What is a disease? On the surface, this might seem like a self-explanatory question. Surely, a disease is some kind of physical disorder with specific symptoms that normally affects a particular location of the body? From a clinical perspective, this is certainly accurate. But diseases are difficult to define and have meanings beyond their physical, biological existence. They can change biologically in response to environmental conditions while germs can evolve to protect themselves against threats, even man-made ones such as antibiotics. But humans also make sense of, experience and respond to diseases in strikingly different ways in different social and cultural contexts. Ideas about disease are highly context-dependent because human disease only exists in relation to people: people who live in varied cultural settings. Medical anthropologists and sociologists have shown that whether people consider themselves to be ill or not varies considerably due to factors such as class, gender and ethnicity. What constitutes a disease in one place might differ vastly in another, reflecting contrasting ecological or biological circumstances but also distinctive theoretical models about the body, cultural values, social and political constraints, technological capabilities and individual and collective expectations. In addition, what doctors choose to classify as a disease can regularly change. As an example, in 1994 osteoporosis changed from being considered an unavoidable part of normal ageing to being officially recognised as a disease by the World Health Organization, turning sufferers into patients. The historical contexts of disease therefore offer an important lens for further understanding how disease takes on various meanings in particular settings.
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