1/27 Lecture

-healthy lifestyles
-"normality"
-feelings of belonging/social support
-coping mechanisms
-familial/informal caregiving
-herbal medicines
-beliefs on suffering (Buddhist - everyone suffers; U.S. - earn to suffer)
-bio-medicalization/rationalizing conditions (eg. disease is better than a moral downfall; stigmas against dieases)
-local cultures deemed uneven (eg. girls/women)
-beliefs on vaccination (eg. Nigeria as "imperialist plot"; wealthy U.S. as causation for Autism, COVID-19 as money-maker)
-global culture (eg. fast food and rising obesity levels)

social factors that influence people's life expectancy, mortality, and morbidity

-access to resources
-control of wealth/land/water
-level of education
-quality of health care
-safety/ability to avoid physical violence
-ability to avoid "structural violence" (systemic disadvantages)

-how they identify the problem and time/effort put into it
-high-income countries
-western biomedicine/psychiatry
-particular disease focus (eg. Mountains Beyond Mountains HIV and TB)
-culture of organization (P.I.H. vs. W.H.O.)
-bureaucratic cultures (self-serving, selfish motives)
-ethnocentrism

valuing your own culture more than others

Tropical Medicine Era, International Health Era, Global Health Era

-European colonization
-focus on tropical infectious diseases (eg. Malaria)
-threat to colonizers and possible return to homeland
-Africa, Asia, Americas, Pacific Islands

-bilateral aid (developed help developing)
-focus on differences between develop and developing
-focus on Western charity, Christian missions, WWII relief
-League of Nations --> U.N. --> W.H.O.

-globalization
-international World Bank cutting loans and aid for developing countries
-private business and non-profits dominate
-NGO ("National Government Organization")
-less equality

"a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" -W.H.O. Constitution

-Health as a fundamental human right -U.N.'s Universal Declaration of Human Rights, 1948

emic perspectives, holistic/day-to-day perspectives, attention to inequalities

insider's cultural views

i.e. ordinary people, healers, biomedical personnel

social and material actions and interactions, health practices, and health challenges

need to look towards improving top-down approaches rather than blame the ignorant bottom\

-social
-gendered
-economic
-political
-environmental
-ecological inequalities

eg. women have higher life expectancies than men due to biology and not social biases

"differences in health status or in the distribution of health determinants between different population groups" —W.H.O.

"a type of difference in health that is closely linked with social or economic disadvantage" —C.D.C.

Differences in health that ARE related to a social inequality or unfairness.

"differences in health that are not only unnecessary and avoidable, but also unfair and unjust" —Margaret Whitehead

-founded by Ophelia Dahl, Paul Farmer, Jim Yong Kim, Todd McCormack, Tom White in 1987 "between Boston and Haiti"
-11 main sites: Navajo nation, Mexico, Peru, Haiti, Sierra Leone, Lesotho, Liberia, Malawi, Rwanda, Kazakhistan, Russia
-slogan: "We go. We make house calls. We build health systems. We stay"
-preference to poor
-bring modern medical science
-treat patients like family members
-medical/moral mission based on humanity/solidarity
-antidote to despair
-sister-organizations
-local government health systems

radical relativism, "we are the world", nation states perspective, world systems perspectives, culturally-informed partnership

one community under humanity (eg. American Red Cross)

independent nation-states responsible for citizens (eg. W.H.O.)

focus on inequalities (i.e. foreign intervention extracts resources)

flows in health, culture, power --> critical relativism (eg. P.I.H.)

many discrete closed communities (local care/self-help)

-aware of other communities and open to their ideas but not very adopting

aware of and knowledgeable about other communities

aware that other communities exist and nothing else about them

only views on other communities stem from preconceived notions in own community