Quantifying Impairment and Disability in Bioarchaeological Assemblages

  • Ann L.W. StodderEmail author
Part of the Bioarchaeology and Social Theory book series (BST)


Global epidemiology metrics provide some useful tools for characterizing health in past populations. Among these are the disability weights developed by the Global Burden of Disease studies. Disability weights are assigned to health states —conditions and sequelae rather than to specific diseases or skeletal lesion types—and encompass a wide range of nonfatal conditions, many of which are recorded in skeletal assemblages. Examples presented here illustrate the application of this approach in quantifying the disability burden represented by skeletal pathology in two Ancestral Puebloan skeletal assemblages. The issues attendant to the evolution of disability weights and the challenges in assigning universal weights to different health states globally are discussed.


Disability Impairment Global burden of disease Disability weights Paleopathology Bioarchaeology Paleoepidemiology Ancestral pueblo 



My thanks to the editors for the invitation to participate in the AAPA symposium and to contribute to this volume, and to the editors and the reviewers for their insights and diligence. My study of the San Cristobal people was supported by the American Museum of Natural History Lounsbery Fellowship and continued access facilitated by Ian Tattersall and Nell Murphy.


  1. Armelagos, G. J., & Van Gerven, D. P. (2003). A century of skeletal biology and paleopathology: Contrasts, contradictions, and conflicts. American Anthropologist, 105(1), 53–64.CrossRefGoogle Scholar
  2. Borck, L., Mills, B. J., Peeples, M. A., & Clark, J. J. (2015). are social networks survival networks? an example from the late prehispanic Southwest. Journal of Archaeological Method and Theory, 22, 33–57.CrossRefGoogle Scholar
  3. Chamie, M. (1995). What does morbidity have to do with disability? Disability and Rehabilitation, 17(7), 323–337.CrossRefGoogle Scholar
  4. Chuipka, J. (2009). Ridges basin excavations: The sacred ridge site. Animas-La plata project (Vol. 12). Phoenix: SWCA Environmental Consultants.Google Scholar
  5. Cohen, M. N., & Crane-Kramer, G. M. M. (Eds.). (2007). Ancient health: Skeletal indicators of agricultural and economic intensification. Gainesville: University Press of Florida.Google Scholar
  6. Collaborators, 2013 Global Burden of Disease Study. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic conditions and injuries in 188 countries: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 368(9995), 743–800.Google Scholar
  7. Cook, D. C., & Powell, M. L. (2006). The evolution of american paleopathology. In J. E. Buikstra & L. A. Beck (Eds.), Bioarchaeology: The contextual analysis of human remains (pp. 281–322). New York: Elsevier Inc.Google Scholar
  8. Cross, M., Smith, E., Hoy, D., Nolte, S., Ackerman, I., Fransen, M., et al. (2014). The global burden of hip and knee osteoarthritis: Estimates from the global burden of disease 2010 study. Annals of Rheumatic Disease, 73, 1323–1330.CrossRefGoogle Scholar
  9. Crown, P. L. (2000). Women and men in the prehispanic southwest: Labor, power and prestige. Santa Fe, N.M.: School of American Research Press.Google Scholar
  10. Douglas, M. T., & Stodder, A. L. W. (2010) Skull morphology in the Animas-La Plata Skeletal series. In E. Perry, A. L. W. Stodder & C. Bollong (Eds.), Bioarchaeological Studies. Animas-La Plata Project Volume XV. (pp. 197–222). Phoenix: SWCA Environmental Consultants.Google Scholar
  11. Galisteo Basin Sites Protection Act (2014) Accessed May 29, 2016.
  12. Gore, F. M., Bloem, P. J., Patton, G. C., Ferguson, J., Joseph, V., Coffey, C., et al. (2011). Global burden of disease in young people aged 10–24 years: A systematic analysis. The Lancet, 377(9783), 2093–2102.CrossRefGoogle Scholar
  13. Haagsma, J. A., Polinder, S., Cassini, A., Colzani, E., & Havelaar, A. H. (2014). Review of disability weight studies: Comparison of methodological choices and values. Population Health Metrics, 12(20).Google Scholar
  14. Hegmon, M., Peeples, M. A., Kinzig, A. P., Kulow, S. M., Meegan, C. M., & Nelson, M. C. (2008). Social transformation and its human costs in the prehispanic U.S. Southwest. American Anthropologist, 110(3), 313–324.CrossRefGoogle Scholar
  15. Hoover, K. C., & Hudson, M. J. (2016). Resilience in prehistoric persistent hunter-gatherers in Northwest Kyushu, Japan as assessed by population health and archaeological evidence. Quaternary International, 405, 22–33.CrossRefGoogle Scholar
  16. Institute for Health Metrics and Evaluation, The University of Washington, Harvard University, Johns Hopkins University, University of Queensland, World Health Organization. (2009). Global burden of disease 2005 study operations manual. The University of Washington.Google Scholar
  17. Jackes, M. K., Lubell, D., & Meiklejohn, C. (1997). Healthy but mortal: Human biology and the frist farmers of western europe. Antiquity, 71, 639–658.CrossRefGoogle Scholar
  18. Larsen, C. S., & Milner, G. R. (Eds.). (1994). In the wake of contact: Biological responses to conquest. New York: Wiley-Liss.Google Scholar
  19. Larsen, C. S. (2015). Bioarchaeology: Interpreting behavior from the human skeleton (2nd ed.). Cambridge, U.K.: Cambridge University Press.CrossRefGoogle Scholar
  20. McClelland, J. A. (2010). Dental biodistance. In E. M. Perry, A. L.W. Stodder & C. Bollong (Eds.) Animas-La Plata project volume xv-bioarchaeology. (pp. 223–238). Phoenix: SWCA Environmental Consultants.Google Scholar
  21. McClelland, J. A. (2015). Revisiting hohokam paleodemography. American Antiquity, 80, 492–510.CrossRefGoogle Scholar
  22. Meegan, C. M. (2009). Nutritional stress and the depopulation of the lower Salt River Valley Hohokam. Ph.D. dissertation. Tempe: Arizona State University.Google Scholar
  23. Murray, C. J. L. & Lopez, A. D. (Eds.). (1996). The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard School of Public Health on Behalf of the World Health Organization and the World Bank.Google Scholar
  24. Murray, C. J. L., & Lopez, A. D. (1997). Mortality by cause for eight regions of the world: Global burden of disease study. The Lancet, 349(9061), 1269–1276.CrossRefGoogle Scholar
  25. Murray, C. J. L., Ezzati, M., Flaxman, A. D., Lim, S., Lozano, Ra, Michaud, C., et al. (2012). GBD 2010: Design, definitions, and metrics. Lancet, 380, 2063–2066.CrossRefGoogle Scholar
  26. Murray, C. J. L., & Lopez, A. D. (2013). Measuring the global burden of disease. New England Journal of Medicine, 369(5), 448–457.CrossRefGoogle Scholar
  27. Nelson, M. C., Kintigh, K., Abbott, D. R., & Anderies, J. M. (2010). The cross-scale interplay between social and biophysical context and the vulnerability of irrigation-dependent societies: Archaeology’s long-term perspective. Ecology and Society, 15(3), 31.CrossRefGoogle Scholar
  28. Nelson, N.C. (1914) Pueblo Ruins of the Galisteo Basin, New Mexico. Anthropological papers of the American Museum of natural history XV(1). New York: American Museum of Natural History.Google Scholar
  29. Nord, E. (2013). Disability weights in the global burden of disease 2010: Unclear meaning and overstatement of international agreement. Health Policy, 11(1), 99–104.CrossRefGoogle Scholar
  30. Nord, E. (2015). Uncertainties about disability weights for the global burden of disease study. Lancet global health, November, 2015, e661–e662.Google Scholar
  31. Ogilvie, M. D., & Hilton, C. E. (2011). Cross-sectional geometry in the humeri of foragers and farmers from the prehispanic american Southwest: Exploring patterns in the sexual division of labor. American Journal of Physical Anthropology, 144, 11–21.CrossRefGoogle Scholar
  32. Oxenham, M. & Pechenkina K. (2013). East Asian bioarchaeology: Major trends in a temporally, genetically, and eco-culturally diverse region. In K. Pechenkina & M. Oxenham (Eds.) Bioarchaeology of East Asia: Movement, contact, health (pp. 482–498). Gainesville: University Press of Florida.Google Scholar
  33. Perry, E. (2008). Gender, labor, and inequality at Grasshopper Pueblo. In A. L. W. Stodder (Ed.), Reanalysis and reinterpretation in Southwestern bioarchaeology. Arizona State University Anthropological Research Papers No. 59 (pp. 151–166). Tempe: Arizona State University.Google Scholar
  34. Potter, J. M. (2010) Animas-La Plata project: Final synthetic Report. Phoenix: SWCA Environmental Consultants, Inc.Google Scholar
  35. Potter, J. M., & Chuipka, J. (2007). Early Pueblo communities and cultural diversity in the durango Area: Preliminary results from the Animas-La Plata project. Kiva, 72, 407–430.CrossRefGoogle Scholar
  36. Potter, J. M., & Chuipka, J. (2010). Perimortem mutilation of human remains in an early village in the American Southwest: A case for ethnic violence. Journal of Anthropological Archaeology, 29(507), 523.Google Scholar
  37. Pinhasi, R., & Stock, J. T. (Eds.). (2011). Human bioarchaeology of the transition to agriculture. New York: Wiley-Blackwell.Google Scholar
  38. Redman, C. (2005). Resilience theory in archaeology. American Anthropologist, 107(1), 70–77.CrossRefGoogle Scholar
  39. Reidpath, D. D., Allotey, P. A., Kouame, A., & Cummins, R. A. (2003). Measuring health in a vacuum: Examining the disability weight of the DALY. Health Policy and Planning, 18(4), 351–356.CrossRefGoogle Scholar
  40. Rehm, J., Frick, U. (2010). Valuation of health states in the US study to establish disability weights: Lessons from the literature. International Journal of Methods in Psychiatric Research, 19(1), 18–33.Google Scholar
  41. Reinhard, K.J. & Bryant, V.M. (2008). Pathoecology and the future of coprolite studies in bioarchaeology. In A. L. W. Stodder (Ed.) Reanalysis and Reinterpretation in Southwestern Bioarchaeology (pp. 199–216). Anthropological Research Paper No 59. Tempe: School of Human Evolution and Social Change, Arizona State University.Google Scholar
  42. Roberts, C. A., & Buikstra, J. E. (2003). The bioarchaeology of tuberculosis: A global view on a reemerging disease. Gainesville: University Press of Florida.Google Scholar
  43. Salomon, J. A., & Global burden of disease collaborators. (2012). Common values in assessing health outcomes from disease and injury: Disability weights measurement study for the global burden of disease study 2010. The Lancet, 380, 2129–2143.CrossRefGoogle Scholar
  44. Salomon, J. A., Haagsma, J. A., Davis, A., Maertens de Noordhout, C., Polinder, S., Havelaar, A. H., et al. (2015). Disability weights for the global burden of disease 2013 study. Lancet Global Health, 3, e712–e723.CrossRefGoogle Scholar
  45. Sheridan, S. G. (2003). Childhood health as an indicator of biological stress. In D. R. Abbott (Ed.), Centuries of decline during the Hohokam classic period at Pueblo Grande (pp. 82–106). Tucson: University of Arizona Press.Google Scholar
  46. Simmons, M. (1979) History of Pueblo-Spanish relations to 1821. In A. Ortiz (Ed.) Handbook of North American Indians, Vol. 9: Southwest. (pp. 178–193). Washington, D.C.: Smithsonian Institution Press.Google Scholar
  47. Spielmann, K. A. (1995). Glimpses of gender in the prehistoric Southwest. Journal of Anthropological Research, 51(2), 91–102.CrossRefGoogle Scholar
  48. Stodder A. L. W. (2006) Skeletal biology: Southwest. In D. H. Ubelaker (Ed.) The handbook of North American Indians volume 3: Environment, origins, and population (pp. 557–580). Washington: Smithsonian Institution.Google Scholar
  49. Steckel, R. H., & Rose, J. C. (Eds.). (2002). The backbone of history: Health and nutrition in the western hemisphere. NY: Cambridge University Press.Google Scholar
  50. Stodder, A.L.W. (1990) Paleoepidemiology of Eastern and Western Pueblo communities in protohistoric New Mexico. Ph.D. Dissertation, Department of Anthropology, University of Colorado, Boulder.Google Scholar
  51. Stodder, A. L. W. (1996). Paleoepidemiology of Eastern and Western Pueblo communities in protohistoric and early contact period New Mexico. In B. J. Baker & L. K. Kealhofer (Eds.), Disease and biocultural frontiers: Native American adaptation in the Spanish Borderlands (pp. 148–176). Gainesville: University of Florida Press.Google Scholar
  52. Stodder, A. L. W. (2010). Paleodemography. In E. Perry, A. L. W. Stodder, & C. Bollong (Eds.), Animas-La Plata project report series (Vol. XV, pp. 67–74)., Bioarchaeology Phoenix: SWCA Environmental Consultants Inc.Google Scholar
  53. Stodder, A. L. W. (2012). Data and data analysis issues in paleopathology. In A. L. Grauer (Ed.), A companion to paleopathology (pp. 339–356). Malden, Mass.: Blackwell Publishing Ltd.CrossRefGoogle Scholar
  54. Stodder, A. L. W. (2016). Quantifying morbidity in prehispanic Southwestern communities. In C. Herhahn & A. F. Ramenofsky (Eds.), Causation and explanation: Demography, movement, and historical ecology in the prehistoric Southwest (pp. 121–135). Boulder: University of Colorado Press.CrossRefGoogle Scholar
  55. Stodder, A. L. W., Osterholtz, A. J., Mowrer, K., & Chuipka, J. (2010a). Processed human remains from the sacred ridge site: Context, taphonomy, interpretation. In E. Perry, A. L. W. Stodder, & C. Bollong (Eds.), Animas-La Plata Project (Vol. XV, pp. 279–415)., Bioarchaeology Phoenix: SWCA Environmental Consultants.Google Scholar
  56. Stodder, A. L. W., Osterholtz, A. J., Mowrer, K. & Salisbury, E. (2010b). Skeletal pathology and anomalies. In E. Perry, A. L. W. Stodder & C. Bollong (Eds.) Bioarchaeological studies: Animas La Plata project report series volume XV (pp. 89–156). Phoenix: SWCA Environmental Consultants, Inc.Google Scholar
  57. Stodder, A. L. W., & Palkovich, A. M. (Eds.). (2012). The bioarchaeology of individuals. Gainesville: University Press of Florida.Google Scholar
  58. Taylor, H. R., Jonas, J. B., Leasher, J., Naidoo, K., Pesudovs, K., & Resnikoff, S. (2013). Disability weights vision disorders in global burden of disease study. The Lancet, 381, 23.CrossRefGoogle Scholar
  59. Tilley, L. (2015). Theory and practice in the bioarchaeology of care. New York: Springer.CrossRefGoogle Scholar
  60. Tilley, L., & Cameron, T. (2014). Introducing the index of care: A Web-based application supporting archaeological research in health related care. International Journal of Paleopathology, 6, 5–9.CrossRefGoogle Scholar
  61. Tilley, L., & Oxenham, M. (2011). Survival against the odds: Modeling the social implications of care provision to seriously disabled individuals. International Journal of Paleopathology, 1, 35–42.CrossRefGoogle Scholar
  62. Tilley, L. & Schrenk, A. (Eds.). (in press). Building a Bioarchaeology of Care. New York: Springer.Google Scholar
  63. van Schaik, K., Vinichenko, D., & Ruhli, F. (2014). Health is not always written in bone: Using a modern comorbidity index to assess disease load in paleopathology. American Journal of Physical Anthropology, 154, 215–221.CrossRefGoogle Scholar
  64. Verano, J. W., & Ubelaker, D. H. (Eds.). (1992). Disease and demography in the Americas. Washington, D.C: Smithsonian Institution Press.Google Scholar
  65. Waldron, T. (2012) Joint disease. In A. L. Grauer (Ed.) A companion to paleopathology (pp. 513–530). New York: Blackwell Publishing Ltd.Google Scholar
  66. Walker, P. L. (2001). A bioarchaeological perspective on the history of violence. Annual Review of Anthropology, 30, 573–596.CrossRefGoogle Scholar
  67. World Health Organization. (2004). Global Burden of Disease Disability Weights. Accessed September 20, 2015, from the World Wide Web:
  68. World Health Organization, Department of Health Statistics and Information Systems. (2013). WHO Methods and Data Sources for Global Burden of Disease Estimates 2000–2011. Geneva, Switzerland: World Health Organization.Google Scholar
  69. World Health Organization. (2016). International classification of diseases of diseases Online 10:2016. Accessed May 29, 2016.

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Office of Archaeological StudiesThe Museum of New MexicoSanta FeUSA
  2. 2.Department of AnthropologyThe University of New MexicoAlbuquerqueUSA

Personalised recommendations