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Medical Anthropology and Its History

Introduction

Medical anthropology is the subfield of human study that aims at determining the relationship between health, diseases, and culture. It uses comparative and ethnographic studies to research and collects data to describe how social and cultural factors influence the manner in which health and diseases are conceived in various places. Medical anthropology plays a significant role in assessing the context of treatment and prevention, disease diagnosis, and the barriers to health status improvement in a population being researched. The field of medical anthropology came to be a formal area of study in the 20th century. Its importance significantly increased after World War II, whereby the application of qualitative research methods on the study of communities’ health was used around the world.

Medical anthropologists research various ways of solving a variety of health problems. They try to focus on explaining the reasons for different communities having varying health outcomes than others. They sometimes aim at identifying why some diseases and illnesses are being experienced in a local context around the world. There are two types of people who practice medical anthropology (Joralemon 2017). These medical anthropologists are academic and applied anthropologists. Academic anthropologists are primarily situated in educational institutions, and they mainly focus on teaching and research. However, applied medical anthropologists perform their research and studies in settings outside of educational institutions. They usually work in teams trying to provide solutions or increase knowledge on specific health problems. They study issues of global health, bioethics, medical technologies, and health issues. The researchers require informed consent from the research subjects and privacy and confidentiality of participants’ names and locations.

Medical anthropology involves studying various lines of research to identify the resources improving health and the spread of diseases. The first research manner is the biocultural examination of health and diseases. It studies the effect of health and illnesses considering the constantly changing environmental conditions and social and cultural factors that affect human biological processes (Hunt et al. 2019). Second, there is the examination of how social institutions, socio-economic processes, and cultural values correlate concerning experiences and responses to health problems and risk of illnesses by varying groups. Third, there is the study of the provision of healthcare and monitoring of diseases to understand the politics of responsibility across the globe. Fourth, the research involves the evaluation of health and development interventions and tracking of their implementations. The fifth line of research focuses on how health problems are described and their application in solving issues concerning health.

The research paper focuses on the history of medical anthropology and its approaches. The interpretive approach, biocultural approach, evolutionary approach, and critical medical approach to medical anthropology are discussed. The interpretive approach incorporates social theories and research in understanding social reality. On the other hand, the biocultural approach defines the interactions between biology and cultural phenomena (Singer et al. 2019). The evolutionary approach focuses on both human biology and cultural evolution. Another approach is the critical medical approach which focuses on the significance of political and economic structures. The study of medical anthropology transforms health beliefs and assists in improving cultures, including changes in a community’s social and cultural systems to limit the risks of ethnocentrism.

The research aims to show how health and illnesses are understood based on social, biological, and cultural experiences. It shows how migrations and different social practices change how health and diseases are understood and perceived. The study shows how health and dialogues promote solving problems related to a specific target population. Change of people’s health practices is challenging mainly when the transformation is aimed at the ethnic, cultural, social, and ethnic backgrounds of the population being studied.

Background

The study of ways in which various cultural concepts influence health-related practices started in the 20th century with the advancement of anthropological studies, which provided insight into the diversity and complexities of local health-related behaviors across societies. Medical anthropology mainly resulted from improved knowledge of multicultural societies and the end of colonialism (Panter-Brick et al. 2018). A significant understanding of medical humanities promotes one’s knowledge of ways health is perceived across cultures. Medical anthropology defines how medical knowledge is improved due to the environment surrounding the cultures and the understanding of the people, and what the society views to be appropriate ethical and moral behavior.

Medical anthropologists still focus on the effects of various familiar and unfamiliar beliefs on the behavior of illnesses in society. The views of a community can have a significant impact on how an individual can perceive chronic disabilities. For example, some communities perceive disabilities with divine judgment. Some societies also have wrong beliefs about malnutrition, and they consider an obese individual to be very healthy. The communities’ views sometimes link diseases and illnesses to ancestral actions which happened in the past hence conflicting with new ideas in science about evolutionary principles and disease vectors. The various theories on infections are mostly accepted after research has been conducted and their merits approved.

Medical anthropologists are mostly clinicians since the field usually requires clinical training. Communication with patients and understanding their backgrounds are generally essential for caregivers, especially when the illness is at stake. There are economic benefits from permitting clinical personnel to access accurate case histories that have been identified. Benefits also include the boosting of a clinician’s sense of worth, which reduces career disenchantment. However, saving time does not translate to saving money, which affects investments for health.

The research in this paper will focus on diabetes mellitus. Diabetes is one of the leading causes of death in the world. It is a group of illnesses that causes increased sugar levels in the blood. Thus, the most common kinds of diabetes comprise type one, type two, and prediabetes. Type two diabetes is a condition affecting how the body processes blood sugar. Type 1, on the other hand, is a situation in which little or no insulin is produced in the body. Prediabetes also causes a rise in blood sugar, but its levels are not as high compared to type 2 diabetes. Diabetes is characterized by increased thirst, extreme hunger, weight loss, and frequent urination.

The average amount of expenditure used by people diagnosed with diabetes is almost three times higher than those used by people who do not have diabetes. According to National Diabetes Statistics Report, over one million people in America receive diabetes diagnoses per year. Despite the disease affecting people from varying backgrounds, the level of diabetes diagnosis is more in ethnic minority groups than in other ethnic groups.

Diabetes is associated with various complications such as macrovascular and microvascular comorbidities. Studies indicate that maintenance of diabetes control by individuals who have type two diabetes within ten years of diagnosis assists in reducing the risk associated with microvascular complications. Insulin is one of the main treatment options available for type 1 diabetes and can also be used in treating type 2 diabetes. However, most adults diagnosed with the illness still underutilize the drug despite its effectiveness and recommendations. There are many cultural beliefs and perceptions, including social, religious, and literacy factors, that inhibit the use of insulin in various racial and ethnic minority groups. Besides, the use of insulin treatment for diabetes treatment also includes control of blood sugar through healthy diets, exercises, and oral medications.

Literature Review

History of Diabetes

Diabetes was first described in the first century by Arataeus of Cappadocia. The Discovery of Insulin led to a significant discovery in the treatment and management of diabetes. Diabetes is currently affecting about 6% of the total world population (Tajik et al. 2017). Studies by the World Health Organization and American Diabetes Association have shown a probability of diabetes affecting five times the current number diabetic population in the next decade. It suggests the application of indigenous and traditional medicines in supporting the interventions present to reduce the effects of diabetes.

Diabetes was once considered a western society disease, but studies reveal that the disease has affected people worldwide. The number of diabetic patients is highest in Asia compared to other countries, and it accounts for about 60% of the total world’s diabetic patients. The prevalence rates for the disease today are 4% to 9% in European countries and up to 20% among immigrants in Asia (Hunt et al. 2019). High rates of diabetes are seen in the American, Australian, and Canadian native populations, and the rates have risen to 50% (Hunt et al. 2019). The most common cause of the disease is obesity and changes in lifestyle.

Characteristics and Impact of Diabetes on the Arabian and Bedouinian Populaces of Israel

A study was done on the features and impact of prediabetes and type two diabetes on people of Arabian and Bedouinian origins in Israel. The results indicated that the disease had caused a decline in life expectancy in the population. The people at a higher risk of getting diabetes are the adult Arab women whose obesity rates are about 70% (Meo et al. 2017). The study also showed that hospitalization rates were high for macrovascular and microvascular complications among patients. Macrovascular conditions affect the large blood vessels, while microvascular affect the small blood vessels.

An examination of the threat factors amongst the Arabs and the Jewish diabetic populations who undertook therapy regarding a primary stroke discovered that a significant proportion of Arabian diabetic clients are experiencing hypertension. The commonness among non-immigrant Jews was 38.5% and 39.1 %, respectively (Meo et al. 2017). Research conducted to determine the existence of a link between genetic backgrounds and the development of diabetes showed that genetics were the cause of resistance to insulin by most of the population. The risk of acquiring diabetes increases significantly as the body mass index grows (Mapa-Tassou et al. 2019). A study in central Israel showed that the average body mass index of adolescent Jews and Arabs is the same.

However, the results differ with an increase in age; 31% of Jewish women are obese compared to Arab women, whose percentage is 52%. Furthermore, a study conducted on overweight Arabs in Israel indicated that 27% of the population had undiagnosed diabetes, and 48% had undiagnosed metabolic syndrome. Studies have suggested that the rate of diabetes incidences has risen among the Israel population by 9.1 per 100 persons. It has been revealed that there is a 21% and 12% prevalence among Arabs and Jews.

In a study of hospitalized patients with a majority of the Arab population, the number of diabetic cases was 39%. There was a higher number of females admitted with diabetes compared to the patients without the disease (Meo et al. 2017). The disparity was also seen in the causes of hospitalization of the patients with diabetes. The investigation indicated that the stoppage of cardiovascular sicknesses and urinary infections was of utmost priority for diabetic patients.

Diabetes and its Effects on Sleep

Sleep among the adolescent population has been viewed as a potential risk factor for high levels and management problems of type 1 diabetes. It has also been targeted since it has the possibility of causing type 2 diabetes, insulin resistance, and obesity. The Standards of Medical Care in Diabetes have recommended access to quality sleep to manage diabetes. However, sleep does not address changing blood sugar levels and the constant requirement for overnight treatment decisions. Therefore, a new closed-loop delivery system of insulin has been recommended to allow enough sleep for health service providers and patients with type 1 diabetes.

Studies have shown that children and adolescents are faced with many public health problems due to lack of insufficient sleep. The risk is significantly higher for children who have chronic diseases such as type 1 diabetes. An analysis of sleep patterns indicated that children with diabetes usually sleep for substantially less time than those who do not have diabetes. Moreover, a study conducted on sleep and its relation to diabetes revealed that children with diabetes mostly lack quality sleep associated with worse life quality. Sleep disturbances are caused by rapid changes in sugar levels and the psychological effects of handling diabetes.

Insulin Delivery in the United States

The United States has currently improved insulin delivery by advancing the use of the closed-loop system to administer insulin and intake meals. The system has been checked and tested for errors and efficiency under varied conditions. The assessment indicated that the machine was safe for use since it does not administer more insulin and it does not produce more ketone during insulin suspension times. The device has also shown efficiency in liming hypoglycemic events and reducing blood sugar variability. Its effectiveness has been significantly seen during the night, and the results have shown no inconsistencies in hospitals, camps, and homes. The development of an artificial practice is also a potential for decreasing blood sugar variability and mainly improving sleep.

Prevalence of Diabetes in Africa

Most African countries are experiencing demographic transformations, and western market economies are currently influencing societies. The lifestyle of most populations has changed, and the consumption of unhealthy food has significantly increased in most cities. These lifestyle changes have led to an increase in the prevalence of diabetes and its complications in Africa. Studies conducted in South Africa have revealed that there are more than six million diabetic patients and probably more undiagnosed patients than those diagnosed. The prevalence of the disease is significantly high in South Africa, and its estimate is 14% of the local community, 13% of Indians, and 6% of African societies and European communities (Meo et al. 2017).

Type 2 diabetes

More than twenty-five million persons, about 8.3 percent of the US residents, have been diagnosed with type 2 diabetes. The people primarily affected by the diseases are the people from ethnic and racial minority groups. The difference between diabetes prevalence between the colored community and the non-Hispanic whites is significant. For instance, 5 % prevalence exists among Hispanics while the majority is 9.8% for non-Hispanics (Meo et al. 2017). Furthermore, Hispanics have a high probability of dying due to diabetes complications compared to non-Hispanics. Research conducted in New Mexico showed that diabetes was among the leading causes of death.

Challenges in Diabetes Prevention

People can reduce the possibility of or avoid acquiring diabetes by engaging in physical activities and consuming healthy diets. However, the practices have not been incorporated into community practices, especially in culturally diverse communities. The development of diabetes prevention measures for specific communities is challenging since it requires an understanding of unique dynamics and the incorporation of cultural factors (Aroda et al. 2017). Furthermore, implementation is more challenging for communities with significant health differences. The racial, social, and economic differences associated with health complicate incorporating prevention into daily practices.

Approaches for identifying and understanding community cultural and social practices are being accommodated to support prevention interventions. Most studies conducted indicate that interventions addressing social and cultural practices are necessary to reduce community disparities. Anthropological approaches have been recommended as effective avenues for identifying these disparities. The health research community has revealed that culture influences health and that cultural constructs help determine the health behavior of populations.

Analysis

The research was conducted to identify and describe how various cultures and communities are affected by diabetes. The study shows that diabetes is a severe health problem, especially among the racial and ethnic minority populations. Anthropological approaches provide comprehension of the interface between social factors, health results, and health differences. The study results indicate the need to examine the local background, social surroundings, and cultural practices and their importance in achieving change. It also offers insight into public health and health disparities currently existing in relation to diabetic populations.

Findings indicate that the prevalence of diabetes in racial and ethnic minority populations is high. It shows that minorities have an increased probability of being affected by the disease and its consequences. A significant disparity is visible in relation to diabetes between inhabitants of color and non-Hispanic whites. The prevalence of Hispanics is almost twice that of non-Hispanic whites. The immigrants are also most affected by diabetes, most of the migrants in Asia are affected by the disease, and they possess the highest percentage of diabetes patients in Asia.

The research examined the relationship between diabetes, gender, and age. The study of the population of Israel indicated that the prevalence of the disease in males and females rose with age. An assessment of hospitalized patients also found that more females were hospitalized due to diabetes-related illnesses compared to those whose issues were not diabetes-related. Furthermore, the investigation found out that the dominance of diabetes was high among individuals with increased body mass index, therefore indicating that obese and overweight persons are more likely to acquire diabetes.

Conclusion

Diabetes is a common health problem that affects diverse communities in the world differently. If the disease is not controlled, it may lead to blindness, heart disease, and kidney failure. Blood sugar is sometimes high, but the level is not enough to identify if it is caused by diabetes. Most people who have prediabetes usually progress to type 2 diabetes despite the availability of ways of avoiding it. Studies on the prevention of type 2 diabetes indicate that the emergence of the ailment could be deferred or stopped mainly through losing weight. However, the present-day public lifestyle does not allow for efficient prevention of diabetes, mostly because weight loss is not permanent. Most individuals consume more food and spend little energy, thus, making weight loss maintenance a challenging task. To manage this situation, an awareness of the biological developments that involve the consumption and spending of this energy is necessary.

Cutting sugar and refined carbs from a diet is essential for reducing the risk of diabetes. In individuals with prediabetes, the sugar levels are high since the body cells are resilient to insulin action, which causes the pancreas to increase the production of insulin in an attempt to lower blood sugar. Eventually, the insulin and blood sugar levels rise, leading to type 2 diabetes. Studies reveal that people who consume fast foods have more chances of developing diabetes than those who consume less.

Another strategy for reducing diabetes risk is regular workouts. Physical activities raise insulin sensitivity, and less insulin is needed to control blood sugar levels when exercising. Exercises are essential for overweight, prediabetes, and obese individuals since they are more likely to develop diabetes. Research indicates that frequent activities and burning of calories are necessary for the improvement of insulin functionality and response and in the prevention of progress from prediabetes to diabetes. Overweight individuals are required to increase their frequency of workouts since most prediabetes patients carry a lot of weight in their mid-section and in areas close to the abdominal organs.

Drinking water as a primary beverage is also vital since it reduces the urge to consume beverages containing high sugars and unhealthy ingredients. Sugary drinks increase the risk of developing diabetes and cause blood sugar levels to rise. Consumption of water is also crucial since it leads to better blood sugar levels and insulin responses. Besides, increasing water intake reduction of food intake is essential to avoid being overweight.

Medical anthropology aims to comprehend human diseases and the methods used in diagnosis and curing in all the different means that are understood and implemented across various communities. It seeks to identify how specific cultures define health and illnesses based on their biological, linguistic, social, and cultural environment. The field uses many different approaches to achieve its goal. Researchers in this field assess how individual health relates to the social and cultural formation of the community. Moreover, medical anthropology investigates the local background of disease diagnosis, prevention, and treatment to improve the provision of health.

The study of medical anthropology has many benefits for the world. The concept of race makes it efficient for all cultures around the world, where health and diseases are perceived differently. It describes how healthcare can be improved among various races, gender, and classes to focus on specific communities. Medical anthropology also raises important questions regarding the economic, social, and global political structure of health and illnesses.

References

Aroda, Vanita R., William C. Knowler, Jill P. Crandall, Leigh Perreault, Sharon L. Edelstein, Susan L. Jeffries, Mark E. Molitch et al. “Metformin for diabetes prevention: insights gained from the diabetes prevention program/diabetes prevention program outcomes study.” Diabetologia 60, no. 9 (2017): 1601-1611.

Hunt, Linda M., Hannah S. Bell, Anna C. Martinez‐Hume, Funmi Odumosu, and Heather A. Howard. “Corporate Logic in Clinical Care: The Case of Diabetes Management.” Medical anthropology quarterly 33, no. 4 (2019): 463-482.

Joralemon, Donald. Exploring medical anthropology. Taylor & Francis, 2017.

Mapa-Tassou, Clarisse, Jean-Claude Katte, Camille Mba Maadjhou, and Jean Claude Mbanya. “Economic impact of diabetes in Africa.” Current diabetes reports 19, no. 2 (2019): 5.

Meo, S. A., A. M. Usmani, and E. Qalbani. “Prevalence of type 2 diabetes in the Arab world: impact of GDP and energy consumption.” Eur Rev Med Pharmacol Sci 21, no. 6 (2017): 1303-1312.

Panter-Brick, Catherine, and Mark Eggerman. “The field of medical anthropology in Social Science & Medicine.” Social Science & Medicine 196 (2018): 233-239.

Singer, Merrill, Hans Baer, Debbi Long, and Alex Pawlowski. Introducing medical anthropology: a discipline in action. Rowman & Littlefield, 2019.

Tajik, Athar A., Daniela Dobre, David Aguilar, John Kjekshus, Faiez Zannad, Kenneth Dickstein, and High‐Risk MI Database Scientific Committee. “A history of diabetes predicts outcomes following myocardial infarction: an analysis of the 28 771 patients in the High‐Risk MI Database.” European journal of heart failure 19, no. 5 (2017): 635-642.

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