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Therefore, elucidating relationships between stress and both chronic and acute skeletal lesions may help clarify our understanding of long\u2010term health trends in the past. In this study, we propose an index of \u201cskeletal frailty,\u201d based on models of frailty used to evaluate the life\u2010long effects of stress on health among living populations. Here, we assess the possible applicability of frailty to archaeological populations. The skeletal frailty index (SFI) is proposed as a methodological liaison between advances made by biological anthropologists studying relationships between stress and health among the living and bioarchaeologists studying stress and health among the dead. In a case study examining skeletal stress in Medieval London, the SFI is applied to nonmonastic (<jats:italic>N<\/jats:italic>\u2009=\u200960) and monastic (<jats:italic>N<\/jats:italic>\u2009=\u200974) samples. We used analysis of variance\/analysis of covariance to compare SFI values between nonmonastic\u2010monastic groups, sexes, and age cohorts. Results indicate higher lifetime morbidity among monastic groups. These results complement previous bioarchaeological findings on the same London populations, wherein lower risks of mortality and longer lifespans were observed for monastic populations. SFI data reflect the morbidity\u2010mortality paradox observed in modern populations and accompany recent findings in bioarchaeology of variation in Medieval monastic and nonmonastic \u201chealth.\u201d Ultimately, this study demonstrates the SFI's utility in bioarchaeology, through its application of commonly assessed skeletal biomarkers, its ease of applicability, and its potential usefulness for assessing changes in skeletal health over time and across specific geographies.<\/jats:p>","DOI":"10.1002\/ajpa.23019","type":"journal-article","created":{"date-parts":[[2016,6,17]],"date-time":"2016-06-17T13:05:03Z","timestamp":1466168703000},"page":"208-225","source":"Crossref","is-referenced-by-count":61,"title":["In sickness and in death: Assessing frailty in human skeletal remains"],"prefix":"10.1002","volume":"161","author":[{"given":"Kathryn E.","family":"Marklein","sequence":"first","affiliation":[{"name":"Department of Anthropology The Ohio State University Columbus Ohio 43210"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael E.","family":"Leahy","sequence":"additional","affiliation":[{"name":"Department of Anthropology The Ohio State University Columbus Ohio 43210"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas E.","family":"Crews","sequence":"additional","affiliation":[{"name":"Department of Anthropology The Ohio State University Columbus Ohio 43210"},{"name":"College of Public Health, The Ohio State University Columbus Ohio 43210"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000231761.73859.2c"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470245842.ch12"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1754-4505.2003.tb00297.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2009.08.006"},{"key":"e_1_2_9_6_1","volume-title":"The Biology of Aging: Observations and Principles","author":"Arking R.","year":"2006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/evan.20239"},{"key":"e_1_2_9_8_1","first-page":"33","volume-title":"Mortality and immortality: The anthropology and archaeology of death","author":"Armelagos G. 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