Access to healthcare is an important topic within medical anthropology, in part because access is denied or complicated through structural forces for many populations in the United States. Anthropological research explores the impact of lack of access to healthcare on the lives of at-risk populations, as well as the differing and unexpected ways that access is denied or limited (Adler and Newman 2002; Becker 2004; Becker 2007; Horton 2004; Horton, McCloskey, Todd, and Henricksen 2001; O'Daniel 2008). For low-income, rural and minority populations, research shows that access to healthcare is further complicated by a higher propensity to break appointments (Bean and Talaga 1992; Bean and Talaga 1995). The act of appointment breaking is an essential aspect of this discussion: it is through appointment breaking and other similar activities that it is possible to understand how people access care when it is “available” to them and what everyday barriers prevent them from having true and full access. In this project, I define appointment breaking as the act of missing a scheduled appointment without prior cancellation. Through this research, I explore how people understand their access to healthcare resources and what factors impact their use by focusing on appointment breaking at a Florida community health center. This research uses a critical medical anthropology approach and is grounded within the anthropological theories of access to healthcare, health disparities, structural violence, and the political economy of health; through this theoretical perspective, the issue of appointment breaking can be studied as a complex and integral aspect of access to healthcare, and rooted in the long history of medical anthropology studies on health disparities. Using qualitative research methods, specifically interviews and participant observation, as well as an analysis of the demographics of those patients that have missed appointments at this community health center, this study investigates the broader implications of a lack of access to care characterized by appointment breaking. This research connects the act of appointment breaking to cultural influences which shape access to healthcare. I found that barriers such as finances, mental health needs, personal issues, and lack of child care prevents patients from accessing healthcare, even through the safety net programs that are in place to serve at-risk populations, such as low income, rural, and minority populations. This research contributes to the existing literature on gaps in access to healthcare that is provided for at-risk populations and develops the anthropological research on the overlooked topic of appointment breaking. By exposing the issue of appointment breaking as a factor in the larger issues of access to care and health disparities, this research highlights the larger structural forces that impact access to care beyond access to insurance and the availability of affordable and accessible healthcare resources.

This politically engaged project locally grounds the efforts of low-wage workers in the United States who are addressing the nationwide epidemic of wage theft by focusing on the particular experience of organized hospitality cleaning workers at a worker center in Nashville, Tennessee. While being both collaborative and reflexive, this activist anthropological research utilizes observant participation, in-depth interviews, and organizational and archival research to explore the issues identified by members and organizers at the worker center, illustrate the alternative theories of change being generated from grassroots labor organizing efforts in light of state mechanisms that do not protect all workers, and to investigate the complex intersections of activism and academia in research settings. This study shows that wage theft is a more nuanced problem than an economic burden alone, that organized low-wage and immigrant workers are changing the landscape of U.S. labor organizing, and that academic-worker justice collaborations hold promising implications for social change.

This cross-sectional, comparative, qualitative study explored language-related issues experienced by low-income Spanish-speaking mothers navigating pediatric care for their children in Hillsborough County, Florida. Hospitals, pediatric clinics, specialists, and dental care have differing degrees of linguistic accessibility and accommodations for limited English proficient families. Two groups of mothers were interviewed: bilingual (n=9) and Spanish-speaking limited-English proficient (SSLEP) mothers (n=21). These groups perceived the effect of language on navigating pediatric healthcare differently, creating tension in perceptions and experience between them. Such tensions included SSLEP mothers expressing satisfaction with pediatric care simultaneously with shortcomings in communication. SSLEP mothers said that everything was easy, at the same time stating that navigating healthcare, and other aspects of their family life would be far easier if they spoke English. SSLEP expressions of self-sufficiency were countered by bilingual mothers who provided language support to SSLEP family members, friends, and strangers. This research points toward the need for consistent language services in healthcare settings as well as facilitation of effective English language acquisition opportunities for families.

This research looks at the production of media in Ghana, specifically, film produced in the “Glamour” style or Western-style tradition that originates in its capitol of Accra. The film industry in Ghana, known as Ghallywood, is a vibrant and prolific field in which content is produced and distributed throughout the country for local consumption. Research on production practice, rather than content, can show cross-cultural differentiation in visual media production and also offers a lens through which to explore Ghanaian culture. The following research questions frame this study: What are the production practices of Ghanaian video films? How do Ghanaians communicate the process of creating Ghanaian video films? How do the practice and discourse of the video film production work to create and reinforce messages from the producers to the audiences? This research necessarily departs from looking primarily at the content of films, instead exploring the processes behind the creation of those products. Nick Couldry recognizes practice as an emerging theme in media research and this work focuses on his theory of media practice, in which the focus shifts from a content analysis to what people are actually doing in relation to media and its production. Using visual techniques and on-camera interviews, this work supplements a documentary about Ghanaian filmmaking and the voices that characterize the industry. This research and its visual product show the processes and conflict within the industry, including several different players who are often at odds with one another: students learning film from either academic or trade institutions, professional filmmakers who are either academically trained or self-taught, as well as scholars who provide their perspective on the industry as a whole. This research shows that filmmaking in Ghana is characterized by many competing elements, including a rift in what is known as “Ghallywood.” Two separate industries actually exist: the Accra “glamourwood” industry and its highly localized “kumawood” counterpart based in Kumasi, Ghana. This research also introduces concepts of how Ghanaians see the world and reproduce it in film, with the use of long takes and wide shots. This work illustrates the value of understanding production practices of media products cross-culturally as a departure from the more traditional approach to media studies of content. The attention given to a supplementary visual product in the form of a documentary aims to raise awareness of visual methodology and the value of visual and public anthropology in research and its applications to dissemination to mass audiences beyond academia.

This dissertation research examines how shared aspects of identity are constructed among the Druze in Lebanon and how it contributes to conceptualizations of heritage. Assessing the educational resources focused on aspects of Druze heritage, the barriers to cultural preservation were elucidated. Utilizing a number of qualitative research methods, participants’ feedback constructed a narrative that considers what they believe to be at risk for their community. These issues included addressing a perceived knowledge gap wherein the majority of Druze expressed a need to expand the educational resources in their community. Participants defined the kinds of resources and social supports that are lacking and explained how existing texts, lectures, and seminars should be improved, increased, and made more accessible. This dissertation is a result of ethnographic fieldwork which I conducted throughout 2014. Having lived in the town of Aley, Lebanon, I conducted research interviews with individuals that represented a broad spectrum of society, taking into account women and men of different ages with diverse social, economic, and educational backgrounds. Through participant observation, I shared many of the daily experiences of research participants and observed the Druze in their regular lives, their social gatherings, and at sites of historical significance. Using a political economic theoretical framework, this research also explored the diversity of ways in which social phenomena are contested among the Druze in Lebanon. While much of the anthropological and social science research on heritage focuses on its material components, utilizing pre-established models that conflate heritage with tangible symbolic expressions, a political economic approach insists that the context of social structures are taken into account. This also lends itself to a conceptualization of heritage as a process by which individuals create meaning in their lives, which are shaped by social contexts such as history and contemporary culture. This research highlights the fact that a priori models that fail to consider both social structures and the fundamental perspectives of participants are based upon ideologies that lack a critical academic lens. This dissertation demonstrates that while Druze particularism often necessitated a level of conformity and ascription to traditional values, the diversity of individual approaches to shared identity contributed to the plasticity of cultural forms and varieties of self-expression. As well, expanded and improved educational resources that encourage individuals to learn more about their history and the basic tenets of their faith were widely seen as a valued means of ensuring the society’s continuation.

This thesis seeks to explore and understand how people perceive and experience the village pub. There has, over the course of time, been a general decline in the social and economic importance of the village pub as well as in their number. The decline in number has accelerated in recent years and been the focus of much media attention with some reports claiming that it has negative consequences for rural life (see, for example, Hill, 2008; Scruton, 2006). Despite this there has been very little social science research conducted on this topic. This research helps to fill this knowledge gap. By using empirical data, principally collected in villages in Lincolnshire and from various groups (mainly newcomer residents, long-standing residents and publicans) to explore multiple representations of the village pub this thesis provides an in-depth exploration and interpretation of the values underpinning the research participants’ representations and experiences of the village pub. In doing this, the thesis shows that village pubs are seen and experienced as adding value of different kinds – economic, social, and cultural, and that the different groups attach different levels of importance to these kinds of value. It also shows that, whilst the different kinds of value can work in the Bourdieusian interpretation as capital, and be self-expanding and inter-convertible, they can also work to undermine one another. By showing how the village pub is seen through the lens of nostalgia and the rural idyll and that contradictions exist between how the village pub is remembered or imagined and how it ‘really’ is, this thesis contributes to rural studies literature and, more specifically, to that which engages with the cultural turn as well as to pub literature. The thesis also offers a contribution to practice. It does this first, by imparting knowledge, to different groups, on the types (economic, social and cultural) of diversification that can be used to help sustain village pubs, especially in Lincolnshire; and second, by showing those groups that beliefs and practices around diversification have important consequences for the sustainability of village pubs.

Many Puerto Ricans living in the United States have underused mental health facilities. Addressing the problem requires knowledge of the clients' perspective, which has not been obtained. This writer studied clients' perspectives on mental health and their expectations of those who help them. Included in the study was a view of Espiritistas and Santeros, practitioners of traditional religions in Puerto Rico, the former religion of French, the latter of African origin. They have functioned as therapists among Puerto Ricans, so the reason for clients' choice of help was important to a study of the problem as a whole. A survey of 100 Puerto Rican subjects in Springfield and Holyoke, Massachusetts, and Hartford, Connecticut, showed that while many clients liked the opportunity to talk about their problems and be understood at a mental health facility, the folkloric practitioners' concentration on and promise of concrete results and delivery of those results, together with the social networking through those practitioners, were a powerful attraction to clients. Men and middle class respondents generally did not use mental health facilities, but did go to the folkloric practitioners.

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This study begins with two premises. The first is that American Studies needs to move beyond the borders of the United States to examine the ideological, cultural and economic effects our country has had on others. The United States has historically been deeply involved in Anguilla's economy, revolution and ideology. The second is that history is a commodity that is selectively deployed in the creation of personal and national cultural values in Anguilla. I use Sherry Ortner's concept of serious games and James Scott's theory of the arts of resistance to analyze how Anguilla's contemporary culture is a product of its history, environment, and a particular industry. Colonial institutional failure created a vacuum in which Anguillians were permitted, even encouraged, to conceptualize themselves as independent. The harsh environment prevented the formation of a plantocracy based on sugar production. The means and modes of the production of salt, Anguilla's only staple, resulted in a social structure that contrasts with those of the sugar islands in the Antilles. Today, independence remains Anguilla's serious game and sole art of resistance on a personal, cultural and national level.;The definition of self and nation as independent is based upon a radical excision of history that is articulated in an invention of tradition. Plato's idea of mythos and logos serve as methodological tools for unpacking how history has been strategically utilized and suppressed to support cultural concepts. The hypothesis of this dissertation is that, if history repeats, Anguilla is trapped in the box of dominant discourse. Anguillians' history does repeat; their version of history fails to benefit them because it elides their basic dependency.;The conclusion is that, in positioning independence as the contrariety of colonialism, Anguilla has created a false dichotomy that is symptomatic of an underlying social malaise. On a personal level, independence is the antithesis of community and nationalism. On a political level, independence works against regionalism. Dependence, the hidden narrative of the Anguillian public discourse of independence, undermines the mythos. Only by deconstructing the contrarieties of independence and colonialism into subcontrarieties, can Anguilla address its cultural dissonances and position itself in a global world.

This dissertation focuses on how history is made meaningful in the present. I argue that within the United States and Brazil, historic narratives and sites are employed in legitimizing and contesting past and contemporary social inequity. National, regional, and local narratives tell the stories of how communities and their members came to be who and where they are in the present. Social hierarchies and inequity are naturalized and/or questioned through historic narratives. Formative education includes telling these stories to children. Commemorative events and monuments tell and re-tell stories to community members of all ages. Enculturation of historical identities, the positioning of self within historic trajectories that connect the past to the present, occurs throughout one's lifetime, developing and shaping one's sense of self. How are members of multicultural, former slaveholding nations, such as the United States and Brazil, taught to see themselves in relationship to the history of slavery? Is this past meaningful in daily life? How are historic sites and figures representing the history of slavery and resistance made meaningful to people in terms of personal, local, and national histories? What pasts are made relevant to whom and for whom? Do ideas of race inform narratives of the past? If so, how and toward what end? Analysis is focused on community action and discussions surrounding two historic cemeteries where the remains of enslaved Africans were interred in the eighteenth and nineteenth centuries: the Richmond African Burial Ground, in Virginia and the Cemiterio dos Pretos Novas in Rio de Janeiro. Upon each site a revolutionary figure is memorialized -- Gabriel in Virginia and Zumbi dos Palmares in Rio de Janeiro.