University of California, Los Angeles doctoral candidate Hannah Reiss, supervised by Dr. Linda Garro, will explore the social contexts of illness in the day-to-day lives patients accepted into a treatment program designed to meet prevailing standards of biomedical care. Why does an illness with effective treatment continue to persist with such high incidence rates? What are the social contexts of illness and care that promote or impede successful treatment?

To address these questions, Reiss will work in Tajikistan, which has one of the highest incidence rates of tuberculosis in the world and high frequencies of treatment failure, default and death. Her research will explore the social forces, practices, and understandings that promote or impede treatment as patients and their families navigate tuberculosis illness and therapy. Her study combines: 1) a longitudinal design to follow patients throughout treatment; 2) a dual focus on clinical and social interaction; and 3) attention to the organization of social support from families and the community. Reiss will collect data through participant observation with families, interviews with patients, their relatives and clinicians, illness narratives, and observations of clinical encounters.

This project will explore the illness experience as a complex social phenomenon, contributing to anthropological theory by 1) incorporating experiential, longitudinal and relational approaches in the examination of infectious disease to expand current conceptual frameworks; 2) adding to the growing body of literature that positions health as a family, network and community concern; and 3) addressing the social structures of care for tuberculosis patients and the role of social support in successful completion of treatment. This project has wider applicability for health care delivery. It is critical to ground health initiatives in a better understanding of local realities of illness. Tajikistan is a vivid example of the tuberculosis epidemic's broad threat to global health.

National Science Foundation (NSF)
Division of Behavioral and Cognitive Sciences (BCS)
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Jeffrey Mantz
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University of California Los Angeles
Los Angeles
United States
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