Toward a bioarchaeology of urbanization: Demography, health, and behavior in cities in the past

Historical Trends and Risk Factors in Chronic Maxillary Sinusitis Among Dutch Pre-Adults (475-1866 CE)

OBJECTIVES

This research examines the prevalence of chronic maxillary sinusitis in pre-adults from multiple Dutch sites, while also considering the effects of associated risk factors such as time period (i.e., urbanization), living conditions, and socioeconomic status. Our aim was to investigate how different risk factors impacted childhood upper respiratory health throughout the Dutch medieval and Post-medieval periods.

MATERIALS AND METHODS

We selected 13 sites representative of different time periods (475-1866 CE), living environments (i.e., rural and urban), and socioeconomic status to provide an in-depth overview of past Dutch societies. We macroscopically and endoscopically analyzed the maxillary sinuses of 227 pre-adult individuals to identify paleopathological signs of sinusitis. Adult data on chronic maxillary sinusitis from 11 of these populations were available for comparison.

RESULTS

Statistical analysis revealed that time period had the most noteworthy impact on sinusitis prevalence. Post-medieval pre-adults were nearly three times more likely to develop sinusitis than their early-medieval counterparts, while post-medieval adolescents faced an eightfold increase in risk compared to adolescents from earlier periods. Neither living environment nor socioeconomic status showed a statistically significant effect on sinusitis prevalence.

DISCUSSION

Our findings highlight the interplay of risk factors affecting respiratory health in pre-adults, contributing to a more comprehensive understanding of the historical burden of respiratory diseases in past populations. Factors such as increased population densities, limited access to resources (e.g., healthcare, nutritious food, and drinking water), and the institutionalization of child labor in the Dutch post-medieval period likely had negative impacts on the respiratory health of pre-adults.

Implementation and improvement of policies for building healthy cities in China

Background and purpose

With the promotion of the World Health Organization, China has also launched a healthy city construction campaign. However, healthy city construction needs to formulate a series of policies. How can the current healthy city policy in China be further improved to provide a policy basis for healthy city construction?

Materials and methods

Collected here are policy texts from the Central People's Government and local government of the People's Republic of China on healthy cities from 2009 to 2023. This paper adopts the policy tool analysis method to design a two-dimensional analysis framework of the "policy tool-construction domain." There are three types of policy tools: demand-oriented, supply-oriented, and environmental-oriented. The field of healthy city construction is based on five fields defined by WHO: healthy population, health service, healthy environment, healthy culture, and healthy society. The policy text was coded and analyzed by Nvivo software.

Results

According to the coding analysis of policy texts, among the three types of policy tools, supply-oriented policies account for 60.5%, environmental policies account for 29.1%, and demand-oriented policies account for 10.4%. In the five areas of healthy city construction, healthy environment accounted for 23.7%, healthy society accounted for 12.3%, health services accounted for 39.1%, healthy population accounted for 13%, and health culture accounted for 11.9%. From the two-dimensional perspective of policy tools and the field of healthy city construction, the five fields of healthy city construction have different emphases on the application of three different types of policy tools.

Conclusion

Currently, the supply-oriented policy, the demand-oriented policy, and the environmental policy tools are used comprehensively in healthy city construction in China. The proportion of supply-oriented policy is high, which emphasizes the government's intervention and neglects the participation of individuals and social organizations. The use of policy tools is not balanced in the five different areas of healthy city construction, which to some extent limits the effect of policy implementation and strengthens the overall effect of the healthy city construction policy.

Urbanization and Infectious Disease

The United Nations currently estimates that over half of the global population has lived in cities since 2017 and that this proportion is continuing to grow, particularly in the Global South. While urbanization is not new, increased population density combined with accelerating rates of (re)emerging and noncommunicable diseases as well as growing economic disparities has created new challenges to human health and well-being. Here, I examine peri-urban communities, peripheral settlements on the edges of urban areas populated by rural people, and argue that these areas are often overlooked, despite becoming increasingly common. Thus, human biologists should move beyond categorizing these spaces as transitional. Using unplanned, peri-urban communities around Lima, Peru as a case study, I detail the complexity of political ecological factors that impact infectious disease risk and rates in peri-urban communities. Using disease mechanisms, I demonstrate the importance of a biocultural approach and a political ecology perspective when investigating infectious disease. I highlight how human biologists and anthropologists are uniquely positioned to explore the heterogeneity of infectious disease patterns and pathways in an increasingly urbanized world.

Urbanicity and child health in 26 sub-Saharan African countries: Settlement type and its association with mortality and morbidity

Urbanization and changing settlement patterns have affected health environments in African countries. A profound understanding of the intricate association between urbanicity and health is imperative for formulating effective interventions. This study aims to classify settlement types based on urbanicity and assess their effects on child health in 26 African countries, utilizing data from the Demographic and Health Survey and the Global Human Settlements Layer. The advanced settlement classification incorporates a multidimensional urbanicity scale and globally standardized urban extents, along with identifying urban slums. This approach derives six distinct settlement types: urban center, urban cluster, deprived urban settlement, rural town, rural cluster, and rural village. A multilevel logistic regression model examines the relationship between settlement types and health outcomes, encompassing mortality, fever, anemia, diarrhea, and cough in children under five. The analysis reveals that children living in rural villages and deprived urban settlements face a high burden of adverse health conditions. However, the size and direction of urbanicity's effects vary depending on the specific outcome. These findings highlight the significance of tailored interventions acknowledging health environments within each settlement to promote health equity.

A distant city: Assessing the impact of Dutch socioeconomic developments on urban and rural health using respiratory disease as a proxy

OBJECTIVES

To investigate the prevalence of respiratory disease in several populations from the Netherlands across different time periods and socioeconomic conditions.

MATERIALS

We analyzed 695 adult individuals from six different Dutch contexts of urban and rural settlements dating to different time periods (i.e., early-medieval, late-medieval, post-medieval).

METHODS

For each individual, the presence/absence of chronic maxillary sinusitis, otitis media, and inflammatory periosteal reaction on ribs was recorded macroscopically according to accepted methods.

RESULTS

Statistically significant associations were found in the presence of sinusitis diachronically (early-medieval to late-medieval period, and early-medieval to post-medieval period) both in rural and urban environments. Differences in prevalence rates of otitis media were found statistically significant when comparing rural to urban environments in the early-medieval and late-medieval periods.

CONCLUSION

Our results suggest that factors such as increased contact between towns and countryside, higher population densities, and intensification of agricultural production impacted the respiratory health of past populations both in rural and urban settings.

SIGNIFICANCE

Our study provides new insights into the impact of environmental changes and urbanization on respiratory disease prevalence, shedding light on the relationship between health and changing social and environmental contexts.

LIMITATIONS

Research limitations included the complex etiology of respiratory diseases, and the impact of uncontrollable factors such as hidden heterogeneity, selective mortality, and rural-to-urban migration.

FUTURE RESEARCH

Further research in different contexts is advised in order to continue exploring urbanization and its impact on human health across both time and space.

Biocultural perspectives of infectious diseases and demographic evolution: Tuberculosis and its comorbidities through history

Anthropologists recognize the importance of conceptualizing health in the context of the mutually evolving nature of biology and culture through the biocultural approach, but biocultural anthropological perspectives of infectious diseases and their impacts on humans (and vice versa) through time are relatively underrepresented. Tuberculosis (TB) has been a constant companion of humans for thousands of years and has heavily influenced population health in almost every phase of cultural and demographic evolution. TB in human populations has been dramatically influenced by behavior, demographic and epidemiological shifts, and other comorbidities through history. This paper critically discusses TB and some of its major comorbidities through history within a biocultural framework to show how transitions in human demography and culture affected the disease-scape of TB. In doing so, I address the potential synthesis of biocultural and epidemiological transition theory to better comprehend the mutual evolution of infectious diseases and humans.

Automated Cognitive Health Assessment Using Partially Complete Time Series Sensor Data

BACKGROUND

Behavior and health are inextricably linked. As a result, continuous wearable sensor data offer the potential to predict clinical measures. However, interruptions in the data collection occur, which create a need for strategic data imputation.

OBJECTIVE

The objective of this work is to adapt a data generation algorithm to impute multivariate time series data. This will allow us to create digital behavior markers that can predict clinical health measures.

METHODS

We created a bidirectional time series generative adversarial network to impute missing sensor readings. Values are imputed based on relationships between multiple fields and multiple points in time, for single time points or larger time gaps. From the complete data, digital behavior markers are extracted and are mapped to predicted clinical measures.

RESULTS

We validate our approach using continuous smartwatch data for n = 14 participants. When reconstructing omitted data, we observe an average normalized mean absolute error of 0.0197. We then create machine learning models to predict clinical measures from the reconstructed, complete data with correlations ranging from r = 0.1230 to r = 0.7623. This work indicates that wearable sensor data collected in the wild can be used to offer insights on a person's health in natural settings.

Discovering and Applying the Urban Rules of Life to Design Sustainable and Healthy Cities

The city and its urban biome provides an extreme laboratory for studying fundamental biological questions and developing best practices for sustaining biodiverse and well-functioning ecological communities within anthropogenic built environments. We propose by studying urban organisms, urban biotic communities, the urban biome, and the interactions between the urban biome and peri-urban built and natural environments, we can (1) discover new 'rules of life' for the structure, function, interaction, and evolution of organisms;(2) use these discoveries to understand how novel emerging biotic communities affect and are affected by anthropogenic environmental changes in climate and other environmental factors; and (3) apply what we have learned to engage residents of the urban biome, and design cities that are more biologically diverse, are provided with more and better ecosystem services, and are more equitable and healthier places to live. The built environment of the urban biome is a place that reflects history, economics, technology, governance, culture, and values of the human residents; research on and applications of the rules of life in the urban biome can be used by all residents in making choices about the design of the cities where they live. Because inhabitants are directly invested in the environmental quality of their neighborhoods, research conducted in and about the urban environment provides a great opportunity to engage wide and diverse communities of people. Given the opportunity to engage a broad constituency - from basic researchers to teachers, civil engineers, landscape planners, and concerned citizens - studying the translation of the rules of life onto the urban environment will result in an integrative and cross-cutting set of questions and hypotheses, and will foster a dialogue among citizens about the focus of urban biome research and its application toward making more equitable, healthy, livable, sustainable, and biodiverse cities.