Managing Chronicity In Unequal States

By portraying the circumstances of people living with chronic conditions in radically different contexts, from Alzheimer’s patients in the UK to homeless people with psychiatric disorders in India, Managing Chronicity in Unequal States offers glimpses of what dealing with medically complex conditions in stratified societies means. While in some places the state regulates and intrudes on the most intimate aspects of chronic living, in others it is utterly and criminally absent. Either way, it is a present/absent actor that deeply conditions people’s opportunities and strategies of care. This book explores how individuals, groups and communities navigate uncertain and unequal healthcare systems, in which inherent moral judgements on human worth have long-lasting effects on people’s wellbeing. This is key reading for anyone wishing to deconstruct the issues at stake when analysing how care and chronicity are entangled with multiple institutional, economic, and other circumstantial factors. How people access the available informal and formal resources as well as how they react to official diagnoses and decisions are important facets of the management of chronicity. In the arena of care, people with chronic conditions find themselves negotiating restrictions and handling issues of power and (inter)dependency in relationships of inequality and proximity. This is particularly relevant in current times, when care has given in to the lure of the market, and the possibility of living a long and fulfilling life has been drastically reduced, transformed into a ‘reward’ for the few who have been deemed worthy of it.

Managing Chronicity in Unequal States investigates how people live with chronic conditions in different contexts around the world, where judgements on human worth have long-lasting effects on people's wellbeing.

Drawing upon the empirical scholarship and research expertise of contributors from all settled continents and from diverse life settings and economies, Viral Loads illustrates how the COVID-19 pandemic, and responses to it, lay bare and load onto people’s lived realities in countries around the world. A crosscutting theme pertains to how social unevenness and gross economic disparities are shaping global and local responses to the pandemic, and illustrate the effects of both the virus and efforts to contain it in ways that amplify these inequalities. At the same time, the contributions highlight the nature of contemporary social life, including virtual communication, the nature of communities, neoliberalism and contemporary political economies, and the shifting nature of nation states and the role of government. Over half of the world’s population has been affected by restrictions of movement, with physical distancing requirements and self-isolation recommendations impacting profoundly on everyday life but also on the economy, resulting also, in turn, with dramatic shifts in the economy and in mass unemployment. By reflecting on how the pandemic has interrupted daily lives, state infrastructures and healthcare systems, the contributing authors in this volume mobilise anthropological theories and concepts to locate the pandemic in a highly connected and exceedingly unequal world. The book is ambitious in its scope – spanning the entire globe – and daring in its insistence that medical anthropology must be a part of the growing calls to build a new world.

Critical Medical Anthropology presents inspiring work from scholars doing and engaging with ethnographic research in or from Latin America, addressing themes that are central to contemporary Critical Medical Anthropology (CMA). This includes issues of inequality, embodiment of history, indigeneity, non-communicable diseases, gendered violence, migration, substance abuse, reproductive politics and judicialisation, as these relate to health. The collection of ethnographically informed research, including original theoretical contributions, reconsiders the broader relevance of CMA perspectives for addressing current global healthcare challenges from and of Latin America. It includes work spanning four countries in Latin America (Mexico, Brazil, Guatemala and Peru) as well as the trans-migratory contexts they connect and are defined by. By drawing on diverse social practices, it addresses challenges of central relevance to medical anthropology and global health, including reproduction and maternal health, sex work, rare and chronic diseases, the pharmaceutical industry and questions of agency, political economy, identity, ethnicity, and human rights.

Drawing on ethnographic studies of the lived experiences of people with rare diseases, this volume critically examines rare, chronic diseases in the context of care, kinship, and technologies, providing in-depth analyses of local worlds that usually remain at the peripheries of medical anthropological inquiry.

Pain Management in Vulnerable Populations addresses the clinical problem of pain in vulnerable populations in our society. Their vulnerability is related to the challenging nature of their clinical conditions, for which standard therapies are often ineffective, or social factors, structural to the nation's health system, that limit access to the personalized, multidisciplinary specialty and integrative care that is needed. Each vulnerable group demands a unique approach - this book reveals the details behind the history, examination, and therapeutic options.to remediate vulnerability and achieve quality care in these populations.

This book shows how dying is a management problem for hospitals, occupying space but few billable encounters and of little interest to medical practice or quality control. An anthropologist and bioethicist with two decades of professional nursing experience, Helen Chapple goes beyond current work on hospital care to present fine-grained accounts of the clinicians, patients, and families who navigate this uncharted, untidy, and unpredictable territory between the highly choreographed project of rescue and the clinical culmination of death.

In the United States, chronic diseases currently account for 70 percent of all deaths, and close to 48 million Americans report a disability related to a chronic condition. Today, about one in four Americans have multiple diseases and the prevalence and burden of chronic disease in the elderly and racial/ethnic minorities are notably disproportionate. Chronic disease has now emerged as a major public health problem and it threatens not only population health, but our social and economic welfare. Living Well with Chronic Disease identifies the population-based public health actions that can help reduce disability and improve functioning and quality of life among individuals who are at risk of developing a chronic disease and those with one or more diseases. The book recommends that all major federally funded programmatic and research initiatives in health include an evaluation on health-related quality of life and functional status. Also, the book recommends increasing support for implementation research on how to disseminate effective longterm lifestyle interventions in community-based settings that improve living well with chronic disease. Living Well with Chronic Disease uses three frameworks and considers diseases such as heart disease and stroke, diabetes, depression, and respiratory problems. The book's recommendations will inform policy makers concerned with health reform in public- and private-sectors and also managers of communitybased and public-health intervention programs, private and public research funders, and patients living with one or more chronic conditions.