By Merrill Singer
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Some cultural patterns, by contrast, may inhibit disease transmission. In his research, Norbert Vecchiato (1997) found that the Sidama of Ethiopia believed that overwork, excessive exposure to the sun, or carrying heavy loads could cause tuberculosis (locally known as balamo). They also believed that “avoiding contact with a patient” was the best prophylactic measure against contracting this disease. It also has been found that certain cultural practices may affect wealthy and poor sectors of a hierarchical society differently.
As this example suggests, humans are having an ever more dramatic adverse impact on the environment, including behaviors that boost the spread and human exposure to infectious diseases. Pulling the various threads of this discussion together, the biocultural/ biosocial conceptualization of infectious disease recognizes that in all cases a complex interplay of biological, social, cultural, and environmental factors 36 ❋ ch a p t er o ne underlies the appearance, natural history, virulence, and outcomes of agentrelated disease.
The Wider Contexts of Infectious Disease Outbreaks There is an identifiable relationship between infectious diseases—including who gets which disease, how sick they get, and the outcomes of their sickness— and the hierarchy of social relationships structured by inequalities in wealth and power within and across societies (Baer, Singer, and Susser 2013; Farmer 1999). . society” (Bateson and Goldsby 1988:2). Although first identified among defining the anthropology of infectious disease ❋ 43 gay men in the United States, HIV disease soon became disproportionately frequent in low-income and socially subordinated communities of color.