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Periosteal reactions, porotic hyperostosis, and cribra orbitalia have been traditionally used in bioarchaeological studies as indicators of poor "health." However, the etiology of these conditions is greatly debated, not to mention the fact that the presence of these non-specific indicators of disease may in fact represent individuals who were able to combat the insult. Bone is limited in the way it can respond; therefore, the osteoblastic and osteoclastic responses involved in these indicators can represent a range of responses to stress (nutritional or environmental), disease, trauma, or congenital conditions. The clinical literature is quite varied on the cause of these skeletal conditions. With a reinterpretation of these pathological conditions in mind, we evaluate data on these three osteological markers of stress in a large skeletal sample from central California (n = 3000+) spanning nearly 5000 years (3050 BC – AD 1899). While there are temporal and regional trends in these skeletal markers, they do not always correspond to known periods of stress (e.g., environmental disruptions, European contact), and do not correspond with each other in terms of prevalence. We, therefore, offer an alternative explanation of these pathological conditions in light of these findings. Patterns of periosteal reactions may be a marker of survivability as they are most commonly seen in older individuals and decrease in times of extreme stress. Patterns of cribra orbitalia and porotic hyperostosis tend to track with times of stress; however, they are predominately seen in old adults. The lack of detailed data collection further makes their interpretation difficult. • Stress and health are complicated phenomena to interpret in bioarchaeology. • Traditional nonspecific stress indicators do not always correspond to stress. • Interpretations of past health and stress should incorporate clinical literature. [ABSTRACT FROM AUTHOR]

Highlights: [•] Three forms: sharp force/projectile trauma, blunt force trauma, trophy-taking/dismemberment. [•] Violence rates highest in areas of highest population density and interface zone between groups. [•] Early peak in trophy-taking/dismemberment: Early Middle Period (500 B.C.–A.D. 420). [•] Peak in blunt force craniofacial trauma and sharp force/projectile trauma: A.D. 1720–1899). [•] Introduction of bow and arrow ca. A.D. 1000–1200 associated with increased violence. [ABSTRACT FROM AUTHOR]