Lecture 1: Introduction to Medical Anthropology

Wednesday, January 10, 2018 5:57 PM

(the past before writing)

Two key words:

1) Biocultural
2) Biomedicine

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 All of these are biological terms.

Concerns of patterns of health and disease - both heavily invested terms.

Health is a complex definition - of how people are feeling about their well-being (very subjective).

(why is one population is more or less affected?)

(perception of
disease)

- Surrounding environment (family)

Disease is a term closely tied in with biology. - Risk factors in environment
Prevalence is an epidemiology term : - Genetics
- Frequency of a disease in a population
Incidence is another term:
- Number of occurrences

Broad term.
Holistic discipline.

19th Century Colonialism

- Exposure to new populations and cultures of European explorers
- Very European centric in history
- A lot of population movement
- People from European context were exploring and conquering many different places and population
- As they went around the world, they saw the range of diversity in humans
- That raised interest in trying to understand and describe it
- So anthropology came out of these early observations that stimulated early interest.

There has been a strong power differential between the people who were studying and the people who were being studied.
Lead to serious misunderstanding.
Anthropologists occasionally influencing health policies that weren't productive but also some that were productive.

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 Important to who
Franz Boaz became.

(studying disease - looked at human remains)

(concerned that distribution of disease was heavily influenced by patterns in society - ex. socioeconomic disparity)
(bulldog of Darwin) Virchow was concerned that the evolutionary
theories would become applied in a context
that could become negative -- like social
Darwinism; but he did not completely disagree
with its primary tenets. He just saw the danger
Learned from Virchow in his early scholarly days. of it so he became an opponent of it.

- Became the father of North American anthropology

- Trained the next generation of anthropologists

(moved to US; has hard science bkg) - Interested in world population - He decided to record the cultures
- Spent a lot of time in the Arctic - But also biological aspects of it
- Thought cultures were disappearing - Rigorous recording; very methodical

Each culture has to be perceived within its own right; can't be perceived in relation to any other culture.
Stepping against the perception of Social Darwinism and that some cultures are more superior/inferior.

We have a culture developing out of its unique historical circumstance. Cultures are
evolutionary products in a sense. They are products of whatever was experienced in
the past. There are some foundation for why they are in a certain way.
Unless you understand the details and put
it within that historical context, you aren't
Taking in the bigger picture of all of the components and detailed studies.
really going to understand anything.

These are the fundamental tenants of Franz Boas.

Ethnography is a primary method in medical anthropology (the recording of cultures).

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 Typical of medical anthropology in North America.
Taking all different components in the study of humans.

You are going to need to segment it in some way.

But they will all relate somehow - so you can't completely separate them.

There is crossover between all of these fields.

Interest in health patterns in population. Trying to treat conditions.

Aside from physicians, there were also missionaries (ppl from christian church).
They were also interested in the same things as physicians.
Except --> supernatural belief for e.g. in what causes a broken bone.

Took detailed field accounts of a number of societies; he wanted to emphasise cultural context in healing
practises. You can't change a practise, if you don’t understand the context of the previous one.
- If a population wasn’t following the recommendation of WHO…
- WHO wanted to figure out why and get to the root of it
Trying to institute
universal health care.

Because WHO's
concerns are global.

2nd point for post WWII (^): Boiling water initiative - to kill a lot of pathogens in the water. Water takes a lot of energy to boil. If you don’t have
enough fuel to boil it; it’s a problem. if hot environment, why boil it? If you are with a population that does not have theconcept of germ theory,
why are you going to spend all this fuel on boiling water for something you can't see? Need to understand all of these barriers.

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Second point:
- Uses any combination of them too!
- Can involve both biology and culture.
- Or also linguistics.
- E.g. how does a language describe illness/disease experiences? Is the reason why
you are not seeing high rates of PMS in certain populations because their
language does not reflect as to the way we reflect it in English?
- We sometimes bring in archeology, if you are trying to understand past health a
bit more and what people left behind (material culture remains).
Third point:
- Might involve completely different cultures from different parts of the worlds
- And also subcultures of two different populations

(process of spending a lot of time with the population you are studying; getting
to know them; spending a lot of time recording - physically writing or using a
voice recorder or using a survey)
(integrating with the community so that you become an accepted member in
some sense; may even be adopted by that community; at the same time you
are the researcher; so you need to step back and take an objective perspective
in terms of what is going on)

(inside)
Sometimes hard to
(outside) separate the two
Integrating with the community - hard to maintain an etic perspective…

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- You may change how they are functioning by your presence (you have to be aware)
- Personal biases (what perception are you bringing into the field that will influence observations - sometimes they are subconscious)
- Morals of how things should or should not be done (ex. you see a practise of feeding that from your western perspective is no t
productive in health but you are trying to understand that practise)
- Who you are and what you are could have an influence (ex. if you are a woman going into a patriarchal society, or your race)
- The nature of society is variable (ex. if a society is less trusting, may be more difficult to access info you want to get at )
- Language barriers (things can get lost in translation - may misinterpret important things)
- May also miss bodily languages that have a particular meaning; could be very subtle

- Medical anthropologists start with biomedical basis

- Western understanding that is based on germ theory and biological basis for all disease
- But with biocultural approach, we understand there are range of factors that will
influence what we are seeing…
- Abiotic environment --> ex. lead poisoning, or soil/climatic factors affecting health
○ The plague in Madagascar; seasonal pattern - also with malaria
- Biotic factors (what is in that environment and how that influences disease)
- Outside of those, we have cultural practises and traditions --> how people are
interacting with the environment
○ Ebola epidemic; cultural practise of how dead people were handled influenced
the spread of Ebola
- Outside of this is population history
○ How a population has experienced health and disease in the past and how this
will shape their responses to it now and shape them in a biological level
- Outside is also evolutionary history which is more broader
○ Looking at patterns in a species or even bigger populations
○ Example: primates cannot produce their own vitamin C, but species outside of
primates can

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 How our bodies function, understanding variation, and common patterns.

Whether infection, metabolic, etc. you want to

understand the underlying process.

- Travel
- Sickness
Exercise (think, pair, share)
- Think of an ill health experience you had (injury or cold)
- Participant (health determinants, what influenced your experience?) and observer (etic perspectives)

(can identify methodically to narrow

options, via repeated testing)
(describe illness to doc, whom
will narrow it down to a cause)

(separation of the brain and the body)

(standard we can apply
across populations -
something that is consistent)
Problem: it's very focused on biology to the
exclusion of everything else that could be
Try to understand the other circumstances that are influencing the experience of the disease by cross -population comparison. influencing the situation

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(rather than just the biological perspective)

(to influence change)

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