Post-Contact Diseases

• TRIBES AFFECTED: Pantribal
• SIGNIFICANCE: Within decades after contact with Europeans, Indigenous American societies experienced rapid population declines; although the reasons for the demographic collapse of Indigenous North Americans are complex, a prominent factor in that decline was Old World infectious diseases introduced by European explorers and settlers

After the arrival of Europeans, the estimated Indigenous population of North America began to decline. The Spanish intrusion into the Southwest and Southeast, circa 1520, launched a series of lethal epidemics that infected various Indigenous American people. The epidemiological conquest of Indigenous North America accelerated after the early seventeenth century with English and French colonization along the Atlantic seaboard. The dramatic population decline of Indigenous people continued until the early twentieth century. By 1920, 270,995 Indigenous Americans remained after the epidemiological onslaught of European colonization. They were the survivors of perhaps 1.2 million to 18 million Indigenous Americans who inhabited North America at the time of the arrival of Europeans.

Increased mortality among Indigenous Americans as a result of introduced European diseases is not attributable to a lack of sufficient immunological response to infections in general but to the fact that Indigenous Americans had no prior exposure to these pathogens. The “new” pathogens, therefore, not only created a high degree of physiological stress but also engendered cultural stress. Epidemic episodes often resulted in a breakdown in the social system, elevating mortality levels.

Although it is recognized that European infectious diseases devastated many Indigenous American societies, it also must be acknowledged that pre-contact North America was not a disease-free paradise. Biological and archaeological evidence documents the fact that pre-contact Indigenous American populations suffered from a number of afflictions. Malnutrition, anemia, and a variety of tuberculoid, trepanematoid, and other degenerative, chronic, and congenital conditions plagued Indigenous populations. The general state of health, combined with ecological and cultural factors, greatly affected the post-contact disease experience of Indigenous American societies.

Sixteenth and Seventeenth Centuries

No Old World pathogen was more lethal than smallpox, which was unleashed in the Americas during the Spanish conquest. For four years, 1520-1524, the disease diffused across Central and North America, and smallpox killed thousands of Indigenous Americans. Whether smallpox reached pandemic proportions is debatable, but in populations with no prior exposure, mortality could be as high as 60 percent. The infected Indigenous populations experienced high death rates. Florida’s Timucua population may have once had 772,000 people, but by 1524, the group was reduced to 361,000. In contemporary times, the Timucua are no longer a distinct ethnic group.

Throughout the 1500s and into the next century, twenty-three European infectious diseases appeared in Indigenous North America. In these various regions, Indigenous American populations contracted diseases on an average of every 7.3 years. Smallpox, measles, influenza, and the bubonic plague affected Indigenous American populations largely east of the Mississippi and in the Southwest. The Huron, which possibly numbered up to 35,000 people in the early 1600s, were reduced by 1640 to an estimated 10,000 people.

Seventeenth-century Europeans generally viewed the decline of surrounding Indigenous American populations as evidence of divine intervention. God would destroy “Godless savages,” they thought, so that Christian civilization could prosper. Demographically, European populations grew and expanded geographically as declining Indigenous populations relinquished their lands and resources. Those Indigenous Americans who resisted White encroachment were vanquished through genocidal warfare or reduced to mission life.

Eighteenth Century

By the eighteenth century, the European population had reached an estimated 223,000 people. Although Europeans were not the demographic majority, epidemics continued to pave the way for further colonization. Throughout the Atlantic coastal region and into the interior westward, Indigenous populations were decimated through genocidal warfare and diseases. In the southeastern region of North America, for example, the estimated Indigenous American population in 1685 was 199,400. By 1790, the population was reduced to approximately 55,900—a decline of 71.9 percent. By contrast, Europeans and Black Americans in the region increased their population to 1,630,100 or 31.4 percent.

In sum, European expansion during the first three centuries of colonization produced a demographic collapse of Indigenous American populations. Introduced European infectious diseases, combined with periodic genocidal warfare and the destruction of Indigenous lifeways, reduced Indigenous Americans to approximately 600,000. By contrast, the European population grew to 5,308,483.

Nineteenth and Twentieth Centuries

The nineteenth century represents the final century of Indigenous American population decline as a result of epidemics. During this century, twenty-four epidemics affected Indigenous American populations. Smallpox continued to appear every 7.9 years among some segments of the Indigenous American population. Between the smallpox episodes, Indigenous Americans contracted measles and cholera every 22.5 years. According to Henry Dobyns, an anthropologist and authority on Indigenous American historical demography, more epidemics occurred during this century, with more frequency, than during any other.

One of the most devastating epidemics during this century was the 1837-1838 smallpox epidemic. The disease diffused across most of Indigenous North America, but the Northern Plans region was hit especially hard. It is estimated that seventeen thousand Indigenous Americans on the northern Plains died before the epidemic subsided. Such acute infectious diseases continued to plague Indigenous American communities into the early reservation period. Only then did these infections give way to the twentieth-century epidemics of influenza, tuberculosis, and trachoma, chronic conditions that would infect Indigenous Americans until the 1950s.

The post-contact epidemic history of Indigenous North America can be described as one of continual population decline, coupled with the destruction of numerous unique lifeways. Indigenous Americans, however, during these tragic times, did not remain passive actors. Indigenous American societies employed a number of cultural adaptations to respond to the onslaught of infectious diseases. Some societies modified their Indigenous American kin systems and social organization, fused with other Indigenous nations, or created new nations from various remnant tribes. Diseases were powerful agents of cultural and biological change.

The placement of Indigenous Americans on reservations or in rural communities did not mark the end of epidemics. Acute infectious diseases have been replaced by “diseases of poverty.” Many of these afflictions reach epidemic proportions in some Indigenous American communities. Deaths from tuberculosis, type II diabetes mellitus, violence, suicide, accidents, and alcoholism exceed the national average. In addition, Indigenous Americans had to contend with another epidemic—the threat of human immunodeficiency virus (HIV) infection—a disease that made its presence felt in some Indigenous American communities.

In the twenty-first century, the opioid epidemic devastated many Indigenous American communities, with overdose death rates among Indigenous American populations surpassing those of other groups. Systemic inequities, such as limited access to healthcare and historical trauma, exacerbated the situation. Similarly, the COVID-19 pandemic disproportionately impacted Indigenous American populations, exposing health disparities and causing significant higher mortality rates than other groups.

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