Diagnostic Criteria

Symptoms of diabetes include frequent urination (polyuria), hunger, thirst (polydipsia), weight loss, blurred vision, and skin itchiness. In children there may be growth impairment. Among type 2 diabetics insulin resistance may be present for a number of years prior to the development of elevated blood glucose levels. When insulin production can no longer compensate for peripheral tissue resistance, blood glucose levels rise, reaching the criteria for a diagnosis of diabetes. The World Health...

Possession Religions as Worship and Tradition

To see Possession Trance only in medical terms would be a mistake. Behavior that might be seen as pathological in the Western or bio-medical system, may be seen in terms of a mythico-religious system in a traditional society. Hollan (2000, pp. 546-547) notes that possession behavior that is culturally normative, no matter how bizarre or irrational it appears from a Western point of view, should never be considered pathological or psychotic It is culturally constituted symbolic behavior As...

Biomedical Knowledge Practice and Worldview

Gaines (1992b) refers to two discursive modes by which Biomedicine is learned, shared, and transmitted embodied and disembodied discourses. Through embodied person-to-person communication and through disembodied texts and images of various kinds, biomedical realities are (re) created over time. Both means have served to (re)produce popular as well as scientific knowledge. But it is noteworthy that science can and does recreate popular knowledge as scientific knowledge. For example, U.S....

Infertility and Fertility Enhancement

The links between the moral order and reproductive health are particularly marked in cases of infertility. The inability to bear a child is understood to reflect moral status, and in particular is usually blamed upon the woman who may suffer abuse and ostracism. In Africa, infertility carries a grave social stigma, and there is an elaborate range of traditional remedies used to address it (Ebin, 1994 Kielmann, 1998). Likewise, Chinese medicine reflects the cultural emphasis placed upon...

Within System Distinctions

One common typology describing complex medical systems is the tripartite scheme of popular, folk, and professional medicine (Kleinman, 1978). The key variables are who provides care and in what context. In the popular sector, non-specialists, such as one's self, mother, friends, or other kin and relations, provide treatment. Treatment is based on shared cultural understandings, and generally occurs in a family or household context. Folk sector healers are specialists their practice is based on...

Medicalized Identities and Conditions

Social science critiques of medicalization, whether associated more closely with labeling theory and the social control of deviance, or with Foucaldian theory and the relationship of power to knowledge, have documented the way in which identities and subjectivity are shaped through this process. When individuals are publicly labeled as schizophrenic, anorexic, infertile, menopausal, a heart transplant, a trauma victim, and so on, transformations of subjectivity are readily apparent (Ablon, 1984...

References

M. (1996). The non-thrifty genotype. Current Anthropology, 37, 831-842. American Diabetes Association (2002a). Expert committee on the diagnosis and classification of diabetes mellitus (Report to the expert committee on the diagnosis and classification of diabetes mellitus). Diabetes Care, 25 (Suppl. 1), S5-S20. American Diabetes Association (2002b). Diabetes among Native Americans. Retrieved 2002 from the American Diabetes Association Website . www.diabetes.org...

Introduction

Patterns of diet and activity, and nutritional and health status vary across cultures and historical periods. For example, currently there are populations living as hunter-gatherers and also groups subsisting on diets high in fat and refined carbohydrates. The nutrition and health situations in developing countries have been exemplified by nutrient deficiencies, such as protein-energy malnutrition, iron deficiency anemia, vitamin A deficiency, and iodine deficiency, in addition to periodic...

Anthropology and Alcohol Studies

The ethnographic or cross-cultural perspective was important early in establishing the simple fact that differences in attitudes, behaviors, and outcomes exist and are important among different populations. Interested observers had long been writing some insightful descriptions but they tended to be fragmentary and scattered in recondite sources. The rapidly expanding cadres of social and cultural anthropologists in the 1950s and 1960s brought a sharper focus to what they called drinking...

Controversies in Medical Ecology

Medical ecology has been criticized by cultural anthropologists and by critical medical anthropologists, who argue that adaptation theory, or adaptationism, is politically conservative. Believing that adaptation theory explains poor health as evidence of inferior genes, some equate medical ecology to Social Darwinism. One positive outcome of this dialogue has been steps toward merging medical ecology and the political economy of health into a political ecology of health. This developing...

Contraceptives and Abortion

Indigenous contraceptive knowledge and practices are widely dispersed, and the systematic importation of new contraceptive technologies does not take place in a vacuum. As with pharmaceuticals, it is largely through the mediation of government that contraceptives such as the contraceptive pill (the Pill) and intra-uterine devices (IUDs) are made available to populations and this is carried out, almost without exception, in association with national policies of family planning. The large...

Death and Rebirth

Shamans' training generally includes a death and rebirth experience, an initiatory crisis typically involving illness and suffering from attacks by spirits that lead to the experience of death. This is followed by descent to a lower world where spirits and animals attack and destroy the victim's body. The initiate is then reconstructed with the addition of spirit allies that provide powers. The death and rebirth experience reflects processes of self-transformation that occur under conditions of...

Measuring Variability in a Cultural Setting and Cultural Consensus Theory

Variability in cultural knowledge about illness within an identified setting was first systematically addressed by Fabrega in the Mayan community of Zinacantan, Mexico (Fabrega, 1970 Fabrega & Silver, chapter 7, 1973). A form of term-frame interview was used where a set of 18 illness terms were paired with 24 possible bodily disturbances (symptoms). Two groups one composed of 30 practicing h'iloletik (shamans) and the other 30 laymen were compared. A chi-square analysis found no significant...

Models of Stress

Research on stress and disease in sociology, psychology, and epidemiology paralleled work on modernization and disease in anthropology. By the late 1970s, a rough synthesis had emerged that could be used in the development of research models that would be useful cross-culturally. The term stress can be used to as a shorthand description for a general area of inquiry. Stress research or the stress model takes as subject-matter the direct link of thought, emotion, and behavior to physiologic...

Contents

Theoretical and Applied Issues in Cross-Cultural Health 3 Evolutionary and Ecological Perspectives 31 Paleopathology and the Study of Ancient Remains 49 Atwood D. Gaines and Robbie Davis-Floyd Medical Pluralism 109 Medicalization and the Naturalization of Social 116 Phenomenology of Health and Illness 125 Political, Economic, and Social Issues Health and Economic Development 164 170 Irene Glasser and Rae Bridgman Nutrition and Health 178 Post-Colonial Development and Health 184 Social...

Post Colonial Medicine

Post-colonial health provisions are an admixture of medical practices and perceptions that reflect the colonial experience. These local health care systems continue to include a combination of hospitals, clinics, health posts, pharmacies, nurse paramedical practitioners, and health cadres as well as a multitude of government-sponsored health programs, for example family planning programs, family nutrition improvement programs, village community health development programs, advanced age...

Post Colonial Developments and Health

Post-colonial development met and continues to meet the challenges of high fertility and mortality rates, health environmental issues, poverty and its impact on segments of post-colonial populations, acute respiratory infections, diarrheal diseases, vaccine-preventable infectious diseases, malaria, and other tropical vector-borne diseases. In fact, the persistence of these health issues is considered the bio-historical facts of under-development that are also the targets of development. Any...

Possession and Healing

In recent years there has been a great and continuous increase in the literature dealing with possession, both descriptively and analytically. This corresponds also to the worldwide distribution of the phenomena in question, as well as to greater interest in various aspects of this complex subject by researchers. Beginning in the 1960s, with the development of transcultural psychiatry, Possession Trance religions and shamanism have been considered with regard to their functions as healing...

The Classification of Disease

Cells continuously adapt to internal and environmental stimuli and stresses. If the cell is no longer able to adapt, then cell injury results, either reversible or leading to cell death, necrosis. Injury that cannot be limited at the cellular level calls forth an inflammatory response. If the stimulus is terminated, then the acute reaction subsides and there is usually healing and regeneration of the tissue, although specialized tissue such as the brain is replaced by scar tissue. If stimulus...

Psychobiological Structures of Shamanistic ASC

All cultures have procedures for accessing ASC but differ in their attitudes toward these states and the means for controlled access (Laughlin et al., 1992). These universals of shamanistic practices reflect underlying brain structures and functions that elicit operations of an integrative mode of consciousness (Winkelman, 2000). This integrative mode of consciousness reflects the ubiquitous response of the brain to diverse conditions that induce synchronized limbic system discharge patterns....

Contemporary Shamanic Illness and Healing

The psychobiological basis of the shamanistic paradigm is revealed in its persistence in contemporary religious experiences (Stark, 1997) and psychological crises. Shamanic dynamics are reflected in the DSM-IV category spiritual emergencies, which includes spontaneous shamanic journeys possession the death and rebirth experience mystical experiences with psychotic features and experiences of psychic abilities (Walsh, 1990). The shamanic paradigm provides a useful framework for addressing these...

Alcohol and Alcohol

Several types of alcohol are known, but ethanol is of special interest to anthropologists, having long been an influential component of many beverages among a large portion of the world's population. A relatively simple chemical compound (C2H5OH), it often occurs naturally without human intervention, although the hominid imagination has resulted in manifold elaborations and refinements of the basic processes of fermentation and distillation. In fermentation, it is microorganisms that convert...

An Anthropology of Aging

Despite the early seminal book by Leo Simmons, The Role of the Aged in Primitive Society (1945), and articles by such luminaries as Gregory Bateson (1950), and Margaret Mead (1967), a concern for a worldwide, cross-cultural analysis of aging has developed late in anthropology. It was anthropologists such as Otto von Mering, Jules Henry, Margaret Clark, and Barbara Anderson who first turned the ethnographic approach into a valuable tool for understanding the relationship of aging, local culture,...

Future Directions

Growing interest in the link between globalization and health has stimulated anthropological research on how large-scale social forces and transnational movements produce local cultural forms. Local inadequacies in public health infrastructure, local disease ecologies that explain differences in exposure to pathogens, and local variations in biology have all been identified by medical anthropologists, and other researchers, as factors influencing the emergence of epidemics. Given the...

Theoretical and Methodological Perspectives

The roots of the current emphasis on the phenomenology of health and illness lie in the field of philosophy. Numerous philosophers have addressed questions that are phenomenological in nature, including Dilthey, Hegel, Husserl, Heidegger, James, Merleau-Ponty, Peirce, Sartre, and Shutz. Central to the phenomenological approach has been an effort to incorporate notions of culture into phenomenological constructs. The term phenomenology refers to the distinction introduced by Kant between...

The Human Genome Project

The Human Genome Project (HGP) project was initiated in 1989 and funded by the U.S. government, with one of its explicit goals set as the understanding and cure of genetic disease. The HGP's initial task was to locate and identify all the coding genes in the human genome by the year 2005. A secondary goal, to sequence the DNA in the entire human genome, was expected to take somewhat longer. The American HGP was eventually combined with the international Human Genome Organization (HUGO) to make...

Primary Goals

Usually, analysis in forensic anthropology is oriented toward two major goals (1) establishing a profile of the individual represented that will assist in positive identification, and (2) the recognition and interpretation of evidence of foul play. As mentioned above, the identification profile can involve determining that the remains are of human origin, estimation of age at death, sex, ancestry, living stature, general robusticity, the presence and treatment of medical conditions, and noting...

Infectious Disease

These disorders are caused by microorganisms, including bacteria, viruses, rickettsia, fungi, and single-celled protozoan parasites. Invasion by macroorganisms, those visible to the eye, such as worms and insects, constitutes infestation. Modern treatment has altered many diseases and comparison between ancient and modern diseases must keep this fact in mind. Most infections do not affect the skeleton directly, but the skeleton can be involved indirectly. Childhood infections can result in the...

Why do Anthropologists Study Human Growth1

The study of human growth has been a part of anthropology since the founding of the discipline. European anthropology of the early to mid-19th century was basically anatomy and anthropometry, the science of human body measurements (Tanner, 1981). Early practitioners of American anthropology, especially Franz Boas (1892, 1940) are known as much for their studies of human growth as for work in cultural studies, archeology, or linguistics. Boas was especially interested in the changes in body size...

Definitions and Theories of Homelessness

A widely used conceptualization of homelessness developed by Peter Rossi (Rossi, Wright, Fisher, & Willis, 1987) distinguishes between the literally homeless (persons who obviously have no access to a conventional dwelling and who would be considered homeless by any conceivable definition of the term) and the precariously or marginally housed (persons with tenuous or very temporary claims to a more or less conventional dwelling or housing). This distinction can be used in studies of the...

In Anticipation of Future Resistance

Vaccine administrators fear that with the increased flows of information accompanying globalization, immunization resistance will increase. Such resistance is considered especially problematic when new vaccines are introduced. In contrast, existing vaccines tend to become part of local health cultures and are viewed with less suspicion. Hardon (1998) describes how a global network of women's health organizations successfully opposed experiments with anti-fertility vaccines. The women's health...

Cognitive Ethnographic Studies of Illness Treatment Decisions

Studies of decision-making in real-world settings provide an arena for addressing the question Why do people do what they do For cognitively oriented ethnographic studies, a frequent starting assumption is that in recurring decision situations where alternative courses of possible action exist, members of a group come to have shared understandings, a common set of standards concerning how such choices are made (Goodenough, 1963, pp. 265-270 Quinn, 1978 Young & Garro, 1994)....

Historical Context of Interest in Drugs

Before moving into the chronology of focused anthropological studies of drugs, the general historical context of drugs deserves brief attention. Western European biomedicine and its power to discover palliatives and topical remedies have exercised strong influence on the place of drug use in Western life. By the time anthropology was emerging as a discipline, the European pharma-copia included numerous remedies derived from plants, many of which were not native to Europe. Opium and its...

Culture Bound Syndromes

Every known cultural group has ways of describing things that go wrong in body and mind. Although biological causes can be identified for many sicknesses, the way local groups identify, understand, classify, interpret, and respond to conditions is cultural, not biological (Kleinman, 1980). Differences in how local groups understand normality and abnormality are particularly marked for psychological and behavioral syndromes. The term culture-bound syndrome developed out of the attempts of...

Culture Bound Syndromes and Social Change

Although the term culture-bound refers to a concept of culture that comes from an earlier period in anthropological theory in which culture was seen as relatively unchanging and localized, contemporary anthropologists increasingly see such syndromes as not only characterized by the same historical changes and globalization that affect all cultural phenomena, but as derived from such changes directly. For example, Carr posits that the incidence of amok may have risen under colonialism and with...

Gender and Aging

A global view of aging shows that women age somewhat differently than men (Cattell, 1995). Although there are slightly more males born than females in most populations, almost universally it is the latter gender which on average survives the longest. At age 15, women in the United States have a life expectancy eight years greater than men, and when they reach age 65 they can expect to survive four more years than their male counterparts. For Third World nations, there is typically about half...

Geographic Distributions and Sociocultural Correlates

In the study cited above, Bourguignon (1973) found that 90 of sample societies had institutionalized Trance (or altered state of consciousness) and or Possession Trance in a sacred context. That is to say, Trance states interpreted as due to possession, or interpreted in some other way, are here grouped together. For the remaining 10 , evidence on the subject was unavailable or inadequate. There were significant differences among ethnographic regions in the utilization of trance states they...

Anthropology and Biomedicine

Early on, Biomedicine was the reality in terms of which other medical systems, professional or popular, were implicitly compared and evaluated. Like science, Western medicine was assumed to be acultural beyond the influence of culture while all other medical systems were assumed to be so culturally biased that they had little or no scientific relevance (e.g., Foster & Anderson, 1978 Hughes, 1968 Prince, 1964 Simons & Hughes, 1985). Not only did this ideological hegemony devalue local...

Nutrients in the soil in the absence of permanently cultivated fields hotcold health systems See humoral medicine human

A worldwide project to determine the DNA sequences in all human DNA. human variation. The study of how and why contemporary human populations vary biologically. humoral medicine. A variety of medical systems based on the belief that a balanced state assures health, while an excess or deficiency yields illness. The balance needs to be maintained between various humors (see humors) and or between elements such as heat and cold. Deducing the etiology of an illness points the...

Types of Syndromes

Despite controversies over the term culture-bound syndrome the concept remains important in the medical anthropology literature. A number of theorists have attempted to classify syndromes named in the anthropological and psychiatric literature into types. For example, Simons and Hughes (1985) divide culture-bound syndromes into startle matching (as in latah) sleep paralysis (a reference to a number of syndromes in which people experience choking and or paralysis during sleep or while falling...

Phenomenology of the Body

Accompanying the interpretive turn of the last 25 years has been a growing emphasis on the body as a topic of social investigation. The work of Mauss (1935) has been rediscovered in this shift, with his conceptualization of habitus, the way social structure leaves its imprint on individuals through bodily training. Mauss maintained that bodily sensations and movements are affected by culture through acquired habits and somatic tacts. Elias's (1939 1978) work on the social development of bodily...

Korean Chinese and Asian Indian Traditional Medicine

Type 2 diabetes mellitus is known as the rich man's disease in Korea. It was not until after the 1960s that diabetes began a rapid increase at an estimated rate of 3-4 per year, with an estimated 500,000 in the year 2000 (Korean National Federation of Medical Insurance, 1993). Gang (1995) investigated traditional and biomedical practices among diabetic Koreans aged 20-80 years. Fifty patients used primarily Western medicine and 33 used primarily traditional therapies. Western therapies included...

Cross Cultural Perspectives on Shamans

The problems of a definitional approach to shamanism (e.g., see Jakobsen, 1999 Townsend, 1997) are overcome by a cross-cultural approach that provides an empirical basis for characterizing shamans. Cross-cultural research reveals an etic shamanism world-wide in hunter-gatherer societies and universal practices using ASC for healing (Winkelman, 1986a, 1990, 1992 see Winkelman & White, 1987 for data and methods). Shamanism was an ecological-psychobiological adaptation of hunter-gatherer...

Gender

Perhaps one of the foremost determinants of social status in the cross-cultural record is gender. The contemporary feminist movement in anthropology dates to the 1970s when Rosaldo and Lamphere (1974) published their revolutionary work, and Ehrenreich and English (1978) realized the feminist agenda through a meticulous critique of the biomedical establishment. Their work added to the existing literature on the health of minority groups, but underscored the notion of biomedicine as a means to...

Theoretical and Applied Implications

Much of modern medical anthropology has its origins in anthropologists' interaction in international public health and medical programs of the post World War II era. Anthropologists, like their medical colleagues, assumed that Western medicine was superior to traditional medicine and that the natural course of things was to replace the latter with the former. The skills of anthropology were needed to gain public acceptance of the new medicine and its practitioners. Both anthropology and...

Diabetes Epidemiology

In 2000 the worldwide estimate by the International Diabetes Federation (IDF) was 151 million adults (20-79 years) with type 2 diabetes. This is an increase from 30 million in 1985 and 135 million in 1995. There is a projected global estimate of 300 million people in 2025 (IDF, 2001). Because higher energy intakes and lower energy expenditures are having differential impacts on developed and developing countries, the prevalence of type 2 diabetes in developing countries is expected to increase...

Life History Theory and Human Growth

The biocultural nature of human growth is best viewed from a life history perspective. The field of life history theory is the scientific study of life cycle strategies and their evolution (Stearns, 1992). Life history refers to major events that occur between the conception and death of an organism. It is defined as the strategy an organism uses to allocate its energy toward growth, maintenance, reproduction, raising offspring to independence, and avoiding death. Living things on earth have...

New Trends in the Study of Biomedicine

The anthropology of reproduction is a relatively new subfield within medical anthropology. It comparatively explores both reproductive processes and their sociomed-ical treatment (for overviews, see Franklin & Davis-Floyd, 2001 Ginsburg & Rapp, 1991). It includes emerging anthropologies of menstruation (Buckley & Gottlieb, 1987) childbirth (see Davis-Floyd & Sargent, 1997) midwifery (see Davis-Floyd, Cosminsky, & Pigg, 2001) and menopause (e.g., Lock, 1993) all of which have been...

Genetic Counseling and Gene Therapy

This is an allied medical specialty that provides an understanding of medical genetics, including the estimation of the empirical risk of recurrent inherited disorders that may be inherent in prospective families. Such counseling may include details of the laws of inheritance and pedigrees, a complete natural history of a genetic disorder, along with empirical risk estimates and the currently available options for testing and treatment. One of the options that may be...

Risk as Self Governance

Activities designed to assist with the avoidance of misfortune and danger are ubiquitous in the history of humankind, but the idea of being at risk in its technical, epidemiological meaning is a construct of modernity. In theory, morally neutral risk provides a means whereby experts can distance themselves from direct intervention into people's lives while employing the agency of subjects in their own self-regulation through risk-management. Among the numerous examples of this process, the...

Medical Anthropology and Diabetes

Since the 1960s anthropologists have published on a diversity of topics related to type 2 diabetes. Weidman (2001) cites over 130 articles, chapters, and books published from 1975 to 2001 by anthropologists. These articles have appeared in anthropology, medical, epidemiology, and nutritional science journals Diabetes research is multifold evolutionary and genetic aspects lifestyle factors, especially dietary factors traditional and contemporary explanatory models of illness and interactions...

Overcoming Structural Barriers

Such applied studies have specifically pointed at the need to consider service-level factors, which matter to people in their day-to-day interactions with immunization programs (Heggenhougen & Clements, 1987 Salkever, 1976 Streefland, Chowdury, & Ramos-Jiminez, 1999), including 1. Convenience of time and space Many studies have pointed to the need to provide immunization services at convenient times and places that are easy for the target population to reach. In the EPI blueprint,...

Illness Narratives in Anthropology and Beyond

The use of narrative to describe other people's experiences of acute or chronic illness is also something of a growth industry. In the last few years, analyses of patient narratives have been used to explore everything from autism (Gray, 2001) to temporomandibular joint syndrome (Garro, 1994). In between one finds studies of breast cancer (Langellier & Sullivan, 1998), depression (Kangas, 2001), diabetes (Hunt, Valenzuela, & Pugh, 1998 Loewe & Freeman, 2000), HIV (Bloom, 2001 Ezzy,...

Alcohol and the Ritual Setting Hypothesis

Alcohol, perhaps the most universally consumed drug, attracted the attention of anthropologists in the context of holistic ethnographies, but by the 1930s it had also drawn the attention of anthropologists who focused on its use in a cultural context. La Barre (1938b) characterized grain-derived, fermented alcoholic beverages among Native Americans, and Heath (1958) embarked on his lifelong inquiries into patterns of alcohol consumption. These investigations either compiled extant ethnographic...

Cultural Models and Illness Narratives

In the 1980s, considerable attention within cognitive anthropology became directed to cultural models presupposed, taken-for-granted models of the world that are widely shared . . . by members of a society and that play an enormous role in their understanding of that world and their behavior in it (Quinn & Holland, 1987, p. 4). Good (1994, p. 50) points to transitional writings in medical anthropology (e.g., Clement, 1982 White, 1982a) in which anthropologists sought ways to represent the...

Biological Warfare Present Future and Past

Concerns about bioterrorists' attacks recently have heightened, for good reason. Outbreaks of anthrax disease and bacterial exposure have placed the United States and portions of Europe on high alert. The alarm has sounded to include other, even more deadly pathogens such as the smallpox virus that possibly are being prepared for attacks on the public. The present status of high alert prompts the same question that goes back to World War I and then repeated at times during subsequent wars and...

Abortion as Birth Control

Few topics engender more heated discussion than that of abortion. It seems fair to say that much of this rancor stems from strong religious and moral prohibitions to the practice of intentionally terminating viable pregnancies. Some concern might also be expressed from a strictly pragmatic point of view that abortion is a costly (in terms of fetal wastage) practice. Here we will focus on non-therapeutic abortion which is meant to limit the number of births, rather than those abortions that...

Breast Feeding Practices in the West

In the United States, the number of mothers who chose to breast-feed their infants had declined by the middle part of the 20th century, with the decline being most rapid in the middle and upper classes, in association with the economic ability to purchase breast milk substitutes. By the end of World War II, most American women bottle-fed their babies (Raphael, 1973). One of the factors behind the decrease in breast-feeding was active promotion of infant formula by food and drug manufacturing...

Review and Critique of Theory and Research

While some early anthropologists remarked on the social position of disabled people cross-culturally (see the discussion in Hanks & Hanks, 1948), it was not until the 1960s with the theoretical impetus of Goffman's (1963) elaboration of the stigma concept and Edgerton's (1993) research on people with mental retardation that a focused interest in the systematic study of the sociocul-tural aspects of impairment and disability began to develop. The seminal work on disability conducted from the...

Pregnancy Outcomes

In parallel with public health interest in maternal and child health during the 1960s and 1970s, ethnographic studies drew attention to the diverse ways of managing pregnancy, childbirth, and mothering (see the entry Birth). The management of pregnancy, birth, and the postpartum period has important consequences for women's reproductive health. Long-term complications of pregnancy and childbirth include uterine prolapse, fis-tulae (holes in the birth canal that allow leakage of urine or feces...

Cultural Consonance Stress and Blood Pressure

One of the challenges in trying to examine more direct (as opposed to contextual) effects of culture on disease risk is finding a definition of culture that is both theoretically satisfying and yet can be used to understand how individuals come to be at risk. The problem of linking culture to the individual is one that has been prominent throughout the history of anthropological theory however, employing a cognitive definition of culture suggests a resolution (Dressler & Bindon, 2000)....

Marriage Also called bride wealth bridewealth or bride wealth See bride price

Group of more than 100 diseases that are characterized by the uncontrolled abnormal growth of cells. cardiovascular diseases. Any of the diseases of the heart and blood vessels. cargo cult. Religious movement in which there is preparation for an expectation of a future state of happiness brought about by the arrival of large amounts of material goods (cargo). carrying capacity. The maximum population size that can be supported in a particular environment to calculate the carrying...

Shelter Life

When anthropologists have focused their attention on shelter living, they have, for the most part, been struck by the corrosive effects of shelter life on the homeless person. Desjarlais (1997) spent time in a mid-size (52 beds) shelter for the homeless mentally ill. Although the staff regarded the shelter as the Rolls Royce of shelters, the place was in fact noisy and distracting. The clients just struggling along, as they put it, can be seen as a shelter-induced adaptation, and may not be due...

Substance Abuse

The relationship of alcohol and drug use to homelessness is interactive, in that it is very difficult for an individual with limited financial resources to remain in housing when much of his her money is spent on substances, and it is difficult for an individual to focus on substance abuse treatment when his her basic survival needs for shelter, food, and warmth are only precariously met. A recurring question is whether substance use disorders precede homeless-ness or are precipitated by it...

Reproductive Tract Infections

Reproductive tract infections, including sexually transmitted diseases (STDs) are a major cause of infertility, genital cancers, pelvic inflammatory disease, ectopic pregnancy, poor pregnancy outcomes, and infections in neonates, and are often less symptomatic, more easily contracted, and have more serious and life-threatening consequences for women than for men. For example, chlamydia infection is a common STD with serious consequences for women's health including increasing risk of ectopic...

Biomedical Realities Constructing Diseases

Biomedicine's non-spiritual, non-religious biotechnical approach stems logically from its core metaphor of the body as machine, which is both grounded in and a result of Biomedicine's secular (i.e., non-divine) worldview (Keller, 1992). This focus leads biomedical practitioners to try to cure (to fix malfunctions), but not to heal (to effect long-term beneficial changes in the whole somatic-interpersonal system). Thus, not only spiritual but also psychosocial issues are still often ignored, as...

Biology and Nature Constructing Biomedicines Ultimate Realities

The study of the clinical practices of Biomedicine has led to major observations about the realities with which it is concerned. Such research has demonstrated that professional medical systems represent a variety of biological realities, not one. Traditional Chinese medicine is very distinct from Biomedicine (Kleinman, 1980 Unschuld, 1985) its biological focus is complemented by a strong focus on energy. The same is true of Unnani, the professional medicine of the Middle East derived from...

Case Studies of Medical Pluralism India

Leslie (1977) has conducted historical and ethnographic research on medical pluralism in India. He delineates five levels in the Indian dominative medical system (1) biomedicine, which relies upon physicians with M.D. and Ph.D. degrees from prestigious institutions (2) indigenous medical systems, which include practitioners who have obtained degrees from Ayurvedic, Unani, and Siddha medical colleges (3) homeopathy, whose physicians have completed correspondence courses (4) religious scholars or...

Conclusion Of Critical Medical Anthropology

Type 2 diabetes is rapidly becoming a worldwide epidemic as populations adopt modernized or Westernized lifestyles. Evolutionary evidence for the selective advantage of diabetes thrifty genotypes and phenotypes predisposes humans to the deleterious and diabetogenic effects of contemporary culture. Recent dietary changes are characterized by an abundance of calorically dense, sugary and fatty foods with low fiber content. In addition, labor-saving, energy-efficient daily activity patterns reduce...

Osteoporosis

Osteoporosis is a disease characterized by loss in bone mass and degeneration of bone microarchitecture resulting in increased bone fragility and vulnerability to fracture (Consensus Development Conference, 1993). Bone tissue is dynamic and is produced through a continuous remodeling process of formation and resorption throughout life. Growth and development during childhood and adolescence involve large increases in bone size and volume (Plato, Fox, & Tobin, 1994), and peak bone mass is...

Anthropological Contributions to the Treatment of Psychosis

The treatment of mental illness is a subject of considerable interest for psychoanalytic anthropology, in nonwestern societies and closer to home. Treatment programs of psychosis that integrate native healers into the treatment process have had striking results. A well-known example is the program started by T. Adeoye Lambo at Naro in Nigeria, in which patients were taken into families in the village of Naro and, as part of the treatment, worked and participated in village and family life....

Colonialism Early Post Colonialism and Health

The health consequences of colonialism immediately faced by post-colonial regimes cannot be characterized by any one set of health problems, health practices, and perceptions. Rather, differences in health and health care reflect regional, class, ethnic, gender, age, rural and or urban circumstances, posing a myriad of challenges for post-colonial development efforts. The withdrawal of colonial powers left behind a mixed legacy of health conditions and health care provisions. Where one lived in...

Resistance to Vaccination Regimes

When vaccination was introduced by colonial governments in the last century resistance was a rather common response. Presently, collective resistance occurs for religious reasons when parents reject protection through vaccination because they consider this unjustified interference with God's will or because their explanatory model of how a child ought to gain resistance against a disease is at odds with the biomedical model. Collective resistance may also occur when the population distrusts the...

Glossary

Any drug or compound that induces the expulsion of an embryo or fetus. abortion. A spontaneous (usually called miscarriage) or induced expulsion of an embryo or fetus. acculturation. The process of extensive borrowing of aspects of culture in the context of superordinate-subordinate relations between societies usually occurs as the result of external pressure. acupuncture. A Chinese medical technique that consists of the insertion of one or several small metal needles into the...

Latino and Hispanic Traditional Medicine

Many cultural factors, including diet, activity patterns, and health beliefs and practices, are involved in the high prevalence of diabetes among Latino populations. Most Latinos believe diabetes is hereditary. Fifty-eight percent in the ADA survey (1994) agreed with the statement Diabetes is hereditary, and therefore there is nothing anyone can do avoid getting it. This fatalistic attitude toward diabetes truncates both preventative and treatment measures. In the ADA survey, 60 of respondents...

Contextualizing Birthing Systems Global and Local Perspectives

Among the principal studies of local birthing systems from the decade of the 1980s are those by Sargent, Laderman, and MacCormack. These studies are characterized by ethnographic detail as well as careful articulation of childbirth as an event with broader sociocultural issues such as gender ideology, domestic power relations, professional specialization, and the components of particular ethnomedical systems. Sargent's (1982, 1989) monographs on birth among the Bariba of Benin contex-tualize...

Demographic Transition Theory

In tracing the demographic history of developed countries it became apparent that a rather regular pattern of change in population growth had taken place. Historical demographers devised a theory to account for this pattern, referred to as the demographic transition model. In its purest application, populations experienced three stages initially represented by high levels of births (largely through short birth intervals) and deaths (largely through high infant and childhood mortality) that for...

Early Ethnographies and Surveys

The earliest anthropological attention to birth is contained within ethnographies devoted to other topics, rather than studies focusing directly on birthing systems (for further discussion, see Browner & Sargent, 1996). Exceptions include Montagu's (1949) discussion of Australian aboriginal understandings of fetal development and Malinowski's (1932) commentary on ideas and practices concerning birth among Trobriand Islanders. A few comparative surveys on human reproduction such as that by...

History of Nutritional Anthropology

The early history of nutritional anthropology dates back to studies of food and social organization in non-industrial societies in the 1930s. The British anthropologist Audrey Richards (1939) is often described as the first one who explicitly focused on food. She studied economic and social factors affecting food among the Bemba in central Africa. Her work was part of the British applied anthropology movement, which was associated with colonial governance and welfare. In the 1940s, studies of...

Movement Against Clitoridectomy And Infibulation In Sudan

To mutilate in the name of Allah and Jehova Legitimization of male and female circumcision. Medicine and Law, 13,575-622. Abusharaf, R. M. (1995). Rethinking feminist discourses on female genital mutilation The case of Sudan. Canadian Woman Studies, 15(2-3),52-54. Abusharaf, R. M. (1996). Revisiting feminist discourses on female circumcision Responses from Sudanese indigenous feminists. Paper presented at the American Anthropological Association 95th Annual...

Brief History of Genetic Disease Antiquity

The Greek historian and geographer Herodotus in the 4th century BCE became the first scholar to produce an attributable description of a genetic condition in humans The goddess Aphrodite afflicted the Scythians and all their descendants forever with hermaphroditism3 (Historiae, book I 105). According to myth, the original Hermaphroditus was first a son of the Greek god Hermes and goddess Aphrodite Hermaphroditus later fused with the nymph Salamacis to produce a single...

Initiation and Maintenance of Breast Feeding

As noted above, breast-feeding a child is a somewhat predictable part of the life course for most women. That does not mean that initiation of nursing is routine and easy. Most populations also have cultural rules that women must follow during pregnancy to prepare for and ensure successful breast-feeding. These may include specific foods to eat or avoid, the wearing of special clothing and amulets, and other prescribed or restricted behaviors. Following birth, cultural practices relating to...

The Five Themes of Human Childhood

Listed in Table 3 are some of the biosocial traits of human children. Many of these traits are shared with other social Table 3. Biosocial Traits of Human Children 1. Slow and steady rate of growth and relatively small body size 3. Higher resting metabolic rate than any other mammalian species 5. Sensitive period for maturation of fundamental motor patterns 6. Sensitive period for cognitive and language development 7. Weaned, with dependence on older people for care and feeding mammals, but no...

Biomedical Anthropology and the Evolution of Diabetes Thrifty Genotypes and Phenotypes

Anthropologists have been interested in evolutionary models of type 2 diabetes that explain the vastly different prevalence rates among worldwide populations. Of interest is the current epidemic in populations with multiple generations of high diabetes rates (i.e., Pima Indians), in newly designated populations with rapidly increasing incidence rates (i.e., urban South African populations), and in children and adolescents in populations that have had a history of high prevalence rates among...

An Anthropology of Western Childbirth

The anthropology of Western childbirth has represented a core element in studies of birthing systems from Jordan's comparative research through the 1990s. A consistent theme in this body of research emphasizes that the dominant cultural definition of birth in the United States is a medical one, in which pregnancy is viewed as a pathological state, requiring specialist attention and hospital delivery. Accordingly, the medicalization of childbirth, characterized by use of technological...

Alcoholics Anonymous

Alcoholics Anonymous (AA) is a fellowship of individuals whose primary concern is to stop drinking. An anomalous organization with no dues, formal membership, or budget, it has millions of attendees and a meeting can be found in most countries around the world almost anytime. AA has served as the model for numerous other self-help (or 12-step or mutual support) groups involving addicts, overeaters, gamblers, and others. An outgrowth of an evangelical group, AA early dropped references to God in...

Embodied Memory in Studies of Age and Terror Violence

The temporal dimension of people's lives plays an important part in understanding embodied health and illness. Phenomenology is less concerned with establishing what actually happened in the past than in exploring the past as a mode of present experience (M. Jackson, 1996, p. 38). People's historical experiences of their bodies is expressed through embodiment (Connerton, 1989). Memory not only reflects personal, subjective experience, it is socially constructed and present oriented, reshaping...

Biographies of Pharmaceuticals and Contraceptives

Numerous scholars, among whom Charles Leslie was perhaps the first, have shown how medical pluralism is the rule in virtually all societies today, so that competition among medical sectors is common (Leslie, 1980), often with major repercussions on the health of populations. This tendency is well illustrated by examining the availability and use of medicinal technologies. Beginning in the 1950s anthropologists showed concern about the effects of imported pharmaceuticals, notably antibiotics, on...

Creutzfeldt Jakob Disease CJD

CJD is a rare, partly inherited disease (about 15 of cases are classically inherited other cases are either infectious or sporadic). Shortly after the outbreak of mad cow disease in Great Britain, the incidence of CJD also increased dramatically. CJD, which had been thought of until that time as a purely genetic condition, was being precipitated in humans after ingestion of contaminated beef. The infection pathway was circuitous the cattle had been fed supplemental bone meal from dead sheep...

Contributors

Abler, Department of Anthropology, University of Waterloo, Waterloo, Ontario Rogaia Mustafa Abusharaf, Carr Center for Human Rights Policy, Kennedy School of Government, Harvard University, Cambridge, Massachusetts Steven Acheson, Archaeology Branch, Government of British Columbia, Victoria, British Columbia Naomi Adelson, Department of Anthropology, York University, Toronto, Ontario Pascale A. Allotey, Department of Public Health, University of Melbourne, Victoria, Australia Hans A....

Theoretical Orientations and Methods in Nutritional Anthropology

As with other fields of anthropology a wide variety of theoretical perspectives and methods are used in nutritional anthropology. A range of ecological, symbolic, materialist, and political perspectives has been used to explain patterns of food selection, nutritional consequences, and the relationships of nutrition to sociocultural, economic, and ecological processes. What foods people eat and how much they eat are determined not simply by physiological needs, but also by political and...

Physiological Cross Species and Evolutionary Perspective

For most women in the world nursing an infant is such a routine and normal part of life that they would be surprised to see an entry for this activity in an encyclopedia. But as with similar life cycle phenomena such as pregnancy, childbirth, and puberty, breast-feeding for contemporary humans is never simply a biological phenomenon, but is typically embedded in a dense context of beliefs, values, and traditions. The physiological ability and requirement to nurse infants from mammary glands is,...

Hunger and Malnutrition in Lowincome Countries

The production and distribution of adequate food is a serious health problem facing the world's population. The concept of food insecurity is often used to describe the limited or uncertain access to nutritionally adequate and safe foods for households and individuals. Hunger and food insecurity are highly relevant problems for health policies and intervention programs because malnutrition has functional consequences both at the individual and societal levels. Women and young children represent...

Bringing Power Relations into the Study of Medical Pluralism

Whereas the early work on medical pluralism tended to focus on levels in plural medical systems, more recent research on this phenomenon has to recognize that, as Stoner (1986, p. 47) asserts, p luralism can now be examined as a multiplicity of healing techniques, rather than of medical systems. Indeed, in its response to the growing popularity of the holistic health movement, biomedical physicians in the United States have increasingly been incorporating various therapeutic techniques, from...

The Illness Autobiography

Over the last quarter century the illness biography or pathography, as some prefer to call it, has emerged as a popular literary form as well as a primary data source for medical anthropologists. Through vivid, personal stories seriously ill patients have attempted to educate medical professionals and the general public about the impact of disease on work, family life, identity, and self-image as well as to recount their experiences with impersonal, bureaucratic, medical institutions. While...

Cross Cultural Review of Responses to Bodily and Behavioral Differences

As a broad inclusive category, and from a strict constructionist perspective, disability exists only in locally specific relation to Western European notions of medicalization, employment, and welfare (Groce, 1999 Whyte & Ingstad, 1995). Yet, some range of physical and behavioral differences are recognized in all societies and there are often social consequences that follow from this recognition. While it is of paramount importance to elucidate local contexts, knowledge, and responses in the...

Vaccination Programs their Culture and Context

Global policy-making processes have been studied more by medical historians and health policy scientists than by medical anthropologists. Medical anthropologists have focused on the implementation of immunization programs and the acceptability of vaccines in diverse socio-cultural settings. They have shown how at the local level immunization programs are characterized by a target-oriented approach and emphasis on strict adherence to vaccination rules and procedures that have been developed in...

Psychoanalytic Movements in Third World Countries Brazil Japan India China and Russia

The establishment of psychoanalytic movements in many non-European countries, especially in the Second and Third Worlds, offers an opportunity for psychoanalytic anthropology to study the adaptation of psychoanalysis itself to diverse cultures (Kutter, 1995). In Russia, psychoanalysis was centrally involved in the 1917 revolution, being regarded as a liberating intellectual movement but was suppressed when Stalin took a dislike to it. Many of the well-known Russian psychologists, such as...

Enculturation See socialization

A disease that has been prevalent in an area over long periods of time. endogamy. The rule specifying marriage to a person within one's own group (kin, caste, community). enteric. Relates to the intestines. endocannibalism. Cannibalism practiced with deceased members of one's own group. epidemic disease. A disease that currently has very high prevalence. (Implies large fluctuation over time.) Compare with endemic disease. epidemiological transition. Can refer to a number of...

Dietary Transitions Lifestyle Factors and Diabetes

Anthropologists have explored cultural models of illness and the experience of being a person with diabetes. Cultural etiological models often include dietary elements, especially sugar and processed foods, that represent a departure from traditional, ethnically important diets (Kuhnlein & Receveur, 1996). Although many studies discuss the historical trends in type 2 diabetes as a result of modernization, Westernization, or even cokacolization and McDonaldization as creating obeseogenic and...