The Health Politics of Asthma

Race, Toxic Exposures, and Environmental Health: The Contestation of Lupus among Farmworkers

“…First, we asked how agricultural workers experience and identify lupus as a contested occupational illness. In this regard, our work builds on previous research focused on environmental exposures (e.g., Brailsford et al 2018; Cherniack 1986; Frye 2020; Souza et al 2010) and contested illness (e.g., Armentor 2017; Brown 2007; Brown, Zavestoski, et al 2003; Jacobson and Adams 2017; Shriver and Bodenhamer 2018). Our findings revealed the specific ways in which the Lake Apopka farmworkers navigated their exposure experiences (see Adams et al 2011; Altman et al 2008) and connected their clear exposures to pesticides with the prevalence of lupus in their community.…”

“…Previous research on contested illness has highlighted the difficulties environmentally ill people can experience trying to obtain accurate diagnoses and care in cases of contested exposures. As mentioned previously, issues such as ambiguity, diagnostic uncertainty, and time lapse between exposure and illness can make legitimizing environmental illnesses extremely difficult (Armentor 2017; Brown, Zavestoski, et al 2003; Lévêque et al 2020). However, our findings revealed that in addition to these issues, factors surrounding race presented obstacles for the former farmworkers trying to garner validation for their illness claims.…”

“…Participants pointed to the political nature of illness contestation (see Brown, Zavestoski, et al 2003), in relation to their race and class, as a major influence on the outcomes of their claims, diagnosis, and treatment. They described systemic racism in the political sphere as having a chilling effect on farmworkers’ ability to seek help and intervention.…”

“…The literature on contested illness provides a framework for understanding not only workers’ exposure experiences but also the years-long process they can go through to seek accurate diagnosis and treatment. Brown, Zavestoski, et al (2003:214) define contested environmental illness as a disease or condition that “engender[s] major scientific disputes and extensive public debate over environmental causes.” Research focused on contested environmental illness centers on making connections between exposures and illness and understanding individuals’ perceptions, lived experiences with environmental illness, and efforts to access care for their conditions. Adams et al (2011) utilize the framework of the “exposure experience” to differentiate traditional illness experiences (where people have a known illness with a known etiology) from the experience of either being exposed to a contaminant with the possibility of becoming ill or having an illness with suspected environmental causes and a lack of epidemiological explanation or treatment (see also Altman et al 2008).…”

Respiratory health and ecosyndemics in a time of global warming

“…There is, as a result, an applied and theoretical need to (fi nally) fully heed Nader's (1972) call 'to study up' by examining structural factors in the development of ecocrises. At the same time, there is a parallel need to focus both on the ways social inequalities construct environmental health injustices and on the experiences, understandings, and conceptual and behavioral responses of disadvantaged and subordinated populations to the experience of maltreatment (Brown et al, 2003;Checker, 2005). A macromicro/political ecology of health lens of this sort offers medical anthropology a strategy for impacting health in a changing environment by providing a framework for understanding ecosocial pathways to deteriorating environmental health conditions and addressing deficiencies in public health infrastructure and planning in an era of enhanced chemical, biological, and social stressors as a consequence of global warming.…”