In an earlier post, I began a discussion about the role of biology in a well-developed biocultural research program by debunking some common misconceptions (at least as I see them). I have argued that biomarkers are neither necessary nor sufficient to define a research program as biocultural, and that the same can be said of genetics/genomics and evolutionary hypotheses.
In this second part of the essay, I turn to the messier question of what a biocultural research program needs from biology.
If the point of biocultural research is to create a new subdiscipline with carefully defined boundaries tended by insiders, then the whole enterprise bores me and I want no part of it. We inhabit an academic universe filled with disciplines and subdisciplines and sub-subdisciplines that guard their borders, and despite moves toward interdisciplinarity (such as at Arizona State University, where they no longer have a conventional anthropology department, but instead a School of Human Evolution and Social Change), anthropology’s recent track record is not spectacular. Holism is not dead, but we collectively struggle with what it means in the 21st century, and worry about whether we are gripping an outdated sacred bundle, some artifact of the early 20th century institutional politics.
If biocultural research is to be a useful force in the future development of our discipline, it needs to be inclusive, flexible, and most importantly not defensive. Many (although not all!) researchers in the positivist anthropological sciences tire of, rail against, or just ignore theory and practice founded in Foucault’s biopower, the de-colonization movement, or critical medical anthropology, for instance. For my part, I find poststructuralist perspectives an essential check on the reductionist tendencies of biological research. One of the most compelling features of anthropology is that every foundational assumption is subject to examination. I don’t want to be satisfied with my work. I hear critiques, and I reconsider my approach. Then I continue my work, hopefully with some improvement. Open mindedness does not require nihilism.
But if biocultural research is a transactional phenomenon without a set trajectory or endpoint, built upon breaching carefully tended boundaries, then it’s an exciting enterprise indeed. For a health researcher with this perspective, each project presents an opportunity to throw out assumptions about causality and rebuild them. At its best, biocultural research can be disruptive, sometimes even a little threatening.
By transactional I mean that we converge on (if never quite reach) an understanding of human experience that incorporates the subjectivity and physicality of the body in the world, and describes exchanges among them. Every element of human state regulation – from gene regulation through neuronal firing patterns and hormone release to complex phenotypes like a disease state or a developmental outcome – is shaped by subjective experience. And that means it is shaped by culture. Through culture we collectively build the niches within which the human organism thrives, or fails to thrive. We do it on a day-to-day basis as we interact with one another, and on a global scale as we alter the composition of life on earth and the carbon content of our atmosphere.
This is all very airy, though. At some point, one has to design an actual study that examines specific biocultural transactions. Then most of this complexity flies out the window because it’s unmanageable to conceptualize – let alone actively study – more than a small slice of human experience at any one time. So in the interest of making broad principles concrete, I propose a rough taxonomy of ways our faculty and students have incorporated biology into biocultural research. This is not all-inclusive, and these categories overlap. Since one major purpose of this post is to explore what biocultural medical anthropology can mean at UA, I rely preferentially on local examples (with apologies to those who, in the interest of not writing a novel, I will omit; I respect your work too!) Some readers may be prospective graduate students. If so, perhaps you can join us and help expand the list.
1) Biocultural by theory. In part 1, I suggested it is not necessary to pursue evolutionary hypotheses to sustain the “bio” in biocultural research. However, strong research programs are grounded in theory, and biocultural research must be grounded in theory with provisions for biocultural transactions. Evolutionary theory continues to be one important way to achieve this. Hence, Catherine Buzney drew from life history theory, a specialty within evolutionary theory concerned with development across the lifespan, to hypothesize and interpret linkages between childhood stress and pubertal timing. Chris Lynn’s Human Behavioral Ecology Research Group (HBERG) pursues several lines of psychobiological and behavioral research driven by evolutionary hypotheses. One strand of my research used two evolutionary constructs (selection and energetic tradeoffs) to interpret sex-differentiated growth outcomes and immune system functioning in children. But there are other theoretical approaches amenable to biocultural integration. I have used ecocultural theory to interpret child stress response patterns and young adults’ physical activity. Toni Copeland has examined health outcomes among poor HIV-positive women in Kenya through the lens of structural violence. Rick Brown and Blakely Brooks built a cultural epidemiology of Type 2 diabetes and Susto, respectively. Bill Dressler, Kathy Oths, Francois Dengah, and several others have used cultural consonance theory as a bridge between a cognitive theory of culture and stress theory, to examine how cultural meaning per se shapes outcomes as diverse as arterial blood pressure, depressed affect, and body mass index. While this represents considerable theoretical pluralism, all these projects are firmly founded in some well-developed theoretical framework that not only permits but encourages reference to the body and its workings. Hence, our work is biocultural by theory.
2) Biocultural by outcome. Theory may encourage a careful look at transactions among the subjectivity and physicality of the body, but it’s still necessary to design a study that locates those transactions and makes them amenable to analysis. In our program, we have emphasized the design and testing of hypotheses concerning measureable health or health-related outcomes. These outcomes can be explicitly physiological, such as Sarah Szurek’s findings regarding glycemic control, Bill Dressler’s work on hypertension, or work that Chris Lynn and I have done regarding immune function. The outcomes may be implicitly biological, such as Kathy Oths’ work on bonesetting and Debilidad, Meredith Jackson-de Graffenried’s and Erica Gibson’s work on pregnancy and birth outcomes, the work of both Sarah Szurek and Katy Groves regarding food models, Jenelle Doucet’s research concerning ADHD, or Mary Campbell’s work on access to healthcare. Hence, our work is biocultural by outcome. Because these outcomes often benefit from quantification, we generally pursue mixed-methods approaches to our research questions. But where we use statistics, we have built our statistical models on an ethnographic foundation and interpreted our findings in an ethnographic light.
3) Biocultural by marker. I noted in my earlier post that the incorporation of biomarkers is neither necessary nor sufficient to a biocultural study. They’re still pretty darn useful, though. As I will use the term here, a marker is distinct from an outcome insofar as it is not directly the target of inquiry, but helps in the description or quantification of another variable important to the study hypothesis while being less amenable to direct measurement. Cortisol, then, is a marker of stress, not stress itself. HbA1c is a convenient marker of glycemic control. C-reactive protein is a one-molecule marker of inflammation. Taking this one step further, genotypes too are markers – markers of gene expression (and consequent variation in biological function). So, serotonin receptor polymorphisms are markers of biological sensitivity to adversity. Depending on study design, sometimes variables can serve as markers or outcomes. Chronic elevated inflammation, for example, can be a marker of pathogen exposure, or may itself be the health outcome of interest. Blood pressure can be a stress marker or a measure of hypertension, a medical condition. My lab, the Developmental Ecology and Human Biology Lab, is deeply concerned with the measurement of biomarkers. Our research can be biocultural by marker when the biomarker serves as a useful tool to address a question that might otherwise be inaccessible to study.
4) Biocultural by extension. Sometimes research that begins with an explicitly biological outcome leads in a direction that encourages a less direct approach to biology. This is a satisfying upshot of biocultural research, because it concerns the development of an entire research program, rather than a single study. As in Part 1, I shall for a moment pick on one of my own current students to illustrate this point, because I know the history of the project fairly well. Martina Thomas began her studies with a thesis project examining cultural models concerning body image among African American adolescents and their mothers in a low-income community with exceptionally high obesity rates. During her work, she found that body image, rather than being strictly concerned with shape or size, was bound up in a complex model also involving social relationships, material possessions, a variety of behaviors including respectfulness, drug use, and gossip; and, hidden in the mix, there were some interesting hints regarding perceptions (sometimes misconceptions) of what a person with AIDS “looks like.” On this foundation she built an entirely new study that examines HIV/AIDS models and social ecologies of risk. This research is not only biocultural by (implicit) outcome – HIV risk – but also biocultural by extension. It follows a trail of evidence, and when that trail leads into social and behavioral research without direct measurement of biological markers or outcomes, there is no wall that prevents the researcher from following along.
5) Biocultural by interpretation. Finally, research may be interpreted in light of human biology without measuring it. Francois Dengah and Chris Lynn have both done work concerning dissociative states evoked in the context of Pentecostal rituals. They are not measuring the neurobiology of dissociation – but they know about it, and can interpret their findings in light of neurobiology (and stress biology, which Chris measured and Francois inferred). My work on physical activity patterns among older adults who have osteoarthritis (with Pat Parmelee and Dylan Smith) and among young adults who do not is interpreted in light of the physiological significance of body movement, but we connect nothing to the body except an accelerometer (like a pedometer, but a little fancier). Beyond this department, a hallmark of neuroanthropology is the interpretation of a vast array of cultural and social experiences (from cancer survivorship to drug use and sport) in terms of neurobiology.
Anthropologists have a tremendous advantage insofar as we get outside of the lab and learn about people’s experiences as they live their lives. Yet that makes us by necessity versatile opportunists when it comes to methodology. When Greg Downey (not one of ours, alas, but an outstanding biocultural anthropologist at Macquarie University) studies Brazilian Capoeira, he can’t stick these martial artists into an fMRI magnet. But he can use the wonderful techniques of participant observation, combined with a healthy respect for the experimental neuroscience literature, to approximate an understanding of what’s happening on a biological level. We can examine questions that no other discipline is equally equipped to handle. But only if we’re prepared to transgress boundaries. Otherwise we may as well let the physiologists do it. After all, they have more money and far better toys.
[Updated and added links 10/23/2013]