Theoretical Approaches

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Medical Anthropology

       2008 @ LIHernandez   1
Donald Jarelmon said…
I wish to show that fieldwork in medical anthropology is a dynamic
process that is not well suited to the structured, hypothesis-testing
research paradigm of the laboratory sciences. In the midst of a research
project, as you are gradually becoming more sophisticated in your
understanding of the social reality in which you find yourself, questions
you had not even contemplated emerge as central. Sometimes, a
research technique you thought would work fails miserably, or you find
that the individuals whom you hoped to talk to have no interest in talking
to you. At the same time, theoretical discussions in the discipline do not
stand still while you carry out your fieldwork. It is not unusual to find that
the direction of your research shifts in response to ongoing debates in
the profession at home. [My aim is] to convey the fluid quality of medical
anthropology fieldwork. (1999:17).

                                  2008 @ LIHernandez                             2
ECOLOGICAL Perspective
   Biology anthropology - Biological or
    Physical Anthropology is the study of both
    present and past human variation relative
    to local ecologies and cultures.
       Biological Anthropologists specialize in Human or
        Primate Anatomy, Genetics, Disease Ecology,
        growth and development, Forensic Anthropology
        and Osteology, Medical Anthropology, Primate
        Behavior, and Paleoanthropology.

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ECOLOGICAL Perspective
   Interactions between our socio-cultural
    patterns and our biology/environment
   We have talked about epidemiology – the
    scientific study of disease causation
       Standard epidemiological practice focuses on
            the correct diagnosis of the responsible pathogen
            the source(s) and mode of its transmission
            the most effective control measures

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ECOLOGICAL Perspective
    epidemiology views disease in ecological terms
      the interaction between a pathogen(s) and its
     host(s) [host = an organism (human or animal)
     that harbors the disease-causing organism] as
     this interaction is shaped by the conditions of a
     specific environment
    draw: host/pathogen/specific environmental

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ECOLOGICAL Perspective
    overarching theoretical framework here is evolutionary
     theory and its central concept of natural selection  any
     genetically governed characteristics that provide a
     selective advantage (i.e., increase the likelihood that
     members of a living population will survive & reproduce)
     will be expressed more frequently in that population over
         Why? Those with the traits tend to live long enough to pass
          the trait (their genes) on to the next generation.
         Adaptation the continuing process by which a population
          adjusts to its environment in response to selective pressures

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CRITICAL Perspective
o   How do distributions of wealth & power and
    divisions of labor affect disease patterns
    and health care access?

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CRITICAL Perspective
o   Political/economy approach  emphasizes
    the importance of political & economic
    forces – the exercise of power – in shaping
    health, disease, illness experience, &
    health care

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CRITICAL Perspective
   Asks: why do the socio/cultural conditions that
    facilitate “success” of the disease continue to
    prevail in a society at specific points in time?
       Example: subjecting epidemiological data on cholera
        epidemic to a class analysis to find out how & why cholera
        differentially affects rich & poor
       Views the disease as the product of social not “natural”

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   Socio-cultural anthropology
   How are society’s understandings of and
    responses to disease shaped by cultural
    assumptions? In other words, how are
    sicknesses culturally constructed?
   A “meaning-centered” approach to illness

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   Asks, what meanings does a disease bring with
       Cholera as caused by goddesses in south India as
        punishment for sinful behavior
   Documents the thoughts and experiences of
    sufferers, their families, and others in their
   Explores how ordinary people and healers
    account for the disease and how they treat it

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APPLIED Perspective
   Consultants, culture brokers; intermediaries
    between biomedical practitioners and
    groups whose cultural assumptions are at
    odds with biomedicine
   When done well, this perspective requires
    some integration of the other three

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