Abstract: While pandemics have exerted a tremendous influence on past and present-day societies, they have not constituted a major research focus within biological anthropology, and within it, bioarcheology and paleopathology, especially within explicitly biocultural analyses. This talk explores research in these fields, including molecular anthropology, that employs biocultural approaches, intersectionality and ecosocial and syndemic theory to unpack relationships between social inequality and past pandemics. An included case study assesses the 1918 influenza pandemic’s impacts on mortality relative to social identity within a socially vulnerable population of patients at the Mississippi State Asylum (MSA)(1855-1935).

Findings from the case study include substantial respiratory mortality during the pandemic, including from influenza and influenza syndemic with pneumonia. Older patients (40 years) had lower odds of dying from respiratory disease than younger, as did female patients compared to males. Age patterns are broadly consistent with national and state trends for the 1918 influenza pandemic, while elevated mortality amongst Black patients may reflect intersections between gender roles and race-based structural violence in the Jim Crow American South. Future bioarcheological and paleopathological work on pandemics will benefit from explicit incorporation of biocultural frameworks, intersectionality, and ecosocial and syndemic theory. Doing so enables holistic analyses of interactions between social context, social inequality and pandemic mortality and outcomes, which generate data useful for directly informing public health responses and pandemic preparedness.