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

博士生萨拉·拉斯金（亚利桑那大学）在苏珊·j·肖博士的指导下，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，对他们来说，无牙既是一种耻辱的刻板印象，也是一种具体的现实。本研究的目的是扩大社会科学对耻辱的理解，它的表现形式，以及它与社区、国家和民族的社会政治历史的联系。这项研究的时间安排与弗吉尼亚州扩大该地区基本牙科保健的倡议相吻合，并与之合作。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。研究方法包括半结构化访谈；免费列出和排名活动，引出口腔及其护理的文化模型；结构观察;媒体扫描。她还将记录牙齿脱落、口腔疼痛、其他牙齿后遗症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想理想的口腔、理想的口腔卫生以及实现这些理想的可能性；(2)利益相关者概念与结构、材料、政治经济和/或象征因素之间的相关性的可变性。这项研究意义重大，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群和地点。通过与当地利益攸关方的合作，该项目的研究结果将为今后关于弗吉尼亚州口腔保健和疾病试点项目影响的研究提供基线数据。资助这个项目也支持了社会科学家的教育。

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.