Stress in bioarchaeology, epidemiology, and evolutionary medicine: an integrated conceptual model of shared history from the descriptive to the developmental

The study of stress has unique, parallel histories in evolutionary medicine (EM) and bioarchaeology. The stress concept was conceived as an experimental enterprise that evolved into comparative studies focused on inequality and social transformation. Modern studies in EM incorporated a life history perspective that explored the consequences of stress in the early life environment across the lifespan. Numerous biomarkers related to the cumulative impacts of stress across the lifespan are now studied and associated with elevated morbidity and mortality. This approach emphasises plasticity in the capacity to survive stress events combined with physiological constraints on investment in future maintenance and survival. Bioarchaeological research integrates these perspectives in four ways. Skeletal pathophysiology carefully considers the skeletal biological origins of lesions attributable to stress, and thus the many biomarkers that may be associated with the experience. Allostasis explores the cumulative impacts of stress across the life course, and while a coherent model has yet to develop, there is great promise in the inclusion of stress indicators from a variety of systems. Finally, life course and life history approaches consider the mutually constituted relationship between the capacity to survive early life stress events and impacts on later stages of development. Findings from EM have been applied to transformative questions such as marginalisation, inequality and racism, while modern bioarchaeological approaches are still in the early stages of engaging these issues.