Doctoral Dissertation Research: The Intersections of Health and Wealth: Socioeconomic Status, Frailty, and Mortality

长期以来，人们都知道社会经济地位（SES）可以调节对危害和疾病的暴露，以及对生长、发育、组织维持和免疫反应所需资源的获取。然而，社会经济状况与死亡率之间的联系往往被过度简化，在极端情况下，可能会使卫生政策和治疗方案错误地认识到个人在各种情况下面临的风险。生物人类学有能力探索过去社会经济地位和健康模式的可变性，根据目前公共卫生研究人员所支持的理论观点来解释生物考古研究的结果，这些研究人员正在调查社会经济地位与生活人群健康之间的联系。该项目为探索过去社会中的SES提供了一个新的模型，并将通过关注不同于这些理论观点已应用于现代工业化人口的背景，拓宽对SES跨时间影响的理解。因此，这一多学科项目将推动生物人类学的研究，并通过将交叉性理论纳入对过去健康的研究，扩大公共卫生研究的时间范围。此外，这项工作将培养一名女研究生，并为美国和英国的公共科学推广工作做出贡献。本论文项目使用骨骼样本来研究社会经济地位、人口特征（如年龄和性别）、暴露于生理压力源和死亡率在19世纪英国工业化背景下的相互作用。来自四个工业时代墓地（Coach Lane, St. Bride's Fleet Street, St. Peter's Wolverhampton和New Bunhill Fields）的骨骼数据将用古人口统计学方法（风险建模，分层对数线性分析和方差分析）进行分析，以确定英国工业地区的发病率和死亡率模式在SES群体之间的差异；研究一生中的生理压力源如何与年龄和性别等有社会意义的类别相互作用，从而产生影响英国工业时代脆弱和死亡率的分层边缘化；并评估在生物人类学文献中未被充分代表的压力源的潜力，以增强对过去边缘化、交叉性和死亡率的理解。

Socioeconomic status (SES) has long been known to mediate exposure to hazards and disease, as well as access to those resources necessary for growth, development, tissue maintenance, and immune response. However, the connection between SES and mortality is often oversimplified, and, in extreme cases, could misinform health policy and treatment protocols about the risks faced by individuals in a variety of contexts. Biological anthropology is well-equipped to explore the variability of patterns of SES and heath in the past by interpreting the results of bioarchaeological research in light of current theoretical perspectives espoused by public health researchers investigating the connection between SES and health in living populations. This project provides a novel model for exploring SES in past societies and will broaden understanding of the effects of SES across time by focusing on a context that differs from the modern, industrialized populations to which these theoretical perspectives have been applied. As a result, this multidisciplinary project will advance research in biological anthropology and extend the temporal purview of public health research by incorporating intersectionality theory into a study of past health. Moreover, the work will train a female graduate student and contribute to public science outreach efforts in both the United States and the United Kingdom.This dissertation project uses skeletal samples to examine the interactions of SES, demographic characteristics (such as age and sex), exposure to physiological stressors, and mortality in the context of industrialization in 19th century England. Skeletal data from four industrial-era cemeteries (Coach Lane, St. Bride's Fleet Street, St. Peter's Wolverhampton, and New Bunhill Fields) will be analyzed with paleodemographic approaches (hazard modeling, hierarchical log-linear analysis, and analysis of variance) to determine how morbidity and mortality patterns in industrial England differed between SES groups; investigate how physiological stressors throughout life interacted with socially meaningful categories such as age and sex to produce layered marginalizations that influenced frailty and mortality in industrial England; and evaluate the potential of stressors underrepresented in biological anthropology literature to enhance understanding of marginalization, intersectionality, and mortality in the past.