Governing How We Care
Contesting Community and Defining Difference in U.S. Public Health Programs
Publication Year: 2012
Published by: Temple University Press
Cover
Title Page, Copyright, Dedication
Contents
Acknowledgments
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pp. ix-x
I extend my sincere gratitude to the Wenner-Gren Foundation for Anthropological Research for its support of this work with the Hunt Postdoctoral Fellowship (2008–2009). Some of the research presented here was funded by the National Institute on Drug Abuse (R01 DA12569, Merrill Singer, Principal Investigator...
Introduction
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pp. 1-17
When I was an ethnographer for a federally funded study on HIV risk and needle use, I met Dave Wood, a middle-aged, slightly built African American heroin user who spent many of his days circulating through a neighborhood shopping plaza where people would arrive to get their morning coffee at McDonald’s, pick up a loaf of bread at Sav-A-Lot...
1. The Governmentality of Community Health
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pp. 18-40
Governmentality, as defined first by Michel Foucault (1991) and elaborated by subsequent social theorists and anthropologists (e.g., Inda 2005; Ong and Collier 2005), explores the knowledge formations and sets of practices that together work to construct and govern populations and subjects...
Part I: Technologies of Citizenship and Difference
Long concerned with urban, low-income, and marginalized populations, community health workers and scholars use a range of strategies to highlight ethnic and racial health disparities and engage diverse groups in programs to improve health. These strategies and programs respond...
2. Community Health Advocates: The Professionalization of “Like Helping Like”
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pp. 43-71
“Sometimes you just have to look the other way,” insisted Ron Washington to the room full of people attending a six-week training for new Community Health Advocates (CHAs). Numbering about twenty, the future outreach workers would go doorto- door in underserved neighborhoods...
3. Neoliberalism at Work: Contemporary Scenarios of Governmental Reforms in Public Health and Social Work
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pp. 72-102
Seven months into my fieldwork in 1998, the CHA program began to receive federal welfare reform monies for operating support. As the health center began to take part in the nationwide reallocation of resources aimed at moving welfare recipients into the “world of work,” this new phase brought many changes...
4. Technologies of Culturally Appropriate Health Care
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pp. 103-132
In the mid-1990s in Thornton, Massachusetts, activists and community health leaders worked to establish what would become Thornton Community Health Center (TCHC) as part of a struggle to bring quality, culturally appropriate health care to low-income and minority patients...
Part II: Technologies of Prevention and Boundaries of Citizenship: Drug Use, Research, and Public Health
Terms such as community, culture, and difference become disaggregated into collections of practices and beliefs as we examine their multiple meanings in community health. Subject positions for health care workers are shaped by diverse forces, including the political...
5. “I Always Use Bleach”: The Production and Circulation of Risk and Norms in Drug Research
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pp. 135-155
“I always use bleach—I never share my needles.” An injection drug user (IDU) speaking to a researcher knows this is the appropriate thing to say when she is asked, “Do you [how often do you, why do you] share your needles?” In ethnographic research I conducted on HIV risk among people who inject drugs in Thornton, participants repeated variations on these themes...
6. Syringe Exchange as a Practice of Governing
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pp. 156-183
Despite widespread evidence of their effectiveness in reducing the spread of HIV among injection drug users (IDUs), syringe exchange programs (SEPs), which provide sterile syringes to IDUs in return for used ones, remain controversial. As perhaps the most widely practiced innovation of the harm reduction movement, SEPs act on users’ actions by providing...
Conclusion
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pp. 184-190
After college, I spent some time as an activist with the AIDS and women’s health movements in New York City. I remember attending endless strategy sessions in advance of protest actions, trying to come up with our demands...
References
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pp. 191-210
Index
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pp. 211-214
About the Author
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p. 215-215
Susan J. Shaw is Associate Professor in the School of Anthropology at the University of Arizona...
E-ISBN-13: 9781439906842
Print-ISBN-13: 9781439906835
Page Count: 214
Illustrations: 6
Publication Year: 2012
