Clinical Medical Anthropology

I think that clinical medical anthropology is essential for helping patients and professional staff understand each other.  The fact that clinical anthropologist act as a cultural mediator not as a whole but from an individual perspective makes treatment much more effective.  I feel that understanding a person’s personal experience with an illness is very important in providing a treatment regimen that will be the most effective.  Of course there are downfalls, such as the tendency to stereotype, but I feel that overall the methods used are necessary to understand cultural beliefs and their impact on medicine.

As a clinician, having a cultural understanding would allow for better communication to the patient.  I think some of the best examples of this were made in the Tribal Jazzman Scholar video.  The examples that he used are great ways to show that knowing more about the culture in an area can make an impact on the approach used to fix an outstanding problem.  Another great example is talked about in the lecture.  The HIV/AIDS epidemic in Africa has had a huge cultural impact. If epidemiologists and doctors could find a better way to communicate to women that breastfeeding is hurting their children and that by not breastfeeding they are being a good parent things may be drastically different.  They also need to find a way for them to provide nutrition for their children that is safer for them.

I remember watching a documentary that talked about how they were able to communicate to different tribes in Africa the importance of family planning.  In these tribes the girls are married very young and the problem is that they become pregnant at too young of an age and it causes major health issues.  The clinicians and anthropologists were able to talk to the men and women about birth control.  The men like the idea because it kept their wives healthy and also allowed them to be able to control the sizes of families so they were better able to support them.  This is just an example of how with the right communication, change can be possible.

Depression

I chose depression as a condition that has been over medicalized in our society because it is something that I can relate to having been diagnosed with depression/anxiety two years ago.  For a long period of time I didn’t recognize the symptoms and I finally lost control and hit rock bottom.  Just receiving a diagnosis made a huge difference for me and I understand how people suffering with depression would want something that is just going to fix the problem.  Personally I am not one that thinks a pill is the answer to everything.  I worked with a doctor to get to the under lying causes and we formed a course of “treatment” that would work long term instead of taking an anti-depressant.  This is another reason that I feel depression is over medicalized.  I feel that having so many advertisements for anti-depressant medications everywhere has increased the amount of people being prescribed.  I’m sure that before anti-depressants, depression was treated successfully with other methods.  A pill is not going to treat the underlying cause of a person’s depression.  Now they have drugs that work with anti-depressants if people still aren’t getting full relief from their symptoms with one prescription.

In this commercial they personify depression as being a hole, a balloon, a ball and chain, etc. It is always following her around.  The patient in the video is a woman, which makes sense because a majority of people suffering with depression are women.  They introduce the doctor into the advertisement by having him “help” the woman out of the hole.  He puts on a video for her that tells her how Abilify can help her as well as the possible side effects. After her meeting with her doctor, she is shown enjoying herself with her family, stating that her depression used to define her and after starting Abilify she “feels better”.

Doctor/Patient

By culture of biomedicine we mean that we are looking at biomedicine from an anthropological standpoint.  Biomedicine is the major authoritative system that people use for treatment in western culture.  It uses scientific and biological factors, like genetics and physiology, to treat disease and illness on the belief that it operates on what is truth.  The culture of biomedicine has been studied by looking at its history, its language, and the rituals observed.  An example of this is when a person feels sick they go to the doctor for a diagnosis, and then they receive a prescription for treatment.  Of course there are non-biological factors like politics, individual choice, and environment also have a role in health and disease.

I think dichotomies are necessary to have full understanding of health and illness in biomedicine.  The doctor/patient dichotomy is necessary to show that each has their role.  The patient seeks the doctor for help in treating their illness.  The patient expects the doctor to make a diagnosis when they feel something is not right.  This is because in western society, we see doctors as being so much greater than the standard citizen. This is also the case in many cultures, where the healer has a higher social standing within the society.

In today’s society there is often an overlap in which the patient becomes the doctor, so to speak.  With access to the internet and through television, people feel that they have the ability to “self diagnosed”, which can in turn lead to over medication.  This leads back to the point made where people expect a prescription when receiving a diagnosis from their health care professional.  As mentioned in the lecture video, media outlets and propaganda can have significant impacts on medicine.  People can get on a website, check off their symptoms, and get a list of things that could possibly be wrong with them, like the Medicalization of Menstruation video demostrates with PMDD.

Restless Leg Syndrome

According to the RLS Foundation, restless leg syndrome is described as a disruptive neurological disorder resulting in the irresistble urge to move the legs. It can be accompanied by strange sensations decribed as a creeping, tugging, or pulling. The first medication for the treatment of RLS was not approved until 2005.

I remember when commercials started advertising drugs for RLS. This is the first time I had heard of the condition. Maybe some of the reason is that sush a small amount of people, about 10%, have symptoms. What I wonder is, would people have even thought twice about their symptoms if it was not brought to their attention through media. Hearing other people’s illness narrative and seeing that they were having similar experiences gave those without diagnoses an explaination of what was happening to them. I cannot say that I believe one way or the other that this is a socially constructed illness or a legitamite disorder. I have some of these sensations in my legs at night, and I find that sometimes they are worse than others. Maybe depending on the activities of the day. However, even though I have had similar experiences, I have not sought a medical opinion or recieved treatment. I would not say “I suffer from restless leg syndrome”.

I think there is a huge connection between belief and healing. Having grown up going to church, I have seen what the “power of prayer” can do. Not saying that it works in all situations, but when a person truly believes in something it can makes of a difference. It’s why people with the same illness

http://www.rls.org/

“A Doctor for Disease, A Shaman for the Soul”

This article from the New York Times talks about shamans being integrated in to the hospital setting in order to better treat patients.  Although it does talk about other tradition healers, it focuses on Hmong shamans in Mercy Medical Center in Merced, California. The shamans have been given the same access as clergy members.  They have been trained and taught aspects of Western medicine.  Hmong tradition believes that illness is caused by the soul wandering off or being captured.  When the Hmong refugees first came over they did not understand Western medicine, many of the practices being taboo, which led to many complications that could have easily been avoided.  By teaching the shamans about germ theory and having them perform different ceremonies for patients, outcomes have improved.  The doctors are better able to communicate with patients and vise versa.  The doctors have also seen differences improvements in patients because of the ceremonies and that has helped them to better understand the beliefs, although they have related this to the placebo effect.

The healers are the shamans and the doctors.  As Mr. Lee, a shaman, states, the disease is the responsibility of the doctor and the shamans the soul.  I would say that the shamans have a high social status, like healers in most societies.  The techniques they use in the hospital are calmer versions of the traditional ceremonies.  These ceremonies aren’t loud and must be approved by a patients roommate if necessary.  Of course, ceremonies done outside of the hospital are different.  The shamans will chant and use different objects as part of the ceremonies.  Sometimes leaving things in the patients room.

The shamans operate within the folk sector.  They are a traditional healer and treat the patients in traditional ways. They also operate within the a professional sector because they work within the hospital, under certain rules, and with licensed physicians.  The shamans care is delivered to the patient by performing a ceremony; in the hospital in Merced there are 9 ceremonies that have been approved.  In Hmong culture they believe that illness is a condition of the soul and the shamans job is to address those issues.

 

http://www.nytimes.com/2009/09/20/us/20shaman.html?_r=3

Unnatural causes 2: when the bough breaks

Racism is still here. Some places it is not as prevalent as others. Racism carries worrisome factors for everyday life that we do not always think about. Our babies, either born or still in the womb feel the pressure and stress that we feel when dealing with such a intense topic. As Americans both black white we expect our health care system to be one of the best, but this is not always true. Women who decide to be mothers are carefully  monitored by themselves, doctors, and family members to help ensure a healthy pregnancy and baby. When stress accompanies you during your pregnancy and it becomes to much it can wreak havoc on your body. complications can arise and can even cause low birth weight or premature births.

Premature birth can happen for many reasons and chooses to happen the most in African American women. African American women are three times more likely to have premature birth than a white woman. It is believed that  one’s upbringing, social standing, health, and education are all important factors. Other important factors include a persons environmental and political lifestyle as well. I would think that with how wary we are about our health system  that this would not be a great issue. Some people I’m sure would love to ignore this issue. But the is that it is real and that pregnant women or women wanting kids need to greatly relieve the stress in their lives as much as possible so that a healthier pregnancy is achieved.

Obesity in African Americans

black history month, African-American, Obesity, overweight, epidemic, Michelle Obama, childhood obesity, BMI, body mass index, US Census, CDC,  Centers for Disease Control, health care, pre-existing condition, health insurance, mortality rate

This map shows the obesity rate of African American adults in the United States according to the CDC. According to this map 40 out of 50 states have obesity rates higher than 30%.(http://www.examiner.com/article/the-growing-threat-of-obesity-for-african-americans)

I am sure there are many Americans that can relate to more than one racial or ethnic background, me being on of them.  My mother is of mixed Caucasian decent and my father is Japanese and African American.  In most situations society makes us choose one race to identify ourselves, and if an APB were put out on me I would be identified as African American or black. So that is why I chose the health disparity of obesity in African Americans.  If a person has a BMI over 25 they are considered overweight and a BMI over 30 is obese.  America as a whole is in the middle of a huge obesity epidemic, but African Americans, especially women, have much higher percentage rates. A person who is obese is at a higher risk for heart disease, high blood pressure, stroke, diabetes, cancer, sleep apnea, depression, some types of cancers, and others problems.  These are all reasons that African American men have higher mortality rates then any other group in America. According to the Office of Minority Health 4/5 Afro-American women are overweight or obese and were 70% more likely to be obese than Non-Hispanic white women; young girls were 80% more likely to be overweight.  Overall African Americans were 1.4 times more likely to be obese than Non-Hispanic whites.

I think the biggest reasons for African-Americans have greater rates of obesity are cultural and socioeconomic rather than genetic.  Culturally it is more acceptable to have a larger body type than in other groups. In some ways this is good, but when it comes to physical health it leads to problems. And according to IMDiversity.com African Americans are also less like to feel guilty about overeating. They also point out that in the environments that blacks live in they have more access to fast food and mini marts that offer more fried, sugary, and over-processed foods and drinks.  One of the biggest culprits lies within the home.  We learn our eating habits from out families, and in African American families the tradition of soul food is passed through the generations.  These foods are usually high in fats and sodium.  This tradition didn’t used to be that big of an issue, but today the same diet is partnered with less activity.  The CDC has also noticed a relationship in socioeconomic status and obesity.  Black men with higher incomes are more likely to be overweight then those with lower incomes. This ratio is opposite for women; higher incomes have lower weights than those with lower incomes.  When it comes to education, women have shown to have lower rates of obesity the more education they receive.

I think that many health disparities among races has more to do with culture and socioeconomic status than actual genetic.  In the United States, racial and ethnic minorities and low-income populations have lower rates of insurance and access to health care. 1/5 of African Americans are insured and 1/10 white Americans don’t have insurance.

– http://minorityhealth.hhs.gov/templates/content.aspx?ID=6456

– http://www.examiner.com/article/the-growing-threat-of-obesity-for-african-americans

– http://www.cdc.gov/obesity/data/adult.html

-http://www.imdiversity.com/villages/african/family_lifestyle_traditions/bpr_obesity1127.asp

-http://www.healthreform.gov/reports/healthdisparities/

 

Spirit Possession

I defined health as “the mental and physical being of a person”, then on a side note said that a healthy person would be free of illness.  It was kind of difficult to define illness. There are a lot of things to consider.  I have learned things and experienced things that have altered my opinion of certain subjects. The way that I defined it at first was “a physical or mental ailment that causes someone to function abnormally”.  Then I thought, what is normal? Does an illness have to have a treatment? Does an illness have to hinder a persons ability to function?  Then we talked about the differences between disease and illness.  Illness is defined by the individual. My thoughts on illness come from my education as an anthropology student, life experiences, and illnesses I have come in contact with. I tend to analyze an idea in every aspect to my knowledge just by nature. I did find it extremely important to include in my definition that an illness could be mental and not just physical.

I am still on the fence about spirit possession. I think I am leaning more towards it not being an illness. It is more of a personal experience. This is an example of where my definition of illness doesn’t fit, because a person who is possessed by a spirit would not be acting normally. And depending on the culture a spirit possession could just be seen as a mental illness like multiple personality disorder or schizophrenia, and it would be treated as such.  Others it would be treated by a holy figure and an exorcism would be performed. Personally, I would have to decide on an individual basis.

Infertility caused by genetics is not an illness.  I see it more as that person had unfavorable genes that should not be passed to the next generation, just a step in natural selection.  It is not truly an ailment and it doesn’t disrupt a person’s ability to function normally.

Cancer is my view is absolutely an illness. It attacks that bodies cells and disrupts the natural function of the body.  It can also have mental implications and cause problems in other areas besides that which is directly effected.

Ethnomedical

I chose the ethnomedical approach because I think that the meanings of health and illness are truthfully in the eye of the beholder.  Different cultures see illness and disease differently and have different treatments.  Every culture and nation does not know about “western” medicine.  Even within the united states, doctors treat patients that may not agree with the treatment that the doctor prescribes or may not understand the implications of a diagnosis.  Much of this does depend of the level of education, but it also depends on the traditional beliefs of a culture and the resources available to them.  An example that makes an argument for the ethnomedical approach would be in the case of Lia Lee. Her story is told in the book “The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures” by Anne Fadiman.  Lia’s family members are Hmong refugees from Laos.  Lia is also epileptic and there is a clash between her family’s spiritual beliefs of the disease and the doctors scientific approach.  Her family doesn’t understand the true implications of her epilepsy, the reasons that she has to take the medicine. The doctors have no understanding of the Hmong culture and how to communicate to Lia’s family the seriousness of her condition. This misunderstanding of both sides causes Lia’s condition to worsen over time.

I think that disease and illness are sometimes interpreted as being the same, but I do that I understand how they are different.  Disease is considered the physical abnormalities and biological symptoms seen clinically.  Illness is based more on the cultural beliefs and experiences of a person and their perceptions of what is healthy.

The culture that Miner is talking about it American culture.  I had a little chuckle after reading through the second paragraph. As I was reading about the location I had an inkling that it was the United States and then when it talked about George Washington that is when I definitely knew.

Miner talks about how people have shrines to avert ugliness and the more affluent a family is the more shrines they have in their household.  These shrines would be bathrooms.   Americans are all about cleanliness and the bathroom is where you get clean. It’s were you take care of your appearance.  The part I found interesting is how Miner interpreted the dentist. Personally, I am always looking at people’s teeth.  Having a good teeth that are healthy is way of telling if a person is in good overall health, it ups the attractiveness of a person, and also can show the social standing of a person.  At the end Miner talks about how human sexuality is taboo, but in other cultures it is not. He also talks about how Americans actively use family planning methods and pregnant women wear clothes to cover up their pregnant bodies.  In other cultures, people are more open about sexuality, pregnancy is openly displayed because it is a sign of health, and less is understood about conception.

Don’t Call It A Comeback

Hey there!  I’m Andrea. I JUST officially hit senior status after first session.  When I graduate I will have a B.S. in anthropology. This summer is my first semester back after taking a year and a half off to work and get some things straightened out. Now I’m back and better than ever! Being able to step away for a while allowed me think about what I really wanted to do in life. I am taking this class because medical anthropology is extremely interesting to me and a lot of my studies have focused in the field.  Before my “leave of absence”, I wanted to go in to bioethics and get my masters and what not in that field, but after some soul searching I realize I want to do something that deals more directly with people and I have decided that public relations is more me. So after undergrad I will be pursuing a masters in PR.

Fun facts about me…. hmmmm….. I am a social butterfly.  I love to EAT, shop and hang out with my friends, sometimes all at the same time. Don’t get it twisted though. I love camping and fishing and being outdoors. I love animals! My dog is my child. Her name is Suki, and she is an extremely spoiled 21 month old pit bull who thinks everyone is her best friend. That’s Suki with me in the picture I posted.