Critical epidemiology in action: Research for and by indigenous peoples

Global social justice movements, including transnational activism for indigenous rights, are working to promote health equity by transforming public health research and policy. Yet little social scientific research has examined how professional epidemiologists are figuring within such efforts. Discussions are unfolding, however, in critical sectors of epidemiology about how to improve the profession’s input into advocacy. Findings from a multi-sited ethnographic study of epidemiological research for and by indigenous peoples in three settings (Aotearoa/New Zealand, the continental U.S., and Hawai’i) demonstrate how researchers/practitioners connect epidemiology and advocacy by: (1) linking the better-known legitimacy of quantitative methods to a lesser-known causal framework that positions colonialism as a sociopolitical determinant of health, (2) producing technical critiques that aim to improve the accuracy and accessibility of indigenous population health statistics, and (3) adopting a pragmatic flexibility in response to the shifting political conditions that shape when, whether and how epidemiological findings support advocacy for indigenous health equity. Attending closely to the credibility tactics at hand in this work, and to the skills and sensibilities of its practitioners, charts new directions for future research about epidemiology’s contributions to advocacy for health equity

Between 'desperation' and disability rights: a narrative analysis of complementary/alternative medicine use by parents for children with Down syndrome

This paper presents a narrative analysis of complementary/alternative medicine (CAM) use by parents for children with Down syndrome (DS), based on interviews conducted with thirty families. Critics often presume that CAM use for children with developmental disabilities reflects parental desperation in the face of limited biomedical options. Integrating insights from anthropological studies of CAM with narrative analyses in disability studies, we constructively complicate this interpretation in two ways. First, we suggest that the appeal of CAM may lie in its discursive consonance with the broader narrative strategies through which parents construct alternatives to conventional definitions of DS as a condition with a fixed, universal, and essentially pathological course. Second, we submit that the process of seeking and evaluating information about CAM is consonant with how parents construct their identities as 'good' parents through describing their roles as committed advocates and service coordinators for their children. In these ways, CAM can be conceptualized as a new discursive resource that parents engage in their culturally and historically specific efforts to articulate the essential human rights of their children, and to assert the moral soundness of their own parenthood. These findings provide a new conceptualization of parents' motives for choosing CAM, thereby posing new questions for further research about CAM use for developmental disabilities.Complementary/alternative medicine Down syndrome Narrative analysis Disability studies Consumerism USA

Making Better Numbers through Bioethnographic Collaboration

In this article, I describe my ongoing bioethnographic collaboration with a multidisciplinary team of exposure scientists in environmental engineering and health. First, I explain how and why integrating ethnography and number‐based disciplines is such a complex, time‐consuming, and worthwhile process, when ethnography produces a kind of excessive “big data” that is not easily enumerated. Then I describe three of our current bioethnographic projects that seek to make better numbers about how (1) neighborhoods, (2) water distribution, and (3) employment and chemical exposures shape bodily processes in a highly unequal world. To conclude, I reflect on how we might harness ethnographic excess for making better numbers and thus better knowledge, and also how bioethnographic collaboration inevitably transforms ethnography even as we insist on its excess. [collaboration, methodology, ethnography, big data, biomedical science]RESUMENEn este artículo, describo mi colaboración bioetnográfica en curso con un equipo multidisciplinario de científicos sobre exposición en ingeniera ambiental y salud. Primero, explico cómo y por qué el integrar etnografía y disciplinas basadas en números es un proceso tan complejo, consumidor de tiempo y útil, cuando la etnografía produce una clase de “big data” excesiva que no es enumerada fácilmente. Luego describo tres de nuestros proyectos bioetnográficos actuales que buscan hacer mejores números acerca de cómo (1) vecindarios, (2) distribución de agua, y (3) empleo y exposiciones químicas impactan los procesos corporales en un mundo altamente desigual. Para concluir, reflexiono sobre cómo podríamos aprovechar el exceso etnográfico para hacer mejores números y así un mejor conocimiento, y también cómo la colaboración bioetnográfica transforma inevitablemente la etnografía aun cuando insistimos en su exceso. [colaboración, metodología, etnografía, big data, ciencia biomédica]Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/168432/1/aman13560.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/168432/2/aman13560_am.pd