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ant208 midterm- full notes for midterms/ book readings

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ANT208 Midterm Notes illustrate the underlying causes of variation Anthropological Perspectives on Health or similarities. and Illness • Holism is the idea that natural systems (physical, biological, chemical, social, What is anthropology? economic, mental, linguistic, etc.) and their • discipline that investigates the nature that properties should be viewed as wholes, not causes of human variation and those as collections of parts. aspects of life that are common to all of • Not one factor contribute the most humanity. It is the study of people . difference in response to disease, it depends • Franz Boas a geographic worker in the Arctic on the environment and different advocated systematic and long-term characteristics. fieldwork as a way of understanding people • Comparative analysis highlights the way of different culture. He includes bio, different combo of factors affect health. language, cultural history and archeological excavations NOT just behavior. The Cultural Concept • Boas came up with the concept of cultural • Culture is the beliefs, values, practices and relativism which means not to judge one traditions of a group. These traditions of culture to another superior one but rather behavior include subsistence and economic made sense of the culture on their terms. practices, social organization, rituals, diets, • Four fields in anthropology- Linguistic and healing practices. anthropology; archaeology; biological • Culture is not static, its dynamic and anthropology; cultural anthropology. changing in a historical and geological context The Development of Medical Anthropology • Ethnographic fieldwork - (Ethnography) is • During WW2 growing employment of the systematics description if human culture anthropologists to gather info on health and by doing fieldwork in a society for long-term. nutrition of populations in the US. • Participation-observation- the participation • Creation of World Health Organization in in, yet detached observation of a group’s 1948, anthropologists were hired to break behaviors, giving an inside and outside view. down cultural barriers. • Insider view is called Emic perspective and • George Foster, a founding figure, would use accounts from a member of that demonstrated the utility of anthological group. knowledge to enhance health intervention. • Etic viewpoint is an outside view observing • Medical Anthropology is centered around 2 behavior as from a distance and with no things: ethnomedicine and international previous knowledge. health. Biocultural Perspective What is Medical Anthropology? • It considers the social, ecological, and • Is the study of health, illness, healthcare, biological aspects of health issues and they and related topics from broad interact with populations. anthropological perspectives. • Bioculture analysis is inherited historical and • It investigates differences in health and seeking the roots of cultural behavior. disease experienced by using cross- • It considers the body as a starting point but cultural approach, comparing and not the ending point like biomedicine contrasting sociocultrual situations to • Biomedicine developed 18th C in europe and views disease as having unique biological causes within the body like individual to his or her experience, microorganisms or cells growth. The body is cultural orientation and social the only “environment” for understanding the environment. disease. • Anthropology started as colonialism began Sickness and studying other people turned from being I. Sick role- Talcott Parson said that it really racist to cultural relativism. means there is a socially recognized set of expectations for sick individuals. What is Health? II. Requires recognition- to take on a sick • According the the WHO, health is a state of role one must have a disease thats complete social, psychological, and physical recognized as legitimate , like a doctors well-being. note. • There is variation in what constitutes III. Can be associated with stigma - Susan healthiness within populations and well- said people with cancer sometimes get being like body fat or blood count, thus this shunned by relatives as if it was an definition can’t be universal. infectious disease. • Health and appropriate measures of well- • Social Integration, a term Lisa Berkam being are culturally specific coined that said relative risk of dying increased as level of social support declined Distinctions between these 3 factors that are for both genders. often interchangeable within populations: Disease refers to the physiological alterations The Locus of Health: The Body and Society that impair functions in some way. • Hughes and Lock said there are 3 bodies to 1. Derived from biomedical science consider in analysis of health and 2. Injury ; infection(derived from disease: the individual body, social body, microorganisms); malnutrition(Lack and the body politics. of food - protein-energy malnutrition • Individual body (self) is focused in Western PEM ). ; genetic (sexual biomedicine as the sole locus of disease reproduction, mutations); • Social body is the physical body and the chronic(from genetic factors but social world of that person. result of long-term behaviors like • Body politics is the way which social and heart disease, cancer); political forces control bodies in a society. psychological or behavioral • Medicalization is define a condition as a Illness is the subjective experience of disease or in need of medical surveillance, symptoms and suffering like pregnancy and childbirth. 1. motivates health-seeking behavior 2. Arthur came up with explanatory Biological/ Medical Normalcy model- individuals construct or • Distinction b/w biocultural and biomedical “make sense” of their experience of perspectives on disease. maladies, describing them as • Both take the focus on the body as the illness narratives. starting point but the endpoint is not the body 3. Needs to be a close articulation for biocultural. between illness and diagnosis of •  Needed to understand disease ** disease in therapeutic encounters. • Need also to establish a relationship 4. Illness is a more holistic concept between traits and increased/decreased than disease , as it links the risks of disease • State versus range ** • Biomedical perspective versus range ** Descriptive Epidemiology • Proximate cause means nearby and in this • Prevalence: The number or proportion of case it refers to the immediate cause of cases or events or conditions in a given some psychological disruption, like a population bacteria is the proximate cause of a fever. •  Incidence: number of new cases in a given • Ultimate causes of disease is what time period/ given population biocultural analysis uses which is to look at •  Epidemic: the occurrence of more cases of the individual in its environment, regional, a disease in a particular area or among a and national condition to how it shaped their particular population in a given period of time risk of disease. • Pandemic :an epidemic which occurs over a • In general the WHO standards are lower very wide area than the CDC standards, especially from • Endemic: the constant presence of a disease ages 6 months to 32 months in growth size or condition, within a particular geographic charts. area or population group • CDC standards are for “optimal” growth • Morbidity: any departure, subjective or but in fact US babies are over-nourished. objective, from a state of well-­‐being • Biological normalcy- the assumption that • Mortality: death all human biologies resemble those of one • Mortality Rate: A measure of the frequency group. Historically European biology is of occurrence of death in a defined considered “normal” for the species, hence population during a specified interval of time the “normal” type of biology. Others are hence “abnormal” Healers and Healing (chapter 3) • Biological normalcy can come to be • Healing: to restore to health applied to what appear to be “abnormal • healing takes time like a bone fracture but states” or no known sure within that given humans intervene by putting splints or cast society. to fasten healing time. • Conversely abnormality can come to be • Culture strongly influences healing applied to what are in fact normal states • Different cultures have different healing • Medicalization or pathologization ( The roles, but all cultures specify healing roles treatment of a health or behavior condition that are recognized and legitimized by as if it were a medical condition)** members. • Race is historically used to describe • Recognize different criteria for becoming a biological distinct types of humans, now healer often used to refer to a group that is socially Medical Pluralism marked as biologically different. These • the existence of multiple healing systems differences are due to genetic variation. within a culture • Common in state-level societies Epidemiology • Persistence of alternative medicines • Study of the distribution and determinants of depends upon multiple factors- Cultural disease (infectious or not) in a population beliefs; relationship to other traditions; and the application of this to health effectiveness, ability to complement problems. biomedical treatments. • Descriptive epidemiology: who, what, • Views of the body and disease causation where, when relate directly to the diagnosis of health • Analytic epidemiology: how and why conditions. Alternative and Complementary Medicines • Placebo effect-a beneficial effect, produced •  Alternative medicine refers to medical by a placebo drug or treatment, that cannot practices that are undertaken to replace be attributed to the properties of the placebo standard biomedical practice itself, and must therefore be due to the • Complementary medicines are those used patient's belief in that treatment. in conjunction with standard biomedical • nocebo effect-harmless substance that practice creates harmful effects in a patient who • ethnocentrism and ethnomedicocentric bias takes it. The nocebo effect is the negative because it views biomedicine as superior if reaction experienced by a patient who other medicine is seen as “alternative receives it = sickness or death. medicine”. Systematically • Ethnopharmacology- the study of • Evidence-based medicine- intellectual indigenous medicines. movement within biomedicine initiated in Alternative Medicines Today 1990s that advocated that patient care be • Acupuncture- A traditional Chinese based explicitly on the best clinical research medicine based on the insertion id needles evidence, and the patient has the right to massages or the application of heat at make their own clinical decisions. specific point of the body. • Differential diagnosis/decision-making • Chiropractic- A clinical system developed at trees (EBM) illustrates the foundation of the 19th C in US, which is based off of experience and systematic research, and manual manipulation of the muscuoloskeletal peer review, on which biomedical practices system and the nerve system and the effects should be based on. Bottom is Expert of these disorders in general health. opinion and top is systematic reviews= • Navajo Medicine- include 4 primary quality of evidence + as u go up the avenues - biomedicine, traditional healing, pyramid. Native American Church healing, and • Existence of such efforts suggest a response Christian healing. to non-systematic nature of such practices Biomedicine as Cultural System • Becoming a h’iloletik involves: visitation • Predominant ethnomedical system of West during a dream(3 dreams summoned before • Has a lengthy history the gods), a potential h’iloletik is identified by • Local/global influence has grown over time - another h’iloletik, and when a person is Why?*** having a seizure means they are • Person’s organs can be harvested if the predisposed to becoming h’iloletik. other person is declared brain dead and • White coat ceremony- for US medical approval from the dead person or their students, promoted by Arnold Gold family. Foundation, self-contuse passage rite • Brain dead- diagnosed when a person is in a coma, unable to breathe on their own, no Evolution On Health response to stimuli in the head or pupils, or • Evolutionary theory is a set if well- swallowing and no electrical activity to the supported hypothesis that explains how brain. biological systems came about and how they • Placebo-a harmless pill, medicine, or changed over time, and how they procedure prescribed more for the maintained. psychological benefit to the patient than for • Charles Darwin provided natural selection- any physiological effect explain how organisms acquired traits and how closely related they are to the reproduction by working on the species environment. inheritable genetics, DNA. • Evolution- changes in the characteristics of • sort term adaptability is called physiological a population over time. Natural selection is a plasticity. mechanism of evolution. • Evolutionary Medicine, Design, Strategy **** Recognizing adaptations: • Much of concern is oriented to the question 1) trait is a variation on an earlier form; of what we are NOT adapted for  2) trait is heritable; • mismatch conditions*** 3) trait enhances reproductive success • Adaptation is a trait the confers some Implications of adaptations survival or reproductive advantage. • context-specific or environment of • Adaptations are measured in fitness, evolutionary adaptation **** defined as reproductive success. • Context specific*** • Humans use health indexes to evaluate • Involve trade-offs- cost and benefits from their fitness. adaptation to genes, or short term • Selective forces are environmental factors alterations, or behavioral change. that pose threats to the survival and • Maximize fitness, not health*** reproductive and immediate danger of their health and wellbeing. Adaptationism • View that most traits are “optimal Natural Selection adaptations” 1. Constitutes to the Variation within a • Constraints on variation? population and b/w populations • Species may be successful in but poorly 2. Many variations are genetically heritable, adapted to their environment and must be inherited to be acted upon 3. Organisms compete for limited resources, Behavioral Adaptability thus fitness of species depend on their • Particularly important for humans , since we traits and how well its suited for the are large brained species, cognitively astute. environment. • Variation in behavioral adaptations may be 4) Natural selection isn’t random, differential evident in:cultural traditions and healing reproductive traditions. Genes aren’t transferred quickly success = fitness and natural selection vs behaviors that can be across works on reproductive success. individuals and populations. 5) Only mutations are random, evolution and • 2 dimensions of biocultural analysis: local natural selection are nonrandom. adaptive responses to health challenges and • Survival and successful reproduction are the nature of those specific challenges and more likely for some than others how they became threats to health in a OR Natural Selection is population. More favorable traits are more successful in • Humans are niche constructors*** 1) surviving; • Present additional challenges** 2) reproducing; and are thus Cultural Approaches in Medical Anthro 3) naturally selected over time • Critical Medical Anthropology- an analysis • Fitness relative ability of an organism to if how power differentially impacts health survive and transmit its genes • Paul Farmer coined “ Structural Violence” - • Adaptation, useful feature, shaped by natural how the social machinery of oppression is selection, that promotes survival and embodies in adverse health outcomes and are quite common needless suffering amongst the poor. 1. Epidemiological problems: • There are clear positive correlation's with confounding factors- when suspected dietary life expectancy and per capita wealth. factors is associated w/ others that isn’t • Ethnomedical Systems- healing traditions considered i.e.. red wine consumption of a given culture. -Duplicate findings of some studies- make • All healing traditions have elements of same errors common: theories of etiology (disease -A lot of dietary studies based off causation), diagnostic criteria, therapeutic questionnaire data i.e.. how much they measures, formalized interactions b/w eat/ amt of alcohol – ppl underestimate patient and healers. Healing traditions seen amount of calorie intake in small scale societies. -Ecological studies- doing diff studies in • Healing traditions have come to be Pluralistic different places, different dietary meaning using elements of various traditions factors, medical practices for their health. 2.Molecular biology: Interpretive Approaches to Illness and Mechanistic models are highly Suffering oversimplified- portray food consumption • Interpretive approach- to understand and digestion as mechanistic processes medical system, health and disease strictly -It is more complicate- enzymes , co enzymes within their cultural context, Clifford Geertz. etc • 6 stages with a patient and a doctor include: -Studies based off lab rats- complicate opening, presenting complaint, examination, validity in comparison to humans diagnosis, treatment, and closing application of study • Applied Medical Anthropology- a branch 3.Intervention studies: of medical anthro that involves applying the -Ie. lifestyle counseling, dietary counseling – principles and enthographic knowledge random control derived from anthropological scholarship to -Cant do lifestyle study through double-blind the design or implementation of health studies lifestyle change ( they’re aware of It) policies and intervention. 4.Publication bias: Chapter 4 -Bias which are derived from non academic Diet and Nutrition in Health factors Diet & lifestyle issues- lifestyle ie. exercise -Discover publication bias through meta- people are more active now than they analysis – studies in the studies were before however obesity has increased and try to find inconsistent trend Biomedicine and nutrition Biomedicine- concern w/ interventions, 5.Preconceived Ideas mechanistic view of health – surgery / - Ideas ppl have in head but don’t know why- pharmaceutical intervention impacts way studies are done Bicultural: viewing all these things from bunch of disciplinary distance than just 6.Citation bias: mechanistic account from biomedicine -Readers don’t have time to follow all Paradigms: organized philosophies guides publications studies , influential Field like social science, no unified paradigms studies become more influential etc – end up Fractured discipline where these changes being more cited -Benefit of omega 3 fatty acids -Lyon diet heart study: lower risk of morbidity -Drug studies tend to get more played out in -Type 2 diabetes, hypertension , stroke etc, media than nutritional common studies- prob from pharm marketing -Better diet than av. western diet but not that much better Part 2: Popular Dietary Ideas High fibre diets: Omega-3 enriched diets: -Often paired with low fat diets Compare Greenland inuit- better health Western med history- fibre in concern w/ outcome “autointoxication” physician paradigm- -High quantities of O3FA may not be good, give to speed up bowels, emerged in 1970s. problem with clotting -Towell and Burkitt- found in clinics that ppl there have no western diseases – CVD, Sodium Restriction: cancer, obesity etc. -Importance of salt in western society -Lancet (1989) – intervention study- mortality 75% of salt in our diet comes from processed over time, group who rec’d fibre advice- more sources ie. bread, crackers etc . likely to die, showing fibre may not be as -Most epidemiology studies weak beneficial relationship w/ blood pressure -Ppl who prefer whole wheat= Less CVD -Ppl who eat a lot of salt, processed foods , or High levels of Phytic acid – binds to minerals lots potassium but less sodium in digestive tract , excrete vitamins. Vitamins and Minerals: -Wheat bran interferes with absorption of vitamins and minerals negative Ca Carbohydrate restriction: balance, decreased iron absorption Glycemic index: how fast carbs break down Irish nutritional survey- increased whole into blood sugar wheat, rickets increased. Rickets (softening of Carb restriction better for ppl who are obese bones) , bone density decreased Cross culturally -Diets high in wheat bran, lead to development of rickets Red wine: Benefit of consuming red wine- “French Low fat diet: paradox” highest amt of sat.fat in western Fruits and vegetables: world, but lowest levels of coronary heart We believe that consumption of fruits/veg disease provide nutrients – high water content Ethanol vs. red wine= bestows same benefit provide satiety- less likely to eat more as red wine up to 62% lower risk but How do we get ppl to eat more fruits/veg impact on total mortality not less b/c increase risk of accidents Calorie Restriction: Resveratol- compound in red wine- beneficial -Increased life expectancy in other animals in some way, lots of studies in lab rats Improved cardiovascular risk factors in non- w/ high fat glucose diets have high lifespan but human primates the amt you’d have to have to get -Don’t eat deserts, sodas etc, but eat nutr. that amt is 700 bottles per day Dense foods like yams and beans etc Part III: Hominin Diets Mediterranean diets: 1.Bipedalism -Lower rates of heart disease Developed bipedalism- frugivory diet- eat nothing but fruit. Everyone in lineage was increased CO2 in atmosphere, affect ability consuming fruit, believe bc forest land to grow stuff depleting developed Able to venture out into -Requires lots of land savanna lands to acquire new sources of -Agriculturalists wean child. At ages 1-2, allow food to have more children faster adapt to 2. Transition away from frugivory lifestyle make hard to go back to h&g after Stopped relying exclusively on fruit adapt to agriculture. great for Australopiths – small canines (for tearing into increase pop, but Decrease in health fruit) robust teeth – grinding USOs -Main dietary changes from H&G to underground storage organs – advantage- agriculture: high storage of food foraging for -Decline in nutritional quality b/c narrower food is reliable range of foods H&G had diverse diet Au. Africanus: robust jaw- larger muscles -Decrease in animal food Crops vulnerable to drought and disease 3. Larger Brains: Dental health : Homo Habilis- first hominid evidence in meat -Increase in carbs in diet consumption –see in dentition, smaller cheek teeth Changes in cavities, lesions and tooth loss Impotysny points- hunting and gathering – smaller bits = lots more in farmer than H&G evolutionary adaptation for modern Smaller posterior teeth b/c increase in humans anatomy cavities Increased brain size correlates w/ more Hyperplasia: enamel defects nutrient dense food. Death of enamel producing cells- weakened Dental chipping- Decrease in agriculturalist b/c -We have small colon b/c we absorb more eating more soft foods nutrients via SI Smaller jaws, decrease in robusticity and size = musculature so vanished over time Teeth crowding- smaller jaw malocclusion Hunting and gathering Meat is important- high fat food Want edge-to- edge bites Dietary quality correlates inversely w/ body Growth rate- less nutritional diets, become size smaller Gathering=gender division of labour Children grow less- lower lvl of stature Hunting= gain of calories Stature declines w/ agricultural adaptation Osteoarthritis- disorder of mech deign of Adaptation- working tgt w/ division of labour Ancestral H&G collect fruit , leaves, roots, skeletal articulations=Loss of bone joint seeds etc surfaces ¼ or less of western diet •Humans require the same amount of High concentration of vit and min, nutrients nutrients and various diets meet these No grains, beans, dairy, refined fats and needs= omnivores= no “ideal diet” A certain number of calories are needed to sugars • stay alive, 20% goes to your brain. 4. Agricultural recolution •Energy is derived from 2 main sources: Dietary change- intensive cultivation of crop carbs in plant foods and fat in animals -Thought that agriculture was greatest human •Protein is needed because of amino acids, adaptation and 9 are essential amino acids. -Agricultural revolution- enviro changes, • Fatty acids are needed too, linoleic acid, • Thus having a lot of Vitamin C to prevent used to make steroid hormones. common cold isn't effective since its • Macronutrients are carbs, protein and fat excreted out. and micronutrients are vitamins and • In response to low nutrients there are minerals. se
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