American Arrivals: Anthropology Engages the New Immigration

8. Anthropologists, Migrants, and Health Research Confronting Cultural Appropriateness

In the autumn of 2000, I received a frantic phone call from an epidemiologist at the Centers for Disease Control and Prevention (CDC). She was investigating a syphilis outbreak among Mexican migrants in rural Alabama and told me that the CDC team was having trouble getting the infected men to speak with them. She wondered whether I, as an anthropologist, could suggest the best way to approach these men. It seemed that she wanted me to let her in on the secret handshake. As a putative expert not just on Mexican migrants in general but also—even better—on Mexican migrants and infectious diseases, what could I tell her that would make them trust her enough to talk? Anthropologists who conduct research with migrant groups sometimes find themselves called on to explain the behavior or experiences of the people with whom they work, either in the court of public opinion or in official discussions about policy formation. This is true in not only the area of health and medical services research but also any area in which public policy might conceivably draw on academic research 229 8 Anthropologists, Migrants, and Health Research Confronting Cultural Appropriateness Jennifer S. Hirsch And if a stranger sojourns with thee in thy land, thou shalt not wrong him.…The stranger that dwell with you shall be to you as one born among you, and thou shalt love him as thyself, for you were strangers in the land of Egypt. —Leviticus, 19:33–34 229 (for example, see Boston Globe, June 29, 2001; Newsday, September 15, 1999 and March 20, 2001; New York Times, May 31, 1998; Columbus Dispatch, March 25, 1998; Washington Post, March 22, 1998). This chapter attempts to sort through several issues involved in deciding how to respond when called on. To a non-anthropologist, it might seem obvious that an anthropologist, when asked about migrant health, would talk about culture. However, within the discipline, we have moved far from the idea that the proper domain of a cultural anthropologist is exclusively culture. Medical anthropologists Nancy Scheper-Hughes (1992), Paul Farmer (1999), and Richard Parker (2001) have argued recently that the reach of both our theoretical and our applied work has been hobbled by an over-investment in the importance of cultural difference. Critical medical anthropologists, however, have largely failed to explore the way in which the knowledge we produce is shaped not only by our own theoretical frameworks but also by the desires of the audiences to whom we are, or might be, speaking. Regardless of theoretical advances in the discipline, anthropologists in public health continue to face the fact that people call in an anthropologist when they want to hear about culture—and in particular, about culture as a barrier to complying with certain desirable behavior (as in the opening anecdote). The demand for “culturological” explanations exists independently of our willingness to produce them. As we develop a research agenda for anthropology and migration, it is urgent to draw on recent developments in anthropological theory and practice, but it is equally urgent to consider how the knowledge we produce fits into broader political economies of knowledge, serving certain political agendas and silencing others. In this chapter, I make this point primarily through an exploration of different ways in which public health research on migrants has incorporated the concept of culture. As I discuss in the conclusion, though, this point applies more broadly to other substantive areas of the ethnography of immigration. Shweder (see Chapter 9) argues that anthropologists might “rise to the moral challenges posed by cultural migration” by using our position as experts on cultural diversity to help our evermore multicultural society “distinguish between a defensible pluralism and the indefensible position of radical relativism.” Here, I make a different point about culture and the moral challenges of migration. Without denying the critical JENNIFER S. HIRSCH 230 role we can play in fighting ethnocentrism, I caution that exaggerating the importance of culture as a determinant of health outcomes can do a real disservice to those for whom we presume to speak. In this chapter, I propose that we conduct research on migrant health within a framework of “liberation anthropology” as a way of resisting the demand for the very sort of anthropological work on culture and health that the CDC epidemiologist asked me to provide. (As I will explain, the pat answer she seemed to be seeking promotes...