ANT 201 Health and Illness
Terms in this set (28)
The spread of diseases and pathogens through the human population.
The interaction of diseases with the natural environment and human culture.
How do humans across culture make sense of health and illness? How do we think and talk about illness, pain, suffering, pain, birth, and mortality?
Critical Medical Anthropology
Explores the impact o inequality on human health in two important ways. 1. Considers how economic and political systems, race, gender, class, and sexuality create and perpetuate unequal access to health care. 2. It examines how heath systems themselves are systems of power that promote disparities in heath by defining who is sick, who gets treated, and how treatment is provided.
holistic approach to health and illness examines epidemiology, meaning, and power (assuming that health and illness are more than a result of germs, individual behavior, and genes. Health is also a product of our environment.
How Does Culture Shapes Our Ideas of Health and Illness?
Few people in the world meet up the WHO definition of health. Need to distinguish between disease and illness to assess how health conditions and disease affect certain populations.
Anthropology of Childbirth:
Cultures around the world have developed unique practices and beliefs about pregnancy, delicacy, and the treatment of newborns and their mothers that shape the way childbirth is understood and experienced.
--A Comparative View of 4 Cultures:
US sees birth as a medical procedure. Women become patients--sick and helpless seeking the aid of professional to resolve dangerous life crisis.
Holland: Entirely natural process;
Sweden: intensely personal and fulfilling achievement
Yucatan, Mexico: stressful, but normal part of life.
Yucatan and US birth procedures are night and day.
--Pain during Childbirth: US: women have to display severe pain to receive pain meds. Bad because it shifts focus on pain, not delivery. Sweden: women can choose what and when to have pain meds. Holland: no drugs, natural. Yucatan: collective process and natural, pain is expected.
--Healing Practices o Tibetan Buddhism Applied in Northern India: Pordie documents Amchis and their holistic approach to health care.
German health care system recognizes two complementary approaches: school medicine and nature cure. While US emphasizes most extreme treatments.
--Biomedical Conceptions of the Body:
Nancy Scheper-Hughes and Margret Lock review the case of woman who suffered headaches and medical students lack to awareness on how social experiences might produce embodied responses.
--The Human Microbiome:
Human body made up of ten trillion cells to one hundred trillion microbes. They are important in body's ecosystem.
Are there other Global Health Systems?
--Chinese Medicine Today:
Chinese medicine conceptualizes health as a harmonious relationship between Heaven and Earth. A person's qi--energy found in all living things must be balanced and flowing in equilibrium with rest of universe for person to be healthy. Illness occurs when qi is blocked. Acupuncture, acupressure, moxibustion (burning of herbs near skin) and consumption of healing herbs and tea. Mei Zhan discuses how Chinese medicine is not the antithesis of western medicine. Rapid expansion of Chinese medicine worldwide.
The absence of diseases and infirmity, as well as the presence of physical, mental, and social well-being.
A discrete, natural entity that can be clinically identified and treated by a health professional.
The individual patient's experience of sickness--the culturally defined understanding of disease (including the way they feel, talk, think, and experience it.
Bridgitte Jordan and Robbie Davis-Floyd
Their study "Birth in Four Cultures" discusses the four ways that four countries/areas view birth: US: life threatening condition women need medical help, Holland: entirely natural process, Sweden: intensely personal and fulfilling achievement, Yucatan: painful but part of life. Birth in Yucatan and US are opposite. Mayan women give birth in dimly lit, small dirt floor attended by local midwife using everyday materials. Women's husband and mother present and help women through process. Other women can provide birth talk by urging and cajoling. While in the US birth occurs in sterile, brightly lit hospital with sophisticated equipment and attention of highly trained medical professional. One third of US births are through C-section.
Jordan notes that some women in every culture give birth without pain. What differs form one medical system to another is the way in which that pain is handled. Jordan's study explores the possibility that cultural expectation of pain during childbirth shape the actual experience. Use of pain medication during labor was not consistent across cultures.
US: Pain medication administered discretion of doctor. Women must convince doctor of severe pain to get drugs. This shifts the women experience of childbirth more to pain than the delivery.
Sweden: quiet intense concentration on process of giving birth. Women are introduced to symptoms and positives and negatives of pain drugs and they make decisions about how much and any medication given.
Dutch: Natural process, no pain meds. They are reluctant to interfere in process.
Yucatan: Pain is natural and expected. It is considerd a collective process. The intense experience of childbirth reinforces key Mayan cultural values and local understanding of importance of hard work and endurance.
Local systems of health and healing rooted in culturally specific norms and values.
The documentation and description of the local use of natural substances in healing remedies and practices.
French anthropologist who documented one typical system of ethnomedicine: a variation of Tibetan medicine practiced in sparsely populated Ladakh region of N. India. Their only healthcare is provided by amchis, traditional healers whose healing practices are deeply rooted in Tibetan Buddhism. Amchi medicine is based on achieving bodily and spiritual balance between individual and surrounding universe. They diagnose by asking questions of patient, examining bodily waste and carefully taking pulse. Recommended treatments include: changes in diet and behavior and uses of naural medicine from local plants and minerals. Pordie reports that amchi treatments are effectives for many Ladakhi's heath problems. Amchis do not perform surgery, if surgery is needed residents will be transported , if possible, to doctors trained in western medicine. Amchis are threatened by government, who favor western medicine, and the military who blocks Kashmir region, and area that they need to go to obtain minerals and natural medicines. Urbanization and modernization threaten them too, they must run their practices like businesses rather than bartering.
A practice, often associated with Western medicine, that seeks to apply the principles of biology and the natural sciences tot he practice of diagnosing disease and promoting healing.
Nancy Scheper-Hughes and Margret Lock
They recount story of challenging case that illustrates powerful influence of cultural values on biomedical healing practices. When the case of abused woman who had been virtually housebound for five years who had family troubles suffered headaches, medical students asked what is the real cause (biomedical cause) of her headaches. The student's biomedical training was so focused on the body it had not prepared her to recognize social experiences might produced embodied responses.
The complete collection of microorganisms in the human body's ecosystem.
Her book "Other-Wordly: Making Chinese Medicine through Transnational Frames challenges many of the stereotypes of Chinese medicine, and that it is the antithesis of western medicine. Instead she argues that it's practice varies widely in China and that doctors and patients carefully negotiate treatments. Government promotes Chinese medicine and worldwide expansion. Shift of CHinese medicine beginning in 1980s.
How Can Anthropologists Help Solve Health Care Problems?
Creating A Public Health System in Rural Haiti:
Paul Farmer strove to understand local language, norms, values, classifications of reality, and religious beliefs. He began to listen to resident's needs and experiences. He helped make many improvements to their village, which increased their health and well-being. Farmer notes that to truly make a difference, anthropology must be used not only to analyze and scrutinize a problem but also to turn research into action.
American Anthropologist visited Canga, Haiti. Intense poverty, farmer found a village overwhelmed by high levels of infant mortality, childhood malnutrition, typhoid, dysentery, HIV/AIDS and tuberculosis. Many residents were water refugees (pushed off their land by construction of hydroelectric dam that flooded valley to provide power to Haiti cities and irrigation for large landholders and agribusiness downstream. He strove to understand local language, norms, values, classifications of reality, and religious beliefs. He began to listen to resident's needs and experiences. He and Pastor Lasante helped construct underground river to provide fresh water, made outdoor toilet, improved homes, added a school, malnourished kids were provided food, and Lasante trained local community members as community health workers.
Why Does the Distribution of Health and Illness Mirror that of Wealth and Power?
Health Transition and Critical Medical Anthropology:
Despite improvements in global health stats, local populations have not experienced the health transition equally. Patterns of inequality in a culture create patterns of inequality in healthcare. Illness can have social origins in poverty, violence, fear of violence, and discrimination based on race, ethnicity, gender, sexuality, and age.
Staff Attitudes affect Health Care Delivery in A New York Women's Clinic:
Khiara Bridges examines how race, gender, class intersect to shape delivery of health care in women's health clinic. Medicaid women are discriminated against because they are classified as a risk. Bridges raises the possibility that physician's racial attitude contribute to health disparities experienced by patients who are women of color.
The significant improvements in human health made over the course of the twentieth century that were not, however, distributed evenly across the world's population.
Critical Medical Anthropology
An approach to the study of health and illness that analyzes the impact of inequality and stratification within systems of power on individual and group health outcomes.
A legal scholar and anthropologist who examines the ways in which race, class and gender intersect to shape the delivery of health care in a women's health clinic at a famous trauma hospital on Manhattan's East Side in her "Reproducing Race". It provides care for poor women. Alpha Hospital, a women's health clinic is a top-tier teaching hospital, treats an incredible diverse population. Physicians working in Alpha are mainly white, but the medical staffers are women of color, tension exists between the two groups. Medicaid women are discriminated against because they are classified as a risk. Bridges raises the possibility that physician's racial attitude contribute to health disparities experienced by patients who are women of color.
Her research documents racist oral tradition within the medical profession that features folklore about black women's bodies. Black women 3x more likely to die from birth complications. Black babies have 2.5x higher chance of infant morality rate. Bridges suggests that mortality rates reflect more than poverty. Ethnic minorities tend to have lower quality health care. She calls for the importance of exploring the possibility that physicians's view regarding patients of color may lead to different treatment during pregnancy and childbirth.
How is Globalization Changing the Experience of Health and Illness and the Practice of Medicine?
Globalization has launched a new intensified era of medical migration.
Multiple Systems of Healing:
--Colliding Cultures: Hmong Refugees and US Health Care System: Anne Fadiman's The Sprit Catches You and You Fall Down narrates the danger of cross-cultural medical encounters through the story of Lia Lee.
--Bridging Cultural Divides via Illness Narratives: After Fadiman finished her research with the Lees she contacted a preeminent medical anthropologist, Arthur Kleinman. He specializes in cross-cultural issues in health and illness and illness narratives. Illness narratives help give cultural perspective and meaning to illness. They can help give essential framework for developing treatment strategies.
The movement of diseases, medical treatments, and entire health care systems, as well as those seeking medical care across national borders.
The intersection of multiple cultural approaches to healing.
Author of book "The Spirit Catches You and You Fall Down. Which captures the intensity and danger of cross-cultural medical encounters through the story of the Lees (Hmong family from Laos who settled in Merced. The Lees' fourteenth child had suffered from epilepsy. In Hmong culture seizures are known as dangerous but also held in high esteem because powerful shamans had these conditions. The Lees saw their daughter as suffering form soul loss. The doctors misdiagnosed their daughter because of communication problems. Lia lee the daughter visited the hospital numerous times and was given many medications, but the Lees were unsure of how to administer the medications. The hospital determined that the Lees were abusing their daughter and ordered Lia to be removed from her parents. She was finally returned back to her family, in no better condition. Lia became brain dead, but her family continued to take care of their daughter with traditional methods.
Personal stories that people tell to explain their illnesses.
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