Images of health, illness, and healing have become key media, a “fragile salvation,” through which societies and groups struggle with central values and beliefs, and negotiate social and political progress. The invention and implementation of techniques of health improvement have taken on many forms, including epidemic control, disease eradication, and combinations of environmental and individual behavioral change and medical advance. Yet definitions of health depend on normative and oftentimes conflictual values. Health as an individual goal coexists with new threats to health worldwide. The spread of advertising for cigarettes or the dumping of expired pharmaceuticals in low-income countries are all part of the globalization of disease. Under such conditions, what was once health, now becomes disease. Health maintenance and promotion, once so influential a concept, can be undermined owing to new political and economic realities.
Contexts of health are themselves undergoing changes and are influenced by transformations in economy and polity, in science and technology, and in culture. These contexts shape the conditions of health and are in turn affected by it. These processes demonstrate that health as an experience is irreducible to a set of norms of physiological and mental activity, or strictly to a set of cultural differences. Only through concrete understandings of particular worlds of suffering and the way they are shaped by local histories and political economies can we possibly come to terms with the complex human dimensions that protect or undermine health. Health, seen in this way, is a construction as well as a contested way of being in the world.
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