Health
At EthnoLab, we are guided by the World Health Organization’s 1948 definition of health: A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
Our work begins from the premise that social conditions and structures affect community members’ health. These forces include: stigma, racism, intergenerational trauma, gender norms and social inequalities; kin and caregivers’ roles in providing and accessing care; patient care provided at places and spaces of healing; unintended health-related impacts of policies and programs; and the experience of suffering from a disorder or illness and the further harms that follow.
We collaborate with our clients to learn how these social forces affect their clientele, and to develop programing that minimizes the negative effects of these social realities on their clientele’s health.
Read below to learn about how we worked with our clients on projects related to Stigma and Migraine Disease, Vulnerabilities to HIV in Somalia, the opioid epidemic in Philadelphia, and frequent use of hospital ERs.
Stigma and Migraine Disease
Migraine is a highly stigmatized disease, and Miles for Migraine programming educates, supports and advocates for people living with migraine. EthnoLab assessed the non-profit’s educational symposium to evaluate what participants learned and barriers they experienced in advocating for themselves in the real world after the symposium, including with their healthcare provider.
EthnoLab found that disclosure of migraine and other forms of self-advocacy may pose risks to individuals by reinforcing internalized stigma when advocacy is rudely rebuffed; by jeopardizing access to healthcare when doctors “fire” patients (especially where healthcare access is limited by geography or insurance); and by jeopardizing standing and reputation in the workplace after disclosure. This finding is important because patient-advocacy organizations typically promote self-advocacy as a means to reduce global stigma, but this approach places the onus of social change on individuals who are already burdened by disease, thereby potentially causing even more harm when social change does not happen.
Read the report and see the poster presented at the American Headache Society’s 67th Annual Scientific Meeting in Minneapolis in June 2025 by following this link.
Vulnerabilities to HIV in Somalia
In this project with UNICEF for The Global Fund, we partnered with local HIV organizations in four cities in Somalia, Somaliland and Puntland to learn about the social landscape of HIV vulnerability among men and women, local residents and displaced persons.
In sensitive interviews and intimate discussions with more than 75 people, we spoke with former street children, soldiers, taxi and tuktuk drivers, truck drivers, pharmacists, women whose work makes them vulnerable to power dynamics from the men they encounter, people affiliated with khat usage, people who are displaced from sources of support due to work or war, and people who have knowledge of or use opioids.
We were able to identify vulnerability hotspots where peer educators could conduct outreach, and this programming has begun. We also found evidence that there is an ongoing unreported opioid epidemic in Somalia. Finally, EthnoLab’s work clarified the social landscape of HIV, providing foundational information for future research, programming and policy design.
Understanding the Opioid Epidemic in Philadelphia
EthnoLab worked in collaboration with the Philadelphia Department of Public Health to learn about barriers and bottlenecks that keep healthcare providers from prescribing buprenorphine to patients who want to stop using opioids. This research was sponsored by the Centers for Disease Control and Prevention.
Other work on the opioid epidemic in Philadelphia includes the Next of Kin project Anastasia spearheaded while at Ethnologica. In that project, researchers interviewed next of kin of 35 people who died of opioid overdose in 2017, the year Narcan became widely available and the same year there was a surge in overdose deaths. Of the 1,217 people who died of overdose in Philadelphia that year, more than 75% died at a private residence. Little was known about this hidden population of drug users - whether they had accessed any social or health services in the past, and how their kin interpreted harm reduction interventions.
These projects resulted in several peer-reviewed publications, a poster presentation, and an invited lecture.
Project Scholarship
Aronowitz, S and A Hudgins. 2022. “Problematizing ‘patient stability’ in opioid use disorder care: Flexible definitions, (in)flexible treatment.” International Journal of Drug Policy. 108: 103804.
Hudgins, A, B Uzwiak, L Pizzicato, and K Viner. 2021.“Barriers to Treatment and Quality Care – Insights from Qualitative Research with Next of Kin of Persons Who Died of Overdose in Philadelphia.” Journal of Substance Abuse Treatment.
Uzwiak, B, A Hudgins and L Pizzicato. 2021. “Legacies of War on Drugs: Next of kin of persons who died of opioid overdose and harm reduction interventions in Philadelphia.” International Journal of Drug Policy. 97; 103351. https://doi.org/10.1016/j.drugpo.2021.103351.
Uzwiak, B and A Hudgins. 2020. “Dying Alone, Dying at Home: Qualitative research with next of kin of opioid overdose victims in Philadelphia.” Poster presented on the panel entitled “Addiction.” Society for Medical Anthropology, Havana, Cuba.
Hudgins, A. 2019. “Narrating Addiction: Weaving Subjectivity through Ethnography,” Global Studies Lecture Series: Mellon Wide Angle Learning Grant Project in Health Humanities. Global Studies Department, St. Lawrence University, Canton, NY.
Drivers of Emergency Department Use: Disrupting the “Frequent Flier” Narrative
In this interdisciplinary project we interviewed emergency room patients at two Philadelphia hospitals to learn about the sum of factors that drive patients to seek care in the ER. The research objective was to learn more about patients’ priorities as situated within their everyday lives and routines.
Qualitative research affords insight into not just what people do but why, and this can lay the groundwork for developing effective interventions and policies. This project used semi-structured interviews with discharged patients in the ER, and ethnographic research with a subset of patients in their homes.
The project challenges the popular discourse about so-called “frequent fliers” that blames people for using emergency rooms non-urgent care. Findings from the research suggest these patients are motivated by fear and uncertainty about their condition, and that this fear is exacerbated by lack of structural competency at the institutional level and an “inattention blindness” which ignore patients’ diverse lived experiences in seeking health care.
This work resulted in scholarship for social science and clinical medicine audiences, and included peer-reviewed publications, a conference presentation, and an invited lecture.
Project Scholarship
Hudgins, Anastasia and Kristin L Rising. 2016. “Fear, Vulnerability and Sacrifice: Drivers of Emergency Department Use and Implications forPolicy,” Social Science & Medicine. 159:50-57. doi: 10.1016/j.socscimed.2016.09.030.
Rising, KL, A Hudgins, M Reigle, JE Hollander, BG Carr. 2016. “I'm Just a Patient": Fear and Uncertainty as Drivers of Emergency Department Use in Patients With Chronic Disease,” Annals of Emergency Medicine. 68 (5): 536-543.
Anastasia Hudgins. 2017. “Anthropology in the ER: Methods and Epistemologies.” Paper presented on the panel entitled “Collaboration across the Divides: Anthropologists in Medicine.” Society for Applied Anthropology, Santa Fe, NM.
Anastasia Hudgins. 2017. “Fear, Vulnerability and Sacrifice as Factors in ED Use: Ethnographic Research Methods and Their Insights.” Invited lecturer, Innovative Discoveries Series, sponsored by the Delaware Clinical & Translational Science ACCEL program and the Value Institute at Christiana Care Health System, Newark, Delaware.