Learning Objectives

-       how medical anthropologists approach the concepts of illness and healing

-       how culture plays an important role in illness and healing

-       the importance of an illness narrative

-       about different approaches to healing

-       about different concepts of body equilibrium

-       how health inequity leads to different outcomes for patients

-       about an anthropological approach to disability

Review Questions

1.     What do medical anthropologists study?

2.     What is the difference between disease and illness, using an anthropological approach?

3.     What strategies do people use to understand and express their experience of illness?

4.     What are the different cultural theories of illness?

5.     What is the main focus of biomedicine?

6.     What are the therapeutic processes used in ethnomedicine?

7.     How are the ancient medical traditions of body equilibrium similar and different?

8.     How does structural violence lead to different outcomes for people with illness?

9.     What is the main factor that shapes a person’s experience with disability?

Discussion Questions

1.     Have you personally undergone a medical treatment that relied on non-Western understandings of healing? If so, how was the experience different than biomedical treatments?

2.     What are some examples of illness that you are familiar with that correspond to each of Murdock’s cultural theories of causation?

3.     What has your science education been like? Have you had teachers that have encouraged you to learn about the scientific discoveries of peoples outside of Europe?

4.     Have you ever injured yourself or been in a situation in which you were temporarily (or permanently) disabled? How did it change the way you thought about yourself or the way others responded to you?

Chapter Outline and Key Points

Introduction: Studying Concepts of Illness and Healing

Medical anthropology is a biocultural field of study that uses a holistic view to examine ideas about illness, health, healing, and the body.

Understanding Illness

Medical anthropologists seek to understand a person’s experience of their disease (the physical manifestation of a clinically identifiable entity) and the set of understandings that comprises their illness (the larger social and cultural context). Illness narratives are the stories that help people understand their own illness and the roles that people and events have played in it. Cultural models about health permeate a social group, such as the Western biomedical model of a “disease” that is separate from one’s “self.” People may ascribe natural or supernatural causation to illness.

Cultural Concepts of Healing

Ethnomedicine is a culture’s concepts, beliefs, and practices regarding health, the body, and healing. This includes the Western concept of biomedicine, which emphasizes the use of pharmaceutical drugs to cure symptoms, and also theories of body equilibrium, such as Traditional Chinese Medicine and Ayurveda. From an anthropological perspective, four processes—clinical therapeutic, symbolic therapeutic, social support, and persuasive—have been identified as helping sick patients heal.

Health Inequity

Health and illness around the world is linked to structural violence, or the ways the social, economic, and political structures of society oppress and harm certain members.

Disability

Although disability is unlike illness, it is also understood within a biocultural context. The reactions of others may be discriminatory or they may be positive, shaping a person’s experience of their disability.

Glossary

Ayurveda: a system of healing used in India that focuses on the restoration of balance to the body’s systems

biomedicine: the field of medical care in which the scientific principles of biology, biochemistry, and physiology are applied to patient diagnosis and treatment

critical medical anthropology: a subfield of medical anthropology that examines health and its relation to power

ethnomedicine: traditional, non-Western medicine

explanatory model: a way of understanding the world; a description of how something functions

homeostasis: stability or equilibrium, especially among bodily processes

humoral theory: the ancient Greek idea that health was achieved by a balance of elements within the body

illness narrative: the explanation of how a person understands and experiences an illness

medical anthropology: a subfield of cultural anthropology that examines ideas about health, illness, and healing

medicalization: the process by which a normal human condition comes to be seen as a medical condition needing treatment

metaphor: an application of a word or phrase to something to which it is not generally applicable; a comparison to things without using the words “like” or “as”

moxibustion: a healing practice used in Traditional Chinese Medicine in which a burning stick of herbs is placed near acupuncture points on the body

naturopathy: a form of treatment for illness that relies on non-pharmaceutical and non-surgical methods such as nutrition, herbal medicine, body work, and self-care

Others: a view of a person or category of people as different from, and therefore less than, one’s self; also used as a verb, “to Other a group of people”

personification: the representation of an inanimate thing as having human qualities

placebo: an inactive medical treatment that may help a patient through psychological, not physiological, effects

qi: the body’s life force in Traditional Chinese Medicine; pronounced “chee”

sit shiva: to engage in a Jewish mourning practice in which family members of the deceased remain at home together for seven days, receive visitors, and observe rules of mourning 

structural violence: how the social, economic, and political structures of society oppress and harm certain members, especially the poor

Traditional Chinese Medicine (TCM): a system of healing used in China that focuses on strengthening the body’s systems and improving the flow of qi

Weblinks

Society for Medical Anthropology (SMA)

http://www.medanthro.net/about/about-medical-anthropology/

Partners in Health (PIH—international social and health justice organization)

https://www.pih.org/

World Health Organization (WHO)

https://www.who.int/en/

Medicine Anthropology Theory Open Access Journal

http://www.medanthrotheory.org/

Somatosphere—a Science, Medicine, and Anthropology Blog

http://somatosphere.net/

Cultural Anthropology Open Access Journal—Issue on “Reproductive Politics in the Age of Trump and Brexit”

https://journal.culanth.org/index.php/ca/issue/view/51

Further Reading

Eli, K., & Warren, M. (2018). Anthropological perspectives on eating disorders: Deciphering cultural logics. Transcult Psychiatry, 55(4), 443–53. 

Ember, C.R., & Ember, M. (2004). Encyclopedia of medical anthropology: ‪Health and illness in the world’s cultures. New York: Springer Science and Business Media.

Fadiman, A. (2012). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures. New York: Farrar, Strauss and Giroux. (Although not written by an anthropologist, this account is well worth reading.)

Farmer, P. (2004). An anthropology of structural violence. Current Anthropology, 45(3), 305–25.

Farmer, P. (2004). Pathologies of power: Health, human rights, and the new war on the poor. California Series on Public Anthropology. Berkeley: UC Press.

Jain, S.L. (2013). Malignant: How cancer becomes us. Berkeley: UC Press.

Katz, P. (1999). The scalpel’s edge: The culture of surgeons. Boston: Allyn and Bacon.

Luhrmann, T.M., & Marrow, J. (2016). Our most troubling madness: Case studies in schizophrenia across cultures. Berkeley: UC Press.

Rebhun, L.A. (1994). Swallowing frogs: Anger and illness in northeast Brazil. Medical Anthropology Quarterly, 8(4), 360–82.

Singer, M. and Baer, H. (2012). Introducing medical anthropology (2nd ed.). Lanham: AltaMira Press.

Skloot, R. (2010). The Immortal Life of Henrietta Lacks. New York: Crown Publishers. (Also not written by an anthropologist, but well-written and compelling.)

Medical Anthropology-Centered Ethnographies

Adelson, N. (2000). Being alive well: Health and the politics of Cree well being. Toronto: University of Toronto Press.

Hamdy, S., & Nye, C. (2017). Lissa: A story about medical promise, friendship, and revolution. Art by Sarula Bao and Caroline Brewer; lettering by Marc Parenteau. Toronto: University of Toronto Press. (a graphic novel)

Scheper-Hughes, N. (1993). Death without weeping: The violence of everyday life in Brazil. Berkeley: UC Press.