Modern medical anthropological research incorporates at least four essential premises and five approaches to the study of health and illness. Medical anthropology’s first premise is that illness and health are human experiences that are best understood holistically in the interactions between human biology and human culture. The second premise is that disease is an aspect of human environments influence by culturally specific behaviours and socio-political circumstances. The third premise says that symptoms of illness are interpreted through cultural filters and assumptions, and the fourth premise is that the cultural aspects of healing systems have practical consequences for how healthcare is perceived, delivered and improved (Brown, 1999). The five approaches that contribute to the unique anthropological perspective are the biological, ecological, ethnomedical, critical and applied approaches (Brown, 1998). The biological approach tries to explain relationships between the evolutionary process of gene variation and different ways that humans in a culture are susceptible or resistant to disease. For example a biological anthropologist may study the health and illness of early hunter gatherer bands and compare this data with changes in health and illness after these hunter gatherers adopted a more sedentary lifestyle based in fixed location. The ecological approach to anthropology refers to the study of the relationship between living organisms and their whole environment. Changes in the environment almost always have an impact on human heath and illness. For example pollution in a water system (environment) may influence the health and illness of a human population who might no longer have access to uncontaminated drinking water. As all societies have developed systems to interpret, diagnose and treat sickness, the ethnomedical approach studies healing practices, how illness is categorised, how a person would seek healing in the healing system, and how effective a healing system is in producing a desired result. A critical approach to medical anthropology incorporates the influence of larger scale political and economic factors and their affect on a society’s risk of disease. The applied approach emphasises the application of anthropological theory to social situations. Donald Joralemon (1999) cites the example of Franz Boas as early example of applied anthropology when research and ethnographic knowledge was used to address social practices and cultural beliefs. Boas used his skills in anthropometry (Anthropometry is the study of human body measurement for use in anthropological classification and comparison) to impact on the discriminatory immigration policies of the 1920’s in America. It was claimed that immigrants should be kept out of America because they had smaller brains and would lower the average intelligence of American citizens if allowed to intermarry. Boas’ work in measuring human brain size showed that this socio-cultural prejudice was not correct .
Cultural assumptions influence how a society views, diagnoses and treats sickness. Because these assumptions can influence a society’s definition of illness and health, anthropological research perspectives can contribute to a fuller understanding of health and illness in the context of a particular culture or social group. ‘Anthropology has biological, social, and cultural branches, but when applied to health issues it most commonly relates to the social and cultural dimensions of health, ill health, and medicine’ (Lambert, 1996:358-361). While a biomedical perspective may have once claimed scientific objectivity and ethical neutrality, the anthropological perspective contends against these claims by proving the influence of historical and cultural contexts upon almost every facet of a society’s definition, diagnoses and treatment of sickness. (Sargent & Johnson, 1996). Because medical anthropologists explore the social and cultural factors that influence sickness, some health and illness stakeholders may feel uncomfortable with the inclusive approach that medical anthropology takes in studying health and illness. The unique anthropological perspective, which incorporates a biomedical viewpoint, is able to study social-cultural factors which impact upon health and illness. The study of cultural and social influences on health and illness allow the Anthropologist to look beyond a strictly biomedical view of heath and illness and gain insight into other influencers in the health and illness equation.
Anthropological research is particularly able to contribute to the understanding of human health and illness. Anthropological research could be said to collect, study, and analyse data from a wide range of cultural, social, environmental and biomedical factors that influence health and illness, utilising approaches from a wide variety of anthropological disciplines to gain the broadest possible perspective, while a strictly biomedical perspective might instead focus on information available from that single discipline. Sir Edmund Taylor’s classic definition of culture, cited by Peacock, states that ‘Culture...taken in its wide ethnographic sense is that complex whole which includes knowledge, belief, art, morals, law, custom, and any other capabilities and habits acquired by man as a member of society’ (Peacock, 1985, p.3). Medical Anthropological study uses the comparative method in researching factors that influence health and illness. The comparative method attempts to explain similarities and differences among people holistically in the context of the totality of humanity and begins with the belief that all human behavior is better understood against the backdrop of the full range of human behavior. Research shows that there can be a difference between what people say, including health professionals, and what they actually do. This factor can sometimes go unrecognized in qualitative research because it can sometimes be based on an interview. ‘Qualitative health research often fails to distinguish between normative statements (what people say should be the case), narrative reconstructions (biographically specific reinterpretation of what has happened in the past), and actual practices (what really happens)’ (Lambert & McKevitt 2002). Anthropologists when analyzing data need to continue to be aware that words cannot be taken at face value. A statement about what is normal behavior needs to be verified to confirm that it is so. Participant observation is another valuable research tool that can assist the anthropologist in sorting through what statements are made because that is what should be done as opposed to what may actually be practiced. ‘Anthropology has a distinctive approach to gathering and interpreting data that can yield productive insights. These insights derive from underlying assumptions about the nature of social reality and human action, as well as using participant observation (anthropology's most characteristic research strategy, which involves direct observation while participating in the study community and includes other methods, such as interviewing)’. (Lambert & McKevitt, July 2002). Anthropological research is particularly well placed to contribute to the understanding of human health and illness through research and analysis.
Anthropological perspectives and research approaches contribute to the understanding of human health and illness as anthropological research methods examine a society’s beliefs and practices regarding health and illness and examine the complex relationships and roles between health practitioners, methodologies of healing, and health systems. Anthropology is well placed to critically analyse health systems as medical anthropologists are not generally stake holders in the healing system. This affords medical anthropologists a unique opportunity to contribute to the understanding of a wide range of factors that enhance health or contribute to illness in a society, as well as assessing the effectiveness of the current practices of biomedical professionals and identify and analyse social-cultural beliefs and values and their fundamental influence of every aspect of health, illness and healing systems.
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