A Companion to Medical Anthropology

554 Pages·2011·2.213 MB·English

by  Merrill Singer, Pamela I. Erickson

A Companion to
Medical Anthropology
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The Blackwell Companions to Anthropology offers a series of comprehensive syntheses
of the traditional subdisciplines, primary subjects, and geographical areas of inquiry
for the field. Taken together, the series represents both a contemporary survey of
anthropology and a cutting edge guide to the emerging research and intellectual
trends in the field as a whole.
1. A Companion to Linguistic Anthropology edited by Alessandro Duranti
2. A Companion to the Anthropology of Politics edited by David Nugent and Joan
Vincent
3. A Companion to the Anthropology of American Indians edited by Thomas Biolsi
4. A Companion to Psychological Anthropology edited by Cornerly Casey and Robert
B. Edgerton
5. A Companion to the Anthropology of Japan edited by Jennifer Robertson
6. A Companion to Latin American Anthropology edited by Deborah Poole
7. A Companion to Biological Anthropology edited by Clark Spencer Larsen
8. A Companion to Medical Anthropology edited by Merrill Singer and Pamela I.
Erickson
Forthcoming
A Companion to Cognitive Anthropology edited by David B. Kronenfeld, Giovanni
Bennardo, Victor de Munck, and Michael D. Fischer
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A Companion to
Medical Anthropology
Edited by
Merrill Singer and
Pamela I. Erickson
A John Wiley & Sons, Ltd., Publication
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This edition first published 2011
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Contents
Synopsis of Contents viii
List of Figures xix
List of Tables xx
Notes on Contributors xxi
Acknowledgments – Personal xxxii
Acknowledgments – Sources xxxiii
Introduction 1
Part I Theories, Applications, and Methods 7
1 Medical Anthropology in Disciplinary Context: Definitional
Struggles and Key Debates (or Answering the Cri Du Coeur) 9
Elisa J. Sobo
2 Critical Biocultural Approaches in Medical Anthropology 29
Tom Leatherman and Alan H. Goodman
3 Applied Medical Anthropology: Praxis, Pragmatics,
Politics, and Promises 49
Robert T. Trotter, II
4 Research Design and Methods in Medical Anthropology 69
Clarence C. Gravlee
5 Medical Anthropology and Public Policy 93
Merrill Eisenberg
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vi CONTENTS
Part II Contexts and Conditions 117
6 Culture and the Stress Process 119
William W. Dressler
7 Global Health 135
Craig R. Janes and Kitty K. Corbett
8 Syndemics in Global Health 159
Merrill Singer, D. Ann Herring, Judith Littleton, and Melanie Rock
9 The Ecology of Disease and Health 181
Patricia K. Townsend
10 The Medical Anthropology of Water 197
Linda M. Whiteford and Cecilia Vindrola Padros
11 Political Violence, War and Medical Anthropology 219
Barbara Rylko-Bauer and Merrill Singer
Part III Health and Behavior 251
12 Humans in a World of Microbes: The Anthropology of
Infectious Disease 253
Peter J. Brown, George J. Armelagos, and Kenneth C. Maes
13 Sexuality, Medical Anthropology, and Public Health 271
Pamela I. Erickson
14 Situating Birth in the Anthropology of Reproduction 289
Carolyn Sargent and Lauren Gulbas
15 Nutrition and Health 305
David A. Himmelgreen, Nancy Romero Daza and Charlotte A. Noble
16 Anthropologies of Cancer and Risk, Uncertainty and Disruption 323
Lenore Manderson
17 Generation RX: Anthropological Research on
Pharmaceutical Enhancement, Lifestyle Regulation,
Self-Medication and Recreational Drug Use 339
Gilbert Quintero and Mark Nichter
18 Anthropology and the Study of Illicit Drug Use 357
J. Bryan Page
Part IV H ealthwork: Care, Treatment,
and Communication 379
19 Ethnomedicine 381
Marsha B. Quinlan
20 Medical Pluralism: An Evolving and Contested Concept
in Medical Anthropology 405
Hans A. Baer
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CONTENTS vii
21 Biotechnologies of Care 425
Julie Park and Ruth Fitzgerald
22 Social Interaction and Technology: Cultural Competency
and the Universality of Good Manners 443
Kathryn Coe, Gail Barker, and Craig Palmer
23 Biocommunicability 459
Charles L. Briggs
24 Anthropology at the End of Life 477
Ron Barrett
Part V The Road Ahead 491
25 Operationalizing a Right to Health: Theorizing
a National Health System as a “Commons” 493
Sandy Smith-Nonini and Beverly Bell
26 As the Future Explodes into the Present: Emergent Issues
and the Tomorrow of Medical Anthropology 515
Merrill Singer and Pamela I. Erickson
Index 533
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Synopsis of Contents
PART I THEORIES, APPLICATIONS, AND METHODS
1. Medical Anthropology in Disciplinary Context: Definitional Struggles and Key
Debates (or Answering the Cri Du Coeur)
Elisa J. Sobo
By setting the development of medical anthropology over the last 60 years in historic
context, this chapter focuses on ongoing struggles to define the field. During the
1960s and 1970s, debate and organizational efforts in medical anthropology centered
on issues of applied versus theoretical approaches and whether a specialized focus on
application would fragment the field. Also of importance were the alternative visions
of biological and cultural orientations within medical anthnropolgy, an issue of con-
tinued importance. In the aftermath of these discussions, the issue of culture took
center state, with strong input from critical perspectives and multidisciplinary think-
ing. The relationship of the field to biomedicine remains a troubled issue. Expressing
concern that an unthoughtout embrace of biomedicine’s factorial model, which disa-
gregates health-related contexts and experiences into discrete units or factors to be
counted, gives undue attention to the parts rather than the whole while treating cul-
ture like just another variable in a researcher-imposed equation. Instead, an argument
is made for retaining a holistic, systems-oriented, comparative approach within medi-
cal anthropology.
2. Critical Biocultural Approaches in Medical Anthropology
Tom Leatherman and Alan H. Goodman
It is the argument of this chapter that in response to the highly reductive biological
orientation of the dominant biomedical system’s explanations of health and illness,
over the course of its history medical anthropology increasingly became focused on
socio-cultural and political aspects of health. The turn away from the biology and
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SYNOPSIS OF CONTENTS ix
evolution while understandable, is none the less unfortunate. Biocultural approaches
can provide a fuller understanding of how large scale political–economic processes
“get under the skin.” In this light, this chapter stresses the importance of biocultural
approaches which have emerged over the past two decades that are designed to
enhance the interface between biology and critical understandings of health. The goal
is not to reduce health and illness to biological terms and mechanisms; rather, it is to
see human biology and health as inherently social and cultural.
3. Applied Medical Anthropology: Praxis, Pragmatics, Politics, and Promises
Robert T. Trotter, II
This chapter examines the eclectic nature of applied medical anthropology application
and theory by reviewing several important contributions of application to medical
anthropology in particular and anthropology as a whole. These contributions include
the mobilization of theory in an applied setting and how this theory is challenged by
other theoretical viewpoints from other disciplines, the numerous contributions that
medical anthropology has made in the development of highly useful research methods
while also expanding the methodological tool kits of the other social and biomedical
sciences and humanities, clarification of the relationship between midrange theory
and applied medical anthropology methods, and recognition of the fundamental
importance of ethics in anthropology. These points are illustrated using examples
drawn from the applied arenas of HIV/AIDS and drug use and health organization
evaluation research but the primary issues of concern crosscut specific health-related
issues that are addressed in medical anthropology.
4. Research Design and Methods in Medical Anthropology
Clarence C. Gravlee
While medical anthropology’s holistic and integrative approach to the human experience
enriches our understanding of sickness and health, it also raises a challenge regarding the
configuration of research methods that are relevant to the field. Drawing on the whole
toolkits of all of the social sciences, as well as methods from public health, biomedicine,
and the life sciences, the question is raised about how to best match methods to the kinds
of research questions raised by medical anthropologists. Medical anthropologists embrace
a wide range of theoretical perspectives, including positivist, critical, constructivist, inter-
pretive, evolutionary, and ecological orientations and no method can lay unique claim to
possession of any method. Consequently, this chapter shows why fluency in a broad
range of methods is essential for developing successful collaborations within medical
anthropology and across disciplinary lines, and for designing research that matters. Tak-
ing advantage of methodological developments throughout the social sciences contrib-
utes to the continued intellectual and practical relevance of medical anthropology.
5. Medical Anthropology and the Policy Process
Merrill Eisenberg
This chapter is directed at students and practitioners of medical anthropology who
work in communities and want their work to contribute to the development of a more
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x SYNOPSIS OF CONTENTS
humane and just world through social policy development and implementation. I
attempt to integrate the disciplines of policy studies, public health, and medical
anthropology to approach policy issues in applied medical anthropology. I first address
the centrality of policy to the human social experience, provide definitions of policy,
public policy and public policy mechanisms, and describe how policy both creates and
addresses health concerns. Next, I review the anthropological study of policy from
both narrative and critical perspectives. The remainder of the chapter focuses on using
medical anthropology research to inform the development of public policy through
advocacy and empowerment activities that medical anthropologists can undertake.
The importance of understanding the policy making endeavor ethnographically is
emphasized as a tool to guide participation in the policy process. Models that can be
used as a lens for understanding the public policy making process are presented, and
a typology of participation is proposed. The examples in this chapter are based on the
US public policy experience, assuming government that is elected and responsive, to
some degree, to citizen input and may not apply to other political contexts. Many of
the concepts can also be applied in private policy making settings, such as the policies
of non-governmental health-related organizations, health care provider institutions,
and public health programs.
PART II CONTEXTS AND CONDITIONS
6. Culture and the Stress Process
William W. Dressler
The risk of illness increases when individuals are subject to stressful experiences in the
social environment and are unable to cope with or resist those experiences. Culture
shapes the stress process. This chapter reviews anthropological research on this topic.
There have been three general approaches to the study of culture and the stress proc-
ess. First, primarily in the 1960s and 1970s, research focused on the stressful effects
of migration and culture change, especially what was referred to as “modernization.”
Second, beginning in the 1970s and continuing today, anthropologists have adapted
social-psychological models of the stress process to settings outside North America
and Europe, showing how the definitions of stressful circumstances and coping
resources change in different cultural settings, and how the interactions among these
elements are modified by culture. Third, and most recently, research has focused more
precisely on how individuals incorporate cultural models into their own beliefs and
behaviors – referred to as “cultural consonance” – and how low cultural consonance
can be a stressful experience. Research on the stress process in medical anthropology
has been fruitful both for increasing our understanding of the causes of poor health
and for the insight into the dynamics of culture it has afforded.
7. Global Health
Craig R. Janes and Kitty K. Corbett
In this chapter we assess the engagement of medical anthropology with the rapidly
growing field of global health. Our discussion is presented in six parts. We first
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