Judith Littleton

Tuberculosis and syndemics: Implications for Pacific health in New Zealand

Syndemics have been conceived of as a way of approaching the multiple levels of causation and linkage between two or more health conditions and their socio-political environment. Our aim in this paper is to use the established literature on syndemic relationships to examine possible interactions involving tuberculosis. In particular, we explore the linkages between tuberculosis and diabetes mellitus which, we argue, is of particular relevance to Pacific populations resident in New Zealand. Reviewing current literature, we identify multiple synergies between these two diseases whereby their mutual presence has an amplified negative effect. Both conditions interact with other practices and aspects of the broader political economic context such as smoking, housing, and nutrition. A syndemic approach to Pacific health is argued as an effective way to address research, policy and prevention questions.

Tacking between Disciplines: Approaches to Tuberculosis in New Zealand, the Cook Islands, and Tuvalu

Earlier chapters in this volume have demonstrated that studies of health and disease, which confine themselves to anthropology on the one hand or epidemiology on the other, offer incomplete understandings of the complex phenomena involved. Yet these disciplines have differing logics. It cannot be assumed that the truths they offer are commensurable and compatible, so a simple “add and stir” approach is seldom satisfactory. In our studies of the political ecology of tuberculosis in New Zealand and two contrasting island Pacific nations, along with the transnational spaces between, we have prioritized anthropological approaches, which are not reducible to “culture” only. We have tacked between history, anthropology, and epidemiological research on tuberculosis and those intertwined health and social conditions that interact with TB to produce worse outcomes. In this chapter we examine historical and contemporary cases that show how “tacking between” disciplines reveals insights contrary to popular understandings.Abstract Earlier chapters in this volume have demonstrated that studies of health and disease, which confine themselves to anthropology on the one hand or epidemiology on the other, offer incomplete understandings of the complex phenomena involved. Yet these disciplines have differing logics. It cannot be assumed that the truths they offer are commensurable and compatible, so a simple “add and stir” approach is seldom satisfactory. In our studies of the political ecology of tuberculosis in New Zealand and two contrasting island Pacific nations, along with the transnational spaces between, we have prioritized anthropological approaches, which are not reducible to “culture” only. We have tacked between history, anthropology, and epidemiological research on tuberculosis and those intertwined health and social conditions that interact with TB to produce worse outcomes. In this chapter we examine historical and contemporary cases that show how “tacking between” disciplines reveals insights contrary to popular understandings.