Evolutionary medicine: its scope, interest and potential

Stearns, Stephen C.

doi:10.1098/rspb.2012.1326

Cited by 142 publications

(117 citation statements)

References 158 publications

(200 reference statements)

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“…All those factors facilitated the spread of virulent bacterial and viral pathogens as well as soil-borne helminths (roundworm, hookworm, and whipworm) (32)(33)(34)(35)(36)(37)(38). Although some argue that Paleolithic foragers experienced high helminth loads (37,39,40), archaeological data instead show an increase in helminths in farming populations (33,(41)(42)(43)(44)(45) as compared with mobile, low-density hunter-gatherers. In summary, the overall effect of agriculture on health was a trend toward increasing morbidity and mortality (16,19,28,46), although the intensity of the trend exhibits some regional variation and inconsistencies (47)(48)(49)(50)(51)(52)(53)(54)(55)(56).…”

mentioning

confidence: 94%

Reproductive trade-offs in extant hunter-gatherers suggest adaptive mechanism for the Neolithic expansion

Page

Viguier

Dyble

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

110

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The Neolithic demographic transition remains a paradox, because it is associated with both higher rates of population growth and increased morbidity and mortality rates. Here we reconcile the conflicting evidence by proposing that the spread of agriculture involved a life history quality-quantity trade-off whereby mothers traded offspring survival for increased fertility, achieving greater reproductive success despite deteriorating health. We test this hypothesis by investigating fertility, mortality, health, and overall reproductive success in Agta hunter-gatherers whose camps exhibit variable levels of sedentarization, mobility, and involvement in agricultural activities. We conducted blood composition tests in 345 Agta and found that viral and helminthic infections as well as child mortality rates were significantly increased with sedentarization. Nonetheless, both age-controlled fertility and overall reproductive success were positively affected by sedentarization and participation in cultivation. Thus, we provide the first empirical evidence, to our knowledge, of an adaptive mechanism in foragers that reconciles the decline in health and child survival with the observed demographic expansion during the Neolithic.quality-quantity trade-off | epidemiological transition | hunter-gatherers | Neolithic revolution | Neolithic demographic transition

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mentioning

confidence: 94%

Reproductive trade-offs in extant hunter-gatherers suggest adaptive mechanism for the Neolithic expansion

Page

Viguier

Dyble

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

110

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“…Although the use of agricultural pesticides is greatly debated, the focal, short-term application of antifungals targeted at a reduction of infection prevalence and infection load in specific cases of acute chytridiomycosisdriven amphibian die-offs is worth exploring [45]. The application of any such measure should be weighed against its potential negative impacts on biodiversity, ecosystem function, human health and the potential for amphibianassociated chytrids to develop resistance to these treatments [46]. Advances in our understanding of the virulence factors and cellular components key for chytrid reproduction, growth and infectivity should inform the selection of compounds that exhibit multi-modal antifungal action, and also guide the development of application strategies [47,48].…”

Section: Trialled and Testedmentioning

confidence: 99%

Mitigating amphibian chytridiomycoses in nature

Garner

Schmidt²,

Martel

et al. 2016

Phil. Trans. R. Soc. B

128

156

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Amphibians across the planet face the threat of population decline and extirpation caused by the disease chytridiomycosis. Despite consensus that the fungal pathogens responsible for the disease are conservation issues, strategies to mitigate their impacts in the natural world are, at best, nascent. Reducing risk associated with the movement of amphibians, non-amphibian vectors and other sources of infection remains the first line of defence and a primary objective when mitigating the threat of disease in wildlife. Amphibian-associated chytridiomycete fungi and chytridiomycosis are already widespread, though, and we therefore focus on discussing options for mitigating the threats once disease emergence has occurred in wild amphibian populations. All strategies have shortcomings that need to be overcome before implementation, including stronger efforts towards understanding and addressing ethical and legal considerations. Even if these issues can be dealt with, all currently available approaches, or those under discussion, are unlikely to yield the desired conservation outcome of disease mitigation. The decision process for establishing mitigation strategies requires integrated thinking that assesses disease mitigation options critically and embeds them within more comprehensive strategies for the conservation of amphibian populations, communities and ecosystems. This article is part of the themed issue ‘Tackling emerging fungal threats to animal health, food security and ecosystem resilience’.

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“…While evolutionary theory and human evolutionary biology have long been viewed as disconnected from the day-to-day practice of medicine, it has become increasingly clear in recent years that evolutionary biology has many practical applications in medicine and public health (Nesse and Schiffman 2003;Trevathan et al 2008;Gluckman et al 2009;Williams 2009;Nesse et al 2010;Omenn 2010;Pearlman 2013;Alcock and Schwartz 2011;Gluckman and Bergstrom 2011;Stearns 2011Stearns , 2012. For example, understanding human evolutionary history and the resulting patterns of human genetic diversity within and across populations can improve diagnosis, treatment, and preventative care (Bolnick et al, in review).…”

Section: Recommendations For Medical Educationmentioning

confidence: 99%

“…Medical school faculty and students should learn to identify the key social and structural determinants of health that should be targeted for intervention, and they should learn to design and implement structural interventions in clinical, community, and public policy contexts. Medical schools should also provide cultural competency training using the newest and most effective evidence-based models of cultural competency (Carpenter-Song et al 2007;Kumagai and Lypson 2009;Coria et al 2013;Metzl and Hansen 2014;Metzl and Roberts 2014).Recommendation #4: Key aspects of evolutionary theory and human evolutionary biology should be incorporated into the medical curriculum, focusing on how knowledge of evolution improves a physician's ability to prevent, diagnose, and treat disease.While evolutionary theory and human evolutionary biology have long been viewed as disconnected from the day-to-day practice of medicine, it has become increasingly clear in recent years that evolutionary biology has many practical applications in medicine and public health (Nesse and Schiffman 2003;Trevathan et al 2008;Gluckman et al 2009;Williams 2009;Nesse et al 2010;Omenn 2010;Pearlman 2013;Alcock and Schwartz 2011;Gluckman and Bergstrom 2011;Stearns 2011Stearns , 2012. For example, understanding human evolutionary history and the resulting patterns of human genetic diversity within and across populations can improve diagnosis, treatment, and preventative care (Bolnick et al, in review).…”

mentioning

confidence: 99%

Combating Racial Health Disparities through Medical Education: The Need for Anthropological and Genetic Perspectives in Medical Training

Bolnick¹

2015

Human Biology

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Despite major public health initiatives, significant disparities persist between racially-and ethnically-defined groups in the prevalence of disease, access to medical care, quality of medical care, and health outcomes for common causes of morbidity and mortality in the United States. It is critical that we develop new and creative strategies to address such inequities, mitigate the social, environmental, institutional, and genetic determinants of poor health, and combat the persistence of racial profiling in clinical contexts that further exacerbates racial/ethnic health disparities. In this article, I argue that medical education is a prime target for intervention, and that there is an important role for anthropologists and human population geneticists to play in efforts to reform medical curricula in this country. Medical education would benefit greatly from the incorporation of anthropological and genetic perspectives on the complexities of race, human genetic variation, epigenetics, and the causes of racial/ethnic disparities. Medical students and practicing physicians should also receive training on how to use this knowledge to improve clinical practice, diagnosis, and treatment for racially diverse populations.For the last two decades, one of the primary goals of the U.S. Department of Health and Human Services (HHS), the National Institutes of Health (NIH), the Institute of Medicine (IOM), the Centers for Disease Control and Prevention (CDC), and many public health programs has been the reduction of health disparities in the United States (Smedley et al. 2003; Centers for Population Health and Health Disparities 2007; CDC 2011; HealthyPeople.gov). However, significant disparities have persisted, not only in the prevalence of disease, access to medical care, and quality of care, but also in health outcomes for the most common causes of morbidity and mortality (including cardiovascular and lung disease, infectious disease, cancer, and diabetes). These disparities fall largely along racial, ethnic, Pre-print version. Visit http://digitalcommons.wayne.edu/humbiol/ after publication to acquire the final version.and class lines, with poor, uninsured, and minority populations affected most negatively (Table 1; Shields et al. 2005;Betancourt 2006; CDC 2011). In some geographic areas, local disparities are even greater than what the national statistics show, and, in many cases, inequalities have increased, rather than decreased, in recent years. Where I live in Central Texas, for example, black infant mortality is now almost four times greater than white infant mortality (Tang 2012), in contrast to the two-fold difference in black and white infant mortality rates nationally (Table 1). Ongoing demographic shifts are expected to further exacerbate this and other disparities, both in Central Texas and nationwide.Given these trends, it is critical that we develop and implement new and creative strategies to address such inequities. There is an urgent need for novel approaches to mitigate (a) the social, env...

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Evolutionary medicine: its scope, interest and potential

Cited by 142 publications

References 158 publications

Reproductive trade-offs in extant hunter-gatherers suggest adaptive mechanism for the Neolithic expansion

Reproductive trade-offs in extant hunter-gatherers suggest adaptive mechanism for the Neolithic expansion

Mitigating amphibian chytridiomycoses in nature

Combating Racial Health Disparities through Medical Education: The Need for Anthropological and Genetic Perspectives in Medical Training

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