Thicker Than Water

A powerful and critical investigation of iron deficiency in women throughout evolutionary history and in our current society

Women of the world are beset by a hidden hunger: iron deficiency. Up to 40% of reproductive-aged women across the globe have iron deficiency anemia, and it contributes to 20% of maternal deaths. Despite these dire statistics, women are not routinely screened for iron deficiency. Iron deficiency has been used as a tool to control, categorize, and even ignore women and their suffering. Biomedical remedies - mostly iron supplementation - are unequally and indifferently applied to global populations of women.

Thicker Than Water explores the reasons women are especially vulnerable, using evolutionary theory and social theory to understand the causes and consequences of iron deficiency in women. Contrary to popular belief, homeostasis protects the iron stores of women from iron loss during menstruation. Women's iron metabolism has evolved to balance the benefits and danger of iron, protecting vulnerable embryos against excessive iron at the cost of reduced iron stores for themselves. This balancing act is threatened when social circumstances prevent women from accessing the dietary iron they need.

Exploring how race, poverty, and gender are entangled with women's evolved bodies, Dr. Elizabeth M. Miller brings a new anthropological lens to this issue that deeply affects and even threatens women's lives. Ultimately, this book shows that women's evolved bodies - optimized to protect themselves and their offspring - are devastated by structural forces beyond their control.