Chapter 5 – Social Anthropology

Lecturer PowerPoint
Lecturer Lesson Plan
Additional Case Study
3 Papers
3 Websites
3 Media Articles
Learning Tasks Discussion
Issues you may have considered in relation to the Learning Tasks in the book…

Learning Task 1: Reflecting upon why culture matters

Thinking about what positively influences our health is an interesting task. Did you think about the networks that you are a member of and how each network influences health? For example, I am a member of many networks that are anti-smoking which is a positive influence upon my own health by discouraging me from smoking. The UK smoking ban has also shifted cultural attitudes towards smoking, which is now a less socially acceptable habit, and so this is again discouraging. There may be many other positive cultural influences upon health – think about how socializing is beneficial for your mental health, exercise is good for your health too, and so the UK gym culture may be beneficial for our health if we engage with it and regularly exercise. Do you have good support networks and good levels of social capital, because cultures of integration are an important positive influence upon our mental health and well-being. Did your list look different to this one, because there are many ways in which culture can positively influence health.

Did you compare to other cultures as well, and think about the ways in which they talk about wellbeing and participate in activities to support the creation of wellbeing? Are we the same in the UK?

Learning Task 2: Lay beliefs

There are many explanations reflected in lay understandings in relation to common colds for example:

Changes in the environment
• The weather is so odd right now with changing temperatures, is there any wonder that everyone is getting colds?
• Now that the weather has taken a turn for the worse, everyone has started getting colds.
Individual behaviour
• I shouldn’t have left the house without my warm jacket; my mother said that I would catch a cold.
• I knew that going out with wet hair was a mistake and here I am with a cold.
Luck/fate
• It is my fault that I have got a cold, I was saying that I hadn’t had one last week and now I do – it is a punishment.
• My star sign report hinted that this would happen this week (ascribing illness to astrological influences).
Treatment approaches
• Feed a cold (i.e. eat more) and starve a fever (i.e. eat less)
• Buying over-the-counter cough and cold treatments in the belief that they work in curing the cold (there is a lack of pharmacological evidence to demonstrate the effectiveness of such treatments).

Learning Task 3: Healthworld, culture and environment

Having completed learning task 1, you should have already given thought to how cultural influences positively affect health, so culture is a starting point for informing our own healthworld. Germond and Cochrane (2010) studied health seekers in Lesotho and found that separate words for health and religion do not exist and that separating these words did not make sense either within such a cultural context. This led to the development of the idea of a healthworld in which health is located in social and religious context. Each of us has our own cultural healthworld, and for some cultures this is linked very clearly to their environment.

Is your healthworld influenced by medical ideas; the biomedical is a key part of our healthworld in the sense that we understand illness in a medical context and seek medical treatment and solutions. Do your religious views also inform your healthworld, e.g. illness as a text/trail from God, illness as a punishment from God or do you perhaps consider illness as a form of spiritual possession? Is your healthworld pluralistic, too: do you use alternative treatments on occasion, e.g. homeopathy? Think too about the language that you use to describe both health and illness; this is part of your healthworld. How does your healthworld link to the environment as well, in terms of how our environment shapes our health and how we use the environment to support our health for example, by taking time to be in nature.

Learning Task 4: Cultural representations of mental illness

In the Global North, mental health awareness is increasing alongside greater diagnosis rates, so social norms have shifted in terms of acknowledging the existence of mental health conditions and reducing associated stigma. This is not true in all cultures, as chapter 5 notes. However, there are still negative connotations associated with some mental health conditions, and associated victim-blaming.

The language we use to discuss mental health reflects both positive and negative understandings.

Positive descriptions
• Mental health consumer
• Psychiatric survivor
• Person diagnosed with a psychiatric disability/disorder
• Person with a history of mental health problems
• Person with mental health issues
• Person experiencing severe and overwhelming mental and emotional problems

Negative descriptions
• Mad
• Loopy/loony
• Off their head
• Nuts
• Crazy
• Screw loose
• Weirdo
Was it easier to think of more negative words that are used to describe individuals with mental health problems? What does this indicate? Take some time too to think about the role that the media plays in western societal understandings. How do media reports construct those with mental health problems?

Multiple Choice Quiz

1. Medical anthropology is concerned with the study of which of the following?
a. The experience and practice of health, illness and healing in different social and cultural contexts
b. Seeing the world as constructed through social facts
c. The experience of psychological differences between individuals
d. The exploration of statistical evidence

ANSWER

The correct answer is a. Answer b is incorrect: medical anthropology focuses upon the experience and interpretations of illness and treatment, which are not described as social facts. Answer c falls within the focus of psychology as a discipline. Statistical evidence is important within social research but is not the main concern of medical anthropology.

2. An illness narrative is an account of illness that does not include which of the following?
a. Illness problems
b. Illness complaints
c. The social lived experience of symptoms
d. The medical model as an interpretation

ANSWER

The correct answer is d: the medical model is concerned with biological causation and explanations of illness.

3. Lay accounts of illness help us to understand that:
a. individuals are responsible for their own health
b. people believe in a wide range of causal factors leading to illness
c. medical treatment is important
d. alternative treatments should replace medical treatment

ANSWER

The correct answer is b. The other answers are incorrect: answer a focuses upon a narrow and limited explanation for health without considering the meanings that emerge from lay accounts of illness; lay accounts explore the way in which people seek treatment and cure for illness but not solely within medical contexts; lay accounts can include descriptions of lay people seeking alternative treatments but do not suggest that these should replace medical treatments entirely.

4. Illness metaphors describe all but one of the following statements.
a. Broad cultural trends about attitudes to certain conditions
b. Stigmatization of certain conditions
c. Mental illness as a social construction
d. Symbols for general anxieties that people have

ANSWER

The correct answer is c: illness metaphors are not concerned with mental illness as a social construction, rather with how illnesses are described in dominant cultural outlets. Answer a is incorrect: there are broad cultural trends messages about some illnesses, e.g. conveyed through the media, which represent illness metaphors (HIV/AIDS has in the past been metaphorically labelled as ‘the gay cancer’). Stigmatization can be part of illness metaphors: Sontag (1989) argued that in the west cancer is seen as uncontrollable, shameful and invasive. Answer d is incorrect because illness metaphors are seen to represent the general anxieties that people have, e.g. cancer has been used in the media to describe an array of social problems, thus reflecting societal anxieties about such issues.

5. Health and illness are culturally bounded because:
a. culture influences our health beliefs, attitudes to treatment and health behaviours
b. culture results in felt stigma
c. culture determines social facts
d. cultural trends result in the adoption of the sick role

ANSWER

The correct answer is a. Answer b is incorrect: culture and associated beliefs can be associated with stigma but this is not the reason why health and illness are culturally bounded. Answer c is incorrect because health and illness are not seen as ‘social facts’ within an anthropological framework, rather individual interpretations are more important. The concept of the sick role is a sociological interpretation (see chapter 4) rather than an anthropological focus of study.

6. Mental illness is culturally defined because:
a. the media stigmatize sufferers
b. mental illness diagnoses and understandings vary according to the society in which people live
c. health is viewed holistically in different contexts
d. it is part of broader trends in which illness is increasingly medicalized

ANSWER

The correct answer is b: anthropologists have demonstrated that there are no universal categories of mental illness across all cultures. The media can represent cultural views of mental illness but these are just representations rather than definitions. It is true that health is viewed holistically in different contexts but this is not an explanation for why mental illness is culturally defined. Not all cultures are medically dominated and therefore explanations of mental illness are not conveyed in medical language or frameworks in all contexts.

7. Incidences of alcoholism and alcohol consumption vary between social and cultural groups for all but one of the following reasons.
a. It is related to cultural meanings
b. Cultural and societal rules underpin what is seen as normal
c. Its use is related to social relationships
d. Consumers are likely to develop illness complaints

ANSWER

The correct answer is d because, whilst illness complaints are part of anthropological concerns, they are not drawn upon to explain differential patterns of alcohol consumption across societies.

8. Examples of culturally damaging behaviours that are seen as acceptable include all but one of the following.
a. Parking a car at a distance from the destination to encourage walking
b. Inactivity and the consumption of high fat foods in the Global North
c. The modern culture of comfortableness
d. Excessive alcohol consumption including binge drinking

ANSWER

The correct answer is a.

9. An increasing number of social problems have been turned into medical complaints according to Furedi (2008) because:
a. illness complaints are increasing
b. powerful cultural signals allow individuals to interpret their problems in a medicalized framework
c. people are more likely to accept the sick role in society
d. health is increasingly important in people’s lives

ANSWER

The correct answer is b: here Furedi (2008) is arguing that the culture of medicalization is acting as a framework to shape people’s views of what can be treated. Social problems are not explained using the concept of the sick role, which is a sociological concern, rather than an anthropological focus.

10. The cultural context of health behaviour has important health implications because:
a. shamans and healers are used in non-western contexts
b. medicalization is an important phenomenon in the west in shaping health behaviour
c. the same behaviours in different cultures can affect health outcomes in different ways
d. people need to be able to understand health and illness

ANSWER

All the answers are correct.

Additional Case Study: The culture of beauty as unhealthy

In recent years, body dissatisfaction has been recognized as a growing problem, and this is an issue for men as well as women. Jankowski (2019) reports that men across all groups – not just young men – are being seriously affected in terms of their mental health because of the shame that they feel in relation to the appearance of their body. Based on research interviews, Jankowski (2019) notes how men engage in punishing gym routines, strict dieting and have anxious thoughts which impact upon their daily functioning, whilst trying to ensure that they replicate popular cultural images displayed in magazines and across social media. Men are increasingly consuming products including make-up products and creams to improve their appearance.

Similar trends have also been noted in women, with societal pressures dictating the ideal body size, which is something that has shifted and changed over historical time periods. Increasingly the rise of social media images and selfie culture is discussed as being part of the ever-widening promotion of the ideal self. The rise of fake beauty in the form of perfected images is, for some, not only detrimental to mental health but also an issue for physical health as both men and women pursue the ideal via the consumption of procedures (Botox, fillers, breast augmentation, liposuction). Widdows (2017) argues that the cosmetic industry is booming as using Botox and having procedures is increasingly normalized, resulting in young women increasingly seeing themselves as failures for not living up to popular cultural idealized and fake images of beauty.

The culture of idealized beauty is one that is increasingly linked to poor self-esteem and mental health problems (Widdows 2017, Jankowski 2019) and is therefore an unhealthy influence.

References

Jankowski, G. (2019) Six-packs and bulging biceps – how appearance pressures take their toll on men’s mental health. The Conversation 10th July 2019.

Widdows, H. (2017) How the duty to be beautiful is making young girls feel like failures. The Conversation June 23rd 2017.

3 Papers

Boucher, M.E., Groleau, D. & Whitley, R. (2019) Recovery from severe mental illness in Quebec. The role of culture and place. Health and Place 56, pp. 63-69. LINK
This article explores the ways in which a community of people (Quebecois living in Montreal, Canada) weaved together aspects of their culture to create their own healing landscapes whilst they were in mental health recovery. The authors suggest that cultural traits and places can be used to support recovery in other communities and that it is important to understand that there is no one-size-fits-all approach based upon their research.

Kingsley, J., Munro-Harrison, E. Jenkins, A. & Thorpe, A. (2018) “Here we are part of living culture”: Understanding the cultural determinants of health in Aboriginal gathering places in Victoria, Australia. Health and Place 54, pp. 210-220. LINK
This article focuses upon the cultural determinants of health within an Aboriginal community in Australia. For Aboriginal community members cultural connectedness and knowledge are important determinants of health that can be supported through the use of meeting and gathering spaces. The authors argue that more attention needs to be paid to the cultural determinants of health.

Napier, D.A., Ancarno, C., Butler, B., Calabrese, J., Chater, A et al. (2014) Culture and Health. The Lancet, 384, (9954) pp 1607–1639. LINK
This detailed commission report starts out by noting how culture (as a system of values) influences ideas about health and is related to health outcomes. Therefore, the authors make the case that there is a need to understand the complex relationship between culture and health.

3 Websites

1. The Society for medical anthropology
This American Anthropological Association website contains documents exploring many aspects of medical anthropology. The website has news sections, and several resources such as reports and webinars, all of which cover a broad range of topics, such as anthropology of the body, epidemiology and anthropology, and anthropology and global health.

2. Association of Anthropologists of the UK and Commonwealth
ASA is a professional association for social anthropology. Founded in 1946, it promotes the study and teaching of anthropology and upholds the interests and status of the discipline, in the UK and across the Commonwealth. The website has a searchable directory of members, which is in effect a register of professional social anthropologists. It publishes the annual ASA monograph; the peer-reviewed open access journal ASA online and the Firth lectures. It supports the communication of social anthropology in various social media.

3. Culture, Health and Illness
These are associated resources that accompany the fifth edition of Helman’s book, one of the key texts in this area.

3 Media Articles

1. Why the NHS needs a culture shift from blame and fear to learning
A report that discusses the culture of the NHS as a health system, and the issues that this brings. There are many critical reports of the NHS in terms of its efficiency and leadership. This author talks about the need for cultural change at the level of organizational leadership.

2. Our drinking culture is a national disgrace
A column about the culture of binge drinking in Britain, reflecting upon the issues associated with this. The reporter argues that the evidence about harm to health is ignored, and people do not care at a cost to the NHS.

3. Denmark’s ‘Pervasive Rape Culture’ Is Detailed in New Report
This report in the New York Times discusses a widespread culture of rape in Denmark despite the country being championed for gender equality. Women describe negative experiences of being disbelieved when they report being raped because of widespread misconceptions about what rape is.