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3.1.98 Health, anthropological aspects

Health and health practices are part of the inmost complexities of social existence, permeating the domains of politics, economics, and religion and almost always connected with dimensions that go beyond the body, such as interpersonal, family, and community relationships. Health is at once an end and a means. Explanations of the causes and patterns of health and disease often convey value judgments, senses of right and wrong and of accountability and blame, as well as reveal what is morally at stake in definitions of health and its failures. Medical anthropological studies have built upon historical and cultural analyses over a long period of time that indicate an array of difference with respect to the metaphors and meanings that signify health. These studies have emphasized cultural fabrics that give coherence and depth to these meanings such that cosmology and ethical traditions come to define the body in states of sickness and well-being.

Anthropological studies focus on local contexts where health and illness are recognized and responded to. Such studies also trace the effects of global flows of commodities, information, finance, images, people, and pathogens on such worlds. Anthropologists have been as interested in the social roots and consequences of health (and illness) as in their cultural representations. But what most particularly characterizes the anthropological perspective is the use of ethnography to understand health, illness, and health care. Anthropological perspectives on health bring together individual and collective realities in the way they are organized, narrated, contested, and in every sense lived as social trajectories (Kleinman 1995).

What anthropologists have learned through research in different societies is a story of diversity in experiences of health and health care giving, as well as of the ways social relationships and emotional processes interfuse in the mediation of health-relevant experiences. The meanings of health range from holistic and organic interpretations to hyper-individualistic ones. While biomedicine has treated health as a separate domain, popular meanings and interpretations of healthy states are often inseparable from other moral, political, and economic domains. Anthropologists have been particularly concerned with the transformations in health as those transformations express differences in power, social position, and social inequality, particularly as experienced by marginal groups and individuals. But in recent years, equal interest has been devoted to studies of health professionals, bureaucrats, and scientists who contribute to the public definition of health and health problems. Culture affects health as much through the culture of biomedicine and bureaucratic institutions as through the popular culture; indeed in the age of the Internet the two are closely related.

Applied medical anthropology addresses issues such as the ones raised and addresses them at the policy level. In heterogeneous societies such as North America and Western Europe, cultural differences continue to matter in the

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