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Epidem of Malaria & Reprsntns

Epidem of Malaria & Reprsntns

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Published by: garddo on Jan 10, 2013
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Life and well-being under historical ecological variation: theepidemiology of disease and of representations.
Robert AttenboroughDon Gardner 
In this paper we report aspect of research undertaken among the small Mian population living the northern fringes of New Guinea’s mountainous backbone. Theethnographic setting is empirically unusual in certain key respects, and while our research demonstrates that cultural factors are integral to the epidemiological and broader social history of the population, it raises questions about the methodologicalshape of cultural epidemiology.
Cultural epidemiology of the Mian?
Most of the field research we discuss in this paper was conducted in 1986, theyear 
Writing culture
was published, the volume that did so much to publicize thedoubts of some cultural anthropologists about the concept that had long been taken to be at the heart of their discipline. Responding to the realities of a decolonising worldand critiques from neighbouring disciplines, these anthropologists expressed their concern at the way anthropological conceptions of culture tended to essentialize other ways of life, and to ignore political and historical processes as well as individualagency. At the same time, however, that very conception of culture was being takenup with great enthusiasm by other disciplines, from literary criticism and history to political science and sociology (see, for example, Walters 1980 or Sewell 1997). Sowhile, within cultural anthropology (and despite strong resistance from somequarters), the classical conception was increasingly criticized in the name of one or more of “power”, “practice,” “agency,” or “history,” other disciplines revelled in theliberation from “positivistic” orthodoxies (Sewell 1997) offered by anthropologicalconceptions of cultural meanings. Variations in cultural meanings were seen,sociologically and historically, to constitute “differences that make a difference” tohuman existence, yet these were “as public as marriage and as observable asagriculture” (Geertz 1973:91). Both these moves (albeit in different ways) had theeffect of increasing the relevance of “arbitrariness” and “meaning” to the analysis of cultures and their historical trajectories, even as the focus turned to
Page 2 of 16social formations; culture’s relevance came to be seen as a matter of what happens atthe
level, one that attends to life as lived and experienced by socio-historicallyemplaced folks. As anthropology’s master concept came under theoretical pressure,its unique “method”, long term fieldwork, assumed greater importance. In anincreasingly globalised world an anthropological perspective meant attending to whatfolks do on a day-by-day basis, and not just to what they say about what they do, or toofficial or media representations of people’s lives. As Brightman (1995) observed andSahlins lamented (1999), this led to a stress on the “cultural” and an avoidance of thenoun, while less (or, at least, differently) freighted terms, like “hegemony” or “discourse” took its place.The ambiguities and tensions remain about the theoretical status of the conceptof culture and its relationships with those other master concepts of contemporaryanthropological analysis (see, for example, Ortner 2006). Accordingly, there are alsodifficulties about what conception of the “cultural” should be paired with“epidemiology…a methodologically exacting discipline…devoted to the discovery of disease prevalence and incidence rates and to the statistical assessment of causalassociations between risk factors and disease outcomes in human populations”(Inhorn 2009:169; Hahn & Inhorn 2009). More specifically, it is theoretically difficultto retain the ideas of systematicity and holism, which have always been integral to“culture”, while expanding the role of agency or idiographic accounts too greatly. Onthe other side, the theoretically conservative stress on the culture as structure has beenimportant for those wary of the mute opposition between the “objective” and the“subjective” (so handy for those inclined to blame the victim) and find an orientationthat provides explanatory power and a critical basis for a sympathy for those whosuffer. Thus, in relation to epidemiology, the concept of culture has been importantnot only for those who wish to identify (otherwise hidden) risk factors and disease, but also for those seeking to explain why medically available options for mitigatingrisk are not in socio-cultural reality available to some members of a population.One theoretical intervention in the debates about culture not so far mentionedis due to the cognitive anthropologist, Dan Sperber, and his colleagues. Although thevigorously formulated arguments of this European wing of the “evolutionary psychology” movement have not proved popular with cultural anthropologists (eventhose who do not dismiss them out of hand for their psychologism and evolutionism)
Page 3 of 16and we mention them here precisely because—as any internet search engine willdemonstrate—the term “cultural epidemiology” is sometimes applied to Sperber’sview that the distribution of (mental and public) representations within a population of interacting individuals (an “epidemiology of representations”) constitutes a localculture (Sperber 1996; Aunger 2004; Heintz 2010). According to this perspective, thedistribution of representations (and institutions) in a population depends upon thegeneral psychological or cognitive capacities of humans, the properties of representations themselves, and the ecological context (which is sociological no lessthan biological) in which they subsist.Although we will
use “cultural epidemiology” to refer to Sperber’sapproach, our research is precisely concerned with the distribution of practices (andthe concepts, beliefs, preferences and values—“representations”—they implicate)among a historically and linguistically defined population that is distributed across a biologically significant altitudinal cline. Our research is predicated on the view that people’s understandings, values and preferences are no less part of the aetiology of  patterns of sickness and well-being than such environmental factors as climate or mosquito-biting densities. Yet while cultural representations/meanings make adifference to Mian historical trajectories, their heterogeneity and contingency on other aspects of social existence gives their analysis an irreducibly idiographic form. Our emphasis, consequently, also contrasts with the pioneers of the epidemiolgy of representations in being rather more focused on the socio-ecology of representation(as process
product) than on its cognitive basis. Gardner’s tentative Ph.D thesis(1982), at least made it clear that historical data on the ecological setting, horticultural productivity and morbidity and mortality of Mian communities could not be omittedfrom a convincing account of the population’s empirical cultural variation.The research discussed in this paper was part of the effort to develop a better model of those historical processes. We believe our case demonstrates that, even inthe face of overwhelming biomedical threats, populations like the Mian interpret andrespond to events in ways essential to their historical fate.
The relevance of this case
Although our epidemiological research sought to make clearer some of the dynamics underlying the pre-colonial distribution of Mian speakers, practices and representations, we do not wish to suggest thatthese can simply be read off from the situation that ensued after the advent of Australian colonialcontrol. On the contrary, precisely because the interactions between all dimensions of social lifecontinued, the
 Pax Australiana,
government directives and Christian missions (whichdispensed medical treatments and advice along with new practices relevant to the organisation of 

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