Negotiating un/sanitary citizenship: the reception of UK government COVID-19 public health messaging by racialised people highly exposed to infection.

Governments across the world differently invoked citizen responsibility for responding to the risk of COVID-19 infection. Approaches which focused on changing social practices served to reinforce distinctions between 'sanitary' and 'unsanitary' citizenship. This paper examines citizens' responses to public health policy messaging, exploring as a case study the reception of UK Government messaging about responsible behaviour during the first two years of the COVID-19 pandemic. We examine the public responses to such messaging from narrative interviews with 43 people who became ill with COVID-19. These interviews were with people who identified as members of the minoritised religious and racialised groups, who were most heavily burdened by the impact of COVID-19. Interviewees challenged assumptions that they were 'irresponsible' for having caught COVID-19, and instead directed attention towards the ways in which pandemic guidance was unworkable. Some actively critiqued government messaging, questioning the problematic racialisation of pandemic messaging and challenging individual responsibilisation for the management of the pandemic. Through this analysis we demonstrate the active role of citizens in enacting, and at times resisting, health policy.

Patient patients: middle-aged British Pakistani women and the intuition of limits to care.

This paper examines the affective inequalities underpinning the extensive responsibilities of care that are shouldered by chronically ill -middle-aged British Pakistani women. In the context of ethnic health inequalities, chronic illness and premature ageing are ubiquitous. Further, mid-life generates gendered pinchpoints in the dynamics of care. The paper draws on extended conversations with women over seven/eight years and tracks their unsettled perspectives on sabar (patient endurance). Middle-aged women described how, over the long haul of living alongside chronic illness, they intuited that they must place some limits on caring for others, and that care required self-care - not in a biomedical sense, but in the sense of attention to their own bodily and relational needs. The paper extends anthropological critiques of Levinas's philosophy of infinite responsibilities to care, tracking how changes at several temporal scales - the life course, intergenerational re-negotiations - affect care. While social transformations of gender, and the proliferation of neoliberal discourses on self-care do affect the traction of normative notions of selfless care for others, the paper locates women's changing perspectives on sabar primarily in the provocations of everyday life.

Justice and the racial dimensions of health inequalities: A view from COVID-19.

In this paper, we take up the call to further examine structural injustice in health, and racial inequalities in particular. We examine the many facets of racism: structural, interpersonal and institutional as they appeared in the COVID-19 pandemic in the UK, and emphasize the relevance of their systemic character. We suggest that such inequalities were entirely foreseeable, for their causal mechanisms are deeply ingrained in our social structures. It is by recognizing the conventional, un-extraordinary nature of racism within social systems that we can begin to address socially mediated health inequalities.

Long-term ill health and the social embeddedness of work: a study in a post-industrial, multi-ethnic locality in the UK.

Against the background of an increasingly individualising welfare-to-work regime, sociological studies of incapacity and health-related worklessness have called for an appreciation of the role of history and context in patterning individual experience. This article responds to that call by exploring the work experiences of long-term sick people in East London, a post-industrial, multi-ethnic locality. It demonstrates how the individual experiences of long-term sickness and work are embedded in social relations of class, generation, ethnicity and gender, which shape people's formal and informal routes to work protection, work-seeking practices and responses to worklessness. We argue that this social embeddedness requires greater attention in welfare-to-work policy.

It's not just pills and potions? depoliticising health inequalities policy in England.

In England, health inequalities policy shifted during the Labour term (1997-2010) from initially strong commitments to tackling the 'upstream' social determinants of health to a technically-driven emphasis on lifestyle risk factors and healthcare access. This multi-sited study, based in and around Westminster (2006-2007), extends our understanding of how political context influences policy-making by drawing from anthropological studies of policy. Qualitative material from central government is put into conversation with theory concerning policy as zones of practices. The paper explores the bristly process through which public health, healthcare and corporate interests vied to shape the political agenda for health inequalities; the selective use of evidence by civil servants in accordance with their perceptions of what politicians conceive to be electorally palatable; the silencing of critique of the dominant narrative about evidence-based policy; and how technical aids developed a life of their own - as a result of which, health inequalities policy ended up being depoliticised.

Talking about inequities: A comparative analysis of COVID-19 narratives in the UK, US, and Brazil.

Disproportionate mortality and morbidity burdens of the COVID-19 pandemic and coinciding media coverage of public acts of violence perpetrated against people of color in 2020 precipitated reckonings with structural inequities in global, national, and local contexts. This cross-country comparative analysis aims to describe how people voice and make sense race, racism, and privilege in their experiences with COVID-19 infection in the United States, United Kingdom, and Brazil. Anchored by continuous reflection on our individual and collective positionality, we conducted an inductive comparative analysis conceptually situated in intersectionality and critical race theory. Countries used a shared qualitative methodology to collect and analyze 166 narratives of people with experience of COVID-19 infection from 2020 to 2023. We selected 19 cases that illustrate cross-national differences in peoples' acknowledgment and narration of structural privilege and disadvantage in their observations of COVID-19 in their countries and in their personal experiences. People in the US had the most fluency with voicing race directly. In Brazil, while some respondents (especially younger people) demonstrated high racial consciousness, others struggled to identify and talk about racial relationships. In the UK, people voiced racial identifications, though often within white norms of politeness and an accompanying sense of discomfort. The findings overall illustrate moments the interview becomes or does not become a space for voicing social categories and systemic underpinnings of difference in COVID-19 infections and healthcare experiences. We reflect on cross-country differences in historical and contemporary racialized discourse and elaborate on implications of focusing on voicing in qualitative research.

Sickness, dreams and moral selfhood among migrant Pakistani Muslims.

This paper draws from two years of fieldwork investigating the social course of illness among Pakistani Muslims in East London, exploring how chronic illness is communicated and negotiated in local worlds disrupted by migrancy. It examines episodic short stories about dreams, premonitions and uncanny coincidences that were prominent within the illness narratives of migrant Pakistani Muslims, recalling and throwing light on complex questions concerning subjective constructions of misfortune, the personal and social meanings of illness and the relationships between narrative and selfhood. The ethnography identifies a strong normative context of communication about ill health and bad news, within which revelation through the mode of the supernatural takes on added significance. Recurrent motifs in the dreams emphasize the connectedness between family members scattered across migratory contexts, and the reawakening of moral obligations in families. Whilst medical anthropology has understood descriptions of dreams and other uncanny experiences as 'subjunctivising tactics' serving to maintain alternative plots about the source and outcome of illness, in the Islamic context the narrating of supernatural encounters can have transformative effects, re-organising praxis and conferring legitimacy to certain forms of moral selfhood. The paper therefore argues that the notion of the 'subjunctive mode' imposes the analysts' own system of logic and that there is a need to understand the interpretive frameworks present in the illness narratives in their own terms.

Resurgence of Measles in Europe: A Systematic Review on Parental Attitudes and Beliefs of Measles Vaccine.

BACKGROUND AND OBJECTIVES: Europe has experienced a major resurgence of measles in recent years, despite the availability and free access to a safe, effective, and affordable vaccination measles, mumps and rubella vaccine (MMR). The main driver for this is suboptimal vaccine coverage. The three objectives of this study are to synthesize and critically assess parental attitudes and beliefs toward MMR uptake, to develop strategies and policy recommendations to effectively improve MMR vaccine uptake accordingly, and ultimately to identify areas for further research. METHODS: A systematic review was conducted using primary studies from PubMed, Medline, Embase, and Scopus published between 2011 and April 2019. Inclusion criteria comprised primary studies in English conducted in Europe and studying parental attitudes and behavior regarding MMR uptake. Data were extracted using an inductive grounded theory approach. RESULTS: In all, 20 high-quality studies were identified. Vaccine hesitancy or refusal were mainly due to concerns about vaccine safety, effectiveness, perception of measles risk and burden, mistrust in experts, and accessibility. Factors for MMR uptake included a sense of responsibility toward child and community health, peer judgement, trust in experts and vaccine, and measles severity. Anthroposophical and Gypsy, Roma, and Traveler populations presented unique barriers such as accessibility. CONCLUSION: A multi-interventional, evidence-based approach is vital to improve confidence, competence, and convenience of measles vaccination uptake. Healthcare professionals need an understanding of individual contextual attitudes and barriers to MMR uptake to tailor effective communication. Effective surveillance is needed to identify under-vaccinated populations for vaccination outreach programs to improve accessibility and uptake.