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Impact of Urbanisation on Population's Health in Mtskheta Region – Georgia

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Impact of Urbanisation on Population's Health in Mtskheta Region – Georgia Impact of urbanisation on population’s health in Mtskheta region – Georgia, from Late Bronze Age to Early Middle Ages A thesis submitted by Marine Chkadua ORCID: 0000-0002-2426-4006 in total fulfillment of the requirements of the degree of Doctor of Philosophy December 2019 Department of Anatomy and Neuroscience Medicine, Dentistry and Health Sciences Faculty The University of Melbourne ii Abstract The emergence of urbanisation is considered to be an important period in human history as it is associated with an increase in population density, diversification of subsistence activites, and the establishment of ancient cities, often with poor sanitation. Each of these factors contributed to the spread of disease and a change in diet. Numerous investigations suggest that the impact of early urbanisation on population health and diet is not homogeneous everywhere but varies based on the particularities of the region in question. The Caucasus is one such region. Located between the Black and Caspian seas it has always been chracterized by vibrant cultural dynamism. It acted as a frontier between urban societies of the ancient Near East and the nomadic populations of the ancient Eurasian steppes. As such this is an excellent location to study the effect of urbanisstion on health and diet. This dissertation focuses on paleopathological examinations of skeletal materials from the region of Caucasus, specifically the Greater Mtskheta territories located in the central part of the south Caucasus. The anthropological material from Greater Mtskheta forms one of the largest collections in the region. Human skeletal materials from 13 cemeteries, from three important time-periods were examined: the Late Bronze/Early Iron Age pre-state society with rural-type settlements (15th– 6th centuries BC); the Antique period with the emergence of urbanisation and the establishment of the Iberian kingdom (5th century BC–4th century AD); and the Early Middle Age period with developed urbanisation and the collapse of the Iberian kingdom (4th–7th centuries AD). To observe the changes in health and diet throughout these different periods, pathological conditions such as porotic hyperostosis and dental diseases—caries, periapical lesions, antemortem tooth loss and calculus—were examined. Besides these pathologies, molecular analysis of dental calculus was done for these three periods. Statistically, there were no significant differences in lesions and the degrees of activity of porotic hyperostosis. But there was a significant trend in prevalence of porotic hyperostosis across time-periods and between sex. This indicated that deterioration in health conditions during the transitional periods was gradual and did not severely affect the population. The incidences of caries, periapical lesions, antemortem tooth loss and calculus throughout the periods may be associated with changing diet. An insignificant decrease of caries lesions during the urbanisation period may suggest diversification of food production and less dependence of grain consumption, rich in hydrocarbonates, which are responsible for caries. iii A statistically significant difference in the oral microbiome in pre-and urbanised-state societies may be associated to an increase of frequency of porotic lesions on the skulls and the rise of abscesses over time. The decrease and low incidences of caries throughout the periods may be associated with the absence of specific bacteria in the oral microbiome of the ancient population of Georgia. This study is part of a growing body of research into the impact of early urbanisation on population health and diet. Using certain pathological changes on human skulls, together with analysis of dental diseases, and combining these with the study of oral microbiomes, it contributes to future research on similar topics. This is particularly relevant for the Caucasus, where this type of research has not yet been conducted. iv Declaration I declare that: The thesis comprises my original work towards the degree of Doctor of Philosophy except where indicated in the Preface. Due acknowledgement has been made in the text to all other materials used. The thesis is 43,942 words in length, including tables, figures, and bibliography. Marine Chkadua December 2019 v Preface This dissertation includes collaborative work that has been contributed by others who are acknowledged here. My principal supervisor Dr. Varsha Pilbrow provided guidance in designing the research project, formulating hypotheses, and developing the methodology and scoring rubrics for data collection. She contributed her ‘Physical Anthropology’ spreadsheet, which formed the basis for the data collection worksheet used in this thesis. Skeletal materials from the Pilbrow lab were used in testing the methodology developed for this study and Dr. Pilbrow assisted with the inter-observer error study. Abby Robinson, Dr. Aleksander Michaelewicz and Dr. Pilbrow edited the language of the first draft of my thesis. Assoc.Professor De longh helped to prepare final version of my thesis and edited the language. I carried out 100% of the statistical analyses. A/Professor De longh and Dr. Pilbrow verified 100% of my results. The ‘Statistics Consulting Centre’ of The University of Melbourne, Yvette Wilson, Kiana Kakavand, Ia Kakichashvili and Nino Butsashvili provided guidance on carrying out statistical analyses in SPSS and Prism Pad. I collected 100% of the data presented in the thesis and photos provided in the dissertation were taken by me. The dental calculus was analysed at the Australian Centre for Ancient DNA, Adelaide by my co-supervisor Dr. Laura Weyrych and her team. Dr. Weyrch assisted with the interpretation of the results and provided assistance in editing Chapter Six. Dr. Giorgi Bedianishvili assisted in preparing maps and figures. vi Acknowledgements First and foremost, I would like to express my sincere gratitude to my principal supervisor, Dr. Varsha Pilbrow for her support during my PhD study and my time in Australia. Her guidance, motivation, patience and immense knowledge helped throughout the time I was conducting my research and writing this thesis. She has been the best advisor and mentor for my Ph.D study. Besides my primary supervisor, I would like to thank my co-supervisors, Dr. Laura Weyrich and Dr. Tosha Dupras, my advisory committee members Assoc. Prof. Robb De longh and Dr. Simon Murray for their insightful comments and encouragement, but also for the challenging questions put to me which provided me incentive to widen my research from various perspectives. I am very grateful to the Anatomy department heads, Profs. Janet Keast and Gary Hime, and post-graduate coordinator, Dr. Peter Kitchener for their help and support. Due to some difficult circumstances that appeared exactly at the end of my PhD, I want to express my deepest thanks and appreciation to Assoc. Prof. Robb De longh, for his support, help and encouragement. With his help it was possible to finish my thesis as he was the only person giving me feedback on my final draft of the thesis. No words can describe how grateful I am for his time, help, advices and suggestions. My thanks and appreciation goes to Prof. Graham Hepworth of the Statistical Consulting centre of The University of Melbourne, the staff of the Australian Centre for Ancient DNA (The University of Adelaide), David Lordkipanidze (General Director of Georgian National Museum), Vakhtang Nikolaishvili, Gela Giunashvili, and Nikoloz Vanishvili of the Georgian National Museum for their help and for providing the permits to conduct my research on the anthropological collection. I thank Dr. Lia Bitadze of Tbilisi State University for letting me include in my research anthropological collections from her Laboratory of Anthropological Research. I thank my friends, Abby Robinson, Aleks Michalewicz, Ia Kakichashvili, Ani Margvelashvili and Nino Butsashvili for their advice, support and help. Without Aleks and Abby’s help in reading chapters and formatting my thesis, providing advice on life in Australia, and their friendship it would have been very difficult to complete this thesis. Ia, Ani and Nino provided advice and kept me connected with Georgia. vii I want to express my deepest thanks to the Ministry of Education and Science of The Republic of Georgia and the Melbourne International Research Scholarship for their scholarship and financial support viii I thank my fellow lab mates from the Pilbrow lab: Natalie, Peter, Tom, Julietta, and Tianshu; my office mates: Yvette, Josiane, Horace, Tess, Amelia, Linda, Kiana, Farnaz and Sherry. They provided stimulating discussions and helped me with many different issues and for fun we had together. A special thanks to my family. Words cannot express how grateful I am to my parents and my sister, my mother-in law, sister- in law and brother-in law for all the sacrifices they made on my behalf. At the end I would like to express my appreciation to my beloved husband, who spent sleepless nights with me and was always my support when there was no one to answer my queries. I want to thank also my children who were born during my study, who brought light into my stressful PhD student life, kept me entertained through my study and reminded me that there was different life other than a PhD student’s life. ix Table of Contents ABSTRACT............................................................................................................................... III DECLARATION ........................................................................................................................V
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