8.1: Theoretical Approaches in Medical Anthropology

Three theoretical approaches exist in understanding human health. First, is the epidemiological or the ecological approach. This approach examines the way culture and the natural environment interact to create the patterns of which result in health and disease. The second is the interpretivist approach, which looks at the way cultures use symbolic meaning to describe and understand health and disease. The third is critical medical anthropology, which focuses on how socioeconomic and political factors affect human health.

Epidemiological Approach

Epidemiology is the study of factors that affect health and disease among populations and is considered a fundamental aspect of public health research. Epidemiology focuses on identifying disease risk factors based on how, when, and where they occur. By collecting this data, epidemiologists provide data for measuring the occurrence of health phenomena. Anthropologists may use this approach to examine cultural patterns such as food, work location, sexual activity, water, and medical practices that may affect or show a correlation with the prevalence of a particular disease. Epidemiology involves the usage of mapping out diseases and showing where in an environment that disease arose. This can be done using geographic information systems to identify where in a population a disease has spread and how far. (http://www.spatialepidemiology.net/)

In addition, epidemiological studies are divided into two types: Retrospective and Prospective. Retrospective describes whether the events have already occurred and Prospective describes whether the events may occur in the future. Retrospective studies are the most common of epidemiological studies and are also known as case-control studies. Case-control studies take place when there is an outbreak of disease in the population and the cause of the disease is unknown or when the population is not familiar with the disease. (http://pmep.cce.cornell.edu/profiles/extoxnet/TIB/epidemiology.html)

Interpretivist Approach

Cultures throughout the world use different systems of meaning to describe and respond to illness. Anthropologists who study these differences with symbolic meaning employ the interpretivist approach to medical anthropology. This approach looks at illness from an emic perspective attempting to understand health and disease relative to a particular culture. Using the emic approach allows the anthropologist to understand the illness from the internal perspective of the subject rather than from an outsiders viewpoint. By gaining an emic perspective on a culture, medical anthropologists can further understand that notion of "embodied person-hood." Embodied person-hood is defined as the relationship of cultural beliefs and practices in connection with health and illness to the sentient human body, this is the core focus for anthropologists using the interpretivist approach.

Critical Medical Anthropology

Critical medical anthropology focuses on how economics and politics shape the overall status of human health. Critical medical anthropology addresses the disparities in the quality of health and care in the presence of social inequalities. Social divisions based on race, ethnicity, gender and class can influence access to health care and susceptibility to disease. Critical medical anthropologists acknowledge these social factors when looking at the prevalence of a particular disease and ways to prevent it. In a 1998 study of inner-city Hispanic children, critical medical anthropologist Merrill Singer found that food insecurity and hunger were prevalent conditions. By identifying variables associated with these conditions, Singer was able to determine risk factors for food insecurity and hunger that could be used by policy makers to improve food programs and public health policy. Critical medical anthropologists have worked hard to critique bio-medical practices to decrease health problems such as hunger, malnutrition, and disease in order to promote wellness.