Ecological Approach

As a student interested in Healthcare Economics I think that the ecological approach to anthropology would be most useful to me in my study of health. The ecological approach takes many facets into consideration when examining health such as the interactions between humans, plants & animals, culture, natural resources, and political economy. Most human issues, at least the most pressing ones are complex and involve many determinants.

Disease and illness are issues that vary person to person and across populations depending on the interaction of the various facets anthropology examines. It is definitely useful to examine what we mean by the terms disease and illness. Our language in surrounding these terms hints at the cultural and psychological approach different people have towards health and wellness. So and so is “diseased” is different from he or she “has a disease”; the latter describes something one possesses while the former is defining someone with a disease. “I feel ill” is different than “I am ill” with one being subjective and the other being rather more objective, respectively.  While many people overlook these distinctions wryly as mere semantics but language, terminology and definitions are important to reach a critical understanding. Disease and illness are distinguished in terms of direction; disease is an outward manifestation generally of physical structure/function, while illness is an inner human experience/perception of the change in health and largely depends on the sociocultural context. As someone who needs to be applied and practical in my line of work that is the economics and management of healthcare it’s easy to forget about subjective or qualitative experience and be immersed in quantities, facts and figures. I certainly see the difference and while it may not be obvious at first it is certainly clear when examined.

The Nacerima article was a great article that examined American medicine as an outsider not immersed in its cultural context. I myself have wondered what future civilizations would make sense of our remnants during their archeological excavations of cities such as Manhattan and D.C. Most things besides the colossal and stone structures would not be around several thousand years from now; how would they make sense of the Superdome, Washington Monument, and Mt. Rushmore? Would they be able to distinguish them from Coliseums, the Great Pyramids, or the Sphyinx? I was able to tell that Miner was describing America when I read about the chopping down of a cherry tree. I was able to use my understanding of American Culture to make sense of the rituals he described. The way hospitals are described as though they are temples is very fitting. Many people try to use medical knowledge to obtain some sort of idealized body image reminiscent of a stone sculpture of a Greco-Roman god or goddess. In our times these can be seen between the glossy pages of popular magazines and late night surfing through television channels. The shamanistic description of drug use makes me think of how primal our behaviors are even with such profound advances in technology. While our hunter gatherers may have come across magic plants in the rainforest along the Amazon many in our times score drugs in concrete jungles between Bourbon and Canal street.

5 thoughts on “Ecological Approach

  1. Let me begin by saying that your choice, the ecological approach, was definitely valid and can be argued for strongly. As I stated in my original post, choosing one approach that stood out was difficult and I believe that all of the approaches had a number of very important and unique aspects that should be incorporated in one general ideology. With that being said, I decided to go with the biological approach. The three pillars of the biological approach were environment, genetics and individual choice. Your environment can determine so many different aspects directly related to health. Access to healthcare, food availability, and quality of life are the aspects I focused on in my argument. Genetics brings into play predetermined susceptibility to certain diseases and is a profound determinant in terms of what your body can sustain/combat. Individual choice also plays a substantial role in the overall health of a person. Choosing to work out and eat a balanced diet can greatly improve one’s helath.
    I agree with your analysis of “idealized body image” and the overall inadequacy of our health system when it comes to drug use. I believe that the idealized body image has been distorted for a while now but has been improving. The movement of “fit” being the new skinny seems to be gaining steam. In today’s world, I feel that we are overmedicalized substantially and the overall level of ignorance in patients is astounding at times. You should be able to trust your doctor at all times but, you should also always be aware of what you’re putting into your body and the potential long term effects it may have.

  2. I also think that the ecological approach can be very beneficial to the study of health because of its multifaceted approach. The ecological approach was my second choice. My first choice was the experiential. I personally think that it is just as important to look at how people and societies experience and understand illness as it is to study the actual disease.

    I agree with how you identified hospitals as temples but today I would apply that less to hospitals in general, since so many different things occur there, and describe that more as plastic surgery centers. Today it seems that a large portion of our society is just as focused, if not more focused, on aesthetics as they are out actual health. In terms of drug use, in the prescription drug sense, I think that some things have not changed very much. I know in my family that we keep left over medication in case of future need. I don’t know how well prescription drugs were labeled when Miner wrote this article, but today they are so carefully and specifically labeled that people don’t have as much of a problem with having pills that they do not know what they are used for. One way that this article could be updated would be to include mention of the problem of prescription drug abuse. While we do still keep old mediciation, we are not as protective of it. Prescription drugs are often abused not in the sense of overdosing but taking medication that was not prescribed to you, even if it is to cure a legitimate problem. Taz spoke in my ANP 320 class last spring about her research on ADHD medication use and that is one example of people buying and selling ADHD medication for several different reasons.

  3. I can see the logic behind your choice of the ecological approach because like you said it does factor in a variety of complex details. Despite this, I found that the critical approach was the best way to understand health for me. I find that understanding the culture’s mindset as well as scientific reasoning would help to create an enlarged view of what it means to each person or community and why.
    As far as the idolized body image goes, I believe that is still very present in society today. A lot of Americans in particular, struggle with body image issues because of what their culture has taught them. In that case, it is clear that even time hasn’t drastically affected it. The other comment you mentioned regarding hospitals as temples also seems to reflect accurately of today’s society. But I do think it may be less so now. There may be more fear with hospitals in a lot of cases, opposed to hope. This could be a result of the new technologies which often scare people away by their intimidating results.

  4. I agree that there is value in adopting an ecological approach to studying health and illness, as it creates interface between a variety of variables. This approach is useful in addressing the interaction between genetic modifiers, biological constraints, physical environment, evolutionary forces, and cultural adaptations. However, I chose the ethnomedical approach because beliefs are one of the most predictive determinants of behavior. Thus, this orientation operates within emic terms, analyzing ideas about health and illness, practitioners consulted, and therapies selected, according to cultural parameters. Inherent in the ethnomedical approach is the experiential aspect of illness (the subjective “I feel ill” element you discussed) and how the health care system of a society, its culture, and individuals reciprocally and mutually influence one another.

    Although the Nacerima article was written half a century ago, I think the cultural values it portrays about American society and our health care system have persisted and are still applicable today. For instance, as you mentioned, the hospitals are described as temples, which is fitting given that people idolize physicians to the point of worship and reverence. In effect, medicine has replaced theology and embodies a mystical quality for the populace; the hospital is a shrine to science and terminal patients invest hope in ‘medical miracles’. Moreover, the pursuit of an unobtainable, ideal body type can be translated into our culture’s aestheticism and glorification of conformity in appearance. The inordinate pressure females in particular put upon themselves manifests itself as eating disorders and cosmetic surgery, compatible with Nacerima’s allusion to breast augmentation. Also, the “shamanistic description of drug use” you described epitomizes the “magic bullet” end-all, cure-all, quick fix mentality that Western medicine has embraced ever since the advent of germ theory, where patients demand “a pill for every ill” and assign almost magical qualities to pharmaceuticals.

  5. I think that the ecologic zipporah is a valid choice to make. You make some very good points to support your selection. When I wrote my post I choose to look at the ethno- medical approach. I think that looking at the culture of a civilization gives a more detailed understanding of how and why things are done. By learning about their belief system you can make sense ours certain rituals. This can make communication easier so that never side feels threatened but respected instead.

    Your analysis of the Miner article was very well written and thoughtful. The descriptions that Miner used for American culture are very true for today as well as the 1950s when it was written. Hospitals are essentially the temples of health care when you want to make you receive quality care that is where you would go. Very similar to going to a temple in hopes to seek a higher level of solace in your beliefs. This its something we still do today. If we believe that a certain health issues requires attention one goes directly to the emergency room not somewhere else.

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