Robert A. Hahn - Böcker

Many serious public health problems confront the world in the new millennium. Anthropology and Public Health examines the critical role of anthropology in four crucial public health domains: (1) anthropological understandings of public health problems such as malaria, HIV/AIDS, and diabetes; (2) anthropological design of public health interventions in areas such as tobacco control and elder care; (3) anthropological evaluations of public health initiatives such as Safe Motherhood and polio eradication; and (4) anthropological critiques of public health policies, including neoliberal health care reforms. As the volume demonstrates, anthropologists provide crucial understandings of public health problems from the perspectives of the populations in which the problems occur. On the basis of such understandings, anthropologists may develop and implement interventions to address particular public health problems, often working in collaboration with local participants. Anthropologists also work as evaluators, examining the activities of public health institutions and the successes and failures of public health programs. Anthropological critiques may focus on major international public health agencies and their workings, as well as public health responses to the threats of infectious disease and other disasters. Through twenty-four compelling case studies from around the world, the volume provides a powerful argument for the imperative of anthropological perspectives, methods, information, and collaboration in the understanding and practice of public health. Written in plain English, with significant attention to anthropological methodology, the book should be required reading for public health practitioners, medical anthropologists, and health policy makers. It should also be of interest to those in the behavioral and allied health sciences, as well as programs of public health administration, planning, and management. As the single most comprehensive and up-to-date analysis of anthropology's role in public health, this volume will inform debates about how to solve the world's most pressing public health problems at a critical moment in human history.

The ways in which people respond to sickness differ greatly from society to society. In this book anthropologist and epidemiologist Robert A. Hahn examines how Western and non-Western cultures influence the definition, experience, and treatment of sickness.Hahn begins by developing a definition of sickness that is based on the patient's perception of suffering and disturbance rather than on the physician's assessment of biomedical signs. After reviewing the principal theories that account for the forms of sickness and healing found in different historical and cultural situations, he explores the relevance of both anthropological and epidemiological approaches to sickness, focusing on the persistent gap between white and black infant mortality in the United States. Hahn then describes contemporary Western medicine as it might be seen by a visiting foreign anthropologist. He delineates the culture of Western medicine and portrays the world of one physician at work, traces the evolution of obstetrics since 1903 by analyzing the principal textbook—Williams Obstetrics—through its first eighteen editions, and explores the gulf between physicians and their patients by examining the accounts of physicians who have written about their own illnesses. He concludes by proposing ways in which some of the ills of contemporary Western medicine might be remedied by applying anthropological principles to medical training and practice.

After putting down this weighty (in all senses of the word) collection, the reader, be she or he physician or social scientist, will (or at least should) feel uncomfortable about her or his taken-for-granted commonsense (therefore cultural) understanding of medicine. The editors and their collaborators show the medical leviathan, warts and all, for what it is: changing, pluralistic, problematic, powerful, provocative. What medicine proclaims itself to be - unified, scientific, biological and not social, non-judgmental - it is shown not to resemble very much. Those matters about which medicine keeps fairly silent, it turns out, come closer to being central to its clinical practice - managing errors and learning to conduct a shared moral dis­ course about mistakes, handling issues of competence and competition among biomedical practitioners, practicing in value-laden contexts on problems for which social science is a more relevant knowledge base than biological science, integrating folk and scientific models of illness in clinical communication, among a large number of highly pertinent ethnographic insights that illuminate medicine in the chapters that follow.