Biocultural perspectives on bioarchaeological and paleopathological evidence of past pandemics

Abstract

ObjectivesPandemics 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 MethodsWe 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).ResultsFindings 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.DiscussionFuture 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.

From ancient pathogens to modern pandemics: Integrating evolutionary, ecological, and sociopolitical dynamics of infectious disease and pandemics through biological anthropology

“…A second major contribution of biological anthropology to research on pandemics is the analysis of pandemics from the past. Even though temporal stories of disease are changing with advanced genomic tools, and are set in specific temporal and geographic contexts, these models still provide a deep time perspective that can be used to investigate the larger causative relationships between demographic, socioeconomic factors, and disease (Harper & Armelagos, 2010; Zuckerman et al, 2023). Following the 2019 outbreak of the novel coronavirus (COVID‐19) that has grown in a global pandemic, (bio)archeological and medical historical studies have offered insight into the “why” (both emergence and persistence in human populations) of global pandemics drawn from the comparison and critical study of past pandemics (Gamble et al, 2021; Green 2020; Gutierrez and Cameron 2021; Piret and Boivin 2021; Wade 2020).…”

“…For example, while tuberculosis ( Mycobacterium tuberculosis ) was long considered to have been passed to humans from domesticated cows ( Mycobacterium bovis ), genomics work has shown this not be the case and modern genetic timing data show that M. tuberuculosis likely came with humans out of Africa (Sabin et al 2020; Ngabonziza et al 2020), and genomes from pre‐Columbian 1000‐year‐old human remains show phylogenetic clustering within an animal‐adapted lineage in modern day seals (Bos et al 2014). In sum, findings from archeological and paleopathological research on past pandemics, including the Black Plague and the 1918 influenza pandemic, have also provided key insights on the genetic, biological, social, and economic impacts of disease outbreaks, which have informed current research and responses to COVID‐19 (Agarwal, 2022; Chiripanhura et al, 2022; Dimka et al 2022; Gamble et al, 2021; van Doren, 2023; Zuckerman et al, 2023).…”

Childhood adversity during the post‐apartheid transition and COVID‐19 stress independently predict adult PTSD risk in urban South Africa: A biocultural analysis of the stress sensitization hypothesis

“…These embodied consequences of stress and social adversity can then alter how afflicted communities respond to their broader environments vis‐á‐vis their biological, psychosocial, and social status (Kuzawa & Sweet 2009; Leatherman & Goodman, 2020). Biocultural anthropologists have shown how these social and biological dimensions of stress can interact with one another to alter phenotypic plasticity across development (Worthman & Kuzara 2005), produce patterns of intersectional health inequalities (Zuckerman et al, 2023), and facilitate pathways of lifecourse and intergenerational disease transmission (Kohrt et al, 2015; Kuzawa & Sweet 2009). Recent biocultural literature on psychosocial stress has examined the biological effects of embodied social adversity, ranging from economic marginalization to transgender‐specific minority stress (Worthman & Kohrt 2005; DuBois et al 2017), and in particular, the long‐term physical and mental health impacts of early life stress exposure and historical trauma (Kuzawa & Sweet 2009; Thayer et al, 2017).…”

Biocultural and evolutionary approaches to the study of human diseases: Integrative perspectives from biological anthropology

“…This collection includes papers from researchers across the sub‐fields of biological anthropology, including paleoanthropology, bioarcheology, primatology, anthropological genetics, demography, and human biology. Papers by Houldcroft and Underdown (2023), Joseph and Lindo (2023), Zuckerman et al (2023), Honap et al (2023), and van Doren and Kelmelis (2023) examine the impact of infectious and non‐communicable diseases on human health in the historic and pre‐historic past. Houldcroft and Underdown (2023) revisit the question of when in our evolutionary history infectious diseases became a major health burden and selective force.…”

“…Papers by Zuckerman et al (2023) and van Doren and Kelmelis (2023) both consider the biosocial dimensions of variation in mortality patterns associated with the 1918 influenza pandemic. Zuckerman and colleagues draw on mortality data from a patient population of the Mississippi State Asylum, whereas van Doren and Kelmelis utilize death records from the Canadian province of Newfoundland, drawn from the digital archives at Memorial University of Newfoundland.…”