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“HEALTH, ANTHROPOLOGICAL ASPECTS” - page 5 / 11

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forces, but as being engendered in complex interactions between individuals and their social contexts. Such lived responses may occur in contexts of medical pluralism where several therapeutic systems coexist in one cultural setting; or in circumstances in which symptoms are subject to several distinct classifications, diagnoses, and hence, therapeutic courses of action or, once again, where different moral and religious values shape health promoting and disease preventing activities related to diet and life style practices and support (Leslie and Young 1992). By stressing contingencies and by detailing local histories of particular places and peoples undergoing many kinds of social change, these ethnographies highlight the way particular worlds define health and conceive of health equity, while also illuminating the ways in which risks to disease and illness interrelate.

It is not surprising that ethnographers have focused on illness whose event structure is relatively defined. Emphasized is the experience of illness as an interpersonal phenomenon as it is narrated through stories of illness. Ethnographies disclose how suffering is transformed through language and cultural meanings into distinctive illness narratives whose shared metaphors, voices, and genres represent distinctive experiences and political processes. This transformation, in turn, shapes the lived experience of illness through embodiment of cultural meanings and social relations into body-self processes. Ethnographers have focused on different mediating processes – ritual, devotional practices, music, poetics – that structure a sociosomatic continuum between moral and emotional processes. This approach relates to the concept of “local biologies” by which is meant the different means of relating social worlds and biological processes such that those processes become particularized. Examples include Margaret Lock’s demonstration of fundamental differences in the experiences of menopausal symptoms and the aging process among women in Japan and North America (1993); Lawrence Cohen’s contrast of distinctive interpersonal experiences of dementia in India and the West (1998); and Rayna Rapp’s description of how experiences of class in the United States and technologies of the female reproductive life cycle come to alter experiences of pregnancy, infertility, abortion, and delivery (1999).

Ethnographers have also analyzed the trajectory and outcome of illness experiences on the social course of illness. Thus Susan Reynolds Whyte and Benedicte Ingstad (1995) have shown how disability is as much a product of social definitions and restrictions and opportunities of access as it is a physical or functional limitation or disease, thus turning disability into an experience of potential wholeness and health. Other anthropologists have investigated societal responses to highly stigmatized disorders that respond to feelings of threat with practices aimed at marginalizing sufferers. Still others have studied experiences of chronic conditions like chronic fatigue syndrome, chronic pain syndrome, and fibromyalgia – disorders that are in a limbo of partial or minimal authorization where patients feel discredited or discreditable because of the lack of social

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