Alejandra Villegas

ANTH 2311

In the first reading by Chris Kiefer, Doing Health Anthropology, Kiefer talks about anthropology where he postulates that culture distinguishes between anthropological thoughts and anthropological research. He states that cultural anthropology is unique to a kind of people in different societies. The concept of culture is derived along such features as; culture being a holistic concept which means the way of life of a people follows certain realistic patterns of belief and behavior. Furthermore, culture is a comparative concept that focuses on the shared and patterned similarities and differences amongst human groupies. He also asserts that culture is learned and no one is born with a specific culture. Apart from that, culture is shared manifested across a group of people and is a feature present in human life with value to the specific group. He further says that the holistic concept makes a culture unique across various groups of people in different societies. Through anthropology, one can understand health and illness by study the way of life of a people. Among the main aims of anthropologists is to understand human behaviors and beliefs to determine the connection between a people’s history, religion, health, politics, economics, art, technology, etc. Kiefer believes that tampering with people’s culture by changing the way they think and how they behave is a step in health and diseases prevention. In his writing, he suggests that social perspective should be used in anthropology research, but then the perspective has experienced limitations as much as it is quite practical. The strategy is complex and expensive which may attract politics. The strategy also has a couple of assumptions which renders it limited in study behavior change and measuring the decree of the change.

In the second reading by Kenneth J. Rothman, Sander Greenland, Charles Poole, and Timothy L. Lash, Modern Epidemiology Essentials of Epidemiology, they write about causation and causal hypotheses. The authors argue that the disease occurs due to a case which they define as an event, condition, or characteristic that gives rise to the occurrence of a disease at a specific time. They articulate certain conditions to diseases and infer that if certain cases occur differently, it influences the chances of disease breaking out. The disease may occur or may not occur at all depending on certain conditions. According to the authors, one event may not be responsible for causing certain illness, but rather multiple events lead to the illness. For instance, one may break ribs while riding a bike, but that does not mean that anyone who rides a bike will break his/her ribs. There should be other events such as bad weather or inexperience in riding bikes etc. the sufficient-cause model provides for the other unknown causes of disease. Some causes are sometimes bound to combine thereby causing diseases. The authors examine the various scientific inferences which hold a certain degree of truths. Some diseases are genetic or caused by environmental factors. Some diseases can be predicted as well. However, there is no sufficient specific criterion for determining whether an observation is causal. The observations are still a subject to explanations that may register certain patterns that can be predicted. Prediction of certain patterns is responsible for the causal inferences provided. The model may not work for all hypotheses which are bound to leave other causes of diseases unsolved.

In the third reading by Lawrence Gostin, Global Health Law, Gostin writes about the International Health Regulations (IHR). The major concern of IHR is to provide health security through the management of global responses to the emerging international health threats such as Ebola. The health threats need to be prevented from spreading across the various trading routes to different countries. Gostin suggests checkups and surveillance at the international ports before letting ships or aircraft into a country. Quarantines are also put up at the sites to help contain the epidemic and prevent it from further spreading to the various countries. In the past, immigration has been recorded to cause disease as well as causing economic consequences in the host countries. He insists that the government should enforce actions to bar the infected groups from entering a state. Tests, medication and quarantines should be mandatory at ports or borders to different states. Upon detection of the diseases too, the host state should notify WHO for immediate action in treating and containing the endemic and preventing further spread. Gostin calls IHR a ‘all-hazards’ approach to solving global health threats because it applies to not only people but also goods, food, water, animals, and the environment. The major pillar of IHR is the preparedness of the states. Some states, however, lack the necessary systems and equipment for testing, treatment, and quarantine which Gostin proposes as a limitation on IHR’s side. The IHR is considered as more powerful and instrumental as compared to WHO even thou WHO has established partnership across the globe including the key NGOs. For equitable global health care provision, WHO should consider negotiating fairer agreements on behalf of states.

In the fourth reading by Moyses Szklo and F. Javier Nieto, Epidemiology: Beyond the Basics, the authors have written on epidemiologic study design. The authors provide the well-explained concept of cohort analysis and application of ecological studies. The book also examines the measures of the occurrences of diseases and association with the cohorts. Furthermore, the book focuses on study designs that are relevant to the study of distribution and determinants of health-related events in specific populations and its application. The designs are supposed to allow assessment of hypotheses of associations of suspected risk factor exposures with health outcomes on a group of cohorts or individual cohorts. In a cohort study, cohorts are picked and studied for a certain period to determine any events related to their ill health. The authors also touch on other studies including the case-control study which involves comparing cases and the controls concerning exposure to suspected risk factor to determine the relative risk. The other study is case-based case-control study whereby a group already in contact with the disease is used as the cases. Controls are then picked from the community and a comparison with regards to exposure to the suspected risk factor. The cases and controls are however expected to have a common origin in the society and should possess the same characteristics. The purpose of these studies is to determine the causes of epidemics among the populations and the level of associations. The study is not perfect as much as it is practical and has limitations such as being open to bias and in the case of case-control study, if the cases and controls are from different origins with different characteristics, it will affect the results.

All the above readings are concerned with the causes of diseases except the third reading by Gostin which focuses on testing, treating, quarantining endemics and keeping them from spreading from one state to another through the states trade routes. The first and second reading is about the causes of diseases directly. Kiefer in the first reading asserts that diseases are connected to the behaviors and beliefs of people. By studying the patterns of people, over time one can determine the causes of common diseases. In the second reading by Kenneth J. Rothman, Sander Greenland, Charles Poole, and Timothy L. Lash, the causes of disease are confined to certain conditions or events, for instance, smoking cigarettes is normally associated with lung cancer. The fourth reading Moyses Szklo and F. Javier Nieto also focus on origins of epidemics in which the authors feature some studies that are used to infer the causes and the extent of the effect of diseases amongst the chosen individuals for the study. This reading is experimental tough; it is considered practical just like the second reading. They both have limitations thus making the less accurate in determining the causes of diseases since they are dependent on certain variables thus may not be effective for all the diseases. Going through the fourth reading on epidemiology had me thinking about the several studies under it and left me wondering its effectiveness. Are the case studies viable? Have they been tested or are they merely theories yet to be tested? Gostin’s book also has limitations related to the course of action in case of an endemic. The IHR requires certain equipment and systems to work well in containing a situation which is barely available in all states. Is WHO more capacitated than IHR?