The most probable evolutionary explanation for apparently ‘selfless’ care ofadult group members lies not only in the benefits of helping relatives but also the selective advantages of reducing the risk of mortality of other group members in situations where groups are highly interdependent (Frank and Linsenmair, 2017). The selective benefits of  are for the ill and injured are clearest where groups consist of close relatives. However where the survival of any one member is strongly linked to that of the others in  the group caring for those who are injured is still selectively advantageous even without a high degree of genetic relatedness.

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Living to fight another day: The ecological and evolutionary significance of Neanderthal healthcare

Penny Spikins, Andy Needham, Barry Wright, Calvin Dytham, Maurizio Gatta, Gail Hitchens

Evidence of care for the ill and injured amongst Neanderthals, inferred through skeletal evidence for survival from severe illness and injury, is widely accepted. However, healthcare practices have been viewed primarily as an example of complex cultural behaviour, often discussed alongside symbolism or mortuary practices. Here we argue that care for the ill and injured is likely to have a long evolutionary history and to have been highly effective in improving health and reducing mortality risks. Healthcare provisioning can thus be understood alongside other collaborative ‘risk pooling’ strategies such as collaborative hunting, food sharing and collaborative parenting. For Neanderthals in particular the selective advantages of healthcare provisioning would have been elevated by a variety of ecological conditions which increased the risk of injury as well their particular behavioural adaptations which affected the benefits of promoting survival from injury and illness. We argue that healthcare provisioning was not only a more significant evolutionary adaptation than has previously been acknowledged, but moreover may also have been essential to Neanderthal occupation at the limits of the North Temperate Zone.