In this article, we critically analyze the implications of "Epidemic 2.0"-specifically the formative role of social media (as an exemplar of Web 2.0 technology) in disseminating information during epidemics. We use a narrative analysis framework to study the Ebola-related messaging on the official Facebook pages of the World Health Organization (WHO) and the Center for Disease Control (CDC) in the wake of the recent epidemic in Western Africa. Using as our corpus all the messages on these pages between the period of July 1 and October 15, 2014, our analysis traces the development of an ontological Ebola narrative: a specific, historically contingent, ideological plot that reaffirms contemporary Western anxieties around emerging infections. Our analysis focuses on the evolution of this ontological narrative from a) consulting and containment, to b) an international concern, and c) the possibility of an epidemic in the United States.
Drawing upon a postcolonial lens, this project looks at how meanings of HIV/AIDS are discursively constructed within the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), which was launched in 2003 under the presidency of George W. Bush and has been heralded as the largest global public health intervention program in history. Building on existing literature that theorizes the interrelationships of public health and national security, global surveillance, and transnational hegemony, the postcolonial theoretical standpoint interrogates how such meanings are constructed within PEPFAR. A postcolonial deconstruction of the 2009 PEPFAR report to the Congress revealed three meanings of HIV/AIDS that were discursively constructed in such policy documents: (a) the "Third World" as a site of intervention, (b) U.S. altruism as "lifting" the burden of the soul, and (c) AIDS, economics, and security. The themes put forth the linkages among the symbolic representations in neocolonial configurations and the politics of material disparities across the globe, thus issuing a call for the creation of participatory and dialogic spaces for engaging subaltern voices that are typically treated as targets of policy and intervention discourses.
Long-distance truck drivers (truckers) in India have been identified as a "high-risk" group for the HIV/AIDS epidemic, and are consequently the targets of prevention and education-based interventions. While such interventions have addressed risk at the level of individual behavior, little attention has been paid to the structural barriers to health for truckers. Research among truckers in India has ignored the economic, social, and cultural context of health. In this article, I employ the culture-centered approach (CCA) to health communication in documenting truckers' narratives of health, which are innately connected to social and institutional structures around their lives. The data included 36 narrative interviews that I conducted as part of my fieldwork with Indian truckers, in addition to field notes and a reflexive journal. Through a reflexive analysis of these narratives, I present three themes: (a) the everyday violence of trucking, (b) health as sacrifice, and (c) migration and HIV/AIDS. I discuss how communication interventions can attend to the relationship between trucker health and the structural barriers they encounter.
While the influence of the culture-centered approach (CCA; Dutta, 2008 ) on health communication scholarship is undeniable, there has been no evaluation of its application in the field. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews (Moher, Liberati, Tetzlaff & Altman, 2009), we analyzed a corpus of empirical, peer-reviewed literature (n = 47) that used the CCA. Our findings demonstrate that (a) the ontological axis of the CCA (culture, structure, and agency) was widely used as a heuristic for defining health problems; and (b) studies varied widely in their adoption of the CCA’s epistemological axis (that of dialogic co-construction with marginalized communities), either at the level of problem definition, problem interpretation, and/or community participation. Finally, while most studies reported self-reflexivity in design, we coded for methodological and philosophical reflexivity to assess fidelity to the CCA axiology. Based on the variations and consistencies in its use, we offer a refined, “nested” conceptualization of the CCA.
This brief essay is a commentary on how critical health communication theory can contribute to an understanding of the cultural dynamics of infectious disease pandemics. In particular, we focus on a specific trajectory of health communication theorizing-the culture-centered approach-and its heuristic and pragmatic utility in enhancing knowledge about public health crises like infectious disease outbreaks. In the backdrop of the mobilizations against the 2014 Ebola virus disease epidemic in the 3 West African nations of Guinea, Sierra Leone, and Liberia, indigenous cultural practices were construed as pathogenic and local agency of affected communities disregarded, even as the global risks of the epidemic were highlighted. In contrast to this interventionist notion of culture, the culture-centered approach offers a heuristic rubric through which to scrutinize the dialectical interrelationship between indigenous cultural practices, structural determinants of health, and the everyday agency of individuals of affected communities. We argue that such a listening-based paradigm of communication theorizing is instrumental in developing authentic, ethical, and effective health communication practice in public health crises.
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