- University of California, Riverside
Department of Anthropology
900 University Ave.
Riverside, Ca 92521 - 951-827-9250
- Social and Cultural Anthropology, Medical Anthropology, Graphic Medicine, Health Disparities, Pacific Islanders, Cancer, and 22 moreHumanities and Health, Latino health, Cancer Prevention, Health Communication, Medical Humanities, Cultural Studies, Medical Drama, Representation of Health, Media, Health, Fiction, Television, Anthropology, Ethics, Science and Technology Studies, Computer Networks, Databases, Software, Comics and Graphic Novels, Narrative Methods, Bodies and Culture, and New Materialismedit
- Prior to joining the Department of Family Medicine to serve as Director and Endowed Chair in Medical Humanities and A... morePrior to joining the Department of Family Medicine to serve as Director and Endowed Chair in Medical Humanities and Arts. I served as a Professor of Anthropology, Co-Director and Community Engagement and Dissemination Lead for the Center for Health Disparities Research. I developed and served as the Director for Medical and Health Humanities Designated Emphasis in the School of Medicine and in the College of Humanities, Arts, and Social Sciences at UCR and developed the undergraduate Minor in Medical and Health Humanities.
My key research and teaching interests include health equity, narrative and medicine, graphic medicine, social dimensions of cancer, land-based health, and community engaged research. I am the author of The Healthy Ancestor: Embodied Inequality and the Revitalization of Native Hawaiian Health, and co-editor of Confronting Cancer: Metaphors, Advocacy, and Anthropology. My work has been published in the Journal of Medical Humanities, Culture, Medicine, and Psychiatry, American Medical Association Journal of Ethics, Medical Anthropology Quarterly, Social Science and Medicine, and other peer-reviewed journals. My research and program development work has been funded by the National Institutes of Health, Patient Centered Outcomes Research Institute, National Endowment for the Humanities, and the National Science Foundation. I currently serves on the editorial board for the journal Literature and Medicine, and as a co-editor for Penn State Press’s Graphic Medicine Series.
My new projects build on my interests in health equity and social determinants that might foster obligation and compassion as a path to wellbeing for patients and health care professionals alike. Central to my new projects are the development of spaces for equal engagement and diverse forms of expression in research and education.edit
This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build... more
This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data collection approach was employed for this cross-sectional study of current or previously funded RCMIs. A total of 18 of the 25 institutions spanning 13 U.S. states and territories participated. CEC specific aims were to support community engaged research (94%); to translate and disseminate research findings (88%); to develop partnerships (82%); and to build capacity around community research (71%). Four open-ended questions, qualitative analysis, and comparison of the categories led to the emergence of two supporting themes: (1) establishing trust between the community-academic collaborators and within the community and (2) building collaborative relationships. An over...
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Research Interests:
In this article we examine the influence of cultural beliefs on behavior or, more specifically, beliefs about cervical cancer risk factors and the use of Pap exams. Individual Latinas' (Hispanic women) holding of beliefs similar to... more
In this article we examine the influence of cultural beliefs on behavior or, more specifically, beliefs about cervical cancer risk factors and the use of Pap exams. Individual Latinas' (Hispanic women) holding of beliefs similar to Latinas' generally (cultural consonance) did not significantly influence their use of Pap exams. Rather, structural factors such as medical insurance, age, marital status, education, and language acculturation explained Latinas' use of this medical service. However, when Latinas held beliefs similar to those of Anglo women, then they were significantly more likely to have had a Pap exam within the past two years. Latinas whose beliefs were closer to those of physicians were significantly less likely to have had the exam recently. Arriving at these findings involved both ethnographic interviews and survey research. That these beliefs proved to be significant influences on behavior suggests not only the important ways that beliefs matter but tha...
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Introduction. This study examines differences in students’ perceived value of three artmaking modalities (poetry, comics, masks) and whether the resulting creative projects offer similar or different insights into medical students’... more
Introduction. This study examines differences in students’ perceived value of three artmaking modalities (poetry, comics, masks) and whether the resulting creative projects offer similar or different insights into medical students’ professional identity formation. Methods. Mixed-methods design using a student survey, student narrative comments and qualitative analysis of students’ original work. Results. Poetry and comics stimulated insight, but masks were more enjoyable and stress-reducing. All three art modalities expressed tension between personal and professional identities. Discussion. Regardless of type of artmaking, students express concern about encroachments of training on personal identity but hoped that personal and professional selves could be integrated.
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Unintentional injury prevention research focuses on parental supervision as critical to reducing toddler injury. We examine how the promotion of childproofing-as a mode of supervision-sells mothers "peace of mind" while also... more
Unintentional injury prevention research focuses on parental supervision as critical to reducing toddler injury. We examine how the promotion of childproofing-as a mode of supervision-sells mothers "peace of mind" while also increasing "intensive mothering" and the "privatization of risk." Drawing on the childproofing literature and meaning centered interviews with mothers of toddlers and childproofing business owners, we argue that the connection made by these groups between childproofing and "good parenting" ultimately obscures how this form of harm reduction economically and socially individualizes responsibility for child care.
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Research Interests: Obesity, Culture, Diet, Community Based Participatory Research, Humans, and 15 moreDiabetes mellitus, Female, Male, Exercise, Hawaii, Body Mass Index, Aged, Prevalence, Middle Aged, Food habits, Adult, Cardiovascular Diseases, Cross Sectional Studies, Metabolic Syndrome X, and Medical and Health Sciences
... you Like . . . by Mark Keali'i Ho'omalu (2003). His response to this question links land, body, and health for off-islanders who, like their counterparts in Hawai'i, do not always have access to the 'āina (land).... more
... you Like . . . by Mark Keali'i Ho'omalu (2003). His response to this question links land, body, and health for off-islanders who, like their counterparts in Hawai'i, do not always have access to the 'āina (land). By imagining Native ...
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... you Like . . . by Mark Keali'i Ho'omalu (2003). His response to this question links land, body, and health for off-islanders who, like their counterparts in Hawai'i, do not always have access to the 'āina (land).... more
... you Like . . . by Mark Keali'i Ho'omalu (2003). His response to this question links land, body, and health for off-islanders who, like their counterparts in Hawai'i, do not always have access to the 'āina (land). By imagining Native ...
Chemotherapy is a standard form of treatment for most cancers. Receiving treatment and “battling” cancer is expected as part of making life flourish. The procedure calls for the support of the chair, which in text is rendered invisible,... more
Chemotherapy is a standard form of treatment for most cancers. Receiving treatment and “battling” cancer is expected as part of making life flourish. The procedure calls for the support of the chair, which in text is rendered invisible, and yet its relationality to toxins, cancer, patients, and medical personnel are drawn into being, made visible through comics. The consistency by which the chair is materialized in comics about cancer orients the author, patient, and reader to ordinary, standardized, normalized, objects necessary for life with cancer and to the nuances and exercise of power.
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Previous work in the anthropology of cancer often examined causes, risks, and medical, familial, and embodied relationships created by the disease. Recent writing has expanded that focus, attending to cancer as a “total social fact” (... more
Previous work in the anthropology of cancer often examined causes, risks, and medical, familial, and embodied relationships created by the disease. Recent writing has expanded that focus, attending to cancer as a “total social fact” ( Jain 2013) and dissecting the landscape of “carcinogenic relationships” (Livingston 2012). Cancer-driven relationships become subjectively
real through individual suffering, stigma, and inequality. This article traces concepts developed from a primarily US-centered discourse to a global cancer discourse, including cancer-related issues continuing to raise concern such as stigma, narrative moments of critical reflection on the dominance of biomedicine, and processes by which individuals and communities manage inadequate access to biomedical technologies. Beyond the medical relations
and politics of cancer, this article considers the ways in which ethnography addresses local moral worlds and differences that come to matter in attending to the disease, the person, and consequent social and material relations.
real through individual suffering, stigma, and inequality. This article traces concepts developed from a primarily US-centered discourse to a global cancer discourse, including cancer-related issues continuing to raise concern such as stigma, narrative moments of critical reflection on the dominance of biomedicine, and processes by which individuals and communities manage inadequate access to biomedical technologies. Beyond the medical relations
and politics of cancer, this article considers the ways in which ethnography addresses local moral worlds and differences that come to matter in attending to the disease, the person, and consequent social and material relations.
Cancer graphic narratives, I argue, are part of a medical imaginary that includes representations of difference and biomedical technology that engage Fassin‘s (2009) concept of biolegitimacy. Framed in three parts, the argument first... more
Cancer graphic narratives, I argue, are part of a medical imaginary that includes representations of difference and biomedical technology that engage Fassin‘s (2009) concept of biolegitimacy. Framed in three parts, the argument first draws on discourses about cancer graphic narratives from graphic medicine scholars and authors to demonstrate a construction
of universal suffering. Second, I examine tropes of hope and difference as a biotechnical embrace. Finally, I consider biosociality within the context of this imaginary and the
construction of a meaningful life. Autobiographical graphic narrative as a creative genre that seeks to give voice to individual illness experiences in the context of biomedicine raises anthropological questions about the interplay between the ordinary and biolegitmate. Cancer graphic narratives deconstruct the big events to demonstrate the ordinary ways that a life constructed as different becomes valued through access to medical technologies. [graphic narratives, cancer, health inequalities, biolegitimacy, medical imaginary]
of universal suffering. Second, I examine tropes of hope and difference as a biotechnical embrace. Finally, I consider biosociality within the context of this imaginary and the
construction of a meaningful life. Autobiographical graphic narrative as a creative genre that seeks to give voice to individual illness experiences in the context of biomedicine raises anthropological questions about the interplay between the ordinary and biolegitmate. Cancer graphic narratives deconstruct the big events to demonstrate the ordinary ways that a life constructed as different becomes valued through access to medical technologies. [graphic narratives, cancer, health inequalities, biolegitimacy, medical imaginary]
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As unintentional injuries continue to be the leading cause of hospitalization and death for toddlers between the ages of 1 and 4, the Centers for Disease Control has argued that child supervision is a key factor in reducing these injuries... more
As unintentional injuries continue to be the leading cause of hospitalization and death for toddlers between the ages of 1 and 4, the Centers for Disease Control has argued that child supervision is a key factor in reducing these injuries and fatalities. This article focuses on the affective relationships in the concept of supervision and practice of watching as an injury prevention method. Three parts frame our argument. First, we describe how watching is an ordinary affect. Second, as part of the ethos of caring, watching is embedded in a temporal frame of anticipation and gives rise to an affectsphere of watching and to a parents’ subjectivity as ‘good’ or ‘bad’ supervisors. Third, these affective relationships generate seemingly contradictory outcomes wherein children are expected to gain independence and experience injury. The affective qualities of watching provide a critique of the individualizing forces of supervision and an analysis of subjectivities generated by gender and class.
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Research Interests:
In this article we examine the influence of cultural beliefs on behavior or, more specifically, beliefs about cervical cancer risk factors and the use of Pap exams. Individual Latinas' (Hispanic women) holding of beliefs similar to... more
In this article we examine the influence of cultural beliefs on behavior or, more specifically, beliefs about cervical cancer risk factors and the use of Pap exams. Individual Latinas' (Hispanic women) holding of beliefs similar to Latinas' generally (cultural consonance) did not significantly influence their use of Pap exams. Rather, structural factors such as medical insurance, age, marital status, education, and language acculturation explained Latinas' use of this medical service. However, when Latinas held beliefs similar to those of Anglo women, then they were significantly more likely to have had a Pap exam within the past two years. Latinas whose beliefs were closer to those of physicians were significantly less likely to have had the exam recently. Arriving at these findings involved both ethnographic interviews and survey research. That these beliefs proved to be significant influences on behavior suggests not only the important ways that beliefs matter but that ethnographic methods for examining those beliefs also matter. [Latinas and cervical cancer, Pap exams, culture and behavior, ethnography and survey research]
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BACKGROUND: Recurrent operational problems in teaching clinics may be caused by the different medical preferences of patients, residents, faculty, and administrators. These preference differences can be identified by cultural consensus... more
BACKGROUND: Recurrent operational problems in teaching clinics may be caused by the different medical preferences of patients, residents, faculty, and administrators. These preference differences can be identified by cultural consensus analysis (CCA), a standard anthropologic tool. OBJECTIVE: This study tests the exportability of a unique CCA tool to identify site-specific operational problems at 5 different VA teaching clinics. DESIGN: We used the CCA tool at 5 teaching clinics to identify group preference differences between the above groups. We averaged the CCA results for all 5 sites. We compared each site with the averages in order to isolate each site’s most anomalous responses. Major operational problems were independently identified by workgroups at each site. Cultural consensus analysis performance was then evaluated by comparison with workgroup results. PARTICIPANTS: Twenty patients, 10 residents, 10 faculty, members, and 10 administrators at each site completed the CCA. Workgroups included at minimum: a patient, resident, faculty member, nurse, and receptionist or clinic administrator. APPROACH: Cultural consensus analysis was performed at each site. Problems were identified by multidisciplinary workgroups, prioritized by anonymous multivoting, and confirmed by limited field observations and interviews. Cultural consensus analysis results were compared with workgroup results. RESULTS: The CCA detected systematic, group-specific preference differences at each site. These were moderately to strongly associated with the problems independently identified by the workgroups. The CCA proved to be a useful tool for exploring the problems in depth and for detecting previously unrecognized problems. CONCLUSIONS: This CCA worked in multiple VA sites. It may be adapted to work in other settings or to better detect other clinic problems.
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Recent theory in anthropology has increasingly been concerned with issues of power. Anthropology also has a long history of interest in variation in cultural knowledge, which, we argue, benefits from attention to power relations. To show... more
Recent theory in anthropology has increasingly been concerned with issues of power. Anthropology also has a long history of interest in variation in cultural knowledge, which, we argue, benefits from attention to power relations. To show this, we examine perceptions of breast cancer risk factors among physicians. Although physicians share a general cultural model of breast cancer risk factors, variation exists, especially between university‐based physicians and community‐based physicians. The nature of the work performed in these two settings influences the acquisition of various sources of information and frames what is considered valid information. Similar to Foucault's argument, we find that physicians working in a university setting are more disciplined in discussing their perceptions of breast cancer risk factors, compared to community‐based physicians, who move away from the centers of knowledge and power (universities).
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The groundwork for the Pacific Islander cancer control network (PICCN) began in the early 1990s with a study of the cancer control needs of American Samoans. The necessity for similar studies among other Pacific Islander populations led... more
The groundwork for the Pacific Islander cancer control network (PICCN) began in the early 1990s with a study of the cancer control needs of American Samoans. The necessity for similar studies among other Pacific Islander populations led to the development of PICCN. The project's principal objectives were to increase cancer awareness and to enhance cancer control research among American Samoans, Tongans, and Chamorros. PICCN was organized around a steering committee and 6 community advisory boards, 2 from each of the targeted populations. Membership included community leaders, cancer control experts, and various academic and technical organizations involved with cancer control. Through this infrastructure, the investigators developed new culturally sensitive cancer education materials and distributed them in a culturally appropriate manner. They also initiated a cancer control research training program, educated Pacific Islander students in this field, and conducted pilot research projects. PICCN conducted nearly 200 cancer awareness activities in its 6 study sites and developed cancer educational materials on prostate, colorectal, lung, breast, and cervical cancer and tobacco control in the Samoan, Tongan, and Chamorro languages. PICCN trained 9 students who conducted 7 pilot research projects designed to answer important questions regarding the cancer control needs of Pacific Islanders and to inform interventions targeting those needs. The legacy of PICCN lies in its advancement of improving cancer control among Pacific Islanders and setting the stage for interventions that will help to eliminate cancer-related health disparities. Cancer 2006. © 2006 American Cancer Society.
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Some problems in clinic function recur because of unexpected value differences between patients, faculty, and residents. Cultural consensus analysis (CCA) is a method used by anthropologists to identify groups with shared values. After... more
Some problems in clinic function recur because of unexpected value differences between patients, faculty, and residents. Cultural consensus analysis (CCA) is a method used by anthropologists to identify groups with shared values. After conducting an ethnographic study and using focus groups, we developed and validated a CCA tool for use in clinics. Using this instrument, we identified distinct groups with 6 important value differences between those groups. An analysis of these value differences suggested specific and pragmatic interventions to improve clinic functioning. The instrument has also performed well in preliminary tests at another clinic.
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Research Interests: Sociology, Cognitive Science, Content Analysis, Ethnicity And Health, California, and 13 moreHUMAN PAPILLOMAVIRUS, Humans, Face to Face, Female, Sexual Behavior, Risk factors, Cervical Cancer, Middle Aged, Adult, Public health systems and services research, Risk Factors, Sexual Activity, and Pap smear
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OBJECTIVE: We evaluated the relationship between U.S. citizenship status and the receipt of Pap smears and mammograms among immigrant women in California. DESIGN: Cross-sectional study using data from the 2001 California Health Interview... more
OBJECTIVE: We evaluated the relationship between U.S. citizenship status and the receipt of Pap smears and mammograms among immigrant women in California. DESIGN: Cross-sectional study using data from the 2001 California Health Interview Survey. PATIENTS/PARTICIPANTS: Noninstitutionalized, civilian women, aged 18 years and older living in California. MEASUREMENTS AND MAIN RESULTS: We analyzed data from the 2001 California Health Interview Survey and used logistic regression models to adjust for sociodemographic factors and for access and utilization of health services. After adjusting we found that U.S. citizen immigrants were significantly more likely to report receiving a Pap smear ever (adjusted prevalence ratio [aPR], 1.05; 95% confidence interval [CI], 1.01 to 1.08), a recent Pap smear (aPR, 1.07; 95% CI, 1.03 to 1.11), a mammogram ever (aPR, 1.17; 95% CI, 1.12 to 1.21), and a recent mammogram (aPR, 1.38; 95% CI, 1.26 to 1.49) as compared to immigrants who are not U.S. citizens. Also associated with receiving cancer screening were income, having a usual source of care, and having health insurance. Hispanic women were more likely to receive Pap smears as compared to whites and Asians. CONCLUSIONS: Not being a U.S. citizen is a barrier to receiving cervical and breast cancer screening. Additional research is needed to explore causal factors for differences in cancer screening rates between citizens and noncitizens.
Research Interests: General Internal Medicine, Health insurance, Multivariate Analysis, Humans, General, and 24 moreHealth Services, United States, Female, Cancer Screening, Mammography, Ethnic Groups, African Americans, Clinical Sciences, Aged, Middle Aged, Asian Americans, Breast Cancer Screening, Adult, Odds ratio, Educational Status, Patient Participation, Cross sectional Study, Logistic Regression Model, Cross Sectional Studies, Pap smear, Logistic Models, Confidence Interval, Socioeconomic Factors, and Health Services Accessibility
Research Interests: Focus Groups, Content Analysis, Life Style, Cancer Prevention, Los Angeles, and 16 moreCalifornia, Pacific Islands, Humans, Female, Male, Focus Group, Aged, Middle Aged, Adult, Public health systems and services research, Neoplasms, Health surveys, American Samoa, Community Based Organization, attitude to health, and cultural characteristics
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On November 8th, 2001, faculty from Universities, government and non-profit community organizations met to determine how, separately and together, they could address disparities in survival of women with breast cancer in the diverse... more
On November 8th, 2001, faculty from Universities, government and non-profit community organizations met to determine how, separately and together, they could address disparities in survival of women with breast cancer in the diverse patient populations served by their institutions. Studies and initiatives directed at increasing access had to date met modest success. The day was divided into three sections, defining the issues, model programs, government initiatives and finally potential collaborations. By publishing these proceedings, interested readers will be aware of the ongoing programs and studies and can contact the investigators for more information. The Avon Foundation funded this symposium to bring together interested investigators to share programmatic experiences, data and innovative approaches to the problem.
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This project shares the stories of Pacific Islander Elders and their role in maintaining knowledge of the Islands in southern California. It is a collaborative project with Pacific Islander Health Partnership, Paradocs Productions, UC... more
This project shares the stories of Pacific Islander Elders and their role in maintaining knowledge of the Islands in southern California. It is a collaborative project with Pacific Islander Health Partnership, Paradocs Productions, UC Riverside, and the Pacific Islander Student Association. The project was funded by the California Humanities.
This video was part of a class project in my Introduction to Cultural Anthropology class. Inspired by Mike Wesch's "A Vision of Students Today", we wondered what student's experiences were like at the 5th most diverse campus in the United... more
This video was part of a class project in my Introduction to Cultural Anthropology class. Inspired by Mike Wesch's "A Vision of Students Today", we wondered what student's experiences were like at the 5th most diverse campus in the United States.