Visual Ethnography and Health

I came upon “Visual Ethnography: Tools for Mapping the AIDS Epidemic,” a 1990 article by Eric Margolis (who is quite famous for his visual ethnography work). This article is helping me “join the conversation” about visual ethnography as a method for studying health issues. Interestingly, Margolis was ahead of his time. In the wake of the recent digital humanities tide (manta: “put a map on it!”), Margolis situates mapping illness as an important way to figure out where health issues exist and the best means to treat them. He also describes image making rhetorically. He argues, “Skepticism that statistics do not tell the whole truth actually makes it possible for us to interpret quantitative data. In a similar vein, being aware that visual images distort and misrepresent reality can help us to define an appropriate role for the use of nonverbal images in qualitative studies” (371). Later, he adds that visuals can “mislead differently” than language (and I assume he’s talking about print texts?) (374). Margolis helpfully traces the history of the incorporation of photographs into sociology and ethnography; he also distinguishes this from photojournalism. (Note: one of this first and most famous uses of photograph in anthropology dates back to Margaret Mead and Gregory Bateson’s study of Bali). Regarding issues of health, Margolis argues that photographs “convey a human scales that is missing in volumes of words and statistics” and that they “have the potential to not just illustrate but illuminate; social processes, events, relationships, and meanings can be discovered in photographs and graphic images” (374). As a case study, he analyzes the work of a San Francisco-based health outreach group, which aims to stop the spread of AIDS by tracking it ethnographically and then working in those areas to prevent transmission (375). What’s not so great about this work is that Margolis seems to unreflexively incorporate image of individuals who are part of multiple marginalized groups without any regard for the individuals themselves. For instance, there is a picture of “prostitutes” receiving condoms from a health worker and a “transvestite” sitting on a car. Margolis does not talk about how these images were solicited, if people gave permission to be photographed, what the people in the photographs thought of the photographs, etc.

Thankfully, there are plenty of other texts to fill in the gaps. A 2015 review article about participant photography as a research method in nursing studies by Balmer, Griffiths, and Dunn lays out how researches might plan, create and interpret photographic data, ethical and legal considers, and impact on research. Other recent texts, such as Melvin Delgado’s Urban Youth and Photovice: Visual Ethnography in Action (2015) as well as

Some texts, including Urban Youth and Photovoice and Switza et al., “Visualizing harm reduction: Methodological and ethical considerations” (2015), focus on photovoice. I’m not sure how different photovoice vs. photo elicitation vs. photo production stories vs. visual ethnography are the same or if they are actually separate methods. I’m grateful that Switza et al. has a lengthy literature review about photo methods in health research and points me to Collier (1957) and Harper (2002) to learn about photo elicitation and Wang (1999) and Wang and Burris (1997)  and Wang et al. (2004) to learn about photovoice. A few studies (such as Morrison and Thomas 2015 and Bukhave and Huniche 2015) focus on work and occupation, which usefully intersects with my health humanities research. Others highlight literacy (Wargo 2015).  Apparently these methods fall under “arts-based research,” which is interesting to me because I originally approached my investigation from a narrative-based research perspective.

I’m excited to see what comes of this…but for now I have to go eat dinner because I am getting cranky.

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