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University of Toronto Scarborough
Health Studies
R Song

2012-09-18 HLTC05H3 S Lecture 2: Biocultural Perspectives on Health (Critical Medical Anthropology) • Anthropologists do play a big role in public health especially epidemiology o Traditionally focused on western cultures but there has been a shift to understand epidemiology in non-western cultures  Try understand the community and the role of individual in the community and trajectory of participation o Culturally-defined= subjective vs. objective causes; particular to the culture and how they view disease; response to disease can also change in culture  Based on social, cultural environment as well as the changes in one’s life (physiological or psycho-social health) • Greater stress can lead to greater susceptibility o Historical contingency= how medical histories/pasts play a current role in YOUR susceptibility to disease, physiological and psycho-social health • Interested in who’s included and who is excluded from the story or analysis o Underlying social factors that affect the majority of the population • Critical medical anthropology o Sub field of bio-cultural anthropology o Biology and culture intertwine o Looks at political-economic sources of why you’re sick and how political- economy plays a role in biology o How policy impacts health?  Determines if one person or not has access to health  Most interested in hidden causes  Neoliberal economic policies  Micro-level is the individual understanding of health and health policies while macro-level is health policies and public health • Goal of CMA= affect and create social change (i.e. community or political) o Active role in challenging social inequity by uncovering the hidden causes  Globally today we live in socially unequal societies in terms of living and working conditions • Social determinants of health and unequal distribution of resources • Belief that living in democratic societies; everything is equal which is untrue but is continued to be perpetuated  Structural violence= social stratification and is entirely rigid (i.e. the caste system in India) • Inequality in democratic countries (look @ prof’s lecture notes for different forms of inequality and structural violence) • Aspects of every society. • These forms indirectly or directly are violent • Significant place put on social determinants of health • Critiques of CMA= (look at professor’s slides) o Interpretive argument= depersonalizes individual conceptualization of disease; focus on political economy o Ecological argument= ignores biological and ecological factors • Social inequality o Macroparasitism= “when organisms appropriate others as continuing sources of food and energy, we can characterize that relationship as parasitism.” (Armelagos et al. 2005:756) o Over time there has been greater parasitism  Egalitarian way of life during hunter-gatherer time  As we change culturally there has been a change in contracting diseases related to animal diseases (zoonotic [wild] and mostly from domesticated animals= suffering from more bacterial diseases with the emergence of urbanization and population density • Higher population density leads to inequality and diseases that feed off this inequality • Change from agriculture to farming (first epidemiological transition) • First epidemiological transition o Agricultural to farming- the fertile crescent  Grains that can be grown in surplus; eliminates the need to move around  Increases population size  Health is impacted from living much closer now • Agriculture, sedentism, and population increase o When settled and concentrated on farming (animals, irrigation)  Mesopotamia= irrigation accompanied agriculture which led to different jobs for individuals= the advent of new jobs; creation of differences now in social status  When there is large-scale agriculture to support a larger population there is increased social inequality and therefore also political power • Change marked from differential access to resources such as food, water, or healthcare • Greater demographic change • This is found in the archaeological record of the first farmers in comparison and contrast to hunter-gatherers using the dental record o Eating more starches by farmers and had a lot of infections in the roots of their teeth, abscesses than hunter-gatherers; dental health can be understood as an indicator of overall health o Greater rates of anemia in farmers than in hunter-gatherers  Farmers ate more grains and starches • Inadequate
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