round, taking over the editorship of the group’s renamed newsletter in 1985 when it finally became the journal Medical Anthropology Quarterly, others held out. Arthur Rubel, for instance, “would not be pigeonholed as a medical anthropologist [ever]… for he always saw health/medical phenomena as human behavior to be understood as anthropologists understood other forms of human behavior” (Cancian et al. 2001).
An Uneasy Resolution
Partially to better demonstrate ties to the parent discipline the GMA continued to push the AAA (which at that time did not have “sections”) to create a mechanism for its affiliation with AAA as a subgroup. Eventually, largely due to the GMA’s own organizing efforts, this came to pass (see Weidman 1986, pp. 121, 124): the group adopted a “constitution” in 1970, incorporated, and in 1972 became an official AAA “affiliate” (Society for Medical Anthropology 1975). This move firmly anchored the group – now the Society for Medical Anthropology (SMA) – within academic anthropology, although many members remained SfAA members also. Additionally, partly because anthropologists eschewing applied work tended not to join SMA née GMA (cf. Good 1994, p. 4), the influence of applied perspectives remained strong. Many SMA members were employed in schools of medicine, nursing, or public health or in the international and public health fields. The authority of biomedical clinical culture, where curative work and saving lives takes precedence, was manifest (Singer 1992a).
To counter accusations of over-specialization, a statement issued by the SMA in 1981 defining medical anthropology asserted unambiguously: “Medical anthropology is not a discipline separate from anthropology” (Society for Medical Anthropology 1981, p. 8). This did not offset objections related to the narrow technical definition of the term “medical,” noted, for instance, at the GMA’s 1968 organizational meeting. Not only did “medical” leave out nurses and members of the allied health professions; it suggested (and still does) a biomedical gold standard. Other concerns have been the implied focus on pathology and the implicit devaluation of interpretive ethnographic methods.
Nursing theorist Madeline Leininger suggested instead “health anthropology” – which an increasing number prefer today as well (e.g., Baer et al. 2016), perhaps most commonly in Europe, where the preference has deep roots (Hsu 2012). The appellation is perhaps least commonly heard in the Global South, where medical utility often is emphasized (Mishra 2007). At the 1968 meeting, however, although the proposal to rebrand instigated “lively discussion” it did not triumph (Weidman 1986, p. 119).
CULTURAL INTERESTS ASSUME THE LEAD
For better or worse, the subfield moved forward as “medical anthropology.” This was accompanied by a number of “What is Medical Anthropology?” essays. Howard Stein in 1980 recognized this “cri du coeur […as] a recurrent, quasi-ritualized annual event” (p. 18). While in its initial phase, generalist–specialist and applied–theoretical tensions had prominence, now the tension between cultural and biological priorities took precedence.
The global reach of British social anthropology notwithstanding – for instance, it was seen in Australian Shirley Lindenbaum’s important work on kuru disease in the early 1960s and the “epidemiology of social relations” she created to illuminate kuru (Anderson 2018) – medical anthropology’s official initial emergence as a named subdiscipline was largely fostered by culturally oriented scholars (see Paul 1963; Polgar 1962). This included those affiliated with the “culture and personality” school. Thus, early reviews of the field’s progress (e.g., Colson and Selby 1974; Fabrega 1971; Scotch 1963) highlighted medical anthropology’s relevance in psychiatry and related areas, their distinct focus on “nurture” over “nature” reflecting the strength of cultural determinism in mid-twentieth-century US anthropology.
The strong cultural bent among the subfield’s main organizers was reflected in the seven goals drafted by the initial steering committee of the emerging network of medical anthropologists: Biological factors received no mention. Furthermore, all of the goals stressed communication (Browner 1997). This was likely in part because, while physical (today’s “biological”) anthropologists had been working and publishing in and with medicine since anthropology’s inception, cultural anthropologists as a whole were still at that time rather new to cross-disciplinary communication and seemed uncomfortable in the medical milieu. In comparison to their physical/biological counterparts, they generally lacked easy access to it anyhow and could claim little authority within it. Cultural scholars’ desire for increased intellectual discourse, reflected in the goals list, also drove the creation of newsletters and forums that would become the subfield’s flagship journals, cementing its anthropological institutionalization, providing venues for specifically anthropological dissemination.
Whither Biology?
Biology’s recession within the subdiscipline irked SMA’s physically/biologically oriented members. Indeed, in his 1975 “What is Medical Anthropology?” commentary Khawaja Hasan – among the first to use the phrase “medical anthropology” in print – took the emerging subfield generally and George Foster specifically to task for neglecting the physical/biological side of the anthropological equation. Foster made this omission in a 1974 commentary contrasting medical anthropology and sociology. Hasan argued that, rather than focusing on the culture–society distinction, which Foster did (not uniquely: see, for example, Dingwall 1980; Paul 1963), Foster should have focused on anthropology’s holistic approach to “man” (sic). “Man” is the major focus of medicine, too, wrote Hasan; this, he argued, gives anthropology and medicine much more in common than anthropology and sociology. Hasan provided example after example of the role that biologists and “medical men” played in anthropology’s development, followed by more examples of physical/biological anthropologists at work within medicine.
It probably did not hurt Hasan’s case that physical anthropology had by this time become more biologically oriented, not only in terms of data favored but also in terms of questions asked. In any event, Foster was responsive: In revising the offending 1974 commentary for use in the first medical anthropology textbook, published in 1978 (twenty-plus years after Benjamin Paul edited the first casebook (1955)), Foster and his co-author Barbara Anderson took a more biologically informed position, even including a reference to Hasan.
Others, too, provided correctives. Take, for example, Medical Anthropology, which Gretel and Pertti (Bert) Pelto founded in 1977 (SMA was still at that time struggling to some degree with the generalist–specialist question and so only wanted a newsletter). The Peltos were committed to including a biological perspective, as reflected not only in the journal’s content but also in its editorial board (Gretel Pelto, Personal communication, December 18, 2008, and January 13, 2009). Also, a key teaching text first published in 1978 specifically highlighted biological and ecological perspectives (McElroy and Townsend 2004); and a 1980 textbook that took a biocultural approach proclaimed in its subtitle to be “expanding views of medical anthropology” (Moore et al. 1980).
Yet, despite these correctives, science itself had by the 1980s come under scrutiny. The scientific method – the paradigm that biological anthropologists most often worked within – was increasingly seen as an “establishment” tool. Worse, evolutionary biology was maligned by some because of its potential use by racists (D’Andrade 2000, p. 223).
Finding itself on the “wrong” side of the culture–biology divide thrown up and vilified by vocal and morally accusatory opponents of positivism, biological anthropology received less than its fair share of recognition. This is not to say that biological medical anthropology did not take place; indeed it did, and continues to do, in ways that have contributed greatly to advancing our biocultural understanding regarding, for example, high-altitude adaptations, lactose tolerance, breastfeeding, stress, substance use, and global disease threats as well as to building a more theory-driven epidemiology and a culturally informed epigenetics. However, such
