In a paper published in the journal Quaternary Science Reviews, University of York’s Dr. Penny Spikins and co-authors argue that Neanderthals embraced healthcare practices, such as assisting in cases of serious injury and the challenges of childbirth.

Neanderthals in a cave. Image credit: Tyler B. Tretsven.
“Neanderthals faced multiple threats to their lives, particularly from large and dangerous animals, but in popular culture Neanderthals have such a brutish and strong image that we haven’t really thought too deeply about their vulnerabilities before now,” Dr. Spikins said.
“We have evidence of healthcare dating back 1.6 million years ago, but we think it probably goes further back than this.”
“We wanted to investigate whether healthcare in Neanderthals was more than a cultural practice; was it something they just did or was it more fundamental to their strategies for survival?”
Dr. Spikins and her colleagues investigated the skeletal remains of more than 30 individuals where minor and serious injuries were evident, but did not lead to loss of life.
The samples displayed several episodes of injury and recovery, suggesting that Neanderthals must have had a well-developed system of care in order to survive.
“The high level of injury and recovery from serious conditions, such as a broken leg, suggests that others must have collaborated in their care and helped not only to ease pain, but to fight for their survival in such a way that they could regain health and actively participate in the group again,” Dr. Spikins explained.
Neanderthals lived in small groups, so any one loss of life was particularly significant to the survival of the whole community.
Injury, over disease, was the most common threat, as Neanderthals didn’t live in the type of environment, or in large enough communities, to be at high risk from pathogens.
Neanderthal women, however, were at risk from difficulties in childbirth.
The shape of their pelvis and the size and shape of a child’s head was similar to that of modern-day humans, so it is assumed that they would also have encountered some common issues in childbirth.
“It is likely that they would have had assisted childbirth; the role that we now attribute to midwives,” Dr. Spikins said.
“Without support, they probably could not have survived the toll that the death rate of mothers and babies could have taken on their communities.”
“When we look at the daily risks and dangers involved in hunting and finding food, as well as in childbirth in respect to their small hunting communities, it is not surprising that they would develop practices to improve health and reduce mortality risk.”
“We can start to see healthcare as a pattern of evolutionary significant collaborative behavior, alongside hunting together, food sharing and parenting. In this we can see why providing healthcare to those in need today is such an important part of human life.”
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Penny Spikins et al. Living to fight another day: The ecological and evolutionary significance of Neanderthal healthcare. Quaternary Science Reviews, published online September 19, 2018; doi: 10.1016/j.quascirev.2018.08.011