Читать книгу A Companion to Medical Anthropology - Группа авторов - Страница 42

During the tumultuous start of the second decade of the new millennium, continued police brutality directed against black men and the COVID-19 pandemic has exposed fault lines of power and inequality in the United States and across the globe. Inequities of life chances and access to basic resources such as housing, food, health care, transportation, and the Internet along axes that include race, class, and gender have been laid bare. Critically informed biocultural approaches in medical anthropology, ones that foreground the health consequences of power and inequalities, are one avenue toward a fuller understanding of how large-scale political-economic processes, including a global pandemic and racism in criminal justice, impact local-level lived realities and become embodied.

Biocultural approaches in medical anthropology have at times occupied center stage and at times have sat on the intellectual periphery. In the latter half of the twentieth century a “chasm” developed between biological and culture perspectives in anthropology, and this was nowhere more evident than in medical anthropology. Yet, there is no escaping that human health – the focus of medical anthropology – is quintessentially a biocultural phenomenon. The question ought not to be whether to engage with biology; rather, it ought to focus us on how biocultural approaches might best enhance our understanding of biology and health in political-economic and sociocultural contexts.

We argue here for approaches we have termed critical biocultural that lie at the intersection of critical medical and biocultural studies of health. The sources of inequalities, whether they link to political oppression, poor access to markets, structured barriers to land ownership, or failed education and health-care systems, are not trivial. The root causes of poverty or inequality shape the forms they take, discourses and practices, efforts to alleviate the problem, and these are all key to a more complete and “critical” biocultural approach in medical anthropology.

The global health problems we face now and in the future are endless, but as Richard Feachem (2000) stated in the first issues of the Bulletin of the World Health Organization for the twenty-first century, addressing the health consequences of social inequalities is the most important global health task for the twenty-first century. We need a full range of anthropological perspectives to meet this task, and biocultural perspectives are particularly important for specifying the biological as well as social dimensions linking inequalities and health. Addressing these issues will call on us to expand our perspectives in new directions and build new collaboration across disciplines. Indeed, “integrating biological and socio-cultural perspectives in concrete and project-oriented situations” (Hvalkof and Escobar 1998, p. 443) may be the best means of achieving a biocultural synthesis.