Midterm Review (Readings)
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Midterm Review Questions from Readings
1. How would you distinguish an epidemiologist’s perspective on disease from that of a
biomedical physician? An anthropologist?
Anthropology: study of infectious disease is an intrinsically biocultural endeavour, the
“anthropology of infectious disease” described here must be a holistic one, in which traditional
subdisciplinary boundaries are irrelevant.
Biomedicine: disease are considered as clinical entities with pathological underpinnings, while
illnesses are more linked to a patients perception and behaviour. ID are caused by biological
agents ranging from microscopic intracellular viruses to large structurally complex helminthic
Anthro field: disease as the broad area which emphasize the interactions between sociocultural,
biological, ecological variables relating to etiology and prevalence of ID.
Epidemiology: study of disease with consideration to the host, agent and the environment. They
determine the causes, etiology, and understand disease patterns to prevent the disease from
occurring and control the spread.
2. What are the critiques of ‘risk factor epidemiology’?
Risk factor epidemiology refers to a type of epidemiology that involves looking for specific risk
factors associated with disease. Examples are: what is the association between hypertension and
developing a heart attack, what is the association between lack of exercise and development of
obesity. It looks at the association between specific risk factors and how those increase the probability
of coming down with a specific disease or form of morbidity.
Risk factor epidemiology, is at the middle ground of cause-effect relationships between exposures to
health risks and health states. Extend the causal search downstream from the individual level to the
molecular level and upstream. Besides the black box, there is a deficiency in its tendency to
function, in a social, economic, political and cultural vaccum.
3. Explain the distinction between incidence and prevalence rates.
Prevalence: proportion of people in a pop who have a specific health problem at a particular point
in time or specific time interval
Incidence: subsets of prevalence cases, but the number of new cases in a pop. during a specific
4. Why are incidence rates important for evaluating the effectiveness of an intervention to
prevent the spread of infectious disease (such as an immunization campaign or safer sex
Prevalence data reveal the extent of a given health problem and can help guide decisions about
allocating resources and providing services. They do not give idea about possible causes of the
health problem or if interventions will help.
Incidence, on the other hand, can be linked with data on risk factors, and used to investigate the
causes of disease and to evaluate the effectiveness of disease treatments or other interventions.
5. How might prevalence rates be significant for health policymakers and planners?
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They can study a disease that has already occurred and cases are already available to study, there
is no surprise, whereas with incidence rates are new cases, so they might have different causes,
6. Why is age-standardization of disease statistics important?
It allows epidemiologists to directly compare health statistics in populations that differ in their
age distribution. It will guarantee that any observed inferences are due to the disease rather than
differences in the numbers of people at risk for the disease.
7. How is mathematical epidemiology and modelling important to the study and management
of infectious disease? What are the challenges?
Mathematical epid. Adapt models to reflect factors operating in actual epidemics more adequately
and strive to capture the most important aspects of the host-agent-environment interaction within
the structure of a model. The ultimate goal of M.E. is to help public health-oriented epid.
Determine how best to control outbreaks of infectious diseases
Mathematical models allow researchers to explore the effects of the disease itself as well as the
impact of disease prevalence if particular control strategies are implemented in a population.
8. Why do we study disease in anthropology? How can anthropology contribute to the study of
disease on a practical level?
Anthropology answers the important ‘why’ questions, by identifying social, cultural, and
psychological correlates of human behavior relating to infectious disease, including indigenous
beliefs about etiology, diagnosis, and cure.
9. What does it mean to say a disease is social?
Social diseases occur in natural and social environments in which the agent and host are
interacting. Sociol-political influences make diseases a ‘social disease’ such as TB. The crucial
role of human behavior factors in the spread of sexually transmitted disease is reason for social
10. How can development lead to disease?
Development projects of dam construction, land reclamation, road construction, and resettlement
have spread more ID.
Critical medical anthropology:
a. Processes of sickness and health are socially constructed, biomedicine is predicted upon
culturally limited assumptions about fundamental categories like “causation” and “disease”
b. That diseases are only the proximate causes of human suffering, since the ultimate etiologies
involve political and economic inequality ( political economy of health)
c. That the institution of biomedicine itself functions to maintain social inequalities
Culture “manufactures” disease in two ways:
a. Societies actively change their ecology so as to increase or decrease the risk of particular diseases
b. Culture provides a theoretical system for understanding and attempting to manipulate through
medicine—the diseases that cause human suffering and health
Anthropological Perspectives on Disease and Human History:
1. Discuss the evidence that adaptations to infectious disease have evolved in human
populations over time.
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Successful human adaptations usually involves the synergistic effects of altered behaviours,
modified phyiochemistry, and genetic polymorphism.
Human adaptations to ID are largely centered around variation in our immune system- two
responses: antibody mediated and cell mediated
The most important nonimmunological adaptation to viruses included lysozymes.
Types: human virus, human bacteria, human protozoa, human-helminth.
**study the disease examples**
2. Explain the concept of “syndemics”. In what way does this concept critique the biomedical
model of disease?
Syndemic refers to two or more epidemics (i.e. notable increases in the rate of specific diseases in
a population) interacting synergistically and contributing, as a result of their interaction to excess
burden of disease in a population. Also refers, to temporal or locational co-occurence of two or
more diseases or health problems, but also to the health consequences of the biological
interactions among the health conditions present
Ex. HIV and TB.
Syndemic points to the determinant importance of social conditions in the health of individuals
and populations.ie. poverty and discrimination place the poor at a disadvantage in terms of access
to diagnosis, treatment, availability and continue with treatment due to economic and social
Ultimately, social factors: poverty, discrimination, stigmatization, racism, sexism, ostracism, and
Syndemics are interactions of disease and adverse health conditions (ie. Malnutrition, substance
abuse, and stress) as a consequence of a set of health-threatening social conditions (e.g noxious
living, work or environmental conditions or oppressive social relationships.
A Syndemic is a set of intertwined and mutually enhancing epidemic involving disease
interactions at the biological level that develop and are sustained in a community/population
because of harmful social conditions and injurious social conditions
3. In what sense can epidemics be understood as “social and cultural processes”? Discuss.
It has also been documented how epidemics emerge in societies when adaptive mechanisms
deteriorate, particularly as a consequence of political subjugation: economic development, culture
contact, social change and acculturation and the alteration of a population’s ecological setting.
Macrosociological behavioral phenomena such as population movements or the alteration of the
environment have been shown to contribute to. The emergence of new or resurgent epidemics.
The course of the AIDS epidemic suggests that emerging epidemics can produce social and
cultural repercussions on a larger societal and even global level. Social and cultural epidemics of
this kind can spread quickly and with strong “social virulence,” which may have enormous
economic consequences for the affected population. Consider, for example, the identification of
Haiti in 1982 with the HIV virus which cost its economy millions of dollars in tourism revenues
and hundreds of jobs due to the exodus of investors
4. Discuss the potential impact of structural factors on all stages of an individual’s experience
of infectious disease, using specific examples.
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