Dissertations, Theses, and Capstone Projects

Date of Degree

9-2021

Document Type

Dissertation

Degree Name

Ph.D.

Program

Sociology

Advisor

Barbara Katz Rothman

Committee Members

Erica Chito Childs

Jessie Daniels

Nick Freudenberg

Subject Categories

Food Studies | Medicine and Health | Other Public Health | Race and Ethnicity | Sociology of Culture

Keywords

East Harlem, ethnography, gluten, healthism, socioeconomic status, wellness

Abstract

Using food-as-medicine, a valuable strategy of health, as its focus, this dissertation examines why and how New Yorkers use food to negotiate their health. I argue that while using food medicinally is a common health practice, food-as-medicine operates unequally among different groups of New Yorkers. I attribute this inequity, in part, to how those in power, including public health experts, biomedical doctors, and the food industry, operationalize food-as-medicine as a health remedy and to a neoliberal, healthist context that ties people’s morally “correct” uses of food-as-medicine to their abilities to access “good” citizenship and optimal health.

I chose to write about food-as-medicine as popular culture and academic literature offer a limited view of the practice, one that either deploys food-as-medicine as a health strategy white people use to optimize their health or as a way for public health experts and doctors to “fix” low-income people of color’s health because they aren’t eating enough “good food.” These narratives fail to show the full scope of what people’s food-as-medicine practices look like and how they employ food-as-medicine as an everyday health strategy. In critically analyzing New Yorkers’ food-as-medicine experiences, I produce a more complete picture of what food-as-medicine is and how it operates throughout people’s everyday lives.

To do this, I utilized a multi-method approach which included interviews, focus groups, and ethnographic field work. As part of this, I interviewed 44 New Yorkers who live in three New York City neighborhoods: Manhattan’s Chinatown, East Harlem, and Park Slope. Looking beyond individuals’ food-as-medicine experiences, I spent two years collecting ethnographic data at Salutem Kitchen, a weekly nutrition education and cooking class held a Salutem, a community-based organization (CBO) located in East Harlem.

Based on this qualitative data, I use chapter 2 to think about what, culturally, prompts this food-as-medicine culture to work. My analysis focuses on news and social media, food industry, expert knowledge, and documentaries’ role in making this culture into a popular health strategy for white people. The second part of this chapter examines the relationship between industrial power, food guidelines, and the production of “good food,” focusing on the dairy, sugar, and meat industries. Chapter three analyzes how New Yorkers experience food-as-medicine, finding that while the majority believe food is medicine, their food-as-medicine definitions are nuanced. Later, this chapter examines the reasons and experiences that bring participants to do food-as-medicine work, identifying lack of control over their health problems, familial food and health practices, fear of getting sick (again), and the importance of managing their kids’ health as reasons why participants practice food-as-medicine and why their food-as-medicine practices look the way they do. It ends with an analysis of how Chinese families pass down the practice of food-as-medicine to Chinese participants.

Chapter four examines how participants negotiate a biomedical system that doesn’t privilege food as a healing modality. After establishing that doctors aren’t food-as-medicine experts, in part because they lack nutrition education, it finds that when doctors bring food into interactions with participants, they often suggest participants do generic food things, like eat better or practice healthy eating. In critiquing these healthy eating prescriptions, this chapter argues that they operate as a neoliberal, healthist technique of self-care and that they assume participants’ knowledge and economic capital while reifying one definition of healthy eating. This chapter then explains why participants choose between biomedicine and food-as-medicine work, focusing on how certain participants’ families socialize them to use food-as-medicine. It finds participants do food-as-medicine work alongside seeking out biomedical care. The chapter concludes with a discussion of privilege, and an analysis of the white and class privilege of participants who work with practitioners who treat them with food.

Chapter five analyzes two strategies of food-as-medicine: feeling food and taste, a cause and effect of feeling food. It finds that participants experience conflict between the foods they eat, how they feel when they eat them, and their knowledge of if these foods are healthy for them, or not. This chapter then uses gluten as an example of how the food-as-medicine culture influences how people approach treating their health problems. Accordingly, it finds this gluten-free trend gives a certain group of people, white women, the authority to “fix” their health problems with a gluten-free diet.

Chapter six situates Salutem Kitchen, Salutem’s weekly nutrition education and cooking classes, as part of Salutem. Chapter seven examines how Salutem Kitchen operationalizes Salutem’s “food as treatment and prevention” philosophy in its food-as-medicine approach. It finds that in its work to “bring good food” and healthy eating education to its mostly Black, Latinx, and Asian participants, Salutem Kitchen reproduces the whiteness and elitism of the food-as-medicine culture. Recognizing that Salutem Kitchen operates in a neoliberal, healthist context, this chapter concludes by thinking about the dissonance that occurs between Salutem’s organizational goals and the value participants place on their participation. Through critically analyzing how people use food-as-medicine as a strategy of health, this interdisciplinary dissertation contributes to scholarship in the sociology of medicine, public health, and food studies.

Download

Share

COinS