Community Health Narratives: A Reader. Emily Mendenhall and Kathy Wollner, eds., Albuquerque: University of New Mexico Press, 2015, 338 pp.
As anthropologists consider ways to engage with broader audiences, reaching middle and high school students may be one way to extend the reach of the discipline beyond university settings. In Community Health Narratives, Emily Mendenhall and Kathy Wollner bring together a collection of narratives that provide rich ethnographic examples of factors influencing community health, targeting students younger than 18. Coupled with a teaching guide aimed to reach middle and high school students, the reader is an excellent example of how to make medical anthropology accessible to young audiences and reach broader publics.
Organized in six sections, Community Health Narratives provides narratives focusing on themes of social ties, gender and sexuality, mental health, violence, prevention, and health care access.
Narratives in the social ties section consider how interpersonal relationships impact individual health, including family, friends, and schoolmates. The gender and sexuality section discusses puberty, the difference between sex and gender, female circumcision, gender identity, sexual orientation, emergency contraception, teenage pregnancy, and the importance of breast-feeding. Topics in the mental health section include psychiatric disorders, social support, suicide, post-traumatic stress disorder, and coping with political violence. In the violence section, contributors discuss child sexual abuse, structural violence, gun violence, and human trafficking. As the name implies, the prevention section provides examples of preventing communicable diseases, driving under the influence of alcohol, and human papillomavirus-related cancers preventable through vaccination. The final collection of narratives, which focus on health care access, consider tensions between traditional and biomedical healers, technological interventions to aid with physical disability, access to safe abortion services, and how politics may influence community health initiatives.
Concluding each of the six sections are brief “Communities in Action” sketches, highlighting examples of good community health programming, which include, among other topics, sexual health education organizations in locations with abstinence-only curricula.
Written in detailed, ethnographic styles, the narratives of each section are accessible to young readers and provide examples of complex ideas that may be challenging to grasp. For young readers with limited exposure to social sciences, the narratives introduce important topics such as structural violence and the difference between sex and gender. Complementing the narratives, the included teaching guide is a thoughtful pedagogical tool that includes content-specific objectives, guiding questions, prerequisite knowledge needed before starting a lesson, discussion questions, and suggested activities for every section of the book. The teaching guide and content make the book most suitable for middle and high school students, but some narratives may also be suitable as introductory material to beginning undergraduate students with little to no background in social or health sciences.
In addition to providing a robust teaching guide, one of greatest contributions of Community Health Narratives is its inclusion of global examples of community health scenarios. A global approach to community health provides the targeted reading audience an early introduction to comparative, cross-cultural health analysis, effectively bringing the most foundational ideas of anthropology to students not yet in universities or just starting their post-secondary education. Furthermore, the diversity of perspectives extends beyond location and encompasses differential experiences based on race, social class, sexual orientation, gender, and body size included in several parts of the reader. Particularly noteworthy is the way in which diverse experiences are represented throughout the sections; sexual orientation, for example, is not relegated solely to the gender and sexuality-themed portion of the reader.
The inclusion of diverse perspectives throughout Community Health Narratives helps demonstrate how health experiences are mediated by a range of experiences. Also, the collection of narratives covers both broad and specific factors related to health outcomes and well-being, particularly highlighting how structural factors can influence personal circumstances. By including structural factors that impact health, the narratives allow young readers to consider how health is shaped beyond individual and genetic factors, potentially creating a foundation for young readers to consider how social circumstances may contribute to poor health.
Some of the greatest strengths of Community Health Narratives also provide drawbacks to the book. For example, the inclusion of multiple scholars sharing work from numerous settings does not guarantee a standard age level of accessibility. Though suitable for young audiences, some narratives in the reader may prove more challenging than others and may require additional instructor guidance. Additionally, while some narratives provide useful examples of embarrassing scenarios, some are perhaps too neatly resolved by the conclusion.
The occasional quick-ending narrative seemed to provide a hasty resolution in order to assert a moral point, and these may be too simplistic or prove less realistic than others for young readers with experience in the topics discussed. A chapter about a gay youth struggling with body image and being overweight, for example, moves from not wanting to try on a bathing suit to accepting his size after one day at the beach with a friend. Similarly, a cyber-bullying tale ends with schoolmates supporting a bullied student after a humiliating incident. For young readers grappling with these topics and others, tidy endings may not resonate with their lived experiences.
Moreover, while the communities in action sections are useful and novel contributions, some examples are not as robust as others and would be stronger with suggestions for how readers can become engaged in the topic highlighted in the section. These minor considerations are all addressable through instructor use, however, and the editors have provided an excellent instructors’ guide.
Overall, Community Health Narratives provides an organized, instructor-friendly, and accessible collection of ethnographic encounters to shed light on health concerns rooted in social conditions and shaped by unique contextual factors. The editors and the contributors have superbly responded to calls for anthropologists engaging with broader audiences by producing a work that facilitates secondary school educators’ discussions of topics informed by anthropological inquiry.