Analyze

The authors offer a review of themes within occupational health and environmental public health surveillance over the past decade. In reviewing the history of public health surveillance, the authors highlight key acts of Congress in the 1970s that have made the development of “modern” occupational health and environmental health surveillance possible—but which also failed to develop into a cohesive and well-connected data management systems across federal agencies. Separate agencies were tasked with different data collection, management and intervention tasks in ways that fragmented the surveillance system to the point of ineffectiveness.

The authors argue that effective surveillance for occupational and environmental health demands development of a clear purpose for collecting data and having the data available to make meaningful analysis possible. They turn to the CDC’s childhood lead prevention program to demonstrate these points.

Byron Good, Ph.D., is a professor of Medical Anthropology at Harvard Medical School. His primary area of research is mental illness and how social perceptions evolves around these issues, in terms of both treatment and social acceptance. Dr. Good has several works on these issues, including several that explore the perspective of bio-medicine in non-western medical knowledge, the cultural meaning of mental illness, and patient narrative during illness. His publications including several papers, books, and edited volumes; he is regarded as a major contributor to the field of psychological anthropology. 

The article primarily asserts that how a patient narrates or describes their medical history is deeply rooted in their native culture. As such, physicians must be aware of how an individual's medical experiences can be altered based on this. In turn, physicians must recognize the importance of story-telling and anecdotes when receiving information directly from patients. Narratives project the patient's experience and events through their perspective, granting professionals a glimpse into their thought processes and action patterns.

The author, Byron J. Good, is a Harvard professor in the department of global health and social medicine. He is the director of the International Mental Health Training Program, and has significant experience with field research that has led to many publications.

The article’s main argument is that the narration of an illness is founded in the emotional connection it has to the sufferers life, the place from which they view the illness which includes individual and cultural aspects. Furthermore any lack of factual accuracy is an indicator of the social and cultural environment in which the illness presents itself and is revealing as to how it will be perceived and treated.

The main argument is supported primarily through interviews with many individuals living in Ankara, through which they describe the first presentation of their seizures and in many cases the steps they tool to attempt a cure. Along with the interviews, statistics of the individuals interviewed and their diagnoses is used to provide a reference point to better understand their stories. Finally the article includes an analysis of narratives in a more general sense that can be applied to the narrative of an illness.

• “… illness narratives - both the corpus of story episodes and the larger life "story" or illness narrative to which they contribute - have elements in common with fiction. They have a plot; succession is ordered as history or event, given configuration.” (164)
• “The diverse accounts of the illness in these narratives represent alternative plots, a telling of the story in different ways, each implying a different source of efficacy and the possibility of an alternative ending to the story. My point is not that persons having access to a plural medical system do not simply choose among alternative forms of healing but instead draw on all of them” (155)
• “Predicament, human striving, and an unfolding in time toward a conclusion are thus central to the syntax of human stories, and all of these, as we will see, are important to stories about illness experience.” (145)

The article provides statistics and excerpts of interviews to support its analysis of the narrative of illness. There are also several quotes from other works that analyze story and narrative to support the claims of the importance of emotion as a method of sharing the plot.

Emergency response is not addressed in this article however it does provide emergency responders with insight into the stories those suffering from illness will have to explain their suffering. As emergency responders will often be working in societies and cultures very different form their own in the case of disaster response, it is important to understand that what may seem like fiction in a story cannot be dismissed without considering the deeper cultural significance of those elaborations.

This article has not been references extensively, it appears to have been used in further research done by the author but I could not find other articles that referenced this one.