Читать книгу A Companion to Medical Anthropology онлайн

80 страница из 242

Human ecology also served as a framework for examining the evolution of disease and disease processes in contemporary human populations, often framed in terms of epidemiological transitions (Armelagos et al. 2005). In the ecological model, the host could be an individual or a group, the environment was composed of social and cultural as well as climatic and bio-geographic conditions, and pathogens were broadened from infectious agents to a wider category of insults such as physical violence, psychosocial stressors, protein-energy deficits, and anthropogenic toxins and pollutants.

The promise of an integrative ecological model in medical anthropology led many to conclude that a theoretically coherent integration of biological, ecological, and cultural domains had been achieved (for a longer analysis, see Goodman and Leatherman 1998). Yet, Landy (1983, p. 187) suggests that although medical ecological perspectives gained considerable acceptance, they only gained a “broad tacit consensus.” Like elsewhere in anthropology, ecological models were soon critiqued by critical medical anthropologists such as Singer (1989) for lack of attention to global and regional processes, social relations of power, overly functionalist and homeostatic orientations, and their reliance on the biomedical models of disease. Singer (1989, p. 223) sums up the critique from the critical medical perspective, stating “The flaws in medical ecology…arise ultimately from the failure to consider fully or accurately the role of social relations in the origin of health and illness.”