Merrill Singer

Overview


Merrill Singer is a key figure in medical anthropology known for pioneering critical medical anthropology. In addition to being one of the first medical anthropologists to employ a critical perspective, Singer has also done significant work on HIV/AIDS, drug use, and developed the term syndemics. His research on drug use, HIV/AIDS prevention, and syndemics, have led to understanding the relationships between social disparities and health concerns. Singer is currently professor of anthropology and public health at the University of Connecticut and has worked with the Hispanic Health Council in Connecticut.

Research & Work


One of Singer’s greatest contributions to anthropology is his development of critical medical anthropology, which uses a political economy of health approach to explore micro and macro level influents of health. Critical medical anthropology explores causes of illness beyond biomedical explanations and incorporates how social phenomena impact on health. In this respect, Singer’s development of critical medical anthropology represented a significant shift in understanding relationships between social inequality and health outcomes. Critical medical anthropology ultimately strives for what Singer calls system-challenging praxis[1] , a type of action to reveal how social inequalities negatively impact health, and find solutions to the social inequalities. In this respect, critical medical anthropology can be considered a vehicle of social change to consider how to reduce social determinants of poor health. In addition to developing critical medical anthropology, Singer has also shed light on how illnesses may aggregate among a specific population.

The aggregation of multiple illnesses that negatively influence one another is what Singer terms syndemics. Syndemics also expands understandings of social determinants of health since, as Singer notes, social conditions may impact health concerns. The concept of syndemics is leading to new ways of understanding health disparities, and syndemic understandings of illness are now used by health institutions such as the United States Center for Disease Control and Prevention (CDC). The CDC has created a Syndemics Prevention Network to educate public health workers on how to employ a syndemic perspective to guide public health programs. Although he is best known for developing critical medical anthropology and syndemics, Merrill Singer has also done significant research on drug and alcohol use and AIDS prevention.

In his work on alcohol and drug use, Singer explains that all drugs are commodities and draws attention to social constructions of legitimate or legal and illegitimate or illegal drugs. In his book Drugging the Poor: Legal and Illegal Drugs and Social Inequality, Singer notes that all drugs are forms of self-medicating, and that distinctions of legal or illegal serve to reinforce social hierarchies and inequalities. Furthermore, Singer argues that drug use among the poor is a type of self-medicating in response to the pressures of being poor. Responding to ways illegal drug users are vilified, Singer argues that by using language of blame to describe drug users as responsible for deteriorating urban centers, “attention is diverted from the role of class inequality as a source of social misery[2] .”
Singer’s work with drug users in the United States has also influenced broader understandings of how social factors impact HIV and AIDS risk. In his research with injection drug users, Singer points out that among other factors, political, economic, social, and environmental inequalities related to gender, age, and race increase risk of HIV associated with drug injecting[3] . Decreasing risk of HIV in this scenario requires broader policy efforts to reduce risk by addressing use of injectable drugs and addressing the motivations associated with injectable drug use. Preventing HIV and AIDS requires a syndemic approach since risk is also related to numerous other health concerns and social inequalities.[4]

Applied Anthropology


As an applied anthropologist, Merrill Singer worked as Director of Research at the Hispanic Health Council (HHC) in Hartford, Connecticut. The HHC is a community-based research, policy, and advocacy organization that promotes the wellbeing of Latino populations. Singer Joined the HHC in 1984 as a research coordinator and became Deputy Director of the HHC in 1990. In 1993 he was promoted to Director of Research, and in 2007 Singer left HHC. During his 25 years at the HHC, Singer headed multiple funded research endeavors to explore drug and alcohol use. In 2003 Singer received a grant from the CDC for a project titled “Building Community Response to Risks of Emergent Drug Use.” This research focused on identifying drug use trends, assessing health risk of trends, and developing community-based public health responses. In 2001 Singer was co-principal investigator on an NIH grant to examine drinking behaviors among non-migrant farmworkers, and in 2000 Singer received a grant from NIDA to examine how partner violence relates to HIV risk and drug use.


Controversies


Singer’s work emphasizing political economic contexts of illness has been met with some controversy. In 1989, Singer published an article that argued biocultural approaches to medical anthropology at the time were flawed because they did not consider social impacts on health[5] . Singer further critiqued the use of adaptation in medical anthropology, which he claimed assigned inequalities to the environment and legitimized inequalities as a natural process. In response to Singer’s critique of biocultural medical anthropologists, Andrea Wiley argued that adaptation was still a useful concept and that adaptation can reveal how past events affect the present[6] . Furthermore, Wiley proposed that biocultural medical approaches to anthropology are more objective, to which Singer responded by noting that value-free knowledge production is impossible since knowledge is always produced in some type of power relationship[7] .

Biography


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Merill Singer


Singer earned his PhD in anthropology from the University of Utah in 1979. He graduated from California State University-Northridge with his B.A. in 1972 and M.A. in 1975. In 1980, Singer was a postdoctoral scholar at George Washington University Medical School where he studied alcohols use, and in 1982 Singer was a postdoctoral scholar at University of Connecticut Medical School, where he studied community mental health. Singer’s started his AIDS prevention research in 1984, the same year he joined the Hispanic Health Council.

During his career, Merrill Singer has published over 200 journal articles and book chapters. He has also published more than 20 books, and received numerous professional honors including: the Rudolph Virchow Prize the AIDS and Anthropology Paper Prize, the George Foster Memorial Award in Practicing Anthropology from the Society for Medical Anthropology, and the Prize for Distinguished Achievement in the Critical Study from the North America from the Society for the Anthropology of North America.

Merrill Singer currently holds a duel appointment as Professor in the Department of Anthropology and as a Senior Research Scientist at the Center for Health, Intervention and Prevention at the University of Connecticut. In addition to his faculty and research positions, Singer is a member of the executive committee of the Center for Interdisciplinary Research on AIDS (CIRA) at Yale University. He currently resides in Connecticut with his two children.

Major Publications


1. Merrill Singer. Introduction to Syndemics: A Systems Approach to Public and Community Health. San Francisco, CA: Jossey-Bass, 2009.
2. Merrill Singer Drugging the Poor: Legal and Illegal Drug Industries and the Structuring of Social Inequality. Long Grove, IL: Waveland Press, 2008.
3. Merrill Singer and Hans Baer Introducing Medical Anthropology: A Discipline in Action. Lanham, MD: Altamira Press, 2007.
4. Arachu Castro and Merrill Singer (Eds.) Unhealthy Health Policy: A Critical Anthropological Examination. Walnut Creek, CA: Altamira Press, 2004.
5. Hans Baer, Merrill Singer and Ida Susser. Medical Anthropology and the World System. Westport, CT: Greenwood Publishing Co., 1997.
6. Merrill Singer and Hans Baer Critical Medical Anthropology. Amiytyville, New York: Baywood Publishing Co., 1995.
7. Merrill Singer (Ed.) The Political Economy of AIDS. Amityville, New York: Baywood Publishing Co., 1997.


Online Resources


For more information on Merrill Singer, see the following links from his professional website and wikipedia page:


http://www.anth.uconn.edu/faculty/merrillsinger.php
http://en.wikipedia.org/wiki/Merrill_Singer

Further Reading


1. J. Bryan Page and Merrill Singer. Comprehending Drug Use: Ethnographic Research at the Social Margins. Rutgers University Press, 2010.
2. Merrill Singer and Pamela Erickson, (Eds.) The Companion to Medical Anthropology. Wiley-Blackwell, 2011.
3. Singer, Merrill. 1986 Developing a Critical Perspective in Medical Anthropology. Medical Anthropology Quarterly, 17 (5): 128-129.
4. Singer, Merrill. 1995 Beyond the Ivory Tower: Critical Praxis in Medical Anthropology. Medical Anthropology Quarterly, 9 (1): 80-106.

  1. ^

    Singer, Merrill
    1995 Beyond the Ivory Tower: Critical Praxis in Medical Anthropology. Medical Anthropology Quarterly, 9 (1): 80-106.
  2. ^
    Singer, Merrill.
    2004 Why is it Easier to Get Drugs than Drug Treatment? In Unhealthy Health Policy. Castro, Arachu and Merrill Singer, eds. Lanham: AltaMira Press.
  3. ^
    Rhodes, Tim, Merrill Singer, Philippe Bourgois, Samuel R. Friedman, Steffanie A. Strathdee.
    2005 The social structural production of HIV risk among injecting drug users. Social Sciecne and Medicine.
  4. ^ Singer, Merrill.
    1994 Aids and the Health Crisis of the U.S. Urban Poor: The Perspective of Critical Medical Anthropology. Social Science and Medicine 39 (7): 931-948.
  5. ^
    Singer, Merrill
    1989 The Limitations of Medical Ecology: The Concept of Adaptation in the Context of Social Stratification and Social Transformation. Medical Anthropology 10:223- 234.
  6. ^ Wiley, Andrea
    1992 Adaptation and the Biocultural Paradigm in Medical Anthropology: A Critical Review. Medical Anthropology Quarterly 6(3):216-236.
  7. ^ Singer, Merrill
    1993 A Rejoinder to Wiley's Critique of Critical Medical Anthropology. Medical Anthropology Quarterly 7(2): 185-191.