Cathriona Kearns Outbreak Anthropology for Epidemiologists, workshop, London, 18-19 May 2015.

Cathriona Kearns

Outbreak Anthropology for Epidemiologists, workshop, London, 18-19 May 2015

Lets work together: the case for interdisciplinarity

Interdisciplinary

Multi disciplinary

Transdisciplinary

ARRRR......

Transdisciplinary: A number of disciplines –often includes societyDevelopment of shared conceptcross-over between disciplines, can form a new approachBoundaries between interdisciplinarity and transdisciplinarity can be fuzzy

Interdisciplinary: • A number of disciplines• Active collaboration between disciplines•Component boundaries broken down•Not just a summation of the different disciplines/parts•Synthesising the disciplines into something new- a co-ordinated holistic

Multidisciplinary: •A number of disciplines• Tends to remain discipline-orientated-silos•Report back on their discipline•Engagement with other disciplines can be limited

Sorting out the terminology

Single disciplines feed into & provide the basis for Interdisciplinary approaches

Team leader = facilitates interactions among team members by conversing with the different disciplines.Team members = develop a working knowledge of each others area of expertise, therefore expanding their understanding of other fields while contributing their own expertise

• Disciplines are governed by scope (boundaries, norms)

• Differing methodologies for research:• Epidemiology: quantitative, statistical models, vital indicators

of distribution of disease patterns(X) social relations way of life, behaviour, knowledge of individuals , generalisation

• Anthropology: qualitative accounts for the socio-cultural context(X) descriptive, subjective, not reflective due to small numbers studied, disregard principle statistical inferences

Challenges and barriers working with different disciplines

• Accept that differences exist – we all come at things in a different way

Fish is Fish: an interdisciplinary parable ( Leo Leonni, 1974)

Additional barriers to consider...........

• Disciplinary hierarchy (epistemic dominance)

• Language – disciplines can have different terminologies and sometimes terms can mean different things to different people

• Privileging- gender, looks race, height, beauty

• Topic status- scientific and technical topics given more attention that the social or cultural factors

• As a team we can create problems none of us could cause as individuals but we can also create solutions that would not be reached on our own

Epidemiology: “study of the distribution and determinants of disease “ (Trostle et al., 1996)The cause and effect can be affected by many factors:- biological, social, cultural, environmental.... These factors are taken into consideration by anthropologists

Anthropology:Anthropology can benefit from epidemiology – provision of insights into patterns of Illness across different communities/cultures

It goes beyond statistical reasons- can be difficult to understand why cholera rates remaining high on epi- curves until e.g. water treatment tablets for cholera are not been used- community thinks chemical poisons

Not so different...... A good marriage

Edward Jenner 1749-1823

The power of anecdotal evidence

Lay theories of health often do not match professional views

Early studies that introduced lay beliefs about health are to befound in social anthropology. First ethnographies - Rivers,1924;Clements,1932; Ackerknecht,1942.

Scientific dominance obviated the need to explore lay beliefs

Popay and Williams (1996) – ‘ignoring the lay voice is foolhardy -it can offer untold insights into the experience of health and illness’.Lay epidemiology: is a term used to describe the processes

through which lay individuals understand and interpret health risks.

The lay epidemiology model suggests: the lay public draws on knowledge and experience to develop a sophisticated system of beliefs that,while mindful of health education messages, are set within the context of experience and, are evidence based. This evidence may be gathered from family, community, or societal events and each event will impact on beliefs tovarying degrees.

Considering Lay epidemiology

“Build on local and cultural narratives: Diseases may be present in the population who have learned how to ‘live’ with them. Incorporation of local cultural logics and social protocols into response strategies e.g. Haemorrhagic fevers-Uganda the ‘gemo’ notion and local isolation procedures” (M. leachSTEPS,2010)

Summary Causal web- web of determinants

Endogenous & exogenous factors: e.g. Genetics/lifestyle/social/culturalNexus relationships – behaviours (individual and/or community)

Epidemiologist aim to identify and measure the important factors in this web

Anthropologist focuses on the social and cultural correlates of behaviours in the web

The synergy of the anthropologist and the epidemiologist – explores the nexus

Principal barrier - divergence away from standard methodology thinking

Epidemiologist: to understand the complex nature of human behaviour – challenge to capture this quantifiably.- look out for ‘paralysis through analysis’

Anthropologists : to see the benefit in the models used to identify patterns and trends