
































Details of Experience on Health and Culture 

Review by Nirmala Jayaraman 

Community Health Narratives: A Reader

by Emily Mendenhall & Kathy Wollner (eds)

University of New Mexico Press, 2015

Health narratives are similar to ethnographies in that they address how culture shapes an individual’s

perception  of  their  selfhood  and  wellness.  In  the  introduction  to  the  volume,  Community  Health

Narratives: A Reader, Emily Mendenhall writes,

If people do not identify a health problem as affecting them, although epidemiologists may

have identified the problem, it is less likely that an intervention will be successful. Therefore,

improvements must come from the bottom up, and people must work together to better the

health  of their  families,  friends,  and communities.  The narratives in  this  book, depicting

different  communities  and  customs  in  rich  detail,  focus  on  common  social  and  cultural

factors that shape community health (4).

In other words, the purpose of collecting stories from people suffering from social and physical distress

is to inform others of how an individual is impacted by community involvement. The editors of this

book, Emily Mendelhall and Kathy Wollner, proceed to cover factors which connect to public health in

sections entitled, “Social Ties,” “Gender and Sexuality,” “Mental Health,” “Violence,” “Prevention”

and “Health-Care Access.” Each section provides a set of discussion questions to provoke the readers’

thinking. Though broad in focus, this volume could be considered substantial as a text for medical

anthropologists and health professionals seeking to teach this material in class.

The first  two sections,  “Social  Ties”  and “Gender  and  Sexuality,”  explore  how people  are

motivated to maintain a healthy lifestyle. For example, belonging to a safe school environment can

motivate students to refrain from succumbing to peer pressure and engaging in risk-taking behaviors,

such as unprotected sex and bullying.  Teachers play a significant role in opening up conversations



among their  students to acknowledge their  daily struggles with healthy eating and exercise.  In the

chapter,  “Mai’suka,  My Island,”  one  teacher  addresses  concern  with students  developing diabetes,

saying:

“You know,” Mrs. Sili said, leaning forward in her folding chair, “my father tells this story

over and over again when he sees his descendants mindlessly stuffing themselves full  of

chips and soda in front of the television or complaining that they don’t have flashier cars.

And he says that we Samoans used to be warriors, muscular and strong.” She shook her head.

“I wonder about it myself. I look at the matais and elders I know, and while some of them are

big,  most  of them are  slender,  like my father.  I  look around at  choir  practice in  church

sometimes and wonder how potato chips and pickup trucks have made us obese and so prone

to mai’suka in just a couple of generations. I don’t want it to happen to me, and I don’t want

it to keep happening to the people on my island” (48-49).

The concept of “mai’suka” represents the local understanding of disease caused by poor nutrition and

high blood sugar; this relates to a larger theme of showing how culture-bound definitions frame an

individual’s  interpretation  of  their  health  needs.  Social  relationships  across  generations,  between

parents and children, also impact the lives of teenagers as well. The overall theme in the section is

strengthened by observations of how children acquire their knowledge about their health from various

role models.

Although a primary care doctor is in a position to help their patients, most people process their

understanding of health from their environment, school, families, and communities at large. The writers

of these stories contextualize the lives of their  informants in a literary non-fiction style.  However,

readers might want more analysis in between the content of each story. Nevertheless, at the end of each

theme, an organization is spotlighted for addressing health policy and healthcare on a local grassroots

level.  In the “Communities in Action” pieces,  there is just  enough practical wisdom and proactive

learning so that readers are not left underestimating the power of preventative action. The remaining

chapters are delivered in such a way that readers can see how cultural constructions, such as gender and

age, contribute to an individual’s perception of their health risks.

In the third and forth sections entitled, “Mental Health” and “Violence,” the editors delve into

the lives of those who continue to experience social isolation as their health needs progress. The writers

provide many details about families who are constantly exposed to violence and are provided little

social  support as caregivers for their  loved ones.  In these sections,  health  narratives become more

readily effective in helping readers understand the lives of patient populations from a holistic approach.

In the chapter, “Chantalle’s Secret”, the story of a Haitian woman’s struggle with depression unfolds



showing how much social support her family needs:

Chantalle sat up, a bit groggy. “I still feel scared, Étienne. I still feel shameful. It’s difficult to

face my husband’s family. It’s difficult to feel hopeful with so much uncertainty.”

“I know it must be tough,” Étienne started. “Perhaps by speaking with others, you

will remember how much love there is in the community. I heard on the radio that when you

feel sad and hopeless, there’s help in a town nearby. There’s someone who works at a clinic

there  who  is  a  psychologist.  Her  job  is  to  speak  with  people  who  are  having  suicidal

thoughts. She can help counsel you. There are many things the clinic can help you with as

well. There may be a mama’s club you can join to speak with other mothers who struggle

with similar  things as  you.  But  I  think the best  thing we can do is  to  support  you as  a

community. We can work together to watch your daughters when you need to work” (139).

The authors demonstrate how not only physicians, but also mental health counselors can provide care

on a regular basis to people in need of support for their psychological well-being. In this example,

readers also realize how individuals may need friends and neighbors to help them with their household

as they recover from their social suffering. Once again, analysis is sparse, however this book is very

readable. Theoretical concepts from cultural studies, such as structural violence, are referenced and

broadly discussed throughout the chapters. Readers will learn how social suffering and human health

influence each other from storytelling that is ultimately engaging.

The  final  two  sections,  “Prevention”  and  “Healthcare-Access,”  show  how  a  thoroughly

impersonal system, such as healthcare, can change the lives of many in a personal way. The most

poignant chapter, “There Will Always Be More Struggles To Win,” reminds readers that attending to

pressing matters in global health will  help bring positive consistent change to the most vulnerable

people, particularly those living in impoverished communities. In this chapter, the writers describe how

people encourage neighbors from their community to address their health needs, saying:

Three times a week, João Pedro’s mother made house-to-house visits, distributing vitamins,

weighing  and  measuring  children,  and  talking  with  families  about  children’s  health  and

safety. She and five other women were employed as community health workers by Brazil’s

government, and each one was responsible for visiting one hundred households each month.

João Pedro loved going out to visit the families and play with friends who lived in the houses

they would visit, but most of all, he loved watching his mom at work. She was proud of the

contr- ibution she was making to the health of their community, and so was João (292).

Reading health narratives can inspire empathy and interest among general readers. Anthropologists will

find its attention to people and their relationships especially interesting. For those who wish to use



health narratives in their work, this book represents an important template for the field. More examples

of narrative-styled stories can also be found in Global Health Narratives: A Reader for Youth (2009)

edited by Emily Mendenhall.

References Cited

Mendenhall, Emily

2009. Global Health Narratives: A Reader for Youth. Albuquerque: University of New Mexico Press.

Nirmala Jayaraman received a B.A. in Cultural Anthropology from Union College in Schenectady,

New York.

© 2015 Nirmala Jayaraman


