Sociocultural determinants of health and wealth in historic African Americans

Early Life Stress and Long-Term Survival in the Hamann-Todd Collection

OBJECTIVES

The impact of physiological stress during growth and development on mortality has been a topic of intense interest in bioarchaeology and other disciplines. In this study, we analyze the association between survival and two markers of physiological stress, linear enamel hypoplasia (LEH) and adult stature, in a sample of 296 individuals from the Hamann-Todd Osteological Collection (HTOC).

MATERIALS AND METHODS

The HTOC is among the most well-known osteological collections in the discipline, representing low socioeconomic status individuals from early 20th century Cleveland, Ohio. Ages-at-death and demographic identifiers (sex and socially ascribed race) were known for all individuals in the sample. The association between the skeletal and dental markers of early life stress and survival was evaluated through Kaplan-Meier survival analysis, using log rank tests to analyze the significance of differences in survival among demographic groups.

RESULTS

Significant differences in survival were observed between demographic groups, regardless of LEH status or stature. However, there were no significant differences in survivorship by LEH presence in this sample, despite the expectation that periods of physiological stress during key stages of development contribute to long-term health consequences such as suppressed immune function. For females, shorter statures were associated with a higher probability of survival, while there were no significant differences in survival for males based on stature.

DISCUSSION

It is likely that differences in survival observed in this sample of the HTOC are the consequence of other factors, most likely related to adult environmental quality, as opposed to early life stress.

How Does Social Inequality Alter Relationships Between Porous Cranial Lesions and Mortality? Examining the Relationship Between Skeletal Indicators of Stress, Socioeconomic Status, and Survivorship in a Pediatric Autopsy Sample

BACKGROUND

In prior exploration of modern and archeological populations, lower SES has been associated with an increased risk of mortality. However, SES is often difficult to ascertain in archeological populations. Thus, explorations of skeletal lesions and their association with mortality may be subject to confounding factors that alter the strength and/or direction of this association.

METHODS

The present study uses data from a modern, documented coronial pediatric dataset to examine the association between porous cranial lesions (PCLs) (cribra orbitalia [CO] and porotic hyperostosis [PH]) and age at death while controlling for SES, as inferred through housing type, with manufactured or apartment housing identified as reflecting individuals from lower SES backgrounds in this context. We include 887 (535 males, 352 females) individuals aged 0.5-20.9 years from New Mexico who died between 2011 and 2022. Kaplan-Meier survival analysis was used to assess survivorship as related to PCLs and SES.

RESULTS

Low SES is associated with lower survivorship. CO does not have a significant association with age at death when not controlling for SES; PH alone is associated with older age at death. Disadvantaged individuals with PCLs have significantly reduced survivorship than those with higher SES.

DISCUSSION AND CONCLUSIONS

The findings of this study demonstrate that low SES results in reduced survivorship, and those with low SES and PCLs have worse survivorship than less disadvantaged individuals with PCLs. Thus, the strong contribution of SES to mortality necessitates the consideration of the sociocultural context as a confounding factor when examining associations between variables of interest (such as lesions) and mortality in both past and present populations.

The relationship between cause of death and skeletal markers of physiological stress in the Hamann-Todd collection

OBJECTIVES

Socioeconomic status, past stress events, and other factors may contribute to the cumulative burden of physiological stress, which influences an individual's susceptibility to mortality and cause of death (COD). Here, we explore the association between skeletal evidence of stress and COD in the Hamann-Todd Osteological Collection (HTOC), a predominantly low socioeconomic status sample from the late 19th and early 20th century.

MATERIALS AND METHODS

Skeletal markers of stress including linear enamel hypoplasia (LEH), stature, and antemortem tooth loss (AMTL) were analyzed in 298 individuals in the HTOC. Recorded CODs were grouped into six broad categories and contrasted with stress indicators, ages-at-death, and demographic variables, using various parametric and non-parametric statistical tests.

RESULTS

COD varied by socially ascribed race and sex within the sample. Overall, infectious diseases were more prevalent than degenerative diseases. Individuals that died of infectious diseases had significantly lower ages-at-death compared to degenerative diseases (p < 0.001). There was no association between LEH and COD (χ2 = 4.449, p = 0.487). Stature varied significantly across COD categories for males (F = 2.534, p = 0.032), but not females (F = 1.733, p = 0.132). Controlling for age-at-death, AMTL prevalence was associated with COD (H = 18.53, p = 0.002), with cardiovascular disease being associated with higher prevalence of AMTL.

DISCUSSION

These findings show that some skeletal stress indicators are associated with COD in the HTOC, but the causal pathways of these relationships are not clear. This study adds to growing bodies of literature exploring relationships between past stress events and susceptibility to mortality and long-term consequences of poor living conditions for past individuals.

Biocultural and social determinants of ill health and early mortality in a New Mexican paediatric autopsy sample

RESULTS

Hispanic children have higher odds of growth stunting than non-Hispanic White children. Native American children die younger and have higher odds of respiratory diseases and porous lesions than Hispanic and non-Hispanic Whites. Rural/urban location does not significantly impact age at death, but housing type does. Individuals who lived in trailers/mobile homes had earlier ages at death. When intersections between housing type and housing location are considered, children who were poor and from impoverished areas lived longer than those who were poor from relatively well-off areas.

CONCLUSIONS

Children's health is shaped by factors outside their control. The children included in this study embodied experiences of social and ELS and did not survive to adulthood. They provide the most sobering example of the harm that social factors (structural racism/discrimination, socioeconomic, and political structures) can inflict.