Doctoral Dissertation Research: The Role of Socioeconomic and Cultural Variation of Neurotrauma Recovery

Northwestern University, Evanston IL

Investigators

Abstract

Traumatic Brain Injury (TBI), or neurotrauma, is a disruption in brain function caused by a blow or jolt to the head that can produce a wide range of physical, cognitive, and psychosocial aftereffects. TBI also represents a critical global health issue with high personal, societal, and economic costs to patients, caregivers, and communities as a whole. Although global health officials have recognized TBI as "silent epidemic," public health approaches have seldom paid attention to the specific cultural and socioeconomic circumstances of this injury. In particular, understandings of life after trauma may vary across cultural contexts, with potentially powerful implications for TBI care within and outside clinical settings. This project, which trains a student in the methods of empirical, scientific data collection and analysis, asks how TBI patients and their families engage popular and medical framings about injury, and how societal and medical understandings of brain injury are differentially affected by constraints of public care and new perspectives on mind and brain. In addition to providing funding for the training of a graduate student in anthropology, the project would enhance scientific understanding by broadly disseminating its findings to organizations and institutions invested in ameliorating the social and medical costs associated with traumatic brain injury. In the research supported by this award, doctoral student Livia Garofalo, under the supervision and guidance of Dr. Rebecca Seligman, will investigate how Traumatic Brain Injury is cared for and experienced in a context of high TBI incidence, healthcare shortage, and increased attention towards neurological conditions. Through ethnographic research in public hospitals in the greater Buenos Aires area, the researcher will collect data through participant observation in clinical spaces and semi-structured interviews with patients, caregivers, and medical professionals, and conduct archival and media research. Triangulating this data will provide an assessment of the socioeconomic and political circumstances in which brain injury occurs, as well as the repercussions of neurotrauma at a broader societal level in the Argentine context. Buenos Aires, in particular, provides an apt site to investigate these issues as a large metropolitan area with a high influx of patients, thus providing a model for other dense and highly unequal urban contexts in the United States. Twelve months of ethnographic research will be conducted at two different hospitals with trauma centers, and their surrounding communities. Data will be collected through participant observation, interviews, and case studies and clinical histories, with medical professionals, TBI caregivers and their families, and TBI patients, with appropriate stratification based on age, gender, class, education, and hospital affiliation. Contributing to interdisciplinary conversations between cultural anthropology, science and technology studies, and global health, findings from this research will offer a multi-level anthropological perspective on how TBI incidence is stratified along socioeconomic lines, how emerging notions of "brain health" affect the attention towards brain injury, and how access to care is crucial for marginalized individuals and families to rebuild lives after trauma. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.