Medical anthropology studies "human health and disease, health care systems, and biocultural adaptation".[1] It views humans from multidimensional and ecological perspectives.[2] It is one of the most highly developed areas of anthropology and applied anthropology,[3] and is a subfield of social and cultural anthropology that examines the ways in which culture and society are organized around or influenced by issues of health, health care and related issues.

The term "medical anthropology" has been used since 1963 as a label for empirical research and theoretical production by anthropologists into the social processes and cultural representations of health, illness and the nursing/care practices associated with these.[4]

Furthermore, in Europe the terms "anthropology of medicine", "anthropology of health" and "anthropology of illness" have also been used, and "medical anthropology", was also a translation of the 19th century Dutch term "medische anthropologie". This term was chosen by some authors during the 1940s to refer to philosophical studies on health and illness.[5]

Historical background

The relationship between anthropology, medicine and medical practice is well documented.[6] General anthropology occupied a notable position in the basic medical sciences (which correspond to those subjects commonly known as pre-clinical). However, medical education started to be restricted to the confines of the hospital as a consequence of the development of the clinical gaze and the confinement of patients in observational infirmaries.[7][8] The hegemony of hospital clinical education and of experimental methodologies suggested by Claude Bernard relegate the value of the practitioners' everyday experience, which was previously seen as a source of knowledge represented by the reports called medical geographies and medical topographies both based on ethnographic, demographic, statistical and sometimes epidemiological data. After the development of hospital clinical training the basic source of knowledge in medicine was experimental medicine in the hospital and laboratory, and these factors together meant that over time mostly doctors abandoned ethnography as a tool of knowledge. Most, not all because ethnography remained during a large part of the 20th century as a tool of knowledge in primary health care, rural medicine, and in international public health. The abandonment of ethnography by medicine happened when social anthropology adopted ethnography as one of the markers of its professional identity and started to depart from the initial project of general anthropology. The divergence of professional anthropology from medicine was never a complete split.[9] The relationships between the two disciplines remained constant during the 20th century, until the development of modern medical anthropology in the 1960s and 1970s. A large number of contributors to 20th Century medical anthropology had their primary training in medicine, nursing, psychology or psychiatry, including W. H. R. Rivers, Abram Kardiner, Robert I. Levy, Jean Benoist, Gonzalo Aguirre Beltrán and Arthur Kleinman. Some of them share clinical and anthropological roles. Others came from anthropology or social sciences, like George Foster, William Caudill, Byron Good, Tullio Seppilli, Gilles Bibeau, Lluis Mallart, Andràs Zempleni, Gilbert Lewis, Ronald Frankenberg, and Eduardo Menéndez. A recent book by Saillant & Genest describes a large international panorama of the development of medical anthropology, and some of the main theoretical and intellectual actual debates.[10][11]

Some popular topics that are covered by medical anthropology are mental health, sexual health, pregnancy and birth, aging, addiction, nutrition, disabilities, infectious disease, NCD's, global epidemics, Disaster management and more.

Popular medicine and medical systems

For much of the 20th century, the concept of popular medicine, or folk medicine, has been familiar to both doctors and anthropologists. Doctors, anthropologists, and medical anthropologists used these terms to describe the resources, other than the help of health professionals, which European or Latin American peasants used to resolve any health problems. The term was also used to describe the health practices of aborigines in different parts of the world, with particular emphasis on their ethnobotanical knowledge. This knowledge is fundamental for isolating alkaloids and active pharmacological principles. Furthermore, studying the rituals surrounding popular therapies served to challenge Western psychopathological categories, as well as the relationship in the West between science and religion. Doctors were not trying to turn popular medicine into an anthropological concept, rather they wanted to construct a scientifically based medical concept which they could use to establish the cultural limits of biomedicine.[12][13] Biomedicine is the application of natural sciences and biology to the diagnosis of a disease. Often in the Western culture, this is ethnomedicine. Examples of this practice can be found in medical archives and oral history projects.[14]

The concept of folk medicine was taken up by professional anthropologists in the first half of the twentieth century to demarcate between magical practices, medicine and religion and to explore the role and the significance of popular healers and their self-medicating practices. For them, popular medicine was a specific cultural feature of some groups of humans which was distinct from the universal practices of biomedicine. If every culture had its own specific popular medicine based on its general cultural features, it would be possible to propose the existence of as many medical systems as there were cultures and, therefore, develop the comparative study of these systems. Those medical systems which showed none of the syncretic features of European popular medicine were called primitive or pretechnical medicine according to whether they referred to contemporary aboriginal cultures or to cultures predating Classical Greece. Those cultures with a documentary corpus, such as the Tibetan, traditional Chinese or Ayurvedic cultures, were sometimes called systematic medicines. The comparative study of medical systems is known as ethnomedicine, which is the way an illness or disease is treated in one's culture, or, if psychopathology is the object of study, ethnopsychiatry (Beneduce 2007, 2008), transcultural psychiatry (Bibeau, 1997) and anthropology of mental illness (Lézé, 2014).[15]

Under this concept, medical systems would be seen as the specific product of each ethnic group's cultural history. Scientific biomedicine would become another medical system and therefore a cultural form that could be studied as such. This position, which originated in the cultural relativism maintained by cultural anthropology, allowed the debate with medicine and psychiatry to revolve around some fundamental questions:

  1. The relative influence of genotypical and phenotypical factors in relation to personality and certain forms of pathology, especially psychiatric and psychosomatic pathologies.
  2. The influence of culture on what a society considers to be normal, pathological or abnormal.
  3. The verification in different cultures of the universality of the nosological categories of biomedicine and psychiatry.
  4. The identification and description of diseases belonging to specific cultures that have not been previously described by clinical medicine. These are known as ethnic disorders and, more recently, as culture-bound syndromes, and include the evil eye and tarantism among European peasants, being possessed or in a state of trance in many cultures, and nervous anorexia, nerves and premenstrual syndrome in Western societies.

Since the end of the 20th century, medical anthropologists have had a much more sophisticated understanding of the problem of cultural representations and social practices related to health, disease and medical care and attention.[16] These have been understood as being universal with very diverse local forms articulated in transactional processes. The link at the end of this page is included to offer a wide panorama of current positions in medical anthropology.

Applied medical anthropology