The trajectory of the word “disease” in anthropology from the 20th century through to the present reflects as much about the constitution of the discipline as it does the discipline’s transformation in focus and paradigms. Following World War II, anthropology began to move away from its conventional objects, and the resultant encounters with non-Western medical systems called anthropologists’ attention to the intersection between medicine, culture, and health and led them to analyze the hegemony of biomedical systems in places where it is critical to understand the indigenous etiologies of diseases and illnesses. Anthropologists mapped out different etiologies and ethnotheories of diseases-illnesses in non-European countries and developed a hierarchy of etiologies from natural to supernatural and even mystical. This focus became the domain of medical anthropology. Biomedicine has always used the word disease to designate the physiological abnormalities or pathological states identified by its diagnostic strategies. Until the 1970s, it was common for medical anthropologists to rebuff the term to the domain of biomedicine while using the concept of illness to give account of individual symptoms and experiences of disease. For many professionals in the field, a clear understanding of the etiology of diseases provides a base for public health prevention, and, in the case of infectious diseases, some even challenged the view that the indigenous causes attributed to contagious diseases are fundamentally different from Western allopathic medicine.
More recently, the division between disease and illness has led to substantial critique by some anthropologists who deconstruct these concepts on social and cultural grounds. Disease, they contend, is not merely a physiological disturbance but takes place in wider social, ecological, political, and cultural processes that are experienced by the whole body. This perspective has given rise to an important line of investigation of diseases in critical medical anthropology, a subsegment of medical anthropology. According to this model, disease is viewed within the larger framework of the political economy of health and what its proponents call “critical biosocial causality.”
In this approach, diseases are located in terms of the loci of social inequality and power differentials within local groups or in the relationship between local groups and wider regional, national, or global structures. As part of this newer approach, the experience of the sufferer is central, and sufferer narratives have been mobilized in efforts to fight the hegemonic worldview of biomedicine. Others are concerned with understanding the underlying social processes that explain the reemergence of old diseases, as, for example, the appearance of multidrug-resistant tuberculosis, as well the contexts of emerging new pathogens, such as HIV, and their impact on the lives of socially vulnerable populations. With the advance of globalization, anthropologists are introducing new approaches for unveiling underlying processes of global inequities and local public inadequacies to deal with emerging plagues, as well as the intertwining of diseases in vulnerable populations, a phenomenon medical anthropologists call syndemics. Within the Western world, some anthropologists are taking the new vantage point offered by advances in various technologies and data collection (for example, the human genome project) to investigate configurations of genetic diseases. By moving away from traditional representations of the non-Western world and incorporating new analytical tools and strategies to account for diseases and their complex interconnections with the political economy of health and sociocultural contexts, anthropology is helping shape new understandings of situations of inequities and actively informing local as well as global health programs.
References:
- Auge, M., & Herzlich, C. (1995). The meaning of illness: Anthropology, history, and sociology. New York: Harwood Academic Publishers.
- Green, E. C. (1999). Indigenous theories of contagious disease. Walnut Creek, CA: AltaMira.
- Singer, M., & Amityville, H. B. (1995). Critical medical anthropology. New York: Baywood.
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