Medical Anthropology

Politics, on a local, national and global level, play an intricate role in the health of all individuals. As Smith-Nonini said, “a medical anthropology approach to analysis helps bring the critical role of political and economic factors, as well as the medical and public health cultures that shape programs, into view” (Smith-Nonini 2009:613). The political economy approach to medical anthropology specifically targets the macro-level decisions and factors that effect health. This provides a new perspective on the interconnected nature of disease transmission, infection and treatment. However, culture is frequently used as catch all for anything without a clear explanation, when much of what is attributed to culture is, in fact, caused by socioeconomics
Hruschka defined culture by saying, “the term has retained a core meaning, as values, beliefs, norms, and behaviors that we learn from others” (Hruschka 2009:2). This definition of culture is broad, as are most, due to the expansive categories included within. It provides many pathways, mechanisms and ways in which culture can be relevant in any given situation. However, this also allows culture to be used as a default or fall back explanation when the real cause for something is difficult to identify. Because so many things are encompassed in culture, this seems reasonable, but actually hides further research opportunities and may result in incorrectly characterizing an issue. Additional problems arise when you ask for proof of the importance of culture in specific instances: “Among the frequent references to culture as a factor in health disparities, the precise mechanisms by which cultural factors influence health outcomes are rarely clarified” (Hruschka 2009:1). The supposed effects of culture are stated, but how it influences health decisions, risk-taking behaviors or access to quality health care is unclear. In about half of articles reviewed by Hruschka, explicit pathways for culture’s influence are provided, but even these frequently lack evidence. This means that explanations of culture are often not empirically sound which
“The most significant point made against CMA is that by stressing political-economic forces that impinge on human health, it underplays or ignores biological and ecological factors” (Joralemon, 2010:46-47). This is a stance largely taken by ecological/evolutionary medical anthropologists. In an example such as the Peruvian cholera outbreak in 1991, poverty played an indirect causal role, but the infectious agent was a bacteria. The argument here is that neither transmission nor the course of the disease are understandable through the political-economy approach. I would agree that there are limits to this approach, as with any other. CMA needs to be paired with biomedical research to treat both the root causes (systemic inequality, leading to a lack of safe food and water, sanitation, and medical care) and the actual disease. This helps those currently suffering, while also working to protect future generations. This approach is the most holistic, incorporating biology, economics, politics and culture into the