In an earlier paper (Dressler, 2001), I suggested that medical anthropology as a research enterprise could not ignore either meaning or structure in human social life in the production of health. Rather, drawing on the early work of Bourdieu, I argued that we need to take into account both how the world is configured by the collective meanings we impose upon it, as well as the social structural (and physical) constraints on our behaviour that exist outside those meanings. Human health can be understood, in part, as the intersection of meaning and structure. Here, my aim is to extend this perspective in three ways. Firstly, I present an expanded theoretical framework within which collectivei meaning and social structure can be conceptualised. A useful theoretical framework must take into account paradoxical features of culture, including the seeming contradiction that it is a property both of social aggregates and of individuals, and that, ultimately, social structural constraints external to individuals depend on shared meaning. Secondly, I review recent research employing this perspective conducted in Brazil, the southern United States and Puerto Rico. These studies have all employed a 'structural-constructivist' theoretical orientation, using especially the concept of 'cultural consonance', or the degree to which individuals incorporate shared meaning into their own beliefs and behaviour. Where individual efforts to attain a higher cultural consonance are frustrated by structural constraints, poor health results. Thirdly, I consider some of the policy implications of this perspective. While much work in traditional public health focuses on a highly individualised notion of meaning (as in 'health beliefs'), it seems unlikely that the health of populations can be altered substantially without taking into account the structures that constrain individual action.
Sara Van Belle
successfully applied to make sense of and improve upon the management of health systems and the implementation of health policies. Due to its practitioners’ engagement with meaning, applied medical anthropology has a critical role to play in enabling community
The articles in this special issue tackle a problem at the heart of medical anthropology today—a problem that bedevils our methods, theoretical ambitions and public stance in the world. How should we rank the relative importance of local cultural meanings, on the one hand, and large-scale political and economic forces, on the other? That is, how should we train our sights on both culture and politics as we study the social contexts of suffering and apply our expertise to the worlds of policymaking and service delivery? How do we keep ‘culture’ and ‘politics’ in motion (and both are very broad analytical terms) without lapsing into one-sided analyses that champion the one term at the expense of the other? The following articles significantly advance the debate about such issues. They offer powerful theoretical models of the dialectic between culture-specific illness idioms and the operations of power that constrain people’s lives. They also re-think the very notion of culture in light of the complex networks—connecting individuals to nationstates, empires, NGOs, pharmaceutical firms and global capital—in which medical anthropologists increasingly work.
Emerging Contributions in Ethnographic Research
Alexa S. Dietrich
for the combined material and embodied experience of contaminated environments within medical anthropology (e.g., Dietrich 2013 ; Dietrich and Harper 2007 ; Harper 2004 ) attending especially to the challenges of proving health impact through
Navigating Research on the Fertility Quests of Mozambican Women and Men
argue for the relevance of flexibility and reflexivity in fieldwork and analytical practice, but also – following authors such as Hansjörg Dilger and colleagues (2015) for the specific case of medical anthropology – for the relevance of the notion that
effervescence can be productively applied to questions in medical anthropology. Incidentally, as will be suggested, Mauss's interest in rhythm and synchronisation as an aspect of the ‘morphology’ of social organisation has more in common than is generally
of dynamism, which, as Cheryl Mattingly (1998) and Arthur Kleinman (1988) showed, is fundamental to any form of care provision. Narrative research in medical anthropology usually focusses on patients as storytellers. Yet, there are also medical
pandemic; who had existing platforms, local anthropologists were presented with opportunities to bear witness through deliberate global and local efforts to collect COVID-19 narratives. Jhaki Mendoza, a medical anthropology graduate student, contributed an