During the early years of medical anthropology's formation, explanations within the discipline tended to be narrowly focused on explaining health-related beliefs and behaviors at the local level in terms of specific ecological conditions, cultural configurations, or psychological factors.
Explanations that are limited to accounting for health-related issues in terms of the influence of human personalities, culturally constituted motivations and understandings, or even local ecological relationships, emergent critical medical anthropologists began to argue, are inadequate because they tend not to include examination of the structures of social relationship that unite (commonly in an unequal fashion) and influence far-flung individuals, communities, and even whole nations.
A critical understanding, by contrast, involves paying close attention to what has been called the “vertical links” that connect the social group of interest to the larger regional, national, and global human society and to the configuration of social relationships that contribute to the patterning of human behavior, belief, attitude, and emotion.
In other words, people develop their own individual and collective understandings and responses to illness and to other threats to their well-being, but they do so in a world that is not of their own making, a world in which inequality of access to health care, the media, productive resources (e.g., land, potable water, clean air), and valued social statuses play a significant role in their daily options.
Additionally, while recognizing the fundamental importance of physical (including biological) reality in health, such as the nature of particular pathogens or the release of toxins into the environment, CMA emphasizes the fact that it is not merely the idea of “nature”—the way external reality is conceived and related to by humans—but also the very physical shape of nature, including human biology, that has been deeply influenced by an evolutionary history of social inequality, overt and covert social conflict, and the operation of both physical power and the power to shape dominant ideas and conceptions in society and internationally through processes of globalization, control of production and reproduction, and control of labor.