What factors guide healthcare strategies over time? A diachronic study focused on the role of biomedicine and the perception of diseases in the dynamics of a local medical system

Abstract

Among the recently discussed evolutionary issues on medical systems, one of the most controversial issues is the replacement of local medical systems with the biomedical system. Our study investigates the hybridization of two medical systems and the role that the perception of incidence and severity of diseases has in memorization and transmission of information about their treatments. We collected data from a rural population in Brazil during two different periods separated by eight years and compared the periods for changes according to the knowledge on treatments with drugs in the biomedical system and according to the incidence and severity of the diseases. We found 147 medicinal plants belonging to 58 botanical families. Our results show that biomedical and local systems complement each other and change over time for the cure of recurrent, instead of the most severe, events. We suggest that based on cultural biases, biomedical and local knowledge can coexist by complementing each other with regards to the range of resources used for healthcare, and that disease perception can guide the evolutionary path of medical systems. Our findings can help elucidate new biases that guide the evolution of medical systems and reinforce important issues in the healthcare literature.

Factors affecting local plant knowledge in isolated communities from Patagonian steppe: Metacommunity theory is revealed as a methodological approach

“…About the concomitant use of medicinal plants with biomedicine tools, the literature brings controversial results [ 32 , 33 ]. However, the most recent studies show that there can be a great dialogue between the two forms of knowledge, even showing a positive relationship between the two types of knowledge [ 25 , 33 ].…”

“…Use of biomedicine —In a very similar way to what happens with studies on access to urban centers, studies that deal with the use of biomedicine by traditional populations reach different conclusions, depending on how they assess this relationship ([ 32 , 33 ]; for ex.). Therefore, following the same logic as the topic above, the idea of competition between different types of resources, we hypothesize that use of biomedicine influences the local botanical knowledge.…”

Farmers’ Perceptions of the Effects of Extreme Environmental Changes on Their Health: A Study in the Semiarid Region of Northeastern Brazil

“…Few diseases were mentioned very often by farmers, and most diseases had a low incidence. A possible explanation is that the diseases experienced by the population and the resources used for their treatment vary within time scales, which points to the existence of dynamic medical systems that can influence the perception of local populations (Santoro and Albuquerque, 2020). A diachronic study (with data collected over an 8-year time interval) also conducted in Carão, Santoro and Albuquerque (2020) observed that although incidence has a positive effect on the number of adaptive strategies, both allopathic and traditional medicines, it does not explain the variation in knowledge associated with these treatments, nor their efficacy.…”

“…A possible explanation is that the diseases experienced by the population and the resources used for their treatment vary within time scales, which points to the existence of dynamic medical systems that can influence the perception of local populations (Santoro and Albuquerque, 2020). A diachronic study (with data collected over an 8-year time interval) also conducted in Carão, Santoro and Albuquerque (2020) observed that although incidence has a positive effect on the number of adaptive strategies, both allopathic and traditional medicines, it does not explain the variation in knowledge associated with these treatments, nor their efficacy. Thus, we believe that diachronic variations should not be disregarded in the analysis of disease perception or the related factors because disease incidence can drive the evolution of medical systems at different time scales (Santoro and Albuquerque, 2020).…”

“…Thus, in addition to the search for understanding how climate change interferes with people's way of life, it is essential to evaluate the perception of human populations in this context because people tend to develop knowledge and practices related to health to prevent the spread of diseases, modifying local medical systems (Ferreira et al, 2015). Therefore, local medical systems may offer clues about recent changes in disease incidences on a time scale (Estomba et al, 2006;Ferreira et al, 2015;Santoro et al, 2015;Santoro and Albuquerque, 2020).…”