Illness and death are significant events for people everywhere. No one is spared. But medical beliefs and practices are not the same everywhere. How people understand the causes of illness and death and how they cope with these events vary from culture to culture. It is not surprising therefore that medical practitioners and others are becoming increasingly aware of the need to understand the influence of society and culture on medical belief and practice. Culture— the customary ways of thinking and acting in a society—often affects the outcome of illness, and even which illnesses occur. So those who are actively engaged in studying health and illness are coming to realize that biological and cultural factors need to be considered if we are to reduce human suffering.

The professional medicine of Western cultures has been called "biomedicine," because it mostly deals with the biology of the human body. But biomedicine, like the medicine of other cultures, is also influenced by conditions and beliefs in the culture, and therefore reflects the value and norms of its creators. So, if biomedicine is socially constructed and not just based on science, its beliefs and practices may partly derive from assumptions and biases in the culture. For example, it used to be thought that some people refrained from drinking milk because they were ignorant. Now, biomedicine realizes that the avoidance of milk is a rational response to the likelihood that drinking milk results in diarrhea and other discomforts in people who lack an enzyme (lactase) that allows easy digestion of the sugar in milk (lactose). Anthropologists were the first to realize that drinking milk would cause serious problems for many people. The anthropologists' fieldwork in other cultures around the world revealed that people in many places that have milking animals must sour the milk before they can drink it, to reduce or eliminate the sugar in it that would otherwise make them sick.

Severe diarrhea may also be an effect of the culture's system of social stratification. The direct causes of the diarrhea may be biological, in the sense that the deaths are caused by bacterial or other infection. But why are so many infants exposed to those infectious agents? Usually, the main reason is social or cultural. The affected infants may mostly be poor. Because they are poor, they are likely to live with infected drinking water. Similarly, malnutrition may be the biological result of a diet poor in protein. But such a diet is usually also a cultural phenomenon, reflecting a society that has different classes of people, with very unequal access to the necessities of life, and unequal access to decent medical care. For this and other reasons, medical anthropology is developing what has been called a "biocultural synthesis" in its studies of health and illness.

Medical anthropology may even be in the forefront of the movement that is returning the entire field of anthropology to its biocultural roots. In any case, the growth of jobs in medical anthropology is one of the more striking developments in contemporary anthropology. Medical anthropology has developed into a very popular specialty, and the Society for Medical Anthropology is now the second largest unit in the American Anthropological Association.

Organization of this Encyclopedia

A total of 53 thematic and comparative essays begin these volumes. These essays are grouped into five sections: general concepts and perspectives; medical systems; political, economic, and social issues; sexuality, reproduction, and the life cycle; and health conditions and diseases. Then there are 52 cultural portraits of health and illness, articles that describe the state of health and illness in 52 particular cultures around the world. Every cultural region of the world is represented, as are cultures at all levels of social complexity. The Encyclopedia of Medical Anthropology is unique. In addition to providing a large range of thematic essays, representing the various perspectives in medical anthropology, these volumes are unique in focusing on so many particular cultures. No other single reference work comes close to matching the depth and breadth of information on the varying cultural background of health and illness around the world. We are able to provide the information contained here through the efforts of more than 100 contributors—generally anthropologists but also other social scientists—who usually have firsthand experience with how medical cultures vary around the world. Focusing on comparative topics and how health and illness are viewed and treated in the world's cultures is consistent with HRAF's mission to encourage and facilitate comparative worldwide studies of human society, culture, and behavior. Our aim is to leave the reader with a real sense of how different cultures deal with health and illness, and what anthropology has contributed to understanding health and illness.

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