Marketing health education: advertising margarine and visualising health in Britain from 1964–c.2000

During the post-war period, margarine was re-conceptualised as a value-added product with distinct health benefits. This article contextualises the advertising of margarine as a healthy food, focusing on Unilever’s Flora brand as an important case study in legitimising the emergent role of disease prevention as a marketing tool. It uses the methodology of visual culture to examine how advertising employed chronic disease prevention as a selling tool. This article assesses how the post-war environment gave rise to new ways of visually advertising food, and how these promoted innovative visualisations of food, the body and their interactions with health.     

Associations between coastal proximity and children’s mental health in Australia

Limited research has explored associations between blue spaces and mental health, specifically in children. This study assessed links between coastal proximity and depression and anxiety among children in Australia and tested whether duration of residency at current address moderated associations. It also explored associations between within-individual changes in coastal proximity and changes in depression and anxiety. Data were from 2400 children aged 11–12 years in Wave 5 (2012) and aged 14–15 years in Wave 6 (2014) of the national Longitudinal Study of Australian Children. Outcomes were children’s self-reported symptoms of depression and anxiety. Exposure was coastal proximity (<2, 2–<5, 5–<10, 10–<20, 20–<50, and ≥50 km). Linear models were fitted to examine cross-sectional associations and fixed effects models for within-individual associations. After adjustment for potential confounders, findings suggested that those living close to the coast (<2 km) had lower levels of depression than those living the furthest from the coast (≥50 km) during childhood (Wave 5) but not adolescence (Wave 6). No associations were observed with anxiety. There was weak evidence to suggest residency duration moderated associations. No associations were observed for within-individual changes. Further research is needed to understand whether and what characteristics of coastal environments may benefit children’s mental health.     

‘It's for the best’: child movement in search of health in Njabini,Kenya

Previous studies produced on the movement of individuals with HIV/AIDS for the obtainment of medical services have rarely been conducted in the Global South and have neglected the experiences of child patients. This article presents a new type of travel for medical care, where HIV+ children in Kenya are being placed or choose to be placed in orphanages in order to obtain constant access to antiretroviral (ARV) therapy, proper nutrition, and education. Through participant observation and photo-elicitation interviews with children in orphanages and their immediate family members in the surrounding Njabini community, this study focused on documenting children's agency in influencing movement decisions to orphanages for better health outcomes. Photo-elicitation interviews in particular allowed for greater insight into children's lives, their motivations for moving to an orphanage, and as a tool to facilitate discussion. Qualitative methods utilized with family members similarly privileged their interpretations of how child movement out of the house would help achieve the ‘best’ possible future for their children, particularly those living with HIV. Study findings shed light on the active role played by children in decisions to move to orphanages, the visualization of these facilities as the best place to secure access to ARV therapy and ensure proper child health, and the interaction that continues to take place between children and their family members once they enter these spaces.     

Who and what is Canada? Constructing cultural identities in health care research

This paper concerns the negotiation of cultural categories embedded in and informing the ongoing nation formation of Canada. It discusses the construction of cultural identities by health care professional students as they participated in a qualitative study concerned with health care practice in an increasingly culturally diverse society. The study methodology, embedded in layers of narrative about «difference», fostered a negotiation of «self» and «other» on the part of the students and provided an intense site for reflection on cultural identities and social categories in a period of rapid demographic change in Canada. As the students defined and interpreted cultural issues during their fieldwork placements they interrogated and contested various dimensions of difference, including their own sense of Canadian-ness as this played out in «lived» multiculturalism in a specific Canadian city. It is argued that the students» negotiations of boundaries of the cultural «self» were closely linked to a changing place narrative and identity of Canada, expressed in discourses and material practices around difference at local and national scales.     

The political anatomy of community health policy in Australia, 1972–1982

This article seeks to account for the survival of the 1973–1975 Labor government's new Community Health policy during the conservative coalition government (1975–1983) (which had managed to completely abolish Labor's national Medibank health insurance program). Through extensive interviews with 74 people who were directly involved in the policy process at national, state and local levels, as well as from other sources of information, inquiry is made into the issues and circumstances that were taken into account in the decisions that affected the course of policy from 1972–82. The important political and economic forces included party politics, federal‐state relations, the national economy, the direction of other fiscal and health policies, private and governmental interest groups, administrative nets, and the mass media. The not surprising conclusion is that changes in Community Health policy did not depend on its effectiveness but rather on the balance of political, economic and organizational power of interested groups at particular points in time. Policy‐relevant issues facing the 1983 Labor government are pointed out.     

Idylls of the piney woods: health and race in southeastern Louisiana, 1878–1956

Scholars have investigated the important connections between racial identity, geography, and environment. Frequently these studies have focused on the location of noxious industries, questions of environmental justice, or segregation of racialized groups in areas of deleterious environmental conditions. In this paper, I argue that beneficial environmental conditions can also be closely tied with racial identity and that racial identity in turn can influence perceptions of the environment. These connections are evident in southern Louisiana—specifically St. Tammany Parish, Louisiana—in the late nineteenth and early twentieth centuries. St. Tammany Parish, located in the piney woods of southeastern Louisiana, served as a health resort for New Orleanians seeking refuge from yellow fever and for other Americans attempting to restore their health. Residents and medical specialists understood the healthful qualities of the parish to emanate from the fragrance of the pine trees and the restorative waters. St. Tammany Parish's reputation for health, however, only applied to people with a white racial identity, despite the fact that St. Tammany Parish had a significant black population. White residents within the parish reserved tuberculosis sanitaria, health clinics, and access to natural springs for white patrons only, even amid fears concerning illness among black residents. Additionally, late nineteenth and early twentieth century medical specialists pointed to morality, criminality, and racial characteristics in their determination of the causes of illness.     

Literature’s place in the global public health arena: Graham Greene’s fictional translation of leprosy in A Burnt-Out Case

ABSTRACT

This paper traces the engagement of Graham Greene's novel A Burnt-Out Case with traditional discourses of leprosy (the biblical ‘leper’ as a sinner, missionary care, tropical medicine, Albert Schweitzer's hospital in Lambaréné, germ theory), and shows how it suggests an ethics of care which highlights the psychosocial aspects of disease and healing. The paper argues that the reception of the novel opened a discursive space for the re-negotiation of images of leprosy after empire, making visible the structures and agents of global public health communication and their diverging conceptions of explanatory authority, scientific accuracy and the relation of science and literature. The article incorporates archival sources from press reviews to draft versions of the novel and the author's correspondence with prominent leprosy experts. It draws on media and science communication studies, disability studies and on contributions to the sociology of knowledge by Ludwik Fleck, Thomas Kuhn and Bruno Latour.     

The “Corona Warriors”? Community health workers in the governance of India's COVID-19 response

India's nearly 1-million strong band of quasi-volunteer accredited social health activists (ASHAs) have been key actors in government efforts to control COVID-19. Utilizing a nationalist rhetoric of war, ASHAs were swiftly mobilized by the government in March 2020 as ‘COVID warriors’ engaged in tracking illness, disseminating information, and caring for quarantined individuals. The speed at which ASHAs were mobilized into mentally and physically grueling labor was all the more stunning given these minimally paid community health workers have long been seen to have low morale given their precarious, informalized work arrangements. Building on work examining the spatialities of global health governance alongside literature on geographic contingency, this paper explores the ways that nationalist COVID-19 war rhetoric promulgated from Delhi worked as a technology of health governance to propel ASHAs into certain forms of action, yet also opened up spaces of potentiality for them to reimagine their relationship to both the state and the communities they serve. In particular, in our analysis of in-depth telephone interviews with ASHA workers in the state of Himachal Pradesh, we find that their hailing as COVID warriors inspired patriotic calls to duty and legitimized their (long over-looked) roles as critical governance actors, yet also was subject to resistance and reworking due to a combination of institutional histories, local politics, as well as happenstantial everyday encounters of ASHA work. The precarious employment of ASHAs – in terms of basic remuneration as well as the great on-the-job risks that they have faced – underscores both the fragile nature of India's health governance system as well as possible political movements for its renewal. We conclude by calling for geographers to give greater attention to community health care workers as a key window into understanding the uneven ways in which health systems are made manifest on the ground, and their ability to respond to citizens' healthcare needs – both in the COVID-19 pandemic and beyond.     

Connecting global health interventions and lived experiences: suspending ‘normality’ at funerals in rural Tanzania

In this paper, we use the funeral space and its liminal nature as a milieu for exploring how a ‘modern’ health intervention, the mosquito bednet, is negotiated by its recipients in relation to its (non)-usage in such spaces. With a focus on sleeping arrangements at funerals and drawing on empirical data from participants living in rural southern Tanzania, we discuss how the bednet is linked to the notion of being unsympathetic to the death. Viewed as a symbol of modernity and a reflection of wealth and individual pride, the bednet becomes physically and symbolically inappropriate in the more sacred, ‘in-between’ site of the funeral. We also uncover how risk perceptions regarding malaria transmission are re-cast in funeral spaces, with socio-cultural practices and health-related behaviours being simultaneously ‘risky’ for individual mourners and reinforcing in terms of group social cohesion. As individual mourners' concerns about malaria risks are suspended, notions of pain and discomfort come to the fore as part of the mourning process and respect for the deceased.     

Medicine,health and medical practice in precolonial Khoikhoi society: An anthropological‐historical perspective 1

Summary

This paper explores the role and function of medicine, and medical practices in precolonial Khoikhoi society, South Africa. It argues that medicine and medical practice was deeply imbedded in Khoikhoi society at the time of colonization, proving that a sound culture of medicine and health existed for centuries.     

Children,social capital and health: increasing the well‐being of young people in rural Wales

This paper explores the usefulness of employing the concept of social capital within a research project investigating the best ways of meeting the health and well‐being needs of young people living in rural Wales. The first part of the paper provides an overview of some of the current research exploring the relationship between social capital, health and young people. The second part provides an overview of findings from an action research project to illustrate how social capital is conceived and applied in this context. It concludes by stating that children and young people do actively generate, draw upon and negotiate their own social capital, and that this is an under‐utilised resource in terms of promoting health and well‐being.     

In sickness or in health? Assessment of Early Iron Age human skeletons from Toutswe sites,east central Botswana

The general health of Early Iron Age (AD 700 to 1300) mixed farmers in east central Botswana has not been studied before. In this study the bones and teeth of 84 individuals from ten Toutswe sites were analysed for osteological manifestations of disease, with the aim of assessing the general health of the Toutswe communities. These individuals were aged between newborn and 75 years old, and include both sexes. Results indicate the presence of diseases commonly found in archaeological populations such as osteoarthritis, spina bifida occulta, cribra orbitalia, porotic hyperostosis and enamel hypoplasias. One possible case of DISH was found. The frequency of lesions was comparable with or even lower than at other similar sites, such as K2 and Mapungubwe and other parts of southern Africa. The samples represent communities with relatively low levels of stress and infections. This seems to support the results of the palaeodemographic analysis, which indicated that the Toutswe people were better off than those of neighbouring K2 and Mapungubwe. Copyright © 2008 John Wiley & Sons, Ltd.     

Interaction during mental health floating support home visits: managing host–guest and professional–client identities in home-spaces

Mental health work has been transformed by ‘shifting geographies of care’ from institutions to care in communities, in particular by the emergence of support located within home-spaces. This article studies a floating support service targeted at people with mental health problems and contributes to research on post-institution and home care geographies. The data contain 17 audio-recorded home visits conducted by professional care workers. An ethnomethodological analysis informed by geographies of care in home-spaces shows how the home as a material space has consequences for conversations and the relations between the service users and workers. The parties orient to two relational and shifting identity pairs in their ‘home-space talk’: a host–guest pair (social call talk) and a professional–client pair (targeted intervention talk). Professional–client pair dominates, and in this sense floating support produces institutionalization of home-spaces. However, social call talk that enables service users to act as hosts governing their home-spaces has important functions. Orientations to hosts and guests create symmetry and trust among the parties that encourages recovery promoting interaction. The article also demonstrates the applicability of the methods developed in the geographies of mental health and home in the ethnomethodological interaction analysis, and the other way round.     

"A matter of physical health and strength”: disciplining the female body and reproducing the Czech national community in the mid-nineteenth century

An 1850 article “Uzavírání sňatku” (“Marriage”) by Czech physician Jan ?pott outlined the requirements for those who considered themselves part of the Czech national community. ?pott stressed that those concerned with the future national existence had to educate themselves and each other to create healthy offspring. I examine ?pott’s article with regard to contemporary ideas about fitness, the role of women, the need to discipline the female body, as well as the importance of education in reproducing the community. This article’s analysis - set in the broader context of the history of women, medicine, and nationalisms - shows that nation-oriented education could be perceived as a way to ensure the nation’s future existence while simultaneously emphasizing the responsibility of individuals, and particularly women, for the reproduction of the community. ?pott’s propositions are significant to other nineteenth-century national movements and to postnational contexts where national fitness is a concern.     

First‐world clinical anthropology and third‐world health issues

Golde, Peggy & Demitri B. Shimkin, eds. Clinical Anthropology: A New Approach to American Health Problems. Lanham, Md.: University Press of America, 1983. xxi + 456 pp. $17.75 (paper).

Morgan, John H., ed. Third World Medicine and Social Change: A Reader in Social Science and Medicine. Lanham, Md.: University Press of America, 1983. ix + 317 pp. $26.25 (cloth), $14.00 (paper).     

Appropriate remedial action? medical students, medical schools, and smoking and health education in New York and the United States, 1964-87

The Surgeon General's 1964 report on smoking and health, which declared that cigarette smoking was a cause of lung cancer, is considered a landmark in the history of medicine and public health. This article examines the impact of the report on medical student education by reviewing how the relationship between smoking and lung cancer was presented in medical school textbooks and syllabi between 1964 and 1987, changes in hospital smoking regulations and doctors' attitudes toward smoking following the publication of the report, and medical students' smoking patterns and attitudes toward cigarette smoking in the years after 1964. Although it provided some advanced students with additional insight into mechanisms of pathogenesis related to smoking, the education that many medical students received seems to have been neither a primary influence on their smoking patterns nor an important source of their scientific understanding of the causal link between smoking and lung cancer for at least a decade following the publication of the Surgeon General's report.