Medical Anthropology (ANG 6737)

Thanks to David for bringing my attention to this story about the politics of climate change and health. Yesterday Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention (CDC), testified before the Senate Environment and Public Works Committee. She reportedly told Senators that climate change “is anticipated to have a broad range of impacts on the health of Americans.” But the written testimony she entered into the record contains few details to support that claim. According to the Associated Press, here’s why:

The White House significantly edited testimony prepared for a Senate hearing on the impact of climate change on health, deleting key portions citing diseases that could flourish in a warmer climate, documents obtained by The Associated Press showed Wednesday.

The White House on Wednesday denied that it had “watered down” the congressional testimony that Dr. Julie Gerberding, director of Centers for Disease Control and Prevention, had given the day before to the Senate Environment and Public Works Committee.

But a draft of the testimony submitted for White House review shows that six pages of details about specific disease and other health problems that might flourish if the Earth warms were not delivered at the hearing.

In a Wall Street Journal report, Dr. Gerberding denies that the White House diluted her testimony, calling such allegations “ridiculous.” It’s hard to know what really happened, but at least the media coverage of this controversy highlights the political context of scientific debates.

The New York Times recently ran an article describing a U.S. Department of Defense program that embeds groups of anthropologists and other social scientists with combat brigades deployed to Afghanistan and Iraq. This article suggests that combat operations, and civilian casualties, have dramatically decreased since the arrival of anthropologists, leaving the military more time for security, peacekeeping, and reconstruction efforts.

Anthropologists have always worked in some capacity with the U.S. government, which has led to numerous ethical crises within the discipline in the last century. Franz Boas, considered a founder of American anthropology, was famously censured by the American Anthropological Association for writing a letter to political journal The Nation in 1919 exposing the spying activities of anthropologists in the field. Anthropologist David Price describes the story behind Boas’s censure, anthropology’s role in the history of American intelligence activities, and the state of contemporary anthropological ethics on this matter.

However, the anthropologists described in the New York Times piece are presumably not pretending to conduct research while actually spying for clandestine services. The article describes some of the ways that anthropologists have contributed to military goals by investigating the problems (poverty, land disputes) facing communities caught in a war zone.

What are the ethical decisions related to working under the aegis of U.S. Army brigades in a combat environment? What if your training contributes to the death and injury of others, but contributes to the military’s success? What if your insights are responsible for decreasing the need for combat operations? How might medical anthropology serve the good of all in a war zone?

You may have noticed that activity on the blog has been fairly sparse. That’s not due to any shortage of issues related to medical anthropology in the news. Rather, it’s mainly because I’ve been busy with other things—like grading your essay exams.

So today I’m happy to introduce a new contributor to the blog, Brian Tyler. Brian is a doctoral student in anthropology. His dissertation research focuses on culture, trauma, and health in contemporary Guatemala. As he puts it:

Researchers across disciplines recognize that exposure to traumatic events can have serious consequences to both biological and psychological health. My research explores the sociocultural correlates of psychosocial stress and health, the nature of social suffering following decades of civil war, and the cultural mediation of individual and collective response to war-related traumatic experience. I am particularly interested in the social and cultural factors that mediate the impact of traumatic experience on individual mental and physical health outcomes.

Given these interests, it is fitting that Brian’s first post deals with the current controversy over the role of anthropologists in the U.S. military. In what’s left of the semester, you can look forward to hearing more from Brian about new research and current events related to the themes of the course.

Via the Well blog at the New York Times, I just learned about the Illustrated BMI Categories Project on Flickr. As of today, the Flickr photoset includes photographs of 80 women, along with their height, weight, and BMI category, based on CDC guidelines (I haven’t verified the BMI calculations). Do the CDC categories fit your idea of who is overweight or obese? And what do you make of the fact that only women are featured in the photos?

Be sure to check out the comments on the original post at the Well blog, too. They give you a good sense of how people react to controversy over the meaning of BMI.

A few weeks ago in class, I recommended Zotero, a free tool for managing references and producing bibliographies. Yesterday, Inside Higher Ed published a detailed review of Zotero that will help you decide if it’s right for you. The best part about the review is that the author, Scott McLemee, is a self-proclaimed newbie with no particular technical expertise. He identifies the key strengths and weaknesses of Zotero and gives a good sense for how you would get started using it.

Whether it’s Zotero or something else, I encourage you to develop a system for managing references. It will save you time and headaches later on.

Yesterday we discussed the question that Wayt Gibbs posed in a recent issue of Scientific American: Is obesity an overblown epidemic? This question is also the focus of a three-part debate that took place last week in the Los Angeles Times. The LA Times pits Kelly D. Brownell, a professor of psychology and public health at Yale, against Paul F. Campos, a professor of law at the University of Colorado. Campos is featured in the Gibbs article you read, too.

This debate has also played out recently in the scholarly literature. For example, see the series of point and counterpoint articles in the February 2006 issue of the International Journal of Epidemiology. What do you make of this debate?

I neglected to remind you in class yesterday that your annotated bibliographies are due next Tuesday in class. From the syllabus:

An annotated bibliography with at least 10 carefully selected references from the scholarly literature is due on Oct. 2. The references should clearly relate to your paper topic. Your annotations should briefly evaluate the content of the source and identify how, it at all, it will contribute to your research paper. Consult the guidelines for how to identify scholarly sources and how to make an annotated bibliography in the Guide to Library Research from Cornell University.

The UF Libraries has a useful web page about citation style guides. It’s not important to me which citation style you use, so long as you use it correctly and consistently. One good option would be to use the American Anthropological Association style. Other good alternatives include the Chicago Manual of Style or APA style.

If you have questions about this assignment, please leave a comments here on the blog.

As you know, on Tuesday you are required to submit a 250-300 word proposal defining the topic of your research paper. Please bring six copies of your proposal to share with classmates in your peer review groups.

Developing a well-defined problem is the key to a successful research paper. As you finish your proposal, keep in mind that a research problem is more than just a topic. Whereas a topic identifies some general phenomenon (e.g., Native American healing traditions), a research problem raises interesting questions of theoretical or practical value (e.g., How do contemporary Native American healing traditions interact with biomedicine?). Your paper will be more fun to write (and to read) if you tackle a specific research problem than it will be if you address a broad, ill-defined topic.

Begin to narrow your focus by doing some exploratory reading on a topic that interests you. You may find that the course readings are a good place to start. As you read, take note of exciting ideas or unresolved puzzles, and try to formulate interesting “what,” “how,” or “why” questions about your topic. Do a preliminary literature search early on to make sure that you’ll have enough—but not too much—material to draw on.

The paper proposal should identify the problem and articulate why it is important. Try to relate your problem to the broader themes of the course, and indicate how you plan to approach the problem.

Many university libraries have useful suggestions for finding appropriate research topics. See, for example, this page at the Cornell University Library.

In class yesterday, you worked through the ways that medical anthropologists from different theoretical perspectives might approach the study of obesity. Some of you took on the role of ecological or evolutionary anthropologists; others became critical medical anthropologists; still others applied an interpretive perspective.

A recent story on NPR provides a perfect follow-up to our discussion. The story deals with the causes and consequences of dietary change on the Greek island of Crete over the last 60 years. There’s a lot to chew on (so to speak). What strikes you most about the story? How do the major theoretical perspectives we discussed apply to this case?

Yesterday in class I mentioned a study that has been in the news this week about the links between mother’s diabetes during pregnancy and their children’s risk of obesity five to six years later. This study is the latest in a growing body of research that shows how health is influenced by early-life experiences, including exposures in utero and even in previous generations.

This work draws on life course epidemiology and on research in developmental plasticity and health. It’s a thoroughly interdisciplinary field and has a new professional society to show for it. This area of research is fertile ground for biocultural approaches to medical anthropology, because it helps us to understand how sociocultural factors impact human biology over the life course and even across generations.

Of course, news coverage of this week’s study focuses narrowly on the links between gestational diabetes and children’s subsequent weight. It doesn’t address the sociocultural factors that put women at risk of developing gestational diabetes in the first place. Where would you begin to look for answers to that question?