Studies in Medical Anthropology – serie

Bringing together essays by nineteen respected scholars, this volume approaches dementia from a variety of angles, exploring its historical, psychological, and philosophical implications. The authors employ a cross-cultural perspective that is based on ethnographic fieldwork and focuses on questions of age, mind, voice, self, loss, temporality, memory, and affect.Taken together, the essays make four important and interrelated contributions to our understanding of the mental status of the elderly. First, cross-cultural data show that the aging process, while biologically influenced, is also culturally constructed. Second, ethnographic reports raise questions about the diagnostic criteria used for defining the elderly as demented. Third, case studies show how a diagnosis affects a patient's treatment in both clinical and familial settings. Finally, the collection highlights the gap that separates current biological understandings of aging from its cultural meanings.As Alzheimer's disease and other forms of dementia continue to command an ever-increasing amount of attention in medicine and psychology, this book will be essential reading for anthropologists, social scientists, and health care professionals.

In The Public Life of the Fetal Sonogram, medical anthropologist Janelle S. Taylor analyzes the full sociocultural context of ultrasound technology and imagery. Drawing upon ethnographic research both within and beyond the medical setting, Taylor shows how ultrasound has entered into public consumer culture in the United States. The book documents and critically analyzes societal uses for ultrasound such as nondiagnostic "keepsake" ultrasound businesses that foster a new consumer market for these blurry, monochromatic images of eagerly awaited babies, and anti-abortion clinics that use ultrasound in an attempt to make women bond with the fetuses they carry, inciting a pro-life state of mind. This book offers much-needed critical awareness of the less easily recognized ways in which ultrasound technology is profoundly social and political in the United States today.

Far from celebrity media spotlight, ordinary individuals, many older and less advantaged, suffer the disabling pain of Parkinson's disease (PD), an illness whose progressive symptoms often mimic old age and cause mobility impairment, communication barriers, and social isolation.At the heart of With Shaking Hands is the account of elder Americans in rural Iowa who have been diagnosed with PD. With a focus on the impact of chronic illness on an aging population, Samantha Solimeo combines clear and accessible prose with qualitative and quantitative research to demonstrate how PD accelerates, mediates, and obscures patterns of aging. She explores how ideas of what to expect in older age influence and direct interpretations of one's body.This sensitive and groundbreaking work unites theories of disease with modern conceptions of the body in biological and social terms. PD, like other chronic disorders, presents a special case of embodiment which challenge our thinking about how such diseases should be researched and how they are experienced.

Embodying Culture is an ethnographically grounded exploration of pregnancy in two different cultures-Japan and Israel-both of which medicalize pregnancy. Tsipy Ivry focuses on "low-risk" or "normal" pregnancies, using cultural comparison to explore the complex relations among ethnic ideas about procreation, local reproductive politics, medical models of pregnancy care, and local modes of maternal agency. The ethnography pieces together the voices of pregnant Japanese and Israeli women, their doctors, their partners, the literature they read, and depicts various clinical encounters such as ultrasound scans, explanatory classes for amniocentesis, birthing classes, and special pregnancy events. The emergent pictures suggest that although experiences of pregnancy in Japan and Israel differ, pregnancy in both cultures is an energy-consuming project of meaning-making- suggesting that the sense of biomedical technologies are not only in the technologies themselves but are assigned by those who practice and experience them.

Embodying Culture is an ethnographically grounded exploration of pregnancy in two different cultures-Japan and Israel-both of which medicalize pregnancy. Tsipy Ivry focuses on "low-risk" or "normal" pregnancies, using cultural comparison to explore the complex relations among ethnic ideas about procreation, local reproductive politics, medical models of pregnancy care, and local modes of maternal agency. The ethnography pieces together the voices of pregnant Japanese and Israeli women, their doctors, their partners, the literature they read, and depicts various clinical encounters such as ultrasound scans, explanatory classes for amniocentesis, birthing classes, and special pregnancy events. The emergent pictures suggest that although experiences of pregnancy in Japan and Israel differ, pregnancy in both cultures is an energy-consuming project of meaning-making- suggesting that the sense of biomedical technologies are not only in the technologies themselves but are assigned by those who practice and experience them.

In the wake of structural adjustment programs in the 1980s and health reforms in the 1990s, the majority of sub-Saharan African governments spend less than ten dollars per capita on health annually, and many Africans have limited access to basic medical care. Using a community-level approach, anthropologist Ellen E. Foley analyzes the implementation of global health policies and how they become intertwined with existing social and political inequalities in Senegal. Your Pocket Is What Cures You examines qualitative shifts in health and healing spurred by these reforms, and analyzes the dilemmas they create for health professionals and patients alike. It also explores how cultural frameworks, particularly those stemming from Islam and Wolof ethnomedicine, are central to understanding how people manage vulnerability to ill health.While offering a critique of neoliberal health policies, Your Pocket Is What Cures You remains grounded in ethnography to highlight the struggles of men and women who are precariously balanced on twin precipices of crumbling health systems and economic decline. Their stories demonstrate what happens when market-based health reforms collide with material, political, and social realities in African societies.

In the wake of structural adjustment programs in the 1980s and health reforms in the 1990s, the majority of sub-Saharan African governments spend less than ten dollars per capita on health annually, and many Africans have limited access to basic medical care. Using a community-level approach, anthropologist Ellen E. Foley analyzes the implementation of global health policies and how they become intertwined with existing social and political inequalities in Senegal. Your Pocket Is What Cures You examines qualitative shifts in health and healing spurred by these reforms, and analyzes the dilemmas they create for health professionals and patients alike. It also explores how cultural frameworks, particularly those stemming from Islam and Wolof ethnomedicine, are central to understanding how people manage vulnerability to ill health.While offering a critique of neoliberal health policies, Your Pocket Is What Cures You remains grounded in ethnography to highlight the struggles of men and women who are precariously balanced on twin precipices of crumbling health systems and economic decline. Their stories demonstrate what happens when market-based health reforms collide with material, political, and social realities in African societies.

Incorporating investigative journalism and drawing on interviews with participants and leaders, Sandy Smith-Nonini examines the contested place of health and development in El Salvador over the last two decades. Healing the Body Politic recounts the dramatic story of radical health activism from its origins in liberation theology and guerrilla medicine during the third-world country's twelve-year civil war, through development of a remarkable "popular health system," administered by lay providers in a former war zone controlled by leftist rebels. This ethnography casts light on the conflicts between the conservative Ministry of Health and primary health advocates during the 1990s peace process--a time when the government sought to dismantle the effective peasant-run rural system. It offers a rare analysis of the White Marches of 2002û2003, when radicalized physicians rose to national leadership in a successful campaign against privatization of the social security health system. Healing the Body Politic contributes to the productive integration of medical and political anthropology by bringing the semiotics of health and the body to bear on cultural understandings of warfare, the state, and globalization.

Chronic Conditions, Fluid States explores the uneven impact of chronic illness and disability on individuals, families, and communities in diverse local and global settings. To date, much of the social as well as biomedical research has treated the experience of illness and the challenges of disease control and management as segmented and episodic. Breaking new ground in medical anthropology by challenging the chronic/acute divide in illness and disease, the editors, along with a group of rising scholars and some of the most influential minds in the field, address the concept of chronicity, an idea used to explain individual and local life-worlds, question public health discourse, and consider the relationship between health and the globalizing forces that shape it.

Comprehending Drug Use, the first full-length critical overview of the use of ethnographic methods in drug research, synthesizes more than one hundred years of study on the human encounter with psychotropic drugs. J. Bryan Page and Merrill Singer create a comprehensive examination of the whole field of drug ethnography-methodology that involves access to the hidden world of drug users, the social spaces they frequent, and the larger structural forces that help construct their worlds. They explore the important intersections of drug ethnography with globalization, criminalization, public health (including the HIV/AIDS epidemic, hepatitis, and other diseases), and gender, and also provide a practical guide of the methods and career paths of ethnographers.

Sleep Paralysis explores a distinctive form of nocturnal fright: the "night-mare," or incubus. In its original meaning a night-mare was the nocturnal visit of an evil being that threatened to press the life out of its victim. Today, it is known as sleep paralysis-a state of consciousness between sleep and wakefulness, when you are unable to move or speak and may experience vivid and often frightening hallucinations. Culture, history, and biology intersect to produce this terrifying sleep phenomenon. Although a relatively common experience across cultures, it is rarely recognized or understood in the contemporary United States.Shelley R. Adler's fifteen years of field and archival research focus on the ways in which night-mare attacks have been experienced and interpreted throughout history and across cultures and how, in a unique example of the effect of nocebo (placebo's evil twin), the combination of meaning and biology may result in sudden nocturnal death.

In a world now filled with more people who are overweight than underweight, public health and medical perspectives paint obesity as a catastrophic epidemic that threatens to overwhelm health systems and undermine life expectancies globally. In many societies, being obese also creates profound personal suffering because it is so culturally stigmatized. Yet despite loud messages about the health and social costs of being obese, weight gain is a seemingly universal aspect of the modern human condition.Grounded in a holistic anthropological approach and using a range of ethnographic and ecological case studies, Obesity shows that the human tendency to become and stay fat makes perfect sense in terms of evolved human inclinations and the physical and social realities of modern life. Drawing on her own fieldwork in the rural United States, Mexico, and the Pacific Islands over the last two decades, Alexandra A. Brewis addresses such critical questions as why obesity is defined as a problem and why some groups are so much more at risk than others. She suggests innovative ways that anthropology and other social sciences can use community-based research to address the serious public health and social justice concerns provoked by the global spread of obesity.

In a world now filled with more people who are overweight than underweight, public health and medical perspectives paint obesity as a catastrophic epidemic that threatens to overwhelm health systems and undermine life expectancies globally. In many societies, being obese also creates profound personal suffering because it is so culturally stigmatized. Yet despite loud messages about the health and social costs of being obese, weight gain is a seemingly universal aspect of the modern human condition.Grounded in a holistic anthropological approach and using a range of ethnographic and ecological case studies, Obesity shows that the human tendency to become and stay fat makes perfect sense in terms of evolved human inclinations and the physical and social realities of modern life. Drawing on her own fieldwork in the rural United States, Mexico, and the Pacific Islands over the last two decades, Alexandra A. Brewis addresses such critical questions as why obesity is defined as a problem and why some groups are so much more at risk than others. She suggests innovative ways that anthropology and other social sciences can use community-based research to address the serious public health and social justice concerns provoked by the global spread of obesity.

Surviving HIV/AIDS in the Inner City explores the survival strategies of poor, HIV-positive Puerto Rican women by asking four key questions: Given their limited resources, how did they manage an illness as serious as HIV/AIDS? Did they look for alternatives to conventional medical treatment? Did the challenges they faced deprive them of self-determination, or could they help themselves and each other? What can we learn from these resourceful women? Based on her work with minority women living in Newark, New Jersey, Sabrina Marie Chase illuminates the hidden traps and land mines burdening our current health care system as a whole. For the women she studied, alliances with doctors, nurses, and social workers could literally mean the difference between life and death. By applying the theories of sociologist Pierre Bourdieu to the day-to-day experiences of HIV-positive Latinas, Chase explains why some struggled and even died while others flourished and thrived under difficult conditions. These gripping, true-life stories advocate for those living with chronic illness who depend on the health care "safety net." Through her exploration of life and death among Newark's resourceful women, Chase provides the groundwork for inciting positive change in the U.S. health care system.