Doing Health Anthropology: Research Methods for Community Assessment and Change

Christie W. Kiefer PhD, 2006,
1
What is the relationship between health, human nature, and human needs?The impact of social change on communities? The processes by which communities confront and overcome their health problems? How do we study these health questions in new communities and become advocates for change? These are critical questions in confronting the social causes of ill health, yet many health students do not have the appropriate training in the anthropological methods and techniques that help answer them. Christie Kiefer has written Doing Health Anthropology to prompt students to enter the community already prepared in these methods so that they can accurately ask and solve these important questions themselves. Using this book as a guide, students learn to integrate cultural anthropology with health science and come to their own conclusions based on field research. The book includes common pitfalls to avoid when conducting interviews and observations, and ways to formulate and answer research questions, maintain field notes and other records, and correctly analyze qualitative data. With the help of this text, practitioners and students alike will be able to integrate cultural anthropology methods of research into their health science investigations and community health initiatives. For news and to learn more about how you can implement a community approach to building global health and social justice, visit.
Table of contents :

Contents……Page 8
Acknowledgments……Page 14
Preface……Page 16
1. Why Anthropology?……Page 22
What is Cultural Anthropology? The Concept of Culture……Page 24
How Do Cultural Anthropologists Collect Data?……Page 27
How Do Cultural Anthropologists Analyze Data?……Page 28
The Advantages of Anthropology for the Health Sciences……Page 29
The Mighty Disease Model……Page 30
The Social Perspective on Health……Page 31
Why Isn’t the Social Perspective More Widely Used?……Page 32
The Advantages of the Social Perspective……Page 34
Summary……Page 40
2. Positivism: The Laboratory Theory of Knowledge……Page 42
The Meanings of Knowledge……Page 44
Positivism: The Laboratory Science Theory of Knowledge……Page 46
Elegance and Parsimony……Page 47
The Limits of Positivism……Page 50
Summary……Page 53
3. The Naturalistic Theory of Knowledge: Anthropology……Page 54
Naturalistic Theory……Page 56
The Idea of Usefulness……Page 57
Intuition, or Using What We Already Know……Page 58
The Process of Naturalistic Research……Page 60
Advantages of Naturalistic Knowledge……Page 61
The Issue of Meaning……Page 62
The Issue of Pattern Coherence……Page 64
Conceptual Problem No. 1: Verification……Page 66
Conceptual Problem No. 2: Objectivity……Page 67
The Naturalistic Response……Page 68
Practical Problem No. 1: Time……Page 69
Practical Problem No. 2: Generalizability……Page 70
What About Theory?……Page 71
Summary……Page 72
4. The Study of Real People in Natural Situations……Page 74
Ethnography and the Anthropological Attitude……Page 76
The Moral Relationship of Researcher and Community……Page 77
Survey Research and the Positivist Attitude……Page 81
The Importance of Contexts in Social Research……Page 83
Summary……Page 88
5. Designing a Research Project……Page 90
Guide to This Chapter……Page 92
The Process of Detailed Understanding……Page 93
Identifying a Research Problem……Page 96
Why Have We Chosen This Problem?……Page 97
How Will We Recognize the Answer?……Page 98
The Problem Statement……Page 99
The Intuition Statement……Page 101
Formulating Specific Research Questions……Page 103
Characteristics of Good Questions……Page 106
Summary……Page 107
6. The Researcher in and Beyond the Community……Page 110
Participant Observation……Page 112
Ethics and Values……Page 114
Ethics for Other Styles of Research……Page 115
Observing Unacceptable Behavior……Page 116
Taking Roles, Fitting in……Page 117
Clothing, Speech, Manners……Page 118
The Role of Student or Scholar……Page 119
The Role of Friend……Page 121
The Roles of Leader, Teacher, and Expert……Page 122
Culture Shock: Unavoidable, Highly Valuable……Page 124
If Your Time in the Community is Limited……Page 125
The Researcher Beyond the Community……Page 127
Summary……Page 129
7. Collecting Data……Page 130
Guide to This Chapter……Page 132
The Research Problem……Page 133
Background Research……Page 134
Observing and Taking Notes……Page 136
General Principles of Observation……Page 137
What Situations and Behaviors to Observe……Page 138
Minimizing Distortion……Page 140
Taking Notes……Page 141
Adding Analytic Details……Page 142
Minimizing Distortion……Page 143
Closed-Ended Versus Open-Ended Interviews……Page 144
Getting Truth Through Interviews……Page 146
Maintaining Rapport……Page 148
Keeping Interview Records……Page 149
Unobtrusive Measures……Page 151
Indirect Indicators……Page 152
Summary……Page 153
8. Analyzing Data……Page 154
Guide to This Chapter……Page 156
Data Analysis Uses Natural Human Skills……Page 157
Analysis: Making Our Implicit Understandings Explicit……Page 158
Data Management……Page 159
Kinship Diagrams, or Genograms……Page 160
Classification Trees, Organization Charts……Page 161
Networks and Flow Charts……Page 162
Face Sheets……Page 163
How to Treat Data Management Tools……Page 166
Analyzing Raw Data: Content Coding……Page 167
Using Statistics……Page 169
Reading for Context……Page 170
Reading and Listening for Technique……Page 171
Persuasion……Page 172
Usefulness……Page 173
Summary……Page 174
9. The Theory of Needs……Page 176
Guide to This Chapter……Page 178
The Concept of Health……Page 179
The Goals and Limitations of the CHP Model……Page 180
Meeting Needs……Page 182
Patterned Context……Page 183
Context, Meaning, and Change……Page 184
The Basic Human Needs……Page 188
Needs and Health……Page 190
Synergy, Conflict, and Substitution Among Needs……Page 191
Conflict……Page 192
Substitution……Page 193
Assessing Health in the Context of Needs……Page 194
The Impact of Planned Changes on Health……Page 195
A Method for Assessing Need Satisfaction Strategies……Page 196
Summary……Page 197
10. Community Change: The Theory of Hope……Page 198
Guide to This Chapter……Page 200
Anomie and Hopelessness……Page 201
The Substitution of Satisfactions……Page 203
Loss of Meaning……Page 204
Self-Wounding Communities……Page 206
Self-Healing Communities……Page 208
The Process of Community Empowerment……Page 209
Helping People Understand Themselves……Page 210
An Alternative Theory of Community Change: Street Marxism……Page 211
The Theory of Hope……Page 212
The Theory of Street Marxism……Page 213
Summary……Page 215
11. Action Anthropology……Page 216
Research as Community Practice……Page 218
The Empowerment Process……Page 219
Action Research Adds a Moral Dimension to Science……Page 221
Developing Self-Awareness in the Community……Page 222
Creating a Liaison Between the Community and Outsiders……Page 223
Doing Action Anthropology I: Knowing the Community……Page 224
Organizing Gatherings and Sharing Information……Page 226
Organizing Work, Collecting Facts, Evaluating Actions……Page 227
The Look, Think, Act Model……Page 228
Sustaining the Process……Page 230
Summary……Page 232
12. Teaching Health Anthropology……Page 234
Teaching and Research Should Go Together……Page 236
A Better Way: Student-Centered Teaching……Page 237
Benefits and Costs of the Student-Centered Method……Page 239
Location……Page 240
Preparation……Page 241
Role of the Teacher/Facilitator……Page 242
Classroom Strategies for Creating Student Confidence……Page 243
Classroom Strategies for Larger Classes……Page 247
Group Teaching……Page 248
Journals……Page 249
Field Work……Page 250
Problem-Based Learning……Page 252
Summary……Page 255
13. Professionalism in Naturalistic Social Science……Page 256
The Quality of Naturalistic Research……Page 258
Positivist-Friendly Naturalistic Method……Page 259
Usefulness as Validity: A Better Solution……Page 261
Objection No. 2: The Problem of Shared Tradition……Page 262
Assessing Community Health Beliefs……Page 264
Summary……Page 265
Appendix……Page 268
References……Page 276
Index……Page 282
A……Page 284
C……Page 286
D……Page 289
E……Page 290
H……Page 291
I……Page 293
L……Page 294
N……Page 295
P……Page 296
R……Page 298
S……Page 299
T……Page 301
Z……Page 302