Multiple Injury and Health in Past Societies: An Analysis of Concepts and Approaches, and Insights from a Multi-Period Study

Earlier clinical and bioarchaeological studies found that injury recidivists were most likely to be young adult males. Since then, the clinical meaning of the injury recidivist has expanded to include all individuals with multiple injuries, and other aspects of health have been considered. Our study sought to apply these advances to paleopathology and place multiple injuries in a wider context by investigating: the age and sex distribution of those with single and multiple fractures, and if people with multiple injuries had poorer general health. The sample of 213 males and 190 females (≥18 years old) from six populations in England, Siberia, and Sudan ranged in date from the 3rd century BC to the mid-19th century AD. Health variables included cribra orbitalia, porotic hyperostosis, periostitis, Schmorl’s nodes, enamel hypoplasias, dental caries, and periodontitis. Antemortem injuries were: fractures (0/1/≥2), myositis ossificans, dental trauma, and sharp-force injuries. The data were analysed using chi-square and hierarchical loglinear analyses (P=0.05). No significant three-way association between age, sex, and injury was found. There was no difference between the sexes when individuals with single versus multiple injuries were compared. There were significant differences in the age-distribution of people with 0 and 1/≥2 fractures. Males and those 26–35 years old were most likely to have fractures and multiple injuries. Porotic hyperostosis was significantly associated with fractures. There was no significant relationship between general poor health and multiple injuries. Copyright © 2016 John Wiley & Sons, Ltd.