Browsing by Author "Bracken, Rachel Conrad"

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    National Bodies: Epidemiologies of Belonging and the Literature of American Public Health
    (2018-04-20) Bracken, Rachel Conrad; Ostherr, Kirsten A
    Tracing the experiences of assimilation, exclusion, and exploitation that accompany demographic change, "National Bodies" reveals the ways in which community is biologically constituted through the spread of contagion, defined by epidemiological records, governed through public health policy, and discursively produced across genres. It draws from an interdisciplinary archive of public health literature that, in addition to nineteenth- and twentieth-century novels, poetry, and modernist autopathography, features domestic hygiene manuals, municipal sanitary surveys, and health policy documents. In so doing, "National Bodies" records the emergence of a vast public health infrastructure--a complex network of housing ordinances, sanitary regulations, quarantine protocols, border patrol, and immigration quotas--that legislatively defines the national population. I designate this interdisciplinary discursive milieu the "literature of American public health," and it is within this literature, I argue, that citizenship status, American identity politics, medical authority, and the purview of public health are continuously renegotiated at the turn of the twentieth century. Amid the turbulence of the postbellum and Progressive eras, as epidemiologists and health policy makers struggled to stem the spread of infection within a larger and increasingly diverse body politic, public health delineated city, state, and national populations by their shared risk of infection and the State's vested interest in their well-being. Policy designed to protect the health of the US population thereby demarcates who does and does not belong to the social and political body of the nation, and, thus, illuminates the broader legal and immunological contours of community identity. "National Bodies" taps into a prolific body of scholarship interrogating the intersections of contagion theory, culture, and community, illustrating how the science of epidemiology, which tracks the potential for contagion to spread between bodies and bodies politic--without regard for the socially constructed borders of race, class, or nation--lays the groundwork for new models of national belonging at the turn of the twentieth century. Within the past fifteen years, especially, contagion has proven a valuable heuristic through which historians of medicine and Americanist scholars analyze community formation, national identity, and social injustice. My project builds on this scholarship by looking beyond direct representations of outbreak or medical practice in American literature. Turning to literary accounts of sociopolitical and demographic upheaval, rather than illness narratives per se, "National Bodies" exposes how completely the language and logic of epidemiology reverberates throughout American social, cultural, economic, and political structures, thereby accentuating what is at stake in contemporary health policy debates, as well. Adopting a methodological approach to American literature I refer to as "reading for public health," "National Bodies" situates literary texts within the context of public health policy and practice in order to uncover the traces of epidemiological thinking on evolving ideas of social obligation, State power, and national belonging. "National Bodies" asserts that, when read for public health, literature offers a vivid record of how health policy shapes the diverse lives of everyday Americans, even in texts that do not explicitly thematize outbreak, contagion, or medical practice. Nativists, progressive reformers, and expansionists alike construct what I term "epidemiologies of belonging" by leveraging late nineteenth- and early twentieth-century advances in bacteriological science and prevailing notions of infection and immunity. The epidemiologies of belonging that "National Bodies" uncovers in the literature of American public health both internalize and resist governmental efforts to circumscribe "American" identity along the lines of race, gender, ethnicity, and immigrant status. Each of the dissertation's four chapters addresses a moment of sociopolitical or demographic upheaval--large-scale immigration, Emancipation, southwestern border expansion, and global pandemic--by attending to models of population flux and community belonging, social obligation and the threat of contagion presented in literary and public health discourses. Together, these chapters demonstrate how literature, laws, and public health policies intersect to imagine the American body politic, as both a legal and biological entity, into being.
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    Reflective Writing about Near-Peer Blogs: A Novel Method for Introducing the Medical Humanities in Premedical Education
    (Springer Nature, 2021) Bracken, Rachel Conrad; Major, Ajay; Paul, Aleena; Ostherr, Kirsten
    Narrative analysis, creative writing, and interactive reflective writing have been identified as valuable for professional identity formation and resilience among medical and premedical students alike. This study proposes that medical student blogs are novel pedagogical tools for fostering peer-to-peer learning in academic medicine and are currently underutilized as a near-peer resource for premedical students to learn about the medical profession. To evaluate the pedagogical utility of medical student blogs for introducing core themes in the medical humanities, the authors conducted qualitative analysis of one hundred seventy-six reflective essays by baccalaureate premedical students written in response to medical student-authored narrative blog posts. Using an iterative thematic approach, the authors identified common patterns in the reflective essays, distilled major themes, coded the essays, and conducted narrative analysis through close reading. Qualitative analysis identified three core themes (empathic conflict, bias in healthcare, and the humanity of medicine) and one overarching theme (near-peer affinities). The premedical students’ essays demonstrated significant self-reflection in response to near-peer works, discussed their perceptions of medical professionalism, and expressed concerns about their future progress through the medical education system. The essays consistently attributed the impact of the medical student narratives to the authors’ status as near-peers. The authors conclude that reading and engaging in reflective writing about near-peer blog posts encourages premedical students to develop an understanding of core concepts in the medical humanities and promotes their reflection on the profession of medicine. Thus, incorporating online blogs written by medical trainees as narrative works in medical humanities classrooms is a novel pedagogical method for fostering peer-to-peer learning in academic medicine.
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    Trust and privacy in the context of user-generated health data
    (Sage, 2017) Ostherr, Kirsten; Borodina, Svetlana; Bracken, Rachel Conrad; Lotterman, Charles; Storer, Eliot; Williams, Brandon
    This study identifies and explores evolving concepts of trust and privacy in the context of user-generated health data. We define “user-generated health data” as data captured through devices or software (whether purpose built or commercially available) and used outside of traditional clinical settings for tracking personal health data. The investigators conducted qualitative research through semistructured interviews (n = 32) with researchers, health technology start-up companies, and members of the general public to inquire why and how they interact with and understand the value of user-generated health data. We found significant results concerning new attitudes toward trust, privacy, and sharing of health data outside of clinical settings that conflict with regulations governing health data within clinical settings. Members of the general public expressed little concern about sharing health data with the companies that sold the devices or apps they used, and indicated that they rarely read the “terms and conditions” detailing how their data may be exploited by the company or third-party affiliates before consenting to them. In contrast, interviews with researchers revealed significant resistance among potential research participants to sharing their user-generated health data for purposes of scientific study. The widespread rhetoric of personalization and social sharing in “user-generated culture” appears to facilitate an understanding of user-generated health data that deemphasizes the risk of exploitation in favor of loosely defined benefits to individual and social well-being. We recommend clarification and greater transparency of regulations governing data sharing related to health.