Reconciling Historic Hospital Records with a Contemporary Skeletal Data Set

Despite Wood et al.’s recognition of the osteological paradox more than 30 years ago, bioarchaeologists continue to struggle to engage with the theoretical constraints that it posed. This work brings historic records from Charity Hospital in New Orleans, Louisiana (AD 1847–1929), to bear on multiple contemporary skeletal samples derived from the hospital’s patients in an effort to explore aspects of the osteological paradox. In this way, we are able to use hospital records as a proxy for the living population for comparison with the skeletal sample and therefore to test for similarities and differences in health and demography between the two. This research finds that while there are significant similarities in the demography of the skeletal sample and the proxy population, there are substantial differences in the health data between the skeletal samples and the hospital records. Although this is unsurprising given that the health of a past population is never fully captured in a skeletal assemblage, the scale of the differences was noteworthy. Using Charity Hospital as a case study with which to assess the osteological paradox shows the continued need for contextualized, multidisciplinary research and, in particular, reinforces the benefits of a historical bioarchaeological approach.