INTRODUCTION TO DIVERGENT PATHWAYS IN APPLIED ANTHROPOLOGY CAREERS

How are we practicing anthropology in the 21st-century?

Where, and in which capacities, are we working as scholar-practitioners?

Can crossing disciplinary boundaries help to address complex community problems with anthropological insights?

How should graduate students be trained to tackle these real-world community problems?

Can scholar-practitioners’ stories help revise and reimagine our training programs?

While we know that the majority of anthropologists currently work outside the realm of academic faculty positions in departments of anthropology, we often do not know these anthropologists’ stories. At the 2018 meetings of the Society for Applied Anthropology in Philadelphia, the guest editors of this special issue organized and participated in in which researchers, practitioners, and educators trained in anthropology shared stories of their careers. These accounts described unexpected opportunities and challenges early in their professional lives and reflected on how practice in community and health care settings, interdisciplinary collaboration, and participation in community networks were essential experiences in building their skills and competence.

The disconnect between our panel members’ original training in anthropology departments and the diversity of their career paths raises some key questions: Have academic programs sufficiently prepared students to practice anthropology? Are training programs in field methods adequately transmitting the interdisciplinary skills needed for applied careers? To begin addressing these questions, we consider excerpts from stories spanning forty years that illustrate the changing roles and status of applied anthropologists.

Four Brief Narratives about the Evolving Roles of Applied Anthropologists

Ann McElroy

“When my husband and I traveled to California in 1978 for a sabbatical year of research with farm workers, I first met with a representative of the United Farm Workers (UFW), Cesar Chavez’s organization, to offer my volunteer services as an anthropologist. I explained how I could work as a participant-observer and interviewer to document migrant farm workers’ needs for health services. After listening politely, the representative said, ‘We know what our health care needs are, but what we need are more doctors and public health workers committed to providing that care. But what can an anthropologist do? Do you have medical training?’ In other words, he wanted me to be a practitioner, but nothing in my résumé assured him that I could actually use what I learned to link farmworkers to health resources.

Eventually, I arranged to do volunteer work in a church-based program and spent the next eleven months doing ‘participant learning’ (that is, self-directed training) in an underserved Hispanic farmworker community in northern California. My husband and I found ample opportunities to address community needs without UFW sponsorship. These included helping families find food supplies from local food banks during a strike, identifying barriers to health care access through household surveys, and helping Hispanic addiction counselors seek funds for an alcoholism prevention program targeted to farmworkers. After returning to Western New York, I applied my experience in California to developing student projects with local migrant farm workers and clinic providers.”

Gemmae Fix

“I am a federal employee working in the Veterans Health Administration (VHA), the largest integrated health care system in the United States. The presence and value of anthropologists is explicitly touted as a strength of VHA’s research program. The national director of VHA health services research has repeatedly and publicly proclaimed the important perspective that anthropologists bring. He demonstrated this by serving as the moderator of a double panel at the 2014 Society for Applied Anthropology meeting in Albuquerque and later writing about it (Atkins 2014). Notably, though, much like McElroy’s experience, he implored us anthropologists to turn our insights into action.”

Renee Cadzow

“I was spending an evening with the women in my leadership fellow-ship program, and we were discussing everything from gender politics to healthy eating to mental health. Somehow, the topic of the noncanonical texts of the Bible came up, and I proceeded to share some knowledge about Thecla (a female disciple of Paul who receives no mention in the traditionally accepted versions of the New Testament.) One of my friends turned to me and said ‘You’re like Wikipedia. I feel like I can just throw out a topic, and you have some knowledge about it.’ I responded, ‘I think it’s because I’m an anthropologist. Everything is connected. Everything is interesting.’”

Linda Kahn

“In 2010, a physician colleague asked me to collaborate on a large, multisite National Institutes of Health (NIH) grant proposal to improve primary care physicians’ detection, diagnosis, and treatment of early chronic kidney disease. NIH had reviewed the proposal favorably but advised the principal investigator to resubmit with a ‘process evaluation’ that would incorporate qualitative methods to identify barriers and facilitators to implementation. My physician colleague emphasized that the team needed a medical anthropologist to develop the process evaluation. I became a coinvestigator on the proposal and designed a qualitative process evaluation with a diverse, national team of researchers. NIH funded the proposal, and we hired a recent anthropology Ph.D. graduate, Bonnie Vest. Together, we led the process evaluation on this multisite NIH study and interviewed primary care physicians across the United States to examine barriers and facilitators to CKD guideline implementation and management of CKD in the primary care setting (Vest et al. 2015). Nine years later, with the current emphasis on pragmatic clinical trials and dissemination and implementation research, Vest and I are frequently asked to mentor physician-researchers on qualitative and mixed methods approaches.”

These four narratives illuminate themes that occur throughout this special issue: the diversity of ways we are perceived by others, how we engage with non-anthropologists, and the variety of skills that we use to conduct research in communities, hospitals, clinics, schools, and other settings. There is no single template for becoming and being an applied anthropologist. Rather, practitioners have diverse backgrounds, take on many roles, and often continue developing skills and knowledge long after completing their formal education.

Encouraged by the engaged and dynamic discussion among presenters and positive audience feedback during our session at the 2018 SfAA meetings, we developed this special issue of Practicing Anthropology to disseminate information shared in the session to a wider audience. To elicit contributors, an invitation went out to colleagues: “Let’s write about how we practice anthropology.” Five individuals who had participated in the session in Philadelphia agreed to contribute papers; eight others accepted our invitations to submit new papers. The authors represent three generations of anthropologists with diverse training backgrounds, professional statuses, and current roles. Some are faculty in departments of anthropology, family medicine, health services administration, and global medicine; others have worked as practitioners and researchers since graduating; and two have written about their graduate school experiences.

The papers focus on three major themes. The first encompasses authors’ experiences dealing with the realities of diverse employment trajectories in their careers. Their narratives reflect on lessons learned while flexibly pursuing professional goals, acquiring cross-disciplinary skill sets, and attempting to communicate anthropological perspectives to medical and community-based agencies. We hope these histories of adapting to divergent work opportunities will be useful for educators, students, and younger colleagues entering the job market.

A second theme considers new models for graduate and post-graduate training programs, including options that provide students a range of potential practice experiences while pursuing graduate degrees and post-MA/Ph.D. training. These options include internships, dual degree programs, collaborative projects, participatory action research, and other formats for working effectively across disciplinary boundaries.

A third theme relates to how stereotyped public images of anthropologists can create barriers to imagining what an anthropologically-trained person can do in a hospital, clinic, or community agency. Ann McElroy’s challenges in negotiating with the United Farm Workers illustrates this problem. The different job demands and work schedules of practitioners and educators isolate them from one another and promote communication gaps. Isolation from colleagues may undermine one’s sense of professional identity. As one of our authors (Jessica Somers) states, there is risk of losing our “anthropological compass” when we choose to work in hospitals, government agencies, nonprofit organizations, and other settings.

Numerous distinctions exist describing types of anthropology and types of careers: academic, applied, practicing, among others (Boyle and Cools 2018; Fiske and Freidenberg 2018). At times, these distinctions are hierarchical and create significant barriers between university-based and community-based anthropologists. Such gaps and barriers may present a dismal picture for graduates looking for meaningful careers as scholar-activists. Our intention in this special issue is to evaluate reasons for those perceived differences, but also we plan to bridge those differences and highlight our common denominators as individuals who have chosen anthropology as a profession.

An Overview of the Papers in This Issue

Our papers begin with accounts by four individuals who followed unusual and challenging career trajectories. Renee Cadzow, Associate Professor of Health Services Administration at D’Youville College in Buffalo, New York, offers insights on a career and personal path that diverged from a traditional academic one and emerged in response to the needs of community and the flexibility to seize opportunities presented. Linda S. Kahn, Research Professor and Associate Vice Chair for Research in the Department of Family Medicine at the University at Buffalo, details how her career path has spanned corporate finance, college teaching, psychiatry research, evaluation, health services research, and translational community-based research. Bonnie M. Vest, a Research Associate Professor in the Department of Family Medicine at the University at Buffalo, writes about her experiences as a “liminal” anthropologist and illuminates the challenges and opportunities that arise from working between and across traditional disciplinary categories. Kathryn M. Glaser, an Assistant Professor of Oncology in the Department of Cancer Prevention and Control at Roswell Park Comprehensive Cancer Center in Buffalo, New York, describes a unique set of cross-disciplinary skills that grew from experiences ranging from study abroad to hospital administration.

The next three articles focus on training programs in university settings. Nancy Romero-Daza, Professor in Anthropology at the University of South Florida, and David Himmelgreen, Professor and Chair in Anthropology at the University of South Florida, discuss lessons learned over twenty-one years of training undergraduate and graduate students. The authors recognize the increasing importance of applied anthropology as an academic field in which faculty train a new generation of practitioners.

Romero-Daza and Himmelgreen describe strategies for preparing students for flexible career choices, either positions at colleges and universities or practitioner careers outside academia, or both. These strategies include workshops in professional skills such as writing grant proposals and submitting Institutional Review protocols in the curriculum; cross-disciplinary courses on professional ethics; summer field schools in Costa Rica and Puerto Rico; and collaboration with nonprofit agencies as well as the private sector on local issues such as food insecurity.

A second paper on training programs describes a cross-disciplinary, team approach in developing an MS in medical anthropology program in the School of Medicine at Boston University. The authors, all faculty in medicine at Boston University, are Linda L. Barnes, Professor of Family Medicine and Director of the MACCP program; Lance Laird, Assistant Director of the program; and Bayla Ostrach, Assistant Professor of Family Medicine and affiliated faculty of the MACCP program.

Following the training section, two articles written by early career authors give us insights about training experiences within applied anthropology and public health disciplines. Sedona L. Koenders, a recent MS graduate from Boston University School of Medicine’s MS program in medical anthropology, writes about her anthropological training within a Service Learning Internship Program (SLIP). This program provides hands-on applied anthropology training in “real-world” settings enabling students to deploy anthropological skills and perspectives in the workplace. Koenders’ co-authors include Linda Barnes, Lance Laird, Bayla Ostrach, and her internship supervisor, Gemmae M. Fix, a Research Health Scientist with the VA Center for Healthcare Organization and Implementation Research (CHOIR) who also holds an appointment as a Research Assistant Professor with Boston University’s School of Public Health.

Jessica Somers, a Ph.D. candidate in Cultural Anthropology at the University at Albany, SUNY, describes the formation of her “cognitive anthropological tool kit” emerging during dual training in public health and anthropology and discusses professional and ethical conflicts that can arise when questioning “How am I using my anthropological training?” during employment in a community health program.

The next paper by Jennifer Randall focuses on pedagogical issues. She describes how a revised anthropological curriculum helped students and teachers alike in London, England, to articulate a critique of current neoliberal policies and actualize a social justice ethos in community health training of minority students. Randall is a Lecturer in Global Public Health and the Programme Co-Coordinator of the Distance Based MSc in Global Public Health at Queen Mary University of London.

In our final paper, Gemmae M. Fix, a Research Health Scientist with a VA Center in Boston, and Ann McElroy, Associate Professor Emerita of Anthropology at the University at Buffalo, SUNY, offer a commentary and analysis of the papers within the larger discussion of anthropology career training and paths in the 21st century. They note fluctuations in anthropology’s emphasis on practitioner careers in the 20th century, including reduced training of applied skills in some higher institutions. The paper concludes with recommendations that practitioners’ narratives about challenges and opportunities be used to re-imagine graduate training programs and to increase the visibility of applied careers across the broad anthropological community.

Goals for This Special Issue

We anticipate that these papers will spark conversation and foster camaraderie among practicing anthropologists, especially those embedded in organizations outside of traditional departments of anthropology. Many of us have experienced isolation while practicing anthropology in medical schools, hospitals, corporations, public health departments, and other settings. On the one hand, being “the only anthropologist in the room” enables us to disseminate anthropological perspectives, such as cultural competency, in these diverse settings. At the same time, however, it is important to feel that we are part of a larger community of practitioners and scholars. An anthropological community bridging both academic and public spheres can provide a sounding board for unique challenges anthropologists might encounter in community settings, help strategize innovative study designs, or link a problem encountered in practice to the larger anthropological literature. Without this discourse, lone anthropologists are left to navigate paths without support from others who have previously followed such journeys.

Of equal importance, we hope to unify and more fully integrate the worlds of practitioners and academics. There should be no essential difference in the inherent value of those who teach and those who practice. In her 2017 Malinowski Award lecture, Louise Lamphere (2018) describes a series of challenges and recommendations to further “collaborative and activist research” within departments of anthropology. Two of her recommendations particularly resonate with the papers presented in this special issue:

1. to “train graduate students so that they develop the skills necessary to approach potential research partners, define a problem collaboratively, design research projects, and provide feedback to collaborators,” and

2. to recognize that “traditional academic departments must hire more faculty who are engaged in collaborative/activist research and make changes in Ph.D. programs to encourage students to take this approach.” (Lamphere 2018:73–74)

The Society for Applied Anthropology was founded in 1941 and now has over 2,000 members. We find it striking that seventy-nine years after the establishment of the SfAA, Lamphere, a distinguished anthropologist, felt compelled to make a long-overdue recommendation that more applied faculty be hired for faculty positions and that doctoral programs encourage students to consider collaborative/activist careers.

Final Thoughts: The Value of Stories

Medical anthropologist and physician Arthur Kleinman (1999:x) once wrote: “Stories open up new paths, sometimes send us back to old ones, and close off still others. Telling and listening to stories, we too imaginatively walk down those paths—paths of longing, paths of hope, paths of desperation.” The narratives told in this special issue demonstrate the diversity of paths open to anthropologists and the challenges that these paths hold. The stories provide opportunities for others to reflect on their own past and future careers and to realize that having anthropologists embedded in a diversity of organizations and explicitly identifying themselves as anthropologists is an opportunity to demonstrate the value of the discipline well beyond academic domains.

We hope that the papers in this volume will resonate with our colleagues who teach and train students in academic and applied settings, with students in anthropology and other social sciences and health programs, with post-degree individuals seeking employment and making career choices, and with college and vocational counselors. The articles may also serve as supplementary readings for college and university courses in research design and methodology and will be relevant to courses on applied anthropology. Ultimately, we hope that our articles will inspire students to see anthropology everywhere and seize opportunities to share their perspective with others.

Biographies

Presenters at the Session on “Divergent Pathways in Community Health Research” at the 2018 Annual Meeting of the SfAA. (front row): Renee Cadzow and Gemmae Fix (back row): Ann McElroy, Tim Dye, Nancy Romero-Daza, and David Himmelgreen

Renee Cadzow with Fellow Co-Chair of the Community Health Worker Network of Buffalo (CHWNB), Dierdre (left) and CHW Trainer, Denise (right)

Ann McElroy (mcelroy@buffalo.edu) is Associate Professor Emerita at the University at Buffalo, SUNY. Her research interests include medical ecology, the history of cultural and environmental change among Canadian Inuit, and disability studies. As an applied medical anthropologist, she has focused on graduate student projects with underserved populations, including migrant farm workers, immigrants, and families traumatized by violent death.

Renee Cadzow (cadzowr@dyc.edu) is a biocultural anthropologist now working as Chair and Associate Professor of Health Services Administration and the Director of the Center for Research on Physical Activity, Sport & Health at D’Youville College. She is also the board co-chair, a trainer, and evaluator for the Community Health Worker Network of Buffalo and an advocate for community and maternal/child health in the Buffalo, New York, region.

Linda S. Kahn (lskahn@buffalo.edu ) is a Research Professor and Associate Vice Chair for Research in the Department of Family Medicine at the University at Buffalo. Her research focuses on people living with substance use disorders (SUD), mental illnesses, and chronic disease in the community, clinical settings, and criminal justice system.

Gemmae M. Fix (gemmae.fix@va.gov) is a Research Health Scientist with the United States Department of Veteran Affairs, Center for Healthcare Organization and Implementation Research (CHOIR) and a Research Assistant Professor with Boston University’s School of Public Health. In these roles, she actively promotes the practice of anthropology. Her research focuses on bringing patients’ life experiences into health care.