Patterns of disease

Aim: Determine risk factors

Ultimately aimed to change & modify the risk factors

Testing: testing of procedures

Testing is quantitative= look for statistical data, measurable data

Shared values, beliefs, customs, traditions & ideas

Medical Anthropology uses this as its basis for the study of disease

Uses a qualitative approach, takes people's cultural belief system into account when explaining illness Methodology

Looking at how these two disciplines go about acquiring information/data

Western perspective is strictly scientific in nature, it involves factual measurable information

While Medical Anthropology perspective is biopsychosocial in nature, look at culture, history & ecology (nature/nurture)= things that can not be measured or tested

Epidemiology is quantitative in nature= look for statistical data, measurable data

Anthropology is qualitative in nature= viewed holistically

Try to understand the inner world of people/communities/cultures in terms of disease

Look at values, perceptions, beliefs (history, ecology, culture)

Called the Emic approach= insiders perspective (find out what the people views are)

Here we try to understand this from an Etic perspective (outsiders view on the community)

Hence interaction in important to get the Emic perspective of the community

Need to look at the Context (biopsychosocial)

Look for the cause of the disease e.g Smoking causes cancer, unprotected sex leads to hiv & sexually transmitted diseases

once this is obtained it will apply universally

Sources of information

For Anthropologist= the field is most important

Participant Observation, Interviews & Oral History

Most Interviews are semi structured & open ended

Anthropologist don't like to deal with yes/no answers= what to know details of why, when, & who

Hence open-ended question are used to find out information

For Epidemiologist= they mostly deal with yes/no questions

They want to look at numbers, information that are measurable

Use surveys & questionnaires

Want to make universal statements based on numbers

For Anthropologist they deal with explaining information

They look at the meanings attached

Look for commonalities of thinking, behaviour & interpretation

For Epidemiologist they at numbers in terms of numbers

Look at risk factors= high risk, low risk & medium risk

Look at what cause what e.g survey of 100 people & 80 of them smoke & further 20 got cancer, hence they will associate smoking with cancer

Not look at the cultural belief behind the problem

Anthropologist say that Epidemiologist ignore the context

As it is the context that shapes a person's behaviour

That determines the risk factor, which leads to the spread of the disease

Epidemiologist on the other hand wants to look at facts in terms of figures (cause & effect) e.g look at HIV,

Anthropology want to under the context of the disease were as Epidemiologist want to just find out how many people are infected and how to treat them

Biomedical don't take context into account

They want to measure things that can be seen (context cant be seen)

Anthropological studies take too long (cant afford keep anthropology for long periods)

They need a quick fix solution i.e mass in vaccination by doctors to help 3^rd world countries prevent diseases

Also how can they trust people's values & beliefs

THESE ARE SOME OF THE DEBATES THAT WERE GOING ON AT THAT TIME

But that was a way to bridge the gap between biomedical & social scientist K.A.P Studies ( Knowledge, Attitudes & Practice Studies)

Small scale qualitative studies & rapid assessment aimed at generating knowledge around a certain health problem

Attempted to do social science studies in a shorter period (2 months)

By using questionnaires & surveys as well as interviews = taking people's cultural beliefs into consideration

An Historic study

1940's famous project in Epidemiology don't in KZN

Was a collaborative study done by doctors & social scientists

Sydney & Emilia Kark- medical doctors that had an anthropological background

Decided to use their Anthropological skills/training to help medicine in Pholela

They hired other anthropologists to help

They also hired field works (which were trained)

Go out & interview people from the community

On social/cultural behaviour & health needs

Do a disease profile (looking at belief systems, ecology & history of the community)

This info was important for building of a clinic in the area

Once info was gathered, the clinic was set up to cater for the needs of that particular community

Many people from overseas came to do the internship at this clinic, it became well known

In 1944 a report was putout called the Glukman Report

This report document the collaboration between Epidemiologists & Anthropologists, in setting up this clinic

As a result 40 clinics were built in rural areas using the same methods

It was recommended that the methods used for the Pholela Project be used else were

Their were political issues surrounding this

1948- government said no money= close down the clinics or size down

After 1948- creation of apartheid

Everything became separated/divided according to racial classification therefore the clinics closed down late 1050's the Kark's moved to the U.S

They attempted to use the same methods in the U.S

They opened the first dept of Epidemiology with Anthropologist At the University of ()

They made the University famous, and when people talk about medical anthropology they refer to the University of ()

As a result of the Kark's collaboration work