April 30th, 2013, by Ali Kenner Comments Off
It’s been nearly four years since The Asthma Files (TAF) really took off (as a collaborative ethnographic project housed on an object-oriented platform). In that time our work has included system design and development, data collection, and lots of project coordination. All of this continues today; we’ve learned that the work of designing and building a digital archive is ongoing. By “we” I mean our “Installation Crew”, a collective of social scientists who have met almost every week for years. We’ve also had scores of students, graduate and undergraduates at a number of institutions, use TAF in their courses, through independent studies, and as a space to think through dissertations. In a highly distributed, long-term, ethnographic project like TAF, we’ve derived a number of modest findings from particular sites and studies; the trick is to make sense of the patterned mosaic emerging over time, which is challenging since the very tools we want to use as a window into our work — data visualization apps leveraging semantic tools, for example — are still being developed.
Given TAF’s structure — thematic filing cabinets where data and projects are organized — we have many small findings, related to specific projects. For example, in our most expansive project “Asthmatic Spaces”, comparisons of data produced by state agencies (health and environmental), have made various layers of knowledge gaps visible, spaces where certain types of data, in certain places, is not available (Frickel, 2009). Knowledge gaps can be produced by an array of factors, both within organizations and because of limited support for cross agency collaboration. Another focus of “Asthmatic Spaces” (which aims to compare the asthma epidemic in a half dozen cities in the U.S. and beyond) is to examine how asthma and air quality data are synced up (or not) and made usable across public, private, and nonprofit organizations.
In another project area, “Asthma Knowledges”, we’ve gained a better understanding of how researchers conceptualize asthma as a complex condition, and how this conceptualization has shifted over the last decade, based on emerging epigenetic research. In “Asthma Care” we’ve learned that many excellent asthma education programs have been developed and studied, yet only a fraction of these programs have been successfully implemented, such as in school settings. Our recent focus has been to figure out what factors are at play when programs are successful.
Below I offer three overarching observations, taken from what our “breakout teams” have learned working on various projects over the last few years:
*In the world of asthma research, data production is uneven in myriad ways. This is the case at multiple levels — seen in public health surveillance and our ability to track asthma nationally, as well as at the state and county level; as seen through big data, generated by epigenetic research; in the scale of air quality monitoring, which is conducted at the level of cities and zip codes rather than at neighborhood or street level. Uneven and fragmented data production is to be expected; as ethnographers, we’re interested in what this unevenness and fragmentation tells us about local infrastructure, environmental policy, and the state of health research. Statistics on asthma prevalence, hospitalizations, and medical visits are easy to come by in New York State and California, for example; experts on these data sets are readily found. In Texas and Tennessee, on the other hand, this kind of information is harder to come by; more work is involved in piecing together data narratives and finding people who can speak to the state of asthma locally. Given that most of what we know about asthma comes from studies conducted in major cities, where large, university-anchored medical systems help organize health infrastructure, we wonder what isn’t being learned about asthma and air quality in smaller cities, rural areas, and the suburbs; what does environmental health (and asthma specifically) look like beyond urban ecologies and communities? We find this particularly interesting given the centrality that place has for asthma as a disease condition and epidemic.
*Asthma research is incredibly diffuse and diverse. Part of the idea for The Asthma Files came from Kim Fortun and Mike Fortun’s work on a previous project where they perceived communication gaps between scientists who might otherwise collaborate (on asthma research). Thus, one of our project goals has been to document and characterize contemporary asthma studies, tracing connections made across research centers and disciplines. In the case of a complex and varied disease like asthma — a condition that looks slightly different from one person to the next and is likely produced by a wide composite of factors — the field of research is exponential, with studies that range from pharmaceutical effects and genetic shifts, to demographic groups, comorbidities, and environmental factors like air pollution, pesticides, and allergens. Admittedly, we’ve been slow to map out different research trajectories and clusters while we work to develop better visualization tools in PECE (see Erik Bigras’s February post on TAF’s platform).
What has been clear in our research, however, is that EPA and/or NIEHS-funded centers undertaking transdisciplinary environmental health research seem to advance collaboration and translation better than smaller scale studies. This suggests that government support is greatly needed in efforts to advance understanding of environmental health problems. Transdisciplinary research centers have the capacity to conduct studies with more participants, over longer periods of time, with more data points. Columbia University’s Center for Children’s Environmental Health provides a great example. Engaging scientists from a range of fields, CCCEH’s birth cohort study has tracked more than 700 mother-child pairs from two New York neighborhoods, collecting data on environmental exposures, child health and development. The Center’s most recent findings suggest that air pollution primes children for a cockroach allergy, which is a determinant of childhood asthma. CCCEH’s work has made substantial contributions to understandings of the complexity of environmental health, as seen in the above findings. Of course, these transdisciplinary centers, which require huge grants, are just one node in the larger field of asthma research. What we know from reviewing this larger field is that 1) most of what we know about asthma is based on studies conducted in major cities, 2) that studies on pharmaceuticals greatly outnumber studies on respiratory therapy; that studies on children outnumber studies on adults; that studies on women outnumber studies on men; and that many of the studies focused on how asthma is shaped by race and ethnicity focus on socioeconomic factors and structural violence; finally, 3) that over the last fifty years, advancements in inhaler technology mechanics and design has been limited in key ways, especially when compared to a broader field of medical devices.
*Given the contextual dimensions of environmental health, responses to asthma are shaped by local factors. What’s been most interesting in our collaborative work is to see what comes from comparing projects, programs, and infrastructure across different sites. What communities and organizations enact what kinds of programs to address the asthma epidemic? What resources and structures are needed to make environmental health work happen? Environmental health research of the scale conducted by CCCEH depends on a number of factors and resources — an available study population, institutional resources, an air monitoring network, and medical infrastructure, not to mention an award winning grassroots organization, WE-ACT for Environmental Justice. Infrastructure can be just as uneven and fragmented as the data collected, and the two are often linked: Despite countless studies that associate air pollution and asthma, less than half of all U.S. counties have monitors to track criteria pollutants. And although asthma education programs have been designed and studied for more than two decades now, implementation is uneven, even in the case of the American Lung Association’s long-standing Open Airways for Schools. This is not to say that asthma information and care isn’t standardized; many improvements have been made to standardize diagnosis and treatment in the last decade. Rather, it’s often the form that care takes that varies from place to place. One example of what has been a successful program is the Asthma and Allergy Foundation of America’s Breathmobile program. Piloted in California more than a decade ago, Breathmobiles serve hundreds of California schools each year and more than 5,000 kids. Not only are eleven Breathmobiles in operation in California, but the program has also been replicated in Phoenix, Baltimore, and Mobile, AL. Part of the program’s success in California can be attributed to the work of the state’s AAFA chapter, and partnerships with health organizations, like the University of Southern California and various medical centers. Importantly, California has historically been a leader in responses to environmental health problem.
As we continue our research, in various fieldsites, grow our archive, and implement new data visualization tools, we hope to expand on these findings and further synthesize from our collective work. And beyond what we’re learning about the asthma epidemic and environmental health in the U.S., we’ve also taken many lessons from our collaborative work, and the platform that organizes us.
During the first year of the Obama administration, there was considerable optimism that the United States might finally catch up with other industrialized countries by developing a national renewable portfolio standard and carbon regulation. However, the hope was dashed by the compromises of the Kerry-Lieberman bill in the Senate and its eventual defeat. Likewise, the rise of the Tea Party movement and influence of fossil-fuel money in the Republican Party has made green-energy policy an increasingly partisan issue. It is hard to believe that in 2008 both McCain and Obama agreed that climate change was real and needed policy attention. By 2012, the pervasive influence of fossil-fuel money and the Republican Party’s anti-green strategy had led even the president who promised five million green jobs to adopt a strategic silence on the issue.
In the Arctic in 2012, the planet passed a significant milestone: the level of atmospheric carbon dioxide passed 400 ppm, a level that the planet has not had for at least 800,000 years. The summer ice melt also reached new levels. Unfortunately, climate change is occurring slowly enough in temperate climates that it is easy for political leaders to ignore the severity of the threat. Human societies face an adaptation problem that they have never experienced before, and it will be exacerbated by the 2-3 billion people who will be added to the planet during the next forty years. As ethnographic field research has shown, the effects are often magnified in marginalized populations located in coastal areas, in urban slums, and in polar regions.
My recent work has been oriented toward what I think of as the “problem behind the problem,” that is, the lack of political will to address the twin problems of environmental sustainability and social fairness that are becoming worse every year. I have written a three-volume series that looks at the role of “alternative pathways” (loosely social movements plus other kinds of reform efforts, including in the private sector) as historical agents that could open political opportunities for sustainability politics. In Alternative Pathways in Science and Technology, I reviewed a wide range of industry-oriented reform movements and showed both their potential and limitations; Localist Movements in a Global Economy focused on the small business sector and community enterprises as another source of countervailing power to the anti-green segment of global capital; and Good Green Jobs in a Global Economy explored the much more mainstream politics of labor-environmental-green business coalitions in federal and state energy policy. Although the work is written for a scholarly audience, I have also been involved in the local living economy and state government policy fields by writing policy reports, engaging in public speaking, and also cofounding an independent business association with a living economy mission.
More recently, I have been working on a project that tracks the record of Republicans on environmental policy issues with the assistance of a very promising graduate student, Jonathan Coley. In both Good Green Jobs and a paper in Energy Policy, we track the reversals that have occurred since the election of President Obama and the rise of the Tea Party movement. Although green-energy politics and policies have subsided from the national stage, in states where Democrats are in power there has been ongoing action. Furthermore, we also found that there are some areas of bipartisanship, especially if proposed legislation does not involve a reform that can be understood as a regulatory burden.
Although my work is highly interdisciplinary, and my institutional home is a sociology department and an energy and environment institute, I find that an anthropological sensibility continues to inform my thinking. For example, I am particularly interested in the role of political ideologies as cultural systems in policy fields, and I am interested in ideology as way in to the study of change in political culture. In addition to the mainstream polarity of American politics between a neoliberal right and social liberal left, I have been building a case that there is a growing influence of other ideologies, notably localism and developmentalism. For example, in Good Green Jobs, I argue that the United States of the twenty-first century is showing signs of a return to its developmentalist politics of the nineteenth century (in the sense of support for industry and trade defensiveness), largely due to the general shifts in the world economy and the aggressively developmentalist policies of emerging industrial powers.
By understanding neoliberalism in the political field as one ideology among others, I am especially interested in the capacity for other ideologies to become embedded in both discourse and policy outcomes, often as compromise formations. The focus is less on the micropolitics of everyday practices than on the broad contours of the political field and its potential to undergo tectonic shifts similar to the transition in dominance from social liberalism to neoliberalism that occurred in the United States during the 1970s and 1980s. The approach allows me to ask the empirical question of “after neoliberalism—then what?” in a way that is not clouded by utopian hopes.
Although there is a green transition in place in both the United States and many other countries, I remain pessimistic that the world’s largest countries will be able to act quickly enough to avert the multiple environmental crises of climate change, desertification, persistent toxics in the biosphere, and exhaustion of land and water resources. The future of the anthropocene looks grim indeed.