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The Political Ecology of Tuberculosis in Auckland: An Interdisciplinary Focus
One of the acknowledged ‘truths’ about infectious disease and the social sciences is the need for an interdisciplinary perspective to tackle issues of public health. While it would be difficult to find a social scientist who would disagree with this statement, it is rather more difficult to achieve interdisciplinarity in research (e.g. Borofsky 2002, Turshen 1984), and to point to its specific influence on research outcomes. As Turshen (1984:17) wrote, “the division of knowledge into disciplines handicaps problem solving in public health.” This paper addresses the issue of interdisciplinarity from the focus of Auckland. Specifically we describe the organisation of one interdisciplinary project, the ‘Political Ecology of TB in Auckland’ (fondly known as the PE of TB), and ask the question does interdisciplinarity provide new perspectives on the issue?
Conceiving a research project
The PE of TB project was a four year project funded by the New Zealand Health Research Council and the University of Auckland. The project commenced in 2002; funding finished in 2006. It involved academics from a range of disciplines: anthropology (both biological and social), geography, history and initially sociology, as well as students from these areas and political studies. The students undertook the main work as a series of Masters and Doctoral theses.
The conception of the project began with interdisciplinarity within anthropology. Julie Park and I co-teach an undergraduate course in medical anthropology. One of the main themes of the course is that the way to understand health is through multiple approaches. From that we became involved in the Social Science for Public Health programme at the University. This meant there were numerous places where there was a forced engagement between different social science perspectives around the issue of health. Arguing for interdisciplinary approaches while teaching raised the prospect of actually engaging in interdisciplinary research. Hence the research impetus for a social science study was born. But of what? The other side of the coin in the project became public health and specifically TB. In informal discussions, Dr Lester Calder, then Medical Officer of Health in Auckland, shared his concern that the rates of tuberculosis appeared to be showing an upward trend. In particular, he was worried about the difficulties of contact tracing, ensuring timely diagnosis, and patients adhering to treatment (Calder 2000, Calder et al. 2001).
TB in Auckland
TB remains a major cause of death around the world despite the condition being largely treatable (Gandy and Zumla 2002). While TB is commonly assumed to be associated with poverty and third world populations, as in many other places it never really disappeared from New Zealand. The increase in numbers observed around 2001 was caused by this mixture of local and global history.
The epidemiology of tuberculosis in New Zealand has been discussed in Chapter one by Thornley and Pikholz. The most obvious gradient is the disparity in rates by ethnicity (Table 1). This is particularly salient for Auckland which experiences the highest TB rates with a very high proportion of overseas born patients (Figure 1).
Chapter 1 Patterns of Tuberculosis Epidemiology in Auckland, 1995-2006
Chapter 2 Man’s Best Friend: Implications of Tuberculosis in a 16th Century Neutral Iroquois Dog from Canada
Chapter 3 The Political Ecology of Tuberculosis in Auckland: An Interdisciplinary Focus
Chapter 4 Tuberculosis and Syndemics: Implications for Winnipeg, Manitoba
Chapter 5 Sorting out TB and Immigration: Politics and Statistics, a View from New Zealand
Chapter 6 An Empowerment Approach to Raise Awareness about and Reduce Stigma around Tuberculosis among the Indian Community in the Auckland Region
Chapter 7 The Treaty of Waitangi Principles in He Korowai Oranga–Maori Health Strategy: A Critique from the Perspective of TB Care
Chapter 8 Matching Research with Evidence: Reorienting Aboriginal Tuberculosis Research in Canada
Part 2 Reproducing Tuberculosis
Introduction: Reproducing Tuberculosis
Chapter 9 The Contribution of Tuberculosis to the Mortality of British Soldiers 1830-1913
Chapter 10 Tuberculosis Mortality among the Students of St. Joseph’s Residential School in 1942-44: Historical and Geographical Context
Chapter 11 “She was weakly for a long time and the consumption set in”: Using Parish Records to Explore Disease Patterns and Causes of Death in a First Nations Community
Chapter 12 Norway House Residential School and Tuberculosis, 1900-1946Chapter 13 A Political Ecological Perspective on Housing Conditions and Tuberculosis Transmission
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Multiplying and Dividing Tuberculosis in Canada and Aotearoa New Zealand
