Ecological Medical Anthropology vs Critical Medical Anthropolopy

The field of medical anthropology is a relatively recent field of studies which first became a coherent discipline in the 1950s. It encompasses human health and disease, health care systems, and biocultural adaptation, drawing on all four fields of anthropology (physical, cultural, archaeological, and linguistic) to analyze and compare the health of human groups. This is a highly interdisciplinary field, overlapping with sociology, economics, geography, medicine, nursing, and public health.

Since the mid-1960s, medical anthropology has developed a number of different theoretical orientations, including the ecological and critical. Medical ecology studies interactions among ecological systems, health, and human evolution, considering cultural as well as biological factors. Critical medical anthropology is more political in nature. This approach, which has been influenced by Marxist theory and dependency theory, analyzes the impact of global economic systems on health.

Anthropologists with an ecological perspective take a systems approach in their research, viewing culture as one human resource for responding to environmental problems. Genetic and physiological processes are equally important. The evolution, demography and epidemiology of humans are subject to ecological forces. Humans continue to adapt to increase changes of survival, reproductive success, and well-being.

Health is a measure of adaptation through genetic change, short-term and developmental physiological responses, cultural knowledge and practices, and individual coping mechanism. Disease is the result of a chain of factors related to ecosystem imbalances linked to biological and cultural evolution. The risks faced by foraging populations are not the same as those affecting agricultural groups and industrial societies. The epidemiological profile is a function of human relations with the environment and other species, particularly food sources, domesticated animals, and pathogens.

In the field, medical ecologists study nutrition, children’s development, pregnancy and birth rates, disease, hazards, demographic change, as well as population size, density and mobility. Prehistoric populations are studied through the analysis of skeletal remains, house sites, settlement patterns, and ecology. Favorite subjects for study are isolated populations living in rigorous environments such as cold or high altitude.

Critical medical anthropologists are involved in a dialog with political economy theorists to develop a political economy of health. What effect do global economic systems, particularly capitalism, have on local and national health? Health care programs must be considered within the dynamics of class interactions, colonialism, and world economic systems. Critical clinical medical anthropology analyzes biomedical practice and the imbalance of power and authoritative knowledge between practitioner and patient. The body can become an arena in which social control conflicts are played out.

Critical medical anthropology expands the context of medical anthropology by seeking to contribute to the creation of global health care systems. It studies medicine from the microlevel of physician-patient relationships, the intermediate level of local hospitals and clinics, and the macrosocial level of political and economic systems. Critical medical anthropologists try to understand how socio-economic factors structure the relationships among the participants in the health care systems, and how they influence the outcome.

In 1994, M. Singer proposed a synthesis of the ecological and critical approaches to describe the dynamics of the AIDS pandemic. He coined the term “syndemic” to describe the synergistic interaction of socio-economic, epidemiological, and political systems. This model challenges health care systems to address the linked processes that support health disparities, rather than simply focusing on cures.

Both approaches to medical anthropology point out that health and disease are not random phenomena, but based on larger patterns that must be considered.

Sources and resources:
Anthropology and public health
Medical anthropology