Doctoral Dissertation Research: An Ethnographic Investigation of Material Implications of Oral Health and Health Care in Central Appalachia

博士生Sarah Raskin(亚利桑那大学)在Susan J.Shaw博士的指导下，将对阿巴拉契亚中部地区口腔健康的物质和象征方面进行文化人类学研究，对这些人来说，无牙既是耻辱的陈词滥调，也是真实的现实。这项研究的目的是扩大社会科学对耻辱的理解，它的情绪化，以及它与社区、国家和民族的社会政治史的联系。这项研究的时机与弗吉尼亚州扩大该地区基本牙科保健服务的倡议相吻合。研究人员将在弗吉尼亚州西南部进行为期13个月的多方法人种学研究，那里35%的成年人报告说失去了许多或全部牙齿，这一比例是美国其他地区的7倍多。研究方法将包括半结构化访谈；免费列出和排名活动，以获得口腔及其护理的文化模型；结构化观察；以及媒体扫描。她还将记录牙齿脱落、口腔疼痛、其他牙齿后遗症的经历，以及家庭和临床护理的经历。研究数据将使用叙事和文化共识技术进行分析。研究问题包括：(1)医疗保健提供者、患者和公共卫生利益相关者如何构思理想的口腔、理想的口腔卫生以及实现这些理想的可能性；以及(2)利益相关者的概念如何与结构、物质、政治经济和/或符号因素相关的变异性。这项研究具有重要意义，因为它将叙事和文化共识分析扩展到社会科学研究不足的疾病聚集地和地点。通过与当地利益攸关方的合作，该项目的结果将为未来研究弗吉尼亚州试点项目对口腔保健和疾病的影响提供基线数据。资助该项目还支持社会科学家的教育。

Doctoral student Sarah Raskin (University of Arizona), supervised by Dr. Susan J. Shaw, will undertake cultural anthropological research on the material and symbolic aspects of the mouth in relation to oral health among central Appalachians, for whom toothlessness is both a stigmatizing cliché and an embodied reality. The goal of the research is to expand social science understanding of stigma, its emobodiment, and its connections to sociopolitical histories of community, state, and nation. The research has been timed to coincide with and collaborate with Virginia initiatives to expand access to basic dental health care in this region.The researcher will undertake thirteen months of multi-method ethnographic research in southwest Virginia, where 35 percent of adults report loss of many or all teeth, a rate more 7 times that of the rest of the United States. Research methods will include semi-structured interviews; free listing and ranking activities to elicit cultural models of the mouth and its care; structured observation; and media scans. She also will document experiences of tooth loss, oral pain, other dental sequelae, and experiences of home and clinical care. The research data will be analyzed using narrative and cultural consensus techniques. Research questions include: (1) how do healthcare providers, patients, and public health stakeholders conceive of the ideal mouth, ideal oral hygiene, and the possibility of achieving those ideals; and (2) is variability in how stakeholder conceptions correlated with structural, material, political economic, and/or symbolic factors.This research is significant because it extends narrative and cultural consensus analysis to an illness cluster and site understudied in social science. Through collaboration with local stakeholders, findings from this project will provide baseline data for future studies on the effects of Virginia's pilot project on oral health-care and disease. Funding this project also supports the education of a social scientist.