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Introduction: Through the analysis of evidence of disease in human skeletal remains, the role of infectious disease and the interaction with subsistence transitions has been a matter for intensive research for decades in the prehistory of Europe and the Americas (Cohen and Armelagos, 1984
Cohen and Crane-Kramer, 2007) and, to some extent, in Southeast Asia (Oxenham et al., 2005). However, as Kirch (2000) suggests, the impact of infectious disease on human populations during the prehistory of the Pacific Islands has received less attention. By reviewing the evidence for infectious disease in human skeletal remains, this chapter will begin to address its role during the human settlement of the Pacific Islands and the effect on human health. The influences of diet, nutrition and growth on the health of prehistoric Pacific peoples are also addressed. These inter-related factors are reviewed in this chapter to complement the several diet and human biology-related chapters in the subsequent Pacific portion of this volume. With regards to infectious disease, this chapter will focus on malaria and treponemal disease as both diseases affected the health of Pacific peoples during different periods and in different ways throughout prehistory. Malaria has a long, but undated, antiquity in the region. As an infectious disease, malaria affected population growth and mortality, and interacted synergistically with other diseases, but still remains invisible in the skeletal record. The impact of this disease on global morbidity and death far outweighs most other infectious diseases today and has influenced the fall of civilisations (Bruce-Chwatt and de Zulueta, 1980). Yaws (<i>Tr. pertenue</i>), on the other hand, is a relatively 'benign' treponemal disease compared to its venereal cousin syphilis (<i>Tr. pallidum</i>), probably has a relatively short history in the region (Buckley et al., 2008) and is highly visible in the skeletal record. These issues are reviewed here using the direct evidence of treponemal disease from skeletal remains and the indirect evidence of the non-specific stress indicator of cribra orbitalia as potential evidence of malaria in the Pacific Islands. Another aim of this chapter is to highlight the gaps in our knowledge of the bioarchaeology of health in this region as an avenue for encouraging future research.
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