In anthropology departments across the country, food systems courses are becoming increasingly prevalent. Their rapid growth makes sense, because there is significant overlap between the study of food systems and traditional areas of anthropological inquiry, such as food security, the anthropology of nutrition, and ethnobotany. Yet, despite anthropologists’ attention to cultural politics, food systems education is still open to the same long-standing critiques of the alternative food movement. As critical food scholars point out, the alternative food movement is characterized by an “unbearable whiteness,” where its agrarian ideals, such as the importance of “getting your hands dirty,” reflect whitened cultural histories and ultimately produce racialized spaces of social exclusion. Anthropologists are increasingly seeking to address these apprehensions by integrating critical perspectives into their food system pedagogies. In this commentary, I discuss an alternate pedagogical framework, known as critical food systems education (CFSE), through which anthropologists can potentially redress these concerns.
CFSE is at once a theoretical perspective, set of pedagogies, and vision for policy (Meek and Tarlau 2015, 2016). By drawing upon this perspective, we are called to critically reflect on what kind of community projects our courses are supporting. Are these projects similar to many in the alternative food movement that are motivated by an honest desire to “bring good food to others,” but end up reproducing racialized conceptions of communities of color as defined by poor food choices? Or do they seek to help develop students who have the mobilizing skills and critical consciousness needed to transform the food system? In redesigning my own courses, I’m striving to connect classroom pedagogy with the actual movements that are attempting to transform the food system.
The first time I taught a course I developed called “The Politics of Food Sovereignty and Society” in a traditional setting, it was at times disappointing. The discussions were lively, but student evaluations highlighted their desire to get out into the community and connect critical theory with praxis. I committed to transforming this course and applied to the University of Alabama Faculty Fellows in Service Learning Program to gain specialized training and for a Learning in Action grant to carry out this change. In redesigning the course around CFSE, I started with what community members identified as the pressing needs of marginalized groups. I developed a partnership with the Sand Mountain Seed Bank (SMSB) in Albertville, Alabama, which is trying to preserve heirloom seed varieties throughout the Southeast. The SMSB was just beginning the process of creating a digital inventory of its seed stock. My students spent approximately fifty hours entering seed records into the online database, helping the SMSB move towards its goal of making the seed library publicly accessible.
One of critical food systems education distinguishing features is that it seeks to advance food sovereignty. As part of the 2007 Declaration of Nyéléni, La Via Campesina, an international federation of rural social movements, defines food sovereignty as “the right of peoples to healthy and culturally appropriate food produced through ecologically sound and sustainable methods, and their right to define their own food and agriculture systems.” Throughout the course, my students struggled to connect with the idea of food sovereignty. For many, it seemed like a concept from a different reality—one from the Global South, from countries where people still identify as peasants and where access to land is key to survival.
Through the service-learning project, students gained a first-hand understanding of food sovereignty. They first watched the documentary film Eating Alabama and learned about the complex dynamics of agrarian change in the state—from the loss of family farms to Monsanto’s litigation against farmers who save seed. They then came upon a critical realization while digitally entering the seed records into the online database—many of the seeds had not been grown in approximately ten years, the period after which the seeds may be unviable. Their work creating a digital inventory of the seeds might be worthless if no one grew the seeds before the ten-year period passed.
We reflected on this realization as a class and collectively decided that we could move our class project beyond simple data entry and towards creative action. We organized a seed swap as a way to generate awareness about the SMSB situation and get area farmers, gardeners, and horticultural enthusiasts to help grow and preserve the seeds. On Saturday, April 23rd, my students and I hosted the first West Alabama Seed Swap at the Tuscaloosa River Market. The event included speakers on food sovereignty and food ways, as well as the dissemination of seeds from the SMSB to the interested public. Following the seed swap, Charlotte Haygood, one of the driving forces behind the SMSB, described the event to me as a widely successful, because “many folks came up, made connections, exchanged information, and took home seeds.”
I found teaching a course grounded in critical food systems education to be an incredible learning experience. As part of a collective course evaluation at the end of the semester, students highlighted how valuable it would be in the future to experience first-hand competing forms of productions—such as a large-scale agroindustrial monocrop operations and small-scale organic farms. Similar to Guthman’s experiences, I also recognized that many of my students truly struggled with understanding the intersection of their white privilege with the food system. As I move forward in educating for food sovereignty, I will increasingly attune my pedagogy to the complicated terrain of racial and class-based identities and the structural relations between the local and global food system.
“Juana,” a Mexican immigrant who lives in Birmingham, Alabama, is a native of a small ranching village in Jalisco. Fifteen years ago, her husband lost his job in Mexico. They had no money saved, and she was scared for the safety of her children because of drug-related crime in their community there. Her husband convinced her that they needed to move to the U.S. where he could find work, they could get their kids in good schools, and they could have better lives. He went first, and, a little while later, Juana paid a “coyote” to take her across the border. After a month-long, treacherous journey, during which she was arrested and sent back, attacked by wild animals, left behind in the desert without food or water, and was constantly scared, she finally made it across the border and eventually to Alabama where her husband was living. He found steady work, and they sent for their three kids, who are now participants in the Deferred Action for Childhood Arrivals program. Juana and her family have achieved all the things they set out to achieve in moving to the U.S. Yet her health has suffered considerably, both physically and mentally. Unfortunately, this is not an uncommon experience for people like Juana.
The typical framework used to study what happens to individuals who developed in one sociocultural context when they attempt to live in another is called “acculturation.” In my work with Mexican immigrant women in Alabama, I’m trying to figure out what the acculturative process looks like and why typical measures of acculturation are associated with a dramatic decline in health outcomes, particularly diabetes and depressive symptoms. To understand how cultural meaning systems change and the effects of such meaning on human lives, we need to have a clear concept of what culture is, how it works, and ways to measure it. A cognitive definition of culture is a good place to start because it moves culture out of the realm of abstraction and allows for it to be measured in concrete terms. As Dressler point out in a previous post, culture is the information needed to think and behave appropriately in certain situations and to interpret the behavior of others correctly. This knowledge is encoded in overarching cultural models, which we draw on to structure our understanding of how we ought to live. Once we have an idea of what a cultural model looks like in a certain context, we can measure individuals against it and see how well they stack up. That stacking up is termed “cultural consonance“—the ability to live up to the shared cultural expectations of the group—and it affects health.
So, what’s going on with women like Juana? We know they tend to be in better health upon arrival than their U.S.-born counterparts, despite tremendous suffering before and during immigration. However, as they carry out their lives in the U.S.—even as their standard of living improves and they gain access to better health care—their health often gets worse. Researchers haven’t been able to explain the underlying cultural mechanism responsible for this. I’m interested in using cultural consonance as an intervening variable between measures of acculturation and health outcomes to determine if the pathway by which acculturation leads to declining health is, at least in part, in its effect on the ability to achieve a culturally valued lifestyle.
I focus on four cultural domains—lifestyle, family life, Mexican immigrant identity, and life goals. Using a technique called free listing, I asked my informants to list as many items as they could in response to these four questions:
What kinds of things are important or necessary to have a good life?
How would you describe a loving family?
What are the qualities or characteristics of Mexican immigrant women?
What are your goals in life? This gives me a glimpse into how cultural realities are changing in a new context
The next step is to understand what kinds of things go together and why as well as which items are most highly valued and sought after. This is analyzed using cultural consensus analysis, which measures the extent to which cultural knowledge is shared among informants and provides the best representation of how the collective thinks about a particular domain.
In general, people act in ways that correspond to cultural influences and expectations. I believe that, as Mexican immigrant women carry out their lives in the U.S., they internalize a new cultural model for how one ought to live, and, as they do this, their positions in the cultural landscape change. The further away they find themselves from living a collectively valued lifestyle in their new U.S. cultural context, the greater risk their risk for declining health. For Juana, adapting to a new culture has been difficult. For example, speaking Spanish in the home and celebrating Mexican traditions is very important to her, but she struggles to get her children to do this, which is a source of family discord. Another thing is that she is scared to drive, so she can’t get around easily and has lost her sense of independence.
Reasons for cultural dissonance among immigrants may range from economic constraints, structural or interpersonal violence and abuse, or lack of interest in engaging with a new culture. I hope to improve understanding what role culture plays in immigrant health outcomes as well as what social and institutional factors may limit the achievement of a culturally valued lifestyle. Such limitations may simply produce new stress that contributes to poor health outcomes.
Biocultural anthropology offers an inherently interdisciplinary, cross-subfield approach to anthropological research. As such, it draws heavily upon various biological, cognitive, and sociocultural theories, among others, to point researchers towards certain methodologies and variables for inclusion in their research design. The outcome of such an approach yields a growing genre of work that articulates the ways in which the human body, at every level, both shapes and is shaped by cultural practices. As one of the four major subfields of the discipline, linguistic anthropology also engages questions regarding bidirectional connections between culture and body. Such work emphasizes the ways in which embodied experience is constantly mediated by interactions that involve words, gestures, and prosodic features such as rhythm and emphasis.
Despite a shared interest in demonstrating links between culture and body, theoretical and methodological approaches within biocultural and linguistic anthropology have only rarely been actively combined. Besides a few outlying studies by, for example, Erica Cartmill, bioculturally oriented research has rarely engaged seriously with language as a multi-modal process shaped by and shaping embodiment. Researchers in linguistic anthropology have likewise, for the most part, chosen not to focus on the biological implications of complex, culturally mediated interactions.
From my current vantage point as a linguistic and psychocultural medical anthropologist working in a department with a strong biocultural program, I am beginning to question what researchers in each area might be missing out on when they choose not to include either linguistic or biocultural perspectives when they design their research. While I fully acknowledge that it is not always possible to do everything in every study, I would like to propose that the two fields are at a point where they could fruitfully be joined together more explicitly and consciously. This is both a methodological and theoretical endeavor.
Methodologically, for example, biocultural work draws upon methods such as cultural domain analysis (including cultural consensus analysis), and inclusion of biological outcomes, in addition to traditional long-term ethnography and interviews. From my perspective, there is ample room in such studies for incorporating additional methods from linguistic anthropology, such as audio and/or video recording and the use of conversation analysis to transcribe and interpret data. For biocultural anthropologists, such an approach can arguably increase the ‘grain’ of research, enabling scholars to track how difficult-to-operationalize concepts, such as “stress” or “belief,” emerge over time in interaction. Likewise, the inclusion of biocultural methods offers linguistic anthropologists an opportunity to study how conversations literally get under the skin.
The incorporation of additional methods alone, however, does not automatically lead to such enhanced results. Research seeking to combine biocultural and linguistic methods must thus be held together, at every level from research question to data analysis, by theory. Here, biocultural theories that recognize bidirectional links between large-scale sociocultural and economic processes and individual human biologies (e.g., Goodman and Leatherman 1998) are a good starting point. Even more relevant, perhaps, for scholars seeking to incorporate a linguistic anthropological perspective is the specific theoretical construct of cultural consonance, described here by Bill Dressler. As Dressler describes, cultural consonance theory pushes past generalized theories of “culture as context” to develop nuanced connections between cultural meanings and individual meanings, further linking such connections to individual biology. Although admittedly I am not yet an expert in this theory, it strikes me as an excellent opportunity to incorporate theories from linguistic anthropology that focus on the emergence of culture as an uneven process that occurs in specific interactions (see, for example, Duranti and Goodwin 1992 or Tedlock and Mannheim 1995). Some specific examples of areas where both the theories and methods of biocultural and linguistic anthropology might be productively combined include, then:
Research on illness and healing: Biocultural anthropologists have made significant contributions in demonstrating the link between cultural processes and health outcomes A lot of work is being done in this realm across anthropology. Some examples from our department include Oths 1999, Lynn 2014, Weaver et al 2015, Dressler et al 2016. At the same time, many linguistic anthropologists, often in collaboration with medical anthropologists, have drawn upon recordings of doctor-patient interactions, and the fine-grained analysis of conversations between suffering individuals and their families to demonstrate the role of micro-interaction in the experience of illness and healing. Future work combining approaches might examine how, for example, conversations with physicians or family members work to mediate stress and other biological outcomes.
Research on child development: Several biocultural anthropologists, including Carol Worthman and Jason DeCaro, have made great strides in demonstrating the ways in which cultural and social circumstances affecting children translate into lasting physiological characteristics. In linguistic anthropology, the field of language socialization observes the role of interaction between caregivers, children, and peers in shaping children as participants in culture, as well as speakers of language. Future research combining approaches offers the possibility of measuring the ways in which different kinds of interactions, over time, form the basis for how children become embodied participants in culture.
Research on emotion: Most subfields of anthropology have considered emotion in some way. Biocultural approaches to the emotions have challenged traditional divides between nature and nurture when it comes to emotional experience. Studies of emotion in linguistic anthropology, on the other hand, have shown that emotion, rather than being a product of individual or a simple reflection of culture upon individual, is a jointly produced phenomenon. Again, future collaborative research might demonstrate how the biology of emotion is similarly mediated by interactions with others.
I have listed just a few examples here. The list could go on. Whatever the specific research topic, however, it is important to reiterate that the combination of biocultural and linguistic anthropology is both a methodological and theoretical endeavor that has certain practical implications. While it would certainly be possible for individual biocultural researchers, for example, to stretch their work to incorporate video or audio recording and analytic theory from linguistic anthropology, this could easily become unwieldy without the participation of a researcher trained in linguistic anthropology. The reverse is also true. From this vantage point, it becomes incredibly important to think about managing the logistics of creating multidisciplinary research teams working with mixed methods. Tom Weisner has, in fact, written that “the future of our field and the social sciences is far more likely to be characterized by interdisciplinary methodological pluralism.” This blog post is obviously in agreement with this. As a linguistic anthropologist, I would just like to note that, at a practical level, this kind of work demands efforts at understanding one another’s language, and developing communicative strategies that serve the project. From my perspective, such strategies can serve to enrich rapport among colleagues, but also form the basis of an enhanced ability to conduct research that addresses pressing social issues in ways that can have a lasting and beneficial impact on human lives.
The relationship between social networks and health has been established in anthropology since Émile Durkheim identified a link between social isolation and suicide. Medical anthropologists have also long recognized that people with more diverse social ties and greater emotional and economic support are typically healthier, but how this association is intensified by culture remains under-explored. Specifically, how does “embeddedness” in a social network influence health and interact with internalized cultural beliefs?
Sociologist Mark Granovetter coined the term embeddedness to describe how social relations shape economic behavior and institutions. Douglas Massey later applied this idea to migration, pointing out that specific families, groups, and classes of people disproportionately gain access to movement via more diverse network ties and social relations. In other words, embeddedness in a migrant network entails status, prestige, or position, which may influence cultural success and well-being. Cultural success is determined by shared knowledge, such as migration goals and lifestyle expectations, which is cognitively embedded in people who then enact these cultural beliefs to varying degrees, depending on the level of power they derive from their position within a social network.
Chugurpampans Embedded in the Trujillo Migrant Network
I recently concluded two years of ethnographic fieldwork in Peru, amassing social network data for hundreds of people. My research involves a group of internal migrants from the hamlet of Chugurpampa in the north Peruvian Andes (pop. ~600), where my adviser, Kathy Oths, began longitudinal research of sickness and treatment choice over 25 years ago. While serving on a research team she assembled for a 2012 restudy of the village, we discovered that overwhelming economic and political pressures, coupled with effects of climate change on the highland agricultural system, have forced many Chugurpampans to pursue work in the coastal city of Trujillo.
Across Trujillo, Chugurpampans maintain a network of kinship and social ties, including a hometown association in which members develop collective financial and material resources for their hamlet. However, there is a rising middle-class within the group’s leadership, while less integrated Chugurpampans struggle to feed their families. Thus, some migrants are more successful than others in achieving shared migration goals and lifestyle expectations. My research focuses on whether one’s embeddedness within the migrant network influences their individual capacity to implement shared cultural expectations and how this impacts well-being.
The concept of embeddedness for this group is best illustrated during Chugurpampa’s annual harvest festival (‘fiesta patronal’), an agro-religious celebration in which migrants attempt to gain and reinforce their social status by making large material and financial donations. Each year, the hometown association selects an organizer known as a mayordomo, whose challenge is to surpass previous years, usually at no small expense. During interviews, high-status Chugurpampans like the mayordomo and other collaborators were most likely to be identified by respondents as close family or friends, even if these highly-embedded individuals did not always return the sentiment. Individuals with lower prestige desire to associate with those whom they see as successful in achieving shared migration goals and lifestyle expectations, such as having a secure job with stable pay, owning a house, or having vacation time, all of which communicate socioeconomic achievement. Essentially, more embedded Chugurpampans serve as cultural prototypes of success in migration.
Combining Social Network and Cultural Consonance Approaches
My research explores interactions between social structure and cultural models–or the cognitively embedded cultural information—to understand how culture mediates relationships within social networks to influence health and well-being. Cognitive theory, in particular Bill Dressler’s theory of cultural consonance, provides a way to measure how fulfillment of such cultural expectations can influence health.
Dressler found that individuals in Brazil with larger perceived social support networks are generally more consonant with an ideal cultural model of social support. My research takes the next step by evaluating cultural consonance in a whole network. This encompasses the entirety of a community’s social relations shared among individuals and households, rather than the ego-centered perspective of a personal network design. I measured the quality and strength of Chugurpampans’ collective social relations to assess whether embeddedness in the migrant network influences consonance in shared models of migration goals and lifestyle expectations.
Cognitive and network approaches are structuralist in nature, meaning that cultural models and social networks exist as part of lived realities. Each method provides the tools to take a ‘snapshot’ (as Dressler calls it) of sociocultural forces in situ, which can then be tested for associations and used to supplement insights from detailed, ethnographic fieldwork. Chugurpampan migrants are strongly-connected via a social network based on shared community origin, and using social network analysis, the power that individuals derive from respective network positions can be compared to consonance with migration goals, lifestyle expectations, and health outcomes. I predict, judging from previous cultural consonance work, that more highly-embedded Chugurpampans will have the highest cultural consonance and lowest blood pressure, perceived stress, and depressive symptoms.
Based on 24 months of fieldwork and preliminary data analysis, it’s clear that combining cognitive and network orientations can improve our understanding of culture’s crucial role in mediating interactions between social networks and health.
Much has occurred in the world of traditional medicine since the World Health Organization first appealed for the integration of Bio- and traditional medicines at Alma Ata in 1978. In the interim, while most efforts to include traditional healers’ services in hospitals and clinics foundered on the basis of distrust and unshared epistemology, paradoxically, worldwide interest in ‘alternative’ medicine only continued to grow.
An unfortunate result is that while the prestige of some traditional medicines heightened, and bioprospecting “integrated” traditional knowledge in pursuit of profits, concern about the survival of folk healers themselves subsided. Climate change, poverty, hypermobility, and globalization, among other factors, have led many young persons with healing potential to choose other career paths, or if they do enter healing fields, to choose professional paths that relocate them to urban areas far from the places of greatest need. Thus, one wonders whether folk healers will survive past the next generation, and what role governments and agencies might play in assuring that they do.
The WHO’s Alma Ata Declaration stated “the need for urgent action …to protect and promote the health of all the people of the world.“ Article VII-7 reads: Primary health care relies, at local…levels, on health workers, including physicians, nurses …as well as traditional practitioners as needed, suitably trained socially and technically to work as a health team …” While the WHO continues to encourage and support traditional healers, these same healers are officially outlawed in some countries, such as Peru, where I work, though there have been efforts to legalize them and standardize their practice (WHO 2001, 2005).
Since Alma Ata
Complicating the picture is the rise of “CAM” or “Complementary and Alternative Medicine,” which is a term even scholars find confusing. Is traditional medicine a subset of CAM, or vice versa? Is a practice traditional in its primary cultural context and CAM if it is exported? While there are no easy answers, WHO would agree with the latter (2001). Great Tradition/Professional medicines such as Ayurvedic, Chiropractic, Traditional Chinese Medicine, etc., are larger, well-organized, and better funded than the small folk traditions found in local contexts, such as midwifery, herbalism, shamanism, and bonesetting (Kleinman, 1980), and thus are given more attention by physicians willing to operate holistic, integrated clinics (Keshet & Popper-Giveon 2013), and by WHO and other regulating bodies. Opinions of professional healers carry more weight when policy is shaped. Yet while in Latin America no Great Traditions exist, socialist-leaning governments in several countries have been at the forefront of sincere, respectful efforts to truly integrate traditional practitioners with biomedicine (Peru is not one of these, despite sincere efforts by CENSI). A recent example is Bolivia, where one finds notable efforts to refashion state health care delivery to accommodate traditional medicine in a spirit of interculturalidad (Johnson 2010).
Loss of Traditional Healers
In the late 1980s in Chugurpampa, Peru, a highland hamlet in the northern Andes of La Libertad, morbidity and mortality were low, in no small part due to a plethora of biomedical and traditional healers (Oths 1998). Since then, drastic environmental changes, such as drought, deluge, unseasonable temperatures, and invasive flora & fauna, have substantially reduced agricultural yields. The ensuing diaspora—one third of the population has fled to the coast for survival—has left the region with few healers, as people are subsistence farmers first and healers as a secondary occupation. Young adults do not have the economic nor residential stability to apprentice to existing healers.
Bonesetter Conference, Julcan, Peru – 2013
Don Felipe Llaro, 80, is the last remaining healer in Chugurpampa and one of the region’s few bonesetters. (He is also a midwife, herbalist, and soul caller.)
A National Committee on Traditional, Alternative and Complementary Medicine operates out of a prestigious medical school in Lima. Its membership includes hundreds of physicians, healers, and others. They regularly hold conferences with much fanfare about reconnecting with their illustrious Incan past.
I accepted the Committee’s invitation to lecture about Don Felipe—twice—and given their insistence on meeting Don Felipe, I arranged a small 2-day conference on their behalf. They clamored to meet him and asked that I bring him to Lima, not considerate of the fact that he is elderly, unfamiliar with urban life, and would be outside of the cultural context in which he best functions. Not being an abstract thinker, he shows and teaches only in the act of working on an injured client.
In 2013 we hosted an “intercultural” conference in the rural highland Hospital of Julcan, the district capital near Chugurpampa, to showcase his talents and to promote apprenticeship to him while he still can teach. It was a success, drawing doctors, academics, healers, and others from around Peru, as well as local injured peasants who came for the free treatment they would get as demonstration patients. However, while a dozen D.s from Lima registered, in the end not a single one showed up. (Free room and board was provided to all.)
We achieved our goals—honor Don Felipe, re-acquaint local medical personnel with his practice, film the event, and identify an apprentice – his own granddaughter. However, who ultimately chose to attend the event, as opposed to who did not, speaks volumes.
Romanticized notions of a glorious medical heritage collide with the reality of the healers—usually impoverished—who struggle to carry on their traditions. If the self-professed M.D. salvagers of traditional medicine are of no utility, the task of preserving traditional knowledge becomes that much harder. Bolivia’s WHO-assisted government initiatives to privilege traditional medicine in its state-run health care system, while not entirely successful—and with opposition from biomedicine and USAID-–provide an illustration of potential new approaches. Treating folk knowledge as valuable though folk healers as dispensable is not a viable long term strategy.
The Last Bonesetter, an ethnographic film of Don Felipe and the conference, will be shown at SfAA in Vancouver in March and at other future venues.
“Bioculturalism” resumes this week with the first of three new interviews with self-professed biocultural anthropologists. This series aims to get anthropologists and closely-related others talking seriously, and thinking practically, about how to synergize biological and social scientific approaches to human health and well-being, and to what positive ends. New interviews will be published every other week, followed by a new piece by series organizer Jeffrey G. Snodgrass on Internet gaming, which has progressed in tandem with the series’ publication.
In this interview, Jason DeCaro responds to questions posed by Snodgrass.
How and why might cultural anthropologists and social scientists interested in health benefit from integrating biological variables/biomarkers into their research and analysis?
This is hard to answer in the abstract because it depends so much on the research question, but I will give it a shot. In psychological and medical anthropology, we talk a lot about embodiment. The body is deeply encultured, to the extent that I am completely convinced neurological functioning can’t be understood properly without reference to the shaping of the nervous system through culturally-constructed developmental experiences throughout the lifespan. Perhaps that is more a case for why biologically-oriented anthropologists should attend to culture. But here’s the thing. It seems to me that the reverse is equally compelling. Twenty years ago, who would have thought that inflammation has a role in depression? (It does.) And we’ve known for a while that physical activity does as well. And undernutrition. And so on and so forth.
Another way of looking at this is that biomarkers provide one part—not the whole, just a piece, but an important one—of the picture regarding the subjective impact of daily experience. I emphasize “subjective,” even though we’re talking about a quantifiable bio measure, because brain-body connections are so pervasive that subjectivity influences a wide array of biological parameters. It’s sort of boring, honestly, when the biomarkers just confirm what you already thought based on talking to people. But on the other hand, when the biomarkers tell you something counterintuitive or surprising—like that some group (or even an individual) is biologically responding in a way that you wouldn’t expect based on what you otherwise know about them—it’s illuminating. Such was my reaction, for instance, when I and collaborators recently completed a data analysis (unpublished but presented at AAA 2015) showing that, once food security was controlled for, a biomarker of chronic stress was “worse” in young children from households with greater material assets in an East African community where I work. I won’t give away the end of the story, which would take too much space anyway, but these “huh?” moments lead us to re-examine what we know about people—re-open those interview transcripts and field notes—and ask “what is the body telling us here?”
How would you respond directly to one potential cultural anthropological or social scientific critique of such an integrative “biocultural” approach?
Not going there anymore. I’m no longer investing energy in endless scripted arguments about the purported value or purported dangers of biocultural research as a general class (which are really just a subset of arguments about integrative holism in anthropology, and don’t seem to have changed much since I was a first year graduate student in 1998). Biocultural research isn’t for everyone, nor is it the best approach for every research question, but ideally it complements cultural anthropology nicely, especially in medical anthropology. On the other hand, done poorly, yes indeed it can be dreadfully reductionist and everything else people fear. So my view boils down to this: do it very well, with careful ethnographic contextualization and a thorough understanding of biology… great. Don’t do it at all, great. AAA is a big conference with plenty of room in those cavernous hotels we rent out. I hope we’ll all see each other in some sessions, but if not I’ll certainly give a friendly wave in the hallways.
What is one potential caution you’d have for cultural anthropologists or social scientists considering a biocultural approach?
To do biocultural research well requires a high level of sophistication regarding social/cultural anthropology and human biology at the same time. For one thing, this means that teamwork is incredibly valuable… I work almost entirely in collaborative teams now, because I just can’t be good enough at everything. And the research question (along with any measures that are going to be employed while addressing it) should flow from theory. If the theoretical framework doesn’t naturally call for an integrative biocultural approach, that is a red flag. Theory can and should be stretched of course, but it’s important to ask ourselves: will including a biomarker or a biological interpretation really tell us something substantially more than we could learn without it? Will it address a theoretically interesting question in a new and exciting way that moves the field forward? I ask students these questions all the time, and if they don’t have strong answers, I send them back to the drawing board. If they do, then I’m the biggest cheerleader they could want for their integrative approach.
What is one piece of research (ideally your own) that points to the benefits of such an integrative approach?
I’d like to point to some work that was done by my colleague Lesley Jo Weaver, on which I am honored to have been a co-author:
In brief, Jo found that congruence with gender roles among women with diabetes in India protected against the adverse effects of diabetes on mental health and inflammation, even when biomarkers showed the diabetes to be poorly controlled. Trade-offs among biological, social, and cultural dimensions of well-being that can only be identified within an integrative framework that joins ethnography and biomarkers with clinical outcomes. Good stuff.
What are some other references to help cultural anthropologists or social scientists interested in such an approach get started?
Jason DeCaro, PhD, Associate Professor of Anthropology at the University of Alabama, is a biocultural medical and psychological anthropologist and human biologist. His research concerns interactions among the social and cultural architecture of everyday life, cognitive processes, and physiologic systems in human development and the production of differential well-being across the lifespan. His primary international research site is Mwanza, Tanzania, where he has conducted research on child care practices, household adversity, caregiver mental health, and young child growth and development. He also is active in the Southeast U.S., where he has investigated emotion regulation and the biological stress response during the transition into grade school. He directs the Developmental Ecology and Human Biology Lab, which supports the analysis of blood and saliva biomarkers related to immune function, stress physiology, metabolism, and nutrition.
“Bioculturalism” aims to get anthropologists and closely-related others talking seriously, and thinking practically, about how to synergize biological and social scientific approaches to human health and well-being, and to what positive ends. It is edited by Jeffrey G. Snodgrass.
Diversity is Our Business1: We Talk the Talk, but do we Walk the Walk?,2
As academic anthropologists, my colleagues and I talk diversity all the time, but it refers to more than heritage, socioeconomic status, or gender. Jo Weaver and I have convened a session at the upcoming AAA conference about “Problems and Priorities in Biocultural Research” (see Jo’s summary in last month’s AN column), but our session is really as much about diversity as it is bringing non-research design-related issues to the fore. What other biases influence who can become an anthropologist? What if I am reliant on medication to stabilize my mood and that medication is poorly understood and my dose-response is sensitive to environmental change? Do I risk going abroad away from my support system to do fieldwork? Do I even bring this issue up with my advisers when I am applying for or in graduate school? Or do I just avoid field-based anthropology or drop out of my program? In another scenario, what if my own experiences of trauma are triggered by the culture shock of going abroad or trauma I witness in the field and I shut down emotionally? Do I fess up to my adviser that I’m in psychological turmoil?3 These may seem like clear-cut examples of issues fairly likely to occur among students of anthropology4, but when are they ever brought up and directly addressed in classes or advisement?
Similarly though perhaps more banal, when is a student ever given to permission to say ‘I love anthropology and I want to go to ___, but I have children and I could not emotionally handle being away from them’? This was an issue I faced. My children are triplets. They’re 12 years old now, but they were 1 when I started graduate school. Balancing children and a career is not easy for anyone, but what if your chosen vocation traditionally involves traveling great distances away for long periods of time? This is a stereotype in anthropology, but I have been surprised by the students and professionals whose expectations reflect this notion.5
Let me be clear—no one in my graduate program told me I needed to leave my family behind to become a real anthropologist. I did my fieldwork in, essentially, my own backyard (which comes with difficulties I wrote about for AN in 2008); and I received NSF funding to do it. But my wife and I made ends meet by the skin of our teeth.6 We lived 1 hours 40 minutes away from campus for the first few years so we’d be near family who could help take care of our children while I fulfilled my obligations as a graduate teaching assistant, took classes, and cloistered myself to get work done.7 I recall asking NSF Cultural Anthropology Program Director Deb Winslow and my advisers if could I use my grant money to pay living expenses? The financial and moral support I got for research was great, but my major expense was the cost of buying salivary cortisol kits and sending them out to be assayed. To save money and build up my skill set, I learned to assay them myself from Jason Paris in Cheryl Frye’s Biopsychology Lab at UAlbany instead of paying to send them out, saving around $9,000. Meanwhile, I had three toddlers at home, and taking care of them was a full time job, which left nothing for rent.8 As you can imagine, a graduate teaching assistantship stipend does not really cover expenses for a family of 5. Answer: We sympathize but, no, NSF funds can’t be used to cover rent unless it is for living somewhere else, where one doesn’t usually live, to do fieldwork at a distance from the usual home. And federal funding can only cover that expense for the researcher.
Not much has changed since I’ve become a tenured professor. I will admit that, although I love anthropology, one of my motivations in pursuing biological anthropology was a mistaken notion that biological know-how would get me paid better.9 But I also looked around at professors with kids and saw the wonderful experience and perspective this life provides to children of anthropologists. One of my advisors, Walter Little, would often take his daughter to Guatemala with him when he conducted fieldwork. I thought, ‘that is the life I want for my children.’ They’ll learn to speak Spanish early enough that it’s not a chore and have an invaluable worldliness (like our President—ahem, raised in a unique family situation by an anthropologist mother). But what I’ve learned is that there is little money out there to support a family while doing fieldwork. We must pay their fares out of pocket if we take them with us. So here my kids are, 12 years old, and they’ve still never left the country. Heck, I think even I had been to Canada by the time I was their age.
What We Know about Family-Career Balances of Anthropologists
I was loathe to talk to my professors about the stresses of supporting my family while going to graduate school. They didn’t have to hear that from other students, I imagined. But I had to. My very first semester, one of my sons was hospitalized for dehydration because of persistent diarrhea caused by an intestinal bug. Not a month later, during finals week, another bug hit the household and took everyone down. Because I saw it coming, I had outlined my answers to our take-home final. When the virus finally got me, everyone else in my house was down for the count and could not so much as get me a glass of water. But I still had one essay to write that was due the next day. I faded in and out of consciousness through the night transforming each outline fragment into a sentence and adding a few qualifiers. It’s probably the worst essay I’ve ever written and it got me a dreaded B (like a D in grad school), but, under the circumstances, it was good enough. As I recovered slightly, I tried to go back to work only to get a call from my wife that one of the kids was vomiting again. Because there was a bug in the house, neither the mother’s helpers we’d hired nor my wife’s family wanted to come in and help out for fear of catching it. But taking care of three sick toddlers was too much for any one person to handle. It pained me, but I explained my situation to my adviser, Larry Schell, and his response has always stayed with me. He said, “No one ever says on their deathbed that they wish they’d spent more time with at work. It’s always that they wish they’d spent more time with their family.”
Family is hard to manage. School is hard to manage. Work is hard to manage. This is life. No one wants to tell their professor or adviser or boss that work or school is putting a strain on their marriage, but we know that many marriages break up over issues like these (the literature on this is huge—this is in no way unique to anthropologists or people who do fieldwork for a living). Stress, as Gary Evans pointed out in a guest lecture at UAlbany when I was in grad school, is not necessarily about having a life full of stressors—it’s often about not having a buffer when there are stressors one is not expecting or has not planned for. I always refer to a poem by Charles Bukowski called “The Shoelace,” which refers simply to the last straw, when you’re dealing with “…roaches or flies or a broken hook on a screen, or out of gas or too much gas, the sink’s stopped-up, the landlord’s drunk, the president doesn’t care and the governor’s crazy. light switch broken mattress like a porcupine; $105 for a tune-up, carburetor and fuel pump at sears roebuck; and the phone bill’s up and the market’s down and the toilet chain is broken, and the light has burned out – the hall light, the front light, the back light, the inner light; it’s darker than hell and twice as expensive…”10
So the culture of academia (not just anthropology) makes balancing parenthood and fieldwork difficult, but how is that biocultural? As Jason DeCaro points out in previous posts for our blog (here and here), biological theory is implicit in studies of family and human development. But let me spell it out in a different way, one I alluded to above. There are certain notions about maternal investment in children that give moms a (justifiable) pass when it comes to saying, ‘I can’t do that because I have to think about my kids.’ And we applaud fathers who do the same (e.g., Joe Biden [maybe], sports athletes). But while there are few institutional accommodations for things like maternity leave, there are even fewer for paternity. I am not crying foul. I’m saying, ‘I love my children so much that it hurts me to leave them behind while I do fieldwork, and it is emotionally hard to handle.’ As you can imagine, I’m a big fan of Peter Gray and Kermyt Anderson‘s Fatherhood: Evolution and Human Paternal Patterns and work by Lee Gettler and others on the hormonal physiology of fatherhood. There is a real physiological change when we become fathers. I want us to think about this diversity more, talk about it more, and support diverse family models and needs more.
Study: Family and the Field
To wrap up and tease you for our November talk and future conferences and papers, these experiences inspired a study I started with my friend and UNCW assistant anthropology professor Michaela Howells this past summer called “Family and the Field.” I was primarily interested in the experiences of fathers and wondered if attitudes, experiences, and paternal investment by anthropologists has changed over the years. However, Michaela pointed out that the whole paradigm of parenting and family is interesting and understudied among anthropologists (but not by anthropologists). We don’t know the answers to questions like, if you want to have a bunch of kids and don’t want to leave them behind to do fieldwork, do you just choose another discipline? Or, do you forego having children for a period of time to complete graduate work and any major field studies? There’s not a lot of data on this within our discipline that we’ve been able to find (but encourage readers to send us sources if we’re wrong).
Our study is preliminary, using an internet paradigm, and hope to follow up in the near future by being able to conduct more intensive interviews. (Perhaps we will be cornering you, dear reader, at next year’s AAA!) So far, as Table 1 shows, we’ve collected data from over 350 anthropologists, nearly 85 of whom are males, and 31 of whom are fathers (mean age = 43.3, SD = 9.33). Of these fathers, 18 self-report their life-work balance as poor or acceptable, while 13 report it as good or excellent. Average perceived stress among these fathers is 33.6 (SD = 1.38), which is consistent with the full sample (33.1, SD = 2.51) (This study is still recruiting professionals and graduate students trained in anthropology, so please consider participating).
In sum, do we structurally bias our training system to undermine some types of diversity in our field? And, what do we really know about diversity, if indeed it is our business. Join us in Denver for “Hidden motivations and glossed justifications” Problems and priorities in biocultural field research” on Thursday, November 19, 4-5:45 PM to explore these questions.
1. Anthropologist Ulf Hannerz (2010) writes convincingly about the identity problem anthropology has, that we need PR help in cultivating what is essentially “brand identity,” and that identity should be diversity—“diversity is our business.” See Greg Downey’s Neuroanthropology piece for further discussion of this (and where I learned about Hannerz’ article). Incidentally, another piece by Hannerz that addresses the identity we as individual anthropologists create for ourselves also appeals to me. “Confessions of a Hoosier Anthropologist” (2014) outlines how Hannerz works, though he is Swedish and has spent his career at Stockholm University, was marked by the year he spent as a Master’s student at Indiana University. Folks from Indiana and who go to IU are known as “Hoosiers.” Just among the Biocultural Medical faculty here at UA, Jo Weaver and I are both Hoosiers by birth and upbringing, and Keith Jacobi and I are Hoosiers by education. Funny. Ha ha.
2. “You talk the talk. Do you walk the walk?” is a quote by Animal Mother from the classic 1987 Stanley Kubrick film Full Metal Jacket.
4. In 2011, the CDC reported that 1 in 10 people in the U.S. age 12 and over (11%) surveyed from 2005-08 were taking antidepressant medication. The youngest among those are college-age now. I don’t have a citation handy, but we have estimated that as many as half of our undergraduates in anthropology at any given moment are taking anti-anxiety or anti-depressant medication.
5. The criteria that render one a ‘Real Anthropologist’ would be a great blog topic, but I will save that for another time.
6. Actually, it was the skin of creditors’ teeth, and we have massive student loan debt as a consequence.
7. I rose at 5 AM most days to make the drive and would be so sleepy, I’d lay down in the shower to get a few minutes more rest and ensure I didn’t fall back to sleep. I was such a regular at the New Baltimore rest stop Starbuck’s on NYS I-87 that they began giving me the “Trucker Discount,” which later became free coffee. I’d hear employees whisper, “he gets a free coffee” as I walked up, so that by the time I finished grad school, the manager who had started this gratuitous gesture was gone and current staff had no idea who I was, just that I merited free coffee for some reason.
8. Either my wife or I needed to stay home or whatever money she earned working covered the cost of childcare [barely] and that’s it.
9. I am the first generation in my family to finish college, let alone go to grad school, let alone become a college professor. So what did I know? Nothing. That’s what I knew. Similarly, another mistaken notion was that my kids would get free tuition wherever I worked.
10. One of my sons was taking lots of photos during one of these periods for me and caught me in a moment when I was working as a GTA at Albany, teaching a course as instructor of record at Marist College, finishing data collection for my dissertation, writing my dissertation, and interviewing for jobs all at the same time. It seems like a lot, right? It was, but that was OK because I accepted those stressors knowingly. It was after getting t-boned in my Prius by a tractor-trailer that I broke down. I wasn’t injured, the truck driver took full responsibility, and my car was fully fixed by insurance; but that extra thing was more than I could handle at that moment.
I continue to be fascinated by the exigencies of fieldwork, perhaps in part because they are so universal yet typically not prioritized in discussion—so familiar, yet so strange, to quote the theme of the upcoming AAA Annual Meeting in Denver.
Chris Lynn and I have organized a session for the meeting titled, “Hidden Motivations and Glossed Justifications: Problems and Priorities in Biocultural Field Research,” which we designed as a forum for an updated discussion of the practicalities of field research. Our inspiration came in part from Clancy and colleagues’ recent PLoS One study on sexual harassment in the field, which received a lot of press last year (a shocking 70% of the over 500 women they interviewed reported experiencing sexual harassment at some point in their field research careers, while 25% reported actual assault). Robin Nelson, one of the study’s authors, will serve as our session discussant.
I am especially excited about this session because, although the presenters are all professors, the topics address challenges common at all stages of research and training.Rebecca Lester’s and Eileen Anderson-Fye’s presentations, for instance, will explore how fieldworkers manage and respond to trauma, both theirs and others’, in field research. My presentation will use data from a small study of fieldworkers at various stages of their research careers to explore how they grapple with racial differences between themselves and their informants. Chris Lynn’s and Michaela Howells‘, meanwhile, will discuss fieldwork and family—a favorite topic of mine and one relevant for graduate students and faculty members. There are important lessons to be learned here for students, mentors, and fieldworkers at all stages.
My desire to talk about race and racially charged encounters in fieldwork stems in part from my employment in a largely white department (as most anthropology departments are) in the deep south. Our department’s faculty are particularly concerned with social inequity in health outcomes, which means that our research and teaching often put us in contact with disenfranchised people in the greater Alabama area, many of whom identify with minority racial groups. The ongoing racial tensions in our community, which are more blatant though probably no stronger than anywhere else in the U.S. right now, undoubtedly shape our research and teaching—especially when it comes to understanding and reflecting on how we are perceived by the people with whom we work.
Early anthropologists were often missionaries or colonial representatives working among peoples in Africa, Asia, Latin America, and Oceania who were assumed to be inferior because of their non-Europeanness…It is a mistake to willfully overlook those racial under- (and over-) tones because what we do today still very closely resembles what we did in the past.
Last year, when I received a student review that claimed my teaching suffered from “white person bias,” I took the comment very seriously because I regularly teach about social inequality and social justice in the south. I’ve spent a lot of time thinking about how to engage racial difference in an overarching cultural context of racial tension meaningfully, respectfully, and in a way that is useful to all parties involved. Although I thought I was doing this pretty well, my student’s comment reminds me that I have a long way to go. So, my motivation for doing a study of fieldworkers’ engagement with race is partially selfish.
This issue is also important from a historic perspective in anthropology. We all know that early anthropologists were often missionaries or colonial representatives working among peoples in Africa, Asia, Latin America, and Oceania who were assumed to be inferior because of their non-Europeanness. Typically, when anthropologists read these materials today, we do so with an understanding that we must overlook the racism embedded in these authors’ works if we want to extract their insights. We say that we can’t get caught up in their racism because that’s just how things were back then.
But I think it is a mistake to willfully overlook those racial under- (and over-) tones because what we do today still very closely resembles what we did in the past. No matter our intentions, we are still an overwhelmingly white discipline that works with people all over the world who do not identify as white. We are still an overwhelmingly white set of authority figures, and our classrooms reflect much greater racial and ethnic diversity than our anthropology faculties and departments do. We need to talk about these things.
So, come to our AAA session and help me figure out how to be a better anthropologist. You might learn something, too.
“Hidden Motivations and Glossed Justifications: Problems and Priorities in Biocultural Field Research”
Invited Session sponsored by the Biological Anthropology Section and the General Anthropology Division
Thursday, November 19 4:00 pm- 5:45 PM
Lesley Jo Weaver (PhD/MPH, Emory) is an Assistant Professor in the Biocultural Medical program and an affiliated faculty member in UA’s Asian Studies program. She studies health and illness in India and rural northern Brazil.
The question of what an anthropology degree means, especially in cultural anthropology, has been asked ever since I was an undergraduate (back when I saw Pigpen on keyboards with the Dead). As things change, in the academy as in the world around us, there is a certain renewed urgency in that question, as we prepare students to do: what? (And don’t for a second think that I regard a university degree as vocational training.)
The what will be what anthropologists have always done. Some will continue in the academy, both in traditional faculty roles and in new ways of teaching and doing research. Others will become applied anthropologists in government and non-profits. More will likely forge new roles for themselves in the shifting landscape of the marketplace. How do we help?
“Bringing something to the table” is a hackneyed but nonetheless useful phrase, and that is of course how we must help in educating anthropology students. The student of anthropology must bring something to the table. That mythical table will be set for some in universities, although it seems for more it will be in novel settings, and ones in which the table will be shared (contested?) by those from other social sciences.
The main dish we bring to the table is the concept of culture and the overarching framework that people and what they do are shaped day-to-day by this mysterious miasma of shared knowledge. And they, in turn, modify that shared understanding in response to changing circumstances. Grasping this and all of its implications is what anthropology is all about. This was, of course, Malinowski’s directive—“to see the world as others see it”—and while other social sciences flirt with this perspective, it remains at the core of anthropological thinking.
Malinowski’s directive—“to see the world as others see it”—remains at the core of anthropological thinking.
Bringing this perspective, however, will get you nowhere if you can’t demonstrate its utility, especially in hard-nosed settings like interdisciplinary research groups, applied projects, or in business. This hinges in part on what we mean by demonstrate. An online dictionary defines this term as “clearly show the existence or truth of (something) by giving proof or evidence.”
We are, in part, talking about methods that our students use to demonstrate the utility of their perspective for explaining something. But this will not be an exhortation just for better methods, mixed methods, or more rigorous qualitative methods. These appeals are correct and important and have been voiced for a long time. What I want to argue for, however, is the development of a configuration of methods that can uniquely capture empirically, in a way that can be clearly communicated to others, the singular contribution of an anthropological perspective.
Research methods are often presented in exhaustive compendia, or, continuing the table metaphor, a smorgasbord. The budding researcher is faced with a vast array of research methods, just like a vast buffet of potential consumables, especially in the day and age of mixed methods. We teach methods as being suited to particular problems. You choose the best set of methods for the problem at hand. Yet, alighting on the best set of methods can be a very difficult task, especially when we are trying to pull together traditional tools of ethnography and quantitative techniques.
I’ve come to think lately about this in a somewhat more focused way, and it goes back to that Malinowskian directive, interpreted from a mixed-methods mindset. We want to understand the world as others see it, then what? The mixed-methods orientation says that we then go on to quantify that in some way. It is worth stopping and reflecting on what that means. In strictly emic terms, seeing the world as others see it is to discover the categories and modalities that people use as their taken-for-granted reality. From a measurement standpoint, quantifying that means coming up with a way to order people along a continuum in terms that they themselves have defined. By ordering people along such a continuum, we can in turn relate that variation to variation in any other variable. Such a measurement strategy generates what Kathryn Oths and I have termed high “emic validity,” which in turn can be used in examining anything you care to study, alongside the etic measurements that are staples of other social sciences.
There are a variety of ways of doing this, and for examples I would start with Lance Gravlee’s research on race in Puerto Rico, Lesley Jo Weaver and associates’ studies of mental health, François Dengah’s studies of religion, as well as my work on cultural consonance. These are all empirically successful approaches in capturing that emic perspective in ways that are both theoretically and methodologically satisfying.
This is something special to bring to the table. This approach requires a rigorous and systematic attention to a way of understanding human existence. It requires mastering a specific set of qualitative and quantitative research skills. And it requires staying true to a particular vision of anthropology. Furthermore, it is a unified perspective that can be taught at any level of study in anthropology.
At this point I would be remiss were I not to give a shout out to a few people who have done our field immeasurable good by putting their energies and efforts behind providing the training to students in anthropology to do just this kind of thing. I’m talking about Russ Bernard, Jeff Johnson, and Sue Weller and the NSF-funded Summer Institute in Research Design (SIRD). The SIRD is coming to a close this year, after providing some 340 anthropology students over 20 years with absolutely top-notch education and critique as they embarked on their dissertation research. They, along with the support offered by Stu Plattner and Deb Winslow at NSF, deserve all our thanks for all they’ve done to enhance anthropological research.
In contrast to early literature, later writing—from both camps—implies that what anthropology most offers epidemiology is its qualitative sensibility (e.g., Ragone and Willis 2000; Scammell 2010). While clearly one of anthropology’s great strengths, sensitivity to qualitative dimensions is not all we have to offer. Rigorous, contextualized mixed-methodology is more likely to be persuasive to other disciplines than mere entrained awareness (Prussing 2014). In fact, by incorporating epi techniques into anthropological designs, we can employ a holistic paradigm on our own—what Inhorn calls synthetic or wearing both hats. (The reverse, training health professionals in anthropology, has also been suggested [O’Mara et al. 2015]).
Anthropological orientations in health research might be glossed as follows: Anthropologists of Suffering record the pain and distress of a people, striving to understand meaning surrounding health problems. Anthropologists of Sickness, in addition to searching for meaning, use structured surveys emerging from ethnographic observation to systematically ferret out factors contributing to dis-ease and illness. The first approach interrogates the meaning of critical life events, while the second investigates how socially and culturally constructed meanings themselves shape risk of morbidity and mortality. As Trostle and Sommerfeld (1996) state, “data can be used to create emotional responses in the reader, or to explain relationships.” Both approaches are vital and mutually enhancing, but less has been written about the latter.
For example, most anthropologists of reproduction interpret the clinical interactions that oppress and mystify women’s knowledge and autonomy, as well as women’s resistance to these controlling forces. They study the technologizing of natural processes and the hegemony of biomedical over self-knowledge. This research is an important corrective to years of neglect of reproductive work (Rapp 2001). The focus of others, including myself, has been more outcome-driven, a systematic explanatory study of the conditions not of clinical but rather daily life—like workplace organization and intimate relationships—that shape women and babies’ health (Oths et al. 2001; Dunn & Oths 2004).
A Word on Publishing
While epidemiology and anthropology share the common goal of improving human health, each field has its own prerogatives. Those who blend qualitative and quantitative methods in the pursuit of an Epidemiological Anthropology of Sickness may face problems getting published in the public health literature. I’ll make three points regarding disciplinary differences of opinion on the accurate specification of analytic models:
1. Anthropological methods are not self-explanatory.
Anthropological methods essential to getting results are detailed, iterative, and not necessarily self-explanatory. However, there is no space to discuss these vital tools in standard public health journal articles. Be forewarned: Public health expects very brief methods sections!
2. What’s reliable to others may not be valid to us.
Other fields are more strict than ours in insisting that survey items be tested for reliability before use. Reliability, or insuring that an instrument gives the same results with repeated use, is a good thing. However, a scale, once published, should not be changed. (A survey instrument you construct yourself? Even more suspect.) Yet without local contextualization, an instrument’s validity—actually measuring what said instrument claims to measure—may be compromised. This is a constant issue when we employ scales that have been normed to populations other than the one we will survey. For epidemiologists, patterns of association are of greater concern than measurement issues. Categories they work with are believed to be fixed in nature, race being a prime example. For us, they are anything but fixed. Anthropologists insist on emic construct validity of categories—categories should make sense in the cultures we’re measuring them in. Rule of thumb: Take care of validity, and reliability will follow.
Rule of thumb: Take care of the validity, and reliability will follow.
3. We lack authority to critique normative methods.
Some journals, such as American Journal of Public Health(AJPH), recommend use of specific statistics, such as logistic rather than ordinary least squares regression. They insist every dependent outcome variable be broken into two discrete categories instead of having the generally continuous, tough-to-define, but more precise character of real life. However, they don’t insist on power analyses, which determine if a given study’s sample size is sufficient to make a statistical test valid. An example from my birth weight study illustrates this: None of six previous studies using a model developed by Karasek found a direct association between job strain and birth outcomes. Four had low power for their logistic regression, which may have resulted in undetected effects. And instead of using the full range of values—500 to 4500 grams for birth weight—logistic regression uses only ‘low’ or ‘normal’ as outcomes, which results in a loss of variability and, thus, information. We would’ve needed twice the sample size in our study to achieve sufficient power using logistic regression. When my colleagues and I demonstrated that least squares regression detects an effect while logistic regression does not, the editor of AJPH was not impressed.
Why the one model fits all assumption regardless of whether it’s the best one? It fits with naturalized categories, like disease and race, which are seen as binary oppositions: yes/no, black/white. This implicit model of the world is simply too rigid for anthropological sensibilities (Dressler, Oths, and Gravlee 2005). Newsflash: The world isn’t always best modeled by dichotomies.
In summary, when we strive to measure more accurately, we may meet with resistance from the gatekeepers of public health journals. Perhaps my outline of some common pitfalls of writing for an interdisciplinary audience will help reduce the frustration of others who attempt the same.