Age distributions of the collections also differ.
Hamann-Todd had the youngest average age, with all
ages represented. This reflects T. Wingate Todd’s inter-
ests in skeletal aging and his desire to have an all inclu-
sive sample (Meindl et al., 1990). The Cobb Collection
had the oldest average age, which may be the result of
the time period in which the collection was started. Indi-
viduals born during the eras examined in this study
would have been over fifty when they were included in
the collection.
U.S. Census records and previous studies on the
demography of the collections indicated that most of the
African Americans examined were Southern-born. Euro-
TABLE 5. Chi-squared analyses of ancestry, birth, and collection cohorts
Cohorts
Porotic
hyperostosis
N/total (%), P
Rickets
N/total (%), P
Treponematosis
N/total (%), P
Tuberculosis
N/total (%), P
Osteomyelitis
a
N/total (%), P
Entire sample 495/578 (85.6) 26/644 (4.0) 30/644 (4.7) 28/644 (4.3) 9/605 (1.5)
African American 263/313 (84.0), 0.229 17/357 (4.8), 0.297 24/357 (4.2), 0.006 23/357 (6.4), 0.004 8/321 (2.5)
Euro-American 232/265 (87.5) 9/287 (3.1) 6/287 (2.1) 5/287 (1.7) 1/284 (0.4)
Antebellum 129/154 (83.8), 0.696 7/175 (4.0), 0.957 5/175 (2.9), 0.277 3/175 (1.7), 0.073 0/166 (0.0)
Civil War 103/118 (87.3) 6/135 (4.5) 9/134 (6.7) 5/134 (3.7) 2/126 (1.6)
Reconstruction 263/306 (85.9) 13/335 (3.9) 16/335 (4.8) 20/335 (6.0) 7/313 (2.2)
Antebellum White 69/81 (85.2), 0.802 3/91 (3.3), 0.943 2/91 (2.2), 0.048
b
1/91 (1.1), 0.015
c
0/90 (0.0)
Antebellum Black 60/73 (82.2) 4/84 (4.8) 3/84 (3.6) 2/84 (2.4) 0/76 (0.0)
Civil War White 52/58 (89.7) 2/60 (3.3) 2/60 (3.3) 0/60 (0.0) 1/60 (1.7)
Civil War Black 51/60 (85.0) 4/74 (5.4) 7/74 (9.5) 5/74 (6.8) 1/66 (1.5)
Reconstruction
White
111/126 (88.1) 4/136 (2.9) 2/136 (1.5) 4/136 (2.9) 0/134 (0)
Reconstruction
Black
152/180 (84.4) 9/199 (4.5) 14/199 (7.0) 16/199 (8.0) 7/179 (3.9)
Pre-Reconstruction 232/272 (85.3), 0.823 13/309 (4.2), 0.833 14/309 (4.5), 0.883 8/309 (2.6), 0.036 2/292 (0.7)
Reconstruction 263/306 (85.9) 13/335 (3.9) 16/335 (4.8) 20/335 (6.0) 7/313 (2.2)
Enslaved Black 111/133 (83.5), 0.667 8/158 (5.1), 0.758 10/158 (6.3), 0.046 7/158 (4.4), 0.007 1/142 (0.7)
Pre-Reconstruction
White
121/139 (87.1) 5/151 (3.3) 4/151 (2.6) 1/151 (0.7) 1/150 (0.7)
Liberated/
Reconstruction
Black
152/180 (84.4) 9/199 (4.5) 14/199 (7.0) 16/199 (8.0) 7/179 (3.9)
Reconstruction
White
111/126 (88.1) 4/136 (2.9) 2/136 (1.5) 4/136 (2.9) 0/134 (0)
Terry 309/357 (86.6), 0.008 14/374 (3.7), 0.889 17/374 (4.5), 0.784 12/374 (3.2), 0.106 3/374 (0.8)
Hamann-Todd 156/178 (87.6) 8/185 (4.3) 10/185 (5.4) 13/185 (7.0) 2/185 (1.1)
Cobb 30/43 (69.8) 4/85 (4.7) 3/85 (3.5) 3/85 (3.5) 4/46 (8.7)
a
Prevalence was too small for statistical analyses.
b
Four cells (33.3%) have expected counts of less than 5.
c
One cell (14.7%) has an expected count of less than 5.
TABLE 6. Chi-squared analyses of age cohorts
Age cohort
Porotic
hyperostosis
N/total (%), P
Rickets
N/total (%), P
Treponematosis
N/total (%), P
Tuberculosis
N/total (%), P
Osteomyelitis
N/total (%), P
Entire sample 495/578 (85.6) 26/644 (4.0) 30/644 (4.7) 28/644 (4.3) 9/605 (1.5)
29–39 5/6 (83.3), 0.873
a
0/6 (0.0), 0.603
b
0/6 (0.0), 0.153
c
1/6 (16.7), 0.001
c
0/6 (0.0)
40–49 36/40 (90.0) 3/43 (7.0) 5/43 (11.6) 5/43 (11.6) 1/43 (2.3)
50–59 96/113 (85.0) 6/117 (5.1) 5 /117 (4.3) 10/117 (8.5) 2/114 (1.8)
60–100 358/419 (85.4) 17/478 (3.6) 20/478 (4.2) 12/478 (2.5) 6/442 (1.4)
a
One cell (12.5%) had expected counts of less than 5
b
Three cells (35.7%) have an expected count of less than 5.
c
Two cells (25.0%) have an expected count of less than 5.
531DISEASE IN 19TH CENTURY MALES
American Journal of Physical Anthropology
Americans were from the collection cities or neighboring
states. Watkins’ (2003; in press) research on the Cobb
Collection supports this finding, indicating that most
individuals were native to Washington, D.C., Maryland,
and Virginia. The demographics of the Hamann-Todd
Collection, published by Cobb (1935), reflected contempo-
rary social, industrial, and migratory patterns. The
‘‘cadavera’’ were ‘‘unclaimed dead from the least stable
elements of marginal economic groups in the living pop-
ulation...people who with few exceptions were without
skilled occupations’’ (Cobb, 1935, p 157). Most of
Hamann-Todd’s native-born whites (n5292) were first
generation Americans, originating from 21 states (Fig.
6). The majority, however, were born in the Northern
states of Ohio, New York, and Pennsylvania. African
Americans (n5447) covered a larger expanse, coming
from 27 states (Fig. 7). Most were Southern-born and
from the cotton belt, with the largest numbers associated
with Georgia, Alabama, and South Carolina. Others
were from Tennessee, Kentucky, Virginia, Mississippi,
North Carolina, and Arkansas.
Cobb (1935) also observed an increase in the number of
African American remains entering the Hamann-Todd
Collection from 1915 to 1930 and attributed this to the
influx of Southern Black migrants associated with the
Great Migration. Census records supported this, revealing
that from 1910 to 1930, the African American population
in Cleveland surged from 8,448 to 72,120 (Cobb, 1935).
The Terry Collection exhibits a similar pattern, with the
majority of African Americans being Southern-born.
Census and morgue records indicated that nearly all
of the individuals examined were unskilled laborers.
None owned property and many lived in boarding houses
or were confined to hospitals. Few were married and
those that were rarely lived with their partners. These
findings supported the claim that the subjects were part
of the poor working-class of late 19th and early 20th cen-
tury America.
These results illustrate the limits of cadaver collec-
tions and the effects of the ‘‘osteological paradox’’ (Wood
et al., 1992). The age at death, age distributions, and
socioeconomic findings are the results of selectivity bias.
Historically, collection managers did not have numerous
options for cadaver acquisition. Most bodies donated to
medical schools were of older unclaimed impoverished
persons. Furthermore, the doctors amassing these collec-
tions chose which remains they wanted to curate for fur-
ther study based on age, pathologies, and abnormalities.
Therefore, the sample analyzed in this study is not rep-
resentative of the general population. The average age
at death and age distributions within the collections
exemplify this. Most individuals examined survived
beyond fifty, which contrasts with the average life
expectancies of twenty to forty years of age that have
been recorded at other 19th century sites (Kelly and
Angel, 1987; Owsley et al., 1987; Rathbun, 1987; Rath-
bun and Scurry, 1991; Rankin-Hill, 1997; Blakey, 2001).
Many persons in this study also survived long enough
for their immune systems to respond by forming bone
lesions, especially those associated with TB, treponema-
tosis, and other disorders. In the ‘‘osteological paradox,’’
individuals with bone pathology are believed to repre-
sent the most robust, or healthiest, citizens in a popula-
tion that have an increased ability to tolerate disease. In
contrast, persons with no skeletal pathologies were ei-
ther extraordinarily healthy before their death, or may
have expired from acute diseases which resulted in quick
death, before a skeletal response could occur (Wood
et al., 1992). The presence of bone lesions in the sample
studied implies that these individuals’ battles with infec-
tious disease were more chronic. Furthermore, this sug-
gests that the African Americans examined were the
most robust as they had the highest rates of TB and
treponematosis.
Despite the ‘‘osteological paradox,’’ anatomical collec-
tions can still be utilized to provide information on
health disparities among 19th-century-born persons of
low socioeconomic status. The results of this study
agreed with historical data and current research on the
susceptibility and higher rates of TB observed among
African Americans. The 1880, 1890, and 1900 U.S. cen-
suses consistently recorded that African Americans had
higher rates of TB and other transmissible diseases for
all ten year intervals (Billings, 1885, 1896; King, 1902).
Research by Stead et al. (1990) has also noted that this
pattern of increased susceptibility to TB continues
among African Americans into the present day. The sam-
ple studied agrees with historical trends about TB and
Fig. 2. Healed rickets in the tibiae and fibulae (TC 770).
[Color figure can be viewed in the online issue, which is avail-
able at wileyonlinelibrary.com.]
532 C. DE LA COVA
American Journal of Physical Anthropology
can provide insight into health among the poorest deni-
zens of Cleveland, St. Louis, and Washington, D.C.
Contextualizing and comprehending
illness in the poorest denizens
Many environmental stressors contributed to the bio-
logical stress and high TB and treponematosis rates
observed in the sample during the Civil War and Recon-
struction periods. Firsthand accounts illustrate how the
Civil War affected soldiers, slaves, and civilians. In Au-
gust of 1865, T. T. Tredway wrote to C. T. Chase express-
ing concern for local yeomen living in Prince Edward
County, Virginia, where both Union and Confederate
armies had foraged from the local population. Tredway
(1865) lamented that ‘‘great destitution’’ existed among
the residents, ‘‘especially those living in the broad track
of the Armies. Bread is scarce & bacon scarcer.’’ The
shortage of tobacco seeds, farming implements and draft
animals, all confiscated by the armies, left tobacco farm-
ers handicapped in planting crops and desperate for
funds.
The time periods associated with the transition from
slavery to freedom were also stressful for African Ameri-
cans, especially those that sought refuge in Union Army
contraband camps. Sanitary Commission agent Maria
Mann described the abuse and neglect she witnessed to-
ward African American refugees while working at the
‘‘sickly, pestilential, [and] crowded’’ government-adminis-
tered St. Helena Contraband Camp in Helena, Arkansas,
in 1863 (Mann, 1863a). The refugees had been destitute
for months with no relief, with the exception of the
males who, through the military, were ‘‘comfortably
clothed’’ (Mann, 1863b). Food was lacking, beef was
scarce, and army rations formed the dietary staple. Liv-
ing arrangements for the runaway slaves were abysmal
and described by Mann as ‘‘sadly narrowed habitations,
half of them with ground floors, without window or
closet, and the mud of this locality’’ (1863b). The hospital
was also a ‘‘wretched hovel’’ where many came ‘‘to
die...very rapidly’’ (Mann, 1863a).
Three months after Maria Mann’s correspondences, T.
A. Goodwin, an Indiana native who observed the condi-
tions of Black refugees in Union army camps, wrote to
fellow abolitionist Robert Dale Owen that ‘‘able-bodied’’
male contrabands ‘‘fair well enough, as laborers or as
servants or soldiers, but the thousands of women and
children which are huddled in the filthy quarters appeal
to our sympathy’’ (Goodwin, 1863). In December of 1863,
an editorial in the Washington, D.C. Daily Constitutional
Union (The Contrabands in the South, 19 December
1863) indicated that the poor conditions of the contra-
bands continued. Fit males were ‘‘forced into the army,
either for labor or military service’’ while the elderly,
women, and children were ‘‘provided with insufficient
shelter and abandoned to the chances of hunger, nudity,
and disease’’ (Washington Daily Constitutional, 19 De-
cember 1863, p 2). The government failed to support the
‘‘miserable wretches’’ who were ‘‘deluded into our lines
by the promise of freedom’’ (Washington Daily Constitu-
tional, 19 December 1863, p 2).
The above conditions, including poor nutrition, crowd-
ing, and inadequate access to food and shelter may be
responsible for the high prevalence of TB and trepone-
matosis observed among the African Americans in this
sample. Poor nutrition could easily compromise an indi-
vidual’s immune system, making them more susceptible
to contagious illnesses. Crowding would also increase
one’s probability of infection.
Treponematosis and TB rates continued to rise after
the Civil War, as indicated by the results of this study.
The Reconstruction cohort and liberated African Ameri-
cans had the largest frequencies of TB and treponemato-
sis. These findings supported the research hypotheses
that African Americans and the Reconstruction cohort
would have the highest prevalence of disease. The
results also agree with historical evidence. At the turn of
the century, more African Americans suffered from infec-
tious illnesses than Euro-Americans (Farley, 1970; Bill-
ings, 1885, 1896; King, 1902). TB was a major killer in
Fig. 3. Healed rickets in the femora (HTH 3119). [Color fig-
ure can be viewed in the online issue, which is available at
wileyonlinelibrary.com.]
533DISEASE IN 19TH CENTURY MALES
American Journal of Physical Anthropology
the Black community, with an affliction rate three times
higher than that of whites (Farley, 1970; Kiple and
King, 1981). In 1920 Cleveland, TB and pneumonia mor-
tality rates were more than twice that of Euro-Ameri-
cans (Giffin, 2005).
Many historical factors may have contributed to the
larger frequencies of TB and treponemal disease
observed among the Reconstruction cohort and liberated
African Americans. These individuals lived through fi-
nancial panics, the 1918 flu pandemic, and industrializa-
tion. However, the increase in TB and treponematosis
may also be reflecting environmental changes from a ru-
ral Southern setting to a Northern or Midwestern urban
ambiance. Census records, morgue documentation, and
previous research by Cobb (1935) and Watkins (2003)
indicated that most of the African Americans studied
were Southern-born. Cobb’s noted increase of African
Americans in the Hamann-Todd Collection during 1915
to 1930 coincided with the largest influx of Black South-
erners in Cleveland. This is significant because it illus-
trates that the historical event of the Great Migration is
represented in the anatomical collections. African Ameri-
can in-migrants would have spent their childhoods in ru-
ral atmospheres where illnesses were not as communica-
ble as in the dense cityscapes of St. Louis, Cleveland,
and Washington, D.C. The move northward exposed
Black Southerners to fatally new environments where
they were more susceptible to contracting diseases.
Finding shelter and employment were obstacles that
faced African American migrants settling in urban areas
(Phillips, 1999; Giffin, 2005). It was easy to obtain work
during the First World War, but finding proper housing
proved to be more difficult. The large influx of migrants
into many industrialized cities led to housing shortages,
tenement overcrowding, and homelessness (Kusmer,
1978; Phillips, 1999; Giffin, 2005). Southern-born African
Americans arriving in these urban centers had limited
options and unequal access to lodging due to color dis-
crimination (Phillips, 1999; Giffin, 2005). Housing short-
ages also prompted landlords to increase rent, often tar-
geting African Americans for higher rates (Giffin, 2005).
Many were marginalized to specific neighborhoods, liv-
ing in tenements, where sanitation was poor. Black
migrants in Cleveland were competing for the scarce
rentals available on the east side, often sharing neigh-
borhoods with European immigrants (Phillips, 1999).
In 1919, the Cleveland Advocate, a historically Black
newspaper, described the substandard lodgings and poor
sanitation along Central Avenue, from ‘‘E. 14th Street to
E. 29th Street,’’ where ‘‘hundreds of respectable Colored
citizens are forced to live because of confounded color
prejudice’’ (Cleveland Advocate, 27 September 1918, p 8).
The Advocate lamented that the area and its associated
houses were ‘‘unsightly, unsanitary, disease-breeding
plague,’’ a ‘‘veritable miasma’’ and a ‘‘menace to the
health and moral civic progress of the Colored people
who are forced to inhabit them’’ (Cleveland Advocate,27
September 1918, p 8). A public plea was made to clean
up Central Avenue and have the tenements razed to the
ground and replaced with new buildings (Cleveland
Advocate, 27 September 1918, p 8).
The conditions of Cleveland’s African American in-
migrants soon became a public health problem. Ohio
officials complained that poor housing and residence
crowding were a threat to the health of the state’s Black
population (Giffin, 2005). In 1920, the Cleveland Hospital
Council health survey indicated that tenement and lodg-
ing houses were ‘‘in a deplorable condition, in no way com-
plying with city regulations. People most crowded are the
Negroes, Italians, Jews, and foreign-born Slavs, Slovaks,
Lithuanians and Poles’’ (Cleveland Hospital Council,
1920, p 7). The survey denoted that the cheapest lodging
houses found in New York City’s Lowest East Side
‘‘shined’’ in comparison to ‘‘Cleveland’s ’flophouses,’ which
are a disgrace’’ (Cleveland Hospital Council, 1920, p 53).
Precisely 27.1% of Cleveland’s industrial workers lived in
crowded tenement housing in 1920 with ‘‘50% of the fami-
lies having less than one room per person’’ (Cleveland
Hospital Council, 1920, p 353). The Council’s review of
lodgings provided by the New York Central Railroad
(NYCR) is of interest as this company recruited heavily
among Southern Black males. These men were enticed to
relocate to Cleveland as railroad workers with promises of
higher wages and free housing (Phillips, 1999). These
complimentary lodgings designated for NYCR employees
were criticized by the Cleveland Hospital Council (1920, p
53) as violating ‘‘reasonable provisions for sanitary living
and disease prevention.’’ The structure had ‘‘inadequate
light and ventilation, old, soiled stained bed coverings, fil-
thy floors, overcrowding, lack of space between bunks,
etc’’ (Cleveland Hospital Council, 1920, p 53).
Fig. 4. HTH 2126, diagnosed with tuberculosis, had lesions
on his lumbar vertebrae and ribs. [Color figure can be viewed in
the online issue, which is available at wileyonlinelibrary.com.]
534 C. DE LA COVA
American Journal of Physical Anthropology
Based on the above descriptions, it is not surprising
that TB and treponematosis peaked among African
Americans, especially those born liberated during the
Reconstruction-era. The stresses of emancipation and
migration to an urban environment with its close prox-
imities and tenement crowding would have taken its toll
on Southern-born African American in-migrants. Poor
sanitation and lack of ventilation associated with these
hovels would have created breeding grounds for infec-
tious diseases such as TB. Historical records confirm
that mortality rates among Blacks in Cleveland
increased by 80% from 1920 to 1926, while the death
rate for other Cleveland inhabitants remained stable
(Giffin, 2005). Census data also indicates that African
Americans were plagued with higher rates of TB, pneu-
monia, scrofula, and venereal diseases from 1880 to 1900
(Billings, 1885, 1896; King, 1902). Since most of the Afri-
can Americans examined in this study were Southern-
born, a shift in environment from a warmer, dispersed
locality, to a Northern city with high population density,
colder climates, and poor living conditions would have
aided the transmission of TB (Roberts and Buikstra,
2003). This shift in venue also meant greater contact
with larger numbers of persons, which would have also
increased treponematosis rates. Racial discrimination
further ostracized Southern-born African Americans,
making them targets for violence at the turn-of- the-cen-
tury and confining them to tenement ghettos with poor
sanitation.
Since the Euro-Americans examined in this research
were mostly from the surrounding regions and the North,
it is possible that they may have lived their entire lives in
more densely populated areas. The urban lifestyle of a poor
Euro-American would have introduced numerous stres-
sors, including poor sanitation, poor housing, and competi-
tion for resources which would have caused the biological
stress recorded in this sample. Overcrowding, as in the
case of African Americans, would have also increased the
risks of infectious diseases in Euro-Americans.
Fig. 5. Rib lesions associated with tuberculosis in HTH
2126. [Color figure can be viewed in the online issue, which is
available at wileyonlinelibrary.com.]
Fig. 6. Birthplaces of native-born Euro-Americans in the
Hamann-Todd Collection (after Cobb, 1935).
Fig. 7. Birthplaces of native-born African Americans in the
Hamann-Todd Collection (after Cobb, 1935).
535DISEASE IN 19TH CENTURY MALES
American Journal of Physical Anthropology
CONCLUSION
The purpose of this study was to determine if skeletal
health disparities existed among African Americans and
Euro-Americans born from 1822 to 1877. Based on previ-
ous studies of 19th century-born Blacks and whites, it
was hypothesized that African Americans and Recon-
struction-born (1866–1877) individuals would have the
highest rates of infectious diseases, nutritional illnesses,
and biological stress. Results indicated that skeletal
health disparities did exist between 19th-century-born
African Americans and Euro-Americans. The Recon-
struction cohort and African Americans, especially those
born liberated during Reconstruction, had significantly
higher rates of TB and treponematosis. Historical sour-
ces were important in illustrating and contextualizing
why these different ethnic patterns existed, pointing to
environmental conditions related to enslavement, post-
liberation migration to the industrialized North, crowded
urban living conditions, and poor sanitation. Further
research is necessary to analyze dental health, enamel
hypoplasia, femoral lengths, skeletal robusticity, and
osteoarthritis. It is hoped that these findings encourage
future comparative studies on health among African
Americans and Euro-Americans so that a better under-
standing of health disparities can emerge.
ACKNOWLEDGMENTS
This work would not have been possible without the
assistance of Della Cook, David Hunt, Paul Jamison,
Lyman Jellema, Mark Mack, Valerie O’Loughlin, Doug
Owsley, Anne Pyburn, and Steven Stowe.
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537DISEASE IN 19TH CENTURY MALES
American Journal of Physical Anthropology
... However, individuals in the Terry Collection, like those in many other historical reference collections, represent a highly specific sub-population, with a distinct set of antemortem, perimortem, and postmortem experiences. Racial categorization on death certificates specifies that Black and/or African Americans comprise 54.4% of the Terry Collection, many of whom were of low socioeconomic status (e.g., "laborer", typically construction, farm, domestic, or industry workers, as the listed occupation on death certificates) 45,46 and arrived to Missouri from the Deep South as part of the Great Migration (c. 1910-1970) 4,[40][41][42]45,47 . ...
... Racial categorization on death certificates specifies that Black and/or African Americans comprise 54.4% of the Terry Collection, many of whom were of low socioeconomic status (e.g., "laborer", typically construction, farm, domestic, or industry workers, as the listed occupation on death certificates) 45,46 and arrived to Missouri from the Deep South as part of the Great Migration (c. 1910-1970) 4,[40][41][42]45,47 . Black and/or African American individuals manifest higher rates of infectious disease, skeletal evidence of interpersonal violence, and skeletal and dental markers of cumulative physiological stress (e.g., periodontal disease), indicative of elevated local and systemic inflammatory burdens, than White and/or European American individuals in the collection 4,16,48,49 . ...
... Therefore, health inequities (i.e., reduced longevity) associated with race represent embodied inequality, which arises through embodiment of structural-level (e.g., social closure) and individual-level (e.g., interpersonal discrimination, root shock) race-based discrimination 86,87 . Information from death certificate data, disease pathogenesis, and immunopathologies, as well as skeletal and microbial data provide insight into aspects of St.LI's lived experiences as a young, Black and/or African American laborer and the embodiment of racial discrimination during a period of great social division and change in St St.LI and his community were likely further impacted by national-level structural processes and events, and their localized expressions, including the 1909 establishment of the National Association of the Advancement of Colored People (NAACP) in response to violence and discrimination; federally mandated segregation in 1913; the intensification of the Great Migration, which carried many Black and/or African Americans to St. Louis; the 1921 Tulsa race massacre; Jim Crow laws; the Great Depression; the Harlem Renaissance; Prohibition 89 ; and World War I. Together, these national-and local-level processes and events represent the deep, historical discriminatory roots of health inequities within BIPOC communities in the present-day 16,41,45 . ...
Article
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Incomplete documentary evidence, variable biomolecular preservation, and limited skeletal responses have hindered assessment of acute infections in the past. This study was initially developed to explore the diagnostic potential of dental calculus to identify infectious diseases, however, the breadth and depth of information gained from a particular individual, St. Louis Individual (St.LI), enabled an individualized assessment and demanded broader disciplinary introspection of ethical research conduct. Here, we document the embodiment of structural violence in a 23-year-old Black and/or African American male, who died of lobar pneumonia in 1930s St. Louis, Missouri. St.LI exhibits evidence of systemic poor health, including chronic oral infections and a probable tuberculosis infection. Metagenomic sequencing of dental calculus recovered three pre-antibiotic era pathogen genomes, which likely contributed to the lobar pneumonia cause of death (CoD): Klebsiella pneumoniae (13.8X); Acinetobacter nosocomialis (28.4X); and Acinetobacter junii (30.1X). Ante- and perimortem evidence of St.LI’s lived experiences chronicle the poverty, systemic racism, and race-based structural violence experienced by marginalized communities in St. Louis, which contributed to St.LI’s poor health, CoD, anatomization, and inclusion in the Robert J. Terry Anatomical Collection. These same embodied inequalities continue to manifest as health disparities affecting many contemporary communities in the United States.
... White researchers have shied away from critically engaging with race unless it somehow bene ts them materially; this is a concept Derek Bell (1995) has deemed "interest convergence". Ignoring socially determined race completely as a factor in skeletal studies would create a false narrative that it has no physiological e ects, which we know not to be true (e.g., de la Cova, 2011de la Cova, , 2014Watkins, 2012). Therefore, we advocate for an intersectional analysis of skeletal health as advocated by Mant et al. (2021:2): "Intersectionality extends biocultural understandings of past lives by engaging with multiple axes of identity, stress, and inequality when they can be ascertained and recognizes these 'distinctive dynamics at their multi-dimensional interface' […] we should avoid projecting contemporary ideals of identity, such as age, sex, and status, into the past or assume they were salient in a society so distant in time and space from our own". ...
Chapter
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This chapter offers a discussion of the ways in which empirical data and theoretical models can be used to expand paleopathology’s understanding of gender, identity, and agency in the past. We begin by reflecting on traditional paleopathological analyses’ reliance on typological and narrow assessments of differential diagnosis, which often results in myopic and inconsistent interpretations that reproduce fixed and antiquated ideas of human experience. By interrogating the static use of sex and gender, and race we show how the evolving discourse in understanding of the complexity of these biological and cultural categories results in complicating our analyses and challenges us to recalibrate how we see the past beyond our own cultural and temporal biases. We then discuss how mortuary context, as well as other sociopolitical factors and forces, traditionally seen as unnecessary in the scientific pursuits of the paleopathologist, juxtaposed with skeletal data can offer new ways to see the agency of people whose lives are being narrated. We briefly define four complex theoretical frameworks that we see as integral to paleopathological analyses: sex and gender theory, structural violence theory, embodiment theory, and queer theory. Weaving the theoretical with paleopathological data our examples and two vignettes illuminate how the status quo in paleopathological analysis can be reframed, illustrating how more nuanced analyses can be used to expand understandings of gender, identity, and human agency in the past.
... Structural violence has been an important framework in paleopathology and bioarchaeology since Carlina de la Cova articulated how gender, race, and class formed the basis for structural and physical violence to be enacted against certain bodies (de la Cova, 2008(de la Cova, , 2011(de la Cova, , 2012(de la Cova, , 2020. A structural violence framework has been applied to historic communities (Tremblay & Reedy, 2020), and to other documented historical skeletal collections (Lans, 2020;Watkins, 2012Watkins, , 2015Watkins, , 2018aWatkins, , 2018b, which are primarily derived from marginalized communities who have not given informed consent, and sometimes no consent (Dunnavant et al., 2021). ...
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Research on infant and child paleopathology is central to understand the human condition. This chapter demonstrates how structural violence is useful for exploring the multivocality of infancy and childhood in paleopathology. We highlight relevant examples from the paleopathological literature, beginning with a brief description of the framework of structural violence. We review some of the work that has been conducted on traumatic injuries and explore debates about applying the concept of structural violence to evidence for past violence. Next, we briefly examine the recent focus in paleopathology on the maternal-fetal nexus as a contributor to infant and child health and lifelong experience, and how this approach can be extended using the structural violence framework. Finally, we highlight research on the varied and adaptive nature of family relationships and structures and how these support systems may be constrained and/or provide resilience in the face of structural violence.
... Bio archae ol o gi cal analysis of sacrificial deposits is key to clarifying how social identities predisposed individuals to specialized forms of ritual killings and sacrificial inclusion overall. The skeleton serves as a record of lived experience, simultaneously documenting an individual's age and sex and showing how these persona intersected with risk of chronic malnutrition, disease, and traumatic injury (De La Cova 2011Null et al. 2004;Watkins 2012). Skeletal analyses of human sacrifices from Mexica cities Tenochtitlan-Tlatelolco have revealed that primary interments largely comprised non-adults López Luján 1993;Román Berrelleza 1990Román Berrelleza and Chávez Balderas 2006), underscoring the importance of age for sacrificial inclusion. ...
Article
Human sacrifice in Mesoamerican cities was diverse and highly ritualized, and it remains incompletely understood. Knowing who was selected for ritual violence is essential for interpreting specialized mortuary deposits and furthering research on Mexica society. To understand the structure and variability of sacrificial and mortuary practices, we examine here three burial contexts from Tlatelolco, a densely populated city in the heart of the Triple Alliance. The interment contexts of Grupo Norte (n = 52) and Paso a Desnivel (n = 45) had been excavated from within the ceremonial center near the Tlatelolco Templo Mayor, and Atenantitech (n = 40) from a bordering calpulli or neighborhood. To establish which contexts are likely sacrificial deposits, we compare the age-at-death distributions, biological sex, and perimortem ritual trauma across these sites. We seek to understand if social status determined sacrificial inclusion by using metabolic and infectious disease as proxies for resource inequality. We find that the residential deposit approximates an attritional mortality distribution and that ceremonial center deposits primarily comprised non-adults, who also presented with significantly higher rates of metabolic and infectious disease than the non-adults from the residential site. Informed by previous studies and the ethnohistorical literature, we propose that impoverished individuals living on the margins of Mexica society were chosen as sacrificial victims. High prevalence of metabolic and infectious disease comorbidity indicates that these individuals endured long-term nutritional deficiency, apparently vitamin C. Further, variation in age, pathology, and perimortem treatment among ceremonial center deposits reveals the striking diversity of ritualized killings in a prominent Mexica city. El sacrificio en mesoamérica fue en extremo diverso, con muy diferentes y complejos rituales, saber quién y porqué fue seleccionado, para ser consagrados en un lugar específico es fundamental para interpretar los depósitos mortuorios y avanzar en la investigación sobre la sociedad mexica. Para comprender la estructura y variabilidad de las prácticas mortuorias, examinamos tres contextos de entierros de Tlatelolco, una ciudad densamente poblada localizada en el corazón de la Triple Alianza. Los contextos de entierro de Grupo Norte (n = 52) y Paso a Desnivel (n = 45) habían sido excavados dentro del centro ceremonial cerca del Templo Mayor de Tlatelolco, y Atenantitech (n = 40) de un barrio o calpulli limítrofe. Para confirmar y explicar qué contextos son depósitos de sacrificio, comparamos las distribuciones de edad biológica al morir, el sexo y el trauma ritual perimortem en estos restos humanos. Buscamos esclarecer si el estatus social determina la inclusión sacrificatoria mediante el análisis de enfermedades metabólicas e infecciosas como parámetros de una desigualdad de recursos. Encontramos que los individuos del sitio de enterramientos residencial se aproxima a una distribución de mortalidad por deterioro físico y que los depósitos de restos humanos del centro ceremonial estaban compuestos principalmente por sujetos no adultos que a su vez presentan tasas significativamente más altas de enfermedades metabólicas e infecciosas que los no adultos del sitio residencial. Con base en estudios previos y la literatura etnohistórica, proponemos que algunos individuos con una calidad de vida menoscabada que vivían en los márgenes de la sociedad mexica, fueron elegidos como víctimas de sacrificio. La alta prevalencia de comorbilidad de enfermedades metabólicas e infecciosas indica que estas personas soportaron durante un largo plazo padecieron deficiencias nutricionales, aparentemente de vitamina C. Además, la variación entre la edad, la patología y el tratamiento perimortem entre los individuos de los depósitos mortuorios del centro ceremonial revela una sorprendente diversidad de rituales sacrificiales en una ciudad mexica prominente.
... Decades of research in social epidemiology and medical anthropology link the embodiment of structural inequity with early mortality and increased morbidity [2][3][4][5][6][7][8]. Bioarchaeological research indicates that inequity is embodied in the body's hard tissues [9][10][11][12][13][14][15][16][17][18][19][20]. ...
Article
Full-text available
Human societies create and maintain structures in which individuals and groups experience varying degrees of inequity and suffering that may be skeletally and dentally embodied. It is necessary to foreground these social and structural impacts for forensic anthropologists to eschew biologically deterministic interpretations of human variation and overly individualistic interpretations of health and disease. We thus propose a ‘Structural Vulnerability Profile’ (SVP), akin to the Structural Vulnerability Assessment Tool of medical anthropology [1], to be considered along with the traditional ‘biological’ profile estimated by forensic anthropologists. Assembling an SVP would involve examining and assessing skeletal/dental biomarkers indicative of embodied social inequity—the lived experiences of social marginalization that can get ‘under the skin’ to leave hard-tissue traces. Shifting our emphasis from presumably hereditary variation to focus on embodied social marginalization, the SVP will allow forensic anthropologists to sensitively reconstruct the lived experiences of the people we examine.
... Previous investigations of African-descended peoples reveal their high rates of degenerative joint disease, pathologies associated with chronic stress, and reduced longevity (Mack and Blakey 2004;Rankin-Hill 2016). The proximate causes for the racial disparities in health and longevity include malnutrition, strenuous labor, violent living situations, poor sanitation and housing, parasites, and infectious diseases (Davidson et al. 2002;de la Cova 2011;Thompson 2017;Watkins 2012). Further, researchers are increasingly more attentive to how social difference, along the lines of age, sex, or socioeconomic status, is implicated in the variations in health outcomes among Blacks (Dent 2017;Watkins 2012). ...
Article
Biocultural studies have illuminated the roles of slavery, racism, and economic marginalization on the health outcomes of African diasporic populations. This paper highlights Black women as historical agents who, after slavery, exerted greater autonomy over their reproductive roles in childbirth and childcare. The paper’s objectives and interpretations are situated within Black feminists’ discourses on Black motherhood as both a site of subjugation and of empowerment. Raced and gendered oppression meant that Black women’s reproductive and productive demands were burdensome. Yet, Black women’s lower fertility rates over time indicate that many of them chose to bear fewer children following slavery, a decision that is partially implicated in their increased longevity. Further, there is bioarchaeological and historical evidence illustrating how Black mothering practices, including women’s social networks, benefited children’s well-being. Comparative data for the occurrence of linear enamel hypoplasias among enslaved and free Black populations suggest that post-emancipation women prolonged nursing, which helped children to survive chronic stress.
... Much of this violence is epigenomic, and these experiences can be transmitted to future generations (Jackson et al., 2018;Kuzawa & Sweet, 2009; see also Chapter 2). Bioarchaeological studies of stress also reveal the disproportionate impacts of colonialism, enslavement and systemic racism (Blakey et al., 1994(Blakey et al., , 2009de la Cova, 2011de la Cova, , 2014Larsen & Milner, 1994;Murphy & Klaus, 2017;Rankin-Hill, 1997;Verano and Ubelaker, 1992). Bioarchaeologists advocate a life history approach to these questions (Temple, 2019a). ...
Chapter
The study of stress has unique, parallel histories in evolutionary medicine (EM) and bioarchaeology. The stress concept was conceived as an experimental enterprise that evolved into comparative studies focused on inequality and social transformation. Modern studies in EM incorporated a life history perspective that explored the consequences of stress in the early life environment across the lifespan. Numerous biomarkers related to the cumulative impacts of stress across the lifespan are now studied and associated with elevated morbidity and mortality. This approach emphasises plasticity in the capacity to survive stress events combined with physiological constraints on investment in future maintenance and survival. Bioarchaeological research integrates these perspectives in four ways. Skeletal pathophysiology carefully considers the skeletal biological origins of lesions attributable to stress, and thus the many biomarkers that may be associated with the experience. Allostasis explores the cumulative impacts of stress across the life course, and while a coherent model has yet to develop, there is great promise in the inclusion of stress indicators from a variety of systems. Finally, life course and life history approaches consider the mutually constituted relationship between the capacity to survive early life stress events and impacts on later stages of development. Findings from EM have been applied to transformative questions such as marginalisation, inequality and racism, while modern bioarchaeological approaches are still in the early stages of engaging these issues.
Article
Objectives Pandemics have profoundly impacted human societies, but until relatively recently were a minor research focus within biological anthropology, especially within biocultural analyses. Here, we explore research in these fields, including molecular anthropology, that employs biocultural approaches, sometimes integrated with intersectionality and ecosocial and syndemic theory, to unpack relationships between social inequality and pandemics. A case study assesses the 1918 influenza pandemic's impacts on the patient population of the Mississippi State Asylum (MSA). Materials and Methods We survey bioarchaeological and paleopathological literature on pandemics and analyze respiratory disease mortality relative to sex, age, and social race amongst patient deaths (N = 2258) between 1912 and 1925. Logistic regression models were used to assess relationships between cause of death and odds of death during the pandemic (1918–1919). Results Findings include substantial respiratory mortality during the pandemic, including from influenza and influenza syndemic with pneumonia. Older patients (40–59 years, 60+ years) had lower odds (p < 0.01) of dying from respiratory disease than younger patients, as did female patients compared to males (p < 0.05). Age patterns are broadly consistent with national and state trends, while elevated mortality amongst Black and/or African American patients may reflect intersections between gender roles and race-based structural violence in the Jim Crow South. Discussion Future work in biological anthropology on past pandemics may benefit from explicit incorporation of biocultural frameworks, intersectionality, and ecosocial and syndemic theory. Doing so enables holistic analyses of interactions between social context, social inequality and pandemic outcomes, generating data informative for public health responses and pandemic preparedness.
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As we enter the third year of the COVID-19 pandemic, the scientific community has met the SARS-CoV-2 virus with efficient and effective responses in epidemiology, molecular biology, genetics, vaccine development, and new treatment options. Yet the toll of the virus on public health has been uneven globally and within nations to an extent that has led STEM professionals to inevitably conclude that a truly effective response requires insights and mobilization from across the social sciences and humanities. It is hard to express how much the pandemic has impacted almost every aspect of life in human communities and how it has laid bare longstanding social problems, like social inequalities. The pandemic has also illuminated the extent of more recent pernicious social forces, such as disaster capitalism, and provides an ominous window into how some governments and societies will meet challenges such as climate change. This introduction presents six commissioned articles that demonstrate the power of an anthropological approach to the biocultural and evolutionary aspects of pandemic and epidemic diseases in the past. In this article, we also frame a path for bioarchaeologists to contribute to incredibly important questions and debates about the global pandemic by situating the articles into holistic theoretical approaches.
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This article presents outcomes from a Workshop entitled “Bioarchaeology: Taking Stock and Moving Forward,” which was held at Arizona State University (ASU) on March 6–8, 2020. Funded by the National Science Foundation (NSF), the School of Human Evolution and Social Change (ASU), and the Center for Bioarchaeological Research (CBR, ASU), the Workshop's overall goal was to explore reasons why research proposals submitted by bioarchaeologists, both graduate students and established scholars, fared disproportionately poorly within recent NSF Anthropology Program competitions and to offer advice for increasing success. Therefore, this Workshop comprised 43 international scholars and four advanced graduate students with a history of successful grant acquisition, primarily from the United States. Ultimately, we focused on two related aims: (1) best practices for improving research designs and training and (2) evaluating topics of contemporary significance that reverberate through history and beyond as promising trajectories for bioarchaeological research. Among the former were contextual grounding, research question/hypothesis generation, statistical procedures appropriate for small samples and mixed qualitative/quantitative data, the salience of Bayesian methods, and training program content. Topical foci included ethics, social inequality, identity (including intersectionality), climate change, migration, violence, epidemic disease, adaptability/plasticity, the osteological paradox, and the developmental origins of health and disease. Given the profound changes required globally to address decolonization in the 21st century, this concern also entered many formal and informal discussions.
Chapter
For the same reasons that explorers of the early twentieth century strove to reach the poles, and their modern counterparts journey to outer space, most people want to visualize the contours of the human experience - the peaks of adaptive success that led to the expansion of civilization, and the troughs in which human presence ebbed. The Backbone of History defines the emerging field of macrobioarchaeology by gathering skeletal evidence on seven basic indicators of health to assess chronic conditions that affected individuals who lived in the Western Hemisphere from 5000 BC to the late nineteenth century. Signs of biological stress in childhood and of degeneration in joints and in teeth increased in the several millennia before the arrival of Columbus as populations moved into less healthy ecological environments. Thus, pre-Colombian Native Americans were among the healthiest and the least healthy groups to live in the Western Hemisphere before the twentieth century.
Book
This is an engrossing study of black disease immunities and susceptibilities and their impact on both slavery and racism. Its pages interweave the nutritional, biological, and medical sciences with demography. The book begins with an examination of the pre-slavery era in Africa and then pursues its subject into the slave societies of the West Indies and the United States. This truly interdisciplinary approach permits the blending of two distinctive concepts of racial differences, that of the hard sciences based on gene frequencies and that of the social sciences stressing environmental factors. The authors investigate black health and white medical practice in the United States during the antebellum period, and establish a link between black-related diseases and white racism. A final section traces major black disease susceptibilities from the Civil War to the present, arguing that the different nutritional and medical needs of blacks are still largely unappreciated or ignored.
Book
Writing in true social history tradition, William W. Giffin presents a magisterial study of African Americans focusing on times that saw the culmination of trends that were fundamentally important in shaping the twentieth century. While many scholars have examined African Americans in the South and such large cities as New York and Chicago during this time, other important urban areas have been ignored. Ohio, with its large but very different urban centers-notably, Cleveland, Columbus, and Cincinnati-provides Giffin with the wealth of statistical data and qualitative material that he uses to argue that the ‘color line’ in Ohio hardened during this time period as the Great Migration gained force. His data show, too, that the color line varied according to urban area-it hardened progressively as one traveled South in the state. In addition, whereas previous studies have concentrated on activism at the national level through such groups as the NAACP, Giffin shows how African American men and women in Ohio constantly negotiated the color line on a local level, through both resistance and accommodation on a daily and very interpersonal level with whites, other blacks, and people of different ethnic, class, and racial backgrounds. This early grassroots resistance provided the groundwork for the Civil Rights movement that would gain momentum some twenty years later. This analysis of the Ohio color line speaks to those historians who still are inclined to discuss Jim Crow as a wholly southern phenomenon. It indicates that the color line in the North was not uniform and provides further evidence of the importance of locale and local people in African American history. At the same time, it offers stories of inherent interest revealing human conduct at its best and worst.
Article
Identification of Pathological Conditions in Human Skeletal Remains provides an integrated and comprehensive treatment of pathological conditions that affect the human skeleton. There is much that ancient skeletal remains can reveal to the modern orthopaedist, pathologist, forensic anthropologist, and radiologist about the skeletal manifestations of diseases that are rarely encountered in modern medical practice. Beautifully illustrated with over 1,100 photographs and drawings, this book provides essential text and materials on bone pathology, which will improve the diagnostic ability of those interested in human dry bone pathology. It also provides time depth to our understanding of the effect of disease on past human populations.