Spinning Our Wheels: The Role of Structural Ignorance in Community Public Health Response

• In Event: Institutions and Ignorance: New Directions in the Political Economy of Science

Abstract

That the United States is in the throes of a major opioid epidemic is so obvious that even the Trump administration, whose policies seem unabashedly guided by whim rather than evidence, has been forced to acknowledge it as a fact and declare the crisis a national Public Health Emergency back in 2017. Public health professionals cite a plethora of frightening numbers of addictions and overdoses, national and local news outlets are publishing stories that raise awareness and give voice to victims, and bereaved families all over the country are channeling their grief into local and national action. And yet despite the growing attention to the problem, efforts to respond to the crisis continue to be hampered by what I call structural ignorance. In this paper, I examine the efforts of a small Midwestern community to mobilize a local response to the problem. Based on ethnographic methods and interviews with healthcare, public health, law enforcement, and addiction treatment professionals, I analyze how this ignorance is constructed and mobilized on the level of institutions, practices and rhetoric. I argue that, although this ignorance manifests itself in and is reinforced by epistemic and rhetorical practices, its foundations are imbedded in the institutional structures of public health administration and the political economy of healthcare.

Author

• Anna Geltzer, University of Notre Dame