Towards a Bioarchaeology of Care:
A contextualised approach for identifying and interpreting
health-related care provision in prehistory.
Characteristics of the care given to those experiencing disability provide a window into important aspects of community and culture. In archaeology, health-related care provision is inferred from physical evidence in human remains indicating survival with, or recovery from, a disabling pathology, in circumstances where, without support, the individual may not have survived to actual age at death. Despite its potential to provide a valuable perspective on past behaviour, caregiving is a topic that has been overlooked by archaeologists. This thesis presents the ‘bioarchaeology of care’ - an original, fully-theorised and contextualised case study-based approach for identifying and interpreting disability and health-related care practices within their corresponding lifeways, and one that seeks to reveal elements of past social relations, socioeconomic organisation and group and individual identity which might otherwise be inaccessible. The applied methodology comprises four stages of analysis: (i) description and diagnosis; (ii) establishing disability impact and determining the case for care; (iii) deriving a ‘model of care’; and (iv) interpreting the broader implications of care given. Each stage builds on the contents of preceding one(s), facilitating scrutiny of the analytical process.
This dissertation first discusses the treatment of healthcare provision in archaeological research, considering where, and why, this has fallen short. Successive chapters establish a context and a conceptual foundation for undertaking archaeological research into health-related caregiving, which includes operationalising terminology surrounding issues of ‘disability’ and ‘care’; exploring the social and biological evolutionary origins of caregiving and the implications of these for understanding prehistoric care practice; and presenting a framework for deconstructing the decision-making involved in giving and receiving care. The thesis then details the stages of the methodology and introduces the Index of Care, a computer-based instrument designed to support bioarchaeology of care analysis and interpretation. Three chapters examine, respectively, the care given to M9 (Neolithic Vietnam), La Chapelle-aux-Saints 1 and La Ferrassie 1 (European Upper Middle Palaeolithic), and Lanhill Burial 7 (early British Neolithic), illustrating the variety, richness and immediacy of insights attainable through application of the methodology. These case studies demonstrate that the bioarchaeology of care’s focus on caregiving as an expression of collective and individual agency allows an engagement with the past that brings us closer to those who inhabited it.
Tilley, L. 2012. The Bioarchaeology of Care. The SAA Archaeological Record: New Directions in Bioarchaeology, Part II. 12 (3): 39-41.
Tilley, L. and Oxenham, M.F. 2011 Survival against the odds: modeling the social implications of care provision to seriously disabled individuals. International Journal of Paleopathology 1:35-42.