Showing papers in "Medical Anthropology Quarterly in 2003"
TL;DR: This article provides the fullest examination of this new concept to date, including a review of relevant new literature and recent research finds concerning coinfection and synergistic interaction of diseases and social conditions at the biological and population levels.
Abstract: The world of public health has undergone dramatic changes since the emergence of AIDS in the early 1980s. The appearance and global spread in recent years of wave after wave of new and renewed infectious diseases and their entwinement with each other and with the social conditions and biopsychological consequences of disparity, discrimination, and structural violence has produced a new significant threat to public health internationally. The term syndemic has been introduced recently by medical anthropologists to label the synergistic interaction of two or more coexistent diseases and resultant excess burden of disease. This article provides the fullest examination of this new concept to date, including a review of relevant new literature and recent research finds concerning coinfection and synergistic interaction of diseases and social conditions at the biological and population levels.
904 citations
TL;DR: Moerman as mentioned in this paper discusses meaning, medicine, and the "placebo effect" in the context of the placebo effect in the medical field, and discusses the placebo effect in general.
Abstract: Meaning, Medicine, and the “Placebo Effect” Daniel Moerman Cambridge: Cambridge University Press, 2002. xiii. 172 pp.
205 citations
TL;DR: If professional anthropologists wish their own best work to speak to "apparitions of culture" within medicine and other "cultures of no culture," it is suggested that they must find compelling new narrative forms in which to convey more complex understandings of "culture."
Abstract: Anne Fadiman's The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (Noonday Press, 1997) is widely used in "cultural competence" efforts within US medical school curricula This article addresses the relationship between theory, narrative form, and teaching through a close critical reading of that book that is informed by theories of tragedy and ethnographies of medicine I argue that The Spirit Catches You is so influential as ethnography because it is so moving as a story; it is so moving as a story because it works so well as tragedy; and it works so well as tragedy precisely because of the static, reified, essentialist understanding of "culture" from which it proceeds If professional anthropologists wish our own best work to speak to "apparitions of culture" within medicine and other "cultures of no culture," I suggest that we must find compelling new narrative forms in which to convey more complex understandings of "culture"
127 citations
TL;DR: This mixed-method study included focus groups to determine the kinds of knowledge women considered authoritative, a mailed survey to quantify these identified sources, and one-on-one interviews to explore outcomes in depth.
Abstract: This article explores the sources of authoritative knowledge that shaped single, white, middle-class women's unintentional pregnancies and childbearing decisions throughoutfive reproductive eras. Women who terminated a pregnancy were most influenced by their own personal needs and circumstances. birth mothers' decisions were based on external sources of knowledge, such as their mothers, social workers, and social pressures. In contrast, single mothers based their decision on instincts and their religious or moral beliefs. Reproductive policies further constrained and significantly shaped women's experiences. The social stigma associated with these forms of stratified maternity suggests that categorizing pregnant women by their marital status, or births as out-of-wedlock, reproduces the structural violence implicit to normative models offemale sexuality and maternity. This mixed-method study includedfocus groups to determine the kinds of knowledge women considered authoritative, a mailed survey to quantify these identified sources, and one-on-one interviews to explore outcomes in depth. [authoritative knowledge, social stigma, abortion, birth mothers, single mothers, unintentional pregnancies] We need to anthropologize the West: show how exotic its constitution of reality has been; emphasize those domains most taken for granted as universal... make them seem as historically peculiar as possible; show how their claims to truth are linked to social practices and have hence become effective forces in the social world.
107 citations
TL;DR: The Fat Talk: What Girls and Their Parents Say about Dieting by Mimi Nichter as mentioned in this paper is a classic book about eating disorders and its impact on young women's health.
Abstract: Fat Talk: What Girls and Their Parents Say about Dieting. Mimi Nichter. Cambridge, MA: Harvard University Press, 2000. xi. 262 pp.
99 citations
TL;DR: It is shown that few studies are appropriately designed to measure health effects, that circumcision is associated with significantly higher risks of a few well-defined complications, but that for other possible complications the evidence does not show significant differences.
Abstract: This two-part article addresses questions that have arisen in current debates on the health consequences of female circumcision The first part responds to a critique of a 1999 article and focuses on three major points: the role of research and advocacy in discussions of harmful effects, the sort of evidence that is appropriate for measuring health effects, and the way in which different disciplines—demography, epidemiology, and anthropology—are brought together to analyze data on health consequences The second part of the article reviews published sources and provides an update on their results It shows that few studies are appropriately designed to measure health effects, that circumcision is associated with significantly higher risks of a few well-defined complications, but that for other possible complications the evidence does not show significant differences, [female genital mutilation, female genital cutting, circumcision, health consequences, advocacy, evidence, multidisciplinary]
82 citations
TL;DR: This article analyzes how Venezuelan public health officials collaborated with journalists in producing information about cholera in January-December 1991 and explores the language ideologies that hide complex sets of practices, networks, and material conditions that shape how public discourses circulate.
Abstract: This article analyzes how Venezuelan public health officials collaborated with journalists in producing information about cholera in January-December 1991 It uses Michael Warner's (2002) observation that such public discourse involves a contradiction: it must project the image of reaching an actually existing public at the same time that it creates multiple publics as it circulates The analysis explores the language ideologies that hide complex sets of practices, networks, and material conditions that shape how public discourses circulate At the same time that epidemiologists targeted poor barrio residents, street vendors of food and drink, and indigenous people as being "at high risk," health education messages pictured women in well-equipped kitchens demonstrating cholera prevention measures The gap between these ideal audiences and the discrepant publics created by their circulation limited the effectiveness of prevention efforts and created a substantial chasm between public health institutions and the publics they sought to reach
77 citations
TL;DR: Research in the indigenous community of Saraguro, Ecuador, employed a combination of in-depth interviews, free-listing, videotaped walk-throughs, and mapping to explore the role of home gardens, which are established and controlled by women.
Abstract: Home gardens are a pervasive component of Andean agricultural systems, but have been ignored in anthropological and agronomic research. Recent research in the indigenous community of Saraguro, Ecuador, employed a combination of in-depth interviews, free-listing, videotaped walk-throughs, and mapping to explore the role of home gardens, which are established and controlled by women. Findings reveal that, although gardens offer multiple benefits, they are overwhelmingly devoted to the cultivation of medicinal plants, operating as de facto medicine cabinets that supply women with most of the resources they need to treat family illnesses. Results also suggest that the natural history of home gardens mirrors transformations within the family, and that Saraguro women study the contents of their neighbors' gardens, using this knowledge as a foundation for deciphering the owners' economic and health status. New threats to the sustainability of home gardens threaten the foundation of Saraguro's ethnomedical system and women's authority in the home and community. [ethnobotany, gardens, Ecuador, women healers, family health] A l humans remake the world in their own image, transforming land- and seascapes into domestic, production, and ritual spaces. Perhaps, then, one might gain insights about individuals or groups by examining how and why people remodel the natural world. Our research in the Ecuadorian highlands suggests that the environment of the huerta, or home garden, illuminates some critical dynamics of a household. In particular, we argue that the home garden embodies a family's health needs, and stands as a tangible and conspicuous affirmation of a woman's identity as family health provider. In the literature, home gardens are alternately termed house, kitchen, or dooryard gardens. We adopt the term home garden to place emphasis on the domestic focus of these plots and to avoid conveying a misleading impression that such gardens
73 citations
TL;DR: In this article, the authors draw on anthropological and feminist scholarship on the body and the nature/culture divide as a framework for understanding the place of surrogate mothers in a conceptual ideology that connects motherhood with nature.
Abstract: In this article, I draw on anthropological and feminist scholarship on the body and the nature/culture divide as a framework for understanding the place of surrogate mothers in a conceptual ideology that connects motherhood with nature. I explore links between the medicalization of childbirth in Israel and the personal agency of surrogate mothers as relayed through interviews. Taking the patriarchal context of the Israeli surrogacy law of 1996 into consideration, I underscore surrogates' imaginative use of medical metaphors as tools for the subversion of surrogacy's threatening social connotations. By redefining the surrogate body as "artificial" and locating "nature" in the commissioning mother's body, surrogates adopt medical rhetoric to transform surrogacy from a transgressive act into an alternative route toward achieving normative Israeli national reproductive goals, [surrogate motherhood, medicalization, nature, body, agency, Israel]
64 citations
TL;DR: Kohler as mentioned in this paper discusses fertility and social interaction from an economic perspective in the context of social interaction and fertility in an economic context, focusing on the relationship between humans and nature.
Abstract: Fertility and Social Interaction: An Economic Perspective. Hans-Peter Kohler. New York: Oxford University Press, 2001. xviii. 211pp.
61 citations
TL;DR: In this paper, Roth Allen et al. discuss managing motherhood, managing risk, and managing risk: Fertility and danger in West Central Tanzania in the 1990s and 2000s.
Abstract: Managing Motherhood, Managing Risk: Fertility and Danger in West Central Tanzania. Denise Roth Allen Ann Arbor. University of Michigan Press, 2002. xxii. 303 pp.
TL;DR: Appetites: Food and Sex in Post-Socialist China by Judith Farquhar.
Abstract: Appetites: Food and Sex in Post-Socialist China. Judith Farquhar. Durham, NC and London: Duke University Press, 2002. xii. 341pp.
TL;DR: It is submitted that most FGC is a proper matter of concern because it is the irreversible reduction of a human capacity in the absence of meaningful consent.
Abstract: A recent article in Medical Anthropology Quarterly (Obermeyer 1999) argues that the "facts " about the "harmful effects " of female genital cutting (FGC) are "not sufficiently supported by the evidence" (p. 79). The article suggests three further hypotheses, among others: (1) FGC may be of minimal harm because the more educated continue the practice just as much as the less educated; (2) FGC may be of minimal harm because it is so widespread and persistent; (3) FGC may be of minimal harm because the supposed link between the clitoris and female sexual pleasure is a social construction rather than a physiological reality. I challenge these hypotheses. I say that by appropriate standards of evaluation, FGC is harmful. Finally, I submit that most FGC is a proper matter of concern because it is the irreversible reduction of a human capacity in the absence of meaningful consent, [female genital cutting, harm evaluation, critical epidemiology, harmful traditional practices]
TL;DR: In this paper, the authors explored why lower-class women in south India in the 1990s were demanding to have childbirth labors induced with oxytocin drugs while rejecting anesthesia.
Abstract: As reproduction becomes increasingly biomedicalized throughout the globe, reproductive technologies are used in unique ways and imbued with different meanings. This article explores why lower–class women in south India in the 1990s were demanding to have childbirth labors induced with oxytocin drugs while rejecting anesthesia. Cultural constructions women's reproductive power are evoked and reworked in discourses of modernity that explain this preference. Discourses on relationships among gender, pain, and modernity relate to political—economic constraints on hospitals to perpetuate this practice, [modernity; reproductive technologies; gender; India]
TL;DR: This article takes a biocultural approach to understanding the nutritional status of elementary school children in a rural community in eastern Kentucky, paying particular attention to the ways in which the school's nutrition environment shapes overweight and nutritional status for many of the children.
Abstract: Overweight and poor nutrition of children in the United States are becoming issues of increasing concern for public health. Dietary patterns of U.S. children indicate they are consuming too few fruits and vegetables and too many foods high in fat and sugar. Contributing to this pattern of food consumption is snacking, which is reported to be on the increase among adults and children alike. One place where snacking is under increased scrutiny, and where it is being increasingly criticized, is in U.S. schools, where snack foods are often sold to supplement inadequate budgets. This article takes a biocultural approach to understanding the nutritional status of elementary school children in a rural community in eastern Kentucky. It pays particular attention to the ways in which the school's nutrition environment shapes overweight and nutritional status for many of the children, focusing on the sale of snack foods and the reasons behind the principal's decision to sell snack foods in the school.
TL;DR: The author concludes that the dominant biomedical explanation of immigrant tuberculosis could be modified with the incorporation of the migratory process as a risk factor.
Abstract: After decades of decline, tuberculosis case rates in New York City more than tripled between 1978 and 1992. While the number of cases of those born in the United States declined after 1992, the proportion of immigrant tuberculosis cases continued to increase and reached 58 percent in 1999. This article questions the biomedical explanation of immigrant tuberculosis as being imported from immigrants' countries of origin. Illness narratives of illegal Chinese immigrants with tuberculosis detailing risks associated with migratory journeys are presented. The social and cultural nature of the concept of risk, as well as the adverse implication of biomedical identification of immigrants as being at higher risk of tuberculosis, are also discussed. The author concludes that the dominant biomedical explanation of immigrant tuberculosis could be modified with the incorporation of the migratory process as a risk factor, [tuberculosis, illegal migration, Chinese immigrants, New York City, Chinatown]
TL;DR: Petryna as mentioned in this paper, Life Exposed: Biological Citizenship after Chernobyl. Princeton: Princeton University Press, 2002. 264 pp. xvii, xviii, n.
Abstract: Life Exposed: Biological Citizenship after Chernobyl. Adriana Petryna. Princeton: Princeton University Press, 2002. xvii. 264 pp.
TL;DR: It is argued that Weil and Chopra both epitomize the limitations of the holistic health/New Age movements, albeit in different ways.
Abstract: Despite the popular roots of the holistic health/New Age movements, a growing number of biomedical physicians have become proponents of holistic health as well as New Age healing. Over the past two decades, Andrew Weil and Deepak Chopra, two biomedically trained physicians, have emerged as the visible and financially successful spokespersons of the movement. This article provides brief biographical sketches of Weil and Chopra and compares and contrasts their respective views on health, illness, healing, and health care. It also considers the response of various biomedical parties to these holistic health/New Age gurus who have attempted to integrate biomedicine and various alternative healing and metaphysical systems. Finally, this article argues that Weil and Chopra both epitomize the limitations of the holistic health/New Age movements, albeit in different ways.
TL;DR: Focus groups in western New York with Latino anglers and partners of anglers revealed that older anglers believed local waters were of good quality and that it was safe to consume fish taken from them, while younger Latinos believed that area waters were highly polluted because of dumping of waste from local industries.
Abstract: Sport fish advisories for the Great Lakes states suggest limiting consumption offish taken from the lakes and their tributaries because of chemical contamination. It appears, however, that minority anglers are less aware of the advisories and also consume greater amounts of sport fish than white anglers. We conducted focus groups in western New York with Latino anglers and partners of anglers to explore these patterns. Analysis revealed that older anglers believed local waters were of good quality and that it was safe to consume fish taken from them. They based their evaluation of both water and fish primarily on visual inspection. In contrast, younger Latinos believed that area waters were highly polluted because of dumping of waste from local industries. They fished away from urban areas in an effort to find cleaner, more swiftly moving waters. They considered consuming sport fish from urban areas highly risky, given their occasional illness experiences following meals of what they thought were polluted fish. For all Latino anglers, however, state-sponsored advisories were minimally effective because of their limited distribution and complex wording. Results point to differences in lay and scientific models of pollution and a need to bridge this gap in future risk-communication strategies. [Latinos; risk perception; risk communication; sport fish advisories]
TL;DR: Inhorn and Van Balen as discussed by the authors describe a "New Thinking on Childlessness, Gender, and Reproductive Technologies" in their book Infertility around the Globe: New thinking on childlessness, gender, and reproductive technologies.
Abstract: Infertility around the Globe: New Thinking on Childlessness, Gender, and Reproductive Technologies. Marcia C. Inhorn and Frank Van Balen. eds. Berkeley: University of California Press, 2002. 347 pp.
TL;DR: Endangered Species: Health, Illness and Death among Madagascar's People of the Forest and Ethnographic Studies in Medical Anthropology Series.
Abstract: Endangered Species: Health, Illness and Death among Madagascar's People of the Forest. Janice Harper. Ethnographic Studies in Medical Anthropology Series. Durham, NC: Carolina Academic Press, 2002. xvii. 273 pp.
TL;DR: In this paper, Kamran Asdar Ali presents a plan for planning the family in Egypt: New Bodies, New Selves, and new Selves of the Egyptian Family.
Abstract: Planning the Family in Egypt: New Bodies, New Selves. Kamran Asdar Ali. Austin: University of Texas Press, 2002. xii. 233 pp.
TL;DR: A cultural explanatory model of disability was elicited from a longitudinal sample of 23 European American adolescents with varied cognitive disabilities and delay, finding a majority of teens had a reasonably rich and coherent EM, blending typical and disability themes of cultural knowledge and identity.
Abstract: What do teens with disabilities believe about their conditions, and what do they understand to be the causes, correlates, and consequences of disability? We elicited a cultural explanatory model (EM) of disabilityfrom a longitudinal sample of 23 European American adolescents with varied cognitive disabilities and delay. We asked teens how they were similar to or different from others; the name of this difference; its causes, severity, course, effects, associated problems and benefits; and needfor treatment. IQ and type of disability strongly affected quality of responses only from the lowest functioning teens. A majority of teens had a reasonably rich and coherent EM, blending typical and disability themes of cultural knowledge and identity. The EM is a window into social context (schools, services, parents, and peers) as well as personal experience. Eliciting explanatory models from teens with disabilities is not only possible but also can enhance understanding of identity, family influence, and appropriate services. [disability; explanatory models; adolescence; culture] fter eras of "blaming" parents for their children's disabilities and relying on biomedical labels as both correct and sufficient to explain and name various conditions, research and practice today recognize the significance of the meaning and understanding of disabilities held by family members and children themselves. What do teens with disabilities believe about their circumstances, and what do they understand to be the causes, correlates, and consequences of their conditions? That is, what are their cultural explanatory models (EMs) of their circumstances (Kleinman 1980; Weiss 1997)? An EM encompasses an individual's beliefs in five domains of an illness or health condition: etiology, time and mode of symptom onset, pathophysiology, course of sickness, and treatment. Our report describes the explanatory models of adolescents with varying impairments in cognitive and social functioning and offers a basis for beginning a line of inquiry about
TL;DR: The idea of health itself is analyzed to show how biomedicine varies across societies and how historical processes have shaped contemporary cultural patterns and led to generational continuities and differences in beliefs and behaviors.
Abstract: Basic beliefs about health in north central Italy derive from an approach to the personal management of the body that is not just reactive but also proactive. This article examines a complex field of health factors in relation to historical processes and a system of medical pluralism. Rapid demographic and social changes over the past century have brought an accommodation of ancient medical beliefs to more recent germ-oriented principles. An enduring belief in the permeability of the body leads to an emphasis on moderation in personal conduct to prevent debilitation, whether by atmospheric insults, microbial infection, or modern-day miasmas such as pollution or additives in food. The idea of health itself is analyzed to show how biomedicine varies across societies and how historical processes have shaped contemporary cultural patterns and led to generational continuities and differences in beliefs and behaviors. This information may also improve interactions between patients and health care providers.
TL;DR: Searching for the Secrets of Nature: The Life and Works of Dr. Francisco Hernandez as mentioned in this paper, trans. Simon Varey. Stanford: Stanford University Press, 2000. 281 pp.
Abstract: Searching for the Secrets of Nature: The Life and Works of Dr. Francisco Hernandez. Simon Varey. Rafael Chabran. and Dora B. Weiner. eds. Stanford: Stanford University Press, 2000. xvi. 229 pp.
The Mexican Treasury: The Writings of Dr. Francisco Hernandez. Simon Varey. ed. Rafael Chabran. Cynthia L. Chamberlin. and Simon Varey. trans. Stanford: Stanford University Press, 2000. xix. 281 pp.
TL;DR: It is shown that children's ADHD symptoms can be, but need not always be, reported differently based on cultural models expecting behavioral differences, and child's gender influences the way psychiatric symptoms are ascribed to them by some, but not all, groups of involved social actors.
Abstract: We test empirically how caregiver reports of DSM-IV symptoms of Attention Deficit Hyperactivity Disorder (ADHD) vary by child 's gender in a sample of 206 middle-class Mexican children, ages 6–12 years. Objective measures of children's hyperactive and inattentive behavior, derived from ethological observation and activity monitoring, are used as a control in regression analyses. When these objective measures of behavioral differences are taken into account, teachers ascribe more inattention symptoms to boys than girls. Parents, by contrast, do not display a significant gender difference in identification of children's ADHD symptoms. This study provides an empirical demonstration that children's ADHD symptoms can be, but need not always be, reported differently based on cultural models expecting behavioral differences. In this case, child's gender influences the way psychiatric symptoms are ascribed to them by some, but not all, groups of involved social actors. [ADHD, gender, culture, symptoms, psychiatric disorders, Mexico]
TL;DR: Based on ethnographic research in three agricultural settings in Florida, one aspect of risk and danger for female sex workers, that of interpersonal violence, is examined, while considering women's responses to a shifting sex trade in areas where farmworkers live and work.
Abstract: Based on ethnographic research in three agricultural settings in Florida, this article examines one aspect of risk ana danger for female sex workers, that of interpersonal violence, while considering women's responses to a shifting sex trade in areas where farmworkers live and work. Sex work in agricultural areas varies from urban sex work. Women eschew pimps, ask for backup from local men entrenched in street settings, and canvass a wide spatial area rather than remained fixed in space. Oscillating between periods of capital-deficiency (nonseason) and capital-intensification (harvest), women respond to increasing risk and danger by building a clientele of regular customers, refusing risky transactions and referrals, and creating a local infrastructure of sanctuary. Some women also construct schemes to relieve men of their money. These men typically are farmworkers, whose vulnerability and image of low riskfor HIVexpands the potential for risk and danger found in these settings, [commercial sex work, migrant and seasonal farmworkers, violence against women, southeastern United States {Florida}]
TL;DR: It is argued that, to a large degree, what fueled and shaped the 1987 survey's codification and quantification of disability was how Chinese officials were incited to shape their own identities as they negotiated an array of social, political, and ethical forces, which were at once national and transnational in orientation.
Abstract: In this article I examine how and why disability was defined and statistically quantified by China's party-state in the late 1980s I describe the unfolding of a particular epidemiological undertaking--China's 1987 National Sample Survey of Disabled Persons--as well as the ways the survey was an extension of what Ian Hacking has called modernity's "avalanche of numbers" I argue that, to a large degree, what fueled and shaped the 1987 survey's codification and quantification of disability was how Chinese officials were incited to shape their own identities as they negotiated an array of social, political, and ethical forces, which were at once national and transnational in orientation
TL;DR: Examination of how a group of public health physicians in the urban Amazon values medicinal plant knowledge finds that context is key to understanding whether, when, and why physicians value certain bodies of knowledge.
Abstract: This article examines how a group of public health physicians in the urban Amazon values medicinal plant knowledge. As biomedical health care providers, physicians routinely draw on scientific plant knowledge. At the same time, as residents of the Amazon and health care providers to the poor, they are aware of and sometimes participate in local systems of plant knowledge. When discussing medicinal plant use, physicians repeatedly mention three themes: science, superstition, and biopiracy. The way in which physicians construct and negotiate these themes is part of the process of maintaining and legitimating their expertise and authority. This analysis finds that context is key to understanding whether, when, and why physicians value certain bodies of knowledge. Locally, in clinics, scientific plant knowledge is constructed as superior. In a global context, however, local plant knowledge is explicitly valued. This situational valuation/devaluation of plant knowledge relates to the positions of power physicians occupy in each context, [medicinal plants, politics of knowledge, Brazil, Amazon, physicians]