Analyze

“Under a 1986 federal law titled the Emergency Medical Treatment and Labor Act (EMTALA), hospitals are required to treat people who come to the ED presenting with an emergency medical condition, defined as a condition that, without treatment, will likely lead to serious impairment or death. … EMTALA is one of the largest federal mandates to provide services to have gone unfunded (Friedman 2011); costs instead fall on states and local health care systems.” 481

“In bringing ethnographic attention to hot spotting as a technique of governance, we find that it provides lifesaving humanitarian interventions while operating within the racialized structures of violence that produce continual life crises. The institutional rationality of hotspotting and the encounters of care that it produces illustrate the often-contradictory role of medicine in the lives of poor people: both caring and coercive, it intertwines care and violence.” 475; “we conclude by suggesting that economic investment and return are becoming a reigning logic in the governance of poverty, generating hot spots as sites of interest for both policing and health care and decentering normative assessments of deviance, illness, and social problems” 476; “Neoliberal social assistance, as it is practiced in the health care safety net, is conceptualized as an “investment “in the population, as a strategic and targeted deployment of basic resources, one that promises to generate a return on investment for the state or health system in the form of cost savings.“ 485

 The authors examine the practice of “hot spotting,” a form of surveillance and intervention through which health care systems in the US intensively direct health and social services towards high-cost patients.  Health care hot spotting is seen as a way to improve population health while also reducing financial expenditures on healthcare for impoverished people. The authors argue that argue that ultimately hot spotting targets zones of racialized urban poverty—the same neighborhoods and individuals that have long been targeted by the police. These practices produce “a convergence of caring and punitive strategies of governance” (474). The boundaries between the spaces of healthcare and policing have shifted as a “financialized logic of governance has come to dominate both health and criminal justice” (474).

What I find really noteworthy in this text is how Julia Watts Belser takes the poem by Leah Lakshmi Piepzna-Samarasinha and includes it into a scientific text. In this way, she not only allows an affected person to have her say, the poem also leaves the reader with a very striking image of the connection between the river and the body, in multiple ways, as well as the connection between enviromental harm and disability.

The text was published in 2020 (Vol. 40, No. 4) by The Ohio State University Libraries in their Journal Disability Studies Quarterly (DSQ). It is, as you can read on their Homepage "a multidisciplinary and international journal of interest to social scientists, scholars in the humanities and arts, disability rights advocates, and others concerned with the issues of people with disabilities. It represents the full range of methods, epistemologies, perspectives, and content that the field of disability studies embraces. DSQ is committed to developing theoretical and practical knowledge about disability and to promoting the full and equal participation of persons with disabilities in society."

The author connects disability theories and activism with environmental justice, this approach allows her to show how disability is related to and through environmental harm, she shows how diagnoses are used politically in these cases, and looks critically at how these processes determine how, when and in what favor human and environmental harm is taken into account. The writing is shaped by the consequences of the Anthropocene like environmental harm linked to health isusses, especially affected are communities of color and poor communities in the United States, here pre-existing patters of structural inequality, already known from climate change come into play,  this communities are the most affected and the least responsible.

I think what is very striking in this text, is the author puts her perspective of the disability studies and uses it to draw lines from the disability studies, more particular the queer black disability studies, to the environmental justice movement. From reading the text, I think one can see, that Julia Belser is very involved in disability studies and the field of critical medicine/ psychology. The way she describes that we should turn away from always seeking to get (back) the pure nature, the healthy environment, the "healthy" body, she reminded me of the general idea of overcoming pure categories (for example Latour etc.) - and dualisms. Additionally, I think one could locate her in the area of inequality studies and the field analyzing structural violence.