LIHernandez 1 Theoretical Approaches Medical Anthropology

LIHernandez2 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).

LIHernandez3 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.

LIHernandez4 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

LIHernandez5 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 conditions ECOLOGICAL Perspective

LIHernandez6 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 time 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 ECOLOGICAL Perspective

LIHernandez7 CRITICAL Perspective o How do distributions of wealth & power and divisions of labor affect disease patterns and health care access?

LIHernandez8 o Political/economy approach  emphasizes the importance of political & economic forces – the exercise of power – in shaping health, disease, illness experience, & health care CRITICAL Perspective

LIHernandez9 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” circumstances

LIHernandez10 INTERPRETIVE Perspective 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

LIHernandez11 Asks, what meanings does a disease bring with it? 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 communities Explores how ordinary people and healers account for the disease and how they treat it INTERPRETIVE Perspective

LIHernandez12 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