Critical Anthropology for Global Health Rudolf Virchow Award
November 14, 2020. The Society for Medical Anthropology’s Critical Anthropology for Global Health special interest group has awarded the Rudolf Virchow Award to Emily Vasquez, Project Director in the Division of Ethics, Department of Medical Humanities and Ethics, for her paper “Detecting diabetes risk: Philanthropy, technology, and epistemic power in Mexico.”
The award is named for Rudolf Virchow, a 19th century German physician and anthropologist, was a key founder of social medicine. His contributions centered on his recognition that multiple intersecting factors—social, political, and economic—produce disease and illness. He argued that the circumstances and deprivations of poverty increase people’s susceptibility to disease and result in reduced life expectancy and quality of life. He eloquently articulated the limits of medicine in the absence of material security, a sentiment which informed his view that nation-states play an important role in ensuring health security for a citizenry.
Each year there are three awards for individuals at different stages in their careers as medical anthropologists to recognize papers that combine a critical anthropology focus with rich ethnographic data, and reflect, extend, and/or advance critical perspectives in medical anthropological questions in the general area of global public health.
Emily’s paper is an ethnographic analysis of public-private partnerships for public health in Mexico. It illuminates how the philanthropic activities of the financial elite can alter the scientific landscape of health. Rather than adopting the holistic approach to health endorsed by a public health approach, private foundations set up to distribute the financial largess of contemporary oligarchs—in this case the Carlos Slim Foundation—succeed in shifting biomedical inquiry away from structural drivers of health disparities and onto the microbiology of non-communicable disease, seeking to discover and leverage genetic testing strategies and metabolic biomarkers to build a public health system that privileges the individual—rather than the social and capitalist forces at play around that individual—as a site if illness.
The paper paints a stark picture of what happens to public health when vital research funding is controlled by private interests—subverted from public coffers through lucrative tax laws and exempt from public accountability as it is spent. For elite philanthropists, this is a double win: their public reputation is improved through their charitable work and the broader public health agenda is drawn away from the structural features of the capitalist system that both produce health inequity and enable the financial success of the Foundation’s primary namesakes. Ironically, therefore, public health can be made remarkably poorer by the injections of cash from these foundations, as structural work in public health science is often left “undone” when private capital drives the agenda.
Emily is a PhD candidate in the Department of Sociomedical Sciences and Sociology, a joint doctoral program between the Mailman School of Public Health and the Graduate School of Arts and Sciences at Columbia University. Her dissertation, entitled “(Pre)diabetic Nation: Diagnosing Risk and Medicalizing Prevention in Mexico” examines the implications for both the public health system and for patients in the Mexican context of identifying and treating those not yet sick, but deemed “at risk” of developing diabetes, as well as the development of new genomic and metabalomic technologies that are rapidly changing how prediabetes and diabetes risk are understood across the scientific community. The project draws on 20 months of multi-sited ethnographic fieldwork, supported by the National Science Foundation and a Mellon/ACLS Dissertation Completion Fellowship.
In the Vagelos College of Physicians & Surgeons’ Department of Medical Ethics and Humanities, Emily directs an NHGRI-funded multi-sited ethnographic study in the Division of Ethics (with principal investigators Dr. Sandra Soo-Jin Lee and Dr. Janet Shim). This project is examining how the concept of “diversity” is interpreted and mobilized in precision medicine research in the United States, as well as the tradeoffs and dilemmas that result from an emphasis on diversity and human difference in precision science.
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