Anthropology in Healthcare
The Intercorrelation with Sickness, Disease, and Illness
Understanding sickness, illness, and disease is not only vital to a community or culture, but also to each individual to establish a system of distinguishable aspects of pathology and retain a relationship between "the biological components of health" within the "social, cultural, and institutional frames"1that healthcare exists. Sickness refers to "cultural conceptions of a condition held by society",2 best understood by the categorization of a social response. Contrarily, illness is defined as "subjective interpretation of unwellness including symptoms." 3 Likewise, disease is defined as an "abnormal condition afflicting the body" 4 due to pathogenic causes and is held within the biomedical sphere of medicine that focuses primarily on biology and physiology. Biological phenomena are evaluated based off of unique experiences and interpretations . However, a person may also be asymptomatic even though they are infecting others.
Sickness, illness, and disease can be understood when they are set within a medical framework for gathering information, such as the SOAP note utilized by hospital nurses and the U.S. military. SOAP (Subjective, Objective, Assessment, and Plan) is a systematic way of evaluating what the patient presents with to determine the overall medical case based on criteria. Subjective findings would include details derived from the mnemonic device of OLDCARTS (onset, location or radiation, duration, character, aggravating factors, relieving factors, timing and severity). Objective findings would be evaluated through physical examination prior to conducting labs. An assessment is then made to determine the diagnosis (whether there is a sickness, illness, or disease) followed by a plan established by a provider. This process becomes medicalization. In medical anthropology, the LEARN model operates much the same as the SOAP model does within clinical medicine.
Cultural Interpretation and Its Guiding Force on Advocacy within the Outreach Ministry Community
Cultural interpretation of sickness, illness, and disease affects overall treatment and interaction between the healthcare provider and patient(s) by divulging stereotypes or interpretation of symptoms which also affects communication. For instance, Schizophrenia and Bipolar Disorder are classified as mental illnesses in the United States, yet are understood as mental diseases in other countries due to "biological components" 5 that affect brain chemistry and function noted by psychological anthropologists, neurologists, and psychiatrists alike. Another example is PTSD (post-traumatic stress disorder). For a while, this condition was very little understood or studied, yet symptoms were persistent in individuals who returned from war zones. Society viewed these individuals as mentally weak and therefore very little treatment was offered. Today, PTSD is vastly studied and is now understood to be among individuals (including children) who encounter prolonged trauma such as war, abuse, and assault or those who encounter such cases through third-person interaction (i.e., case management, crime scene investigations, social work, witnesses of crime, etc.).
Ethnomedicine and How it Impacts Our Perception of Human Rights
Ethnomedicine, or how people "cope with illness and disease" 6 further evaluates cultural interpretation. Within this category of medical anthropology, ethnomedical studies are conducted through "anthropological approaches, ecology, epidemiology, and medical history." 7 Empirical data is gathered on healing and overall health outside of the biomedical realm. Scripture uses the metaphor of a temple for the body, denoting how God dwells among humanity, specifically His people (John 2:21, Romans 12:1-6, 1 Corinthians 6:19-20, NASB). In cultures like Japan, for instance, the body is understood as a place in the natural world that has the ability to receive peace, energy, or knowledge from outside forces. In the United States, and other Western societies, the body is compared to a machine that can be "serviced, repaired, and maintained." 8 A Confucian-centered healing approach will "connect, harmonize, or integrate" 9 where a body-as-a-machine healing approach will repair or replace. Culture-bound syndrome where usage of "cultural tools" to explain "symptoms, the suspected causal agents, and preferred treatment" 10 also influence health and interactions between healthcare provider and patient since conditions may have real and fatal physical consequences yet lack biomedical explanation 11. Overall, worldview plays a crucial part in interpreting data (both subjective symptoms of patients and objective findings through testing) and helps analyze what is true and real.
1 Brian M. Howell and Jenell Paris, Introducing Cultural Anthropology: A Christian Perspective, (Grand Rapids, MI: Baker Publishing Group, 2019), 214-215
2 Ibid, 230
3 Ibid, 230
4 Ibid, 230
5 Ibid, 216
6 Ibid, 217
7 Ibid, 217
8 Ibid, 218
9 Ibid, 218-219
10 Ibid, 220
11 Ibid, 220