Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Murray K. Marks

Committee Members

Lyle W. Konigsberg, Lydia M. Pulsipher, Lynne P. Sullivan


The Western Hemisphere Health Index was applied to prehistoric contemporaneous skeletal populations from Tennessee and the semi-arid North of Chile to ascertain four things: 1. overall health status for each culture; 2. comparison of health status between contemporaneous cultures; 3. if subsistence change (i.e., transition from gathering-hunting to agriculture) is consistently accompanied by a decline in overall health; and 4. the utility of the health index methodology. The skeletal populations analyzed from the semi-arid North of Chile were Archaic (7730 B.C. – A.D. 245) and Diaguita (A.D. 1000 – 1536). Prehistoric individuals examined from Tennessee were Archaic (8000 – 1000 B.C.); Woodland (1000 B.C. – A.D. 1000); and Mississippian (A.D. 1000 – 1600). (Total n = 433 individuals). Both Archaic populations had primarily a gathering and hunting subsistence strategy, Woodland peoples were emerging horticulturalists, and Mississippian and Diaguita populations practiced full-scale agriculture.

As per health index methodology, seven indicators of health were scored (stature, linear enamel hypoplasia, dental disease, anemia, infection, degenerative joint disease, and trauma). Health index statistical methodology and Pearson chi-square were used to test the proposed hypotheses. Results indicated that the Archaic Tennessee population had the lowest health index value, and both Chilean populations had the highest. The results of the chi-square analyses run on each of the health indicators by population were in tandem with the health index results. In Tennessee, health appeared to improve through time; while in Chile, health essentially stayed the same during the subsistence transition.

Such results suggest that the hypothesis of a health decline during and after subsistence change to agriculture is not always demonstrated. These findings further indicate that general rules regarding the association between health and subsistence change do not exist. Rather than applying generalizations to populations, research should focus on the specific situation of each population (environment, subsistence, socio-political organization, etcetera) followed by a comparison between populations to reveal similarities and differences. Such analyses will assist with identifying the relative importance of particular factors for each site.

The utility of the health index methodology was also discussed. The index is a useful tool for population comparison, though further refinement of the methodological protocol is warranted.

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