AbstractInteractions between humans, animals, and the environment facilitate zoonotic spillover—the transmission of pathogens from animals to humans. Narratives that cast modern humans as exogenous and disruptive forces that encroach upon “natural” disease systems limit our understanding of human drivers of disease. This review leverages theory from evolutionary anthropology that situates humans as functional components of disease ecologies, to argue that human adaptive strategies to resource acquisition shape predictable patterns of high‐risk human–animal interactions, (2) humans construct ecological processes that facilitate spillover, and (3) contemporary patterns of epidemiological risk are emergent properties of interactions between human foraging ecology and niche construction. In turn, disease ecology serves as an important vehicle to link what some cast as opposing bodies of theory in human ecology. Disease control measures should consider human drivers of disease as rational, adaptive, and dynamic and capitalize on our capacity to influence ecological processes to mitigate risk.