Health impacts of agricultural intensification and urbanisation in Early China: A bioarchaeological analysis of disease patterns, subsistence economies, and lived environments in Shaanxi from 3000 BC to AD 220

Today, half of the world’s population live in cities, while one-third of the global gross-domestic-product comes from agricultural production. In 2050, 9.7 billion people will rely on agricultural production for food, and 70% of them will live in cities. Yet agricultural production and urbanism are associated with many adverse health outcomes, including malnutrition, infectious diseases, and respiratory illnesses. Analysis of archaeological populations also suggests that agriculture and urbanism were two of the most important factors that caused past human health to deteriorate. Despite the profound health impacts of agriculture and urbanism in the past, present, and future, relevant bioarchaeological studies have rarely been conducted in China. To strengthen the knowledge base, the current research explored temporal health trends and their associations with agricultural intensification and urbanisation in Early China. Adult stature and skeletal and dental lesions suggestive of malnutrition, infections, and respiratory illnesses were recorded from 249 skeletons excavated from six sites in Shaanxi (3000 BC-AD 220). The results showed that the intensification of millet agriculture and emergence of urbanism in Shaanxi increased the frequencies of long bone periostosis, maxillary sinusitis, inflammatory rib lesions, cribra orbitalia, porotic hyperostosis, enamel hypoplasia, and dental caries. Yet such a health decline was soon reversed by cultural adaptations, and population health improved as indicated by increased adult stature over time. The frequency of tuberculosis also increased following the emergence of urbanism, although such a trend is based on a small number of affected individuals. In contrast, the frequencies of inflammatory endocranial lesions, scurvy, and vitamin D deficiency were influenced by biological, social, and climatic risk factors rather than changes in subsistence economies and lived environments. The findings of the current research contribute to the knowledge of the health impacts of agriculture and urbanism, as well as provide a deep-time perspective on major societal challenges facing living people.