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Health and Medicine

Essays in Cultural Anthropology have sought to make sense of health and illness both at the level of individual experience and perception and at the level of institutionalized systems. Often, the goal is social theoretical analysis of the significance of modern medicine. Equally important is the imperative to do ameliorative work to address problems such as social inequalities in health and access to healthcare, failures of health professionals to address patients’ primary concerns, and the need to evaluate the impact of health services in populations’ well being. We recognize that these different motivations in the cultural analysis of health, the desire analytically and theoretically to understand, as well as the desire to contribute to change, need to be maintained and appreciated. Accordingly, we present a diverse selection of essays that question dominant definitions of health and illness, evaluate alternative options for achieving health, and assess the appropriateness of healthcare systems for individuals and groups.

Prominent organizing themes for many essays are social and cultural frameworks of analysis of health, and the experience of health and illness. Such essays often explore the centrality of the individual’s views, perceptions and responses to the experience of health problems. While examining the systemic and social factors that shape individuals’ risks of ill health, they also examine the underlying social and cultural attitudes that shape perceptions of health and illness held by individuals, groups and societies as a whole. This interpretative focus recognizes that the healthcare system must increasingly take account of patients’ and caregivers’ personal experiences and perceptions if it is to provide effective care. At the same time, it recognizes the constraining circumstances of the individual: limitations of resource, education, income, location and biology. Thus, cultural frameworks of explanation, and prevailing formal and informal understandings of health and illness, when analyzed for their roles in channeling health perception and health seeking behavior, are seen as both resource and constraint. Essays in this category include Deepa Reddy’s “Good Gifts for the Common Good: Blood and Bioethics in the Market of Genetic Research” (2007), Ann Julienne Russ’s “Love’s Labor Paid For: Gift and Commodity at the Threshold of Death” (2005), and Judith Farquhar and Qicheng Zhang’s “Biopolitical Beijing: Pleasure, Sovereignty, and Self-Cultivation in China’s Capital” (2005). Other examples are Karen-Sue Taussig’s “Bovine Abominations: Genetic Culture and Politics in the Netherlands” (2004), Jean Langford’s “Traces of Folk Medicine in Jaunpur” (2003), Stacy Leigh Pigg’s “Languages of Sex and AIDS in Nepal: Notes on the Social Production of Commensurability” (2001), and Christine Walley’s “Searching for ‘Voices’: Feminism, Anthropology, and the Global Debate Over Female Genital Operations” (1997).

Another important organizing theme is healthcare systems and practices. Here the analytic gaze shifts to the organizational and institutional arrangements for healthcare. Historically, the medical profession has been viewed as the crucial shaping force of healthcare systems. However, transformations in work processes in the healthcare system have led to increasing emphasis on market competition, business ethos, and governmental supervision and accountability, so that these factors are now being recognized as gaining ground. Meanwhile, the practice of medicine continues to be influenced by the need to deal with old and new uncertainties. For example, expansion in the evidence base of medical knowledge often seems, paradoxically, to enhance the sense of medicine’s epistemological insecurity. Essays in Cultural Anthropology have tended to emphasize the scope for alternative health systems and practices, if not to question the institutional dominance of biomedicine, at least to fill the record on increasing numbers of cases in which healthcare is neglected or mishandled by biomedicine. Some examples of essays that address the organizational aspects of healthcare are Michael Montoya’s “Bioethnic Conscription: Genes, Race and Mexicana/o Ethnicity in Diabetes Research” (2007), Shao Jing’s “Fluid Labor and Blood Money: The Economy of HIV/AIDS in Rural Central China” (2006), and George Lipsitz’s “Learning from New Orleans: The Social Warrant of Hostile Privatism and Competitive Consumer Citizenship” (2006). Other examples are Peter Redfield’s “Doctors, Borders, and Life in Crisis” (2005), Sarah Pinto’s “Development Without Institutions: Ersatz Medicine and the Politics of Everyday Life in Rural North India” (2004), and Matthew Kohrman’s “Authorizing a Disability Agency in Post-Mao China: Deng Pufang’s Story as Biomythography” (2003).

In the February 2012 essay collection on immunology, authors examine the anthropological implications of the microscopic processes of the immune system. A. David Napier’s “Introduction” (2012) and “Nonself Help: How Immunology Might Reframe the Enlightenment” (2012) problematize what is often assumed to be a clear divide between one’s own body, which the immune system must defend, and foreign bodies such as viruses, bacteria, and toxins, which the immune system is meant to protect against. Medical gray areas that introduce ideas of a non-static self, such as transplanted organs and cancerous tumors, have complicated scientific distinctions between “self” and “nonself” in a way that leads Napier and other contributors both to question existing frameworks for conceptualizing immunological theory and to explore alternative ways to classify what constitutes the self. In his essay “Immunology and the Between” (2012), Paul Stoller encourages an appreciation of the creativity that becomes possible when binary thinking and its inherent limitations are rejected.

by Shailaja Valdiya (June 2008); updated by Cari Merritt (October 2012)

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