Intended for healthcare professionals

Rapid response to:

Education And Debate

Anthropology in health research: from qualitative methods to multidisciplinarity

BMJ 2002; 325 doi: (Published 27 July 2002) Cite this as: BMJ 2002;325:210

Rapid Response:

Anthropological Methods

The BMJ has been an interesting and unexpected forum for the social
scientific debate on the value, and associated problems, of qualitative
methodology in health research. This undoubtedly reflects the growing
interest in the social sciences from within medicine. However, as Lambert
and Mckevitt (BMJ 2002; 325: 210-3) eloquently expose, the wholesale
adoption of selected methods has led to some confusion. In particular, a
conflation of anthropology and ethnography with "popular" qualitative
methods (e.g. focus groups, interviews) has developed. Anthropology, as
Lambert and Mckevitt argue, has a distinctive approach, a theoretical and
methodological history, and a vast, cross-cultural literature that is a
vibrant source of comparison, ideas, and tools for general understandings
of the human condition. As a result, anthropology does not lend itself to
the stark division between qualitative and quantitative methods. In
general, anthropologists adopt a highly elastic approach and will draw
upon any number of methods of data collection and processes of analysis in
order to achieve a fuller understanding of a question. It can be as
appropriate to collect quantitative data (e.g. household economic data,
prevalence of illness, disease, attitudes, agricultural production) as it
is to collect qualitative data through cultural immersion. For an
excellent account of the value and difference between qualitative and
quantitative social research, I would recommend Richard Lapiere's 1934
paper "Attitudes Vs. Actions" in Social Forces, Vol 13.

My point is that it is inappropriate to fit social or medical
anthropology into a binary system of classifying methods, something the
authors do not make explicit in their paper.

In Cambridge we have overcome this problem by establishing an
institutional collaboration between the Department of Social Anthropology
and the Department of General Practice and Primary Care. As a Ph.D
student, I was supervised and supported by both departments and given time
to develop an anthropological approach to a pilot programme to prevent
type 2 diabetes. The thematic focus (risk) became the engine that drove
the success of the collaboration. In order to understand the ways that
risk was being interpreted and acted upon in everyday social worlds, it
was necessary to consider the ways in which risk was constructed, often
quantitatively, within epidemiology and public health. In keeping with a
flexible anthropological approach and making use of the heuristic device
of "making the familiar strange" (and vice versa), it was possible to
reveal how medicine had constructed a system of risk classifications which
resonate in some ways, but not others, with the lived ('lay') experience
of risk. Furthermore, the use of participant observation in both the
medical and non-medical fields of research, allowed the difference between
verbal responses and social action to become apparent. This an important
element of an anthropological approach and is elaborated upon in Lapiere's

Without the institutional collaboration, along with peer support, it
is possible that as an anthropologist working in a predominantly medical
environment would lose sight of their disciplinary insights and engage
only with "popular" qualitative methods.

In summary, I firmly agree with Lambert and Mckevitt's conclusion
that anthropology can offer relevant conceptual frameworks, knowledge and
methodological insights. However, I would add that the success of such
truly multidisciplinary approaches are greatly facilitated by a supportive
institutional or disciplinary collaboration.

Competing interests: No competing interests

02 August 2002
Claire L Somerville
PhD Student (submitted)
Dept.of Social Anthropology and Dept of General Practice and Primary Care, Cambridge.