Much of the literature supports Larsen (1995)’s claim that agriculture had a negative
impact on human skeletal and overall health. However there are other studies that have found
that, in some areas, while agriculture plays a direct role in the decline of health, it is not
necessarily exclusive. Larsen et al. (2007) showed that in Georgia and Florida there was a shift
from foraging to farming that was accompanied by a decline in health and a change in lifestyle.
This change in health was related to the dietary change and nutritional decline but was also
affected by population size and density (Larsen et al., 2007). Whenever the populations
increased, skeletal morbidity increased, suggesting that an increase in population was also
important and that an emphasis on agriculture was not the only factor determining health (Larsen
et al., 2007). It is important to clarify that populations did not simply shift completely from a
nonagricultural subsistence system to an agricultural society. Most populations kept a mixed
economy of subsistence, utilizing all available resources even if some resources were utilized
more than others over time.
The addition of skeletal data in debates about the subsistence of past populations is
imperative. Archaeological excavations collecting botanical and faunal remains, while important
for the conversation about subsistence and diet, also tend to be biased on what is available in the
archaeological record, which is heavily influenced by the methods and tools of the excavation.
The data from these excavations provide a description of what is left to be seen, but not
necessarily an accurate depiction of how human health was impacted by what was being
The skeletal remains from Town Creek suggest a similar pattern to the botanical and
faunal remains found. The individuals of the Town Creek sample show signs of dental health that
are common in agricultural societies. New excavations are happening soon that will provide
more botanical and faunal remains to contribute to this discussion (Hutchinson, personal
communication, March 2014). It could also be indicative of the large population contributing to
decreased overall health. The archaeological record suggests a large population at Town Creek
from 1200 to 1400, and Larsen et al. (2007) has shown how an overall health decline can be
influenced by population size.
The sample from Forbush Creek shows some signs of being an agricultural society, with
certain dental and cranial pathologies suggesting a diet high in carbohydrates and lacking animal
products. The results at Forbush Creek show a possible lack of meat and animal products in the
diets of individuals or an inability to digest the nutrients in the diet. These patterns could be the
result of a predominantly agricultural subsistence. However, a majority of the health indicators
studied show lower frequencies which could suggest a mixed economy with a majority of
individuals that would limit the cases of anterior carious lesions, alveolar infection, premortem
tooth loss and scurvy. Forbush Creek is an earlier site, where corn was possibly not introduced
until the last 50 to 100 years of occupation. This could mean a low agricultural diet because of its
late introduction into the occupational period. The absence of analysis of botanical and faunal
remains from Forbush Creek makes any further assumptions difficult.
The results of this study do not suggest a large decline in nutritional and dietary health as
a result of European contact. The presence of infectious disease from Europe caused a population
decline, which created mobile populations among the indigenous communities. However, the
may have reduced the nutritional strain on the indigenous populations. According to the results
of this study, the nutritional and dietary health improved from the Middle sample to the Late
sample. This could be as a result of a decrease in agriculture, as it would have been difficult to
maintain an agricultural subsistence in mobile environments. Decreases in agriculture would
mean a return to a more mixed economy of subsistence, with possibly more reliance on hunting
and gathering.
For this study, some of the results are in opposition to the archaeological record of
botanical and faunal remains. The presence of porotic hyperostosis and scurvy show deficiencies
in the diet even in populations that have records of plenty of animal products or foods rich in
folic acid and vitamin C. These results could be conclusive of possible cultural practices where
certain individuals in the populations have restricted diets. The presence of botanicals such as
maize and of faunal remains such as deer does not necessarily mean that all individuals have
equal access to these resources, either by status, preference or other cultural reasons. Females in
most of the sample showed higher percentages of porotic hyperostosis and cribra orbitalia. These
two conditions may be indicative of diets low in meat or other animal products. In some
societies, there are dietary restrictions that limit the amount of meat consumed for women who
are pregnant and breastfeeding. This pattern of higher instances in the female sample is
suggestive of possible cultural taboos in these communities. Males had higher cases of scurvy. A
possible reasoning for this dietary deficiency is a limit of fruits and vegetation in the diet of men
who are spending their time hunting and away from the rest of the population. While we know
that fruits and foods rich in vitamin C were present at the sites, we do not know the consumption
Overall, the results show that the sample populations that most likely relied on a more
mixed economy (the Early and Late period) had the lower frequencies of individuals affected by
dental and cranial pathologies and that the Middle period, with a more established and dominant
agricultural subsistence had the higher frequencies of individuals affected by nutritional
pathologies. This conclusion is consistent with the predicted frequencies in relation to the
cultural and biological context of the sample populations used in the study. I hope this work has
contributed to the understanding of the nutrition and health in the North Carolina piedmont
populations and the effects that agriculture and European contact had on these indigenous
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Appendix I: Data Collection Codebook