With the Institute of Medicine’s report on racial disparity (a biomedical perspective) and the National Black Women’s Health Project’s report, which uses an intersectional ap- proach, she argues “that women of color went beyond the discourse of ‘rights’ to show how capitalist social relations effec- tively prevent the poor from exercising fun- damental rights” (p. 400). Morgen notes that women of color were the primary ones to nurture the intersectional approach. They had no choice. If health issues of women of color are subsumed under ei- ther women or minority, they become marginalized and invisible.
This volume moves the focus of scholar- ship on health disparities from personal be- havior to structural constraints and social justice. Although the intersectional ap- proach is rooted in the principles of social justice, this does not oppose or conflict
308 Medical Anthropology Quarterly
with the positivist biomedical model. To- gether, both approaches, biomedical and intersectional, can provide a more robust critique of health disparities. Weber states that the intersectional approach emerged to promote an explicit social justice agenda “countering the dominant-culture institu- tions that reinforce and reproduce health and other social inequalities” (p. 45). So- cial justice is the backdrop for intersectional theory and there is no apology. Rather, it is argued that this approach can bridge the gap between the academy and social action.
This edited volume will be a valuable resource for professionals in health-related fields and for those interested in inter- sectional approaches to social issues. It could be used in upper-level undergraduate courses in medical anthropology or medical sociology as well as graduate courses in the social sciences and public health.
Introducing Medical Anthropology: A Dis- cipline in Action. Merrill Singer and Hans Baer. Lanham, MD: AltaMira Press, 2007, v + 246 pp.
Priscilla Song Yale University
This concise new volume by veteran text- book authors Merrill Singer and Hans Baer provides an engaging introduction to the discipline by focusing on what medical an- thropologists do. The emphasis on practice guides both the purpose and style of the book in productive directions. Intended for undergraduates with no prior exposure to the field, the book aims to convince read- ers that “medical anthropology is not an ivory-tower discipline insulated from the off-campus realities of human illness, suf- fering, and death” (p. 9). They make a compelling case for why medical anthropol- ogy matters by presenting concrete exam- ples of how practitioners actively address health problems in diverse settings through- out the world. Their tone is accordingly pragmatic rather than philosophical, fore-
grounding empirical research and applied contributions over abstract theory.
The authors begin their overview of the discipline by introducing readers to ac- tual cases of medical anthropologists in action, an expository technique they utilize throughout the book. In answering the ques- tion “Why have a medical anthropology?” the introductory chapter also provides a brief history of the field’s emergence within the parent discipline of anthropology and situates the field in relation to other health- related disciplines. The next two chapters give readers a grounding in the founda- tional methods and core issues of the dis- cipline, utilizing the case study approach to explore research design (ch. 2) and concepts (ch. 3), medical anthropologists employ to understand health-related activities and ill- ness experience. The book then shifts to a systems-level analysis of disease and heal- ing by situating medical beliefs and prac- tices in their wider social contexts, first com- paring various ethnomedical systems among nomadic foraging, pastoral, and chiefdom societies (ch. 4) and then discussing medical pluralism in complex societies (ch. 5). The final two chapters examine health problems from a critical perspective, focusing on the structural causes of health inequalities (ch. 6) and the negative health consequences of environmental degradation (ch. 7).
Although previous textbooks coauthored by Singer and Baer have emphasized a politicoeconomic approach to understand- ing health problems, here the two aim to present a more general overview of med- ical anthropology. They thus explore the cultural construction of illness and dis- ease, reviewing meaning-centered concepts such as stigmatization, illness narratives, and embodiment. They also address bio- cultural approaches, outlining an evolution- ary model of ethnomedical systems and as- sessing key features of the medical ecology model. As long-standing proponents of crit- ical medical anthropology, however, Singer and Baer continue to place their emphasis on a world-systems perspective that links health and suffering to wider structures of
Book Reviews 309
power and inequalities. Their critical analy- sis ultimately blames global capitalism for a wide range of health injustices, and the book concludes with a radical call to replace the current world order. Although the authors seek to galvanize readers into “pragmatic solidarity with a broad coalition of progres- sive people” to create a “healthy planet for both humanity and ecosystem” (p. 207), their sweeping prescription for change at the global structural level may ultimately dissuade new learners about their own and medical anthropologists’ abilities to make a significant difference. This contrasts with the bulk of the book, which documents the many productive ways in which anthropol- ogists address health problems in diverse locales.
This book would be a good primary text in survey courses that seek to introduce stu- dents to a broad range of work in med- ical anthropology. Singer and Baer con- dense an impressive array of book-length monographs and journal articles into short case studies ranging from a few paragraphs to several pages. The authors showcase projects as diverse as preventing dengue transmission in Malaysian communities and increasing breast cancer screening among African American women in Arkansas, to investigating medical pluralism in rural Bo- livia, studying the indigenous use of medic- inal plants in a Madagascan village, and understanding the culture of surgeons in a Canadian hospital. The result is a slim and portable paperback volume that offers students and instructors a sampling of the eclectic variety of projects in which medical anthropologists engage.
No book is without limitations. The book’s usefulness as a primer for students who are new to the discipline is some- what offset by its lack of learning aids such as chapter summaries and review ques- tions. Instead of a comprehensive glossary or boldface terms, each chapter elaborates a few concepts in boxes separated from the main text (e.g., bioculturalism, community- based organizations, ethnography, and capitalism). Also, although the black- and-white photographs provide important
visual context for readers, the generic “artist depictions” scattered throughout the book reduce complex biosocial phenomena to overly simplistic line drawings that fail to do justice to captions such as “snorting co- caine,” “mother nursing infant,” and “dia- betic injecting dose of insulin.”
The book’s emphasis on case studies might be a pedagogical challenge for in- structors who want to provide a more sys- tematic overview of specific topics and con- cepts in medical anthropology. Important concepts tend to get buried within or scat- tered among various case studies, when they would be more productively considered as overarching principles tying together vari- ous examples.
The book’s vivid case examples from around the world can enrich students’ ap- preciation for the diverse range of work en- compassed by medical anthropology. But in skipping from one continent to the next, often within a single paragraph, the book runs the danger of reinforcing a problematic view of the world as a mosaic of bounded cultures. In their account of folk under- standings of health and illness, for exam- ple, Singer and Baer describe how concep- tions of good health differ among the James Bay Cree in subarctic Canada, the !Kung San of the Kalahari Desert, the Tongans of Polynesia, and the Han of China (p. 69). This breathtaking coverage inadvertently contributes to a reified understanding of cul- ture as an immutable property of internally homogenous groups that map neatly onto distinct geographical locales.