on October 26, 2026
Health as a biological, psychological and cultural experience
Illness and health are two conditions deeply rooted in human existence, but they are not experienced in the same way by everyone. The experience of a symptom, a diagnosis or a functional limitation is influenced not only by the biological characteristics of the condition, but also by individual history, the environment, relationships, expectations and cultural context.
Medical anthropology studies precisely this intersection: the way in which the body, health and illness are interpreted and experienced within different social and cultural contexts.
This perspective allows us to move beyond a conception in which the patient is considered simply as the bearer of a pathology. The person instead becomes an integral part of the care pathway, with their own experience, values, expectations and ability to participate in decisions.
The contemporary concept of person-centered medicine finds an important point of contact with this approach. Shared decision-making, in fact, aims to involve the patient in the choices concerning their own care pathway. A recent umbrella review of 48 systematic reviews highlighted generally neutral to positive effects of shared decision-making on some health outcomes and the quality of care, while emphasizing that the certainty of the evidence remains variable.
Patient participation should therefore not be interpreted as a simple communication choice, but as a component of a therapeutic relationship in which the person acquires greater awareness and ability to contribute to the decisions that concern them.
From ethnocentrism to a medicine capable of listening
One of the fundamental concepts developed by medical anthropology is that of ethnocentrism, that is, the tendency to interpret the behaviors, beliefs and practices of other cultures using exclusively the criteria of one's own.
In the history of medicine, this attitude has contributed to considering some therapeutic traditions through a rigid hierarchy, in which the Western biomedical model was assumed as the only valid reference.
Moving beyond this perspective does not mean putting any therapeutic practice on the same level nor giving up evidence-based medicine. It means rather understanding that the experience of illness is also a social and cultural phenomenon and that the quality of the relationship between the professional and the patient can be influenced by the way in which the person's values, language, expectations and context are recognized.
Contemporary evidence on cultural concordance between healthcare professionals and patients indicates favorable associations especially for communication, trust, satisfaction, perceived respect and engagement, while the effects on clinical outcomes appear more heterogeneous.
Person-centered medicine therefore does not consist in replacing science with individual beliefs. It consists in making sure that scientific knowledge is applied within a relationship capable of recognizing the person in their complexity.
Beyond the body-machine model
Modern biomedicine has produced extraordinary results precisely thanks to the ability to rigorously study biological processes, identify pathological mechanisms and develop increasingly precise diagnostic and therapeutic tools.
The limitation emerges when the biological model is used as the sole interpretive key of the human experience.
Reducing the body to a machine means risking considering illness exclusively as a quantitative alteration of a parameter: a value too high or too low, an altered structure, a biomarker outside the reference range.
But the same biological alteration can be experienced in a completely different way by different people.
Pain, for example, is not only a signal coming from the tissues. It is also an experience processed by the nervous system and influenced by attention, emotions, expectations, memory, sleep quality, stress and social context.
For this reason, a truly personalized medicine must be able to hold together two apparently different levels: biological precision and listening to the person.
The body as an open system
An ecological perspective of health further expands the concept of the organism.
The body does not live isolated from the environment. It is continuously crossed by signals coming from nutrition, sleep, physical activity, the quality of the environment, social relationships and psychological conditions.
The organism continuously maintains a dynamic condition of balance through complex regulatory mechanisms.
In this sense, health can be interpreted not as a static state, but as a capacity for adaptation.
Nutrition, movement, sleep, social relationships and stress management therefore become elements that participate in the daily construction of the state of health.
This perspective does not imply that every illness is caused by lifestyle or that a person can simply recover by changing their behavior. It means rather recognizing that the biological determinants of health interact with behavioral, environmental and social ones.
Salutogenesis: from the question "what causes illness?" to the question "what sustains health?"
Within this paradigm, the concept of salutogenesis assumes particular interest.
While the pathogenetic model focuses attention on the factors that produce illness, salutogenesis is interested in the processes through which people manage to maintain and develop health despite exposure to difficulties, stress and changes.
The goal is not to deny illness, but to expand the question.
Not only:
What is the pathological mechanism?
But also:
What resources can sustain the organism's capacity to adapt?
This approach values awareness, autonomy, adaptability and the person's participation.
The patient is therefore not only a recipient of a prescription, but can become a conscious protagonist of a pathway in which individual and environmental resources are also considered.
PNEI: when brain, endocrine system and immunity communicate
One of the areas of biomedical research that best lends itself to dialogue with this integrated vision is psychoneuroendocrinoimmunology (PNEI).
PNEI research studies the bidirectional communications between the nervous system, endocrine system and immune system, showing how psychological state and stress conditions can alter some physiological responses.
The biological bases of this communication are now widely documented.
The nervous system and immune system communicate through neuroendocrine mediators, neurotransmitters, neuropeptides, hormones and cytokines. Stress activation can alter the function of immune cells and the production of inflammatory mediators.
A large meta-analysis that collected over 300 studies on humans highlighted associations between psychological stress and alterations of several immune parameters, with different effects in relation to the duration and nature of stress.
A more recent review confirms that stress, depression and the quality of social relationships can influence immune and endocrine function, with possible consequences on inflammation, tissue healing and biological resilience.
Also a recent preregistered meta-analysis analyzed 43 studies on the relationship between distress and inflammatory response to acute stress, confirming the scientific interest in the link between psychological experience and immune response.
These results do not mean that emotions directly "cause" a specific illness, nor that it is possible to treat a pathology simply by intervening on the emotional state.
They indicate rather that mind and body communicate through measurable biological mechanisms.
The meaning of emotions in contemporary medicine
Emotions can influence the way symptoms are perceived, the response to stress and some physiological processes.
In chronic pain, for example, the relationship between pain, fear of movement, stress, sleep and behavior can become circular.
The symptom can generate worry; worry can increase attention towards the symptom; the reduction of physical activity can worsen functionality; the loss of autonomy can increase stress and discomfort.
A person-centered medicine seeks to break these circuits through a coordinated set of interventions: education, adapted movement, rehabilitation, medical treatment when necessary, psychological support and lifestyle modification.
In this sense, the integrated approach does not coincide with the simple sum of different therapies.
It is above all a different way of building the therapeutic pathway.
Integrated medicine and therapeutic pluralism
Talking about integrated medicine means creating a dialogue between different disciplines while maintaining a rigorous distinction between what is supported by scientific evidence, what is plausible on a biological level and what belongs to cultural or philosophical tradition.
Traditional Chinese, Ayurvedic and Mediterranean medicines constitute complex historical systems, in which nutrition, movement, environment and body practices have traditionally been considered part of maintaining balance.
Some practices coming from these systems are today the object of scientific research; others have insufficient or inconclusive evidence.
The scientifically correct approach consists in evaluating each practice for what the evidence really allows to state, without idealizing it and without rejecting it a priori simply because it belongs to a different tradition.
This allows us to avoid two opposite extremes:
on one hand reductionism, which considers irrelevant everything that does not immediately fit into the biological model;
on the other therapeutic relativism, according to which any practice would be valid simply because it belongs to a tradition.
Evidence-based integrated medicine should instead build a bridge between biology, the person's experience and culture, maintaining as a reference the safety of the patient and the quality of the available evidence.
Humanizing care
Humanizing care means recognizing that in front of the healthcare professional there is not only a pathology, but a person.
It means understanding that a diagnosis can alter the way a person interprets their body, their relationships, their future and their possibilities.
It also means listening to what the patient considers important.
Medicine can be highly technological without becoming dehumanized. On the contrary, the greater the complexity of the available technology, the greater the importance of the relationship that allows it to be used correctly.
The person must be able to understand the available possibilities, the expected benefits, the risks and the uncertainties.
Shared decision-making represents one of the tools through which this principle can become operational. The available evidence shows, however, that its concrete application in clinical practice remains heterogeneous and also depends on the organizational context and the time available for the relationship.
From the care of illness to the construction of health
The anthropological approach and contemporary biomedical research can meet precisely in the need to overcome a fragmented vision of the person.
Illness can be studied through biomarkers, diagnostic imaging, genetics and physiology.
But the person experiences illness through the body, emotions, family, work, culture and the environment.
A truly person-centered medicine must therefore be simultaneously scientific and relational.
The future of integrated medicine should not be represented by the replacement of biomedicine with other care systems, but by the ability to integrate different competencies according to criteria of evidence, safety, appropriateness and personalization.
Health thus becomes a dynamic process in which the person can recover awareness of their body and actively participate in decisions.
It does not mean having absolute control over illness.
It means acquiring a greater ability to understand what is happening, recognize their needs and build, together with healthcare professionals, a pathway coherent with their condition and their history.
It is in this space, between biology and biography, body and environment, science and relationship, that medical anthropology can offer an important contribution to contemporary medicine.
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