ETHNIC STUDIES 262

 

“Race, Inequality, and Health”

 

Fall 2004

 

Thursdays, 2:00-4:50 pm, in SSB 103

 

 

Prof. Steven Epstein

Department of Sociology

Office phone: 858-534-0489

E-mail: sepstein@ucsd.edu

Home page: http://sociology.ucsd.edu/~sepstein

Office hours: Mon 2:30-3:30 pm and Tue 2:00-3:00pm in SSB 476

 

 

Prof. Nayan Shah

Department of History

Office phone: 858-822-2544

E-mail: nbshah@ucsd.edu

Office hours: Mon 1:00-2:00 pm and Wed 2:00-3:00 pm in HSS 6086 B

 

 

Description:

 

This course was developed by a multidisciplinary group of faculty in the Humanities, Social Sciences, and School of Medicine. It explores controversies over health disparities—why various groups have less access to health care, receive inferior treatment, and have greater and intensive experiences with sickness—and relates these disparities to social inequalities structured by race, class, gender, sexuality, and nation. Discussions of health inequalities will include cases drawn from the nineteenth century to the present and from regions around the world. The course will examine tensions between different understandings of illness and different medical practices; and it will explore the processes by which diseases come to be racialized or imbued with racial meanings. The course also examines the possibilities of understanding and countering health disparities through changes in research strategies, policy decisions, and programs for prevention and treatment.

 

 

 

Readings:

 

The following required books are available for purchase at Groundwork Bookstore in the old student center. Copies are also on reserve at the library.

 

Arnold, David. 1993. Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India. Berkeley: University of California Press.

Fadiman, Anne. 1997. The Spirit Catches You and You Fall Down. Farrar, Straus and Giroux.

 

Farmer, Paul. 1999. Infections and Inequalities: The Modern Plagues. Berkeley: University of California Press.

 

Shah, Nayan. 2001. Contagious Divides: Epidemics and Race in San Francisco’s Chinatown. Berkeley: University of California Press.

 

All other required readings will be available from e-reserves (http://reserves.ucsd.edu/). These items are preceded with “**” on the syllabus.

 

Please note that you are responsible for downloading and printing each item. You can access the files from any campus computer, and you can print them with an ACS laser printing account (see http://sdacs.ucsd.edu/~icc/laser.php). You can also download and print the files from off-campus, but in order to do so you need to specify a proxy in your web browser (an easy process; see http://www-ono.ucsd.edu/documentation/squid/). In the case of any problems accessing e-reserves, library staff are available to help you.

 

PLEASE NOTE: There are some short readings assigned for the first meeting of the course!

 

 

Requirements:

 

Students taking the course for credit are expected to submit a paper (20-25 pages in length) by Wednesday, December 8. You must get the instructors’ approval of your proposed topic by submitting a short written description by no later than the end of Week 5 (October 22). Incompletes are heartily discouraged.

 

In addition, each student (including auditors) will be asked to circulate discussion questions in advance of two class meetings during the quarter. These questions must be emailed to all participants in the seminar by 5:00 pm on the day before class. Students will sign up for specific weeks at the first meeting of the seminar.

 

 

Schedule:

 

Week 1 (September 23): Introduction

 

Farmer, Infections and Inequalities, chapter 2 (pp. 37-58; notes on 288-91).

 

**Williams, David R. “Race and Health: Basic Questions, Emerging Directions.” Annals of Epidemiology 7, no. 5 (July 1997): 322-333.

 

**Fullilove, Mindy Thompson. 1998. “Comment: Abandoning ‘Race’ as a Variable in Public Health Research—An Idea Whose Time Has Come.” American Journal of Public Health 88, no. 9 (September): 1297-98.

 

            RECOMMENDED:

 

Smedley, Brian D., Adrienne Y. Stith, and Alan R. Nelson. 2002. “Summary.” In Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, Brian D. Smedley, Adrienne Y. Stith, and Alan R. Nelson, eds., pp. 1-27. Washington, DC: National Academy Press (available a www.nap.edu).

 

 

Week 2 (September 30): Theorizing Race, Inequality, and Health

 

**Omi, Michael, and Howard Winant. 1986. Racial Formation in the United States: From the 1960’s to the 1980’s. New York: Routledge & Kegan Paul, Chapters 4 & 5 (pp. 57-86; notes on 162-172).

 

**Rose, Nikolas. 2001. “The Politics of Life Itself.” Theory, Culture & Society 18 (6):1-30.

 

**Krieger, Nancy, and Elizabeth Fee. 1996. “Man-Made Medicine and Women’s Health: The Biopolitics of Sex/Gender and Race/Ethnicity.” Pp. 15-35 in Man-Made Medicine: Women’s Health, Public Policy, and Reform, edited by K. L. Moss. Durham, NC: Duke University Press.

 

RECOMMENDED:

 

Bird, Chloe E., and Patricia P. Rieker. 1999. “Gender Matters: An Integrated Model for Understanding Men’s and Women’s Health.” Social Science and Medicine 48 (6): 745-755.

 

Janet K. Shim, “Bio-Power and Racial, Class, and Gender Formation in Biomedical Knowledge Production,” Research in the Sociology of Health Care 17 (2000): 173-195.

 

Krieger, Nancy. 1999. “Embodying Inequality: A Review of Concepts, Measures, and Methods for Studying Health Consequences of Discrimination.” International Journal of Health Services 29 (2):295-352.

 

Crawford, Robert “The Boundaries of the Self and the Unhealthy Other: Reflections on Health, Culture and AIDS” Social Science Medicine, vol 38, no 10, pp. 1347-1365 (1994).

 

Michel Foucault, “Governmentality,” in The Foucault Effect, ed. Graham Burchell et al.(Chicago: University of Chicago Press), pp. 87-104.

 

 

WEEK 3 (October 7): Epidemic Imperialism: Race and Public Health in Colonial Regimes

 

Arnold, Colonizing the Body, pp. 1-10, 116-159, 200-294

 

**Rosenberg, Charles. 1992. Explaining Epidemics and Other Studies in the History of Medicine, pp. 293–318. Cambridge: Cambridge University Press.

 

**Bashford, Alison. 2004 Imperial Hygiene: A Critical History of Colonialism, Nationalism and Public Health 2004, pp. 1-13; 164-185

 

**Anderson, Warwick. 1997. “The Trespass Speaks: White Masculinity and Colonial Breakdown.” American Historical Review 102(5):1343-70.

 

RECOMMENDED:

 

Anderson, Warwick, 1996 “Immunities of Empire: Race, Disease and the New Tropical Medicine, 1900-1920” Bulletin of the History of Medicine 70 (1996), p. 94-118

 

--- ---- --- 1995 “Excremental Colonialism: Public Health and the Poetics of Pollution,” Critical Inquiry, pp 640-669

 

David Armstrong, Public Health Spaces and the Fabrication of Identity” Sociology 27 (1993), pp. 393-410

 

Prashad, Vijay, 1994 “Native Dirt/Imperial Ordure: The Cholera of 1832 and the Morbid Resolutions of Modernity” Journal of Historical Sociology, vol 7, No 3

 

McLeod,Roy. 1988 Disease Medicine and Empire: Perspectives on Western Medicine and the Experience of European Expansion Routledge

 

David Arnold, 1988 Imperial Medicine and Indigenous Societies Manchester

 

Megan Vaughn, 1994 Curing their Ills: Colonial Power, African Illness

 

Franz Fanon “Medicine and Colonialism” in a Dying Colonialism trans by Chevalier (NY Grove 1965, p. 121-145

 

 

WEEK 4 (October 14): Globalization, economic restructuring, and the healthy citizen

Guests: Charles Briggs (Ethnic Studies and CILAS) and Clara Mantini-Briggs (CILAS)

 

Farmer, Infections and Inequalities, 59-93, 127-49.

 

**Briggs, Charles L., and Clara Mantini-Briggs. 2003. Stories in Times of Cholera: Racial Profiling During a Medical Nightmare. Berkeley, CA: University of California Press, chapter 1, 11, 12.

 

**Larvie, Patrick. 1999. “Queerness and the Specter of Brazilian National Ruin,” GLQ 5, no. 4: 527-58.

 

**Packard, Randall M., and Peter Brown. 1997. “Rethinking Health, Development and Malaria: Historicizing A Cultural Model in International Health.” Medical Anthropology 17: 181-194.

 

RECOMMENDED:

 

Listios, Socrates. 1997. “Malaria Control, the Cold War, and Postwar Reorganization of International Assistance. Medical Anthropology 17 (1997): 255-278.

 

Randall Packard, White Plague, Black Labor: Tuberculosis and the Political Economy of Health and Disease in South Africa

 

 

WEEK 5 (October 21): Immigration, governmentality, and the construction of the Other

Guest: Natalia Molina (Ethnic Studies)

 

Shah, Nayan. 2001. Contagious Divides: Epidemics and Race in San Francisco’s Chinatown. Berkeley: University of California Press. pp. 1-104; 179-203, 225-258

 

**Molina, Natalia. Book manuscript. “Introduction: Contested Bodies and Cultures: The Politics of Public Health and Race within the Mexican, Chinese, and Japanese Communities of Los Angeles, 1879-1939” (pp. 1-21); and “Chapter 4: ‘We Can No Longer Ignore the Problem of the Mexican’: Depression-Era Public Health Policies in Los Angeles” (pp. 182-244).

 

**Ong, Aihwa. 1995. “Making the Biopolitical Subject: Cambodian Immigrants, Refugee Medicine and Cultural Citizenship in California.” Social Science and Medicine 40 (9):1243-1257.

 

RECOMMENDED:

 

Markel, Howard, and Alexandra Minna Stern. 2002. “The Foreignness of Germs: The Persistent Association of Immigrants and Disease in American Society.” Milbank Quarterly 80, no. 4.

 

Farmer, Paul. 2003. “Pestilence and Restraint: Guantánamo, AIDS, and the Logic of Quarantine,” in Pathologies of Power, (Berkeley: University of California Press, 51-90.

 

 

WEEK 6 (October 28)

Part I: Culturally Effective Care and Health Disparities

Guests: Larry Palinkas (Department of Family and Preventive Medicine, School of Medicine) and Vivian Reznik (Department of Pediatrics, School of Medicine)

 

            Fadiman, The Spirit Catches You and You Fall Down (entire)

 

            RECOMMENDED:

 

Hahn, Robert A. 1985. Culture-Bound Syndromes Unbound. Social Science and Medicine 21(2):165-171.

 

Santiago-Irizarry, Vilma. “Culture as Cure.” Cultural Anthropology 11, no. 1 (1996): 3–24.

 

Part II: Reproduction, Gender, Race and Sexual Health

 

**Briggs, Laura. 2002. Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in Puerto Rico. Berkeley: University of California Press. Pp. 74–108.

 

**Hunt, Nancy Rose. 1999. A Colonial Lexicon of Birth Ritual, Medicalization, and Mobility in the Congo. Duke University Press. Pp. 1-26; 237-280+ notes

 

**Hammonds, Evelynn. 1986. “Race, Sex, AIDS: The Construction of ‘Other’, Radical America 20, no. 6: 28-36.

 

RECOMMENDED:

 

Levine, Philippa 2003 Prostitution, Race and Politics: Policing Venereal Disease in the British Empire. Routledge

 

Anderson, Warwick. 2002. The Cultivation of Whiteness: Science, Health and Racial Destiny in Australia. Melbourne: Melbourne University Press. Chapter 8

 

Johanna Schoen, “Fighting for Child Health: Race, Birth Control and the State in Jim Crow South “ Social Politics (1997) pp. 90-113

 

 

WEEK 7 (November 4): Bioethics and Inequality from Tuskegee to AIDS Trials

 

**Brandt, Allan M. 2000. Racism and Research: The Case of the Tuskegee Syphilis Experiment. In Tuskegee’s Truths: Rethinking the Tuskegee Syphilis Study, Susan M. Reverby (ed.), 15-33. Chapel Hill: University of North Carolina Press.

 

**Vanessa Gamble, “Under the Shadow of Tuskegee: African Americans and Health Care” American Journal of Public Health 87 (1997) p. 1773-1778

 

**David J. Rothman, “The Shame of Medical Research,” New York Review of Books, 30 November 2000, 60-64.

 

**Rayna Rapp, Testing Women, Testing the Fetus: The Social Impact of Amniocentesis in America (New York: Routledge, 1999), chapters 3-4 (pp. 53-102; notes on 319-29).

 

**Cohen, Lawrence. 2001. “The Other Kidney: Biopolitics Beyond Recognition.” Body and Society 7 (2-3): 9-29.

 

            RECOMMENDED:

 

Scheper-Hughes, Nancy. 2000. “The Global Traffic in Organs.” Current Anthropology 41 (2): 191-224.

 

--- --- --- 2002. “The Ends of the Body: Commodity Fetishism and the Traffic in Human Organs.” SAIS Review: A Journal of International Affairs (Winter/Spring) 22 (1): 61-80.

 

Thomas, Stephen B., and Sandra Crouse Quinn. 1991. “The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV Education and AIDS Risk Education Programs in the Black Community.” American Journal of Public Health 81 (11):1498-1505.

 

Fairchild, Amy L., and Ronald Bayer. 1999. “Uses and Abuses of Tuskegee.” Science 284 (7 May): 919-921

 

 

WEEK 8 (November 11): Genomics, Racial Profiling, and the Biomedical Remaking of Difference in the 21st Century

 

[NOTE: Veterans’ Day Holiday: We will reschedule this class meeting.]

 

**Duster, Troy. 2003. “Buried Alive: The Concept of Race in Science.” Pp. 258-277 in Genetic Nature/Culture: Anthropology and Science Beyond the Two-Culture Divide, edited by A. H. Goodman, D. Heath and M. S. Lindee. Berkeley: University of California Press.

 

**Kahn, Jonathan. 2004. “How a Drug Becomes ‘Ethnic’: Law, Commerce, and the Production of Racial Categories in Medicine.” Yale Journal of Health Policy, Law & Ethics 4 (1):1-46.

 

**Epstein, Steven. 2004. “Bodily Differences and Collective Identities: Representation, Generalizability, and the Politics of Gender and Race in Biomedical Research in the United States.” Body and Society 10 (2-3):183-203.

 

**Epstein, Steven. 2003. “Sexualizing Governance and Medicalizing Identities: The Emergence of ‘State-Centered’ LGBT Health Politics in the United States.” Sexualities 6 (2):131-171.

 

RECOMMENDED:

 

Lee, Sandra Soo-Jin, Joanna Mountain, and Barbara A. Koenig. 2001. “The Meanings of ‘Race’ in the New Genomics: Implications for Health Disparities Research.” Yale Journal of Health Policy, Law and Ethics 1:33-75.

 

Root, Michael. 2003. “The Use of Race in Medicine as a Proxy for Genetic Differences.” Philosophy of Science 70:1173-1183.

 

                       

WEEK 9 (November 18):

 

Part I: Racializing Diseases

 

**Tapper, Melbourne. 1995. “Interrogating Bodies: Medico-Racial Knowledge, Politics, and the Study of a Disease.” Comparative Studies in Society and History 37, no. 1 (January): 76-93.

 

**Wailoo, Keith. 2003. “Inventing the Heterozygote: Molecular Biology, Racial Identity, and the Narratives of Sickle Cell Disease, Tay-Sachs, and Cystic Fibrosis,” in Donald Moore, Anand Pandia, and Jake Kosek, eds., Race, Nature, and the Politics of Difference (Duke University Press).

 

RECOMMENDED:

 

Kaufman, Jay S., and Susan A. Hall. “The Slavery Hypertension Hypothesis: Dissemination and Appeal of a Modern Race Theory.” Epidemiology 14, no. 1 (January 2003): 111-26.

 

Wailoo, Keith. 2001. Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health. University of North Carolina Press.

 

Wailoo, Keith. 1997. Drawing Blood: Technology and Disease Identity in Twentieth-Century America. Johns Hopkins University Press.

 

Part II: Environment, Race and Social Justice Movements

Guests: David Pellow and Lisa Park (Ethnic Studies)

 

**Pellow, David Naquib, and Lisa Sun-Hee Park. 2003. The Silicon Valley of Dreams: Environmental Injustice, Immigrant Workers, and the High-Tech Global Economy. New York: New York University Press, 85-192 (Ch. 5-7).

**Brown, Phil, Brian Mayer, Stephen Zavestoski, Theo Luebke, Joshua Mandelbaum, and Sabrina McCormick. 2003. “The health politics of asthma: environmental justice and collective illness experience in the United States.” Social Science & Medicine 57, no. 3 (August): 453-64.

 

**Murphy, Michelle. 2004. “White Noise, Race and the Privilege of Imperception in the US EPA.” Osiris 19.

 

            RECOMMENDED:

 

Chavez, César. 1993. “Farm Workers at Risk,” in Toxic Struggles: The Theory and Practice of Environmental Justice. Philadelphia: New Society, pp. 164-170.

 

Di Chiro, Giovanna. “Living is for Everyone: Border Crossings for Community, Environment and Health.” Osiris 19.

 

Nash, Linda. 2004. “The Fruits of Ill Health: Pesticides and Workers Bodies in Post World War II California.” Osiris 19.

 

 

Week 10 (December 2): Social Movements and Subcultures of Resistance

 

**Epstein, Steven. 1997. “AIDS Activism and the Retreat from the Genocide Frame.” Social Identities 3 (3):415-438.

 

**Crimp, Douglas, and Adam Rolston. 1990. AIDS Demographics. Seattle: Bay Press, 76-121.

 

**Klawiter, Maren. 1999. “Racing for the cure, walking women, and toxic touring: Mapping cultures of action within the Bay area terrain of breast cancer.” Social Problems 46, 104–26.

 

**Parikh, Shanti. 2004. “From Auntie to Disco: The Bifurcation of Risk and Pleasure in Sources of Sexuality Education in Uganda.” In The Moral Object of Sex: Science, Development, and Sexuality in Global Perspective, V. Adams and S. Pigg (eds). Durham: Duke University Press.