Biology Reference
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individuals. The age-at-death distribution is the framework upon which pathologies are eval-
uated. Certainly age estimates must be robustly determined, but cemeteries are an accumu-
lation of the dead and pathology prevalence in these individuals may not reflect the
prevalence of health stress in the living population.
With regard to the second point, the scholar must be mindful that conclusive statements
about community health are relative (between samples, between subsistence strategies,
between age cohorts, between the sexes) and not necessarily indicative. Along these lines,
the health status of an individual may also be misleading. The individual who lives long
enough for a disease process to disseminate to bone may demonstrate resiliency in contrast
to an individual who, without osteological evidence of illness, dies at the acute stage. The
latter may give a false impression of good community health. Therefore it is necessary to
control for age-at-death, that is, compare by same skeletal age cohorts. If it is possible, the
disease process should be identified as active or healed at death. The scholar must be aware
of when the health status marker manifests itself. For example, cribra orbitalia is a marker of
childhood stress (
Stuart-Macadam, 1985
; Stuart-Macadam and Kent, 1992). Adults with cri-
bra are therefore survivors of this childhood stress.
Differential vulnerability to disease (frailty), the third point, is difficult to identify or
quantify. There are, however, nonpathological data variables that can be marshaled to
provide the extenuating circumstances that synergistically increase the likelihood of frailty.
These include evidence of a poor-quality diet (e.g., through trace element analysis, isotope
analysis, see Bethard [Chapter 15], this volume) and compromised growth (rate of long
bone growth) (see
Wright and Yoder, 2003
; Uhl [Chapter 3], this volume). Certainly
multiple stress indicators should be assessed together to address the issues raised by the
osteological paradox. But if for whatever reason(s) this is not possible, analytical paleopa-
thology should always consider alternative explanations and suggest avenues for future
research.
Post-processualism and Agency Theory
Bioarchaeology as a research methodology is certainly an offshoot of (the New) processual
archaeology, as already discussed. However, since the 1980s, there have been criticisms of its
essentially exclusive adherence to external or environmental causal variables (e.g., climate,
agricultural intensification; population growth) and systems theory (variables are intercon-
nected components that create a system) to explain culture change (e.g., Hodder and Hud-
son, 2003;
Trigger, 2006
). This approach certainly limited the avenues of explanation and,
among other things, negated the social role(s) individuals play in self-determination. This
reaction has come to be known as post-processualism. In turn post-processualism has
been criticized as being cross-disciplinary social-science rhetoric, nonscientific, and devoid
of method (e.g.,
Bintliff, 1993; Arnold and Wilkens, 2001
).
Bioarchaeology has essentially sidestepped the theoretical criticisms of processualism for
three main reasons: (1) because of its medical underpinnings; (2) because it draws data and
explanation from multiple disciplines; and (3) probably because skeletal analysis remains
peripheral to problem solving within archaeology (e.g.,
Bentley et al., 2009
). However, there
are more measured assessments of processualism and post-processualism (e.g.,
Kosso, 1991;
Huffman, 2004; Trigger, 2006; Bentley et al., 2009
) and what has positively emerged are
