Anthropologists Have Important Role to Play in Public Health Crises, Veteran Scholar Says

The role of the social sciences in responses to health crises is well established, given the extent to which human behavior determines how infectious diseases spread.

The Ebola outbreak in West Africa between 2014 and 2016 made it even more apparent why anthropologists could help medical authorities consider local cultural and social characteristics in their response to virus outbreaks. That outbreak also provided new perspectives on the origin of social and individual attitudes during epidemics and how to assist grieving families.

Today, as the world faces yet another global health crisis, Charles L. Briggs, president of Society for Medical Anthropology, says anthropologists can help us dismantle our views of established social categories and think more deeply about things we take for granted.

A professor at the University of California, Berkeley, Briggs has contributed to books and research papers about epidemics. His work explores the relationships between bodies, viruses and bacteria, and the narratives about infectious diseases that proliferate in the media and shape public views.

He spoke to Al-Fanar Media in a video call about the role of anthropologists in studying the spread of infectious diseases and how this research is changing. The following transcript of that interview has been edited for clarity and length. 

What role can anthropologists play in a public health crisis like the one we are facing now with Covid-19?

We are told all the time that the epidemic is unprecedented, which means we have no frame to understand it.

Every epidemic is unique, but anthropologists can point out the parallels with other sources of epidemics and therefore suggest what made them have their particular shapes and their particular outcomes, to provide us with a basis for understanding what’s going on.

The second role is to be able to push people outside of the frame of “Now, this is Covid-19,” to be able to understand the underlying factors that helped shape the current situation.

It is not entirely by accident in the United States that right now you have massive protests against police violence that targets particularly African Americans and that Covid-19 is massively differentially killing black Americans.

It’s extremely important to ask what are the underlying factors of race, racism and unequal distribution of resources in the United States that are affecting who lives and who dies.

Otherwise, people tend to rationalize the effects of an epidemic as being dependent upon the cultural or biological characteristics of particular populations as responsible for their own differential rates of infection and death instead of asking what is it about society that renders some people more likely to get infected and more likely to die.

Why do societies tend to think of such events as unprecedented despite having been through similar situations before? 

A crisis tends to make a particular period of time separated off and seemingly unrelated to what goes before it and to what will happen afterwards once we return to normal.

But if you look at it in deeper anthropological or epidemiological terms, you find that what happens before and what happens next are themselves not normal. It is not normal that vastly more African American women die of complications of childbirth, or that infant mortality among African Americans is much greater, and that indigenous people all over the world face the worst health conditions.

Think of the Navajo Nation, which has the highest percentage of infections per capita in the United States. That’s not unprecedented. That’s precisely a characteristic of little things like access to drinking water.

The different rates of infection and death among different racial and social groups is hard to miss. Can this recognition lead to significant changes? 

Unfortunately, one of the most familiar results of epidemics is deepening the inequities that excerpted them. That’s what’s happening in the United States with Covid-19.

The effects of the mitigating measures are not randomly distributed. We need to ask who will be out of work or unemployed for years? Who will have acute food shortages in the future? That’s what’s most crucial for the society, which is also right now experiencing this tremendous movement that has been going on for a long time. All of a sudden, the killing of George Floyd made that movement visible and unmistakable, so now that’s beginning to have a transformative effect.

If the epidemic could potentially have this transformative effect, this would be a very different outcome than the usual one of simply making things worse for the people who have it worst.

Do you expect anthropologists to come up with new theories in relation to social and cultural views of infectious diseases, or are anthropologists more concerned with testing pre-existing theories in this regard? 

The tendency unfortunately for many people described as authorities in an epidemic is to take the established ways of thinking about them and to simply reproduce and reuse them and apply them to a particular epidemic.

However, it’s those “common sense” ways of thinking that helped to make epidemics what they are in the first place.

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I don’t mean that those ways of thinking make pathogens. But the ways of thinking about racial and ethnic inequality, the ways of building health-care systems and jobs—all these sorts of things that give this particular epidemic its parameters. If these established ways of thinking are part of the problem, you don’t want just to recycle them in an epidemic.

An epidemic should challenge anthropologists and public health scholars, historians, journalists and all of us to develop new ways of thinking about disease, epidemics, people, and health systems.

Therefore we should use this opportunity as a way to overthrow established ways of thinking. That’s what should be unprecedented, to change the way that we theorize and see epidemics, rather than just using the same old theories and the same old stories.

Did the international nature of this epidemic have any effect on the social and cultural attitudes related to Covid-19? 

These days, every epidemic is international. Even if the pathogen doesn’t travel beyond particular borders, the narrative about it travels across those borders. I want to emphasize that those narratives have their own acute effects on the way that people perceive themselves, others, health care, and the decisions that are made about health care.

So I don’t think that the global nature of this pandemic is in any way different. But I think we would want to look at what are the specific features of these social and cultural attitudes related to Covid-19. It would be fascinating to see how these attitudes are shaped by scale and by the projection of this being a global phenomenon, a national phenomenon, a state phenomenon, and a local phenomenon.

When the pandemic comes to an end, how can anthropologists prepare for future social and cultural consequences?

A report published by the Institute of Medicine in the United States in 2003 under the title of “Unequal Treatment” suggested that African Americans and Latinos—even after taking into account socioeconomic status and health insurance—receive worse medical treatment in the United States. Why? Because thinking of the good patient as normatively white, an African American or Latino walks into a doctor’s office and is seen as not white and therefore as not as rational, not as capable of understanding what the doctor says, not as likely to take the pills or do the exercise, so even a good doctor is more likely to give bad treatment.

Here we take categories such as racial and ethnic categories (black versus white) and positions (doctor versus healer versus patient) as separate worlds.

Anthropology can challenge the logics that make these categories seem stable and autonomous and say: We have got to attack those logics and be able to understand how to keep from subordinating populations, because subordination leads to stigmatization and further denial of resources—in other words, more suffering and more death.