This book discusses the various social, political, and cultural forces that shape the distribution of diseases in populations. It is based on a series of comparative studies of the historical and contemporary disease patterns of the indigenous peoples of America north of Mexico, Polynesia, andAustralia. The purpose of the comparisons is to control in a quasi-experimental way certain crucial variables in order to examine the impact on health of other variables. The comparisons are made at increasingly more refined levels of analysis. Thus, once disease ecology has been held roughlyconstant, one can see more clearly the ways in which colonial policy and political institutions have shaped the affairs of indigenous peoples. And once policy has been held constant, one can see more clearly how culture can make a difference. And once culture has been held constant, one can see howgender and status make a difference. Kunitz argues that very few broad generalizations adequately explain the distribution of diseases in populations and that to truly comprehend such patterns one must understand the local social context as well the biological characteristics of diseases. The book is thus an argument for theimportance of local knowledge as a complement to the universalizing sort of knowledge that we associate with science.