I am a medical anthropologist and Associate Professor of Global Health in the Science, Technology, and International Affairs (STIA) Program in the Edmund A. Walsh School of Foreign Service at Georgetown University. My scholarship focuses on how social trauma, poverty, and social exclusion become embodied in chronic mental and physical illness as well as the theory and concept of syndemics.
My most recent project is a book forthcoming with Cornell University Press (2019), Rethinking Diabetes: Entanglements of Poverty, Trauma, and HIV. Rethinking Diabetes considers how "global" and "local" factors transform how diabetes is perceived, experienced, and embodied from place to place. Drawing from a decade of research and hundreds of interviews among low-income people living with Type 2 Diabetes in Chicago, Delhi, Johannesburg, and Nairobi, this book investigates how deeply embedded social, economic, psychological, and physiological pathways of stress are to their sense of self, illness, and suffering. The four case studies investigate how social, cultural, and epidemiological factors shape people's experiences and why we need to take these differences seriously when thinking about what drives diabetes and how it affects the lives of the poor.
I also am the author of Syndemic Suffering: Social Distress, Depression, and Diabetes among Mexican Immigrant Women (Routledge, 2012). This book dives deep into 121 life history narratives of women in Chicago who face considerable social distress and duress associated with immigration, poverty, interpersonal violence, social exclusion and longing for companionship, family stress, and financial insecurity. Together these social factors become entangled in their psychological suffering (examined through depression) and physical distress (examined through Type 2 diabetes). I argue that these social and health problems travel together and become syndemic, or inseparable in cultivating poor health.
In 2017, I led a Series of articles on Syndemics in The Lancet. The Series explores how we think about disease pathologies affects how we design policies and deliver care to those most affected by social and economic inequities. Conventional frameworks in medicine and public health, such as comorbidity and multimorbidity, often overlook the effects of social, political, and ecological factors. The papers in the Series show that the theory of syndemics improves on conventional frameworks in both theoretical and practical terms by illuminating how macro-level social factors promote disease clustering at the population level and impact disease pathologies at the individual level.
For several years I have been engaged with the movement for global mental health. I co-edited a book with Dr. Brandon Kohrt entitled, Global Mental Health: Anthropological Perspectives (Routledge, 2015), along with a companion article published in Lancet Psychiatry (2016). Drawing on the experience of many well-known experts in this area, these projects illustrate that mental illnesses are not only problems experienced by individuals but must also be understood and treated at the social and cultural levels. In 2016, I co-organized an international conference on "Global Mental Health: Transdisciplinary Perspectives" at Georgetown University. I also collaborated with and contributed to small projects associated with PRIME and with the Africa Mental Health Foundation.
I hold an Honorary Appointment in the Faculty of Health Sciences at the University of the Witwatersrand where I mentor PhD Students and have conducted multiple research projects. This work is primarily in the Developmental Pathways for Health Research Unit located at Chris Hani Baragwanath Hospital. We recently received a new R21 grant from the Fogarty International Center at the National Institutes of Health to investigate “Soweto Syndemics”; my co-investigators are Prof Shane Norris (Wits) and Prof Alexander Tsai (Harvard/Mass Gen).
In 2017, I was awarded the George Foster Award for Practicing Medical Anthropology by the Society for Medical Anthropology. My work has been supported by the National Science Foundation, National Institutes of Health Fogarty International Center, South African Medical Research Council, and my research institutions. Most recently I have benefited from many small grants from Georgetown University from the SFS Dean's Office, Provost Office, Global Futures Initiative, Global Environmental Initiative, and the Global Health Initiative.
For more than I decade I have also developed global health curriculum for youth. More information is available at www.GHN4C.org.