The second thing that in part defines the work of the Center for Critical Public Health, is making central the fact that public health knowledge emerging from research is also socially constructed.
Now I’m not arguing against the existence of facts — I’m not completely postmodern in that way.
But what I am suggesting is that the nature of our research, the questions that we ask and don’t ask, the literature that we cite and don’t cite, the interpretations of our analyses, the nature of the recommendations we make in public health, are very much socially structured…
To one degree or another, all of us here today operate within the domain of public health and therefore we share some understanding about what public health is and should do.
Typically, public health is defined as “promot(ing) and protect(ing) the health of people and the communities where they live, learn, work and play” (from the American Public Health Association website).
On the surface, this is pretty uncontroversial. It’s straightforward — might be a bit vague, but it’s a straightforward description of what people in the public health field are all working towards. But upon closer reflection, maybe there are some questions that we should be asking, like…
The first is that the publics — as in the publics in public health, their experiences of the world, particularly as they are structured in an inequitable society — shape the ways in which they engage in their everyday lives, the choices that are available and that they make, the behaviors they engage in or don’t engage in.
This isn’t rocket science, but what is often neglected is that that very knowledge may often lie in direct opposition to the working knowledge that surrounds our work in public health, and how public health is defined within our fields.
By doggedly pursuing strategies that are defined by our existing knowledge, by what the orthodoxy thinks is important for protecting and promoting people’s health, we may fail some groups of people.
Now, of course, all research has elements of critique. Academics love critiquing their peers. And, critique, of course, is an important part of the process for producing scientific knowledge.
But to do critically-engaged research is different. A critical approach to public health research engages more explicitly with the politics of health.
It is research that doesn’t intend to just understand a phenomenon by uncovering “facts” that we gather through a specific “mechanical process”,13 but instead it is explicitly focused on challenging the status quo — challenging what “we” believe to be true in public health, and attempting to understand phenomena within the oppressive structures of our society in which those phenomena exist and/or emerge.9, 12
I am so grateful for this chance to confess to you active social scientists about my applied anthropology career crisis, and explore with you potential ways to weather and even prevent such a crisis for me, perhaps for you someday, and maybe even for the discipline.
Many people study anthropology and we embrace it as part of our identity. In fact, per the National Science Foundation and the National Center for Educational Sciences, an estimated 400,000 people in the United States have anthropology degrees, including about 20,000 PhDs and 50,000 masters, presumably many in applied anthropology. Further, the American Anthropological Association (AAA) boasts over 10,000 members and the Society for Applied Anthropology (SfAA) about 2,500.
Of AAA members, 75% are employed in higher education or students of anthropology, and it’s safe to assume that these folks practice anthropology daily. What about those who aren’t in academia? What do they do? Just about anything and nearly everything, with more or less success at incorporating our anthropology learnings in a sustained way. Those of us not in academia work for governments, development agencies, NGOs, tribal and ethnic associations, advocacy groups, social-service, health, and educational agencies, and businesses. These organizations often have a different set of values, methods, and priorities that compete with our applied anthropology tenets. And this culture clash sets us dyed-in-the-wool anthropologists up for conflict.
Take, for example… me! I was an applied medical anthropologist before I even heard of the term. I came of age on the Navajo Reservation, hearing stories from my step-mom, an Indian Health Service doctor. As a high school student, I pondered ways to prevent kids from being bounced out of pick-up truck beds. I envisioned policy to enable my friends preparing for military deployment to both take peyote in their protection ceremony and pass their pre-deployment drug test. I devised a group prescription system that would allow my high school girlfriends to obtain and take birth control pills together as a community, a way that would prevent more pregnancy than each of us playing roulette by taking turns popping out pills from a single, shared pill pack. Continue reading