Infant Mortality in China

There are a number of causes to the infant mortality rate in China. Overpopulation is a huge problem in China, with the country being the home to over 1.344 billion people. This causes many problems it self, such as a deep economic disparity and an enormous number of people living in extreme poverty. The economic divide also causes a great number of the population to not have access to quality health care at all. Some citizens may have never even gone to any kind of health care center in their life. For this reason, plus the Chinese culture placing women secondary to men, means that maternal health care is very rare and a persistent issue. Lack of access to affordable health care for mothers is a leading cause for infant mortality in China because it means that many mothers are giving birth in non sterile locations which can lead to many neonatal infections and infant death. Looking at the results of authors Xu, Rimpela, Jarvelin and Nieminen, the infant mortality rate is higher in female infants than in males, and even though there has been a decrease in the rate, the rate has been notably decreased more in males than in females. One explanation for this lies both in cultural norms as well as public policy. Because of the population issues, the government set regulations that each family could only have one child, and because the culture focuses more on having male children, some families may purposefully choose to allow the death of a female child so that they may have a male child. The government is working towards making health care more accessible for women so that there may be less deaths for infants, there is also huge amount of adoption agencies so that infants can be placed with families that can take care of them.

 

I had a difficult time finding out too much biographical information about anthropologists working in this area of study, but there are many papers I saw written out of the Department of Public Health in China that worked with a couple different areas of the topic. It’s definitely something that is a growing area of study and work though, especially in China itself.

 

Population, China – www.google.com/publicdata

Sex differences of infant and child mortality in China. – http://www.ncbi.nlm.nih.gov/pubmed/7716434

Infant mortality among various nationalities in the middle part of Guizhou, China. – http://www.ncbi.nlm.nih.gov/pubmed/9257395

Public Health and Medical Anthropology

I chose public health because it is what I want to do with my life. I have always been driven to work in some area where I could help people, and for the longest time I thought that was by becoming a doctor. That was until I read the biography of Dr. Paul Farmer, the same that the 60 Minute video was about. I read his story, Mountains Beyond Mountains, around my Freshman year of college, ever since then I’ve know that I want to work in public health. I am looking to go to graduate school and get my Masters in Public Health, and I would eventually like to set up clinics that can provide medical care to those who may not regularly have access to it. I have thought about working over seas, and I am not necessarily opposed to it, but I also know that there is just as much need for better access to health care right here in the United States. There is some need in a lot of inner city areas here, like Detroit for instance, but I also know from personal experience that there is just as much need for better access to health care in a lot of rural areas. The closest hospital to my home town was 30 minutes away, and if it was anything serious or urgent you’d have to go to a hospital that was almost an hour away, so there is definitely need there.

 

I can definitely imagine working in that kind of situation. I’m originally from Ohio, and my town sits right in the center of Ohio’s “Amish Country”. There are a lot of doctors, who are definitely not anthropologists, who work with the Amish but don’t really understand them too much. An Anthropological approach would be very useful in the area of public health because it would allow doctors like these to understand the cultures of the patients that they are working with and better provide care for them. Much like Paul Farmer looked at the culture of the Haitians and made a system of care that works with their culture, anthropologists working in public health could do the same for cultures around the world.

 

“Mountains Beyond Mountains” by Tracy Kidder, 2009

Erectile Dysfunction

I personally think that erectile dysfunction is one of the most overly medicated illnesses in the United States and in Western Culture. I think it is pretty easy to understand why this is considered an illness and why we are so quick to medicalize it. Erectile Dysfunction strikes right at the heart of the male psyche. It ruins the idea that a male must be fertile and virile. It strikes at male dominance and vitality. Western Culture is still slighted to male dominance even though we are making strides to fix this. The reasons for making this illness something that requires biomedical intervention is largely cultural. Men want a way to feel young and virile again, especially if they feel like their illness at all makes them feel less than whole. When a drug was found that could help men deal with erectile dysfunction it gained huge popularity because there was finally a chance that men could fix their problem.

 

Commercial for Viagra:

 

http://www.youtube.com/watch?v=Xk9JwV8sZTs

 

It is very easy to do an analysis of this commercial. It shows men rejoicing, showing new vitality, and just being generally happy. This plays off of a lot of cultural values existing in western culture. First is the idea that a person must be sexually active in order to be happy. We idolize sex in our culture, make it something that must be achieved in order to be “normal” and that if you are not having sex or are incapable of performing then you are by definition “abnormal”. The commercial also shows the created and accepted social roles that we place in our society. Men must be able to perform sexually to be normal. How many commercials do you see about female sexual performance enhancers? Not very many, our society focuses on how females look, but how men perform. There is very little actual medical information giving in the commercial, and only in writing at the very end of the commercial. There is also no doctor patient interaction at all, even though it is a prescribed drug.

Life/Death

So often in western culture, I feel like we fall into the problem of treating our customs and rituals as what should be “normal” and that anything outside of that is taboo or odd. Biomedicine is no different. Biomedicine is treated as the best way to solve illness and western culture is so quick to prescribe pharmaceuticals for issues instead of looking at alternatives. This can be seen clearly in how many M.D.s that we have in our country compared to D.O.s. Osteopathic medicine is still science based but it looks at the body more as a holistic unit, and works to make the body as a whole work, not just to fix problems in individual units. We as a culture very much buy into the culture of biomedicine. This can be seen with how many prescriptions drugs are available for so many things, and so many over the counter drugs for colds and coughs, when little things like that can honestly be taken care of with chicken noodle soup. Understanding this culture is important because it can help us not only understand some issues in our society, like drug abuse and hypochondria, but also help us understand how other cultures view us and our customs.

 

I think that the life/death dichotomy is very interesting. Mostly because I had never thought of it until now. I had always thought of the lines between life and death pretty clear, but the points brought up in the lectures made me think. I personally believe that human life begins when a fetus is to the point in development that they can live without the mother, but I respect that people may disagree. Death is a bit harder for me to define, and I think that’s a pretty normal thing. I think that humans are reluctant to declare something as dead because we don’t want to let go. That’s why we have people kept in vegetative states. I understand why people would want to keep their loved ones alive, but also there needs to be a point where it’s healthiest to let go.

Real Life: I’m Obese

This episode dealt with the lives of three individuals who live with one of the most common health issues in the United States, obesity. The first, Corey, approaches obesity with restitution. He realizes that his weight is a problem and resolves to “fix” his illness with gastric bypass surgery. In his mind he sees the surgery as a cure to eating and a cure to gaining weight, overall making him healthier and “normal”. The second, Amy, also realizes her illness but deals with it very differently. Her life is much more chaotic, everything she does is controlled by her weight. It is almost as if she is addicted to eating, because she is unable to stop. She also realizes all of the effects of obesity, like diabetes, heart attack, etc, but this makes her afraid that without surgery she will die. Finally the last individual, Frances, embraces her obesity, saying that her weight is part of who she is. For her she owns what the others see as a disorder. She rejects the cultural need to be thin, and says that she can be perfectly happy the way she is.

 

They use their different narratives to deal with their lives. Each one comes from a different background and sees the obesity as a different thing for them. Corey uses his narrative to come to terms with his obesity and to do something about it. Amy uses the chaos of her situation seek medical help and avoid the negative ramifications of her weight. Frances makes it her quest to show people that obesity may not be a bad thing and that you can be obese and still enjoy life.

 

Obesity is prevalent in our culture and is definitely stigmatized. I can speak from personal experience. Much of my family is overweight, and my mother was obese for most of my life. She face many difficulties. Finally, around the time my brother announced that he and his wife were expecting, she resolved to do something about it. She had struggled with dieting for years, and finally decided on gastric bypass surgery. It was incredible. It made such a change in her life, she is now down to a healthy weight, she is able to do much more around the house, and most of all, she can play with my niece.

 

The two individuals in the show that took the same route as my mom also found that there was a very supportive environment to help them, but its also a very realistic environment, showing the the true consequences of obesity. As far as rights and responsibilities, I believe that obese individuals deserve to be treated like any others, but it is there responsibility to accept or deal with their obesity.

Bipolar Disorder

Bipolar disorder is a psychiatric disorder where an individual may switch between moods, most commonly depression and mania, (which explains the other title, manic-depression disorder). During the depression suffer all of the effects of clinical depression like lack of motivation, fatigue, and dis interest. The manic state involves euphoria, sleeplessness, and hyperactivity, but can be susceptible to hallucinations.

 

Our culture as a whole is pretty insensitive to bipolar individuals. Many people quickly say that those with bipolar disorder are crazy or unstable. Sufferers will often blame themselves because society doesn’t understand the disorder. I had friends in high school with bipolar disorder, and they were often dismissed by teachers as under achievers or drama queens because they would go from being fine, to being to depressed to focus on schoolwork to being to hyper active to sit still in class. Many of them began to rebel because the teachers treated them as such. Some of them were diagnosed with ADHD because they were unable to focus. Because of this they were prescribed Ritalin, which actually had a negative effect on them because they didn’t actually have ADHD. One of them actually got so bad that she became suicidal and resorted to self mutilation during the bouts of depression, but no one could really tell anything was wrong because during school hours she was always very peppy. Only after one attempt was she actually sent to a psychiatrist for help. It was there that they diagnosed her with bipolar disorder. I think that if society was able to recognize the disorder better, sufferers could get better treatment faster.

 

My personal opinion is that belief is a strong part in healing. Drugs and doctors may help, and do a great deal of good biochemically, but I think that a positive outlook is what makes it even more effective. The film shows that positivity and belief that something is working can help in healing. Placebos are shown to help many things, depression included. There is so much that we don’t know about the human mind and its capabilities, and I truly believe that if a person sets their mind to becoming better, it can do a great deal to get better.

In Sickness and in Wealth

I did pretty decent on the Health Equity quiz, but I was also pretty surprised by it as well. I ended up getting a 7/10, which wasn’t too bad. I definitely didn’t expect the quiz to be as economical or as political as it was, but I was able to at least make educated guesses for most of the questions. For the questions I did get wrong I was really interested in learning the correct answers. The fact that I was most interested in and that completely took me off guard was about new immigrants being the healthiest of all people in the United States. I had no idea that was true, and I would have definitely though that it would a wealthy U.S. Citizen or something like that.

 

The case study that I chose was “In Sickness and in Wealth”. The study showed the lives of four families living in very different social and economic situations. The video does a pretty good job of showing the vast differences in health in all of the situations. It didn’t surprise me that the family with the highest status had the highest level of health. They were able to eat healthy, fresh foods. They could relax, exercise, and take vacations. All of the reasons help this group achieve the highest life expectancy. As the socioeconomic class went lower, the video showed that their life expectancy would drop as well. These classes might not have the same access to foods and health care that the higher classes might have. Another possible reason is that higher classes are usually spaced out more as far as their living situation. Lower classes might be in apartments or slums that are very close to each other, which would spread disease easier.

 

Politics, economics, environment, culture, biology and choice all have a part in the development, spread and treatment of illness. As I mentioned disease spreads much easier among lower classes that are grouped very close together, and lower economic classes have less access to health care. Politics can affect who gets what level of health care. Culture can determine how common regular health practices are or if it is “normal” to see any kind of medical professional versus a medicine man. And then of course individual choice has a part to play because we are all on some level responsible for what we do with our bodies.

 

Heart Disease among White Americans

Map for heart disease, white males

http://www.cdc.gov/nchs/images/atlas/hdwm.gif

Heart disease is the leading cause of death in the United States for both men and women, causing roughly one fourth of all deaths every year. Heart disease is the leading cause of death for most ethnicities including African Americans, Hispanics, and whites. For those ethnic groups that it is not the leading cause of death, heart disease is second only to cancer. Heart disease is most prevalent however in white Americans with 25.1% of deaths each year. Heart disease may be this prevalent in whites for many different reasons. Leading causes to heart disease include inactivity, obesity, high blood pressure, smoking and diabetes. We can write off obesity as the reason more whites are dying of heart disease, as blacks and Hispanics have a higher rate of obesity than whites. Also surprising, is that African Americans have a higher rate of high blood pressure than white Americans. The minorities also have a higher rate of smoking and diabetes than white Americans. So why then do whites have a higher rate of heart disease than minority groups? I believe that it has something to do with stress levels and inactivity. I was unable to find any data for this, but I would imagine that the amounts that white americans are inactive is higher than the inactivity found in minority groups. I don’t think that is is any kind of genetic predisposition to heart disease, but more of a socially determined thing, with more white Americans having higher income and what might be considered an easy life style, at least as far as physically.

 

I believe that there is a close relationship between race, genetics, and health. Obviously genetics has control over what a persons race may be and it also can affect a person’s health in a whole multitude of ways. For instance, a person may be genetically inclined to have high blood pressure or high cholesterol which would put them at risk for heart disease. Race can also play a part in health. While there are no actual restrictions on certain races not getting medical care, there are definitely social factors that play into who has access to quality medical care or who has access to good health insurance, etc.

 

 

http://www.cdc.gov/heartdisease/facts.htm

http://www.cdc.gov/Features/dsObesityAdults/

http://www.atlantamedcenter.com/en-us/ourservices/communityservices/pages/what%E2%80%99s%20race%20got%20to%20do%20with%20high%20blood%20pressure.aspx

Old Age

My definition would be any individual being in the normative state and free from any kind of disease or illness. I know its kind of a broad definition but it works pretty well too, it means that you are not suffering any kind of pathogenic disease and that your body is functioning properly and with out any issues. It also means that your mental state is normal too. Normal can have different meanings and definitions for different people but in this case it would mean was is generally considered normal for your society and culture.

 

Illness on the other hand I think is pretty much the opposite. Illness is the state of being anywhere away from “normal” whether that is biological, psychological, or even socially and culturally.

 

I really feel like these ideas came from how I was raised and is just part of the American culture. We generally see health as being able to function completely and illness as somehow being wrong or off and in some way not being able to function like everyone else.

The Flu: I consider this a definite disease, not an illness. it is something that is caused by the pathogenic inflenza virus that causes the bodies response to it. Definitely a disease.

Cancer: Again, I would consider this one a disease and not an illness.  Cancer is caused by a genetic mutation and some problem in the chromosome.  This mutation grows and effects many systems of the body.  While there are definitely some psychological and societal attributes of cancer, it is definitely more of a disease.

Anxiety: this is one that I would consider more of an illness. Though it has some physical attributes I would say that it is largely a psychological and social effector. I would say that because it effects more in these realms that it is an illness and not a disease.

Ethnomedical

I think that the ethnomedical approach would be best for studying health because it looks both at how the culture looks at health and illness, and how individuals seek out help for those diseases and illnesses, so it gives a broad and pretty comprehensive look at any kind of problem.

 

The distinction between disease and illness is that disease is a physical result of some kind of infection or other pathogenic cause, where as illness in something that separates an individual from normal, whether it’s a mental illness because their mind does not work the way a “normal” mind might and etc. The distinction is pretty easy for me to make, having a little bit of a background in the medical world and a pretty solid understanding of diseases and their effects on the body. Illnesses are a bit harder for me to distinguish, mostly because there are so many more factors that define an illness, even socially and culturally, so it’s more of a spectrum of things instead of a specific effect.

 

The culture that Miner is talking about is the American culture. It definitely took me two reads through the article to figure this out though. The first read I thought that all of the rituals sounded really bizarre and the second time I read it I noticed all of the things that were spelled backwards and really felt a little silly when I started recognizing all of the rituals.

 

One of the first rituals that Miner mentions is the sacred box within the shrine. I think this says a lot about how we treat health and medicine. We focus so much on using drugs and prescriptions to treat all of our problems with disease and illness. Another ritual I thought was interesting was his look into hospitals and how we have to pay so much to go to hospitals and have procedures done and then get charged for release. Finally I really enjoyed how he looked into how we treat going to the bathroom and just personal cleanliness in general. Its such a taboo thing to talk about going to the bathroom or to be unclean.