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Health Studies
R Song

HLTC05 FALL 2012 Week # 2 Readings – “Evolutionary, historical and political economic perspectives on health and disease” Authors: George J, Armelagos, Peter J. Brown and Bethany Turner Abstract - Dgf Introduction - U.S. Surgeon General, William T. Stewart testified before congress in 1969 (America’s Chief Medical Officer) o Essentially said it was the end or almost at the end of infectious diseases era (think: smallpox, bubonic plague, malaria, typhoid, polio, diphtheria etc) due to the advent of vaccines, antibiotics, and pesticides o America was about to usher in the age of chronic and degenerative diseases due to a myriad of reasons (which will be discussed later) o This shows institutional myopia on the part of the US Gov’t because it failed to consider the extent of infectious diseases in “Third World” and the damage of antibiotics (antibiotic resistant pathogens) and insectides/pesticides  Who reports 14 million of the 55 million global deaths due to respiratory, infectious and parasitic diseases  3 million hiv/AIDS  4 million respiratory illness  1.5 million TB  1 million TB  2 million Diarrheal  2 billion have HEP B, 2 billion TB, 40 million AIDS - Ecological destruction has made it near impossible to ever fully eradicate some vectors o Homo Sapiens – greatest impact on evolutionary process – accelerated changes in antibiotic and pesticide resistance costing US 33 billion to 50 billion per year - Epidemiological Transition Theory – first discussed by Abdul Omran (1971) saw that human populations shift from a phase of only infectious diseases to chronic, degenerative diseases over time as level of socioeconomic prosperity increases o Processes that eliminated infectious diseases allowed the life expectancy to increase at which point chronic, degenerative and manmade diseases (pollution) caused illness o Social stratification of society has affected some groups (women, elderly, children, marginalized, racialized, queer, low income, etc) disproportionately in terms of health outcomes, access to resources (healthcare, education, wealth) due to macroparasitism o Macroparasitism: Elite few have monopolized resources leaving little else for majority of people (food, energy, etc) – an EVOLUTIONARY STRATEGY Epidemiological Transition - Some may reject Omran’s model of epidemiological transition theory based on the fact that there are still istectious/emergent diseases but we are applying his model in the BROADER evolutionary context - 1 = infectious, 2=chronic, 3=combo/infectious/chronic/reemergent - 1 epidemiological transition (10,000 years ago; Neolithic) HLTC05 FALL 2012 o Primary food production; domestication of plants and animals o All these factors have changed disease ecology  Domestication of animals  Increased population and density  Sedentarism  Cultivation  Social stratification - 2ndepidemiological – next phase, we live in the 3 epidemiological transition - Criticisms of “emerging” diseases o Paul Farmer (1996) argues that emerging diseases are only “discovered” when they have an impact on Americans  Example: Lyme Disease – didn’t matter till it affected wealthy AngloSaxons  A product of human behaviour and microbial changes but usually fails to contextualize the political/social/economic environment o Meredith Turshen (1977) argues that epidemiological models TOO NARROWLY focus on the epi. Triad (host, pathogen, environment) and forget the cultural, political and economic complexity o Increases in economy, technology and education further deepens the social inequality between nations, people (affluent from the poor) o We can prevent many disease, what stands in the way -> poverty The Paleolithic as a baseline - Heirloom species as parasites - Zoonoses are souvenir species o Primary hosts are non-human animals but just happen to also infect humans  Examples: Insect bites, contaminated meat, animals bites  Types of diseases: Tetanus, sleeping sickness, etc o Deadly diseases only occurred endemically when there was a large enough populations 200,000 o Paleolithic populations lack common communicable diseases o Gatherer/Huntes – are equal opportunity hosts  Lack social strafication therefore are not differentially exposed but are differentially infected  DON’T GET THIS PARAGRAPH OMG The first epidemiological transition - Time Period: 10,000 - Area of cultivation: (Mesopotamia, Sub-Saharan Africa, Southeast Asia, Northern China, Southern China, West
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