Review of Food Allergy Advocacy: Parenting and the Politics of Care. Danya Glabau, Minneapolis: University of Minnesota Press, 2022, 288 pp.

Food Allergy Advocacy: Parenting and the Politics of Care. Danya Glabau, Minneapolis: University of Minnesota Press, 2022, 288 pp.

Jennifer Patico

Georgia State University

Danya Glabau’s Food Allergy Advocacy: Parenting and the Politics of Care draws on extensive and varied ethnographic fieldwork conducted in 2013–2016, including five months of participant observation in two academic allergy clinics as well as a total of over 70 interviews with activists, parents, and other stakeholders in food allergy advocacy; participant observation while co-leading a support group; and tracking of relevant print and social media. Glabau observes that some readers may find her book “a nontraditional ethnography” inasmuch as it combines “empirical reporting of a style familiar across qualitative fields in the humanities and social sciences and theoretical development rooted in feminist and STS questions” (p. 29). While such a hybrid of ethnographic description and cross-disciplinary theoretical framing is not in itself so unconventional—surely that is the hallmark of some of the most impactful contemporary ethnographies—Glabau’s study is innovative and valuable for its clear-eyed, synthetic analysis of an under-studied movement.

Glabau’s premise is that food allergy politics operate as a form of reproductive politics: People understand questions of responsibility (whose job is it to protect children with food allergy from potential harm?) and legitimacy (what types of arguments, by whom, are persuasive in winning new legal protections?) in ways that are entangled with established norms for parenting, gender, and the family. Food allergy advocacy tends to reinforce the idea that it is mothers—and really only certain kinds of mothers—who are responsible for these issues and who have the authority to speak about them in public. While advocates have achieved modest successes in improving society-wide measures of care, such as securing access to epinephrine in school health clinics, Glabau argues that:

The strategy behind these wins depends on well-off mothers performing white, feminine norms of socially appropriate American motherhood for lawmakers … simultaneously reproducing norms of gender, sexuality, family, class, and whiteness that harm many other families, children, and adults by maintaining existing systems of difference and exclusion and cementing them as prerequisites to political representation. (p. x)

Each chapter of the book develops an aspect of this overarching critique. In Chapter 1, “The Moral Life of Epinephrine,” the argument is built in part through the stories of women like Sarah, who gave up her career to take care of her two food-allergic children and expressed that she continually was trying to “walk a line between seeming crazy [to those around her] and keeping these kids alive” (p. 57). Glabau heard repeatedly from food allergy mothers that their husbands were unwilling to make similar sacrifices. Moreover, she tells us, medical professionals provided emergency medications to families but little real guidance on the daily, “deeply social” complexities of feeding and protecting food allergic children (p. 51). Thus, while Chapter 1 introduces issues surrounding the use and availability of epinephrine as a life-saving medication for anaphylaxis, it is more fundamentally about establishing that nuclear families, especially mothers, are the naturalized locus of responsibility for food allergy care in the United States. Those threads are developed further in Chapter 2, “Who Is to Blame?,” which considers debates about the causes of food allergy, including interviewees’ opinions on the “hygiene hypothesis,” popular conceptions of the hazards of modernity, considerations of the role of breastfeeding, and other versions of mother blame.

Chapter 3, “The Hygienic Sublime,” contends that the pursuit of cleanliness and purity to protect food-allergic people again positions “the white, middle-class, heteronormative family as a resource for ensuring health in the contemporary United States” (p. 103). Allergic Living magazine articles illustrate how images of the safe, clean home environments that are supposed to be beneficial for food-allergic people affirm classed, raced, consumer-oriented versions of safety. The author’s rendering of these images is exclusively narrative (whereas visuals might have rendered her points about representations of hygiene and whiteness more vividly), but material from three life history interviews provides additional insight into how differently situated parents (two mothers—one Black and one White—and one White father) inhabit and negotiate these expectations.

Lived experiences of protective parenting within the private spaces of the home are not at the center the book, however; we get tastes of these experiences gleaned from interviews, but Glabau’s ethnographic eye is trained more effectively on the discursive and legal arenas in which food allergy activism takes place. Chapters 4 (“Activist Politics: Disability Law, Legislative Advocacy, and Public Motherhood”) and 5 (“The Epipen Pricing Scandal”) are perhaps the most absorbing and compelling of the book, interweaving participant observation, interviews, social media tracking, and other sources to reconstruct the activist worlds in which people seek to make a difference and end up also reproducing gendered, raced, and classed structures of inequality. Glabau argues that initiatives such as getting stock epinephrine available in schools represent a kind of progress—placing responsibility not only in private homes but also in public institutions—but also tend to reinforce familiar dynamics by relying on female educators’ implementation of the policies. Likewise, mother advocates are most successful when they enact standards of “nice,” “professional,” and “sweet” femininity (pp. 154–55). We see in these chapters how food allergy politics are complex and confounded in additional ways, such as in activists’ ambivalent relationship to disability politics and in advocacy organizations’ entanglement with pharmaceutical company sponsors.

At times, Glabau’s key arguments about the roles of gender and race in advocacy feel more top-down than built from detailed ethnographic ground. The book does articulate its arguments clearly, making it relatively accessible to many undergraduates. For that audience in particular, and especially for students of anthropology, more reflexive discussion of the study’s methods and ethics would have been welcome. For example, Glabau offers that she focused on adults rather than children for ethical reasons, but these are left assumed rather than being unpacked; the ethical constraints that likely explain why she shared only a few broad insights about what she observed in clinics are unexamined as well. She opens the book with a reflection on finishing the manuscript during the COVID pandemic and shares some details of her own social positionality, including being a food allergic person herself, but the narrative does not dwell much on how these factors shaped the study. These absences could provide stimulating points for class discussion.

The greatest strength of this book is in its positioning of food allergy activism as a case study in how neoliberalism, patriarchy, and racism intersect, how they work to constrain social actors’ visions of progress, and how they ultimately reproduce themselves. The book’s concluding sections raise provocative questions about how advocacy might be done differently if we denaturalized assumptions about how to care for food allergic people. Is it “inevitable that providing safety and health for people with food allergy would rely on patriarchal and market-based understandings of the role of the family and the free market in the maintenance of health?” (p. 211). Might advocates instead call for single-payer health care coverage, or for obligatory nonprofit status for pharmaceutical companies? (pp. 206–7). Glabau calls for a coalitional project that would “dislodge the nuclear family from health research and politics, and the whiteness that unmarked appeals to family typically encode” (p. 215). Her declared primary audiences—scholars of science and technology studies, feminist studies, and medical anthropology (p. 29)—should find this call stimulating. Indeed, the book provides a fresh angle on a larger conversation, already underway in the humanities and social sciences, that challenges the wisdom and necessity of individualized, privatized solutions to collective problems of health and vulnerability.