International Journal of Paleopathology 5 (2014) 46–54 Contents lists available at ScienceDirect International Journal of Paleopathology j ourna l ho me pa ge: www.elsevier.com/locate/ijpp Research Article Scurvy in the Greater American Southwest: Modeling micronutrition and biosocial processes in contexts of resource stress John J. Crandall * Department of Anthropology, University of Nevada, Las Vegas, USA a r t i c l e i n f o Article history: Received 23 June 2013 Received in revised form 30 April 2014 Accepted 2 May 2014 Keywords: Vitamin C deficiency Scurvy Violence Inequality Differential diagnosis Paleopathology Tepehuan Southwest a b s t r a c t As Donald Ortner and other scholars have noted, the prevalence of subadult scurvy ranges widely among skeletal assemblages. Prevalence variation across the Americas has been attributed to seasonality and environmental instability, although no cohesive model has been proposed. Integrating new evidence from an analysis of 31 burials found in an ancestral Tepehaun cave site (A.D. 571–1168), this paper proposes a model of biosocial change and nutritional stress for the Prehispanic American Southwest. The role of warfare and social control are emphasized to complement prior studies that have focused on the role of droughts and aggregation. Bioarchaeological evidence demonstrates that scurvy prevalence increases among subadults in associ- ation with violence and exploitation by regional political centers. Hinterland communities exhibit higher prevalence rates of scurvy than found within nearby political centers. This is consistent with hypotheses that social control involved complex inequalities in resource redistribution in the Southwest that neg- atively impacted the communities from which food resources were extracted. Evidence of scurvy also appears to be found most often in assemblages associated with violent conflict. Further exploration of the role structural inequalities play in shaping nutrition will enable a better understanding of how to improve health in contexts of resource instability. © 2014 Elsevier Inc. All rights reserved. 1. Introduction Studies of human health in the prehistoric American South- west have increasingly evaluated the biological impacts of social change. Historical approaches to health stress in bioarchaeology have emphasized the effects of environmental shifts on community health (Stodder, 2012). Building on political–economic approaches applied in bioarchaeology and medical anthropology (Farmer, 2003; Goodman, 1998; Holmes, 2013), this paper reviews the skele- tal evidence of subadult scurvy across the North American Greater Southwest to model structural violence’s role in shaping subadult risk of undernutrition. A summary of evidence for subadult scurvy serves as a baseline for evaluating risk factors in relation- ship to social inequality and varying environmental marginality throughout the Greater Southwest. Considering social control and inequality as variables in paleonutrition reconstructions may help better explain variability in the epidemiological patterning of nutri- tional deficiencies seen in human skeletal assemblages. * Correspondence to: Department of Anthropology, University of Nevada, Las Vegas, 4505 S. Maryland Pkwy Mailstop 455003, Las Vegas, NV 89154-5003, USA. Tel.: +1 315 679 1495; fax: +1 702 895 4823. E-mail address: cranda28@unlv.nevada.edu Nutritional quality in the ancient Southwest has been docu- mented to respond sensitively to environmental and subsistence changes. Increasing agricultural dependence and/or population aggregation are frequently noted to negatively impact nutritional quality (e.g. Stodder et al., 2002). Shifts in socio-political structure are understood to accompany dietary or demographic transitions yet their impacts on nutritional quality are not fully understood. Explaining increases in mortality, nutritional stress and infec- tious disease resulting from colonial contact represent one area where scholars have considered political–economic factors (e.g. Spielmann et al., 2009). Socio-political organization and evidence of violent conflict are also variable throughout prehistory. Compar- isons of skeletal data within the Southwest may illuminate the ways socially-sanctioned inequalities undermine community nutrition. Models incorporating inequality have been posed for other regions (e.g. Klaus, 2012; Schug et al., 2013), and these provide inspiration for such research in the Southwest. 2. Background 2.1. The paleopathology of scurvy Vitamin C, or ascorbic acid, serves a number of purposes through the body, including assisting the immune system, forming collagen, http://dx.doi.org/10.1016/j.ijpp.2014.05.001 1879-9817/© 2014 Elsevier Inc. All rights reserved.