This article describes the integration of medical anthropologists as direct members of health care teams within a large, urban teaching hospital as a means to address the role of structural inequality in unequal health care delivery within the context of COVID-19. The pandemic starkly underlined the role structural forces such as food insecurity, housing instability, and unequal access to health insurance play among vulnerable populations that seek health care, particularly within the emergency department (ED). There is a critical need to recognize the reality that disease acquisition is a cultural process. This is a significant limitation of the biomedical model, which often considers disease as a separate entity from the social contexts in which disease is found. Further, a focus on patient-centered care can open the door for critical, clinically applied, medical anthropologists to team with physicians, merging ethnographic methods with health data and the socially constructed realities of patients’ lived experience to build new pathways of care. These pathways may better prepare physicians and health care systems to respond to novel threats like COVID-19, which are rooted in pathophysiological origins but have outcome distributions driven by cultural and structural determinants. To this end, we propose a reconfiguration of dominant biomedical ideologies around disease acquisition and spread by examining our work since 2018, which sees anthropologists embedded both locally and systematically in the creation of anthropologically informed treatment pathways for socially complex disease states like HIV, Hepatitis C, and Opioid Use Disorder (Henderson 2018). Understanding how these socially complex diseases concentrate and interact in populations is a potential opportunity to model solutions for other widespread and complex health care crises, including COVID-19.

中文翻译：

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在 COVID-19 不断变化的背景下应用医学人类学和结构知情的紧急护理

本文描述了将医学人类学家整合为大型城市教学医院内医疗团队的直接成员，以此作为解决 COVID-19 环境下结构性不平等在医疗服务提供不平等中的作用的一种手段。这场大流行病清楚地强调了结构性力量在寻求医疗保健的弱势群体中所起的作用，尤其是在急诊科 (ED) 中。迫切需要认识到疾病获得是一个文化过程这一现实。这是生物医学模型的一个显着局限性，该模型通常将疾病视为与发现疾病的社会背景不同的实体。此外，专注于以患者为中心的护理可以为关键、在临床应用中，医学人类学家与医生合作，将人种学方法与健康数据和患者生活经历的社会建构现实相结合，以建立新的护理途径。这些途径可以更好地让医生和医疗保健系统做好应对 COVID-19 等新威胁的准备，这些威胁植根于病理生理学起源，但结果分布受文化和结构决定因素的驱动。为此，我们通过检查我们自 2018 年以来的工作，提出了围绕疾病获取和传播的主要生物医学意识形态的重新配置，其中看到人类学家在本地和系统地嵌入为艾滋病毒、丙型肝炎等社会复杂疾病状态创建人类学知情治疗途径和阿片类药物使用障碍（Henderson 2018）。