Faith and the Pursuit of Health: Cardiometabolic Disorders in Samoa. 2019. In the Medical Anthropology series, Health, Inequality, and Social Justice. New Brunswick, NJ: Rutgers University Press.
Faith and the Pursuit of Health explores how Pentecostal Christians manage chronic illness in ways that sheds light on health disparities and social suffering in Samoa, a place where rates of obesity and related cardiometabolic disorders have reached population-wide levels. Pentecostals grapple with how to maintain the health of their congregants in an environment that fosters cardiometabolic disorders. They find ways to manage these forms of sickness and inequality through their churches and the friendships developed within these institutions. Examining how Pentecostal Christianity provides many Samoans with tools to manage day-to-day issues around health and sickness, Jessica Hardin argues for understanding the synergies between how Christianity and biomedicine practice chronicity.
Reconstructing Obesity: The Meaning of Measures and the Measure of Meanings. Edited by Megan McCullough and Jessica Hardin. Berghahn Books, 2013.
In the crowded and busy arena of obesity and fat studies, there is a lack of attention to the lived experiences of people, how and why they eat what they do, and how people in cross-cultural settings understand risk, health, and bodies. This volume addresses the lacuna by drawing on ethnographic methods and analytical emic explorations in order to consider the impact of cultural difference, embodiment, and local knowledge on understanding obesity. It is through this reconstruction of how obesity and fatness are studied and understood that a new discussion will be introduced and a new set of analytical explorations about obesity research and the effectiveness of obesity
interventions will be established.
Hillary Kaell & Jessica Hardin. "Ritual Risk and Emergent Efficacy: Ethnographic Studies in Christian Ritual." 2016. Journal of Contemporary Religion 31 (3): 323-334.
Ritual is a domain of analysis shared across Christian confessions and continents. Yet in anthropological work on Christianity, studies of ritual have thus far remained piecemeal and disjointed, unwittingly perpetuating distinctions between north and south, ‘secular’ and ‘religious’ publics, Pentecostals and ‘the rest’. This introductory essay charts the analytic potential of developing a robust cross- cultural analysis of ritual from the perspective of anthropologists of Christianity. We employ ritual risk and e cacy to expand the ongoing study of the practice of Christian sociality, which we explore through three themes. Firstly, this collection is united by a shared interest in ritual ine cacy—the ‘infelicitous’ moments when ritual go awry— and the societal and metaphysical risks that may result. Secondly, the collection examines the social ‘work’ of ritual in de ning and authorizing particular forms of Christianity. Finally, the essays explore the ways Christian futures are imagined and created through ritual.
Refereed Journal Articles
“’It’s almost like paying for praying’: Giving Critiques and the Discursive Management of Denominational Difference.” Forthcoming. Anthropological Quarterly.
Based on fourteen months of fieldwork, this article explores how in Samoa, Christians from diverse denominational backgrounds regularly talk about and critique church giving practices ranging from weekly announcements of offerings to tithing. By comparing Pentecostal and mainstream Christian giving practices, this article shows how Pentecostals discursively created denominational difference through valuation-- the comparative process of differentiating between ways of giving. Pentecostals cultivated moral awareness through giving critiques, which demonstrates the ways that denominational comparison is religious practice. By looking at the metapragmatics of giving, that is how accounts of giving are used in everyday life, discussions of giving become a primary means to evaluate the moral qualities of persons and communities. This article thus shows how critiques of giving collapse the distinction between "religious" and "economic" spheres showing that they are often co-constitutive.
"Body size, body norms and some unintended consequences of obesity intervention in the Pacific islands." Annals of Human Biology. 2018. 45(3): 285-294. Special Issue: “Human Biology in the Pacific, “ edited by Nicola Hawley and Stephen McGarvey. (Co-Authored with Amy McLennan and Alexandra Brewis.)
Background: Pacific Islanders have experienced over 50 years of obesity interventions—the longest of any region in the world. Yet, obesity-related non-communicable diseases (NCDs) continue to rise.‘Traditional’ body norms have been cited as barriers to these interventions.
Aim: In this study, we ask: ‘What is the relationship between health interventions, body norms and people’s experience of “fatness”? How – and why – have these changed over time?’ We study two nations with high rates of obesity: Nauru and Samoa.
Subjects and methods: Ethnographic fieldwork with people in everyday and clinical settings in Samoa (2011–2012; 2017) and Nauru (2010–2011).
Results: Body norms are not a single or universal set of values. Instead, multiple cultural influences—including global health, local community members and global media—interact to create a complex landscape of contradictory body norms.
Conclusions: Body norms and body size interventions exist in an iterative relationship. Our findings suggest that Pacific island obesity interventions do not fail because they conflict with local body norms; rather, they fail because they powerfully re-shape body norms in ways that confuse and coun- teract their intended purpose. Left unacknowledged, this appears to have (unintended) consequences for the success of anti-obesity interventions.
"Embedded Narratives: Metabolic Disorders and Pentecostal Conversion in Samoa." 2018. Medical Anthropology Quarterly 32(1): 22-41.
Drawing from interviews and participant observation, this article explores the intersection of diagnosis of metabolic disorders and religious conversion among Pentecostal Christians in Samoa by analyzing what I call embedded narratives––conversion narratives embedded in illness narratives. Drawing from ethnographic data, I examine how using conversion narrative conventions enabled those living with metabolic disorders to narrate behavior change in a culturally and socially valorized way. By embedding their narratives, I suggest those living with metabolic disorders shifted the object of care from a disease process toward the creation of a religious life and in turn transformed the risks associated with metabolic disorders, including diet, exercise, and pharmaceutical use into moral risks associated with everyday religious life. In these cases, Pentecostal conversion created possible scripts for changing health practices, managing stress, and shifting resource use in the name of religious commitment, providing insights into how self-care can be an expression of religious practice. [metabolic disorders, Christianity, narrative, conversion, self-care]
"Challenging Authority, Averting Risk, Creating Futures: Intersectionality in Interpreting Christian Ritual in Samoa." 2016. Journal of Contemporary Religion 31(3): 379-391.
This article explores how prayer group leaders manage and interpret risk-in-ritual during a home-based Pentecostal intercession. The group was formed in an office setting and led by three female managers. They interceded together during their lunch hour for over a year. The intercession was the one time the prayer group moved from the office to the home of one of the female leaders. This transition sparked a number of problems associated with group unity, which indicated risks-in-ritual. Managing risk was focused on managing forms of social difference such as age, gender, rank, and denomination. I draw from the feminist theory of intersectionality to argue that in the process of translating social differences of gender, age, rank, and denomination into spiritual differences in ritual, future ritual agendas are created. This future-creating capacity of ritual reinforced the authority of those who adjudicated and interpreted those risks-in-ritual. My example is taken from 14 months of ethnographic fieldwork in Samoa between 2011 and 2012.
“'Healing is a Done Deal': Temporality and Metabolic Healing Among Evangelical Christians in Samoa." 2016. Medical Anthropology 35(2): 105-118.
Drawing on fieldwork in independent Samoa, in this article, I analyze the temporal dimensions of evangelical Christian healing of metabolic disorders. I explore how those suffering with metabolic disorders draw from multiple time-based notions of healing in order to draw attention to the limits of biomedicine contrasting this to the effectiveness of Divine healing. Specifically, by simultaneously engaging evangelical and biomedical temporalities, I argue evangelicals create wellness despite sickness and, in turn, re-signify chronic suffering as a long-term process of Christian healing. Positioning biomedical temporality and evangelical temporality as parallel yet distinctive ways of practicing healing, therefore, influences health care choices.
“Producing Markets, Producing People: Local Food, Financial Prosperity, and Health in Samoa." 2015. Food, Culture, and Society 18(3): 519-539.
In the context of rising rates of metabolic disorders and global attention to the “obesity epidemic” in Oceania, public health in Samoa tends to focus on multi-sectoral efforts to increase vegetable consumption and production. To understand better what non-health officials thought about food environments and health, we sought out a group of food actors (food trade and agricultural entrepreneurs, distributors, producers and food policy practitioners) who were actively creating a “healthier” food environment in Samoa. They posited that the market was both the problem and the solution to the “obesity epidemic.” These food actors positioned themselves as social entrepreneurs, or more aptly as altruistic capitalists, who aimed to transform the food environment by fixing the market, a practice that would in turn produce healthier and more prosperous Samoans. We argue that while alternative food movements in the global north tend to link local production with local consumption, Samoan food actors have focused on local production as a way to provide Samoans with financial prosperity, which in turn will provide opportunities for healthier consumption. This article is based on qualitative interviews with food actors and an ethnography of food, public health and development in Samoa.
“Christianity, Fat Talk, and Samoan Pastors: Rethinking the Fat-Positive-Fat-Stigma Framework.” 2015. Fat Studies: An Interdisciplinary Journal of Body Weight and Society 4(2): 178-196.
Anthropology, public health, and epidemiology have long researched meanings of body size and factors that contribute to epi- demiological transition. The author draws attention to a dichoto- mous framework operating with these fields where fat-positive and fat-negative cultures are represented as oppositional. Drawing from fieldwork among Samoan evangelical Christians, the author argues that contextual analysis of fat reveals ambiguity and ambivalence. In Samoa, negative and positive meanings associ- ated with fat are dynamically engaged. In conclusion, she argues that representing fat in dichotomous terms is Othering because “the West” is represented as the fat-negative while “the rest” is represented as fat-positive.
"Everyday Translation: Health Practitioners’ Perspectives on Obesity and Metabolic Disorders in Samoa." 2015. Critical Public Health 25(2): 125-138.
Research in Samoa and the diaspora has documented the nutrition transition and related rising metabolic disorders. Research suggests cultural influences, including large body size preference, sedentarism, and dietary patterns, as well as political and economic influences, including changed labor patterns and food dependence, contribute to rising metabolic disorders. This article documents how Samoan health practitioners understand barriers to lifestyle change as primarily cultural rather than structural. They highlight differences between health, framed as individually oriented, and well-being, framed as socially oriented. Drawing from participant observation and semi-structured interviews, this article shows how health practitioners engage in ‘everyday translation’ by aiming to change the meaning of food, body, and wealth. Attention to everyday translation provides insights into the ambivalent ways interviewees identify culture as a barrier to health care. They avoid blaming patients, which has the paradoxical effect of suspending blame on individuals for not changing health behavior until cultural change occurs. This requires local leadership to effect community-wide change. When culture is recognized as the primary barrier to lifestyle change, health practitioners inadvertently reproduce structural inequalities in their daily interactions with patients. This has the effect of obscuring structural influences and promoting the idea that metabolic disorders are under individual control.
"Electronic Decision Supports for Obesity Prevention." 2012. Clinical Pediatrics 51 (5): 490-497. (Co-authored with Eileen Dryden, Julia McDonald, Elise Taveras and Karen Hacker.)
Despite the availability of national evidenced-based guidelines related to pediatric obesity screening and prevention, multiple studies have shown that primary care physicians find it difficult to adhere to them or are unfamiliar with them altogether. This article presents physicians’ perspectives on the use of electronic decision support tools, an alert and Smart Set, to accelerate the adoption of obesity-related recommendations into their practice.The authors interviewed providers using a test encounter walk-through technique that revealed a number of barriers to using electronic decision supports for obesity care in primary care settings. Providers’ suggestions for improving their use of obesity-related decision supports are presented. Careful consideration must be given to both the development of electronic decision support tools and a multilayered educational outreach strategy if providers are going to be persuaded to use such supports to help them implement pediatric obesity prevention and management best practices.
Forthcoming. Corwin, Anna and Jessica Hardin. “Religion and Medicine: Productive Contrasts and Their Limitations.” Oxford Handbook of the Anthropology of Religion, edited by Simon Coleman and Joel Robbins.
“‘God is Your Health’: Healing Metabolic Disorders in Samoa.” Forthcoming. In Christianity, Conflict, and Renewal in Australia and the Pacific, edited Carolyn Schwarz and Fiona Magowan. Leiden: Brill.
"Fasting for Health, Fasting for God: Samoan Evangelical Christian Responses to Obesity and Chronic Disease." 2013. In Reconstructing Obesity: The Meaning of Measures and the Measure of Meanings. New York: Berghahn Books.
“Claiming Pule, Manifesting Mana: Ordinary Ethics and Pentecostal Self-making in Samoa.” 2016. In New Mana: Re-theorizing Mana across the Pacific, edited by Matt Tomlinson and Ty Kawika Tengan. Canberra: ANU E-Press.
Book and Film Reviews
Review of Kimura and Suryanata (2016). Food and Power in Hawai’i: Visions of Food Democracy. Pacific Affairs 91(2): 435-437.
Review of Burchardt (2015). Faith in the Time of AIDS: Religion, Biopolitics, and Modernity in South Africa. Medicine Anthropology Theory 4 (5): 108–111.
Review of Unity Suhr, Christian and Ton Otto (2011). Unity through Culture. Anthropology News.
Review of Patterson, Mary and Martha Macintyre (2011). Managing Modernity in the Western Pacific. The Contemporary Pacific.
Review of Gershon, Ilana (2012). No Family is an Island: Cultural Expertise among Samoans in Diaspora. Pacific Affairs.
Review of Wentzell, Emily (2013). Maturing Masculinities: Aging, Chronic Illness, and Viagra in Mexico. Association of Feminist Anthropology Book Reviews.