An anthropology in health: The relevance of medical anthropology to the health and health care needs of the Kumiai of San Antonio Necua and their indigenous relatives, Baja California, Mexico.

摘要

In The Nuer (1940), Evans-Pritchard simultaneously charges the anthropologist to use theory to select and arrange facts for analysis of cultural groups and criticizes social anthropology for its lack of guiding theory. Approximately sixty years later, we in medical anthropology find a plethora of guiding theories. In the subdiscipline of applied medical anthropology, however, we still struggle with just how to apply anthropological theory in a needs-based and/or locally driven analysis of health and health care in medically underserved communities. I contend that there are two roles for applied medical anthropology in needs-based research. The anthropologist is both researcher and analyst, but theoretical analysis should begin after basic health and health care needs are assessed according to the expressed interests of marginalized communities and their aid organizations.; Using research from twelve months of fieldwork among the Kumiai Indians and their indigenous relatives of Baja California, Mexico, this dissertation will demonstrate that theoretical medical anthropology improves the analytical power of needs-based analyses in marginalized communities. Methodologically, health and health care problems were first defined by indigenous community members and local players in indigenous health. Three of the most prevalent problems (access to health care, clinical diabetes, and the lay condition of low/variable blood pressure) were selected and allied with three corresponding analytical constructs (respectively, medical pluralism, the sick role, and embodiment) from medical anthropology to extend analysis for more robust and relevant intervention strategies.; In addition to contributing to anthropological literature on the use of theory in applied medical anthropology, this dissertation adds to general anthropological knowledge of Yuman groups. The Kumiai Indians are among the approximately 1,000 native Yuman people left in Baja California. In addition to being highly underrepresented in the anthropological literature of Yuman groups, the Kumiai routinely suffer from structural violence arising from the forces of simultaneous assimilation into and marginalization by the mainstream mestizo society. As a result, their health and illness beliefs reflect a strained blend of Kumiai and mestizo cultures. This dissertation will document through ethnographic data and observation this Kumiai experience of cultural change and consistency.