Session 3B: Risks to health, safety, and identity

Session 3B: Risks to health, safety, and identity, Tate Hall, room 135. Chair: Deborah Crooks.

8:30-8:50         Alyson Young, Risky resources: Household production, food contamination and perceptions of aflatoxin exposure among Zambian female farmers

A key component of ensuring nutritional security is access to and utilization of safe, affordable and nutritious foods. Mycotoxins pose a significant threat to food and nutrition security through their health and economic impacts. In Zambia, women are central to household food production and are responsible for preparing, storing, and processing staple crops, including groundnuts. As such, they are key to ensuring household food safety and prevention of aflatoxin contamination, yet their ability to feed their families properly is often compromised by lack of physical and human capital.

This paper uses semi-structured interviews, participatory risk assesssment techniques and focus group discussions to examine the relationship between women’s workloads and management of aflatoxin contamination among female farmers in Eastern Province Zambia. Interviews were conducted in July-August 2015 and consisted of individual interviews with 25 women and five focus groups in three regions of Eastern Province. Interviews focused on knowledge of aflatoxin-producing fungi and food contamination, groundnut production practices and the groundnut value chain–including use of aflatoxin reduction strategies and choices in grading, use and sale of groundnut products.

Women’s knowledge of aflatoxin-producing fungi and aflatoxin contamination of groundnuts varied although all of the women were familiar with basic strategies for reducing contamination during post-harvest storage and links between aflatoxin exposure, child stunting and cancer. The extent of women’s knowledge about aflatoxin-producing fungi and its prevention was linked to thier participation in community organizations and access to extension services. Overall, participants were less familiar with pathways of exposure, particularly risks of exposure through animal pathways or during pregnancy/breastfeeding. Women’s post-harvest practices were driven primarily by labor constraints and market demand. For example, women added water to shells to soften them for shelling and sold top grade groundnuts while keeping the least healthy specimen for household consumption, despite the increased risk of aflatoxin exposure associated with both practices.

Results from this study indicate the importance of gender disaggregated data on differences in household allocation of labor/resources, risk management and participation in agricultual value chains for understanding food safety risks and exposure. It also emphasizes the importance of including women in rural advisory services and training. Future research that integrates participatory approaches to gender and risk assessment with analyses of exposure pathways and biomarkers of exposure to mycotoxins can help strengthen research on the mechanisms that link social and biological components of risk and resilience.

8:50-9:10         Discussion

9:10-9:30         Jennifer Jo Thompson, Amanda June Brawner, and Usha Kaila, At risk of “knowing where your food comes from”: How food safety concerns can threaten the success of farm to school initiatives

Farm to School (FTS) programming is a national initiative in the United States to “teach children where their food comes from.” Most often this involves bringing local food into school cafeterias by connecting farmers with existing school nutrition programs. Since the mid-20th century, directors of school nutrition programs have primarily procured food for schools through national or global producers and distributors. Thus, recent efforts to source food locally have been met with a variety of obstacles, from compliance with USDA procurement regulations, to distribution across the district. Where these initial obstacles are overcome, however, new ideological barriers emerge.

We draw from 18 months of ethnographic research with a regional FTS project and interviews with district-level school nutrition directors across the state of Georgia (n=17) to examine food safety as an emerging barrier in efforts to bring local foods into school cafeterias. Our analyses are informed by social theories of risk and responsibility as late-modern techniques of governance reliant upon the development of expert knowledges, the responsibilization of individuals as prudent yet entrepreneurial subjects, and the identification of at-risk and risky populations as targets for external surveillance and management (Castel 1991; Dean 2002; Foucault 1975; O’Malley 2000).

We argue that, paradoxically, this barrier emerges as the result of FTS ideology: knowing where food comes from. Nutrition directors voice strong support for FTS as a means of bolstering local economies. Nevertheless, visits to farms, intended to promote enthusiasm for the purchase of local foods among school nutrition staff, render visible the realities of food production (e.g., food growing in the “dirt,” the presence of pests, or unfamiliar systems such as aquaponics). The transparency of local food production invites scrutiny, especially toward unfamiliar practices, and can fuel uncertainty about whether on-farm practices pose risks to food safety. In an example of the neoliberal “downshifting of responsibility” (DuPuis, et al. 2005), nutrition directors are cast in the role of having to audit and assess on-farm safety practices, despite their lack of expertise, in an effort to protect at-risk subjects (school children) from potentially risky objects (fresh produce). In contrast, food procured through standard institutional channels is protected from scrutiny by an opaque supply chain that renders invisible the realities of growing, harvesting, processing, and transporting food—allowing school nutrition directors to place their trust in distant forms of expertise and an abstract system of regulations (Giddens 1991).

These findings highlight the assumption of oversight that accompanies food procured through commodities markets and the converse supposition that local foods are “risky.” This rationale casts nutrition directors, already tasked with ensuring food safety practices in school cafeterias, in the role of having to assess and verify the on-farm food safety practices of farmers. Importantly, because this places the responsibility on individuals often unqualified and unprepared to be farm safety auditors, many nutrition directors may decide that “it’s not worth the risk” to purchase from local farmers. We argue that this may have detrimental effects on the success and long-term viability of FTS.

9:30-9:50         Discussion

9:50-10:10       Steve Winterberg, Risking ethnic pride in business among Kashmiri tourism-related shopkeepers

Kashmiri tourism-related shopkeepers rely on tourists in order to survive financially. They also view their role as ambassadors of Kashmiri ethnic pride to non-Kashmiri tourist customers coming to visit as a significant way to display and demonstrate their ethnic superiority. India and Pakistan have fought over the Kashmir Valley for a long time, which fosters a feeling that Kashmiris are caught in the middle between outsider goals and objectives. The militancy, along with other factors are fostering risks for shopkeepers as outsiders’ perceptions of Kashmiri ethnicity are challenged. At the same time, changes in tourism have challenged Kashmiri shopkeepers in their business goals and in their desire to reestablish Kashmiri ethnic pride. How do Kashmiri tourism-related shopkeepers understand the risks to their ethnic pride and to their business pursuits? How has the Kashmiri militancy movement and changes in tourism impacted Kashmiri objectives? How have Kashmiri tourism-related shopkeepers adjusted and adapted as a result of these challenges? This presentation will demonstrate that Kashmiri tourism-related shopkeepers are caught in the middle between their objectives of ethnic reestablishment, which they feel are being challenged, and their goal of financial gain through their business.

This ethnographic study was conducted in the summer of 2014 and involved participant observation and ethnographic interviews. This study demonstrates that Kashmiri tourism-related shopkeepers risk losing business if they fail to address changes in global tourism that are impacting them, but they also face a decrease in ethnic pride and prestige if they make adjustments. The most common way that shopkeepers have adjusted was through making changes in their products. Kashmiri shopkeepers felt that selling machine-made products challenged their ethnic identity, but they felt compelled to do so in order to survive economically. The participants in this study all sold machine-made goods, but they certainly did not broadcast it. Also, they felt justified in calling the products “Kashmiri” since the styles and patterns on those products were Kashmiri, even if they were not produced by hand in a traditional manner. This adaptation demonstrates that the shopkeepers face ethnic risks in order to survive financially, but also that they were resilient in attempting to find ways of continuing to pursue both their goal of financial success and their goal of ethnic reestablishment.

10:10-10:30     Discussion

10:30-10:45     Break

10:45-11:05     Lauren Johnson, Making “easy” money: Resilience and risk in Jamaica

Problem Statement and Theoretical Frame: Local adaptations to economic blight and overreliance on the tourism industry demonstrate varying aspects of resilience and risk among Caribbean populations. Those individuals who choose sex tourism as a way to benefit from the increasing revenue generated demonstrate resilience through their adaptations to shifts in the local and national economies, including national debt, expansion of the all-inclusive hotel industry, and seasonal variations in tourist arrivals. In a locale where it has become common for men to sell sex to women tourists for a living, residents rationalize female sex tourism using constructs that correlate with traditional views of masculinity, sex, and sexuality. This paper argues that the very activities of hustling and sex work that illustrate men’s resilience are the same practices that put their sexual health at risk. As a result, the question becomes whether or not male sex workers in tourist areas are targeted by the same condom use and STI/HIV programs as female sex workers. To what extent is the health of this population prioritized over the revenue generated by the (sex) tourism industry? Using a political economy approach, this research contextualizes the practice of female sex tourism using the anthropology of tourism, gender and sexuality studies, and the anthropology of HIV/AIDS with a focus on the Caribbean region.

Methodology: This study draws conclusions from ethnographic research conducted in Negril, Jamaica in 2010-2011. My research project on the local impact of female sex tourism involved observation, semi-structured interviews, and life history interviews with a total of 54 Negril residents, tourist visitors, government health officials, local doctors, and tourism officials and workers. Qualitative data were compiled, coded, and analyzed with Atlas.TI software using a grounded theory approach.

Results and Implications: Many men in Jamaica demonstrate a convergence of sexual risk factors including poor health seeking behaviors, multiple sex partners, drug and alcohol abuse, sex with a female sex worker, fear of needle testing, and relatively low condom use despite knowledge of sexually transmitted infections (STIs) and HIV. Men who sell sex to support themselves and their families face the added factors of transactional sex with multiple partners, both local and foreign, and express the need to establish intimacy quickly in relationships with tourist women in order to build a basis for requesting funds. Informants for this project indicate that health and tourism officials have normalized this tendency towards engagement in male sex work in key tourist destinations. Despite the development of health interventions targeting female sex workers, no such programming exists for men who sell sex. Further, tourism officials have generally avoided the issue of safer sex practices and condom use in touristic spaces due to concerns over the loss of tourism revenue. In order for the issue of STI/HIV risk to be adequately addressed among this population, effective public health efforts must prioritize health over tourism revenue and utilize anthropological approaches to explore the health costs of the tourist dollar.

11:05-11:25     Discussion

11:25-11:45     Rebecca Adkins Fletcher, The financial risks of living wellness: Contextualizing the Affordable Care Act wellness incentives through the political-economy of health risk management and health insurance governance

Numerous Medical Anthropological accounts describe disparities in accessing health care in broad relation to neoliberal market transformations and state governance.  It is in the intersections of political-economy and biomedicine that we see the ways in which individual abilities to maintain health are determined by ties to the global job market that regulate access to resources, including health insurance and health care.  Within this framework, the ability to manage one’s health is increasingly tied to market principles that increase vulnerability regarding access to an assembly of resources that affect health status.  However, belying the consequences of neoliberal economic policies and transformations that decrease security for individuals and families, public health paradigms largely focus on health behaviors and individual lifestyle choices to explain health disparities.  This paper describes the financial links to health behaviors that emerged through ethnographic participant-observation and semi-structured interviews in an urban Central Appalachian community in 2007-2008.  While my research broadly asked how union members of the United Steelworkers (USW) and Retail, Wholesale, and Department Store Union (RWDSU) unions in this community described the links between health insurance, access to health care, and union membership, this paper relocates health behaviors within a political economic framework to showcase the complexities of cultural and economic factors (e.g. changing employment statuses, wage differentials, social location, and health insurance status) that influence individual and family choices for maintaining health.  Theoretically, this paper utilizes political-economy, health risk behavior, and health insurance governance perspectives to contextualize the ways in which differentially insured individuals and families seek to mitigate the financial burden of health risk, including health risk avoidance and prevention.  In so doing, I discuss instances of “job lock” in terms of health insurance access and draw upon recent reevaluations of fatalism to reassess how negative health and lifestyle behaviors are sometimes rational responses in the form of risk management regarding employment and health insurance governance.  Ultimately, I argue that revisiting the actions (agency) individuals take towards securing health and financial security within a health behavior paradigm unmasks the political-economic nature (structure) in which health disparities have expanded from the rewriting of the social contract linking work with culturally appropriate access to health care.  I argue here that expanding the health behaviors concept to include a broader array of actions individuals take to better their health and well-being provides a means of placing health disparities into meaningful social context, creating avenues for better public health outcomes.  The implications of this research point to the need to re-categorize health behaviors within a framework that acknowledges the political-economic shifting of risk management to individuals and families, especially as through increased consumer cost-sharing disincentives (health insurance premiums, deductibles, and co-pays) to health seeking behavior.  In so doing, I offer an informed critique of the Wellness programs incentivized in the Affordable Care Act in relation to health behavior risk assessment.

11:45-12:05     Discussion