Evolutionary medicine, also called Darwinian medicine, derives its intellectual and theoretical base from the theory of natural selection. Differences in mortality and reproductive success linked to genetic traits lead to the differential intergenerational transmission of those traits. Traits that emerge from random mutations and that prove beneficial in given environments are differentially transmitted and retained under selective mortality over many generations. Selective forces include climate, altitude, food availability, environmental hazards, and disease.
Hypothetically, genetic variation providing resistance to infection, accommodation to nutritional deficiency, or acclimation to environmental constraints such as hypoxia are retained at varying rates in diverse populations due to differential survival and differential reproduction. That is to say, variants are correlated with increased Darwinian fitness. Stressors affecting the survival of children and the fecundity of young adults are most pertinent. While discrete genetic markers such as hemoglobin variants are easiest to correlate with morbidity, mortality, and fertility rates, behavioral traits may clearly correlate with fitness. Pregnancy management techniques, dietary patterns, birth systems, and infant care are non-genetic variables with immense importance in maternal and child survival rates in rigorous or pathogenic environments.
Differential fitness involves more than disease resistance, of course. The evolution of successful reproductive traits and strategies is a central interest in biocul-tural anthropology (Trevathan, 1987) and underlies much of "life history" theory (Hill & Hurtado, 1996). Parental care (especially maternal stimulation and bonding) has been studied in relation to normal and abnormal infant and child development in various environments, including historical conditions of extreme poverty in which child abandonment and infanticide were common (Hrdy, 1999).
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