ABSTRACT This article chronicles the process by which a homeless tuberculosis patient is located,... more ABSTRACT This article chronicles the process by which a homeless tuberculosis patient is located, interviewed and placed on a course of directly observed therapy (DOT). This approach, based on an illness narrative model, emphasizes the intersubjective nature of both illness and treatment and the powerful impact of an impoverished social environment. Based on the extensive field notes of a public health worker in the city of Chicago, the article demonstrates how the social process of `building rapport' enables completion of a complex treatment regimen amid adverse circumstances. Nevertheless, the article concludes that the administration of individualized therapies, even when couched in culturally sensitive methods that respect social difference, cannot overcome the deleterious health effects of structural poverty and inequality.
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, a... more JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected].
In this article, the authors used data from economic and ethnographic interviews with heroin user... more In this article, the authors used data from economic and ethnographic interviews with heroin users from Detroit, Michigan, as well as other sources, to illustrate the relationship between heroin users’ mobility patterns and urban and suburban environments, especially in terms of drug acquisition and the geography of opportunity. The authors found that although geographic location and social networks associated with segregation provided central city residents and African Americans with a strategic advantage over White suburbanites in locating and purchasing heroin easily and efficiently, this same segregation effectively focuses the negative externalities of heroin markets in central city neighborhoods. Finally, the authors consider how the heroin trade reflects and reproduces the segregated post-industrial landscape and discuss directions for future research about the relationship between ethnic and economic ghettos and regional drug markets.
ABSTRACT This article chronicles the process by which a homeless tuberculosis patient is located,... more ABSTRACT This article chronicles the process by which a homeless tuberculosis patient is located, interviewed and placed on a course of directly observed therapy (DOT). This approach, based on an illness narrative model, emphasizes the intersubjective nature of both illness and treatment and the powerful impact of an impoverished social environment. Based on the extensive field notes of a public health worker in the city of Chicago, the article demonstrates how the social process of `building rapport' enables completion of a complex treatment regimen amid adverse circumstances. Nevertheless, the article concludes that the administration of individualized therapies, even when couched in culturally sensitive methods that respect social difference, cannot overcome the deleterious health effects of structural poverty and inequality.
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, a... more JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected].
In this article, the authors used data from economic and ethnographic interviews with heroin user... more In this article, the authors used data from economic and ethnographic interviews with heroin users from Detroit, Michigan, as well as other sources, to illustrate the relationship between heroin users’ mobility patterns and urban and suburban environments, especially in terms of drug acquisition and the geography of opportunity. The authors found that although geographic location and social networks associated with segregation provided central city residents and African Americans with a strategic advantage over White suburbanites in locating and purchasing heroin easily and efficiently, this same segregation effectively focuses the negative externalities of heroin markets in central city neighborhoods. Finally, the authors consider how the heroin trade reflects and reproduces the segregated post-industrial landscape and discuss directions for future research about the relationship between ethnic and economic ghettos and regional drug markets.
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Papers by Paul Draus