Med Anthropol Q
· 2021 Dec · PMID 35066931
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This article presents ethnographic research with in situ seed savers and seed activists in London. Unpicking the knotty relations between kinship, place, and generation among seed savers and their seeds, this article foc...This article presents ethnographic research with in situ seed savers and seed activists in London. Unpicking the knotty relations between kinship, place, and generation among seed savers and their seeds, this article focuses on how the intrinsic and extrinsic get woven through generations and how the situ or environment of an entity is (and is not) recognized in its identity and multispecies kin relations. I argue that thinking about seeds and the worlds in which they grow suggests that they are not only embedded in their environments, but also embody their environments. If seeds bring with them their worlds, then they are inherently malleable, so seed savers are concerned about how commercial seed breeding and ex situ conservation denatures seeds' embodied relationships with their environments and, with that, their inherent intergenerational malleability. [seed saving, multispecies kinship, generation, environment].
Med Anthropol Q
· 2021 Dec · PMID 35066930
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Microbiome science considers human beings supraorganisms: single ecological units made up of symbiotic assemblages of human cells and microorganisms. Microbes co-evolve with humans, and microbial populations in human bod...Microbiome science considers human beings supraorganisms: single ecological units made up of symbiotic assemblages of human cells and microorganisms. Microbes co-evolve with humans, and microbial populations in human bodies are determined by environments/exposures including family, food and place, health care, race and gender inequities, and toxic pollution. Microbiomes are transgenerational links, disarrangements between different bodies and the outside world. This article asserts that microbes are kin-kin that are made of and making environments, across generations. Post/nonhuman theories have debated the agency, sociality, and ontologies of microbes and things like microbes, all the while appropriating and eliding Indigenous scholarship that directly address the nonhuman world. Microbial kin evokes Indigenous formulations that necessitate reciprocal, ethical accountability to more-than-human relations. This article uses fieldwork in a transnational microbiome malnutrition project in Bangladesh to explore what develops for both the biological and social sciences if we call human-microbe relations kinships, and call microbes our kin.
Med Anthropol Q
· 2021 Dec · PMID 35066927
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Situated alongside and drawing from emerging inquiry, debate, and reflection about making and unmaking kin at a moment of critical reflection on racial, social, and reproductive inequities and changing environments, this...Situated alongside and drawing from emerging inquiry, debate, and reflection about making and unmaking kin at a moment of critical reflection on racial, social, and reproductive inequities and changing environments, this special edition considers how anthropology can ethnographically examine and engage with intergenerational dynamics as they influence different scales and spheres of life. It brings together medical anthropologists and science and technology scholars conducting research in Bangladesh, China, the United Kingdom, South Africa, and the United States as they reflect on the un/making of kin in settings of expert knowledge production and dissemination, including practices of seed collecting, epigenetic science, birth cohort studies, social policy generation, and clinical trials. Contributors to this special issue consider how intergenerational relations and modes of transmission take form in and through biosocial research-both as an object of study and a method of analysis. [intergenerational, environmental change, kinship, biosocial].
Med Anthropol Q
· 2021 Dec · PMID 35066926
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Environmental epigenetics has become a site of growing attention related to the intergenerational effects of stress, trauma, and adversity. This article draws on a multi-sited ethnography of epigenetic knowledge producti...Environmental epigenetics has become a site of growing attention related to the intergenerational effects of stress, trauma, and adversity. This article draws on a multi-sited ethnography of epigenetic knowledge production in the United States and Canada to document how scientists conceptualize, model, and measure these experiences and their effects on children's neurodevelopmental and behavioral health. We find that scientists' efforts to identify the molecular effects of stress, trauma, and adversity results in a temporal focus on the mother-child dyad during early life. This has the effect of biologizing early childhood adversity, positioning it as a consequence of caregiving, and producing epigenetic findings that often align with individually oriented interventions rather than social and structural change. Our analysis suggests that epigenetic models of stress, trauma, and adversity therefore situate histories of oppression, inequality, and subjugation in discrete and gendered family relations, resulting in the temporal embedding of adversity during early life.
Trainer S, SturtzSreetharan C, Wutich A
… +2 more, Brewis A, Hardin J
Med Anthropol Q
· 2022 Mar · PMID 35051296
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Norms valorizing not-fat bodies appear to have spread around the world, combined with a globalizing belief that thinness is the result of individual management of self and hard work. We examine themes of blame and felt r...Norms valorizing not-fat bodies appear to have spread around the world, combined with a globalizing belief that thinness is the result of individual management of self and hard work. We examine themes of blame and felt responsibility for weight and "fat" in four distinct geographic and cultural locations: peri-urban Georgia, United States; suburban Osaka, Japan; urban Encarnación, Paraguay; and urban Apia, Samoa. Use of a novel metatheme approach that compares and contrasts these four distinct places characterized by different population-level prevalences of obesity and by specific cultural histories relevant to body norms and ideals provides a flexible toolkit for comparative cross-cultural/multi-sited ethnographic research. We show that self-blame, marked by an articulated sense of individual responsibility for weight and a sense of failing in this responsibility, is present in every field site, but to varying degrees and expressed in different ways. [fat, obesity, metatheme, stigma, self-blame].
Med Anthropol Q
· 2022 Mar · PMID 35038347
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This article contributes to anthropological debates surrounding borderlands and biosecurity by tracing the multiple pursuits of protection that emerge between the state and minorities during infectious disease outbreaks....This article contributes to anthropological debates surrounding borderlands and biosecurity by tracing the multiple pursuits of protection that emerge between the state and minorities during infectious disease outbreaks. Drawing on an ethnographic study of child health in Jerusalem following epidemics of measles and COVID-19, the article demonstrates how responses to public health interventions are less about compliance or indiscipline than a competing pursuit of immunity to preserve religious lifeworlds. The voices of Orthodox Jews are situated alongside printed broadsides that circulated anonymous truth-claims in Jerusalem neighborhoods. These broadsides cast state intervention against historical narratives of deception and ethical failures. Borderland tensions, like a virus, mutate and influence responses to authority and biosecurity, and they reconfigure vernacular entanglements of religion, state, and health. The article encourages anthropologists to consider responses to public health interventions and non-vaccination beyond a COVID-19 silo, as part of situated relations between states and minority populations.
Med Anthropol Q
· 2022 Sep · PMID 35029315
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Adolescents living with perinatally acquired HIV are among the first generation in South Africa to grow up with anti-retroviral therapy and democratic freedoms. In this article, we explore the biosocial lives of adolesce...Adolescents living with perinatally acquired HIV are among the first generation in South Africa to grow up with anti-retroviral therapy and democratic freedoms. In this article, we explore the biosocial lives of adolescent boys and young men living with HIV in the Eastern Cape Province of South Africa. We conducted qualitative research with 36 adolescent boys and young men in 2016-2018, including life history narratives, semi-structured interviews, and analysis of health facility files. [masculinity, South Africa, HIV, adolescence].
Med Anthropol Q
· 2021 Dec · PMID 35023589
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Since 2013, we have studied the logic and narratives of an environmental epigenetics research team that studies the correlations between early childhood adversity (ECA), specific biomarkers, and suicide risk. Within this...Since 2013, we have studied the logic and narratives of an environmental epigenetics research team that studies the correlations between early childhood adversity (ECA), specific biomarkers, and suicide risk. Within this research program, kin of the deceased participate in psychological autopsies, which researchers use to establish to classify the deceased within a typology of suicide with or without abuse. We focus on the words of these family respondents and their reflections on the life and death of their loved ones, and life after that death, to consider the slippery, transgressive, and relational character of trauma and its effects. Studies of the residues of past experiences provide crucial insights into the complex, unpredictable, and unsettled nature of kin relations. These relations are based in entwined biographies of the living and the dead and illustrate the holds that people have on each other and destabilize biomedical models of individualized trajectories of suicide risk. [suicide, psychological autopsies, trauma, care, kinship].
Med Anthropol Q
· 2022 Mar · PMID 34813120
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Irritable bowel syndrome (IBS) is a health challenge in Denmark, especially among young and middle-aged people. It raises questions about control, alienation, responsiveness, and responsibility in relation to the body in...Irritable bowel syndrome (IBS) is a health challenge in Denmark, especially among young and middle-aged people. It raises questions about control, alienation, responsiveness, and responsibility in relation to the body in welfare societies. Based on long-term ethnographic fieldwork, this article explores how young and middle-aged Danes diagnosed with IBS inhabit and relate to their bodies. Previous studies have described how IBS patients experience their bodies to be unreliable, unpredictable, and embarrassing. Drawing on phenomenological explorations of bodily alterity, we argue that the gut transforms into "an other" for the afflicted. It is involved in a restless process in which it sometimes emerges as "me," sometimes as "not-me," and sometimes as "not-not-me." People attempt to theorize and control their gut trouble, yet it continuously escapes their grasp. How do people live with and care for such an alienness-within? Does an IBS diagnosis make bodies feel more or less alien?
Med Anthropol Q
· 2022 Mar · PMID 34762750
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Since the early 2000s, Turkey has been going through a dynamic period of health reforms where the global push toward health statistics has converged with the state's pronatalist concerns over declining birth rates. Repro...Since the early 2000s, Turkey has been going through a dynamic period of health reforms where the global push toward health statistics has converged with the state's pronatalist concerns over declining birth rates. Reproductive behaviors are now monitored via health information technologies such as centralized databases. The World Health Organization and the Turkish Ministry of Health celebrate these technologies as essential steps toward evidence-based health care delivery. The everyday realities of these technologies, however, are more complicated, especially for nurses and their patients. Drawing on ethnographic fieldwork in state-run health clinics in Istanbul, this article demonstrates how these data-driven health technologies build on nurses' gendered care labor and increase surveillance on urban poor and/or ethnoracially minoritized communities. In doing so, I argue that the datafication of reproduction operates as a particular mode of "reproductive governance" (Morgan and Roberts 2012) that reflects and reproduces existing social hierarchies and inequalities.
Hanssmann C, Shim JK, Yen IH
… +5 more, Fleming MD, Van Natta M, Thompson-Lastad A, Rasidjan MP, Burke NJ
Med Anthropol Q
· 2022 Mar · PMID 34762740
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As medicine integrates social and structural determinants into health care, some health workers redefine housing as medical treatment. This article discusses how health workers in two U.S. urban safety-net hospitals work...As medicine integrates social and structural determinants into health care, some health workers redefine housing as medical treatment. This article discusses how health workers in two U.S. urban safety-net hospitals worked with patients without stable housing. We observed ethnographically how health workers helped patients seek housing in a sharply stratified housing economy. Analyzing in-depth interviews and observations, we show how health workers: (1) understood housing as health care and navigated limits of individual care in a structurally produced housing crisis; and (2) developed and enacted practices of biomedical and sociopolitical stabilization, including eligibilizing and data-tracking work. We discuss how health workers bridged individually focused techniques of clinical care with structural critiques of stratified housing economies despite contradictions in this approach. Finally, we analyze the implications of providers' extension of medical stabilization into social, economic, and political realms, even as they remained caught in the structural dynamics they sought to address.
Med Anthropol Q
· 2022 Mar · PMID 34743374
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This article takes a case study approach to the predominance of Pentecostalism, a Christian movement emphasizing conversion and testimony to divine grace, among patients at Sommeil Psychiatric Hospital in Yaoundé, Republ...This article takes a case study approach to the predominance of Pentecostalism, a Christian movement emphasizing conversion and testimony to divine grace, among patients at Sommeil Psychiatric Hospital in Yaoundé, Republic of Cameroon. I argue that certain patients' desire to serve as témoignage (French) or "testimony" (English) to life before and after Sommeil-to the efficacy of biomedical psychiatry-indicates a pattern in which patients drew on their Pentecostal affiliation to navigate psychiatric treatment. Grounded in 24 months of fieldwork with patients and families and hospital staff, I contend that patient experiences of treatment imperfectly paralleled prior and ongoing experiences of Pentecostalism, including cultivation of the desire to convert and testify. Taking this cultivation of desire as a form of subject-making, I conceptualize the entanglement of religious and therapeutic subjectivities at Sommeil as a patient-driven "Pentecostalization" of psychiatry, which offers patients plural possibilities and timeframes of health.
Med Anthropol Q
· 2022 Mar · PMID 34661308
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Mental illness approaches in public health have resulted in controversies around the adequacy of interpretative and therapeutic models. These controversies engage polarized debates amid understandings of mental illnesses...Mental illness approaches in public health have resulted in controversies around the adequacy of interpretative and therapeutic models. These controversies engage polarized debates amid understandings of mental illnesses either as brain disorders or as socioculturally determined entities. Aiming to investigate how mental health care is implemented in a Latin American metropolis, we conducted an ethnographic study of the approach to depression in a primary care unit in Rio de Janeiro between 2016 and 2017. "Life" emerged from our fieldwork as the main local category for understanding the experiences of patients with depressive symptoms and the work of reengagement performed by family physicians. With this investigation, we seek to provide insights into an approach to mental illness in primary health care that moves away from polarized interpretive frameworks and remains open to the singularities of patients' experiences of suffering.
Med Anthropol Q
· 2022 Mar · PMID 34350615
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Shortly after losing her health insurance in 2018, Jane Robinson died of a treatable respiratory infection. This article argues that Jane's death occurred at the nexus of two different approaches to care: the necropoliti...Shortly after losing her health insurance in 2018, Jane Robinson died of a treatable respiratory infection. This article argues that Jane's death occurred at the nexus of two different approaches to care: the necropolitics of uncare and the micropolitics of generative care labor. Both of these approaches to care increased Jane's health and social vulnerability, in turn quickening her death. We adopt the necropolitics of uncare framework to identify and name the harmful policies and attitudes of disregard that control access to life saving medical care. In the micropolitics of care in Jane's life, she became the safety net for others, which left little over when her health began to deteriorate. This social autopsy reveals that her care networks were insufficient to undo the uncare enshrined in state policy. Jane's unnecessary death foreshadowed the excess mortality that the United States has experienced from COVID-19.
This article examines how staff and patients worked to reconcile the rhythms of the body with those of gender-normative health care bureaucracy in a U.S. Midwest gender-affirming health clinic. Drawing from observations...This article examines how staff and patients worked to reconcile the rhythms of the body with those of gender-normative health care bureaucracy in a U.S. Midwest gender-affirming health clinic. Drawing from observations of clinical appointments and routine bureaucratic practice, as well as debriefing interviews with transgender and gender-expansive patients, this article applies Laura Bear's theory of "time-maps" and a new materialist approach to bodily agency that recognizes the variability of the body's responses to gender-affirming health care. This evidence demonstrates how health care staff and patients' labor practices structured patients' abilities to embody their plans for medical transition. Anticipating the varied trajectories bodies take during medical transition can interrupt the reproduction of harmful cultural assumptions about sex difference in U.S. health care bureaucracy.
The decolonization framework in medical anthropology is slowly reframing tropes of cultural competency toward decolonizing health care. For decolonization of health care to occur, both colonial histories and continuing p...The decolonization framework in medical anthropology is slowly reframing tropes of cultural competency toward decolonizing health care. For decolonization of health care to occur, both colonial histories and continuing postcolonial inequities must be recognized from the first diagnostic moment. We report on qualitative research into the role of culture, history, and family experience in person-specific reactions to receipt of a diagnosis. A collaborative approach at an urban inter-tribal clinic was used to interview patients with a recent (within six months) diagnosis of diabetes or related condition. Interviews revealed ways that the Relocation Act eventuated in isolation, poverty, and diabetes among now-urban Native Americans. We discuss how patients may or may not have the ability to (re)connect with their heritage and may simultaneously perceive only recent family contexts as influential in their diabetes. We conclude by acknowledging how postcolonial harms are not captured in diagnoses but should not be left out of diagnostic discussions.
This article explores how incurable cancer patients in the affluent Danish welfare state are recruited to clinical trials. We show that patients' impending death constitutes their potential for being configured as resear...This article explores how incurable cancer patients in the affluent Danish welfare state are recruited to clinical trials. We show that patients' impending death constitutes their potential for being configured as research subjects. To produce valuable data, patients who enroll in trials and health care professionals must engage in daily "time practices" that prolong the threshold between life and death. When death becomes inevitable, the limit of configuring dying cancer patients as research subjects is reached. Navigating this temporal logic, health care professionals balance the boundary between patients' instrumental worth as research subjects and their intrinsic worth as dying cancer patients. Whereas previous studies have critically uncovered how clinical trials operate at socioeconomic margins, we point to the ways in which clinical trials operate through temporal margins. We argue that clinical trials are dependent on configuring marginal societal spaces and marginal bodies from which to produce knowledge.