At some point, this book has to end. It would be nice if we could conclude with some definitive answers to the questions posed at the beginning. Why did we go from small groups roaming the landscape to giant ones packed into apartment blocks and overcrowded commuter trains? Was it even a good idea? What evidence do we have? Is it enough?
I’ve suggested that history is a liar and bioarchaeology a more devoted servant of the truth, but the reality is that we can only investigate what we can find. The trouble comes when we do not know what it is that we’re missing in the body of evidence of all of our thousands of years of bones. Thinking back to the burial of the suicide by gunshot in the crypt of St Bride’s in Chapter 7, we can see explicit rules of society clearly and definitely recorded by history being flouted by friends, family and community undergoing the real experience of a young man’s suicide. Just a hundred and a bit years earlier, however, the sad case of Amy Stokes is a lesson in the opposite direction. The unfortunate woman hanged herself in early September 1590 and, found guilty of such a mortal sin by an inquest, was taken out to a crossroads and buried at night with a stake through her heart. We must be very, very clever indeed if we think to account for the amount of variation possible in the afterlives of the dead within societies, given all the differences that existed in the lives that have occupied our great big planet.
The late Peter Ucko’s seminal 1969 work on the many different ways to dispose of the dead practised in the world, past and present, doesn’t even touch much on archaeology, but has vast implications for how we understand lives in the past. In it, he describes ways of getting rid of the body that even a decade of CSI spinoffs haven’t come up with, all of which are perfectly normal in their societies of origin and all of which leave larger or smaller gaps in the skeletal record. Exposing the dead on arid hillsides for vultures, caching them on platforms for leopards or taking them out of the grave every year for a bit of a dance: these are just some of the ways humans live with their dead. Without careful thought and strategic sampling, we will always miss part of the story.
In looking for the answers to this book’s big questions, the first thing to understand is that we really don’t know it all yet. This applies particularly to the evidence of our earlier hominin escapades, but most of prehistory is a selection of anecdotal finds; we don’t leave obvious enough scars in the earth for archaeologists to find easily until we start to build permanent settlements.1 Of course, we certainly do find remnants of our life before settling down, but we may never have as strong a grip on where and how many people lived lightly on the land as those who burrow into it and stay there. Imposing settlement mounds are easier to spot than little scatters of stone tool debris, and the history of archaeology has not always favoured the little guys. One of the things to be said about Childe’s Revolutions – Neolithic and Urban – is that they were theorised on the backs of macro-scale artefacts: pots, buildings, things you can see with the naked eye. Now that archaeologists, myself included, spend so much time reconstructing the micro-artefacts of the past (pollen, seeds, cellular growth structures, even DNA), we find we have to rewrite the ‘big picture’ of how we first moved to no longer moving.
In chapters where we focused on the Neolithic, the revolutionary consequences of this new way of life were fairly clear. Childhood diseases, dental decay, even a loss of height all accompanied our first experiments at living agriculturally. Depending on what set of evidence you focus on, you could make the argument, and many have, that villages are the deadliest invention we have ever come up with. The category of evidence I know best is teeth, and we saw in the first few chapters that teeth especially record the struggle to survive in those early Anatolian villages. Those poor Aşıklı children were hit by some sort of disease, malnutrition or combination thereof more often than we think their foraging forebears were. And the children at Çatalhöyük, who were even more firmly embedded into the Neolithic way of life, may have suffered even more.
And yet, and yet. As our French dentist with the insatiable curiosity about syphilitic prostitutes says, the teeth of the children hold the secrets of the parents. It’s true in two ways for our Anatolian skeletons. The systematic timing of the lines on their teeth suggests that they were getting sick at regular intervals – possibly when siblings were born. The other thing to consider is, of course, that lines on teeth might mean sickness – but they mean sickness survived. Sicklier, scrawnier, but alive to produce another generation, and with more siblings besides. Cycling up by several orders of magnitude to a full-scale map of the Near East and Europe, we see the success of the Neolithic writ large in the numbers of people it produces, and in the successful spread of the genes it carries with it. We don’t know enough yet about Neolithic population scales and genetic flow in other parts of the world, but the data is coming, and we will watch it carefully to see if the faint suggestion that some Neolithics in some parts of the world were easier on our bodies than others really holds.
But the Neolithic is, of course, just a warm-up to the business we have at hand: our increasingly urban lives. I have skated around defining a city in this book because, frankly, I don’t see that it helps to declare a particular population size threshold or rattle off a list of key traits.2 What we need to know is which features of settled – then increasingly urban – life are the ones that change us, kill us and leave their traces in our bones.
This book really hinges on Chapter 5, the one about inequality, because that’s at the root of every subsequent chapter and is the defining feature of city life when it comes to our bodies and our health. Inequality is the result of specialised roles in society that get codified into differential access to resources. Specialisation isn’t limited to cities per se – people apprenticing and then working full-time as shamans or craft specialists have also been important in more mobile communities.3 But think for a bit about those new walls that go up, turning public space into private and shamans into temple priests. It takes a city to support a temple, which doesn’t just have one ‘big man’ to go with it but an entire class of bureaucrats and adjutants and priests and hangers-on and the people that fetch coffee for them in the morning. You can bet your bottom clay tablet that the head priest at the temple of Inanna eats better than the poor sod who has to fix their half-caff almond milk latte.4 That difference is real, even if I’m being facetious about it, and it manifests physically, in our very bones. Cities foster social roles that are more stratified and more profoundly separated from the means of production (where and by whom all the food and other stuff get made). Limit people’s access to resources and you in turn limit their health, undermining their natural immune response via malnutrition.
Turning to the violence we have discussed, against individuals or against entire peoples, this occurs in all of these types of settlements and cities, across time and across the globe. The head-smacking and the genocidal campaigns actually predate urban life by some margin, with clear evidence emerging in the archaeological record that people have a long history of being, well, terrible people. But, having gone through the old arguments, it’s hard to disagree with Keeley in Chapter 8, who saw us as red in tooth and claw but, crucially, getting better about it. I’m not optimistic that people will ever stop smashing each other – with fists, with pint glasses, with baseball bats. Nor do I look around the shattered lives and pockmarked landscape of places I’ve lived and worked in and see an end to war. No one could look at the fate of the Yazidi women captured by ISIS in their rampage through the former Mesopotamia and argue that people are not dying as horribly as they did 5,000 years ago. I would like to be able to say that we can follow Keeley’s thesis that war is no longer as fatal as it once was to a happy conclusion: that states have a pacific effect. This would mean accepting that the numbers and types of people killed have narrowed; that war is between great nation-state combatants and not some sort of community genocide where you smash the legs in just for good measure. But there are massacres in this recent world too: in Yemen, in Syria, in Sudan and other places where the state has failed but the villages, cities and people remain. And when we think of mass causalities, do we forget that it wasn’t just fighting-age men in Nagasaki and Hiroshima? If this is the pax of a global nation-state system, it’s too wretched to take any joy in.
If you think about the types of structural violence, the kind that comes with a power differential, the vast majority are now on the way out. Not fast enough, and in some places the numbers have not moved an inch, but the very fact that we have a medical and legal framework for discussing child abuse is a remarkable change from the hundred years previous. There is an increasing trend away from corporal punishment in Europe; it has been banned in schools and even homes in some countries. The UN Convention on the Rights of the Child is, yes, an airy bit of UN-speak, but it enshrines principles we might actually all someday adhere to. Domestic violence aimed at women is another area where the crushingly morbid statistics hide the flickering lights of hope. There are cultural changes happening at a glacial pace, but again, legislation is slowly wending its way into ever more countries. The funding for organisations like IMECE, the local domestic violence charity that helps members of the Turkish-speaking community near where I live, has been slashed and burned in the name of austerity politics, but I still see their employees going to work every day and giving their free time at night to women’s rights issues around the globe. Campaigns against marital rape, child marriage and all forms of domestic abuse have entered the public awareness, not just in cushy Western Europe and North America, but on a global scale.
One in three women experiencing domestic violence in her lifetime is still abhorrent. But there are reasons for optimism; I for instance take great joy in the work of Mona Eltahawy, who manages to be a feminist just fine, communicating her message in societies usually dismissed as being unsalvageably misogynistic. I think there is actually a slightly paradoxical argument for the main agent of structural violence – the state – being in more recent incarnations the agent of decreasing structural violence. The abandonment of the death penalty, and the prosecution of extra-state, extra-judicial killings like those of so-called witches, suggest a pattern where state-sponsored structural violence is decreasing, not increasing. Again, not fast enough for the people caught with the rope (or the tire) around their necks. And there are extremely worrying trends towards the use of drones or special forces to carry out killings that would be illegal in the state that ordered them. But where once capital punishment was the norm, it’s now a last resort, or even, in the case of many countries, the subject of an outright ban. It’s hard to imagine any modern nation-state returning to the days of plucking the bloody, still-beating hearts out of prisoners of war, so perhaps we can count that as progress.
Cities also play many roles in a larger political landscape. They might be regional hubs, drawing in the loyalty and resources of a territory that lacks clear borders or edges based on geographic or cultural convenience. Cities might exert very little power beyond their own domain. Or cities might be parts of a larger whole. Think of Caffa, the Silk Road city that sent plague back to Italy, which had all the hallmarks of urbanism (dense population, walls and a bureaucracy), but that just happened to be run by people from hundreds of miles away. You could have dropped Caffa on the moon and it still would have functioned, as long as there were trade routes to sustain it.5 Cities might also be cogs in the regional machine, instruments of a larger power. Alternately, they might stand alone, pinned into limited territory claimed by rivals of similar size and strength.
Cities draw in population through some arcane formula fought over by social scientists for hundreds of years. Part of this is native internal growth, a phenomenon we have discussed mostly in terms of the Neolithic Demographic Transition: an increase in agricultural calories and the reduced requirements of staying put spur birth rates upwards. However, growing past the scale of villages and into the heady numbers of the more properly urbanised world, cities incubate not just people but all the things that kill people: inequality, disease, other people. These are the three things needed to unleash the catastrophic mortality of epidemic diseases and the horrific physical consequences of some of our more disfiguring endemic ones. We can actually see the role that our cities play in controlling which disease we get in two ways. In the first, we see the diseases of density: diseases that need a big enough reservoir so that they can burble away in the background, slowly making your fingers rot off. For the second function, we see the diseases of enhanced urban connection: take all of these lovely endemic problems that we’ve been carefully cultivating and fling them over the parapets at whomever we meet. The decimation of the Americas was set in motion by the globalisation of the urban world and by cities in contact with other cities, constructing rapacious nation-states on the back of resource acquisition and competition. It’s not hard to imagine that our globalised network of disease could come back to haunt us some day.
Cities are mortality sinks. The death rates, especially in the post-Black Death European cities for which we have the most evidence, are clearly outrunning the birth rates. But a quick shuffle of the economic order and they then turn that demographic frown right back upside down by attracting new residents, drawn by the prospect of participating in a waged labour economy. But as we’ve seen, that work can kill you, break down your bones and leave scars on your skeleton. What’s more, it’s done in a dirty, filthy world, where the sheer number of people leaves the streets paved in what I will euphemistically call horse-gold, and worse. Yet you cannot kill so many people and have it go unnoticed, and this may be the secret of the modern city’s success. So many eyes on so many problems will, however grindingly slowly, force action. We saw it happen in an instant with Snow getting that pump handle removed,6 but we saw it happening slowly, around the edges of the main thrust of our story, too. Leprosaria. Hospitals. Even the dreaded workhouses, which, remember, were not actually meant to kill people. The outrage at the working conditions, the living conditions and the filth of the city is funnelled into a force for change.
This, I think, is the heart of the matter. To strip away any nuance and come back to a simple idea: societies adapt – and physically concentrated urban societies perhaps more rapidly than most. It’s easy to see the scope of the challenge we have set ourselves to adapt to. In the Marxist sense, cities remove people from the means of production. They accumulate people who must specialise in some form of exchange in order to survive. The power any individual has over this set-up is not some God-given equal share of an esoteric money pie, but instead reflects hoarded wealth (whether investment in physical survival, material goods or otherwise) and social status, both of which can be either built up or lost on the throw of dice.
Cities allow the accumulation of surplus, both of people and things, and that can be exploited. That surplus becomes a more fluid object than the harvest it derives from; it can be invested, capitalised and used to start sending out little urban tentacles of power to feed back into the gaping urban acquisitive maw. The absolute necessity of having lapis lazuli beads brought a couple thousand miles from Afghanistan to a small river valley in southeastern Turkey, as happened at Başur Höyük in the third millennium, is not because some vain chief decided he needed a bit of blue to his bling (although that may have been part of the process). The lapis in those graves is the eventual outcome of a larger metals trade, a peoples trade and those Uruk Starbucks-style colonies. The push factor comes from the need to be seen with the power to acquire such an exotic thing in an increasingly settled, urban and urbane world that is filling up with such goods.
The urban tentacles, eventually, get everywhere. They encircle agricultural systems, locking people onto land and creating pools of labour (voluntary or not) that can be exploited to feed more profitable industries – whether it’s Mesopotamian weaving factories or armies to besiege Naples. The global connections we have talked about in terms of the transmission of disease could just as easily be discussed as the transmission of a creeping network of trade, of exploitation, of shipping thing A to place B, and unintentionally creating a world of cities that are linked through roads and sea lanes, air travel, migration and, above all, the buying, selling and trading of things. As a species, we seem to have accidentally created a global market that we don’t quite know what to do with. In its very bones and with all of its health consequences, the urban European world of the last few chapters is one only possible with lopsided trade, crass exploitation of labour and gross inequality.
And yet. I will rather controversially say that cities are not inherently a bad thing to adapt to. Inequality is a bad thing. Inequality, as we have seen through the course of this book, is the driving force in killing humans since we came up with this whole urbanism lark. And the driving force behind that inequality is two-fold. On the one hand, we have a world where the financial engine of all of our great cities is built on rewarding acquisition and hoarding capital; this is why the insanely wealthy own everything and you do not. Think what it takes for that statement to be true. The wealthy are not better than you, and many of them merely have better inherited investments. Those investments are crystallised in a monetary economy geared towards rewarding capital, and expressly for establishing fluid and expansive modes of financing things – things like expeditions to new continents where more money and more things can be acquired. New continents full of money are required because it’s very expensive to be a nation-state – to field a standing army, to defend territory against other nation-states and, critically, to show off your extraordinary wealth to the other five people at the top of the urban food chain. None of this capitalisation would have been necessary if a little bit of lapis lazuli had been enough to wow the guys back home at Başur Höyük, but of course, once the transport is good enough, who doesn’t have some foreign goods? No one in their right mind would go to the time and effort of acquiring endless amounts of bronze, trading it and developing complicated burial practices just for a bit of bling if there was an easier way to achieve power, the guys sitting at the edge of urban life just said: ‘Hey. Great job on the Creation Eagle story. We’ll bury you with a lot of tortoises.’
Probably not. Which is what takes us all the way around the houses to the second reason that it’s inequality we should be blaming for urban deaths. To go right back to the example of Barbara and that Creation Eagle story in Chapter 5, collectivism is based on a way of life that depends on biological determinism including factors such as overall strength and the ability to give birth; and it sucks for a large number of people. What you call meritocratic your wives, children and pets might call tyranny. The past is not, as the yoghurt-crocheters would have it, an egalitarian wonderland. It may have been less brutal than the economic inequalities we can see written in our paycheques, in world poverty statistics, in the endless stream of sexist, racist, homophobic invective that is the comment section of any major news site and, most starkly, in the global health outcomes for the haves and have-nots. We cannot, however, assume that a world where the demands of biology were unsurmountable was uniformly kind.
Cities remove people from the means of production, and that cuts both ways. It allows them to support specialists, it allows for the creation of new kinds of specialisation and it keeps churning over the social structures that encourage innovation and adaptation. For a very large part of our urban history, the price cities have paid for that adaptability has been high. Specialists and non-specialists alike get wiped out in plagues that ferment in cities and run riot along the roads between them. Cities with walls get those walls smashed and their inhabitants perish alongside. That separation from the agricultural base for urban life means that, in a bad harvest year, neither love nor money will save the urban citizen. It has been a tortuous road, and I don’t think that even the most optimistic of souls can say our urban future is one of immediate escape from the inequality that has plagued us for thousands and thousands of years. But those specialisations, as limited as they are to a privileged urban class, are freeing in a way that nothing else in our evolutionary history has ever been.
It’s a very unique and recent specialisation, coming on the back of a long line of increasing specialisations in medicine, in health and in governance, that leads us to a reason for optimism about our urban future. These are the august international bodies, consolidated out of very specialist knowledge indeed, designed to compile and collate health policy and research from all corners of the globe. Their very existence is something that not even John Snow could have predicted. From our little isolated villages we have built ourselves into cities, and then linked those cities so thoroughly together that we come at last to a point where we can directly discuss health in a global context. Indeed, it is critical that we do so, because what kills people in China today can kill people in Brazil tomorrow; our world is so relentlessly connected that individual outbreaks of famine, war and disease are no longer the concerns of one great city or one nation-state, but the problem of all. At the time of writing, this is most evident in the collapse of Syria, which has sent refugees scrambling for security in an increasingly xenophobic, protectionist world. Two hours from the Syrian–Iraqi border, I have won (and lost) rather unequal footraces with children whose parents escaped from Syria into the uncertain limbo of Turkish asylum in the last few years and now live in a converted school behind the dig house. Five minutes from my home in London, I have watched the tents of refugees spring up among the cowslip and bramble that line the edges of the local park. These are global problems, which, while heartbreaking and seemingly intractable, offer at least some potential rays of hope.
The World Health Organization is one of those rays of hope, as are the many international charitable and government organisations that take world health as their remit. Our global world has its global challenges, yes, but it also has the seeds of the structures H. G. Wells and all those wide-eyed internationalists dreamed of more than a century ago – structures like the United Nations, the International Criminal Court and the World Health Organization. And it’s through these international structures that we start to see the edges of a picture of human evolution that has yet to be fully painted in, the edges of new social and cultural adaptations that will change us yet again. We can see in the archaeology of our ancestors the signs of violent conflict, the burden of disease and the risk of being (or becoming) human. We can see in the archaeology of our early experiments with settling down the new threats we unleashed. We dig up our earliest cities and read the history of our urban past, with its wars and its diseases of density and inequality. We can look to the beginning of our own global era and see our cities as engines driving disease and conflict across continents and oceans, killing more people than even existed when we started this game 15,000 or so years ago. And finally, finally, we can look at the present, with these global risks, and we can see what urbanism has done to us.
The World Health Organization has drawn in the borders of our urban world with stark warnings. Urban living can be deadly, and this is as true now as it was 3,000 years ago. The urban poor living in 2015 are not only worse off than their richer neighbours, they are worse off than their rural counterparts. But by 2030 it is estimated that 60 per cent of the world’s populations will be living in cities; we apparently are not giving up on this urban experiment any time soon. Is this nothing more than an exercise in masochism? Walking between the rough sleepers on a street in Cairo, Tokyo or San Francisco, you would be forgiven for believing exactly that. But there are moves afoot to break the crippling hold that inequality has on our species’ health and survival. And, like modern urban cities, they are global in nature. Campaigns to eradicate disease such as polio and malaria cross national and social borders. Across the planet, individual cities subscribe to a global ideal of reducing health inequalities. There are targets identified: universal health coverage; using population density to combat disease transmission and establish immunity (instead of the other way around); treating those conditions that accompany urban life and inequality, like malnutrition; safe water, safe travel, safe homes; sustainability; and mobility. These are actually the headings given in the World Health Organization and the UN-Habitat’s joint 2015 Global Report on Urban Health. And slowly, grindingly slowly, we are making progress. It can seem, in late 2016 as I write this, that the mechanisms of democracy and progress have broken down. The gears of our world have slipped. But it is still possible that among the gnashing metal teeth of our social structures, a new, better fit will be found. More and more, cities are leading the way in this. We have not reached the point where we are any good at living in cities, but give us time. It took hundreds of thousands of years to work ourselves up to settling down; but in 15,000 years we have transformed into a species where no aspect of life can be assumed untouched by urbanism. If we are going to be 60 per cent urban by 2030, then we are going to have to get better at it. Happily, adapting is what humans do.
Like nearly two centuries of wide-eyed speculators on the human future before me, I still see the city as a promise. It’s currently an unfulfilled promise until we can deal with the inequality that has picked us off huddled mass by huddled mass, but our densely packed urban lives offer the opportunity to adapt, to invent and to collectivise in ways that don’t rely on base biology. You would think it would be very difficult to write an entire book on such a long stretch of horrific human experiences and come out of it an optimist, but by and large I am. Inequality is the killer. Urbanism offers another way out. I can only really speak to my own experience, but of course that is one of the secrets of archaeology – interpretation is never really free of the personal. The city, you see, has jobs. The city thinks it’s a good idea to provide specialist employment for female people who are adamant that thin-sectioning 10,000-year-old teeth is critical to understanding the human condition. So it seems that, however much it has warped our bones, rotted our teeth and inflamed our sinuses – the city is right.7
1 To everyone who has ever worked on an isolated microlith scatter or at the bottom of a terrifyingly narrow cave system: I salute you.
2 Also, it’s very, very difficult and escalates to esoteric social concepts very quickly.
3 Much of the pottery we see in the prehistoric world that looks so similar we refer to it as a ‘type’ may have in fact occasionally been made by the same people, or carried by the same people – all these itinerant pots going around messing up our concepts of territory, trade and mobility in the deep past.
4 Always tip your barista.
5 Okay, yes, and atmosphere and boats to Genoa and all the other things medieval Genoese couldn’t survive without.
6 Turns out he did know something after all.
7 A list of references is available at https://figshare.com/articles/BOB_full_bibliograpphy_pdf/4106247. DOI: 10.6084/m9.figshare.4106247.v1