This book began by extolling the benefits of studying very long-term trends in health using evidence from skeletal remains. To this end, we coordinated the preparation of the largest comparable database ever assembled in the field of bioarchaeology, which consists of observations on 12,520 individuals who lived over the past several millennia at 65 composite sites in the Western Hemisphere. The database is available to the public and includes seven commonly measured, basic indicators of health: stature inferred from long bone lengths; evidence of anemia from porotic hyperostosis or cribra orbitalia; linear enamel hypoplasias; trauma; infectious lesions on bones; dental health; and degenerative joint disease. The first three indicators reflect the health quality of life in childhood, while the last two are connected with the degenerative processes of aging and hard work. Trauma and infectious lesions can occur at any age but are more common among older children and adults.

Our conclusions first highlight methodological contributions, beginning with a technique for measuring health based on two essential ingredients: health quality of life while living and length of life. The Mark I version of the health index, which roughly gauges chronic conditions of the first component, is based on the prevalence and severity of the basic health indicators. We tabulated separate indexes for each attribute and weighted them equally in calculating the overall index. Attributes for individual observations were scored from 0 (worst outcome) to 100 (no evidence of pathology), and the results at each site were converted to age-specific rates, which were weighted by the distribution of person-years lived by age in a reference population (Model West, level 4).