Med Anthropol Q
· 2025 Mar · PMID 39145768
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Drug overdose is a leading cause of death among adults in the United States, prompting calls for more surveillance data and data sharing across public health and law enforcement to address the crisis. This paper integrat...Drug overdose is a leading cause of death among adults in the United States, prompting calls for more surveillance data and data sharing across public health and law enforcement to address the crisis. This paper integrates Black feminist science and technology studies (STS) into an anthropological analysis of the collision of public health, policing, and technology as embedded in the US National Overdose Response Strategy and its technological innovation, the Overdose Detection Mapping Application Program (ODMAP). The dystopian Netflix series "Black Mirror," which explores the seemingly useful but quietly destructive potential of technology, offers a lens through which to speculate upon and anticipate the harms of collaborative surveillance projects. Ultimately, I ask: are such technological interventions a benevolent approach to a public health crisis or are we looking into a black mirror of racialized surveillance and criminalization of overdose in the United States?
This article examines how militarized regimes of narcotics and price control sustain unpalliated cancer pain in Pakistan. It shows how these regimes of control-reimagined as "regimes of pain"-render morphine, a cheap, ef...This article examines how militarized regimes of narcotics and price control sustain unpalliated cancer pain in Pakistan. It shows how these regimes of control-reimagined as "regimes of pain"-render morphine, a cheap, effective opiate analgesic, scarce in hospitals. Meanwhile, heroin, morphine's illegal derivative, proliferates in illicit circuits. The article highlights a devastating consequence of the global wars against drugs and "terror": the consignment of cancer patients to agonizing end-of-life pain. Widening the analytic lens upon palliation beyond bodies and their clinical encounters, the article offers a geopolitics of palliation. It shows how narcovigilance targeting illicit drugs has the perverse effect of throttling morphine's licit supply. It shows further how unviably low price ceilings, purported to ensure a poor population's access to morphine, render it scarce on the official market. These mutually reinforcing regimes of control thus thwart their own purported objectives, consigning cancer patients to preventable, yet unpalliated, pain.
Med Anthropol Q
· 2025 Mar · PMID 38847424
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Cancer patients and survivors in the United States are increasingly likely to use online crowdfunding as a means of offsetting the expenses associated with their medical care. This practice of making an online appeal for...Cancer patients and survivors in the United States are increasingly likely to use online crowdfunding as a means of offsetting the expenses associated with their medical care. This practice of making an online appeal for support to a broad public audience constitutes an inadvertent form of informal emotional labor for its practitioners-labor in which striking the right affective notes in one's appeal is believed to be critical to fundraising outcomes. Drawing on ethnographic interviews, we suggest that crowdfunding produces an array of complex, often contradictory sentiments and narrative incentives for cancer patients and survivors-ultimately transforming the experience of serious illness.
In November 2020, North Dakota reported a higher number of cases and deaths per capita from COVID-19 than any other state in the United States. Several months later, it reported one of the country's highest rates of vacc...In November 2020, North Dakota reported a higher number of cases and deaths per capita from COVID-19 than any other state in the United States. Several months later, it reported one of the country's highest rates of vaccine hesitancy, leading to the development and implementation of the state-funded and physician-led "Vaccine Champion" ("VaxChamp") program. Glossing the primary problem as one of "provider confidence," the VaxChamp program emphasized a standardized, scalable intervention that targeted healthcare providers directly, and patients only indirectly. Although the program hit its quantitative benchmarks, a qualitative inquiry into the program's history and context reveals multiple crises of confidence, many beyond the bioscientific domain of the program's focus. Drawing from work in medical and linguistic anthropology, we describe and analyze the "multiple levers of vaccine confidence" at play in the intervention and its surrounding context, as well as how these crises of confidence emerged.
Recent ethnographies have investigated self-care as a socially driven configuration of care. This analysis engages theorizing on the imagination to expose new social dimensions of self-care in cases of mental health as e...Recent ethnographies have investigated self-care as a socially driven configuration of care. This analysis engages theorizing on the imagination to expose new social dimensions of self-care in cases of mental health as embodied and communal. Based on fieldwork across Canadian universities and in conversation with students, campus wellness providers, and a group of psychiatric epidemiologists seeking to understand the mental health treatment choices of students, this article examines how these different subjects activate what I call an imaginarium of self-care. Among young adults in Canada, mounting social ills that go therapeutically unaccounted for have relocated forms of self-care into the imagination through play and world-building in ways that challenge the distinction between material and speculative healing. Attending to the imaginative dimensions of self-care makes coherent the ways that young people are grasping for hope in a world that-when embodied-resists recovery.
We compare the social determinants of health (SDOH) and the social determination of health (SDET) from the school of Latin American Social Medicine/Collective Health. Whereas SDET acknowledges how capitalist rule continu...We compare the social determinants of health (SDOH) and the social determination of health (SDET) from the school of Latin American Social Medicine/Collective Health. Whereas SDET acknowledges how capitalist rule continues to shape global structures and public health concerns, SDOH proffers neoliberal solutions that obscure much of the violence and dispossession that influence contemporary migration and health-disease experiences. Working in simultaneous ethnographic teams, the researchers here interviewed Honduran migrants in their respective sites of Honduras, Mexico, and the United States. These interlocutors connected their experiences of disaster and health-disease to lack of economic resources and political corruption. Accordingly, we provide an elucidation of the liberal and dehumanizing foundations of SDOH by relying on theorizations from Africana philosophy and argue that the social determination of health model better captures the intersecting historical inequalities that structure relationships between climate, health-disease, and violence.
Recent research has unveiled the pervasiveness with which Indigenous patients are subjected to racialized stereotypes within the Canadian health system. Because discrimination in health care is associated with poor healt...Recent research has unveiled the pervasiveness with which Indigenous patients are subjected to racialized stereotypes within the Canadian health system. Because discrimination in health care is associated with poor health outcomes and undertreated illness, there is a need to better understand how racism is perpetuated systemically in order to rectify the policies, practices, and attitudes that enable it. This article outlines a moral economy of care in emergency departments in western Canada by exploring the discourses that medical professionals employ when discussing cases of medical racism. While these discourses respond to the everyday realities of working in hospitals, they are also rooted in the colonial genealogy of health care in Canada and perpetuated by neoliberal shifts in health care services. By exploring the moral economy of care, this article sheds light on the way pervasive discourses contribute to reproducing and circulating Indigenous-specific racism and its role in decision-making.
Padilla M, Varas-Diaz N, Rodríguez-Madera S
… +9 more, Vertovec J, Rivera-Custodio J, Rivera-Bustelo K, Mercado-Rios C, Matiz-Reyes A, Santiago-Santiago A, González-Font Y, Ramos-Pibernus A, Grove K
Med Anthropol Q
· 2024 Jun · PMID 38642372
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Puerto Rico (PR) is facing an unprecedented healthcare crisis due to accelerating migration of physicians to the mainland United States (US), leaving residents with diminishing healthcare and excessively long provider wa...Puerto Rico (PR) is facing an unprecedented healthcare crisis due to accelerating migration of physicians to the mainland United States (US), leaving residents with diminishing healthcare and excessively long provider wait times. While scholars and journalists have identified economic factors driving physician migration, our study analyzes the effects of spatial stigma within the broader context of coloniality as unexamined dimensions of physician loss. Drawing on 50 semi-structured interviews with physicians throughout PR and the US, we identified how stigmatizing meanings are attached to PR, its people, and its biomedical system, often incorporating colonial notions of the island's presumed backwardness, lagging medical technology, and lack of cutting-edge career opportunities. We conclude that in addition to economically motivated policies, efforts to curb physician migration should also address globally circulating ideas about PR, acknowledge their roots in coloniality, and valorize local responses to the crisis that are in danger of being lost to history.
Med Anthropol Q
· 2024 Jun · PMID 38630020
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After the legalization of abortion in 2018, Ireland needed clinicians to become abortion providers and make this political win a medical reality. Yet Irish doctors had next-to-no training in abortion care, and barriers r...After the legalization of abortion in 2018, Ireland needed clinicians to become abortion providers and make this political win a medical reality. Yet Irish doctors had next-to-no training in abortion care, and barriers ranging from stigma to economic pressures in the healthcare system impacted doctors' desire to volunteer. How did hundreds of Irish doctors make the shift from family doctor to abortion provider? Drawing on ethnographic research conducted between 2017 and 2020, this article explores the process by which Irish general practitioners became abortion providers, attending to the material impact of medical technologies on that journey. Drawing from medical anthropologists who have examined similar themes of agency, pharmaceuticals, and medico-legal frameworks within the topic of assisted dying, I build on Anita Hannig's idea of "agentive displacement" to frame the productive impact of abortion pills on this transition.
Med Anthropol Q
· 2024 Jun · PMID 38626350
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What does it mean that hospitals in Haiti have become widespread sites of "kidnapping" for mothers and babies? In at least 46 countries, including Haiti, indebted patients are extralegally held prisoner in hospitals unti...What does it mean that hospitals in Haiti have become widespread sites of "kidnapping" for mothers and babies? In at least 46 countries, including Haiti, indebted patients are extralegally held prisoner in hospitals until family members, kin, outside groups, or charities pay their outstanding bills. The majority of those detained globally are women following complicated births. This article introduces and situates the global problem of "hospital detention" as it is practiced in Haiti, tying it to transnational architectures that target Black reproduction in global health. In this piece, Senisha and Mari share their experiences of detention, revealing the practice as continuous with other forms of coercion, neglect, and violence they face in seeking safe births, and highlighting the communal care, refusals, and acts of self-liberation that oppose these oppressions.
Med Anthropol Q
· 2024 Jun · PMID 38416990
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The COVID-19 pandemic prompted critical attention to the performative power of metrics. We suggest that the existential capacities of metrics as a means of pandemic living warrant further consideration. We describe how t...The COVID-19 pandemic prompted critical attention to the performative power of metrics. We suggest that the existential capacities of metrics as a means of pandemic living warrant further consideration. We describe how the COVID-19 pandemic that came into existence as a public health and political event could only have occurred because of the anticipatory metrical practices that were used to transform SARS-COV-2 into a matter of global health concern. By exploring the affective potencies of COVID-19 metrics we show their abilities to engage the public in ways that cannot be contained; in detailing the narrative arcs created through metrics we show their opportunities, misdirections, and erasures. A pandemic way of life persists: a pandemic of metrics.
Med Anthropol Q
· 2024 Jun · PMID 38386863
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The COVID-19 pandemic has prompted a re-examination of public health preparedness with an emphasis on lessons learned following the West African Ebola epidemic. However, much of this work focuses on technological solutio...The COVID-19 pandemic has prompted a re-examination of public health preparedness with an emphasis on lessons learned following the West African Ebola epidemic. However, much of this work focuses on technological solutions rather than social learning. Drawing upon anthropological work, this paper examines how Sierra Leoneans prepared for COVID-19 through a lens of "embodied epidemic memory." Findings reveal that while people felt more empowered to respond to COVID-19 due to their past experiences, traumatic memories from the Ebola outbreak also sparked logics of fear and avoidance, driven by mistrust toward the state and its healthcare system. As a result, people avoided healthcare facilities, and rumors concerning government corruption threatened mitigation efforts. While local populations should be better leveraged for their existing epidemic expertise, greater attention is needed to the "higher hanging fruit" of preparedness: restoring trust in the government's ability to respond to epidemics.
Med Anthropol Q
· 2024 Jun · PMID 38373155
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In the contemporary American political landscape, gerrymandering and the passage of anti-abortion legislation are intimately connected in what I call reproductive gerrymandering. I develop this concept as an analytic too...In the contemporary American political landscape, gerrymandering and the passage of anti-abortion legislation are intimately connected in what I call reproductive gerrymandering. I develop this concept as an analytic tool to understand the disjuncture between the passage of laws restricting reproductive healthcare access and the will of the majority of voters. In this ethnographic project, Ohio serves as an important case study where efforts to elect a supermajority of extremist anti-abortion Republican officials has allowed for the passage of unpopular legislation restricting abortion. I argue that the mundane bureaucratic processes involved in electoral redistricting and state budget procedures are forms of bureaucratic violence that result in structural harm experienced by pregnant people, especially those who are most marginalized. Reproductive gerrymandering provides a means for theorizing the connections across domains involving partisan redistricting, reproductive governance in the form of anti-abortion legislation, and the structural violence experienced by pregnant people seeking abortion.
Med Anthropol Q
· 2024 Dec · PMID 38285808
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This paper explores how Brazilian Black queer women's sensorial knowing expresses the ways that anti-Blackness and anti-queerness are experienced within Brazilian gynecological spaces. I show how Black queer forms of sen...This paper explores how Brazilian Black queer women's sensorial knowing expresses the ways that anti-Blackness and anti-queerness are experienced within Brazilian gynecological spaces. I show how Black queer forms of sensory representations signal the intimacy of occupying place and time in power relations. What does it mean to feel, touch, and see the mechanisms of prejudice and institutional power? What are the sounds and vibrations of racism and heteronormativity in medicine? What do the senses tell us about Black queer bodies' orientations and adverse reactions within those spaces? I engage the senses to understand how sensorial knowledge is keenly embedded in the evidence and informs how Black queer life is shaped within the quotidian. I discuss how sensorial experiences for the critical possibilities of conceptualizing sensoriality and social meanings of medical space and place and in relation to the material world of gynecology and its technologies.
Med Anthropol Q
· 2024 Mar · PMID 38112051
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At the only standalone pediatric hospital in Zambia, patient wellbeing often rests in the hands of bedsiders. Bedsiders are caregivers, often family, who sit at the patient's bedside, feeding, cleaning them, and running...At the only standalone pediatric hospital in Zambia, patient wellbeing often rests in the hands of bedsiders. Bedsiders are caregivers, often family, who sit at the patient's bedside, feeding, cleaning them, and running medical errands. Bedsiders are critical human infrastructure for the hospital and its staff. In our research, we heard repeatedly that bedsiders must have a "heart" for caregiving, taking on unremunerated and exhausting informal labor. We draw on Wendland's "heart for the work," a phrase commonly used among healthcare workers in Malawi and Zambia describing the medical profession, to explore what this metaphor reveals about care.
Med Anthropol Q
· 2024 Dec · PMID 38010275
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This article analyzes 40 years of Black feminist scholarship, art, and grassroots activism dedicated to the lives and legacies of the "foremothers of American gynecology." Infamously, in Montgomery, Alabama, between 1845...This article analyzes 40 years of Black feminist scholarship, art, and grassroots activism dedicated to the lives and legacies of the "foremothers of American gynecology." Infamously, in Montgomery, Alabama, between 1845 and 1849, up to 16 enslaved women were exploited at a backyard hospital, some subjected to surgical experimentation by Dr James Marion Sims. He was a famous and world-renowned surgeon who died in 1883, with a reputation as "the father of modern gynecology." Sims achieved the medical knowledge that catapulted him into American and European fame, using skills gained from the exploitation of the enslaved women in his early career. Famously, three of these women are referenced by their first names: Anarcha, Lucy, and Betsey. This research asks: how have these important figures been remembered in 20th and 21st-century Black feminist scholarship, art, and grassroots community activism? Further, what are the broader impacts of this pathbreaking truth, reckoning, and reconciliation work?
Jephcott FL, Wood JLN, Cunningham AA
… +4 more, Bonney JHK, Nyarko-Ameyaw S, Maier U, Geissler PW
Med Anthropol Q
· 2024 Mar · PMID 37948592
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Over the last 30 years, there has been significant investment in research and infrastructure aimed at mitigating the threat of newly emerging infectious diseases (NEID). Core epidemiological processes, such as outbreak i...Over the last 30 years, there has been significant investment in research and infrastructure aimed at mitigating the threat of newly emerging infectious diseases (NEID). Core epidemiological processes, such as outbreak investigations, however, have received little attention and have proceeded largely unchecked and unimproved. Using ethnographic material from an investigation into a cryptic encephalitis outbreak in the Brong-Ahafo Region of Ghana in 2010-2013, in this paper we trace processes of hypothesis building and their relationship to the organizational structures of the response. We demonstrate how commonly recurring features of NEID investigations produce selective pressures in hypothesis building that favor iterations of pre-existing "exciting" hypotheses and inhibit the pursuit of alternative hypotheses, regardless of relative likelihood. These findings contribute to the growing anthropological and science and technology studies (STS) literature on the epistemic communities that coalesce around suspected NEID outbreaks and highlight an urgent need for greater scrutiny of core epidemiological processes.
Med Anthropol Q
· 2024 Dec · PMID 37874945
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In the context of a steadily decreasing Indigenous population, active military occupation, and a documented history of human rights abuses perpetrated by Indonesian state security forces, Black Indigenous Papuans have ut...In the context of a steadily decreasing Indigenous population, active military occupation, and a documented history of human rights abuses perpetrated by Indonesian state security forces, Black Indigenous Papuans have uttered phrases like extinction, and we will be gone in public and private spaces. These utterances often follow an indictment of Indonesia's national family planning program as a key node of state apparatuses of domination and, by extension, genocide. Amid Indonesia's global health success story of a historically lauded national family planning model, I examine the emergence of a local pronatalist program in which health workers are both providers and deniers of access to birth control. Through highlighting this story of Indigenous refusal and racial survival in the terrain of women's reproduction the stakes of a necropolitical environment marked by occupation, population control, and fears of genocide are brought into high relief.
Med Anthropol Q
· 2024 Mar · PMID 37853528
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In this paper we use quantitative and qualitative methods to examine how death investigations in Los Angeles County jails disproportionately naturalize death among Black and Latino incarcerated people. Our study is based...In this paper we use quantitative and qualitative methods to examine how death investigations in Los Angeles County jails disproportionately naturalize death among Black and Latino incarcerated people. Our study is based on an assessment of 58 autopsies, coroner investigator narratives, and toxicology reports produced between 2009 and 2018. We found that the Medical Examiner frequently arrived at natural or undetermined death determinations that minimized the culpability of carceral staff for loss of life that occurred within county jail. In our dataset, Black people were disproportionately classified as natural. Undetermined deaths were almost exclusively Latino. More than 75% of the cases in our study were deaths that occurred before standing trial. Our findings reveal how biomedical knowledge about incarcerated Black and Latino people is used to erase the life-diminishing effects of punishment, neglect, and maltreatment that are central to the project of mass incarceration.
Med Anthropol Q
· 2024 Mar · PMID 37853527
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Chronic kidney disease of non-traditional cause (CKDnt) is commonly associated with monocropping agriculture, heat stress and impoverished working conditions, referred to as CKDnt "hotspots." The condition is also emergi...Chronic kidney disease of non-traditional cause (CKDnt) is commonly associated with monocropping agriculture, heat stress and impoverished working conditions, referred to as CKDnt "hotspots." The condition is also emerging in various sites of environmental contamination, raising questions as to whether multiple variants of the condition exist as a result of different ecologies and different human-environment interactions. This paper examines the emergence of CKDnt around Lake Chapala in Mexico, where we document local efforts to gain recognition and reparation for CKDnt. We follow the ways patients, families and activists have mobilized specific and interlocking infrastructural failures to enact complaint and confront state inaction and neglect of their bodies, communities, and environments. Though their labors have formally achieved little, we discuss how they make visible a biopolitics of indifference, one bound to the production of structural "blindspots."