17.3.2 Methods of Medical Anthropology

Medical anthropology is a highly intersectional subfield of anthropology. The field addresses both the biological and social dimensions of maladies and their treatments. Medical anthropologists must thus become comfortable with a wide-ranging tool kit, as diverse as health itself. Like all anthropologists, medical anthropologists rely on qualitative methods, such as ethnographic fieldwork, but they also must be able to appropriately use quantitative methods such as biometrics (including blood pressure, glucose levels, nutritional deficiencies, hormone levels, etc.) and medical statistics (such as rates of comorbidities, birth rates, mortality rates, and hospital readmission rates). Medical anthropologists can be found working in a myriad of endeavors: aiding public health initiatives, working in clinical settings, influencing health care policy, tracking the spread of a disease, or working for companies that develop medical technologies. The theories and methods of medical anthropology are invaluable to such endeavors.

Qualitative Methods

Within medical anthropology, a number of qualitative research methods are invaluable tools. Qualitative methods are hands-on, first-person approaches to research. An anthropologist in the room or on the ground writing down field notes based on what they see and recording events as they happen creates valuable data for themselves and for others.

Participant observation is a methodology in which the anthropologist makes first-person observations while participating in a culture. In medical anthropology, participant observation can take many forms. Anthropologists observe and participate in clinical interactions, shamanic rituals, public health initiatives, and faith healing. A form of participant observation, clinical observations allow the anthropologist to see a culture’s healing practices at work. Whether a doctor is treating COVID-19 or a shaman is treating a case of soul loss, the anthropologist observes the dynamics of the treatment and in some cases actually participates as a patient or healer’s apprentice. This extremely hands-on method gives the anthropologist in-depth firsthand experience with a culture’s health system but also poses a risk of inviting personal bias.

Anthropologists observe a myriad of topics, from clinical interactions to shamanic rituals, public health initiatives to faith healing. They carry these firsthand observations with them into their interviews, where they inform the questions they ask. In medical anthropology, interviews can take many forms, from informal chats to highly structured conversations. An example of a highly structured interview is an illness narrative interview. Illness narrative interviews are discussions of a person’s illness that are recorded by anthropologists. These interviews can be remarkably diverse: they can involve formal interviews or informal questioning and can be recorded, written down, or take place electronically via telephone or video conference call. The social construction of sickness and its impact on an individual’s illness experience is deeply personal. Illness narratives almost always focus on the person who is ill but can at times involve their caregivers, family, and immediate network as well.

Another method commonly used in medical anthropology, health decision-making analysis, looks at the choices and considerations that go into deciding how to treat health issues. The anthropologist interviews the decision makers and creates a treatment decision tree, allowing for analysis of the decisions that determine what actions to take. These decisions can come from both the patient and the person providing the treatment. What religious or spiritual choices might make a person opt out of a procedure? What economic issues might they face at different parts of their illness or sickness? Health decision-making analysis is a useful tool for looking at how cultures treat sickness and health, and it highlights a culture’s economic hierarchies, spiritual beliefs, material realities, and social considerations such as caste and gender.

Quantitative Methods

Quantitative methods produce numeric data that can be counted, correlated, and evaluated for statistical significance. Anthropologists utilize census data, medical research data, and social statistics. They conduct quantitative surveys, social network analysis that quantifies social relationships, and analysis of biomarkers. Analysis of census data is an easy way for medical anthropologists to understand the demographics of the population they are studying, including birth and death rates. Census data can be broken down to analyze culturally specific demographics, such as ethnicity, religion, and other qualifiers as recorded by the census takers. At times, an anthropologist may have to record this data themselves if the available data is absent or insufficient. This type of analysis is often done as a kind of background research on the group being studying, creating a broader context for more specific analysis to follow.

Also important to medical anthropologists are analyses of medical statistics. The study of medical records helps researchers understand who is getting treated for what sickness, determine the efficacy of specific treatments, and observe complications that arise with statistical significance, among other considerations. Analysis of census data combined with medical statistics allows doctors and other health providers, as well as medical anthropologists, to study a population and apply that data toward policy solutions. Famous examples include the World Health Organization’s work on health crises such as HIV/AIDS, Ebola, and COVID-19.

Questionnaires are more personal to the anthropologist, allowing them to ask pointed questions pertinent to their particular research. Surveys make it possible for anthropologists to gather a large quantity of data that can then be used to inform the questions they ask using qualitative methods. Distribution methods for surveys vary and including means such as personally asking the questions, releasing the survey through a health care provider, or offering online surveys that participants choose to answer.

These are the most common methods used by medical anthropologists. Different theories are influential in determining which of the methods a particular research might favor. These theories inform how an anthropologist might interpret their data, how they might compose a study from beginning to end, and how they interact with the people they study. Combined with more general anthropological theory, each anthropologist must craft a composite of theory and method to create their own personalized study of the world of human health.