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In a major contribution to the study of diabetes, this book is the first to analyze the disease through a syndemic framework. An innovative, mixed-methods study, Emily Mendenhall shows how adverse social conditions, such as poverty and oppressive relationships, disproportionately stress certain populations and expose them to disease clusters. She goes beyond epidemiological research that has linked diabetes and depression, revealing how broad structural inequalities play out in the life histories of individuals, families, and communities, and lead to higher rates of mortality and morbidity. This intimate portrait of syndemic suffering is a model study of chronic disease disparity among the poor in high income countries and will be widely read in public health, medical anthropology, and related fields.
In a major contribution to the study of diabetes, this book is the first to analyze the disease through a syndemic framework, offering a model study of chronic disease disparity among the poor in high income countries.
This book explains the growing field of syndemic theory and research, a framework for the analysis and prevention of disease interactions that addresses underlying social and environmental causes. This perspective complements single-issue prevention strategies, which can be effective for discrete problems, but often are mismatched to the goal of protecting the public's health in its widest sense. "Merrill Singer has astutely described why health problems should not be seen in isolation, but rather in the context of other diseases and the social and economic inequities that fuel them. An important read for public health and social scientists." —Michael H. Merson, director, Duke Global Health Institute "Not only does this book provide a persuasive theoretical biosocial model of syndemics, but it also illustrates the model with a wide variety of fascinating historical and contemporary examples." —Peter J. Brown, professor of Anthropology and Global Health and director, Center for Health, Culture, and Society, Emory University "The concept of syndemics is Singer's most important contribution to critical medical anthropology as it interfaces with an ecosocial approach to epidemiology." —Mark Nichter, Regents Professor, Department of Anthropology, University of Arizona "Merrill Singer offers the public the most comprehensive work ever written on this key area of research and policy making." —Francisco I. Bastos, chairman of the graduate studies on epidemiology, Fundacao Oswaldo Cruz "Exquisitely describes how this new approach is a critical tool that brings together veterinary, medical, and social sciences to solve emerging infectious and non-infectious diseases of today's world." —Bonnie Buntain, MS, DVM, diplomate, American College of Veterinary Preventive Medicine "For too long the great integrative perspectives on modern biomedicine and public health disease ecology and social medicine-have remained more or less separate. In this innovative and provocative book, Merrill Singer develops a valuable synthesis that will reshape the way we think about health and disease." —Warwick H. Anderson, MD, PhD, professorial research fellow, Department of History and Centre for Values, Ethics, and the Law in Medicine, University of Sidney
In Rethinking Diabetes, Emily Mendenhall investigates how global and local factors transform how diabetes is perceived, experienced, and embodied from place to place. Mendenhall argues that the link between sugar and diabetes overshadows the ways in which underlying biological processes linking hunger, oppression, trauma, unbridled stress, and chronic mental distress produce diabetes. The life history narratives in the book show how deeply embedded these factors are in the ways diabetes is experienced and (re)produced among poor communities around the world. Rethinking Diabetes focuses on the stories of women living with diabetes near or below the poverty line in urban settings in the United States, India, South Africa, and Kenya. Mendenhall shows how women's experiences of living with diabetes cannot be dissociated from their social responsibilities of caregiving, demanding family roles, expectations, and gendered experiences of violence that often displace their ability to care for themselves first. These case studies reveal the ways in which a global story of diabetes overlooks the unique social, political, and cultural factors that produce syndemic diabetes differently across contexts. From the case studies, Rethinking Diabetes clearly provides some important parallels for scholars to consider: significant social and economic inequalities, health systems that are a mix of public and private (with substandard provisions for low-income patients), and rising diabetes incidence and prevalence. At the same time, Mendenhall asks us to unpack how social, cultural, and epidemiological factors shape people's experiences and why we need to take these differences seriously when we think about what drives diabetes and how it affects the lives of the poor.
Central to this volume, and critical to its unique creative significance and contribution, is the conceptual unification of syndemics and stigma. Syndemics theory is increasingly recognized in social science and medicine as a crucial framework for examining and addressing pathways of interaction between biological and social aspects of chronic and acute suffering in populations. While much research to date addresses known syndemics such as those involving HIV, diabetes, and mental illness, this book explores new directions just beginning to emerge in syndemics research – revealing what syndemics theory can illuminate about, for example the health consequences of socially pathologized pregnancy or infertility, when stigmatization of reproductive options or experiences affect women’s health. In other chapters, newly identified syndemics affecting incarcerated or detained individuals are highlighted, demonstrating the physical, psychological, structural, and political-economic effects of stigmatizing legal frameworks on human health, through a syndemic lens. Elsewhere in the volume, scholars examine the stigma of poverty and how it affects both nutritional and oral health. The common thread across all chapters is linkages of social stigmatization, structural conditions, and how these societal forces drive biological and disease interactions affecting human health, in areas not previously explored through these lenses.
In Rethinking Diabetes, Emily Mendenhall investigates how global and local factors transform how diabetes is perceived, experienced, and embodied from place to place. Mendenhall argues that the link between sugar and diabetes overshadows the ways in which underlying biological processes linking hunger, oppression, trauma, unbridled stress, and chronic mental distress produce diabetes. The life history narratives in the book show how deeply embedded these factors are in the ways diabetes is experienced and (re)produced among poor communities around the world. Rethinking Diabetes focuses on the stories of women living with diabetes near or below the poverty line in urban settings in the United States, India, South Africa, and Kenya. Mendenhall shows how women's experiences of living with diabetes cannot be dissociated from their social responsibilities of caregiving, demanding family roles, expectations, and gendered experiences of violence that often displace their ability to care for themselves first. These case studies reveal the ways in which a global story of diabetes overlooks the unique social, political, and cultural factors that produce syndemic diabetes differently across contexts. From the case studies, Rethinking Diabetes clearly provides some important parallels for scholars to consider: significant social and economic inequalities, health systems that are a mix of public and private (with substandard provisions for low-income patients), and rising diabetes incidence and prevalence. At the same time, Mendenhall asks us to unpack how social, cultural, and epidemiological factors shape people's experiences and why we need to take these differences seriously when we think about what drives diabetes and how it affects the lives of the poor.
Unmasked is the story of what happened in Okoboji, a small Iowan tourist town, when a collective turn from the coronavirus to the economy occurred in the COVID summer of 2020. State political failures, local negotiations among political and public health leaders, and community (dis)belief about the virus resulted in Okoboji being declared a hotspot just before the Independence Day weekend, when an influx of half a million people visit the town. The story is both personal and political. Author Emily Mendenhall, an anthropologist at Georgetown University, grew up in Okoboji, and her family still lives there. As the events unfolded, Mendenhall was in Okoboji, where she spoke formally with over 100 people and observed a community that rejected public health guidance, revealing deep-seated mistrust in outsiders and strong commitments to local thinking. Unmasked is a fascinating and heartbreaking account of where people put their trust, and how isolationist popular beliefs can be in America's small communities. This book is the recipient of the 2022 Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of art or medicine.
This book focuses on syndemics in the Global South and uses COVID‐19 as a window to understand clusters of disparities and disease comorbidities. The pandemic has exposed and multiplied structural inequalities and certain subpopulations were more exposed to COVID‐19 as well as experienced greater morbidity and mortality. The effects of the pandemic differ between countries but have had an especially major impact, although in varying ways, in the Global South. The contributions in this volume explore the differential impacts of COVID‐19 at individual, community, national, or regional levels, considering how structural violence is institutionalized in a way that creates vulnerable situations and disproportionate suffering. The book will be of interest to anthropologists and sociologists as well as to those working in global and public health.
Following criticisms of the traditionally polarized view of understanding suffering through either medicine or social justice, Lowe makes a compelling argument for how the medical humanities can help to go beyond the traditional biographical and epistemic breaks to see into the nature and properties of suffering and what is at stake. Lowe demonstrates through analysis of major healthcare workforce issues and incidence of burnout how key policies and practices influence healthcare education and experiences of both patients and health professionals. By including first person narratives from health professionals as a tool and resource, she illustrates how dominant ideas about the self enter practice as a refusal of suffering. Demonstrating the relationship between personal experience, theory and research, Lowe argues for a pedagogy of suffering that shows how the moral anguish implicit in suffering is an ethical response of the emergent self. This is an important read for all those interested in medical humanities, health professional education, person-centred care and the sociology of health and illness.