Adversity ‘matters’ to health because it is responsible for human suffering on a scale that demands both objective research and ethical intervention (Panter-Brick & Fuentes, 2009, p. 1).
The volume presented by Panter-Brick and Fuentes tightens the correlation between health and adversity in a manner new to the fields of anthropology and public health. This second of three publications for Studies of the Biosocial Society attempts to address the who, what, how, when and why of differential health outcomes. While the ‘social gradient’ of health has been widely acknowledged in public health and social science circles independently, Health, Risk and Adversity bridges the nexus between medical anthropology and public health by examining, through case studies, those who suffer from poor health outcomes (Marmot & Wilkinson, Reference Marmot and Wilkinson2006).
An attempt at a stable balance between medical anthropology and public health is found in the basic organization of the book with an opening chapter written from the view of anthropology (Panter-Brick and Fuentes) and countered by a concluding chapter from the perspective of public health (Martin White). The three internal sections – covering Health Risks and Disease Transition, Generational and Developmental Change and Gene Evolution, Environment and Health – each contain three chapters written by biological or medical anthropologists, epidemiologists and/or clinicians. Experts from archaeology, human biology and sociocultural anthropology introduce each of the three sections, respectively.
The third section, Gene Evolution, Environment and Health, for example, addresses how we understand the social and cultural foundations of health inequalities, in a multi-disciplinary manner. It acknowledges that there is a large and precise collection of research documenting disparities, but focuses on explanations for those disparities. Development Origins of Health and Disease (DOHaD) (Keith Godfrey and Mark Hanson) tackles the why, Socioeconomic Status (SES) and Health Inequalities (Thomas McDade) highlights the who and when beyond the social gradient, while the Genetic-Deterministic Explanation (Lorena Madrigal et al.) demonstrates the how through hypertension prevalence rate inequalities.
It is an admirable goal to bring anthropology and public health closer together, especially in the realm of adversity and risk where both fields are equally important. In his concluding remarks, White expresses the role of anthropology in these endeavours as a neutral one – the anthropologist being free from statutory responsibilities and governments that can bias research. I would beg to differ that, in fact, anthropologists do have responsibilities beyond themselves; they are responsible to the individuals and populations they study and balancing these human biases can be tricky. This volume actively engages the social side of epidemiology but in some ways disengages from the social side of anthropology.
Health, Risk and Adversity is very well organized, overall, with a layout ideal for students and academics who are looking to collaborate with their colleagues in anthropology and public health. The chapter structures, while slightly inconsistent, offer well thought out summaries; a helpful glossary is found in the back. Policy makers, however, may find the volume overwhelming if they are unfamiliar with the basic tenants of anthropology and/or public health. Those curious about human action and inaction as sources of ill health will find adversity and risk's impact on health clearly and vibrantly displayed through Panter-Brick and Fuentes' bio-cultural investigation of unequal health outcomes (Whitehead, Reference Whitehead1992).
