Although the antiquity of the earliest colonists in the Americas remains a controversial subject, human presence is well established by the close of the Pleistocene, approximately 10,000 B.P. (before the present) (Bryan 1978, 1986; Shutler 1983; Fagan 1987). Kill sites and habitation areas, in conjunction with lithic tools and a few human remains, provide convincing evidence for the presence of highly mobile, small groups whose subsistence was based on hunting and gathering of naturally available “wild” resources.

The health of these most ancient American populations, poorly documented owing to a paucity of human remains (Hrdlicka 1907, 1912; Stewart 1946, 1973; Young 1988), can best be inferred by analogy with recent hunting and gathering peoples. In making inferences we must keep in mind that such groups today tend to occupy marginal environments, unlike the often resource-rich ecosystems that attracted early human populations. If we use contemporary hunter-gatherers for our model, then parasitic infections, infections for which insects and animals serve as the primary vectors or intermediate hosts, and traumatic episodes would have been among the primary sources of ill health among the earliest Americans (Dunn 1968; Truswell and Hansen 1976; Howell 1979; Lee 1979; Cohen 1989). Degenerative diseases, neoplasms, and epidemic diseases would have been extremely rare, as would have been chronic undernutrition. Seasonal periods of nutritional stress would, however, have been expected. Thus, health status would have reflec ted the exceptionally close relationship between hunter-gatherers and their environment.