Along with answers above, you also need to consider that up until recently, we were very open to nature dictating things.
So compromised genes from inbreeding that manifested as a complication may not live long enough to matter, or would be lost in the shuffle. After all, if you’re bringing food home, who cares if your teeth are a bit screwy (before modern dentistry especially) or you had webbed toes, or some type of genetic predisposition (before we figured out genetics especially).
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