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City of Chicago officials adopted a "racial equity" approach to mitigate the disproportionate racial impact of COVID-19, yet according to interviews with racially and socioeconomically marginalized Chicagoans, this approach failed to address core vulnerabilities associated with health, housing, mental health, and welfare. This article argues that COVID-19 represents and reifies the convergence of three sets of emergencies. First, federal and local governments governed through emergency, enacting temporally bounded governmental strategies that presumed scarcity, triaged care, and naturalized structural inequality by delinking the effects of racism from its causes. This response was spectacular and anticipatory—designed to safeguard the status quo until "normalcy" could be restored. This approach exacerbated two existing endemic emergencies: (1) the slow emergencies racially marginalized populations have faced for decades due to neoliberal restructuring and fragmented care infrastructure and (2) the sacrifice of lower-income frontline workers to premature death to safeguard the economy and protect the middle class. [ABSTRACT FROM AUTHOR]

The city government of Chicago adopted a 'racial equity' approach to tackle racial disparities in COVID‐19 outcomes. Drawing on experience addressing core vulnerabilities associated with HIV risk, Chicago public health experts who designed COVID‐19 mitigation initiatives recognised that the same social determinants of health drive racial disparities for both HIV and COVID‐19. Yet, when building an infrastructure to respond to COVID‐19, disease surveillance and data collection became the priority for investment ahead of other forms of public health work or the provision of social services. The building of a disease surveillance infrastructure that responded to and supplied data took precedence over addressing social determinants of poor health. Community‐based organisations that might have otherwise organised for social service provision were incorporated into this infrastructure. Further, public health officials often failed to heed the lessons learned from their experience with HIV vulnerability. Based on qualitative analysis of 56 interviews with public health experts and policymakers in Chicago, we argue that the prioritisation of disease surveillance, coupled with a scarcity model of public health provision, undermined the city's attempt to redress racial inequities in outcomes. We argue that the economisation of pandemic response exacerbates health disparities, even when racial equity frameworks are adopted. [ABSTRACT FROM AUTHOR]

Autism is one of the twenty-first century's most contested illnesses. Early controversies around vaccine harm have irrevocably structured the field of autism science. Despite incredible investment in genetic research on autism over the past 30 years, scientists have failed to identify a set of "genes for" autism, and genomic causality has become more complex. Yet, orthodox genetic explanations for autism have retained dominance over a vociferous field of heterodox experts pointing to a series of environmental insults (vaccines, heavy metal exposure, overuse of antibiotics, toxic pollution) as the main causes of autism. To make sense of this puzzling trend, we develop a novel theoretical synthesis combining a Bourdieusian field analysis with a Gramscian conception of hegemony, centered around the concept of "subsumptive orthodoxy." Analyzing multiple years of archival data from the Interagency Autism Coordinating Committee, we argue that when faced with heterodox challenges, dominant members of the field shore up hegemony by incorporating environmental causal factors into the genome, thus engaging in subsumptive orthodoxy. This move gives rhetorical space to environmental explanations without providing them substantive causal weight, which renders particular environmental causes (like vaccines) impossible. This article traces the strategies dominant members of the field use to retain control over the definition and etiology of autism. We develop the broader implications of the study within autism science and beyond. [ABSTRACT FROM AUTHOR]

In this paper, we analyze the debates surrounding the fifth edition of the Diagnostic and Statistical Manual (DSM-5), psychiatry’s manual of mental disorders. One critical component of the recent DSM-5 debates focuses on how expanding definitions of illness reconfigure the underlying category of ‘normality.’ The literature on biomedicalization and neoliberalism suggests that we have moved past the discrete categories of abnormal/normal into an era in which we all must strive for scales of normality, only achievable via scientific optimization - a shift from normalization to normation. However, the DSM-5 debates suggest that this argument may be too totalizing. Many commentators on the DSM-5 revisions pine for an idealized era when the normal and abnormal were ontologically differentiated in dichotomous terms. We show how this desire to salvage normality from the ambiguity of the norm and the expansion of psychiatry’s domain over human conduct constitutes a critique of the neoliberalization of mental health and the biomedicalization of everyday life, which nonetheless essentializes ‘human nature.’ We excavate these figurations of the normal to highlight the ways in which psychiatry both relies upon and troubles the binary between normal and abnormality, and between optimization and essentialization. [ABSTRACT FROM AUTHOR]

This chapter suggests that moving beyond positivism entails a recognition that the social world is made up of complex phenomena that are heterogeneous, and events are caused by contingent conjunctures of causal mechanisms. To theorize the social world as heterogeneous is to recognize that social causes, categories, and groups combine different kinds of phenomena and processes at various levels and scales across time. To speak of conjunctural causation implies not only that events are caused by concatenations of multiple, intersecting forces but also that these combinations are historically unique and nonrepeatable. Both the historical materialist conception of the "conjuncture" and the poststructuralist theory of "assemblages" take heterogeneity and multicausality seriously. I compare and contrast these formulations across three dimensions: the structure of the apparatus, causation, and temporality. I argue that these theories offer useful tools to social scientists seeking to engage in complex, multicausal explanations. I end the article with an example of how to use these concepts in analyzing a complex historical case. [ABSTRACT FROM AUTHOR]

In contemporary processes of citizenship, parents and other caregivers often must make claims to the state on behalf of children with disabilities. In this article, we draw from data on the Omnibus Autism Proceedings ( OAP), which were a series of hearings in 2007 and 2008 in which parents of children with autism attempted to receive compensation from a federal program for vaccine injury. During these hearings, parents and their attorneys obfuscated the children's subjectivity and instead showcased the children's physical suffering in order to claim that their children had suffered a legitimate injury from vaccines that warranted compensation. We develop the concept of custodial citizenship to account for the process by which a legible rights-bearing subject appropriates the bodily suffering of the injured party in order to gain citizenship rights on behalf of that individual. In doing so, we trace the slippages of harm that occur in the lived experience of disability among family members and caregivers, in contrast to the individualizing rights-granting framework of the court system. [ABSTRACT FROM AUTHOR]

This article reports on data from two research projects with people whose own illness narratives and etiologies challenge the western biomedical ontology of the body. This paper argues that Reed’s ‘landscapes of meaning’ allow researchers to make sense of the invisible, causal mechanisms operating in these particular epistemic communities. If ontology is an issue of perspective, then part of the ethnographer’s task is to ‘learn to see otherwise’ by situating themselves in people’s systems of signification and thereby grasping and analyzing the causal forces at work. And yet exploring data from these cases also allows for intervention into Reed’s account of causality which lends causal primacy to symbolic systems over structural and agential ones. [ABSTRACT FROM AUTHOR]

Critical realism is a philosophy of science, which has made significant contributions to epistemic debates within sociology. And yet, its contributions to ethnographic explanation have yet to be fully elaborated. Drawing on ethnographic data on the health-seeking behavior of HIV-infected South Africans, the paper compares and contrasts critical realism with grounded theory, extended case method and the pragmatist method of abduction. In so doing, it argues that critical realism makes a significant contribution to causal explanation in ethnographic research in three ways: 1) by linking structure to agency; 2) by accounting for the contingent, conjunctural nature of causality; and 3) by using surprising empirical findings to generate new theory. The paper develops the AART (abduction, abstraction, retroduction, testing) research schema and illustrates its strengths by employing a Bourdieusian field analysis as a model for morphogenetic explanation. [ABSTRACT FROM AUTHOR]

The critical realist and Bourdieusian conceptions of action fundamentally disagree on a number of fronts: the synthetic versus dualistic relationship between structure and agency; the social nature of the self/body; the link between morphogenesis and reflexivity. Despite these differences, this article argues that re-reading Bourdieu’s theories with attention to some of the core tenets of critical realism (emergence, the stratification of reality, and conjunctural causality) can provide insights into how the habitus is capable of reflexivity and social change. In particular, this article reworks Bourdieu’s theory of habitus by suggesting that social selves are always situated at the intersection of multiple and competing social locations (or field positions) and that the habitus itself is always layered. Reflexivity arises from horizontal disjunctures (between field positions) and vertical disjunctures (across temporal sedimentation). [ABSTRACT FROM AUTHOR]

After 5600 families of children diagnosed with autism filed claims with the National Vaccine Injury Compensation Program in the United States, the court selected ‘test’ cases consolidated into the Omnibus Autism Proceedings, held from 2007 to 2008, to examine claims that vaccines caused the development of autism. The court found all of the causation theories presented to be untenable and did not award damages to any parents. We analyze the Omnibus Autism Proceedings as a struggle within the scientific field between the scientific orthodoxy of the respondents and the heterodox position taken by the plaintiffs, suggesting that the ruling in these cases helped to shore up hegemony on autism causation. Drawing on the literature on non-knowledge, we suggest that only the respondents had enough scientific capital to strategically direct non-knowledge toward genetic research, thereby foreclosing the possibility of environmental causation of autism. The plaintiffs, who promote a non-standard ontology of autism, suggest that the science on autism remains undone and should not be circumscribed. In analyzing the Omnibus Autism Proceedings with field theory, we highlight the way in which scientific consensus-building and the setting of research agendas are the result of struggle, and we show that the strategic deployment of non-knowledge becomes a major stake in battles for scientific legitimacy and the settling of scientific controversies. [ABSTRACT FROM AUTHOR]

In postapartheid South Africa, a “crisis of masculinity” has become the most prominent explanation for high rates of violence against women and the gendered nature of the HIV/AIDS pandemic. This article offers a critique of such an analysis, and suggests that the sexualization of politics in the postapartheid era allows both state actors and impoverished community members to manage and negotiate the paradoxes of postcolonialism. Combining a discourse analysis and ethnographic study, the article analyzes the various ways in which the tropes of “modernity” and “traditionalism” are deployed (and resignified) in and through discursive struggles over masculinity and sexuality. Overall, the article argues that gender has become a primary terrain upon which colonial and postcolonial conflicts are played out. As such, rather than a “crisis of masculinity,” the sexualization of politics signifies and masks deep-seated concerns about the “success” of liberation. [ABSTRACT FROM AUTHOR]

Sociologists have tended to construct theories of identity based on unitary notions of social location which avoid conceptualizing disjunction and contradiction and which therefore fail to capture certain characteristics of" the postcolonial condition. This paper engages in a postcolonial re-reading of sociological theories of practice (in particular, Pierre Bourdieu's notion of habitus). It does so through an analysis of the historical development of the field of health and healing in South Africa. From the beginning of the colonial enterprise, biomedicine resisted amalgamation with other forms of healing and insisted on a monotherapeutic ideology and practice whereas indigenous healing accommodated not only biomedicine, but invited pluralism within and across cultural and ethnic differences. As such, a bifurcated and parallel system of healing emerged, whereby Black South Africans practiced pluralism and white South Africans utilized biomedicine in isolation. This disjuncture became acrimonious in the post-apartheid era as the state attempted to forge a united health system and battle the AIDS epidemic. Despite the historical and contemporary bifurcations within the field of health and healing, people living with AIDS continue to subscribe to a hybrid health ideology. There is, therefore, a structural disjuncture between the realities of consumption within the fieM of health and healing and the logic of the field as it is articulated in the symbolic struggle raging in the field of power. The field of health and healing is characterized, therefore, by a simultaneous bifurcation and hybridity - which is reflected in HIV-infected South Africans' beliefs and practices. In order to make sense of this puzzling disjuncture and its impact on subjects" trajectories of action, this paper draws insight from Pierre Bourdieu's theory of habitus and Homi Bhabha's conceptualization of hybridity - transforming each of them through their synthesis and application to the postcolonial context. [ABSTRACT FROM AUTHOR]

Reporting on a study of activists living with HIV/AIDS who give testimonials of their experiences with the disease in various educational settings, this article employs the notion of ‘haunting’ as a means of analyzing the effect of social justice activism in the “aftermath” of the HIV/AIDS epidemic. Because of a shift in both the discursive construction of AIDS and the material symptoms of the disease (due to widespread availability of anti-retroviral medication), the signified of AIDS is “out of joint” with the signification of the disease in the public sphere. AIDS, as a social phenomena and a personal, traumatic experience has been rendered spectral through processes of social othering, structural disenfranchisement, and cultural denialism. Most of the presenters included in this study utilize a strategy of “survivorhood” in order to promote prevention and combat stigma. In doing so, they inadvertently buttress dominant discourses that claim that the disease is now “manageable,” normalized, and under control. By contrast, one presenter utilizes a completely different performative approach. In order to confront and subvert the “aftermath” discourse and thereby presence the living trauma of AIDS, this presenter embodies the specter of AIDS. As such, his presentation forces the audience to reckon with processes of social exclusion and cultural otherness. [ABSTRACT FROM AUTHOR]