Using Population Health Constructs to Explore Impairment and Disability in Knee Osteoarthritis
Current population health research has demonstrated that social and physical environmental factors impact people with health issues. This should also apply to earlier populations where the human condition was not entirely dissimilar to today. Examining a disease state in archaeological populations without the benefit of contextual information limits our understanding to biological expression; however, individuals are more than biological entities. People are biopsychosocial composites that are born, shaped, and embedded in social and physical environments. To understand impairment and disability consequences of skeletal manifestations of disease, bioarchaeological researchers must embrace this holistic view and not limit examinations to a restrictive biological lens that views every geographical and cultural group of varying circumstance equally. Using knee osteoarthritis as an example, this paper explores how population health constructs can identify barriers that can lead to disability. This exercise highlights the challenges of moving from knee osteoarthritis identification, through impairment assessment, to the conclusion of disability. With this approach, broadened frameworks to investigate not only impairment potential but also disability potential in archaeological populations are presented.
KeywordsHealth determinants CAOS OAI Physical environment Social environment Disability Impairment Bioarchaeology
The authors would like to thank the OAI for the use of their data and acknowledge the support of the Canadian Museum of History and The Ottawa Hospital Rehabilitation Centre. We would also like to thank the editors and anonymous reviewers for their useful suggestions and comments.
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