In the Journals, October 2024, Part 2
Somatosphere welcomes you to the second part of our October edition of “In the Journals.” Scroll through our monthly round up of new research across anthropology, STS and social science journals.
East Asian Science, Technology and Society: An International Journal
Ming-Sin Choong, Ying-Che Hsieh and Chan-Yuan Wong
This paper examines and reviews three years of the preventive measures taken by different countries, which led us to frame the most effective mitigation and coping mechanisms that were deployed to cushion the impact of Covid-19 outbreaks on respective health systems. Measures taken by five countries (the United States, United Kingdom, India, South Korea, and Taiwan) are used as case studies. We delineate the resilience measures within the scope of “coping” and “transcending.” The elucidation of these measures is demarcated into three control phases: feedforward control, concurrent control, and feedback control. Our review reveals that the US, UK, and India struggled as a result of chaotic coordination by their public health systems to cope with high admission rates of Covid-19-infected patients; however, they possessed the ability to learn swiftly and to identify and produce vaccine candidates to transcend the crisis. Meanwhile, South Korea and Taiwan were found to have the ability to cope with the upheavals they encountered during the pandemic crisis. The holistic framework of resilience measures we derive may be instrumental to policy makers, public health specialists, and researchers, setting out as it does the coping and transcending abilities within the context of a learning society.
Health and Place
Trina Robinson, Bryan Boruff, John Duncan, Kevin Murray, Jasper Schipperjin, Andrea Nathan, Ben Beck, Gareth Stratton, Lucy J Griffiths, Richard Fry, Bridget Beesley and Hayley Christian
We know relatively little about the role the neighbourhood built environment plays in promoting young children’s physical activity, particularly its longitudinal effect either through repeated exposure to the same environment or through change in exposure by moving from one neighbourhood to another. This study characterised the neighbourhood environment of young children in the PLAYCE cohort study over three timepoints from 2015 to 2023. There were statistically significant differences in built environment attributes between timepoints and across socio-economic status, however they did not represent practically significant differences. These findings inform the analysis approach of subsequent research in the BEACHES Project, an international study examining the role of the built environment on child physical activity and obesity using multiple cohorts.
Nadra Elhania, Gregory Moullec and Yan Kestens
This study examines the complex interplay between social and spatial structures among older adults, emphasizing the interest in considering the social composition of activity spaces and the spatial characteristics of social networks. There is a growing interest in the collection and analysis of both social and daily mobility spatial information to better understand people-place interactions and determinants of health. Yet, few analyses have explored how the social and spatial dimensions of people’s lives relate. In this exploratory study, we analyze how social and spatial indicators collected with the VERITAS-Social questionnaire among 98 older adults in Montréal, Canada, relate, using confirmatory principal component analysis. The aim of the article is to provide empirical evidence on the reduction of dimensions of measures related to social networks, activity spaces, and combined socio-spatial structures.
“Poor and Dirty”: Unintended consequences in a hygiene material Distribution in Burkina Faso
Salam Zoungrana
The practical interrelationships between the African environment and hygiene practices during a pandemic period is a topic of significant importance. Specifically, this research explores the intersection of cultural dynamics and hygiene practices in Burkina Faso, focusing on a recent example of distribution of hygiene materials. It highlights the negative reactions to these foreign interventions, perceived as patronizing and stigmatizing, which underscores the complexities of implementing health initiatives in diverse socio-cultural landscapes. These findings stress the importance of culturally sensitive approaches and greater engagement in public health initiatives like the latrine usage with specific designs for communities.
Daniel A. Scheller, Katharina Sterr, Andreas Humpe, Filip Mess and Joachim Bachner
Public urban places and their environmental characteristics impact youth’s physical activity (PA) through perceptions. The objective of this study was to use a qualitative participatory approach with children and adolescents to understand how their attachment to urban places perceived as PA-friendly or unfriendly is related to their PA behaviour. Ninety-three participants aged six to 17 from six neighbourhoods with varying objective walkability engaged in photovoice and walking interviews. Data were analysed by using the tripartite framework of place attachment (PPP model), which was adapted for application to PA behaviour and supplemented by photographs. Themes were identified for each (sub-)dimension of the PPP model with person, place and process factors influencing attachment. Further subdimensions (PA and other behaviours) and categories (travel mode, trip length and frequency of visits) were added to the PPP model. Urban design recommendations were derived by age and gender to promote PA through place attachment.
Visualising legitimacy: An analysis of medicinal cannabis images in Australian news
Hannah Adler, Barbara Pini and Monique Lewis
This paper reports on a visual framing analysis of Australian online news media images of medicinal cannabis (MC) from 2014 to 2021. It reports on two themes – people and place, and plant and place. The first theme reveals that images of MC users, including children, and familial caregivers were commonly emplaced within quotidian middle-class, suburban, domestic settings, thereby demarcating them from recreational cannabis users. The second theme situated cannabis as a plant in spaces which defined it visually as an agricultural product, pharmaceutical drug, herbal medicine, and less commonly as a recreational drug. This disparate photographic storyline blurred the boundary between recreational and medicinal cannabis.
Thomas Astell-Burt, Michelle Kondo, Tanya Pritchard, Katarzyna Olcon, J. Aaron Hipp, Deepti Adlakha, Ecangelos Pappas and Xiaoqi Feng
Evidence to support nature contact and nature prescriptions to reduce loneliness is scant. A total of 2100 individuals took part in a survey conducted in Australia (n = 525, mean age = 34.1), India (n = 526, mean age = 29.5), Singapore (n = 523, mean age = 36.1), the UK (n = 526, mean age = 37.3), and the US (n = 525, mean age = 43.6) in 2022 (overall age range 18–89yrs). Multilevel logistic regressions adjusted for confounding indicated mean levels of overall loneliness tended to be higher in India (Odds Ratio [OR] 1.21, 95% Confidence Interval [95%CI] 0.90–1.62), Singapore (OR = 1.54, 95%CI = 1.15–2.07), the UK (OR = 1.26, 95%CI = 0.96–1.67) and the US (OR = 1.24, 95%CI = 0.94–1.64) compared with Australia. Notable differences were observed by loneliness type, for example, with lower odds of social loneliness (OR = 0.57, 95%CI = 0.41–0.79) and higher odds of emotional loneliness (OR = 1.57, 95%CI = 1.14–2.06) in India compared with Australia. Findings with regards to loneliness and nature contact varied between country. In general, social loneliness was lower in participants who visited natural surroundings regularly (OR = 0.81, 95%CI = 0.61–0.98) and spent two hours or more per week in nature (OR = 0.65, 95%CI = 0.49–0.81). Overall loneliness (OR = 1.98, 95%CI = 1.48–2.47) and emotional loneliness (OR = 2.84, 95%CI = 2.13–3.51) were substantially higher among those who felt having no-one to go with was a barrier to spending time in nature. Emotional loneliness was higher in those who had more time in nature (OR = 1.32, 95%CI = 0.94–1.75) or more frequent visits (OR = 1.24, 95%CI = 0.94–1.49), which may be indicative of selective processes by which some people who feel emotionally lonely seek meaningful sources of connection or solace in natural environments. In sum, these findings highlight potentially important contingencies in how people feel lonely in different countries, and the potential of contact with nature as a means to address this critical issue of modern times. Randomised trials of nature prescription interventions for loneliness co-designed with respect to contrasting cultural, economic, and climatic contexts are needed to ensure programs intended to reconnect people with nature are effective, equitable, and acceptable for everyone.
Eric Robinson, Kathleen Stewart, Erin Artigiani, Margaret Hsu, Amy S. Billing, Ebonie C. Massey, Sridhar Rao Gona and Eric D, Wish
As opioid-related overdose emergency department visits continue to rise in the United States, there is a need to understand the location and magnitude of the crisis, especially in at-risk rural areas. We analyzed sets of ZIP code level electronic health records for emergency department visits from 6 hospitals for two rural regions of Maryland with higher opioid-related overdose rates. Analysis of the demographics of visits found Black or African American emergency department visits in both rural regions were higher than the proportion of their population per region. We trained random forest models with socio-demographic factors and health risk factors on the visits data to understand drivers and risk factors for opioid misuse. The models ranked factors relating to opioid prescribing rates, race, housing, and poor mental health as highly important. Factors associated with opioid-related overdose emergency department visits were found to vary by race, gender, and location and may provide useful insights for designing mitigation initiatives.
Evord Kimario, Lucy Joseph, Nestory Yamungu and Joseph Mango
Two hours of travel time specified by the World Health Organization (WHO) to access quality health services is among the most important criteria for the Universal Health Coverage. However, locations of health facilities (HF) in many developing countries fail to realise this target due to a lack of appropriate models considering the local environment. This work used the central-place theory to explore locations of HF in Kishapu and their accessibility status based on two means of transport in the AccessMod tool: walking only and the combination of walking-and-motor devices. The results of the walking scenario indicated that the travel times to the health centres and hospitals exceeded 2 h, and a direct relationship existed between the facility level and the travel time spent to access it. The combined transport (walking and motorized) showed that dispensaries are easily accessible (14.5 min) compared to health centres (42.8 min) and hospitals (67.3 min). To address the challenge, we have developed a model revealing optimal sites with quick access for HF construction and improvement using Multi-Criteria-Evaluation and Analytical-Hierarchy Process methods weighting five criteria including distance from settlements (44% weight), roads (26% weight), existing health facilities (16% weight), rivers (9% weight) and railway (5% weight). A test of the model with both means of transport shows that at all places proposed to be optimal allow patitents to travel in less than 2 h, indicating that the proposed model can effectively and efficiently solve the challenge of allocating HF in society.
Journal of the Royal Anthropological Institute
Sincere critique in Israeli filmmaking
Maayan Cohen
This article investigates an increasingly observable yet insufficiently studied phenomenon: the emphasis placed by artists on personal experience as the most legitimate inspiration for art. To this end, I introduce the term ‘sincere realism’ to describe an emerging form of personal cinema in Israel, illustrating how sincerity has evolved into a dominant ‘regime of truth’ that moulds modern forms of critique and expression in contemporary Israeli filmmaking. Through a critique of Foucault’s concept of ‘regimes of truth’, I argue that ‘sincere realism’ has ethical and political implications and therefore allows a more nuanced anthropological approach to Foucault’s concept of power. This perspective offers a fresh insight into how artists negotiate contemporary ‘regimes of truth’.
Ashley Hahn
Recent debates in the anthropology of Islam have centred on the relationship between ‘everyday Islam’ and ‘piety’. Some scholars have posited that these are two opposing theoretical poles, while others have described how religion permeates the everyday. I add to these debates by describing how, for one group of young Turkish-American Muslim women in a piety movement, the everyday permeates religion. Specifically, my ethnography shows that the ‘everyday’, constructed as a site of struggle and reflection, is seen as at the core of being and becoming a Muslim. Their diverse and shifting responses to the ethical dilemma of how to emulate the Prophet’s vefa (loyalty) after moving away from one another – specifically whether to engage with Facebook for this reason – show how piety and the everyday, and the sacred and the secular, infuse one another in complex ways in their moral projects, and hence how what is considered normative and pious need not be static and homogeneous.
The artisanal underground: gold, subsistence, and subsurface materiality in Colombia
Jesse Jonkman
This article focuses on subsurface materiality to explore how small-scale gold miners in Colombia navigate formal politics. In much critical research, the underground appears as a space of great developmentalist ambition, whose resources enable corporate expansion and bureaucratic rule. Here I take a slightly different route, as I demonstrate that subterranean matter makes possible ways of knowing and working that are anathema to a pro-corporate legal regime. More specifically, I maintain that Colombian small-scale miners experience the underground as invisible and unruly matter, and I show that this experience mediates their everyday criticism of, and resistance to, state governance.
Angelina Kussy and Dolors Comas-d’Argemir
There have been plenty of interpretations regarding the meaning and function of sacrifice within the discipline of anthropology. Going beyond sacrifice as a ritual and exploring a wide range of its manifestations and functions as contemporary cultural practices, discourses, and underlying logics, we reveal its role in the social organization of social care provision within the framework of neoliberal capitalism. Our analysis supports the theory that sacrifice can have the function of social control, and of preserving hierarchies. The forgoing of a minority of migrant domestic workers to provide intensive social care becomes the (no) solution to the ongoing care crisis. It thus becomes the way to hide structural violence and dilute responsibilities for society, which benefits from the servile conditions under which the labour is performed. The ethnographic material (observations, informal conversations, and interviews) that is part of our analysis originated from fieldwork in Castellón de la Plana, Spain (2018/19). This analysis, however, goes beyond that case, being valid for reflecting on the position of care for elderly and dependent people in our societies, care in general, the current global trend in social care provision, and the new social reproduction regime in which sacrificial logics play an increasing role.
Alice Pearson
This article interrogates relations between dual senses of economics as ‘discipline’: as a form of knowledge and as a form of training. Scholars have suggested that economics performatively brings homo economicus into being. Yet this has been often posited as a singular figure, while eclipsing the unequal forms of personhood and sociality it instantiates. Through ethnography of elite undergraduate economics education in the United Kingdom, I ask how the ‘representative agents’ of homo economicus are considered ‘representative’, and how they relate to the forms of ‘agency’ that students cultivate. I argue that ambivalent epistemologies in economics oscillate between a-realism and what I term ‘brutal realism’, which appeals to epistemic prowess yet normalizes the partial perspective of a detached elite masculinity. Students are encouraged to foreclose critique to stabilize these unstable models; thus the multiplicity of representative agents paradoxically contributes to their traction. Meanwhile, students cultivate ethics of efficiency that facilitate this wilful blindness, shaping their trajectories into finance. I demonstrate that the authority of economics emerges through distinct affective, pedagogical, and epistemological forms, and there are multiple mirrors between these forms and the content of economics education.
Medicine Anthropology Theory
Sara Bea
This article presents an ethnographic study of the donor body in deceased organ donation. Drawing on the science and technology studies’ incitement to study bodies being enacted and acted upon in situated practices, I explore the body being done and becoming undone in the practices of organ procurement at a Catalan hospital. The hospital has uniquely high rates of organ donation and transplantation, and deceased organ donation has become routinised and integrated into everyday hospital activities. I attend ethnographically to the medical professionals’ accounts of and interactions with bodies and organs in their work dealing with both donors after brain death diagnosis and uncontrolled donors after circulatory death diagnosis. During fieldwork, I followed the struggles of the transplant coordination team grappling with unruly bodies under different maintenance technologies. The body being done in these hospital practices is an active and unstable materiality that must be contended with: a labile body, or a fragile assemblage of interdependent functions, requiring multiple interventions provided by a host of dedicated hospital practitioners. The article shows that staying close to the medical professionals’ situated accounts is a valuable route to gaining novel understandings of the donor body.
Maria Pozzio and Daniela Testa
The article analyses the politicisation of nursing personnel during the COVID-19 pandemic in Argentina, focusing on the trajectories of nurses trained in the public universities of the so-called ‘conurbano bonaerense’, especially in the young universities of the ‘Bicentenario’, rooted in a territory with strong traditions of popular political participation. The pandemic context accelerated the struggles for professional recognition among nurses. Analysing this process constitutes a significant contribution to the social studies of health and illness in Latin America, particularly regarding the role of gender. The pandemic has highlighted the necessity of making the history and demands of the nursing profession visible. Against this background, this article emphasises the challenging working conditions and lack of recognition faced by the nursing profession in Argentina, both materially and symbolically. Based on the analysis of narratives provided by nurses in the context of the COVID-19 pandemic, the article analyses three politicisation trajectories of nursing graduates of Universidad Nacional Arturo Jauretche, on the conurbano bonaerense, the metropolitan area of Buenos Aires. We demonstrate the importance of the institutional context of the universities in this territory and underline its significance for the politicisation process we have observed.
Hope and Haunting Images: The Imaginary in Danish Parkinson’s Disease Rehabilitation
Merete Tonnesen and Claus Vinther Nielsen
Much in life is imagined: hoped for, dreamed about, or dreaded, as we engage with potential futures. Parkinson’s disease is a progressive and neuro-degenerative disease, currently incurable. During long-term fieldwork among Danish rehabilitees with Parkinson’s disease, rehabilitees’ mentioning of hope and images of the future gradually inspired attention to an imaginary dimension in rehabilitation. We explore haunting images and hope among rehabilitees as examples of the imaginary in rehabilitation, but also as windows into how rehabilitees orientate themselves towards an uncertain future. We show how rehabilitees’ imaginations of the future resemble hauntings instigating an urge to ‘do something’ to avoid their actualisation; to insist on living in the now, keeping up training, and partaking in clinical trials. This urge translates into rehabilitation practices, where rehabilitees and professionals work with both hope and rehabilitation goals to maximise the present and postpone the future. We emphasise that hope is a complex phenomenon; it is multiple and has a certain elasticity. A person can carry multiple hopes at once; hope can be agentic, co-created and worked with, located, or be an existential stance.
Mother of All Labour: Vulnerability and Immunity in Times of Ebola
Veronica Gomez-Temesio
Wonkifong Ebola treatment unit was unique at the time of the outbreak that hit the Guinea in 2014. Contrary to other infrastructures run by Western workers, Wonkifong mainly employed personnel from Guinea, the Democratic Republic of Congo, and Cuba. Even so, the unit constituted a racialised landscape where proximity to white agencies granted privileges to certain groups of racialised people while excluding others. In a humanitarian infrastructure aimed at empowering knowledge of epidemics in the Global South, Black children were quarantined without their parents and left mostly unattended. After many months, former patients were hired as nannies to remedy the infrastructure’s blind spot. These women were employed to care for the children thanks to their immunity to the virus. Building on the concept of a ‘politics of life’ and exploring how these women were exploited as ‘medical superbodies’, my article sheds light on how the humanitarian infrastructure produced a gendered labour that mirrors other economies exploiting female Black bodies such as the colony or the plantation. Relying on an ethnography of practices of care and mobility within the unit, this piece underlines how the postcolonial segregation at play during the outbreak operated not strictly in terms of skin colour, but in terms of gender and closeness to white power.
New Genetics and Society
Luciano Ferrari, Roberta Raffaetà and Lorenzo Beltrame
This article analyses valuation practices, focusing on the way health data constitute different kinds of assets for different actors within an industry-academia partnership in the field of microbiome research. It examines emerging bioeconomic dynamics within data-driven computational biology, contributing to debates about the sociopolitical implications of multiple and synergic valuation practices in personalized medicine for future public health. Through the ethnographic exploration of a personalized nutrition startup active in Europe and the US and a metagenomics research lab based in Italy, we explore the dynamics around the intersection of knowledge production with scientific, economic, and health value. In contrast to traditional commodity and rent-based structures, we expose a hybrid model of bioeconomic enterprise that challenges rigid distinctions between commodification and asset-based rentiership, highlighting synergic business models where multiple registers of the value of worth are played out, translated, and combined. The study unveils a nuanced relationship between data, research, and economic drivers, where scientists perceive they can pursue research independently from market pressures. Beyond these perceptions and narratives, we highlight the economic dynamics that suture basic research and industry in their promotion of health governance that causes social justice concerns by restricting access to high income and hegemonic types of clients/patients. We clarify that epistemic aspects cannot be disentangled from sociopolitical aspects, especially in the digital age, and that where governments implement and enhance digital health solutions, they also need to plan for consistent social (re)adjustments.
Brigitte Nerlich and Rusi Jaspal
In May 2023, The Guardian announced that babies had been born through mitochondrial replacement therapy (MRT). MRT and its ethical and legal implications have been discussed in the media for over a decade. These discussions have been examined by social scientists and communication scholars. In this article, we seek to determine whether and, if so, how social representations have changed since this announcement. Using thematic analysis and social representations theory, we studied a corpus of 70 English language newspaper articles. Results show three thematic dichotomies: (1) moderation vs. sensationalism; (2) ontologising vs. de-ontologising MRT; and (3) using metaphors for persuasion vs. explanation. The societal concern representation largely dominated reporting around 2015 and the hope and opportunity representation was prominent in current reporting. We argue that the hope representation may facilitate greater patient and public acceptance of MRT but that it may also limit awareness, understanding and discussion of its possible risks and limitations.
Science, Technology and Human Values
Small Chemicals of Trauma: Epigenetics as Colonial Unknowing
Henrietta Byrne and Jaya Keaney
In Australia, some Indigenous and non-Indigenous scientists, health workers, psychologists, and others have identified a resonance between epigenetics and Indigenous scholarship on intergenerational trauma. Epigenetics is a postgenomic science that seeks to demonstrate how environments can “get under the skin” to shape health outcomes by altering gene expression. Intergenerational trauma is a similar concept, as it describes how past harms such as colonial policies can make themselves felt in the present. Using ethnographic data from interviews with researchers across Australia and observations from scientific conferences, this article critically examines how the normative tools of epigenetic studies are increasingly positioned by scientists as the route to a valuable form of evidence for addressing intergenerational trauma and health injustice. Through the frame of “colonial unknowing,” we argue that the settler state functions by valuing certain forms of evidence of trauma over others; namely, epigenetics is positioned as offering objective scientific evidence seen as more valuable than narrative testimony and evidence rooted in Indigenous ontologies, thereby displacing prior knowledges of how trauma is embodied and enrolling communities into conditions of perpetual rediscovery. While many participants reject epigenetic knowledge production outright for this reason, we explore how others strategically engage with it in the present while simultaneously challenging its growing epistemic power and future promise.
Ethics and Practice in Communities of Care
Joan H. Fujimura
The Society for Social Studies of Science (4S) annually awards the John Desmond Bernal Prize to one or more individuals who have made distinguished contributions to the field of Science and Technology Studies. Past winners have included founders of the field, along with outstanding scholars who have devoted their careers to the understanding of the social dimensions of science and technology. This article is the revised text of Joan H. Fujimura’s 2023 Bernal Lecture.
Loïc Riom, Solène Gouilhers and Claudine Burton-Jeangros
This article analyzes the development process of a software solution designed to assist researchers in writing biomedical research–informed consent forms. Funded by a Swiss ethics committee, the purpose of the software is to enhance the readability of such documents to improve biomedical research participants’ understanding of the information disclosed therein and to reduce the editing work of research ethics committees. Drawing on an embedded ethnographic research, we show how concerns that emerge in ethics reviews shape ethics committee IT infrastructure and how, in turn, this infrastructure contributes to redefining research ethics. We demonstrate that while the software reinforces the biomedical framing of research ethics, it also generates unexpected overflows. By forming new collectives, this infrastructuring process furthers expertise on informed consent forms while giving rise to new areas of inquiry and redefining the issue of readability in biomedical research. Thus, we provide insights into the complex entanglements between research ethic, computer programs, and writing practices. We conclude by reflecting on the role played by our research team during the software’s development and outline proposals on how ethnographic methods can contribute to make research ethics review accountable.
Social Science and Medicine
“Dengue fever is not just urban or rural: Reframing its spatial categorization.”
James A. Trostle, Charlotte Robbins, Betty Corozo Angulo, Andrés Acevedo, Josefina Coloma and Joseph N.S. Eisenberg
Infectious diseases exploit niches that are often spatially defined as urban and/or rural. Yet spatial research on infectious diseases often fails to define “urban” and “rural” and how these contexts might influence their epidemiology. We use dengue fever, thought to be mostly an urban disease with rural foci, as a device to explore local definitions of urban and rural spaces and the impact of these spaces on dengue risk in the provinfine urban and rural locales. Interviews conducted from 2019 to 2021 with 71 residents and 23 health personce of Esmeraldas, Ecuador. Ecuador, like many countries, only uses population size and administrative function to denel found that they identified the availability of basic services, extent of their control over their environment, and presence of underbrush and weeds (known in Ecuador as monte and maleza and conceptualized in this paper as natural disorder) as important links to their conceptions of space and dengue risk. This broader conceptualization of space articulated by local residents and professionals reflects a more sophisticated approach to characterizing dengue risk than using categories of urban and rural employed by the national census and government. Rather than this dichotomous category of space, dengue fever can be better framed for health interventions in terms of specific environmental features and assemblages of high-risk spaces. An understanding of how community members perceive risk enhances our ability to collaborate with them to develop optimal mitigation strategies.
The effect of cash transfers on health in high-income countries: A scoping review
Robbie Brydon, Saud Bin Haseeb, Gum-Ryeong Park, Carolyn Ziegler, Stephen W. Hwang, Evelyn L. Forget, Navindra Persaud, Arjumand Siddiqi and James R. Dunn
High-income countries use cash transfer programs to mitigate poverty, in part to improve the health of low-income populations and potentially reduce their use of public health care. This review synthesizes evidence from studies that employed experimental or quasi-experimental designs to evaluate the effect of cash transfer interventions on health outcomes or health care utilization in high-income countries. We excluded interventions if they required prior contributions for eligibility, substituted cash transfers for in-kind services, or were contingent on specific health behaviours, and excluded studies published before 1970. We searched 14 academic databases on May 13, 2022 and April 18, 2023, identifying 20,978 unique records. After screening, 164 studies were included. These studies covered interventions in 14 countries, with the largest share from the United States. The most common health outcomes examined were fertility, birth weight, self-rated health, tobacco use, and depression. We classified studies into seven intervention categories and eight health outcome domains, and identified where systematic reviews may be possible. We found relatively few studies examining health care utilization as an outcome and identify this as a knowledge gap. We categorized effects as beneficial or harmful, except for fertility and health care utilization where effects were categorized as increase or decrease. With insufficient consistency of outcomes for meta-analysis, we employed a vote count and sign test to assess the presence of any effect. Across the six relevant health domains, 98 of 130 studies (.75; 95% CI: .67, .82) reported a beneficial median effect, significantly different from the null value of 50% (p = .000). Of 37 studies examining fertility, 23 showed increases (.62; 95% CI: .46, .76) in fertility, which did not clear our threshold for statistical significance using conservative assumptions (p = .094). However, a larger share of studies reported increased fertility for child/family benefits (.69, n = 26) than for employment-related cash transfers (.44, n = 9). Results for health care utilization were evenly distributed (5 increase, 4 inconsistent, 6 decrease), but these are difficult to interpret as outcomes include both preventive and acute care. Our study provides replicable methods to enable future meta-analyses.
Maria Węgrzynowska, Nina Sahraoui, Ilona Nenko, Beata Szlendak and Barbara Baranowska
The outbreak of the full-scale war launched by Russia against Ukraine and, following it, significant migrations have not only increased the diversity of the Ukrainian migrant population in Poland, but also added to the complexity of their health needs and strategies. This study seeks to explore Ukrainian migrant women’s experiences and practices related to the use of maternity care services. The article is based on fieldwork conducted between February and October 2023 and included 23 semi-structured interviews with Ukrainian migrant women who gave birth in Poland after February 24, 2022. To understand Ukrainian women’s pathways to maternity care in Poland and unpack the differences in experiences within this group of migrants, we explore participants’ healthcare strategies against the background of existing inequalities in access to quality care in Poland and Ukraine, in particularly the division between private and public services. We consider the role of financial, social and cultural resources and distinguish for this purpose between three groups of permanent, circular and wartime migrants. We show the decisive role of economic resources, nonetheless in articulation with the creation and mobilisation of social networks and time spent in Poland, which play a role in shaping migrant women’s capacity to access better maternity care.
Sara Evans-Lacko, Paulino Font Gilabert and Martin Knapp
Early childhood socioeconomic disadvantage and mental health problems are both important determinants of adult social and economic experiences, but little is known about how they interact in this respect. We aimed to assess whether poor mental health in adolescence exacerbates labour market inequalities originating from low socioeconomic status (SES) in childhood. We use a birth cohort of individuals born in 1958 in England and follow their employment experiences and cumulative earnings up to age 55. We proxy low SES in childhood with father’s occupational class at the time the respondent was aged 11, and use caregiver (usually, parent) ratings of the Rutter inventory at age 16 to identify mental health problems in adolescence. We fit ordinary least squares (OLS) models to estimate the effect of growing up in a low-SES family and experiencing mental health problems (conduct or emotional problems) in adolescence on cumulative earnings (log-transformed). We use an interaction term to test whether the association between mental health problems (conduct and emotional separately) and earnings differed by socioeconomic group. Individuals who experienced conduct problems in adolescence had lower cumulative earnings and employment levels up to age of 55. Moreover, the association between mental health problems and cumulative earnings was higher among individuals who also experienced low SES in childhood. Families from a higher socioeconomic group may have more effective means to counteract the adverse impacts of adolescent mental health problems, likely due to broader access to resources, support systems and opportunities. This underscores the role of structural supports in addressing socioeconomic inequalities in mental health outcomes and their long-terms implications.
Mitsuri Pacheco-Zapata, Fernanda Pérez-Lombardini, Benjamin Roche, Audrey Arnal, Erika Marcé and Gerardo Suzán
Although disease ecology recognizes the multiplicity of factors involved in the (re)emergence of vector-borne diseases (VBD), it is necessary to strengthen attention to the social context and the social determinants of health. It is essential to integrate a sociocultural approach to health into the biological analysis of VBD ecology. To implement a coherent One Health approach in the prevention and control of VBD, it is pivotal to first understand the social and ecological interactions of the local context. Between October 2021 and June 2022, a social contextual study was made through surveys, semi-structured interviews and participatory activities in 12 localities with diverse ecological, economic and socio-cultural contexts in the Yucatan Peninsula. Through the perceptions of the populations on health and VBD, specifically mosquitoes, we gained knowledge on socio-cultural dynamics that influence people’s relationship with pathogens. Local knowledge, management, and control of vectors; interactions with domestic and wild animals; and health-landscape relationship, were identified as factors that determine health-disease processes. This study contributed to a better understanding of local contexts and therefore, to the design of socially pertinent strategies for the reduction of vector-borne diseases risk scenarios in the study sites with an integrated approach.
Claudia Nieto-Sanchez, Stefanie Dens, Jesus Cisneros, Karla Solari, Mario De Los Santos, Victor Vega, Alfonso Silva-Santiesteban, Larissa Otero, Koen Peeters Grietens and Kristien Verdonck
The goal of this qualitative research study, part of an interdisciplinary project, was to understand the overlapping geographical distribution of COVID-19 and tuberculosis burden in Lima. Using an ethnographic approach, we applied the concept of disease situations to explore how inhabitants’ social and spatial situatedness affected their capacity to respond to the pandemic. Our results show that for some populations in Lima, the risk to develop COVID-19 did not emerge suddenly; it could be traced back to situations of living under subsistence models, relying on unstable sources of income, facing food insecurity, depending on certain mechanisms of social protection, residing in precarious living environments and lacking access to quality health care. These populations did not only have less resources to adjust to changes in daily life induced by the pandemic; they were also forced to constantly weigh the risk of COVID-19 against other pressing needs and potentially face increased risks when control measures were actually followed. Pre-existing social networks played fundamental roles as sources of emotional and material support. The lens of disease situations can help to identify and explain spatial and social configurations that enhance vulnerability, as well as resilience mechanisms that are in place to deal with crises. This perspective could inform the design of contextualised prevention and response strategies around health risks in cities as diverse as Lima, whilst building on existing resources at local levels.
Suicide variations between English neighbourhoods over 2017-21: The role of spatial scale
Peter Congdon
Geographic studies of suicide variation typically focus on predictors at the same level as the event rates, and the possible interplay between different spatial scales does not generally figure. In this paper we focus on suicide variations between 6856 small area census units in England, but against a background provided by nine regions, broad urban-rural categories, and 155 local labour markets. Suicide death totals vary considerably between the small areas, with more areas than expected having no deaths, so we apply zero inflated regression. With this framework, we consider the relative contribution of factors at higher and lower spatial scales in explaining small area suicide contrasts, and why some areas have unduly elevated or unduly low suicide rates. We find significantly lower suicide levels in English metropolitan regions, after allowing for neighbourhood influences, but considerable heterogeneity in risks within broader spatial units. Varying incidence in general is associated significantly with all observed neighbourhood risk factors (social fragmentation, socioeconomic status, mental ill-health, ethnic mix), but low fragmentation and low psychiatric morbidity are the only significant influences on unduly low incidence.
Sociology of Health and Illness
Catherine Coveney and Basma Salem
Little is known regarding the future reproductive decision-making of parents of children with rare genetic conditions. Our research draws on data from an online survey and qualitative photo-elicitation interviews with families living with Noonan Syndrome. We demonstrate how genetic knowledge and prenatal genetic testing become embedded in reproductive practices. Yet the idea of using selective genetic technologies to influence reproductive outcomes remains highly emotive. Our analysis reveals that for these parents, the rationalities of reproduction, although technologised and biomedicalised, remain centred on caring for their disabled child. Genetic subjectivities become entangled with responsibilities of care-giving and emotion tied to the realities of living with disability. We argue that for these parents, reproductive decisions are relational and affective, situated within families and communities and shaped by access to emotional, financial, physical and temporal resources. Our findings provide new insights into the ontologies of selective genetic technologies and reproductive governance in families living with disability.
Positioning comfort measures in antenatal counselling for periviable infants
Katherine Caroll, Megan Thorvilson and Christopher Collura
Caring for the extremely premature infant born in the grey zone of viability is the most difficult area of neonatal medicine. Little research has been done on antenatal communication between neonatologists and parents anticipating the birth of a periviable infant. This article analyses 25 antenatal consultations between neonatologists and parents in one Midwestern hospital in the United States of America. It explores how neonatologists position comfort care as one of two predominant care trajectories for extremely premature infants born into the grey zone of viability. We found comfort care featured minimally in and was often marginalised by neonatologists’ language. The two dominant discourses contributing to this were acute medicine’s life-saving capacity and a limited temporal window marked by gestational age where comfort measures were deemed appropriate. Antenatal consultations framed by shared decision-making could be approached as a form of care characterised by a relational openness and responsiveness to parents’ views on care. This asks neonatologists to enter antenatal consultations for periviability without knowing ahead of time which care trajectory will necessarily call one’s attention or the particular response one should take, thus highlighting the skills of reflexivity in addition to an attentiveness and openness towards those receiving care.