In the Journals

In the Journals, April 2021, Part 2

Here’s the second part of the round-up for April. Enjoy!

Social Science & Medicine 

Help me quit smoking but don’t make me sick! The controversial effects of electronic cigarettes on tobacco smokers

Jérôme Ronchetti, Anthony Terriau

Despite its increasing use, little is known about the effect of electronic cigarette. This study estimates the impact of the use of electronic cigarettes on tobacco smoking and health among tobacco smokers, using French panel data derived from the Health, Health Care, and Insurance Survey for 2010–2014. We use a difference-in-differences propensity score matching approach to identify the effect of electronic cigarette use on a sample of 982 smokers. We show that the use of electronic cigarettes increases the probability of quitting smoking and reduces the number of regular cigarettes smoked per day. However, we also find evidence that electronic cigarette users have a higher probability of reporting poor health status and suffering from a chronic disease compared with those who only smoke regular cigarettes. Overall, our results do not support the use of electronic cigarettes for tobacco smokers.

Incorporating Social Determinants of Health into Modelling of COVID-19 and other Infectious Diseases: A Baseline Socio-economic Compartmental Model

Giorgos Galanis, Adam Hanieh

The role of socio-economic conditions has been largely implicit in mathematical epidemiological models. However, measures to address the current pandemic, specifically the relevant interventions proposing physical distancing, have highlighted how social determinants affect contagion and mortality dynamics of COVID-19. For the most part, these social determinants are not present in either policy discussions or in epidemiological models. We argue for the importance of incorporating social determinants of health into the modelling dynamics of COVID-19, and show how global variation of these conditions may be integrated into relevant models. In doing so, we also highlight a key political economy aspect of reproduction dynamics in epidemics.

Young women’s and midwives’ perspectives on improving nutritional support in pregnancy: The babies, eating, and LifestyLe in adolescence (BELLA) study

Sofia Strömmer, Susie Weller, Leanne Morrison, Hora Soltani, … Mary Barker

Rationale: Teenage pregnancy has a high risk of poor outcomes for both mother and baby. Teenage girls have the poorest diets of any population group in the UK, which compounds the risk of poor pregnancy outcomes. Pregnant teenagers trust advice from their midwives, but midwives feel they do not have time, confidence, or knowledge to discuss nutrition. Objective: This study examined how the relationship between pregnant teenagers and their midwives could be utilised to deliver support to improve diet quality. Method: Qualitative interviews were conducted across three urban sites in the UK: Manchester, Doncaster, and Southampton with adolescent mothers and their midwives regarding diet and lifestyle, and what form of support would be helpful. In total, 106 young women and 20 midwives were interviewed. Most of the young mothers were 19 or younger (67%). Half had had their first child in the past year (52%) and 21% were pregnant during the study. Thematic analysis was used to identify ways to better support young mothers to eat well. Results: Young women found it difficult to prioritise healthy eating; they often felt isolated and not in control of their own lives and wanted support from their midwife. Midwives felt that it was their role to support young mothers with diet in pregnancy but were anxious about initiating conversations and felt they lacked clear guidance. Conclusions: Pregnant teenagers and their midwives lack reliable resources and strategies for healthy eating support. An effective intervention to improve pregnant teenagers’ diet quality must empower, inform, and motivate young mothers and their midwives, and enable connections between young mothers.

Internal migration, urban living, and non-communicable disease risk in South Africa

Chantel F. Pheiffer

This paper offers theoretical and substantive contributions to migration-health scholarship by employing rich panel data with biomarkers to estimate the effect of migration and urban living on non-communicable disease risk in South Africa. Internal migration and urbanization continue to be pervasive demographic and socio-economic phenomena that structure daily life in low– and middle– income countries (LMICs). Yet, how these processes affect illness and disease in low-resource settings is still not well understood. Five waves (2008–2017) of South Africa’s National Income Dynamics Study data and fixed-effects modeling are used to estimate the relationship between urban residence, migration, and health. Results indicate that the migration-health relationship differs by gender: urban living for men is associated with lower blood pressure. While urban residence appears to convey a health advantage when men reside in urban compared with rural places, there is no evidence of an urban health advantage among women. Migration does, however, negatively affect women’s health through higher blood pressure (BP). These findings highlight the need for further interrogation of the ways in which processes and health consequences of migration and urban living are structured by gender in LMICs. Given the importance of urbanization and the prevalence of migration in LMICs, the gendered determinants of blood pressure may be key to understanding rising hypertension incidence in contexts like South Africa.

Health-related quality of life of hospitalized COVID-19 survivors: An initial exploration in Nanning city, China

Chenhui Wu, Jianquan Cheng, Jun Zou, Lian Duan, Janis E. Campbell

Understanding the health-related quality of life (HrQoL) of hospitalized COVID-19 survivors is an emerging global challenge arising from the current pandemic. A qualitative study of the experiences of sixteen hospitalized COVID-19 survivors from Nanning City, China, was conducted using semi-structured telephone interviews in May 2020. These first-hand accounts were critically and empirically analysed to identify emerging health and social issues, and provide potential solutions to improve survivors’ quality of life. This in-depth, qualitative study of HrQoL for hospitalized COVID-19 survivors provides the first empirical evidence and conceptual framework with eight dimensions (physical symptoms, anxiety, trauma, economic loss, place-based identity, self-stigma, health self-interventions, and changing lifestyle) for understanding the physiological, psychological, socio-economic and health behavioral aspects of their daily lives. We argue that local and global governments should provide integrated healthcare, social and digital infrastructure to support this vulnerable group. More comparative and multi-disciplinary studies in this area are needed to generate academic standards of assessing health-related quality of life and produce good practice guidelines for promoting urban resilience in response to public health disasters.

“Cured” but not “healed”: The application of principles of palliative care to cancer survivorship

Chelsea MacDonald, Julie A. Theurer, Philip C. Doyle

Application of principles of palliative care to the concept of survivorship may serve to establish an interdisciplinary approach to guide those treated for cancer through the experience of being “cured” but not “healed”. Valuable lessons may be garnered from palliative care if its principles are considered within the context of survivorship. This work aims to define key terms including cured, healed, survivorship, and quality of life (QoL) and delineate the central tenets of palliative care and disease-modifying care. Since pursuit of a cure tends to dominate provision of oncological care, Western society’s prevailing death denying attitudes often equate to the prioritization of advanced medial treatment to postpone death. Accordingly, the “modern paradox” of medicine (Cassell, 2004) is examined in consideration of the suffering that often results from advanced medical treatment that is intended to alleviate the cause of suffering and ultimately, “deny” death. However, owing to the profound consequences of advanced medical treatment and the associated losses of function concomitant with cancer, there is an apparent need for a framework of care that attends to these survivorship issues. When the experience of being cured but not healed is articulated through a theoretical discussion of liminality and the “remission society” (Frank, 1995), the applicability of palliative care to survivorship care becomes apparent. By embracing principles of palliative care, survivorship care may be guided by a theoretical foundation that provides cancer survivors with care that supports increased QoL, biopsychosocial symptom management, and a holistic perspective of the illness experience. Accordingly, application of palliative care to survivorship may establish congruence between notions of cured and healed.

The disparate impact of COVID-19 on the mental health of female and male caregivers

Mark Wade, Heather Prime, Dylan Johnson, Shealyn S. May, … Dillon T. Browne

Caregiver mental health is crucial to the wellbeing of children. This is most apparent when caregivers face high levels of stress or life adversity. To study this phenomenon in the current global context, this study examined the relation between stress/disruption from the COVID-19 pandemic and the mental health of female and male caregivers. Pre-pandemic childhood adversity was considered as a moderator of this association. A multi-national sample (United Kingdom, 76%; United States, 19%; Canada, 4%, and Australia, 1%) was recruited in May 2020, of whom 348 female and 143 male caregivers of 5–18 year-old children provided data on the constructs of interest. At this time, caregivers reported on their history of adverse childhood experiences (ACEs) and COVID stress/disruption. About two months later (July 2020) caregiver mental health was evaluated. We examined differences between female and male caregivers on ACEs, COVID stress/disruption, and mental health (distress, anxiety, substance use, and posttraumatic stress). Main and interactive effects of ACEs and COVID stress/disruption on each mental health outcome were examined. Female caregivers reported higher COVID stress/disruption, more ACEs, and greater distress, anxiety, and posttraumatic stress symptoms compared to male caregivers. Among female caregivers, higher COVID stress/disruption and more adverse childhood experiences (ACEs) independently predicted all mental health outcomes, consistent with a stress accumulation model. Among male caregivers, a pattern of interactions between COVID stress/disruption and ACEs suggested that the effects of COVID stress/disruption on mental health was stronger for those with higher ACEs, especially for substance use, consistent with a stress sensitization model. Higher levels of stress and mental health difficulties among female caregivers suggests a disproportionate burden due to pandemic-related disruption compared to male caregivers. Findings speak to the disparate effects of COVID-19 on the mental health of female compared to male caregivers, and the role of pre-existing vulnerabilities in shaping current adaptation.

Clinical practice guidelines in courts’ representation of medical evidence and testimony

Jaakko Taipale, Lotta Hautamäki

This article examines clinical practice guidelines (CPG) in the courtroom. The guidelines in question are Finnish national current care guidelines for brain injuries, and the case context is traffic insurance compensation cases contested in the Helsinki district court. We analyse 11 case verdicts qualitatively, drawing from earlier sociological and theoretical accounts of clinical practice guidelines and evidence-based medicine. What makes the case-type relevant for studying clinical practice guidelines is the fact that the cases, which feature a medical dispute concerning traumatic brain injury, involve highly specialized expertise and contradictory expert claims, but the cases are decided in a generalist court by non-expert judges. What we show in the article is how the guidelines structure, sequence and initiate temporal reworking in the judges’ representation of medical evidence and testimony, and how the plaintiffs’ delayed diagnoses complicate the application of the CPG in the evaluation. We further discuss the guidelines’ epistemic authority in the verdicts and finish by comparing the 2008 and 2017 editions of Finnish CPGs for brain injuries, suggesting a multifaceted, courtroom-mediated feedback loop between the patient-plaintiffs and the clinical practice guidelines.

“PrEP just isn’t my priority”: Adherence challenges among women who inject drugs participating in a pre-exposure prophylaxis (PrEP) demonstration project in Philadelphia, PA USA

Marisa Felsher, Eliza Ziegler, K. Rivet Amico, Adam Carrico, … Alexis M. Roth

Pre-exposure prophylaxis (PrEP) has the ability to curb HIV transmission among women if they are highly adherent (e.g. 6/7 weekly doses). In a recent PrEP demonstration project with 95 women who inject drugs (WWID) in Philadelphia, PA, USA, PrEP uptake was high but adherence was low. This qualitative study draws upon the Behavioral Model for Vulnerable Populations (BMVP) to describe how the context of 23 WWID’s lives challenged PrEP adherence using narrative data from in-depth interviews. Content analysis suggests that women’s need to organize their day around predisposing survival needs made it difficult to prioritize PrEP. Adherence was further challenged by dis-enabling structural forces such as entry into institutions that do not provide PrEP (e.g., drug treatment and correctional facilities) and medication diversion to illicit marketplaces. Overtime, women’s perceived need for PrEP was dynamic: in periods they characterized as risky, women considered PrEP highly beneficial and described enhanced motivation to adhere. In periods of low perceived risk, women were less committed to continuing daily PrEP in the context of their competing survival needs. In sum, WWID faced challenges to PrEP adherence that correspond to all of the BMVP domains. To optimize PrEP for WWID, multi-level programs are needed that address the determinants that both increase HIV susceptibility and undermine adherence.

“PrEP just isn’t my priority”: Adherence challenges among women who inject drugs participating in a pre-exposure prophylaxis (PrEP) demonstration project in Philadelphia, PA USA

Marisa Felsher, Eliza Ziegler, K. Rivet Amico, Adam Carrico, … Alexis M. Roth

Pre-exposure prophylaxis (PrEP) has the ability to curb HIV transmission among women if they are highly adherent (e.g. 6/7 weekly doses). In a recent PrEP demonstration project with 95 women who inject drugs (WWID) in Philadelphia, PA, USA, PrEP uptake was high but adherence was low. This qualitative study draws upon the Behavioral Model for Vulnerable Populations (BMVP) to describe how the context of 23 WWID’s lives challenged PrEP adherence using narrative data from in-depth interviews. Content analysis suggests that women’s need to organize their day around predisposing survival needs made it difficult to prioritize PrEP. Adherence was further challenged by dis-enabling structural forces such as entry into institutions that do not provide PrEP (e.g., drug treatment and correctional facilities) and medication diversion to illicit marketplaces. Overtime, women’s perceived need for PrEP was dynamic: in periods they characterized as risky, women considered PrEP highly beneficial and described enhanced motivation to adhere. In periods of low perceived risk, women were less committed to continuing daily PrEP in the context of their competing survival needs. In sum, WWID faced challenges to PrEP adherence that correspond to all of the BMVP domains. To optimize PrEP for WWID, multi-level programs are needed that address the determinants that both increase HIV susceptibility and undermine adherence.

“You have to start normalizing”: Identity construction among self-changers and treatment changers in the context of drug use normalization

Keren Gueta, Gila Chen

Identity transformation and stigma management have been widely acknowledged as significant factors in various drug-cessation pathways, such as self-change (SC) and treatment-change (TC). These processes involve the employment of symbolic boundaries within which people associate themselves with desired groups and/or distance themselves from less desirable ones. However, the relevance of the drug-cessation pathway to identity construction in an era of drug-use normalization has not yet been explored. The present study used thematic discourse analysis to compare the drug-cessation narrative and the reflected identity construction of 41 former drug users in Israel (25 SCs and 16 TCs). The findings revealed a shared trigger for drug cessation that was related to impaired functionality and a threat to their identity. However, the groups differed in other drug-cessation factors that served their identity-negotiation strategies. The SCs negotiated stigma by distancing themselves from other drugs users, minimizing drug risk, and denying the need for drug treatment. In contrast, the TCs negotiated stigma by distancing themselves from their former user identities, embracing the disease model of drug use, and confirming the necessity of treatment. This identity construction reflects continuous framing of ideals of subjectivity, such as self-regulation, which policy makers and treatment stakeholders should consider in developing services and conveying substance-use policy messages.

What are the challenges for antibiotic stewardship at the community level? An analysis of the drivers of antibiotic provision by informal healthcare providers in rural India

Meenakshi Gautham, Neil Spicer, Soumyadip Chatterjee, Catherine Goodman

In many low- and middle-income countries, providers without formal training are an important source of antibiotics, but may provide these inappropriately, contributing to the rising burden of drug resistant infections. Informal providers (IPs) who practise allopathic medicine are part of India’s pluralistic health system legacy. They outnumber formal providers but operate in a policy environment of unclear legitimacy, creating unique challenges for antibiotic stewardship. Using a systems approach we analysed the multiple intrinsic (provider specific) and extrinsic (community, health and regulatory system and pharmaceutical industry) drivers of antibiotic provision by IPs in rural West Bengal, to inform the design of community stewardship interventions. We surveyed 291 IPs in randomly selected village clusters in two contrasting districts and conducted in-depth interviews with 30 IPs and 17 key informants including pharmaceutical sales representatives, managers and wholesalers/retailers; medically qualified private and public doctors and health and regulatory officials. Eight focus group discussions were conducted with community members. We found a mosaic or bricolage of informal practices conducted by IPs, qualified doctors and industry stakeholders that sustained private enterprise and supplemented the weak public health sector. IPs’ intrinsic drivers included misconceptions about the therapeutic necessity of antibiotics, and direct and indirect economic benefits, though antibiotics were not the most profitable category of drug sales. Private doctors were a key source of IPs’ learning, often in exchange for referrals. IPs constituted a substantial market for local and global pharmaceutical companies that adopted aggressive business strategies to exploit less-saturated rural markets. Paradoxically, the top-down nature of regulations produced a regulatory impasse wherein regulators were reluctant to enforce heavy sanctions for illegal sales, fearing an adverse impact on rural healthcare, but could not implement enabling strategies to improve antibiotic provision due to legal barriers. We discuss the implications for a multi-stakeholder antibiotic stewardship strategy in this setting.

Dutch COVID-19 lockdown measures increased trust in government and trust in science: A difference-in-differences analysis

Joost Oude Groeniger, Kjell Noordzij, Jeroen van der Waal, Willem de Koster

Many governments have implemented strict lockdown measures to prevent the transmission of the new coronavirus (SARS-CoV-2). Compliance with these restrictions is vital and depends greatly on the level of trust in the institutions central to their development and implementation. The objectives of this study were to assess: (1) the effects of the Dutch lockdown measures imposed in March 2020 on trust in government and trust in science; and (2) whether these differ across social groups. We draw on unique data from the high-quality Longitudinal Internet Studies for the Social Sciences panel, which comprises a true probability sample of Dutch households (average participation rate: 80.4%). Our data were collected on an ongoing basis from December 2017 to March 2020 (n = 2219). Using the implementation of lockdown measures in mid-March as a natural experiment, we employed difference-in-differences analyses to assess the causal effect of the Dutch lockdown measures on trust in government and trust in science. We estimated that the imposition of the measures caused an 18% increase (95% confidence interval (CI):15%–21%)) in trust in government and a 6% increase (95% CI: 4%–8%) in trust in science. The impact on trust in government was greater among the participants aged 65 and older and those with poor self-assessed health, although the relevant CIs were wide and, in the case of self-assessed health, included the null. No differential effects were observed for trust in science. Our study indicates that the strict public-health measures imposed in the Netherlands during an acute phase of the COVID-19 pandemic generated trust in the institutions involved in drafting and implementing them, especially among those with a higher risk of serious health outcomes. This suggests that, to prevent a major public-health crisis, people appreciate firm government intervention during the acute phase of an infectious disease pandemic.

Social Studies of Science 

The model crisis, or how to have critical promiscuity in the time of Covid-19

Warwick Anderson

During the past forty years, statistical modelling and simulation have come to frame perceptions of epidemic disease and to determine public health interventions that might limit or suppress the transmission of the causative agent. The influence of such formulaic disease modelling has pervaded public health policy and practice during the Covid-19 pandemic. The critical vocabulary of epidemiology, and now popular debate, thus includes R0, the basic reproduction number of the virus, ‘flattening the curve’, and epidemic ‘waves’. How did this happen? What are the consequences of framing and foreseeing the pandemic in these modes? Focusing on historical and contemporary disease responses, primarily in Britain, I explore the emergence of statistical modelling as a ‘crisis technology’, a reductive mechanism for making rapid decisions or judgments under uncertain biological constraint. I consider how Covid-19 might be configured or assembled otherwise, constituted as a more heterogeneous object of knowledge, a different and more encompassing moment of truth – not simply as a measured telos directing us to a new normal. Drawing on earlier critical engagements with the AIDS pandemic, inquiries into how to have ‘theory’ and ‘promiscuity’ in a crisis, I seek to open up a space for greater ecological, sociological, and cultural complexity in the biopolitics of modelling, thereby attempting to validate a role for critique in the Covid-19 crisis.

Science, technology, security: Towards critical collaboration

Sam Weiss Evans,, Matthias Leese, Dagmar Rychnovská

Science and technology play a central role in the contemporary governance of security, both as tools for the production of security and as objects of security concern. Scholars are increasingly seeking to not only critically reflect on the interplays between science, technology and security, but also engage with the practices of security communities that shape and are shaped by science and technology. To further help this growth of interest in security topics within science and technology studies (STS), we explore possible modes of socio-technical collaboration with security communities of practice. Bringing together literatures from STS and critical security studies, we identify several key challenges to critical social engagement of STS scholars in security-related issues. We then demonstrate how these challenges played out over the course of three case studies from our own experience in engaging security communities of practice. We use these vignettes to show that there is a rich vein of developments in both theory and practice that STS scholars can pursue by attending to the interplay of science, technology and security.

Atmospheres of science: Experiencing scientific mobility

Sarah R Davies

This article uses notions of the atmospheric to engage with empirical material concerned with international mobility in science. It draws on recent conceptual work on atmospheres that frames them as allowing access to the affective qualities of everyday life and as ‘productively nebulous’: atmospheres exist between the local and the globally diffuse, the emergent and the staged, the intangible and the brutally present. Using atmospheric thinking, I devise ‘apparatuses of attunement’ to capture elusive aspects of life in science, as discussed in interviews with natural scientists about their experiences of international mobility. In particular I use ideas of the situation, atmospheric threads, and the staging of atmospheres to argue that scientists represent themselves as existing in between the particular and the general: they are never wholly at the mercy of the structures and expectations of globalized science, but are also never not in the grip of them. In closing I reflect on what this analysis reveals about the affective qualities of contemporary science, the forms of life being nurtured by the norms and expectations of research (policy), and the kinds of agency available to (these) scientists. The aim of the article is thus twofold: to demonstrate how concepts of atmospheres can be put to work in STS, and to contribute to research on international mobility in science and contemporary scientific careers.

Maintenance epistemology and public order: Removing graffiti in Paris

Jérôme Denis, David Pontille

Taking part in the growing concern for repair and maintenance in STS, this article investigates epistemic dimensions of maintenance. Drawing on an ethnographic study of graffiti removal in Paris, it highlights the different objects of knowledge involved in this specific setting of urban maintenance and documents their relationships. It shows that, inspired by the ‘broken windows’ thesis, the anti-graffiti program that emerged in Paris at the turn of 2000 articulates three objects of knowledge – public order, graffiti and the city – whose intertwined definitions root a restorative maintenance epistemology. Such epistemology unfolds in an assemblage of policy documents, regulatory texts, contracts, technical specifications and procedures, information infrastructures and categories, removal techniques, tools and situated gestures, which take place in municipality’s offices, contractors’ workshops and during each intervention in the streets. The Paris graffiti removal program instantiates a preservationist approach which focuses on recurrent visual signs of disruption occurring on the façades and rests on both a distributed attention and a particular pace for interventions. It involves three main operations: measuring surfaces, identifying public expressions and composing with materials. None of these operations are neutral. Aimed at preserving a specific order, they also participate in the daily transformation of urban reality. The heterogeneous knowledge at play in maintenance practices intricately takes part in the becoming of the things whose stability it strives to ensure.


Maintenance epistemology and public order: Removing graffiti in Paris

Jérôme Denis, David Pontille

Taking part in the growing concern for repair and maintenance in STS, this article investigates epistemic dimensions of maintenance. Drawing on an ethnographic study of graffiti removal in Paris, it highlights the different objects of knowledge involved in this specific setting of urban maintenance and documents their relationships. It shows that, inspired by the ‘broken windows’ thesis, the anti-graffiti program that emerged in Paris at the turn of 2000 articulates three objects of knowledge – public order, graffiti and the city – whose intertwined definitions root a restorative maintenance epistemology. Such epistemology unfolds in an assemblage of policy documents, regulatory texts, contracts, technical specifications and procedures, information infrastructures and categories, removal techniques, tools and situated gestures, which take place in municipality’s offices, contractors’ workshops and during each intervention in the streets. The Paris graffiti removal program instantiates a preservationist approach which focuses on recurrent visual signs of disruption occurring on the façades and rests on both a distributed attention and a particular pace for interventions. It involves three main operations: measuring surfaces, identifying public expressions and composing with materials. None of these operations are neutral. Aimed at preserving a specific order, they also participate in the daily transformation of urban reality. The heterogeneous knowledge at play in maintenance practices intricately takes part in the becoming of the things whose stability it strives to ensure.

The financial market of ideas: A theory of academic social media

Alessandro Delfanti

Millions of scholars use academic social media to share their work and construct themselves as legitimate and productive workers. An analysis of Academia.edu updates ideas about science as a ‘marketplace of ideas’. Scholarly communication via social media is best conceptualized as a ‘financial market of ideas’ through which academic value is assigned to publications and researchers. Academic social media allow for the inclusion of scholarly objects such as preprint articles, which exceed traditional accounting systems in scholarly communication. Their functioning is based on a valorization of derived qualities, as their algorithms analyze social interactions on the platform rather than the content of scholarship. They are also oriented toward the future in their use of data analytics to predict research outcomes.

The imagined scientist of science governance

Heidrun Åm, Gisle Solbu, Knut H Sørensen

In this article, we introduce the concept of ‘the imagined scientist’. It inverts previous discussions of the public as an imagined community with a knowledge deficit, to examine imagined scientists representing an actor (or group of actors) with deficits in knowledge or concern about social issues. We study how Norwegian science policymakers, on the one hand, and biotechnologists and nanotechnologists, on the other, articulate and engage with social responsibility. The article identifies what we call ‘deficit trouble’, when there is poor alignment of the deficits of different imagined scientists, which may lead to a stalemate in the communication between science policymakers and scientists. We argue that ‘the imagined scientist’ can function as sensitizing concept for further studies of science governance across a range of topics, bringing into view how different deficit logics operate in science policy.

Transforming Anthropology

Fat, Black, and Ugly: The Semiotic Production of Prodigious Femininities

Krystal A. Smalls

Taking up the trinomial “fat, Black, and ugly” as a discomforting point of departure, this piece explores several ways fatness and Blackness are discursively constructed as social comorbidities for feminine people and examines how this discourse affects lived experience. It considers how the discursive field in which “fat, Black, and ugly” dwells traverses temporal and social scales: from early twentieth‐century science discourse to recent social media discourse, and from state policies to inner voices. Inspired by Gina Athena Ulysse’s rasanblaj approach, the analysis uses a combination of personal narrative/autoethnography and discourse analysis, and draws from sociocultural anthropology, linguistic anthropology, Black feminist studies, African feminist studies, and fat studies. I convene these fields and methodologies in an effort to think about a semiotic collusion between fatness and Blackness that expels certain subjects from legible and legitimate humanness and value in an anti‐Black anthroposphere—or, via the illuminations of Hortense Spillers, that renders them prodigious flesh that prevails in the beyond.

“If Geert Wilders Has Freedom of Speech, We Have Freedom of Speech!”: Girls’ Soccer, Race, and Embodied Knowledge in/of the Netherlands

Kathrine van den Bogert

This article discusses the role of race as it intersects with religion, gender, and class in Dutch public spaces through an ethnography of Moroccan‐Dutch Muslim girls playing soccer. Racialized Muslim girls are “othered” and portrayed as unemancipated and inactive in Dutch society, not in the least by politicians such as Geert Wilders. Yet, racialized girls resist their “othering” by appropriating public sports spaces for their own girls’ soccer competition. I show how soccer players deal with racist comments in sports and how they respond to right‐wing nationalism and racist populism by playing soccer. I argue that the girls’ embodied knowledge of such experiences is crucial for scholarly understandings of race, racialization, public space, and sports. This article demonstrates how race works in Dutch public sports spaces, and how gender, religion, and class are produced through racialization in sports.


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