This thesis details a study of nonspecific periosteal lesions, commonly referred to as periostitis, in a skeletal sample from Cerro Mangote, a preceramic shell midden site. This sample was chosen due to its known high frequency of periostitis. The site of Cerro Mangote dates to between 7000 and 5000 years ago and is located in central Panama.

Traditionally, crude lesion frequencies have been used to determine which subgroups were most affected by disease. However, hidden heterogeneity in risk of death makes comparing lesion frequencies a problematic way to assess health because each individual’s frailty, or age-specific risk of death, is unknown and because frailty varies across the lifespan. This study uses a method of assessing survivorship (a survivorship index) that addresses the osteological paradox. Specifically, this thesis investigates differences in survivorship across the lifespan and between both sexes by examining the relationship between those with healed lesions and those with unhealed lesions.

Of 78 individuals examined, 39 had periostitis. Juveniles had significantly lower survivorship than all adults and most adult subgroups. No significant differences were found between males and females. Most adults lived long enough for at least one area of a lesion to fully heal, but only eight individuals, all young adults, lived long enough for all lesions to completely heal. The results indicate that survivorship of the conditions that cause periostitis was highest among young adults and lowest among juveniles at Cerro Mangote.

This thesis demonstrates that lesion frequencies can be misleading and that survivorship indices can be a useful way to examine variations in frailty.