The LEH results suggest that early exposure to stressors increased frailty in the context of famine. The periosteal lesion results suggest that individuals were more likely to survive stressors and thus form these lesions under nonfamine conditions. Hazard analysis suggests that a cultural or biological transformation during this period affected sex differences in mortality. Possible causes include the selective mortality during the Black Death, which might have influenced risks of mortality among survivors, or unequal distribution of improvements in standards of living after the epidemic. Am J Phys Anthropol 160:272-283, 2016. © 2016 Wiley Periodicals, Inc.

Objectives: Intersectionality theory argues that various categories of identity and forms of systemic oppression interact and produce inequalities in resource access, economic opportunities, and health outcomes. However, there has been little explicit engagement with this theory by bioarchaeologists examining disparate health outcomes in the past. This study examines the associations among frailty, age at death, sex, and socioeconomic status (SES) in 18th-and 19th-century England. Materials and methods: The sample for this study comes from four industrial-era cemeteries from England, ca. 1711-1857. The associations among adult age (18+ years), SES, sex, and three skeletal indicators of stress (dental enamel hypoplasia [DEH, n = 293], cribra orbitalia [CO, n = 457], periosteal lesions [PNB, n = 436]) are examined using hierarchical log-linear analysis.Results: Significant interactions existed among the variables examined for two skeletal indicators: high SES females had lower frequencies of CO relative to other groups and males between ages 30-45 years exhibited higher frequencies of PNB compared to females or males of older or younger ages, regardless of SES. Additionally, sex and SES were consistently associated with age at death.Conclusions: These results suggest that patterns of stress indicators cannot be examined solely across unilateral axes of age, SES, or sex. Intersecting axes of privilege, marginalization, and structural oppression may have buffered high SES females from some negative health outcomes (CO) while predisposing them to others (risk of maternal mortality). Likewise, the hazardous working conditions relegated to adult males may have heightened the risk of injury, infection, and death for middle-aged men in industrial-era England. K E Y W O R D Sbioarchaeology, hierarchical log-linear analysis, intersectionality, mortality, paleopathology

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Objectives: Dental plaque is associated with a variety of systemic diseases and mortality risks in living populations. However, bioarchaeologists have not fully investigated the mortality risks associated with plaque (or its mineralized form, calculus) in the past. This study examines the relationship between survivorship and calculus in a medieval skeletal sample.Materials and methods: Our sample (n = 1,098) from four medieval London cemeteries, c. 1000-1540 CE, includes people who died under attritional (normal) and catastrophic (famine and plague) conditions. The associations between age and the presence of dental calculus on the permanent left first mandibular molar are assessed using binary logistic regression and Kaplan-Meier survival analysis. Results: The regression results indicate a significant negative relationship between age and calculus presence for individuals of all ages who died under normal mortality conditions and for adults who died under both normal and catastrophic conditions. Survival analysis reveals decreased survivorship for people of all ages with calculus under normal mortality conditions. Similarly, during conditions of catastrophic mortality, adult males with calculus suffered reduced survivorship compared to males without it, though there was no difference in survivorship between adult females with and without calculus. Conclusions: These results suggest that, as in modern populations, calculus accumulation in the inhabitants of medieval London reflects a greater risk of premature death. The evaluation of calculus, a potential measure of underlying frailty, in the context of a demographic measure of general health suggests that it might provide insights into health in past populations. K E Y W O R D S binary logistic regression, bioarchaeology, mortality, paleodemography, paleopathology, survival analysis

Intersectionality refers to the potential for multiple axes of identity to overlap and interact within a single individual, whose lived experiences are further affected by structural forms of oppression that are perpetuated within their society. Intersectionality has been adapted by a variety of social science disciplines exploring the negative effects of multiple marginalization and systemic inequality in living populations, but remarkably few intersectional studies of health or pandemics in the past have been produced in bioarchaeology. Bioarchaeologists, specifically, are uniquely positioned to contribute to interdisciplinary discourse by expanding the contextual and temporal purviews of intersectionality scholarship, which currently focuses primarily on living populations from Western, industrialized contexts. The purpose of this review is to encourage and facilitate intersectionality research within bioarchaeology. To accomplish this goal, the article is divided into three sections: the first section provides a general overview of intersectionality, the second section discusses examples of intersectional scholarship from related disciplines that address health disparities and modern pandemics, and the third section considers the ways in which bioarchaeologists might integrate intersectionality in our empirical research on health and disease in the past. Given the potentially daunting task of using bioarchaeological data to investigate intersectionality and health in the past, the third section also highlights three quantitative methodologies that intersectionality scholars have used to investigate the independent, additive effects of individual social identities as well as the multiplicative effects of those same identities as they operate in conjunction with each other to produce patterns of health outcomes in living populations.