RETHINKING INEQUALITIES AND DIFFERENCES IN MEDICINE

Over the last decade, two interconnected issues have occupied a rapidly growing place in social studies of medicine: disparities in health and health care, and cultural differences that affect health-related behaviors and patients' interactions with the health-care system.

These topics have proved remarkably fruitful as subjects for research and teaching. Yet the underlying concepts and assumptions have rarely received the critical reexamination they deserve.

This conference will bring together scholars from multiple disciplines to share and discuss new approaches to the study of inequalities and differences in medicine.

FELLOWS

This conference began as a project of the fellows in the 2003-2004 Fellows Program of the Robert Penn Warren Center for the Humanities, which was devoted to the theme “Medicine, Health, & Society.”

Vanderbilt fellows

Larry R. Churchill (Center for Clinical and Research Ethics), program co-director

Craig Anne Heflinger (Human and Organizational Development, Peabody College)

Leonard M. Hummel (Pastoral Theology and Counseling, Divinity School)

Scott Pearson (Division of Surgical Oncology, School of Medicine)

Matthew Ramsey (History; Center for Medicine, Health & Society), program co-director

Ruth Rogaski (History)

Peggy A. Thoits (Sociology); now at University of North Carolina, Chapel Hill

Arleen M. Tuchman (History)

Visiting fellow

Stephen D. Rachman, English/American Studies, Michigan State University.

ACKNOWLEDGMENTS

The organizers gratefully acknowledge financial support for the conference from the Robert Penn Warren Center for the Humanities, the Center for Medicine, Health and Society, and the Office of the Provost, Vanderbilt University.

Special thanks to the Medical Historical Library at Yale University for the loan of five paintings by Lam Qua for the exhibit “Perspectives on the Diseased Body,” and to Stephen Rachman for curating the exhibit.

Thanks also to:

Robert Penn Warren Center for the Humanities

Mona Frederick, Executive Director

Galyn Glick Martin, Activities Coordinator

Lacey F. Galbraith, Office Assistant

Center for Medicine, Health & Society

Adam Morgan, Administrative Assistant

Vanderbilt University School of Medicine Division of Continuing Medical Education

Donald E. Moore Jr., Director

Linda Todd, Coordinator of Program Data & Analysis

Eskind Biomedical Library, Historical Collections

Mary Teloh, Special Collections Librarian

Jean and Alexander Heard Library

Juanita Murray, University Archivist and Director of Special Collections

Student Assistant

Jonathan Justl

SCHEDULE OF SESSIONS

FRIDAY, APRIL 29, 2005

Bus departs the conference hotel for the Vanderbilt campus at 7:45 A.M.

Light Hall 208

Vanderbilt University School of Medicine

Opening remarks, 9:00-9:15

Welcome: Mona Frederick, Executive Director, Robert Penn Warren Center for the Humanities

Introduction: Matthew Ramsey (Vanderbilt Center for Medicine, Health, & Society)

Session 1, 9:15-10:15: Keynote address

Chair: Tony Brown, Vanderbilt University

"Racial/Ethnic Disparities in Health and Health Care: Challenges and Opportunities."

David Williams, University of Michigan

Break, 10:15-10:30

Session 2. 10:30-12:15: Conceptualizing differences and inequalities

Chair: Matthew Ramsey, Vanderbilt University

"Cultural Competency" Obscure Inequalities in Health? Views from Medical Anthropology.

Peter Brown, Emory University

Culture, Behavior, and Health Disparities: Implications for Research, Policy, and Intervention.

Hector Betancourt and Patricia Flynn, Loma Linda University

The Medical Construction of Race.

Matthew Anderson, Albert Einstein College of Medicine

Lunch, 12:15-1:15

Session 3, 1:15-3:00: Disparities and race

Chair: Vera Chatman, Vanderbilt University

Patient Safety and Prescription Medication Error: Differences in Patient Attitudes and Actions.

Gail Hughes, and Chris Arthur, University of Mississippi Medical Center

Virgin Soils Revisited

David Jones, Harvard University and Massachusetts Institute of Technology

Concepts of Race/Ethnicity in Maternal Health Care: Implications for Diminishing Racial Health Inequalities in Brazil.

Molly Robertson, Brown University

Break, 3:00-3:15

Session 4, 3:15-5:00: The health of immigrants

Chair: Scott Pearson, Vanderbilt University

Distinctiveness, Difference and Disease: Medical Responses to Post-Colonial Immigration.

Roberta Bivins, Cardiff University

Reflections on Disparities in the Utilization of Medical Specialists Between Immigrants and Non-Immigrants in Canada.

Alice Chen and Arminée Kazanjian, University of British Columbia

"Illegal" Migration Status as Axis of Health Inequality.

Sarah S. Willen, Emory University

Bus departs for conference hotel at 5:15, for those not attending gallery talk and reception.

CENTRAL LIBRARY, SPECIAL COLLECTIONS

Reception and Gallery Talk, 5:15-7:00

Conference exhibit: Perspectives on the Diseased Body

Commentary: Stephen Rachman, Michigan State University

The talk will start at about 5:30

Bus departs for conference hotel at 7:15.

Dinner on your own in Nashville or Brentwood.

SATURDAY, APRIL 30

Bus departs conference hotel for Vanderbilt conference at 7:45 A.M.

Light Hall 208

Vanderbilt University School of Medicine

Welcome, 9:00-9:15

George Hill, Associate Dean for Diversity in Medical Education, Vanderbilt School of Medicine

Session 5, 9:15-10:15: Keynote address

Chair: Patricia Foxen, Vanderbilt University

The embodiment of health inequalities: the case of rapidly expanding access to antiretrovirals in West Africa

Vinh-Kim Nguyen, McGill University

Break, 10:15-10:30

Session 6. 10:30-12:45 Genomics and concepts of racial difference

Chair: Larry Churchill, Vanderbilt University

Making Sense of Race.

Howard Brody, Michigan State University.

What the HapMap Can Teach Us about the Challenges of Dissecting Genetic Variation and Race/Ethnicity/Geographic Ancestry .

Ellen Wright Clayton, Vanderbilt University.

Pharmacogenetics and Implications for Understanding Race, Justice and Health Disparities.

Sandra Soo-Jin Lee, Stanford University

The Molecular Politics of HIV: Tracking Difference and Inequality across Genomes and Continents.

Johanna Crane, University of California, San Francisco

Lunch, 12:45-1:30

Session 7, 1:30-3:15: Cross-cultural encounters and mediations

Chair: Elizabeth Heitman, Vanderbilt University

Does Culture Matter? Experiences of Health Care and Telehealth in the Far North.

Lorna Heaton, University of Montreal

The Place of Islam and Social Inequality in Egypts Organ Transplant Debate.

Sherine Hamdy, New York University

Nursing Differences: Negotiating Traditional Medicine in a Tanzanian Hospital.

Stacey Langwick, University of Florida

Break, 3:15-3:30

Session 8, 3:30-4:30: Perceptions of risk

Chair: Craig Anne Heflinger, Vanderbilt University

Unorthodoxy Governed: Using the Technique of Risk in Regulating Latino/a Defined Behavior in Public Health.

Karen Holliday, University of California, Los Angeles

Medication Consumption and Sociocultural Analysis of Risk Among Hypertensives: Redefining Social and Health-Related Disparities.

Michelle Proulx, Université de Montréal

Session 9, 4:30-5:30: The socialist model at home and abroad

Chair: Arleen Tuchman, Vanderbilt University

Inequality and Health in Contemporary Cuba.

Katherine Hirschfeld, University of Oklahoma

An Alternative to Capitalist Health Regime? Socialist Hygienic Modernity and the Third World during the Cold War.

Young-sun Hong, State University of New York, Stony Brook

Bus will depart for conference hotel at 5:40. Leaves conference hotel for Vanderbilt campus at 7:10.

Conference dinner, 7:30-9:30

Board Room, Vanderbilt Children’s Hospital.

SUNDAY, MAY 1

Bus departs conference hotel for Vanderbilt campus at 8:15 A.M.

If you are planning to leave for the airport after the conference, it is recommended that you bring your luggage with you.

Vanderbilt University

Bishop Johnson Black Cultural Center

Session 10, 9:00-11:15: Mental health, race, and disparities

Chair: Peggy Thoits, University of North Carolina, Chapel Hill

From "Spiritual Crisis" to "Mental Illness" Racial Disparities in Mental Health Care, Historically.

Kirby Randolph., University of Pennsylvania

African Americans and Psychiatry in the U.S. During the 1950s.

Ellen Dwyer, Indiana University

Marital Status, Socioeconomic Status, Cultural Variations and Mental Health Status Among Latinos.

Mercedes Rubio, American Sociological Association

The Medical Use of Racial Difference: The Case of Jewish Nervousness.

Christopher Crenner, University of Kansas

Break, 11:15-11:30

Session 11, 11:30-12:30: conclusions

Co-chairs: Larry Churchill and Matthew Ramsey, Vanderbilt University

Lunch, 12:30-1:30

PROGRAM PARTICIPANTS

(Note: a list of all persons registered for the conference, with contact information, with be included in the registration packet.)

Anderson, Matthew (Albert Einstein College of Medicine). Session 2.

Arthur, Chris (University of Mississippi Medical Center). Session 3.

Betancourt, Hector (Loma Linda University), Session 2.

Bivins, Roberta (Cardiff University). Session 4.

Brody, Howard. Michigan State University. Session 6.

Brown, Peter (Emory University), Session 2.

Brown, Tony (Vanderbilt University). Session 1.

Chatman, Vera (Vanderbilt University). Session 3.

Chen (Alice), University of British Columbia. Session 4.

Churchill, Larry (Vanderbilt University). Sessions 6 and 11.

Clayton, Ellen (Vanderbilt University). Session 6.

Crane, Johanna (University of California, San Francisco). Session 6.

Crenner, Christopher (University of Kansas). Session 10.

Dwyer, Ellen (Indiana University). Session 10.

Flynn, Patricia (Loma Linda University), Session 2.

Foxen, Patricia (Vanderbilt University). Session 5.

Hamdy, Sherine (New York University). Session 7.

Heaton, Lorna (University of Montreal). Session 7.

Heflinger, Craig Anne (Vanderbilt University). Session 8.

Heitman, Elizabeth (Vanderbilt University). Session 7.

Hirschfeld, Karen (University of Oklahoma). Session 9.

Holliday, Karen (University of California, Los Angeles). Session 8.

Hong, Young-sun (State University of New York, Stony Brook ). Session 9.

Hughes, Gail (University of Mississippi Medical Center). Session 3.

Kazanjian, Arminée (University of British Columbia). Session 4.

Jones, David (Harvard University and Massachusetts Institute of Technology). Session 3.

Langwick (Stacey), University of Flordia. Session 7.

Lee, Sandra Soo-Jin (Stanford University). Session 6.

Nguyen, Vinh-Kim (McGill University). Session 5.

Pearson, Scott (Vanderbilt University). Session 4.

Proulx, Michelle (Université de Montréal). Session 8.

Rachman, Stephen (Michigan State University). Gallery talk, Friday, April 29.

Ramsey, Matthew (Vanderbilt University). Sessions 2 and 11.

Randolph, Kirby (University of Pennsylvania). Session 10.

Robertson, Molly (Brown University). Session 3.

Rubio, Mercedes (American Sociological Association). Session 10.

Thoits, Peggy (Vanderbilt University). Session 10.

Tuchman, Arleen (Vanderbilt University). Session 9.

Willen, Sarah (Emory University). Session 4.

Williams, David (University of Michigan). Session 2.