Civilization's Cost: The Decline and Fall of Human Health

Civilization's Cost: The Decline and Fall of Human Health
Ann Gibbons

AMERICAN ASSOCIATION OF PHYSICAL ANTHROPOLOGISTS, 31 MARCH-4 APRIL 2009, CHICAGO, ILLINOIS

When humans were freed from searching for food from dawn to dusk, they finally had time to build cities, create art, and even muse about the gods. Agriculture and cities made human life better, right? Wrong, say archaeologists who presented stunning new evidence that most people's health deteriorated over the past 3000 years. "We document a general decline in health across Europe and the Mediterranean," says bioarchaeologist Clark Spencer Larsen of Ohio State University in Columbus. He's a coinvestigator of the European Global History of Health Project, an ambitious new effort to study the health of Europeans during the past 10,000 years.

Most bioarchaeology studies tend to tell the tale of illness and death of people from a single site, such as a burial pit for plague victims or an ancient cemetery. Larsen's project is one of the first—and the largest—to try to reveal broad trends by assembling standardized data from large samples. In a series of posters, the team presented the first analysis of data on 11,000 individuals who lived from 3000 years ago until 200 years ago throughout Europe and the Mediterranean. "This is a real tour de force," says bioarchaeologist George Armelagos of Emory University in Atlanta, after reviewing the posters.

The project has taken 8 years and $1.2 million to organize so far. The goal was to pool 72 researchers' data on standardized indicators of health from skeletal remains, including stature, dental health, degenerative joint disease, anemia, trauma, and the isotopic signatures of what they ate, says project leader Richard Steckel of Ohio State. They also gathered data on settlement size, latitude, and socioeconomic and subsistence patterns so that they could compare rich and poor, urban and rural, farmers and hunter-gatherers.

They found that the health of many Europeans began to worsen markedly about 3000 years ago, after agriculture became widely adopted in Europe and during the rise of the Greek and Roman civilizations. They document shrinking stature and growing numbers of skeletal lesions from leprosy and tuberculosis, caused by living close to livestock and other humans in settlements where waste accumulated. The numbers of dental hypoplasias and cavities also increased as people switched to a grain-based diet with fewer nutrients and more sugars.

The so-called Dark Ages were indeed grim for many people who suffered from more cavities, tooth loss, rickets, scurvy, and bone infections than had their ancestors living in hunter-gatherer cultures. People became shorter over time, with males shrinking from an average of 173 centimeters in 400 B.C.E., for example, to 166 centimeters in the 17th century—a sure sign that children who were not members of the elite were eating less nutritious food or suffering from disease.

Why would people want to settle in towns or cities if it made them sick? One answer is that settlers suffered less bone trauma than nomadic hunter-gatherers, suggesting to Steckel that they might have felt safer in villages and, later, towns where an emerging elite punished violent behavior—but also controlled access to food.

The social and political inequities in urban centers meant that for nonelites, moving into cities was "almost a death sentence" for centuries, notes Armelagos. In the Middle Ages, people in the countryside were generally taller than people in cities.

After a long, slow decline through the Middle Ages, health began to improve in the mid-19th century. Stature increased, probably because of several factors: The little Ice Age ended and food production rose, and better trade networks, sanitation, and medicine developed, says Steckel. But take heed: Overall health and stature in the United States has been declining slightly since the 1950s, possibly because obese Americans eat a poor-quality diet, not unlike early farmers whose diet was less diverse and nutritious than that of hunter-gatherers. By understanding how disease and malnutrition spread in the past, researchers hope to apply those lessons in the future. "Our goal is to understand the health context for what we have today," says Larsen.