Читать книгу A Companion to Medical Anthropology - Группа авторов - Страница 52

The bulk of health-related research in other disciplines has either focused on individuals and their attributes, or on population samples collected through probabilistic sampling procedures. While this approach has a number of strengths, its weaknesses are twofold. First, the cultural context of health problems is all too often ignored by individually centered approaches. Second, people spend a significant portion of their lives within small interactive groups, where their behavior may be impacted as much or more strongly by the group than by any individual characteristic that they bring to the group. Anthropological midrange theory has been highly productive in establishing the importance of cultural contexts and the organization and structure of human systems. These approaches derive from theories of kinship and social network analysis and the impact of cultural structures on human behavior.

Ethnographic network mapping allows applied anthropologists to describe the participants, the behaviors, the kinship and friendship ties, and the consequences of small “bounded groups” in a community. It is accomplished through extensive qualitative interviewing at the community level. In the drug field, the composite ethnographic characteristics of the networks have subsequently been used to create a “drug network” typology or classification system that describes the individual and group context of drug use (such as crack houses, local manufacturing, and distribution). Trotter et al. (1995) and Williams and Johnson (1993) have demonstrated that this type of data is extremely useful for targeting intervention and education activities for the highest risk groups, based on multiple risk criteria. The data can also provide important information about the sub-epidemics that are likely to be part of drug use in network groups (Trotter et al. 1993). In HIV and drug risk prevention, several projects have tested very useful midrange theory to identify network structural elements. These findings provide public health measures of HIV and drug risk conditions (Trotter et al. 1995; Weeks et al. 2001, 2006) as well as epidemiological comparisons of HIV risks within their personal network context in cities around the United States (Williams et al. 1995).

More recently, social network paradigms, combined with community-based participatory principles (CBPR) have provided an important theoretical foundation for understanding infectious disease carriage and transmission through the confluence of Staphylococcus aureus genomics and network analytics. The project has focused on health disparities in Staphylococcus aureus transmission and carriage in a border Region of the United States based on cultural differences in social Relationships (Pearson et al. 2019), providing an example of the potential confluence between biology, social organization, culture, and communication. The epidemiological aspects of genomics are a strong fit with paradigms that include organized social relationships.