Class Notes (838,985)
Canada (511,151)
Anthropology (1,602)
ANTC68H3 (58)
Bryce (14)
Lecture 3

Lecture 3.docx

8 Pages
Unlock Document


Lecture 3 Epidemiological Transitions, Syndemics, Disease Transfer at Contact Anthropological Approaches (Manderson 1998) - Health Belief Model: says that educating patients will lead to a change in behaviour by replacing ‘false’ beliefs with ‘accurate’ knowledge o Doesn’t always work in practice. o WHY? o Ex: bed nets, water, drug packaging - Rapid Anthropological Assessments: anthropologists familiar with a particular population may be asked to quickly ascertain human behaviour and specific local beliefs and knowledge. o May be rapid because of time or money constraints or in locations without trained personnel o During an epidemic it is especially important to come up with quick interventions - All we need to do is educate people and then we’ll do things that lead to health Health Belief Model - If you live in an area where malaria is a endemic, we know bed nets are important. They may understand the relationship with mosquitos, but they may not use them because the nets are uncomfortable or smell bad etc - People have their own internal reasons, may give father the net and not the children even though they need it most - No matter how much you educate someone about drinking clean water, wont help if they don’t even have clean water - Knowledge does not always equal behaviour - This model says it does but anthropology says there are problems with that - Good written question for exam - Anthropological methods include in-depth interviews and focus groups. - Anthropologists also contribute to the study of infectious disease by discovering LOCAL taxonomy (how a disease is defined) and aetiology (how a disease is caused) o Identifying the factors that influence people’s decisions to diagnose illness or differentiate between threatening and life-threatening diseases o Identifying factors that affect people’s preparedness to use biomedical services and adhere to prescribed treatment - Anthropologists help minimize suffering - Anthropologists facilitate ACCESS to biomedical resources and SUSTAINABLE interventions - Anthropologists help translate information between biomedical practitioners and local populations to result in more effective health interventions Syndemics - Syndemic refers to the synergistic interaction of two or more co-existing diseases AND the resultant excess burden of disease - Medical Anthropology contributes to the study of illness by exploring alternate concepts of sickness in a socio-cultural context - As the way we think about sickness changes our response to it changes as well (ie. Biomedicine sees all diseases as discrete and bounded; treatment is based on symptoms of individual maladies) - In a syndemic, the whole is greater than the sum of the parts o ex: HIV AND TB: patients with both have decreased survival compared to those with either separately o HIV+ patients develop symptoms of TB earlier than HIV- patients - The way we think of sickness changes our response to it. If it’s a big deal for us we will do something about it otherwise we don’t care to treat it - Doctors hate overlap of disease - In biomedicine, treatment is about individuals - The interaction between two diseases can occur at a biological level, for example genes of two viruses mixing in the body - A syndemic doesn’t have to just be two sicknesses, it could also be the interaction of a disease with something else, such as poverty or stress. - Ex: asthma sufferers have higher rate of influenza infection than non-asthma sufferers. - Hospitalization rates are higher in inner cities (poor) and for racial minorities - Asthma rates are also higher in children surrounded by neighbourhood violence - Syndemic could also be TB and poverty or stress. Does not have to be two diseases Syndemics: Poverty - Rates of impoverishment increase every year, as does the gap between the rich and the poor - Poverty impacts nutrition, shelter, access to health care, sanitation, water, political power, psychological stability, … - Overall: increased poverty leads to increase susceptibility to infectious diseases and limited means to change/adapt - It is one of the greatest determinants of human health today Syndemics – Some Definitions - Structural Violence: “violence of poverty, social and political marginalization, racism, sexism, and other forms of structured inequalities and their effects on people’s lives, health, and agency” (Leatherman & Thomas 2009: 197) - Agency: “the capacity of human beings to affect their own life chances and those of others and to play a role in the formation of the social realities in which they participate” (Barfield 1997: 4) - Structural violence being put down systematically - If you have agency, you have control to do what you want. If someone if constraining you, you have no agency - Agency is hard to change on a large scale Syndemics - A common component of syndemics is MALNUTRITION, which lowers the body’s ability to fight infection o Ex. Malnourished patients have longer duration of influenza infection than well-nourished patients o Poverty and poor childhood nutrition are associated with heart disease in adulthood. o Patients experiencing stress and stigma have quicker progression of HIV - SAVA: a syndemic between Substance Abuse, Violence, and AIDS. Unfortunately, a very common combination - Anthropological application: since we know certain populations (poor, homeless, malnourished, stigmatized, etc.) are at high risk of AIDS, target interventions at similar populations not currently experiencing AIDS epidemic - Malnutrition makes diseases progress further easily Epidemiological Transitions - First proposed by Omran (1971) - Epidemiological Transition Theory focuses on the complex change in patterns of health and disease & on their demographic, economic and sociological determinants and consequences. - Omran says MORTALITY is the key to understanding population dynamics - Before you can understand Epidemiological Transition, first need to talk about Demographic Transition - Omran’s three disease stages correspond with first three demographic transition stages - Defines the stages by mortality - How to understand everything else going on in the population Demographic Transition Stage 1 - Demographic Transition describes the change from high fertility and mortality to low fertility and mortality (and accompanying changes in population size) - STAGE 1: birth rates and death rates are both high with occasional fluctuations (war, disease, famine) - Population size at constant low level - OMRAN STAGE 1: Age of Pestilence and Famine - Life expectancy low (20-40 years), children and women most affected by poor conditions - Demographic transition change in human population from high mortality/fertility period to low mortality/fertility (both are low and constant) but it wasn’t like that in the past - Stage 1 birth rates and death rates are high, fluctuations occur cuz disease occurs, war, famine but the pop is constant and not increasing Demographic Transition Stage 2 - STAGE 2: Mortality experiences rapid decline while birth rate still high and stable - Population size increases rapidly - WHY does mortality decline? Improvements in sanitation, hygiene, nutrition (Note time period: this is before effective medical interventions) - Mortality falls down by a lot - People started dying less of infectious diseases - Germ theory and biomedical theory didn’t happen until after this period of 1760-1870 - People are still having a lot of babies - These are demographic transitions versing omran’s stages Demographic Transition Stage 3 - STAGE 3: Mortality stabilizes at lower level, birth rate falls - Population size increases less rapidly (this graph doesn’t do good job of showing that) - Why a falling birth rate? Higher infant survival, transition to industry, fewer children needed - Women are becoming me independent, birth rates are falling - Babies are living longer, women are working outside now, less children, less mortality - OMRAN STAGE 3: Age of Degenerative and Man-Made Diseases - Life expectancy still improving (50+ years) - Fertility now critical factor in population growth (mortality stable) - Infectious diseases are still going on but not as much - People who were dying by 30 never experiences old age problems - People are living longer now and experiencing different issues like heart disease and old age problems Demographic Transition/ Omran - Note that the reason for transitions is NOT medical science. (Medicine does help with later transitions) - Infectious disease mortality was already declining long before Germ Theory (recall 1860-ish) - Better standards of living, hygiene, health habits, nutrition (all by-products of social change) - The most profound improvements in health were seen in children and young women. - Omran did have variations on his models: (i) Classical (western) – what you just saw (ii) Accelerated (Japan) – took longer to reach stage 3 but quick catch-up (iii) Delayed (Latin America, Africa, Asia) – slower changes to health infrastructure, sanitation. Fertility still quite high. - Know the 3 models, don’t need to draw anything Demographic Transition: Stage 4 - OMRAN did not differentiate; part of degenerative and man-made disease - STAGE 4: mortality and birth rates at new, lower level - Population size remains constant at high level (or slow increase) Demographic Transition - STAGE 4: better health care, nutrition, family planning, later marriages - STAGE 5: (?) Fertility drops below replacement levels, population size slowly decreases Examples: China (one-child policy), Italy - Women have more agency to say that they don’t want to have so many kids - 5: fertility dropping below replacement levels Criticisms of Epidemiological Transition Theory - Teleological (goal-directed): it suggests that there is an end goal of being “developed” (at which point change may stop) - Actually: we are always changing and there is no end point - Hierarchical: societies are expected to pass through each stage in order. Those in an earlier stage are less advanced. - Actually: The Epidemiological Stages occurred in a specific historical context with circumstances that may/may not be replicated - Stages are fixed, with no overlap. No going back and forth between stages. - Actually: many societies have elements of more than one stage at the same time (ex. Obesity and ‘old’ infectious diseases such as cholera) - Omran’s vision Advancing to a point and staying there (telelogical) - But we say that we are always changing, we don’t stop - He believed that if you had moved onto the next stage, the previous diseases had disappeared
More Less

Related notes for ANTC68H3

Log In


Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.