Introduction
Health can be understood as a concept, a practice and a capacity , and is inherently complex, fluid and indeterminate. Ethnography, with its attention to how relations unfold between people, places, practices and things, is well suited to explore the situated meanings of health. However, while there is increasing recognition of the value of ethnography in different health and health-related research fields, there has been little consideration to date of the multiple ways in which ethnography and health become âentangledâ with one another through the research process, and how ethnographic and health knowledge emerge, take form, shape and challenge one another. This edited collection draws together reflections on a wide variety of contemporary ethnographies investigating health, through a broad range of topics, settings and disciplinary perspectives. We discuss emerging directions in ethnography and health, and raise important questions about how these entanglements produce new ways of doing both.
Ethnography has been employed in studies ranging from explorations of experiences of health and illness to the techno-scientific and organisational practices and processes of health, research and care delivery. There is now a plethora of disciplinary engagements with ethnography around the topic of health, extending far beyond its traditional anthropological origins, including sociology, geography , science and technology studies and in health care professions such as nursing and occupational therapy . This presents a dynamic and evolving landscape in which ethnography and health are entangled in new and different ways. It also provides an important opportunity to reflect carefully and critically on how ethnography and health might constitute and shape each other as part of this wide range of research possibilities. In this edited collection, we not only discuss the strengths (and limitations) of ethnography for engaging with health and health-related research, but also ask: What does ethnography enable, make visible and possible for knowing and doing health in contemporary research settings? And, how do the dynamics of these settings shape our ethnographic practice and the mechanisms through which we seek to engage with, and know, our research topics and fields?
Origins of the Book
This collection grew out of a two-day workshop for early-career researchers entitled Ethnographies & Health held in October 2015 at the London School of Hygiene & Tropical Medicine. It brings together empirical contributions by researchers who participated in the workshop, and who have employed ethnography from different disciplines and fields of research. While ethnography has increasing presence and recognition within health research, the researchers themselves can be thinly spread across academic departments or research settings, including both traditional social science departments and, increasingly, more biomedically-oriented health sciences departments. The workshop highlighted the wide range of contexts, approaches and interpretations of ethnography in explorations of health, and the different ways in which ethnographic practice and health become entangled through the research process. As editors, the process of reflecting on the workshop and reading and reviewing the chapters for this book has prompted us to consider and take seriously other ways of knowing and doing ethnography. We have become familiar with new theories and empirical fields, and have embraced different assumptions about what ethnography is and what it can do, even if these come into tension with our own epistemic and disciplinary traditions, rooted in anthropology .
Attending to the intricacies of method and experience led us towards identifying the ways in which situated encounters with health shape the unfolding of ethnography and the formation of empirical understanding. The chapters in this collection address a wide variety of topics, contexts and methodological styles, and in each, ethnographic practices are opened up for interrogation, and questions around what health is, or how health is made to matter in different situations, are actively and productively explored. Moving beyond a simple methodological framing of what ethnography can(not) offer, we propose that reflecting on the limitations and possibilities of ethnography in practice gives rise to important and critical questions about the ways in which health can be researched and known.
The subsequent parts of this introductory chapter are arranged into three sections. First, we foreground varied contemporary approaches to ethnography. Second, we explore different ways in which health has been framed and known through ethnography. In the final section, we provide an overview of each contributing chapter, highlighting the breadth of âethnographiesâ and âhealthsâ addressed in this collection.
Emerging Directions in Ethnography
Ethnography has been variously described as a method, a methodology, a âsensibilityâ, a âway of seeingâ and a âpractice of descriptionâ (Star 1999; Wolcott 1999; Hammersley and Atkinson 2007; Ingold 2014). It has been interpreted as both a form of research and the product of that research (Hammersley 2007). As such, ethnographic practice has been debated, critiqued, applied and interpreted in multiple ways. Increasingly, ethnography is taking place across a range of disciplines and for different audiences and purposes, so that how ethnography is practised and performed can now vary greatly. In this section, we seek to highlight the value of acknowledging ethnography as necessarily situated, drawing on examples (many from health and related research) to illustrate how ethnographic practice unfolds in contingent and often productive ways.
Ethnography is commonly framed as both a methodology and a form of writing (see, for example, Clifford and Marcus 1986; Wolcott 1999; Hammersley and Atkinson 2007). With its earliest roots in anthropology from the late nineteenth century onwards, ethnographyâs traditional form emerged alongside European colonialism and typically involved immersion in a specific, often remote, geographical location and unfamiliar âculturesâ. Early ethnographers in anthropology were methodologically eclectic but what they held in common, according to Nader, was that âthey went, they observed, they stayed, they returned home and they wrote ethnographyâ (2011: 212). In sociology, however, ethnography was applied closer to home from the outset, for example in the studies of (Western) urban environments associated with the Chicago School from the early twentieth century. These ethnographic studies typically presented âdescriptive narrativesâ of everyday interactions occurring among communities living in cities (such as Chicago) experiencing rapid social and industrial change (Deegan 2001). Ethnography in other disciplines, however, such as geography , remained fairly limited until the shift towards post-positivist and post-structuralist theories of relationships between people and place in the 1990s (Crang and Cook 1995).
Since the âcrisis of representationâ in the social sciences, critical attention has been paid to the ways in which ethnographic research is produced and how it can or should be represented as âknowledgeâ. While some contemporary ethnography continues to centre on geographically defined âfieldsâ, attention to emerging âglobalisedâ and âpostmodernâ worlds have prompted other kinds of ethnographic engagements with âunboundedâ fields (Marcus 1995; Gupta and Ferguson 1997). Within this framing, the remit of ethnographic inquiry extends along flows and networks of relations to consider how these may âmake upâ places rather than simply reflecting static geographic locations (Choy et al. 2009). In the context of health, this may mean, for example, studying a medical intervention that spans multiple countries (Montgomery 2012); tracing health inequalities policy through multiple zone...