Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness

Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness

Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness

Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness


Chronic Conditions, Fluid States explores the uneven impact of chronic illness and disability on individuals, families, and communities in diverse local and global settings. To date, much of the social as well as biomedical research has treated the experience of illness and the challenges of disease control and management as segmented and episodic. Breaking new ground in medical anthropology by challenging the chronic/acute divide in illness and disease, the editors, along with a group of rising scholars and some of the most influential minds in the field, address the concept of chronicity, an idea used to explain individual and local life-worlds, question public health discourse, and consider the relationship between health and the globalizing forces that shape it.


Lenore Manderson and Carolyn Smith-Morris

In the past century, the world has witnessed dramatic epidemiological change. For reasons that we explore in this volume, the relative weight of infectious disease and injury on mortality and morbidity has declined, and instead, in the poorest and the wealthiest of nations, extended, often lifelong medical conditions predominate. These conditions neither develop nor continue in a vacuum, but are profoundly shaped by persistent injustice, inequality, poverty, and physical expressions of structural violence. These are all chronic problems; they interact with, contribute to, and shape the experiences of living with chronic health problems. These health problems include both infectious and noncommunicable diseases.

Our intent in this book is to draw on the idea of chronicity to heighten sensitivity to the structural factors that create, maintain, and produce fluidity and flux in these disease patterns, their management, and outcomes in the twenty-first century. As we will elaborate here, anthropologists have exposed the structural factors behind everyday suffering for some decades, but we have been slow to theorize the relationship between social forces and epidemiology, let alone our own discourses of illness. Certain ideological assumptions remain invisible to us, and therefore influential in conversations that would otherwise be more vigilant of structural violence around the globe. the nomenclature that categorizes some illness categories as chronic is one such assumption. Our task has been to challenge a single, hegemonic conceptualization, to illustrate its role in supporting existing power structures behind global health paradigms, and to reaffirm the habitus of illness as a segregated, individual, and stigmaproducing event.

Forty-seven percent of global morbidity is now attributable to what are called chronic conditions. the use of a temporal marker—the chronic or longterm aspect of disease—has largely gone unquestioned until now, at a time when some previously acute and infectious diseases can be survived long term, and . . .

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