Carolyn Smith-Morris

For the past forty years, the Pima Indians living in the Gila River Indian Community have been among the most consistently studied diabetic populations in the world. But despite many medical advances, the epidemic is continuing and prevalence rates are increasing. Diabetes among the Pima is the first in-depth ethnographic volume to delve into the entire spectrum of causes, perspectives, and conditions that underlie the occurrence of diabetes in this community. Drawing on the narratives of pregnant Pima women and nearly ten yearsÕ work in this community, this book reveals the PimasÕ perceptions and understanding of type 2 and gestational diabetes, and their experience as they live in the midst of a health crisis. Arguing that the prenatal period could offer the best hope for curbing this epidemic, Smith-Morris investigates many core values informing the PimasÕ experience of diabetes: motherhood, foodways, ethnic identity, exercise, attitude toward health care, and a willingness to seek care. Smith-Morris contrasts gripping first-person narratives with analyses of several political, economic, and biomedical factors that influence diabetes among the Pimas. She also integrates major theoretical explanations for the disease and illuminates the strengths and weaknesses of intervention strategies and treatment. An important contribution to the ongoing struggle to understand and prevent diabetes, this volume will be of special interest to experts in the fields of epidemiology, genetics, public health, and anthropology. Click here for a Facilitator's Guide to Diabetes among the Pima

Stories of Survival

Diabetes Among the Pima

This collection is dedicated to the diagnostic moment and its unrivaled influence on encompassment and exclusion in health care. Diagnosis is seen as both an expression and a vehicle of biomedical hegemony, yet it is also a necessary and speculative tool for the identification of and response to suffering in any healing system. Social scientific studies of medicalization and the production of medical knowledge have revealed tremendous controversy within, and factitiousness at the outer parameters of, diagnosable conditions. Yet the ethnographically rich and theoretically complex history of such studies has not yet congealed into a coherent structural critique of the process and broader implications of diagnosis. This volume meets that challenge, directing attention to three distinctive realms of diagnostic conflict: in the role of diagnosis to grant access to care, in processes of medicalization and resistance, and in the transforming and transformative position of diagnosis for 21st-century global health. Smith-Morris’s framework repositions diagnosis as central to critical global health inquiry. The collected authors question specific diagnoses (e.g., Lyme disease, Parkinson's, andropause, psychosis) as well as the structural and epistemological factors behind a disease’s naming and experience.

Cultural Perspectives on Competing Knowledge in Healthcare

Diagnostic Controversy

Lenore Manderson

"A major collection of essays from leaders in the field of medical anthropology, Chronic Conditions, Fluid States pays much-needed attention to one of the greatest challenges currently faced by both the wealthiest and poorest of nations. For anyone wishing to think critically about chronic illness in cross-cultural perspective, the social forces shaping this issue, and its impact on the lived experiences of people worldwide, there is no better place to start than this pioneering volume."---Richard Parker, Columbia University, and editor-in-chief, Global Public Health --

Carolyn Smith-Morris

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