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Medical Anthropology Definition
-A biocultural discipline concerned with both the biological and sociocultural aspects of human behavior and particularly with the ways in which the two have interacted throughout human history to influence health and disease.
Medical Anthropology Goals
-Medical anthropology is the study of how people in different cultures & social groups explain the causes of ill health, the types of treatment they believe in and to whom they turn to if they get ill
Branches of Anthropology: Physical Anthropology
-Human evolution -Population Diversity
Branches of Anthropology: Archeology
-How human societies existed in the past -Examines material culture to interpret the past
Branches of Anthropology: Sociocultural
-Compares societies and cultural systems
Branches of Anthropology: Linguistic Anthropology
-Evolution and Diversity -Preservation of human language
Social and Cultural Dimensions of Anthropology
-Europe: more social (organization of humanity) is most important. Culture is a result of social organizations. -America: culture is important. Our rituals/traditions/etc. dictate our social organizations.
Culture Definition
-cultures compromise systems of shared ideas, systems of concepts, rules, & meanings that underlie & are expressed in the way that human beings live
Society Definition
-society as comprising a total social system whose members share a common language & cultural tradition
Different Levels of Culture: Tertiary Level
-Explicit manifest culture -Visible to the outsider -Examples include: Social rituals, traditional dress, national cuisine, and festive occasions 
Different Levels of Culture: Secondary Level
-underlying rules & assumptions are known to the members of the group but are rarely shared w/others
Different Levels of Culture: Primary Level
-Rules are known by all, obeyed by all, but seldom if ever stated -Rules are implicit, taken for granted, almost impossible for the average person to state as a system and generally out of awareness 
Misuses of Culture
-Generalizing Cultures -Never generalize or homogenize culture -Generalizing cultures can lead to discrimination, stereotypes, and prejudice  
Childhood and Old age (study of)
Childhood: there are many different definitions to childhood, come cultures try to keep a child innocence while others expect children to grow up fast and perform adult duties (usually poorer societies) Old age: Gerontology and is seen as a chronic illness that can not be cured only all…
Health and Socioeconomic Status
Study in UK found that there were higher rates of mortality and illness in poorer social classes U.S. has found that members of minority groups suffer disproportionately from things such as heart disease, asthma, cancer, etc. yet minorities are the ones with less health care coverage.  
Health, Status, Affluent Socities
The higher socioeconomic status a person has the more likely they are to live longer However lower is not always detrimental- in China some groups became more affluent and started to eat more processed foods and became unhealthier while those who stayed in the same socioeconomic class s…
Transcultural Nursing
-A formal study of practice focused on comparative holistic approach with respect to differences and similarities in their cultural values and to provide culturally congruent, sensitive care to people of different cultures
Cultural Competence and Health Care
-Goals: to improve health professionals sensitivity to different cultures and to eliminate “structural barriers” to improve health access.
Status Syndrome
-25 year study of Government employees -Lower ranking officials had a greater rate of mortality; heart disease -Higher ranking officials live longer
Boiling Water in Peru: Reasons for Boiling
-Chronic illness, or illness -Already out of accepted culture (moved from another area) so can do it without social violation -Person thought it showed higher status 
Boiling Water in Peru: Reasons for not Boiling
-To not be rejected form acceptable society -Didn't have the time/ or resources  -Didn't think it made a difference
Body Image (Definition and Concepts)
-Four main concepts:    -beliefs about the optimal shape and size of the body, including the clothing and decoration of its surface -beliefs about the boundaries of the body -beliefs about the body’s inner structure -beliefs about how the body functions
Body Weight (Culturally- Influenced Notions)
-Western societies encourage “thinness” whereas other parts of the world ( West and Central Africa) affluent families send their daughters to ‘fatting houses’ which is called cultural obesity
Anorexia
-constitutes an extreme pathological form of dissatisfaction with body image in societies that value and rewards slimness -can only be understood in the context of certain cultural values that are spread through the media, in magazines, tv and movies
Ideal Body Size and the Media (Barbie Doll)
-Widening gap between ideas of the ideal female body size and reality of the population weight  -Ex. Barbie doll was a lot thinner than the average woman -Between 1950 & 1978 average weight of most women was increasing, whereas the size of models kept decreasing
Gestures and Profession
-A person's gestures & posture differ from culture to culture or even within individuals of a particular culture ex: the body language of doctors, police officers, sales people, bartenders
Clothing and Authority
-Clothing can signal status, as well as wealth & authority ex: a doctor's white coat & a nurses cap are symbols of cleanliness & prevention of infection, it also signals their membership to a prestigious group
Thinness and the Media
EATING DISORDERS & WESTERNIZATION exposure to super slim females in the media & encounters w/foreign tourists result in females dissatisfaction w/their body image global incidence of eating disorders has risen steadily over the past 50 years & is affecting poorer countries (esp. in Afr…
Culturally Induced Body Modifications: Circumcision
-The most widespread form of bodily mutilation is MALE CIRCUMCISION -- practiced by 1/6th of the world’s population -Has been around in some communities for over 5,000 years to the present
Culturally Induced Body Modifications: Female Circumcision
-FGM is the most controversial artificial changes of the body -FGM involves the removal of all or part of the external genitaliza & is carried out on girls ranging in age from 1 month to puberty -80 million girls today have undergone FGM esp. in Sub-Saharan Africa
Culturally Induced Body Modifications: Tattoos (Western Society)
-Tattoos have become common--a phenomenon that represents a craving for a permanent, fixed identity in an age of unpredictability & constant flux
Eating Disorders Around the World
-Cultural obesity in West & Central Africa affluent members of society send daughters to fattening-houses girls are fed fatty foods, with minimal exercise, so as to gain weight, which is a sign of fertility & wealth obesity/plumpness is a sign of wealth and status
Eating Disorders Around the World cont.
-Global incidence of eating disorders has risen over the 50 past years & is now affecting many poorer countries, especially those in Africa, the Middle East, Latin America, & Eastern Europe -Nasser & Di Nicola: eating disorders “are not just an imitation of the western body image; on a m…
Notions of the Body: Individual Body
-Individual body-self  -Both physical and psychological -Acquired at birth 
Notions of the Body: Social Body
-Social body is one that is needed in order to live within a particular society & cultural group
Notions of the Body: Body Politic
-Body politic exerts a powerful control over all aspects of the individual body--its shape, size, clothing, diet, & postures -Its behavior in sickness & health and its reproductive, work & leisure activities  -Individuals EMBODY the culture they live in Their sensations & perceptions, …
Different Models of the Body: Machine Model
-The conceptualization of the body as an internal combustion engine or as a battery driven machine has become more common in western society -Central to the body as a machine concept is the idea of a  renewable fuel/battery power needed to provide the energy for the smooth working of the…
Different Models of the Body: Plumbing Model
-Cavities are connected to each other by pipes such as the intestines, the windpipe and blood vessels -From book - “the body is conceived as a series of hollow cavities/chambers, connected w/one another & w/the body’s orifices by a series of pipes/tubes” - Belief that health is maintai…
Different Models of the Body: Computer Model
-New metaphors for the mind as mainly a processor/storehouse of information & personality are all seen as forms of ‘software’ or programs hidden inside the hardware of the brain & skull
Disease vs. Illness
-Illness” represents what the patient feels when he(she) goes to the doctor -“Disease” is what he or she has on his or her way home from the doctor (Cassell 1976) -Disease is something an organ has; illness is something a person has -Book defines disease as “a deviation from normal va…
World Health Organization Defining Health
-In 1946, the W.H.O. defined “health” as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (126-127).
Biomedicine
-Biomedicine can be regarded as the ethnomedicine of the western industrialized world -Western biomedicine is now the dominant form of health found worldwide, & in most countries forms the basis of the professional sector -It is important to realize that for all its power & prestige, we…
Biomedicine and Power/ Authority
-The only practitioners of scientific medicine form the only group of healers whose positions are upheld by law -Practitioners of scientific medicine enjoy higher social status & greater income, more clearly defined rights, & obligations than other types of healers  -In hospitals, pr…
Biomedicine and Power/ Authority Cont.
-Western practitioners have the power to question & examine patients, prescribe powerful & sometimes dangerous treatments/medication, & deprive certain people of their freedom & confine them to hospitals if they are diagnosed as psychotic/infectious  -They can also label their patients…
Medical Facts
-Constructed from the “consensus” of the observers who carry out these measurements according to specific rules or guidelines -The assumptions behind these guidelines, which determine search and measurement of a given phenomena, provide what is called a “conceptual model” (122) -Accordi…
Medical Facts Cont.
-Modern medicine relies on DIAGNOSTIC TECHNOLOGY to collect/measure clinical facts this implies a shift from the subjective towards notionally objective forms of diagnosis -Increasing use of NUMERICAL definitions of health & disease
Medical Facts Cont.
-Medicines main focus is on the consequences of illness, accident/misfortune, rather than on their CAUSE -Medicines predominant approach in clinical practice remains the search for PHYSICAL EVIDENCE of disease of dysfunction & the use of physical treatments in correcting underlying abn…
Medical Students and illness
-Medical students develop some type of hypochondria while learning about various diseases, and may even develop the symptoms
Culture Counter Transference
-Whatever speciality they chose to work in, physicians themselves are also part of the ‘fol’ world for most of their lives- both before & after graduating medical school -Cultural transference is when physicians unconsciously impose their own cultural values, assumptions & expectations o…
Biomedicine and Diagnosis
-The physician has to ‘decode’ a patient’s discourse by relating symptoms to their biological referents in order to diagnose a disease entity (p.122) -The traditional method of biomedicine/diagnosis It implies a shift from the subjective (patients’ subjective symptoms, the physicians su…
Biomedicine Health/ Illness Definition
-For the most part, a person is defined as being ‘ill’ when there is agreement between his/her perception of impaired wellbeing and the perceptions of those around him. -In other words, becoming ill is always a social process that involves other people in addition to the patient (128)
Psychiatry and Models
-Psychiatry uses multiple & manifestly contradictory models that are used by different psychiatrists in explaining psychosis
Psychiatry and Models: Organic Model
-Emphasizes physical & biochemical changes in the brain
Psychiatry and Models: Psychodynamic Model
-Concentrates on a developmental & experiential factors
Psychiatry and Models: Behavioral Model
-Psychosis is maintained by environmental contingencies
Psychiatry and Models: Social Model
-Emphasis on disorders & role performance
Different Health Care Sectors: Popular Sector
Non-specialist and non-professional Sector; ill health is first recognized Self medication and treatment and advice from friends and family Main providers are women 70-90% of all health care takes place in this sector; both western and non western societies
Different Health Care Sectors: Folk Sector
Prominent in large unindustrialized societies Individual specialized in secular (non-religious), sacred (religious), or mixture of the two Healers are not part of the medical system Intermediate sector between popular and professional
Different Health Care Sectors: Professional Sector
Organized, legally sanctioned, health professionals (physicians, nurses, etc.) Biomedicine Constitutes the dominant form of healing worldwide, and is ethnomedicine
Food and Culture
-Food: not just nutrition, in all human societies it plays an important role and it is “deeply embedded in the social, religious, and economic aspects of everyday life” (52) - Food carries a lot of symbolic meaning. It expresses and creates the relationships between human, between humans…
Food and Cooking; Levi- Strauss
-all cultures in some way prepare/cook food. It sets mankind apart
Food Preparation and Gender
-STAT: in Africa, women prepare 70% of food -Women are mainly the ones responsible for food preparation in many parts of the world & societies -Women are also the ones more closely involved in FOOD PRODUCTION(milking animals, caring for livestock, planting/harvesting crops)(many African…
Different Systems of Food: Profane vs. Sacred
-Sacred is validated by religious beliefs while profane is forbidden In some cultures all food is profane at certain time (e.g. fasting for yom kippur) Cultural Taboos for Islam: Meat is only allowed from cloven hooved animals that chew the cud; no pork. Fish have to have scales and fins…
Culture and Malnutrition
-May exclude nutrients that are needed from their diets to classify them as “non-foods”, as profane as poison, lower class food, or food on the wrong side of the hot/cold dichotomy - Other hand may encourage consumption of certain types of foods and drinks by defining them as whole foo…
Health Care or Medical Pluralism
-In most societies people suffering from a physical or emotional distress employ several strategies to alleviate it: Rest, home remedy, seek advice from a friend or relative, consult with a priest, consult with a healer, or see a doctor.
Social and Cultural Dimensions of Pluralism
-Healthcare systems should not be studied in isolation; embedded in social, economic, religious and political systems -Has cultural aspects: basic concepts, theories, and and shared modes of perception  -Has social aspects: organization of roles (doctors and patients), and rules of gove…
Dominant Health Care Systems
-In the western hemisphere, the dominant healthcare system is biomedicine
Sacred and Secular Healers
-Secular: Bonesetters, midwives, herbalists, etc. and give injections Shai of Yemen (health worker) -Sacred: Spiritual healers, clairvoyants, and shamen. Use holistic approach (look at all parts of the patient, including relationships with others, with the environment, and with superna…
Premises of the Bio Medical Profession
Physician Centered: Physician, not the patient defines the nature of the patients problem Specialist Oriented: Specialists are given higher prestige and awards Credentials Oriented: Higher credentials= higher in medical hierarchy
Premises of Bio Medical Profession Cont.
Memory Based: Memory is rewarded and gains respect from peers Single Case Centered: Decisions on a case are made from a cumulative description of previous cases Process Oriented: Evaluations of the doctor are made on the doctors clinical skills made by measuring the impact on quantifia…
Different Systems of Food: Food vs. Non-Food
Different cultures have different beliefs of what is edible and what is not; however this can change under times of deprivation, famine, etc.  All cultures agree that human flesh is not food. even under conditions of extreme starvation, utilizes all available nutritional substances as f…
Different Systems of Food: Parallel Food Systems
-Parallel food classifications are the divisions of all foodstuffs into 2 main groups: HOT and COLD -The theory of physiology on which this is based, equates health w/ balance between these two categories
Different Systems of Food: Food and Status
-Protein meals are often associated with powerful dominant groups, caviar in Europe, and pig in New Guinean societies -In cases status is shown by throwing huge feasts in which a lot of the food is consumed and wasted. (e.g. Native American Groups: the Potlach)
Different Systems of Food: Food and Identity
Identities can include regional ones, familial ones, ethnic, or religious. Each country has their own traditional dish and regions within that country have their own traditional cuisine.

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