“Health…But”

For full disclosure, I’ve known Jenna Loyd for years. Therefore I can’t divorce my experience of reading of her new book, Health Rights Are Civil Rights from knowing her as both a scholar and a friend. As long as I have known Jenna, she is constantly on the move, intellectually restless, travelling constantly, and always seeking political change. As a practice, Jenna adds a “militant” modifier to this movement, a reminder that everything can be turned into a political moment and open to analysis. When Jenna rolls into town, she gathers together an amazing group of scholar/activist/artists and she is always bringing in new people, forming an ever-increasing constellation of thoughts and actions. How I was brought into her circuit was such an illustrative exchange, indulge me for just a moment because this digression is a good introduction to the book.

I was visiting Syracuse, I found myself in corner of a large social gathering with Jenna. We introduced ourselves and eventually, I asked the worst question ever, “so what do you do?” Jenna replied “Well, health…but” and all these caveats came pouring out: militarization, feminism, violence, abolition, anti-racist, justice, and immigrant dentition. I got excited “I do health too…But” and I added my own waterfall of caveats. This “health…but” moment is useful because it articulates how Jenna’s book is not only a contribution to the sub-discipline of health geography, but also to geography writ large or at least a geography based in historical geographical materialism. To explain, let me put on a more formal voice.

While the book’s title starts with the word “health,” Loyd gives us a much broader history of political organizing in California. She illustrates how health is a process that emerges from a wide variety of mobilizations around the necessities of everyday life. Health is a product of these political struggles. And, accordingly, health is also highly uneven, depending on race, class and geography. Loyd starts from the political and writes a particular history of Los Angles from early 1960s to the 1980s that pulls apart the tangled threads of: anti-racist activism and state violence; property rights, planned shrinkage, and urban crises; the military industry complex and welfare rights organizing; and the war on poverty and the feminist self-help clinics. Loyd shows how these threads of local activism and politics of identity were not discrete, rather they interact in specific sites, against institutions, or through key activists. Loyd situates these interactions in the landscape of LA. The book is an on-the-ground account of the messy and fractious politics of particular communities and for particular sites and neighborhoods, and how these movements were structured by patriarchy, white supremacy, neglect, slow violence, and slow death.

At its core Loyd’s book follows “popular struggles for health—social welfare, housing, jobs, parks, peace, justice, child care, and a clean environment” (2). Now, if you take health out of that sentence, the book is a geography of popular struggles. And the ‘geography of popular struggles’ is a great definition what Loyd does as scholar, albeit in different places, time periods and struggles. So why leave in health? What work does that health modifier do? Loyd shows how popular struggles became articulated through health. The archives told a story of how health became the vehicle through which people lives and community actions became articulated. In addition, Loyd contributes her own definition of health, a very particular formulation that I have not seen elsewhere in geography, or beyond. Her definition envisions health as “individual and collective bodily self-determination” (2, my emphasis). This version of health is completely outside of the “normal and pathological” binary (Canguilhem, 1989) that limits the imaginations of health, especially by doctors, experts, policy makers, and many times geographers. The health articulated in this book is markedly different than healthism (see Guthman, 2012 for a brilliant takedown of that concept) or “total health” based on some mythical unattainable equilibrium of either the mind and/or the body (69). Loyd’s definition is health…but a health founded upon politics, a necessarily political definition, even pre-figuratively political. The “and” in her articulation therefore becomes crucial because it links bodies—both singular and collectives bodies—through everyday politics. This conceptualization shows how inherently feminist this book is; reformulating the classic ‘the personal is political’ and a reminder that this call was always a collective call. Loyd’s conceptualization of health arose from her engagement with the archive. She articulates a definition that is rooted in the organizing of feminists and communities in LA who worked hard to produce their own survival practices.

Yet, this definition departs from traditional understanding of health and therefore needs to be explained and argued for. Health has this double life, or Jenna calls it “double-edged quality of health discourses.” (17). One strand consists of detached doctors, hospital administrators, Big Pharma, and the rightwing origins of Obamacare. The other edge is community organizing, free clinics, environmental justice, and survival programs.  This double life is conveniently represented on the cover of the book through the symbol of medicine.[1]  While the symbols’ edges run parallel, these edges intersect in the United States and that is where the contradictions emerge and conflicts take place. The book gives us a detailed history of these intersections. I’m a scholar with historian tendencies, so I appreciated her attention to detail. It is through the details that the specific contours of political struggles, social experiments, and partial failures and successes become clear. I didn’t know many of these stories and I think everyone should.

This history speaks to our current political moment, especially in light of events in Ferguson, Missouri. One historical detail I want to repeat is from the Kerner Commission of 1967 that convened to examine the urban uprisings in the 1960s. When I first read the report I remember being shocked that their conclusion described how the ghetto was produced. The conclusion stated:

“White institutions created it, white institutions maintain it, and white society condones it” (89).

I was shocked by the honesty and self-awareness back in 1960s. But, I then checked myself; “just knowing” can never be enough to dismantle these institutions. I repeat this quote because Loyd’s book is provocation to geographers to rethink how health and our knowledge of “health disparities” are structured. This book inspired me to re-think how health currently intersects with white supremacy and patriarchy to create and maintain and condone new forms of inequalities. Just as the War on Poverty did not get rid of poverty in America, how will Obamacare reshape new formulations of illness, pain, and suffering?

While I cherish the historical details of the book, theory is not absent from Loyd’s account.  Theoretical interventions are suffused into the rich empirical narrative of historical change.  Loyd gives us useful concepts and formulations, such as “militarized ecologies,” “slum reasoning,” and the “mothering underground.” Loyd pulls the concept of health brutality from the archive, reworking it to capture the dissonance in how health (care) is practiced, accessed, and distributed. Health brutality is an especially useful concept since it contains a friction in the act of bringing those two words together (similar to slow violence, Nixon, 2011). Loyd demonstrates a practice of theory building up from the archive and the empirical material. And, like all great theory, it calls to the reader to actively rework, apply, and build upon these new and specific formulations.

Loyd’s book can be read alongside Michelle Murphy’s recent book Seizing the Means of Reproduction (2012). Murphy and Loyd use similar archives of the feminist self-help clinics of the 1960s and 1970s. Murphy, from a feminist science and technology studies framework, suggests that these self-help groups were a “protocol feminism.” In Murphy’s genealogy of these practices, protocols are guidelines or tasks – instructions, techniques, and equipment – and how these technosocial practices were politicized and seized for empowerment. Jenna’s book, however, shows how essential it is to bring different archives together and to look for correspondences between documents and narratives that link self-help with hospital closures and the military industrial complex. Jenna’s book gives us a different set of the “protocols” based neither on single issues nor identity politics, but made through geography. These protocols illustrate how to organize for Loyd’s definition of health, practices and techniques of different struggles of the past, such as survival programs, discursive maneuvers, organizing techniques, and ally building.

The original title of the book was “Freedom's Body” and that concept has become so suffused throughout the narrative that I want to conclude by making this idea more overt. As I see it, this conceptualization of the body and freedom relates to the articulation of health as “individual and collective bodily self-determination.” Yet, this formulation can’t be individual freedom nor a sense of universal freedom, because as Loyd says elsewhere, “the project of building common futures must confront the specific ways in which racism and class undercut universalist visions.” (178). Read again alongside Murphy, she helps to supplant this lingering universalism and to seek what she calls “ontological collectivity—a materialization of a continuous field of difference rather than a fixed form. That is, inter-individual differences were not judged by an abstract norm, or in terms of a fixed fact; rather they were assembled into a collectivity of living variation both between bodies and within any given body. Thus, for feminist self-help, the category of “woman” was not absolutely unitary; instead it was a living ontological collectivity across bodies and over time.” (Murphy, 2012: 87)  Loyd takes a different path, by tackling freedom directly. Her theory of freedom’s body emerges in the text with the reworking of freedom as biological. In the introduction, Loyd articulates how the conditions for premature death get embedded into the landscape. Loyd writes (13):

This visceral quality of unfreedom captured by ideas of structural violence and excess death is an inverse way of understanding what philosopher and New Left theorist Herbert Marcuse meant when he called freedom “biological.” For Marcuse, times of “rebellion” are when the “instinctual basis for freedom” “take[s] root in the very nature, the ‘biology’ of the individual.”

Loyd runs with this, transforming it into freedom’s body, which includes the necessary “and” that emphasizes the interplay between individual and collective politics. Loyd’s contribution to geography provides a re-conceptualization the body, not as biology rather as an active site of collective remaking. 

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Notes

[1] They are also snakes and I don’t want to read too much into that metaphor, but there might be something “snakey” about health. Interestingly, Jenna pushed for this symbol to have a liberation fist (justice) rather than a peace dove.

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References

Canguilhem G (1989) The Normal and the Pathological New York: Zone Books.

Guthman J (2011) Weighing In: Obesity, Food Justice, and the Limits of Capitalism. Berkeley, CA: University of California Press.

Murphy M (2012) Seizing the Means of Reproduction: Entanglements of Feminism, Health, and Technoscience Durham, NC: Duke University Press.

Nixon R (2011) Slow Violence and the Environmentalism of the Poor Cambridge, MA: Harvard University Press.