Matching Items (10)
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Medical practice surrounding tuberculosis (TB) treatment in two nineteenth-century Scottish charitable hospitals reveals that in developing empirically-positioned constructs of this and related diseases, medical practitioners drew upon social assumptions about women and the working classes, thus reinforcing rather than shedding cultural notions of who becomes ill and why. TB is

Medical practice surrounding tuberculosis (TB) treatment in two nineteenth-century Scottish charitable hospitals reveals that in developing empirically-positioned constructs of this and related diseases, medical practitioners drew upon social assumptions about women and the working classes, thus reinforcing rather than shedding cultural notions of who becomes ill and why. TB is a social disease, its distribution determined by relationships among human groups; primary among these is the patient-practitioner relationship, owing to the social role of medical treatment in restoring the ill to both health and society. To clarify the influence of cultural context upon the evolution of medical constructs of TB, I examined Glasgow Royal Infirmary (GRI) and Royal Infirmary of Edinburgh (RIE) ward journals, admissions registers, and institution management records from 1794 through 1905. Medical practice at the turn of the nineteenth century was dominated by observation and questioning of the patient, concordant with conceptions of physicians' labor as mental rather than physical. This changed with the introduction of the stethoscope in the 1820s, which together with the dissection of the poor allowed by the 1832 Anatomy Act ushered in disease concepts emphasizing pathological anatomy. Relationships between patient and practitioner also altered at this time, exhibiting distrust and medical dominance. The mid-Victorian era was notable for clinicians' increasing interest in immorality's contributions to ill health, absent in earlier practice and linked to conceptions of women and the working classes as inherently pathological. In 1882, discovery of the tubercle bacillus challenged existing nutritional, hereditary, and environmental explanations for TB. Although practitioners utilized bacteriological methods, this discovery did not revolutionize diagnosis or treatment. Rather, these older models were incorporated with perceived behavioral, environmental, and biological degradation of the working classes, rendering marginalized groups "soil" prepared for the "seeds" of disease -- at risk, but also to blame. This framework, in which marginalized groups contribute to their increased risk for disease through refusal to accord with hegemonically-established "healthy" behavior, persists. As a result, meaningful change in TB rates will need to address these longstanding contributions of social inequality to Western medical treatment.
ContributorsFarnbach Pearson, Amy Walker (Author) / Buikstra, Jane E. (Thesis advisor) / Fuchs, Rachel G (Committee member) / Brewis Slade, Alexandra (Committee member) / Roberts, Charlotte A. (Committee member) / Arizona State University (Publisher)
Created2013
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As a form of bodily modification, female circumcision has generated unprecedented debates across the medical community, social sciences disciplines, governmental
on-governmental agencies and activists and others. The various terminologies used to refer to it attest to differences in knowledge systems, perceptions, and lived experiences emerging from divergent cultures and ideologies. In

As a form of bodily modification, female circumcision has generated unprecedented debates across the medical community, social sciences disciplines, governmental
on-governmental agencies and activists and others. The various terminologies used to refer to it attest to differences in knowledge systems, perceptions, and lived experiences emerging from divergent cultures and ideologies. In the last two decades, these debates have evolved from a local matter to a global health concern and human rights issue, coinciding with the largest influx of African refugees to the Western nations. Various forms of female circumcision are reported in 28 countries in the African Continent; Somalia has one of the highest prevalence of female circumcision and the most severe type. The practice is antithetical to Western values and poses an ideological challenge to the construction of the normal body, its bodily processes and its existential being-in-the-world. From the global health perspectives, female circumcision is deemed to be a health hazard--especially during childbirth--though the scientific evidence is inconclusive from studies conducted in post-migration. Yet, Somali refugee women have higher childbearing disparities in host nations, including the U.S. They are also perceived as difficult patients and resistant to obstetrics interventions. Although their FGC status and "cultural" differences are often cited, there is a lack of adequate explanations as to why and how these factors shape patient-provider interactions and affect outcomes. The objectives of this dissertation study are to quantitatively and qualitatively explore these questions within and between Somali refugee women and their healthcare providers in Arizona. Two theoretical frameworks and methods--culture consensus and embodiment-- are applied to identify variations in childbearing knowledge and to explore how the cultural phenomenon of circumcision is subjectively and intersubjectively embodied in the context of childbearing. Culture consensus questionnaire (N=174) and ethnographic interviews (N=40) using phenomenology approach were conducted. Analyses suggest cross-cultural disagreement hinged on: faith in science versus God, pregnancy/childbirth interventions, language challenges, and control-resistance issues; intra-cultural disagreement underscores that Somalis are not culturally homogenous group. Preconceptions of female circumcision body as a cultural phenomenon has different and conflicting meanings that may adversely impact patient-provider interactions and outcomes.
ContributorsFawcett, Lubayna (Author) / Maupin,, Jonathan N. (Thesis advisor) / Brewis Slade, Alexandra (Committee member) / Johnson-Agbakwu, Crista E. (Committee member) / Arizona State University (Publisher)
Created2014
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Food deserts are the collection of deprived food environments and limit local residents from accessing healthy and affordable food. This dissertation research in San Lorenzo, Paraguay tests if the assumptions about food deserts in the Global North are also relevant to the Global South. In the Global South, the recent

Food deserts are the collection of deprived food environments and limit local residents from accessing healthy and affordable food. This dissertation research in San Lorenzo, Paraguay tests if the assumptions about food deserts in the Global North are also relevant to the Global South. In the Global South, the recent growth of supermarkets is transforming local food environments and may worsen residential food access, such as through emerging more food deserts globally. This dissertation research blends the tools, theories, and frameworks from clinical nutrition, public health, and anthropology to identify the form and impact of food deserts in the market city of San Lorenzo, Paraguay. The downtown food retail district and the neighborhood food environment in San Lorenzo were mapped to assess what stores and markets are used by residents. The food stores include a variety of formal (supermarkets) and informal (local corner stores and market vendors) market sources. Food stores were characterized using an adapted version of the Nutrition Environment Measures Survey for Stores (NEMS-S) to measure store food availability, affordability, and quality. A major goal in this dissertation was to identify how and why residents select a type of food store source over another using various ethnographic interviewing techniques. Residential store selection was linked to the NEMS-S measures to establish a connection between the objective quality of the local food environment, residential behaviors in the local food environment, and nutritional health status. Using a sample of 68 households in one neighborhood, modeling suggested the quality of local food environment does effect weight (measure as body mass index), especially for those who have lived longer in poorer food environments. More generally, I find that San Lorenzo is a city-wide food desert, suggesting that research needs to establish more nuanced categories of poor food environments to address how food environments emerge health concerns in the Global South.
ContributorsGartin, Meredith (Author) / Brewis Slade, Alexandra (Thesis advisor) / Boone, Christopher (Committee member) / Wutich, Amber (Committee member) / Arizona State University (Publisher)
Created2012
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Obesity has become a major area of research in many fields due to the increasing obesity rate not only in The United States, but also around the world. Research concerning obesity stigma has both physical and mental health implications. Weight bias and obesity stigma represent important research areas for health

Obesity has become a major area of research in many fields due to the increasing obesity rate not only in The United States, but also around the world. Research concerning obesity stigma has both physical and mental health implications. Weight bias and obesity stigma represent important research areas for health professionals as they confront these issues on a daily basis in interactions with their patients. To explore how gender, ethnicity, and a person's own BMI affect the stigma of certain weight related terms, a set of 264 participant's surveys on weight related situations on the campus of Arizona State University were analyzed. Using univariate analysis to determine frequency of words deemed most or least acceptable as well as independent t-test for gender and ANOVA for ethnicity and own BMI, we found that participant's view more clinical terms such as "unhealthy BMI" and "BMI" as acceptable words for use during a physician-patient interaction. Analysis across genders revealed the highest number of differences in terms, with females generally ranking terms across the board as less acceptable then men. Differences varied little between ethnicities; however, own BMI revealed more differences between terms; underweight participants did not rank any terms as positive. We analyzed average ATOP (Attitudes Toward Obese People) scores and found that there was no significant difference in average ATOP scores between gender and a participant's own BMI, but a statistical significance did exist between ethnic categories. This study showed that the term "obese/obesity", although normally considered to be a clinical term by many was not ranked as very positive across gender, ethnicity, or own BMI. Based on these findings, new material should be created to inform physicians on how to talk about weight related problems with certain populations of patients.
ContributorsBlasco, Drew Adair (Author) / Wutich, Amber (Thesis director) / Brewis Slade, Alexandra (Committee member) / Barrett, The Honors College (Contributor) / School of Politics and Global Studies (Contributor) / Department of Psychology (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2014-12
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Understanding more about the similarities and differences in cultural perceptions of climate change-related disease causation can better inform culturally specific public health measures. Using interviews conducted with 685 adults in eight diverse global locations ranging from Fiji and China to England and Phoenix, Arizona, this study explores climate change-disease beliefs

Understanding more about the similarities and differences in cultural perceptions of climate change-related disease causation can better inform culturally specific public health measures. Using interviews conducted with 685 adults in eight diverse global locations ranging from Fiji and China to England and Phoenix, Arizona, this study explores climate change-disease beliefs within and across diverse cultures and comparisons between cultural and scientific models. A cultural consensus analysis was employed to identify a "culturally correct" model for each study site. Next, a scientific model was generated based on current scientific consensus regarding climate change- disease connections. Using the Quadratic Assignment Procedure (QAP), we determined the amount of correlation shared between the scientific model and each cultural model. The analysis revealed a high level of intercorrelation between the models of English speaking, economically developed sites such as Phoenix, Arizona. Additionally, cultural models from the non-English speaking sites were highly intercorrelated with one another. Overall, the English speaking sites tended to have more complex models with a greater density of causal links. Cultural models from the English speaking sites also demonstrated high levels of correlation with the scientific model. In comparison, the cultural models from the non-English speaking sites exhibited little correlation with the scientific model. Based on these findings, we suggest that cultural beliefs related to climate change-related disease causation may be influenced by complex local factors. For example, differences in education and media influences along with localized differences in climate change impacts may, in part, contribute to divergences between the cultural models.
Created2014-05
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In this study, we examine how development status and water scarcity shape people's perceptions of "hard path" and "soft path" water solutions. Based on ethnographic research conducted in four semi-rural/peri-urban sites (in Bolivia, Fiji, New Zealand, and the US), we use content analysis to conduct statistical and thematic comparisons of

In this study, we examine how development status and water scarcity shape people's perceptions of "hard path" and "soft path" water solutions. Based on ethnographic research conducted in four semi-rural/peri-urban sites (in Bolivia, Fiji, New Zealand, and the US), we use content analysis to conduct statistical and thematic comparisons of interview data. Our results indicate clear differences associated with development status and, to a lesser extent, water scarcity. People in the two less developed sites were more likely to suggest hard path solutions, less likely to suggest soft path solutions, and more likely to see no path to solutions than people in the more developed sites. Thematically, people in the two less developed sites envisioned solutions that involve small-scale water infrastructure and decentralized, community-based solutions, while people in the more developed sites envisioned solutions that involve large-scale infrastructure and centralized, regulatory water solutions. People in the two water-scarce sites were less likely to suggest soft path solutions and more likely to see no path to solutions (but no more likely to suggest hard path solutions) than people in the water-rich sites. Thematically, people in the two water-rich sites seemed to perceive a wider array of unrealized potential soft path solutions than those in the water-scarce sites. On balance, our findings are encouraging in that they indicate that people are receptive to soft path solutions in a range of sites, even those with limited financial or water resources. Our research points to the need for more studies that investigate the social feasibility of soft path water solutions, particularly in sites with significant financial and natural resource constraints.

ContributorsWutich, Amber (Author) / White, A. C. (Author) / White, Dave (Author) / Larson, Kelli (Author) / Brewis Slade, Alexandra (Author) / Roberts, Christine (Author) / College of Liberal Arts and Sciences (Contributor)
Created2014-01-13
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Background: Weight-related stigma is reported frequently by higher body-weight patients in healthcare settings. Bariatric surgery triggers profound weight loss. This weight loss may therefore alleviate patients' experiences of weight-related stigma within healthcare settings. In non-clinical settings, weight-related stigma is associated with weight-inducing eating patterns. Dietary adherence is a major challenge

Background: Weight-related stigma is reported frequently by higher body-weight patients in healthcare settings. Bariatric surgery triggers profound weight loss. This weight loss may therefore alleviate patients' experiences of weight-related stigma within healthcare settings. In non-clinical settings, weight-related stigma is associated with weight-inducing eating patterns. Dietary adherence is a major challenge after bariatric surgery.

Objectives: (1) Evaluate the relationship between weight-related stigma and post-surgical dietary adherence; (2) understand if weight loss reduces weight-related stigma, thereby improving post-surgical dietary adherence; and (3) explore provider and patient perspectives on adherence and stigma in healthcare settings.

Design: This mixed methods study contrasts survey responses from 300 postoperative bariatric patients with ethnographic data based on interviews with 35 patients and extensive multi-year participant-observation within a clinic setting. The survey measured experiences of weight-related stigma, including from healthcare professionals, on the Interpersonal Sources of Weight Stigma scale and internalized stigma based on the Weight Bias Internalization Scale. Dietary adherence measures included patient self-reports, non-disordered eating patterns reported on the Disordered Eating after Bariatric Surgery scale, and food frequencies. Regression was used to assess the relationships among post-surgical stigma, dietary adherence, and weight loss. Qualitative analyses consisted of thematic analysis.

Results: The quantitative data show that internalized stigma and general experiences of weight-related stigma predict worse dietary adherence, even after weight is lost. The qualitative data show patients did not generally recognize this connection, and health professionals explained it as poor patient compliance.
Conclusion: Reducing perceptions of weight-related stigma in healthcare settings and weight bias internalization could enhance dietary adherence, regardless of time since patient's weight-loss surgery.

ContributorsRaves, Danielle (Author) / Brewis Slade, Alexandra (Author) / Trainer, Sarah (Author) / Han, Seung-Yong (Author) / Wutich, Amber (Author) / College of Liberal Arts and Sciences (Contributor)
Created2016-10-10
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Background: Multiple studies show that obesity and depression tend to cluster in women. An “appearance concern” pathway has been proposed as one basic explanation of why higher weights might lead to depression. The transition to motherhood is a life phase in which women’s body image, weight, and depressive risk are in

Background: Multiple studies show that obesity and depression tend to cluster in women. An “appearance concern” pathway has been proposed as one basic explanation of why higher weights might lead to depression. The transition to motherhood is a life phase in which women’s body image, weight, and depressive risk are in flux, with average weight increasing overall during this period. Examination of how these factors interact from pre- to post-pregnancy provides a means to test how body image plays a key role, as proposed, in causally shaping women’s depressive risk.

Methods: Tracking 39,915 pregnant women in the Norwegian Mother and Child (MoBA) Cohort Study forward 36 months after their deliveries, we test the moderating and mediating effects of body image concerns on the emergence of new mothers’ depressive symptoms by using a binary logistic regression model with a discrete-time event history approach and mediation analysis with bootstrapping.

Results: For women with high pre-pregnancy body mass index (BMI), weight gain heightens their depressive symptoms over time. Body image concerns mediate the association between weight gain and the development of depressive symptoms regardless of weight status. However, the mediation effect is more evident for women with higher pre-pregnancy BMI. Conversely, better body image is highly protective against the transition to mild or more severe depressive symptoms among new mothers, but only for women who were not classified as obese prior to their pregnancies.

Conclusions: These findings support a role for body image concerns in the etiology of depressive symptoms during the transition to motherhood. The findings suggest body image interventions before or during pregnancy could help reduce risks of depression in the early postpartum period and well beyond.

ContributorsHan, Seung-Yong (Author) / Brewis Slade, Alexandra (Author) / Wutich, Amber (Author) / College of Liberal Arts and Sciences (Contributor)
Created2016-07-29
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Food and water shortages are two of the greatest challenges facing humans in the coming century. While our theoretical understanding of how humans become vulnerable to and cope with hunger is relatively well developed, anthropological research on parallel problems in the water domain is limited. By carefully considering well-established propositions

Food and water shortages are two of the greatest challenges facing humans in the coming century. While our theoretical understanding of how humans become vulnerable to and cope with hunger is relatively well developed, anthropological research on parallel problems in the water domain is limited. By carefully considering well-established propositions derived from the food literature against what is known about water, our goal in this essay is to advance identifying, theorizing, and testing a broader anthropology of resource insecurity. Our analysis focuses on (1) the causes of resource insecurity at the community level, (2) “coping” responses to resource insecurity at the household level, and (3) the effect of insecurity on emotional well-being and mental health at the individual level. Based on our findings, we argue that human experiences of food and water insecurity are sufficiently similar to facilitate a broader theory of resource insecurity, including in how households and individuals cope. There are also important differences between food and water insecurity, including the role of structural factors (such as markets) in creating community-level vulnerabilities. These suggest food and water insecurity may also produce household struggles and individual suffering along independent pathways.

ContributorsWutich, Amber (Author) / Brewis Slade, Alexandra (Author) / College of Liberal Arts and Sciences (Contributor)
Created2014-08-01
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Hygiene stigma can exist in tandem to gender stigma which could mean the marginalization of certain groups due to stigmatized identities, specifically women. The marginalization of women is important because of the United Nations Sustainable Development Goal 5: Empowering women and girls and achieving equity. Figuring out how hygiene

Hygiene stigma can exist in tandem to gender stigma which could mean the marginalization of certain groups due to stigmatized identities, specifically women. The marginalization of women is important because of the United Nations Sustainable Development Goal 5: Empowering women and girls and achieving equity. Figuring out how hygiene stigma specifically affects women in Fiji required researching the effects of hygiene stigma, gender inequity and indigenous Fijian societies could influence respondents’ answers. After researching these different topics, these questions were developed: does hygiene stigma and gendered stigma have an overlap? If so, are men more biased than women when it comes to objectifying women? Do indigenous Fijian societies possess an immunity to objectifying women since are considered to have Fijian women have more agency? The data was retrieved from the Global Ethnohydrology Study from 2015-16 in the Viti Levu, Fiji, which was specifically researching whether hygiene stigma is an effective method of helping people have better hygiene norms. A thematic analysis was then conducted, and the data was coded. Based on the results from 28 respondents we were able to conclude that there is gendered stigma within Fijian populations. We found that both men and women objectified women at similar rates and Fiji is not immune to hygiene stigma. The limitations to this analysis were there was no statistical analysis to find correlations hygiene stigma and gendered stigma. There was only one specific code that was being analyzed in this research project which limits the other types of stigma that may exist.
ContributorsKibuka Musoke, Paula Kulabako (Author) / Wutich, Amber (Thesis director) / Schuster, Roseanne (Committee member) / Brewis Slade, Alexandra (Committee member) / School of Molecular Sciences (Contributor) / School of Human Evolution & Social Change (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2019-05