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Health Humanities in Application

Christian Riegel
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SDG: 3
Sustainable Development Goals Series Good Health and Well-Being

Health Humanities in
Application
Edited by
Christian Riegel
Katherine M. Robinson
Sustainable Development Goals Series
The Sustainable Development Goals Series is Springer Nature’s inaugu-
ral cross-imprint book series that addresses and supports the United
Nations’ seventeen Sustainable Development Goals. The series fosters
comprehensive research focused on these global targets and endeavours to
address some of society’s greatest grand challenges. The SDGs are inher-
ently multidisciplinary, and they bring people working across different
fields together and working towards a common goal. In this spirit, the
Sustainable Development Goals series is the first at Springer Nature to
publish books under both the Springer and Palgrave Macmillan imprints,
bringing the strengths of our imprints together.
The Sustainable Development Goals Series is organized into eighteen
subseries: one subseries based around each of the seventeen respective
Sustainable Development Goals, and an eighteenth subseries, “Connecting
the Goals,” which serves as a home for volumes addressing multiple goals
or studying the SDGs as a whole. Each subseries is guided by an expert
Subseries Advisor with years or decades of experience studying and
addressing core components of their respective Goal.
The SDG Series has a remit as broad as the SDGs themselves, and con-
tributions are welcome from scientists, academics, policymakers, and
researchers working in fields related to any of the seventeen goals. If you
are interested in contributing a monograph or curated volume to the
series, please contact the Publishers: Zachary Romano [Springer; zachary.
romano@springer.com] and Rachael Ballard [Palgrave Macmillan; rachael.
ballard@palgrave.com].
Christian Riegel • Katherine M. Robinson
Editors

Health Humanities
in Application
Editors
Christian Riegel Katherine M. Robinson
Department of English Department of Psychology
Campion College, University Campion College, University
of Regina of Regina
Regina, SK, Canada Regina, SK, Canada

ISSN 2523-3084     ISSN 2523-3092 (electronic)


Sustainable Development Goals Series
ISBN 978-3-031-08359-4    ISBN 978-3-031-08360-0 (eBook)
https://doi.org/10.1007/978-3-031-08360-0

© The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer
Nature Switzerland AG 2023
Chapters 1 and 8 are licensed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/). For further details
see licence information in the chapters.
Color wheel and icons: Fromwww.un.org/sustainabledevelopment/, Copyright © 2020
United Nations. Used with the permission of the United Nations.
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This Palgrave Macmillan imprint is published by the registered company Springer Nature
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The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Acknowledgements

The editors thank the editorial staff at Palgrave Macmillan for their careful
preparation of the book: Allie Troyanos, Chandralekha Mahamel Raja,
Brian Halm, Imogen Higgins, and Sindhuja Aroumougame. Thanks also
to Molly Beck for the initial welcome response to our query.

v
Contents

1 Introduction:
 What Does It Mean to Do the Health
Humanities in Application?  1
Christian Riegel and Katherine M. Robinson

2 Mapping
 Reproductive Health Policy Using Arts-Based
Research Methods: A Model of Pedagogical Transgression 17
Angie Mejia and Danniella Balangoy

3 Black
 Feminist Field Notes: On Designing an
Undergraduate, Online, Health Humanities Course in
Women’s and Gender Studies 43
Rachel Dudley

4 Viral
 Pedagogical Narratives: Artistic Expressions of
Living During the COVID-19 Pandemic 75
Karen Keifer-Boyd, Michele Mekel, and Lauren Stetz

5 Narratives
 of Repair and the Re-articulation of the Pained
Self: A Study in Painscapes103
Tea Gerbeza

vii
viii Contents

6 Exploring
 Cultural Dance as a Medium for Improving
Cross-Cultural Communication in Medicine: The
Aseemkala Model123
Shilpa Darivemula, Moondil Jahan, Lindsay Winters, and Ruta
Sachin Uttarkar

7 Deep
 Flow: A Tentacular Worlding of Embodied Dance
Practice, Knowing, and Healing153
Jeannette Ginslov

8 Interdisciplinarity,
 Transdisciplinarity, and Health
Humanities: Eye Tracking, Ableism, Disability, and Art
Creation175
Christian Riegel and Katherine M. Robinson

9 Listen,
 Play, Learn: Rethinking Expertise and
Collaboration in the Field of Disability Support Services195
Myles Himmelreich and Michelle Stewart

10 Deconstructing
 Disability from a Global South
Perspective: Examples from an Interpretive
Phenomenological Study223
Festus Yaw Moasun

11 The
 Networked Human: Coronavirus, Facebook, and
Indian Politics247
Rimi Nandy, Agnibha Banerjee, and Santosh Kumar

12 On
 the Use of Encapsulation, Parity, and Visual
Storytelling in Graphic Medicine265
Spencer Barnes

13 Medical
 Progress, Health, and the Chronic Disease of
Racism in Kindred: A Graphic Novel Adaptation287
Tatiana Konrad

Index319
List of Figures

Fig. 4.1 Workshop participants’ curation of Viral Imaginations


artworks related to food sustainability issues includes work by
Isabella Del Signore (2021, top left), Anonymous (2021a, b,
top middle), Elaine Lacina (2020, top right), Anonymous
(2020, bottom left), Zena Tredinnick-Kirby (2020, middle),
Patricia (2020, bottom middle), and Rebecca Morris (2020,
bottom right) 86
Fig. 4.2 Workshop participants’ curation of Viral Imaginations
artworks related to hope includes work by Anne Lavo (2020,
top right), Amy Frank (2020, top middle), Claudia McGill
(2020, top right), Christina Fridman (2020, bottom left),
Oana Bollt (2020a, middle), Oana Bollt (2020b, bottom
middle), and Stella Talamo (2020, bottom right) 88
Fig. 5.1 Samples of paper quilling shapes. Photograph taken by the
author for the purposes of this chapter 104
Fig. 5.2 “Scar” Painscapes. Scanner photograph. https://teagerbeza.
com/projects/painscapes111
Fig. 5.3 “Bending Over.” Painscapes. Scanner photograph. https://
teagerbeza.com/projects/painscapes114
Fig. 6.1 Aseemkala traditional dance framework for patient-provider
cross-­cultural understanding 134
Fig. 7.1 Ginslov, J. (2017) Dancer Suet-Wan Tsang in Conspiracy
Ceremony—HYPERSONIC STATES (photograph) 156
Fig. 7.2 Spikol, D. (2019) Dancer Jeannette Ginslov in Deep Flow at
the Symposium on Digital Urbanism, Blekinge Institute of
Technology, Karlshamn, November 14, 2019 (photograph) 161
Fig. 7.3 Ginslov, J. (2020) Movement hieroglyph (photograph) 164

ix
x List of Figures

Fig. 7.4 Ginslov, J. (2020) Figuring-figure (photograph) 166


Fig. 9.1 Myles walking through the post-it notes that captured the
feedback from the youth who had participated in the
improvision series. Credit: Michelle Stewart 212
Fig. 9.2 Themes that emerged during the arts-based evaluation with
the youth included the role of advocacy as they learned more
about their disability they were better able to advocate for
themselves. Credit: Michelle Stewart 213
Fig. 9.3 The swirl of words around “advocacy” also traces out the
ways in which self-awareness and advocacy are linked, for
participants, to acceptance, hope and loving oneself. Credit:
Michelle Stewart 214
Fig. 9.4 Images of cups of water were references to the water activity
that had different expectations and tasks for different groups
of individuals and participants recalled that the individuals
with an “empty cup” can face blame and punishment. Credit:
Michelle Stewart 215
Fig. 11.1 Facebook data demographics 256
Fig. 11.2 Facebook data: political thoughts 256
Fig. 12.1 Standard EIPR narrative structure 273
Fig. 12.2 EEIPRR variation of standard EIPR narrative structure 276
Figs. 13.1 Dana is performing cardiac massage on Rufus and
and 13.2 giving him artificial respiration, thereby reanimating the boy
(p. 13). Kindred: A Graphic Novel Adaptation, by Octavia
E. Butler, adapted by Damian Duffy, illustrated by John
Jennings (c) Abrams ComicArts 295
Fig. 13.3 Dana witnesses Alice’s father being whipped by a white man
(p. 43). Kindred: A Graphic Novel Adaptation, by Octavia
E. Butler, adapted by Damian Duffy, illustrated by John
Jennings (c) Abrams ComicArts 295
Fig. 13.4 Dana is taking care of a beaten-up Rufus (p. 115). Kindred:
A Graphic Novel Adaptation, by Octavia E. Butler, adapted
by Damian Duffy, illustrated by John Jennings (c) Abrams
ComicArts296
Fig. 13.5 Dana is trying to save Tom Weylin when the man is having a
heart attack (p. 183). Kindred: A Graphic Novel Adaptation,
by Octavia E. Butler, adapted by Damian Duffy, illustrated by
John Jennings (c) Abrams ComicArts 297
Fig. 13.6 The Black body in pain (p. 42). Kindred: A Graphic Novel
Adaptation, by Octavia E. Butler, adapted by Damian Duffy,
illustrated by John Jennings (c) Abrams ComicArts 299
List of Figures  xi

Fig. 13.7 Dana is being whipped by Tom Weylin (p. 162). Kindred: A
Graphic Novel Adaptation, by Octavia E. Butler, adapted by
Damian Duffy, illustrated by John Jennings (c) Abrams
ComicArts300
Fig. 13.8 Injured Alice is returned to the plantation (p. 136). Kindred:
A Graphic Novel Adaptation, by Octavia E. Butler, adapted
by Damian Duffy, illustrated by John Jennings (c) Abrams
ComicArts301
Fig. 13.9 Dana finds Alice’s dead body (p. 219). Kindred: A Graphic
Novel Adaptation, by Octavia E. Butler, adapted by Damian
Duffy, illustrated by John Jennings (c) Abrams ComicArts 302
Fig. 13.10 Dana is caring for severely injured Alice (p. 138). Kindred: A
Graphic Novel Adaptation, by Octavia E. Butler, adapted by
Damian Duffy, illustrated by John Jennings (c) Abrams
ComicArts304
Fig. 13.11 Dana’s kit includes aspirin (p. 107). Kindred: A Graphic
Novel Adaptation, by Octavia E. Butler, adapted by Damian
Duffy, illustrated by John Jennings (c) Abrams ComicArts 306
Fig. 13.12 Dana is giving aspirin to Rufus to ease his suffering (p. 126).
Kindred: A Graphic Novel Adaptation, by Octavia E. Butler,
adapted by Damian Duffy, illustrated by John Jennings (c)
Abrams ComicArts 307
Fig. 13.13 Dana steals a bottle of medicine to help Alice flee (p. 204).
Kindred: A Graphic Novel Adaptation, by Octavia E. Butler,
adapted by Damian Duffy, illustrated by John Jennings (c)
Abrams ComicArts 309
Fig. 13.14 The opening image of Dana (n.p.). Kindred: A Graphic Novel
Adaptation, by Octavia E. Butler, adapted by Damian Duffy,
illustrated by John Jennings (c) Abrams ComicArts 311
Fig. 13.15 Dana returns home from the antebellum South for the last
time (p. 234). Kindred: A Graphic Novel Adaptation, by
Octavia E. Butler, adapted by Damian Duffy, illustrated by
John Jennings (c) Abrams ComicArts 314
List of Tables

Table 3.1 Week 1 Course Schedule Snapshot 65


Table 3.2 Reading Worksheet Example 67

xiii
CHAPTER 1

Introduction: What Does It Mean to Do


the Health Humanities in Application?

Christian Riegel and Katherine M. Robinson

Health, Humanities, and Application


Three key concepts situate the approach of this book: health, humanities,
and application. Health, in health humanities, relates to all imaginable
configurations of health and well-being ranging from individual health
concerns to formal health, medical, and clinical contexts. The humanities
pertain to “the knowledge the human species has acquired about itself
over the centuries” (Aldama 2010, 1) and include conventional humani-
ties disciplines such as literary studies, history, philosophy, and religious
studies, the arts and artistic creation, and the social sciences, where they

C. Riegel (*)
Department of English, Campion College, University of Regina,
Regina, SK, Canada
e-mail: Christian.riegel@uregina.ca
K. M. Robinson
Department of Psychology, Campion College, University of Regina,
Regina, SK, Canada
e-mail: katherine.robinson@uregina.ca

© The Author(s), under exclusive license to Springer Nature 1


Switzerland AG 2023
C. Riegel, K. M. Robinson (eds.), Health Humanities in
Application, Sustainable Development Goals Series,
https://doi.org/10.1007/978-3-031-08360-0_1
2 C. RIEGEL AND K. M. ROBINSON

examine the human condition, including disciplines such as anthropology,


sociology, and psychology, amongst others. Multidisciplinary, interdisci-
plinary, and transdisciplinary modes also inform the configuration of
health and humanities in domains such as disability studies, women’s and
gender studies, and the study of race and ethnicity. The concept of appli-
cation is a central tenet of health humanities in that they are concerned
with how one does things and to what particular use one puts things, fit-
ting with a standard dictionary definition of the word application
(Cambridge English Dictionary).
Health Humanities in Application is concerned with the relationship of
application to health and humanities; that is, in how we do the health
humanities. This interest fits well into the rapidly growing field of
the health humanities, which consolidates knowledge and practice at the
intersections of health and the humanities. At core, health and the human-
ities come together in application: it is how the humanities are used by
health care practitioners, artists, individuals interested in health, caregiv-
ers, students of the health disciplines, athletes, educators, and academic
researchers, amongst others, that defines the field. Health Humanities in
Application underscores the need to articulate the deployments of the
humanities in health contexts to understand the contours of the field and
its applied concerns more fully.
The shape of the health humanities is quickly coming into focus even as
there is much work yet to be done to define its boundaries. Klugman sees
the health humanities as “a field concerned with understanding the human
condition of health and illness in order to create knowledgeable and sensi-
tive health care providers, patients, and family caregivers” (Klugman 2017,
422), and Klugman and Lamb note that “health humanities puts the
humanities, arts, and social sciences in the center, rather than as an add-on
to clinical and basic science” (2019, 3). Crawford broadens the focus on
“health and illness” to account for the expansive potential of the health
humanities as “an evolving, game-changing field that attracts different arts
and humanities traditions to work more closely with the public to advance
health care, health, and well-being” (Crawford 2020, “Introduction,” 6).
The origins of health humanities in relation to medical humanities are
articulated by Jones, Wear, and Friedman in their essay “The Why, the
What, and the How of the Medical/Health Humanities” (2014). Inherent
in their configuration of “medical/health” is a tension between the pur-
poses of the humanities and the arts in the service of medicine and medical
education and the role of the humanities intersecting health and
1 INTRODUCTION: WHAT DOES IT MEAN TO DO THE HEALTH… 3

well-­being broadly conceived. Victoria Bates and Sam Goodman recog-


nize this tension in their conception of the term medical humanities as
malleable, making its “definition problematic and arguably unnecessary”
(2014, 3). The focus in medical humanities is on the biomedical sciences
and their relation to “the arts and humanities, and the social sciences” and
their “intersections, exchanges and entanglements (Whitehead and Woods
2016, 1). Bates and Goodman argue that the danger of entrenching a
specific set of qualities in the term medical humanities would result in “an
unfortunate narrowing of the field.” Yet, the very conception of the term
is rooted in the medical, which necessarily narrows the focus to largely
biomedical contexts even when there is a “huge range of subjects and
approaches” (2014, 5) in the medical humanities. The Edinburgh
Companion to the Critical Medical Humanities, in its 36 chapters, rein-
forces both the breadth of the medical humanities and how they are range
bound, returning always to contexts relating to medicine. Whether the
interest is in narrative, literary expressions of illness, historical perspectives
on matters of health, politics, culture, and society, emphasis threads to
expressions of medical domains.
Health and wellness are not limited to medical contexts, and indeed
they supersede such a limitation given humanity’s concerns with issues
such as physical fitness, mental health, the benefits of being in nature, dis-
ability, ableism, illness, and caregiving, amongst many other health-related
matters that can be situated in and outside biomedical spaces. So, too, are
the myriad possibilities of the humanities and the arts—and those areas of
the social sciences that overlap--to expand knowledge of how we under-
stand health as individuals, communities, and societies, how we practise in
health settings, and how we implement health education for students
beyond the confines of a medical education to include the breadth of
domains that have an interest in matters of health. Having introduced the
concept of the health humanities as a field in 2010, Crawford, Brown,
Tischler, Baker, and Abrams put forward a self-described “manifesto”
(Crawford “Introduction” 2020) for the health humanities in their aptly
titled volume Health Humanities calling “for a new kind of debate at the
intersection of the humanities and healthcare, health and well-being”
(Crawford et al. 2015, 1). There was a need, they argued, “to address the
increasing and broadening demand” for a health humanities approach as a
way to account for “how arts and humanities knowledge and practices can
inform and transform healthcare, health and well-being,” and to create
space for the large cohorts of individuals engaged in health-related work
4 C. RIEGEL AND K. M. ROBINSON

who do not fit within the boundaries of medical humanities (Crawford


et al. 2015, 1). The health humanities, they note, create space for “differ-
ent disciplines … to value the contribution made by the arts and humani-
ties” and for “new opportunities [to] emerge in health for the development
and inclusion of new approaches” (Crawford et al. 2020, 1).
The concept of health humanities serves as a catalyst for those inter-
ested in health and wellness to situate their intellectual, practical, and per-
sonal concerns in a manner that is “more inclusive and international” than
the previously constituted medical humanities (Crawford et al. 2015, 1).
Crawford remarks that health humanities is beginning to mature “as an
energetic, robust, and inclusive field: one that signals a more co-created
and co-operative vision for how the arts and humanities can stand as an
interdisciplinary, and not solely medicalized, shadow health care service”
(Crawford 2020, 6; see also Banner 2019, 2).
The present book is born out of the observation that the tension articu-
lated in the hybrid “medical/health humanities” conception of how health
and humanities fit together (Jones et al. 2014, 1) has dissipated quickly as
the field of health humanities has become entrenched in a process of for-
mation that is ever expansive, including exceptional growth in baccalaure-
ate programmes (Klugman and Jones 2021) and in graduate and research
institute or centre growth (Crawford 2020). Klugman and Lamb note
that the term “health humanities does not replace nor compete with the
medical humanities” (Klugman and Lamb 2019, 3). Researchers, educa-
tors, students, health professionals and practitioners, creators, and mem-
bers of the community recognize their interest in health and its intersection
with humanities rather than seeing their approach be excluded by the
boundaries of medicine. This is an important development that predicts an
ever-growing field. Olivia Banner highlights the diversity of approaches in
their discussion of health humanities educators, describing them as “a
diverse group of bricoleurs” in their teaching and scholarship (2019, 1).
Those engaged in health humanities come from a wide range of humani-
ties disciplinary backgrounds “with divergent disciplinary and field train-
ing” (Banner 2019, 1). Jones et al. (2014) note that the health humanities
arise out of a conventionally understood set of humanities disciplines, such
as “history, literature, philosophy, bioethics, and comparative religion”
and are augmented by a more elastic understanding of the humanities to
include “those aspects of the social sciences that have humanistic content
and employ humanistic methods relevant to medical inquiry and practice,
particularly sociology, anthropology, and psychology” (4–5). Additionally
1 INTRODUCTION: WHAT DOES IT MEAN TO DO THE HEALTH… 5

influential in the health humanities are “philosophical and pedagogical


projects as postmodernism, feminism, disability studies, cultural studies,
media studies, and biocultures” (Jones et al. 2014, 5). The over-arching
challenge, then, is to account for the breadth of the field while still main-
taining an understanding of what binds the immense range of interests,
approaches, and practices that contribute to the intersection of health and
humanities.

Situating Health Humanities: Family Resemblances


The health humanities, then, are primarily understood outside the recur-
siveness of medical humanities to have its own vectors of development.
There is still the challenge of how to capture the diversity and breadth of
the field’s intellectual terrain and practical applications. This challenge is
evident in the range of contributors to this book, who include physicians,
creative artists engaged in dance and visual art, professors and researchers
in cognitive psychology, social work, justice studies, literary studies, digital
humanities, health humanities, education, pedagogy, civic engagement,
media and communications, women’s and gender studies, Africana stud-
ies, art education, and bioethics. The work produced by the contributors
fits simultaneously within and outside their disciplines and artistic prac-
tices further complicating how we might collectively situate the volume.
And yet, health humanities as a term captures the intersection of interests
despite the breadth of perspectives that are brought to bear across the
individual chapters. Ludwig Wittgenstein (Wittgenstein [1953] 1967), in
his book Philosophical Investigations, offers possibilities for how one might
account for the expansiveness of health humanities while also recognizing
that individual contributions are situated within an identifiably similar cat-
egory of intellectual and practical enterprise. Wittgenstein argues that a set
of family resemblances can be used to identify concepts. Writing about
games, specifically, Wittgenstein remarks that

we see a complicated network of similarities overlapping and criss-crossing:


sometimes overall similarities, sometimes similarities of detail.
67. I can think of no better expression to characterize these similarities
than “family resemblances”; for the various resemblances between the mem-
bers of a family; build, features, colour of eyes, gait, temperament, etc., etc.,
overlap and criss-cross in the same way. And I shall say: “games” form a
family (32e).
6 C. RIEGEL AND K. M. ROBINSON

Wittgenstein’s concept of family resemblances is useful to define the


scope of health humanities as it erases the need to distinguish the medical
humanities specifically from health humanities. Indeed, the medical
humanities and its longer history, operating as a distinct educational, prac-
tical, and research discipline within a set of bounds defined primarily by
biomedical and clinical contexts, nestle comfortably within health human-
ities, which serves as an umbrella field to encompass a range of similar and
divergent practices and approaches, some of which are identifiable as dis-
ciplines such as narrative medicine (Charon 2006; Charon et al. 2016),
and others that are situated within health humanities through their family
resemblance to each other, such as disability studies, which is inherently
interdisciplinary.
The health humanities are thus well served by Wittgenstein’s consider-
ation of the “complicated network of similarities” (32e) that bind together
otherwise seemingly disparate domains of knowledge and application for
he asks us to consider primary the points of overlap between various
domains. For example, literary studies and health, and history and health:
both are grounded in the disciplinary conventions of their respective dis-
ciplines and find commonality in their relevance to understanding of mat-
ters relating to health. Similarly, disability studies and the study of sexual
and reproductive health policy are configured at the intersections of
numerous disciplinary approaches, such as history, politics, and ethics,
that find commonality when discerned in health humanities contexts.
These examples sit uncomfortably in the conception of the medical
humanities as it existed prior to the identification of health humanities
(Crawford et al. 2010).
The constraints of the medical humanities can be seen pessimistically by
recognizing the “broader, more inclusive approach [of the health humani-
ties] than the earlier designation, one that welcomes a range of health
professionals even as it shifts the focus to embrace health and wellbeing”
(Shapiro 2015, 268). Shapiro defines health humanities as “fuzzy” yet
comfortable as a “big, admittedly at times unwieldy, tent” (Shapiro 2015,
269). To begin to conceive the family resemblances amongst the educa-
tors, practitioners, and students of health, medicine, and the humanities
that fit within Shapiro’s unwieldy tent is part of the task of those who
identify health humanities as the most accurate conception to account for
the breadth of interest in health and humanities.
1 INTRODUCTION: WHAT DOES IT MEAN TO DO THE HEALTH… 7

Application and Health Humanities


A key purpose of this volume is to consider application as a central family
resemblance, to invoke Wittgenstein, that binds together so many dispa-
rate approaches. Whether our interest lies in pedagogy, creative produc-
tion, scholarship and research, health care practice, or as students of health,
medicine, the humanities, and the arts, what links us together in the field
of the health humanities is what we do when we do health humanities: we
engage in an application in a health domain that is deeply informed by,
and implicated in, an approach defined by the humanities broadly con-
ceived. Crawford, Brown, and Charise (2020) identify “application” as a
key element of how the humanities are situated in relation to “health care,
health, and well-being,” and Charise (2020) emphasizes the “pressing
new reasons to consider the matter of application within” the humanities.
What happens in the context of health humanities, then? Health
Humanities in Application draws together scholars, physicians, educators,
artists, community members, and health care practitioners with multiple
global perspectives to address this question to demonstrate that the health
humanities have immense reach in day-to-day practice, whatever the con-
text, and that the boundaries of the field can be understood through the
field’s work in action. This book has a distinctive shape beginning with
pedagogical engagements, then moving to discussion of theoretical and
artistic applications of creativity, and then shifting to considerations of
health humanities related to disability and ableism, before finishing with
considerations of social media and health, and graphic medicine and
health. However, this is not the only way to conceive the shape of the
volume as threading through the text are numerous other configurations,
such as justice, technology, and communication, as they pertain to health,
the nature of the health humanities, the nature of applied humanities and
health work, amongst many other possible ways to link the individual
chapters.
This book, in particular, invites readers to engage in what can be termed
an ethics of reading whereby the act of reading the chapters recognizes
what R. Clifton Spargo (2004)defines as ethics, which is to see the “pri-
mordial facticity of the other. [I]t is the inevitable act and persistent fact of
finding oneself in relation to the other” (7). Through engagement with
considerations of health, as researchers, teachers, practitioners, or indi-
viduals otherwise interested in our own or other people’s health (as a
caregiver for a family member, for example) we are constantly in
8 C. RIEGEL AND K. M. ROBINSON

recognition of others who exist with us in society and are thus in a form of
relation to them. It is one of the roles of the humanities to help us to
understand depths of this sense of relation to others, and it is the configu-
ration of health and humanities that applies ethical dimensions to that
relationship. When we encounter the health humanities in application we
can situate ourselves in just such an ethical position, opening ourselves to
recognition of the social, cultural, and historical complexity of health as it
affects individuals and societies. Consequently, this book is constructed to
bring to bear global considerations of health humanities, touching upon
North American, Indian, and African contexts in addition to its other
concerns.
The first three chapters, following this one, of Health Humanities in
Application are concerned with educational applications, focusing on
postsecondary contexts within which the intersections of arts and humani-
ties practices with health concerns prove fertile grounds with which to
catalyse student interest in their own well-being as well as with that of
society at large. In Chap. 2, Angie P. Mejia and Danniella Balangoy show
how undergraduate health sciences students can learn about the asymmet-
ric power structures in U.S. reproductive health policy through an applied
arts-based research methodology that involves intersectional analysis. The
application of intersectional theory in the classroom, they argue, serves to
challenge invisible privilege, as Mejia and Balangoy identify their own sub-
ject positions as “feminists of colour” to counter structures of oppressions
in their institutional contexts. Intersectional analysis is conjoined with per-
formance and reflective writing in the classroom as an arts-based research
process. Students were engaged in in-class role play performance and writ-
ing relating to state-based reproductive and sexual health legislation that
is restrictive that lead to learning relating to reproductive health, rights,
and justice, which is critical to training effective health practitioners.
Working also from a perspective grounded in intersectional feminism
and health justice, Rachel Dudley in Chap. 3 demonstrates that a feminist
health humanities approach offers applied opportunities to develop
impactful new courses in the health humanities. Knowledge of the devel-
opment of Dudley’s course, Feminist Health Humanities, shows how the
health humanities can serve a vital role in bringing awareness to students
of privilege, power, and oppression as they relate to social structures that
impact health and medicine. A key experience of developing the course is
recognition of how inseparable issues of health are from social and politi-
cal factors relating to oppression and inequality. The health humanities
1 INTRODUCTION: WHAT DOES IT MEAN TO DO THE HEALTH… 9

serve as application for the development of a new course that challenges


assumptions about health and justice, as well as they serve as tools in the
classroom setting.
The health humanities also serve applied purposes as a response to the
COVID-19 pandemic in designing pedagogical approaches to help stu-
dents cope with the disruption of the pandemic. Health humanities, art
education, and bioethics are brought together by Karen Kiefer-Boyd,
Michele Mekel, and Lauren Stetz in Chap. 4. Their chapter outlines the
role of an online platform, Viral Imaginations: COVID-19, that elicited
creative writing and visual art from Pennsylvanians to understand their
coping during the early period of the pandemic. Viral Imaginations serves,
in part, as an archive of collected creative works that can be implemented
in K-16 classrooms to help offset the challenges of remote learning and
isolation in the age of the coronavirus. A series of pedagogical interven-
tions, theorizations, and discussions form the focus of the chapter to artic-
ulate how creative practice and the engagement with creativity focus
attention on understanding our humanity amidst a health crisis. Viral
Imaginations, as online forum extended into classroom practice, under-
scores the need to share and engage with others as a means of coping.
The understanding of application shifts to the purposes of creating art
in the three chapters that follow, beginning with artist, poet, and academic
Tea Gerbeza’s autobiographical examination of the challenges of social
definitions of disability as they intersect the experience of living in our own
bodies in Chap. 5. Gerbeza outlines the theoretical perspectives on able-
ism and disability that inform their artistic practice. The creation of art is
simultaneously exploration of the self and its relation to disability and
serves as a form of ethics through which those who view the art are able
to reflect upon the challenges of ableism as a set of discriminatory prac-
tices. Gerbeza creates multimedia art, working with paper and a scanner to
create paper-quilled designs that reflect their experience of chronic pain.
The chapter focuses on the nine works in the Painscapes series as they
explore experiential knowledge of pain that belies medically oriented defi-
nitions of pain. “Transformation, reclamation, and restoration” are at the
core of the creation of art for Gerbeza as art making involves resituating a
self and body that has been medically and socially determined. Viewing
Painscapes provides an ethical space that is partly aesthetic enjoyment and
partly educational, and thus serves applied functions beyond the creation
of the works themselves. How we understand pain, disability, ableism, and
10 C. RIEGEL AND K. M. ROBINSON

ourselves situated in a complex social world results from engaging in the


ethical realm of Painscapes.
Chapters 6 and 7 demonstrate how one can use dance to resituate the
binary of the medical practitioner-patient model to a more divers and
inclusive mode of understanding that places the individual at the centre of
the articulation of health concerns, thus breaking down the hierarchical
structures that can impede full understanding if individual health needs.
Dance performance is connected to cross-cultural health communication
in “Addressing Cultural Competency in Physician-Patient Communication
Through Traditional Dance Exchanges.” Working in a variety of health
professions and from several global locations—the United States, India,
and Nepal—Shilpa Darivemula, Moondil Jahan, Lindsay Winters, and
Ruta Sachin Uttarkar articulate the “Aseemkala Model” as a way to extend
conventional dance movement therapy (DMT) models that primarily
focus on a therapist-patient dynamic that does not account for cultural
and environmental factors and that reinforces the separation of therapist
and patient in clinical settings. The Aseemkala Model employs traditional
dance exchanges to reconfigure incongruity in how medicine and patients
interact and understand each other to allow cultural, historical, and expe-
riential diversity to be communicated to health care providers. In “Deep
Flow: A Tentacular Worlding of Embodied Dance Practice, Knowing, and
Healing,” dancer and academic Jeannette Ginslov defines an embodied
dance practice that has as its goal to allow for arts-based knowing and arts-­
based healing. Employing a dual approach, combining phenomenological
research and phenomenological arts practice, Deep Flow is concerned with
working through the lived experience. Conventional health and medical
models are shifted to use one’s own body in the aim of wellness and self-­
understanding. Deep Flow is an applied practice grounded in theory.
Ginslov’s discussion emphasizes application and theory by working
through the methods and practice of Deep Flow to provide a guide for
potential practitioners to consider.
The move away from overtly clinical medical contexts is one of the
hallmarks of the health humanities as they privilege not only health con-
ceived broadly, but also the range of individuals implicated in consider-
ations of health. One of the distinguishing features of the health humanities
is the interdisciplinary and transdisciplinary dimensions of the field. Our
contribution, Chap. 8, is interested in what happens when we step outside
our disciplinary boundaries to address the challenge of how to create art
with the eyes only. We outline a research project that takes eye tracking
1 INTRODUCTION: WHAT DOES IT MEAN TO DO THE HEALTH… 11

hardware and adapts it with custom software to allow individuals to create


art using eye movements. As such an art practice opens possibilities for
people with limited mobility given that only a single eye is needed to
engage in art making, the how and why shifts to a community setting creat-
ing a transdisciplinary approach that not only supersedes disciplinary col-
laboration but also relies on shared definition of the research questions
and research processes. Disability has often been defined against a physical
norm that marginalizes individuals who do not fit within an arbitrary set
of physical conditions, leading to ableist views of those deemed to be dis-
abled. Our transdisciplinary approach shifts the locus away from a
researcher-subject model to instead define the conditions of the research
through collaboration.
Similarly, in Chap. 9, Michelle Stewart and Myles Himmelreich present
a model of research collaboration that seeks to erase the distinction
between research and research subject in the discussion of a project related
to Foetal Alcohol Syndrome and provision of disability support services.
What happens when the fundamentals of research design are challenged
by the “subjects” in researchers’ attempts to implement what they consid-
ered to be a health care solution? The notion of a community shifts to that
which one becomes part of as a researcher, and the research project evolves
to include collaboration as an essential part of community engagement
and defines an important intersection of the health humanities and dis-
ability justice. The application becomes of interest to those with Foetal
Alcohol Syndrome and other disabilities, as well as to researchers, artists,
and educators. Disability sits uneasily as an opposition to a norm and
researchers who shift the focus from a researcher-subject model gain added
insights into how we conceive of disability and ability socially, culturally,
and historically.
Writing about the experience of disability in Ghana in Chap. 10, Festus
Moasan examines how the concept of disability cannot be detached from
time and place. Moasan outlines how disability is understood differently in
the Global North, where it is largely seen through a rights-based lens, and
the Global South, where medical and moral/religious models dominate.
Working from a phenomenological study he conducted in Northern
Ghana in Konkomba communities, Moasan uses the voices of individuals
with disabilities to understand how basic citizenship rights, such as the
right to work, are denied to people with disabilities. People born with a
disability lead a fraught and perilous life, yet health humanities, combined
with disability studies, offers the opportunity to shift the epistemology of
12 C. RIEGEL AND K. M. ROBINSON

disability in Ghana through a resituating of language and terminology


relating to disability. Moasan follows Ikem Ifeobu’s (2020) insightful
articulation of a framework within which African health humanities prac-
tices might engage “to avoid the imposition of paradigms alien to African
culture, as is evident in its history” (230). While the health humanities
have “consolidated an international appeal” (Ifeobu 2020, 231), it is clear
that the young field is rooted in Europea and North America, which makes
contributions like this chapter especially valuable in furthering dialogue
about a global health humanities.
The understanding of personhood in relation to COVID-19 social media
political discourse in India is the focus of Chap. 11. Rimi Nandy, Agnibha
Banerjee, and Santosh Kumar examine how human bodies are understood
historically in relation to pandemics, focusing on the challenge of how to
view diseased bodies and the volume of dead bodies that arise due to pan-
demics. Bruno Latour’s Actor Network Theory is combined with Gilles
Deleuze and Felix Guattari’s articulation of networks as a form of rhizome
to understand the complex relationship of human life to disease as a type
of non-hierarchical interconnectedness. Linked to Giorgio Agamben’s
concept of bios, referring to a conception of personhood as sovereign, and
his concept of zoe as a kind of bare life, the effects of COVID-19 are seen
to shift the place of the human from bios to zoe as the social and political
needs require individuals to be subservient to the needs of public health as
a whole. Using several conversations from Indian Facebook pages, the
authors use a health humanities approach to examine how COVID-19
patient bodies have been politicized through a social network that is itself
reflective of the social world.
The closing chapters shift to applications in graphic medicine to dem-
onstrate the varied potential of the application of comics into health care
contexts. Spencer Barnes in Chap. 12 is interested in how encapsulation as
a mechanism through which information is transformed in visual and text-­
based forms to create effective narratives. Visual storytelling is one way
that experiential narrative of a health experience or concern can be con-
veyed, and social media platforms afford opportunities for such narratives
to be constructed and disseminated. Through a case study of a “small
story,” such as one might find in social media, Barnes demonstrates that
mixes of media (such as 360-degree video and audio narration) can be
arranged using several types of narrative structure to help viewers—
patients, caregivers, health care providers—gain cohesion of the health
experience or concern.
1 INTRODUCTION: WHAT DOES IT MEAN TO DO THE HEALTH… 13

Likewise, Tatiana Konrad uses a health humanities lens to read a graphic


novel and its consideration of medical progress in Chap. 13. Health
humanities widens the perspective from a graphic medicine perspective to
include consideration of individuals and issues beyond the medical and
clinical contexts. The graphic novel Kindred: A Graphic Novel Adaptation
(2017) serves as an example of how history, culture, medical progress, and
racism can be understood. Racism is shown to be a disease that the United
States has struggled to contain across the centuries. Reading the narrative
of racism in Kindred: A Graphic Novel Adaptation as a pathography (or
illness narrative), Prorokova-Konrad argues, allows the pathological nature
of racism to be conveyed and reinforces the urgency with which it must be
dealt with.
Writing in 2010, Crawford et al. noted the boundaries of the medical
humanities, remarking that “The very term ‘medical humanities’ encapsu-
lates the dominant force in the discipline. Historically, medicine has cap-
tured the intellectual and clinical high ground” (Crawford et al. 2010, 6)
and called for a new approach that would result in “an inclusive health
humanities” (Crawford et al. 2010, 7). Such an inclusive field of endeav-
our has indeed developed rapidly as researchers, educators, students, prac-
titioners, and members of the community, recognize the place of their
inquiry, work, and practice within the space of the health humanities. As
Health Humanities in Application demonstrates, the realm of the health
humanities is ever expanding as they open themselves to new ways to
understand the intersections of health, the arts, and the humanities.

Acknowledgments Open Access Publishing funds provided by the Office of the


Vice President (Research), University of Regina, the Office of the Dean, Campion
College, and the Social Sciences and Humanities Research Council of Canada.

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1 INTRODUCTION: WHAT DOES IT MEAN TO DO THE HEALTH… 15

Christian Riegel is Professor of Health Humanities and English at Campion


College, University of Regina, Saskatchewan, Canada. He is a Fellow of the Royal
Society for the Arts (FRSA) in the United Kingdom. Amongst his books are
Writing Grief: Margaret Laurence and the Work of Mourning, Response to Death:
The Literary Work of Mourning, and Twenty-­First Century Canadian Writers. He
is coordinator of the Certificate programme in Health and Medical Humanities at
the University of Regina.

Katherine M. Robinson is Professor of Psychology at Campion College,


University of Regina, and Graduate Chair of the Experimental and Applied
Psychology programme, University of Regina, Saskatchewan, Canada. She is a
Fellow of the Royal Society for the Arts (FRSA) in the United Kingdom. She spe-
cializes in mathematical cognition, the psychology of evil, and eye tracker com-
puter game design for data collection. She recently published Mathematical
Learning and Cognition in Early Childhood Education: Integrating Interdisciplinary
Research into Practice.

Open Access    This chapter is licensed under the terms of the Creative Commons
Attribution 4.0 International License (http://creativecommons.org/licenses/
by/4.0/), which permits use, sharing, adaptation, distribution and reproduction
in any medium or format, as long as you give appropriate credit to the original
author(s) and the source, provide a link to the Creative Commons licence and
indicate if changes were made.
The images or other third party material in this chapter are included in the
chapter’s Creative Commons licence, unless indicated otherwise in a credit line to
the material. If material is not included in the chapter’s Creative Commons licence
and your intended use is not permitted by statutory regulation or exceeds the
permitted use, you will need to obtain permission directly from the copy-
right holder.
CHAPTER 2

Mapping Reproductive Health Policy Using


Arts-Based Research Methods: A Model
of Pedagogical Transgression

Angie Mejia and Danniella Balangoy

Introduction
This chapter engages with “the magic of health humanities” (Crawford
2020, 3) with an applied approach that merges arts-based research meth-
ods and intersectional analysis to introduce undergraduate health sciences
students to the asymmetric power relations of U.S. reproductive health
policy. We affirm our commitment to what Charise termed the urgent task
of an applied health humanities praxis “infused with advocacy and alive to
activism” (2020, 25) to respond to the effects of neoliberalism on the
health and wellbeing of underserved populations. We concur with recent

A. Mejia (*)
Center of Learning Innovation, University of Minnesota Rochester, Rochester,
MN, USA
e-mail: amejiame@r.umn.edu
D. Balangoy
Farmington, MN, USA
e-mail: balan017@umn.edu

© The Author(s), under exclusive license to Springer Nature 17


Switzerland AG 2023
C. Riegel, K. M. Robinson (eds.), Health Humanities in
Application, Sustainable Development Goals Series,
https://doi.org/10.1007/978-3-031-08360-0_2
18 A. MEJIA AND D. BALANGOY

scholarly work that asserts a need to critically assess how the health human-
ities might be apolitically applied in clinical education to meet the market-
driven demands of healthcare institutions (Diedrich 2015; Fletcher and
Piemonte 2017; Charise 2020). By remaining vigilant about how we do
health humanities, we can more easily “talk back” (hooks 1989) and inter-
vene in practices and systems that marginalize subaltern groups’ health
conocimientos (wisdom and knowledge) and mute their transformative
potential. We enter this conversation with a pedagogical process that chal-
lenges university undergraduate students and others to critically examine
the role of U.S. reproductive health policy as a driver of inequities that
impact how health professionals engage in the clinical encounter.
The use of qualitative methods in health sciences and STEM (Science,
Technology, Engineering, and Mathematics) classrooms has been referred
to as a “transgressive practice” (Hsiung 2016). We, as Women of Colour
(WoC) teaching (Mejia) and learning (Balangoy) at a Predominantly
White Institution (PWI) in the Midwestern United States, are also coded
as transgressors and trespassers. PWIs, institutions where Anglo Whites
make up over 50% of the student body (Von Robertson et al. 2016) and
whose practices, policies, and institutional ideologies have been shaped by
and entrenched in a legacy of racial segregation and exclusion (Allen 1985;
Hurtado 1992; Smedley et al. 1993; Apugo 2019), are in urgent need for
humanities-based and critically liberatory-inspired pedagogies that apply
an intersectional lens and praxis. Introducing controversial topics in aca-
demic settings is not always fruitful as “[i]t takes time for students to deal
with all the assaults on their ways of perceiving the world” (Bickford et al.
2001, 92). However, the pedagogical use of performative research meth-
ods might allow for the exploration of power, domination, and their inter-
sectional oppressions in accessible and transformative ways, for both
audience and learner (Cabaniss 2016; Tintiangco-Cubales et al. 2016).
This chapter presents a model and a qualitative analysis of an applied
health humanities assignment that used arts-based methods to introduce
health sciences undergraduates to the intersectional barriers connected to
reproductive health policy in the United States. We begin by outlining the
concepts driving our pedagogy as well as our analysis (intersectionality,
arts-based methods, performativity) and summary of key literature on
U.S. health providers’ knowledge about reproductive health policy. Then,
we go on to describe the assignment in more detail before delving into our
qualitative analysis of students’ written reflections on dramatizing the
intersectional consequences of restrictive reproductive health policy. We
2 MAPPING REPRODUCTIVE HEALTH POLICY USING ARTS-BASED… 19

close this chapter with a reflection on this health humanities assignment’s


limitations when exploring controversial issues in the classroom.

Literature Review

Intersectionality
Intersectionality emerged from the work of Black feminist scholars
(Crenshaw 1990; Collins 2002; Combahee River Collective 2014) and
other Women of Colour thinkers, activists, and academics (Lugones 1987;
Hurtado 1989; Sandoval 1998; Moraga and Anzaldúa 2015). This con-
cept illustrates how socio-political markers of identity (race, gender, class,
ability, nationality, sexual desire, language, among others) and systems of
domination, power, and differentiation (such as racism, sexism, classism,
ableism, ethnocentrism, and others) work in complex and mutually consti-
tutive ways (Crenshaw 1990; Collins 2002) to shape and solidify inequities.
Expanding upon the theoretical and methodological possibilities of
intersectionality, Patricia Hill Collins (2002) proposed a sociological and
feminist-informed analytical framework to understand these complex and
mutually constitutive dynamics. Calling it a Matrix of Domination, Hill
Collins argues that power and domination operate at four dimensions to
organize social life: structural, disciplinary, hegemonic, and interpersonal
domains of power. Within the structural domain, power operates via laws,
legislations, and other larger, more abstract tools of power to organize
social oppression. Hill Collins sees the disciplinary domain as managing
oppression via institutional formations, such as schools, health systems,
workplaces, and other organizations, including governmental ones. The
hegemonic domain is connected to the power of culture, ideas, and social
norms to perpetuate oppression by normalizing untrue and damaging nar-
ratives about minoritized groups. The interpersonal domain within this
framework examines the power of everyday relations between people to
sustain and perpetuate the status quo.
Scholars have noted various challenges when teaching intersectionality
while proposing interventions in classrooms and other learning contexts.
A full discussion of these challenges and strategies developed to teach
intersectionality as an analytical framework is not the focus of this chapter.
However, we wish to highlight our commitment to meeting these provo-
cations by emphasizing Kim Case’s (2016) powerful words on the neces-
sity of intersectional teaching in the classroom of today:
20 A. MEJIA AND D. BALANGOY

Without intersectional theory applied in the classroom, educational


spaces serve to both perpetuate invisible privilege by focusing on personal
oppression and construct only mythical norms as worthy of earning valu-
able real estate within course materials and broader curricular designs
(Case 2016, 2). Thus, the pedagogical model and analysis of learners’
writing and other data presented here is our intervention as Feminists of
Colour to make visible those mechanisms of power and domination within
our institutional contexts (Mejia, in the classroom; Balangoy, in the clini-
cal learning space) and to act upon them.

Arts-Based Research
We use the term arts-based research (ABR) to conceptualize the integra-
tion of the arts and research as a dynamic “process of inquiry whereby the
researcher alone or with others, engages the making of art as a primary mode
of inquiry” (McNiff 2019, 24, as cited in McNiff, 2014, pp. 59, emphasis
in the original.) Practices under the umbrella of ABR act as “methodologi-
cal tools used by research across the disciplines during any or all phases of
research” (Leavy 2019, 4). By performance, we mean the way “research is
presented … for others” (Gergen and Gergen 2019, 54, emphasis in the
original). This definition takes into account the audience, what the
researchers wish to communicate to said audience, the researchers’ ratio-
nale in using the performance approach to share research findings, and the
myriad of ways audiences may respond or react to the knowledge com-
municated via the performance (de Carvalho Filho et al. 2020; Saypol
et al. 2015; Shapiro and Hunt 2003).

Performance as a Pedagogical Tool


When reflecting on the use of performance as a pedagogical tool with
healthcare professionals, Nelles and others suggest that “[t]heater and
medicine have commonalities where human bodies are relational sites of
practice, knowledge, and complex content” (2018, 14). The application
of humanities-based pedagogical approaches via mediums of artistic
expression allows learners to reflect on “ethics, ambiguity, and complex
topics that can be difficult to talk about abstractly [while] expos[ing]
[them] to themes they may not feel comfortable with and provide a safer
space to investigate these themes” (Nelles et al. 2018, 180). Thus, it is no
surprise that educators have found the pedagogical value of performativity
2 MAPPING REPRODUCTIVE HEALTH POLICY USING ARTS-BASED… 21

when teaching future healthcare providers. Kumagai et al. (2007), for


example, highlight how the use of theatre in the classroom allows instruc-
tors to engage in productive discussions around race, ethnicity, gender,
and other dimensions of difference and power as related to healthcare.
Rizk et al. (2020) show how performance as a teaching tool can help stu-
dents examine challenging clinical encounters. Rapisarda et al. (2011)
demonstrated how role-playing in the classroom positioned graduate-level
counselling students to realize that working with diverse clients requires
additional sets of knowledge, training, and a significant change in profes-
sional disposition. The activity divested them from the assumption that
multicultural counselling was a mere “understanding of the basic facts
about a client’s culture” (Rapisarda et al. 2011, 372) and inspired appre-
ciation for the additional levels of training needed to serve diverse clients.

Reproductive Health, Rights, and Justice


When designing learning classroom exercises that incorporated intersec-
tional analysis and employed performance and reflective writing, we were
operating from research findings that suggest U.S. adults have limited
knowledge on topics related to reproductive and sexual health (Kavanaugh
et al. 2013), including abortion (Bessett et al. 2015), and state laws on
reproductive and sexual health (Swartz et al. 2020). We were also aware of
our campus’s location in a tends to be politically conservative area of
Minnesota. Research has shown that religious students in allied health
(Papaharitou et al. 2008), medicine (McKelvey et al. 1999; Bennett et al.
2018), and nursing (Marshall et al. 1994) are more likely to hold negative
attitudes towards controversial issues of sexuality than their secular coun-
terparts. Providers with rigid attitudes towards sexuality have been shown
to feel less comfortable discussing sexual health issues with their patients
(Tsimtsiou et al. 2006).
In addition, we took into consideration how learners might be unaware
of the complexities between state and federal reproductive health laws.
Research suggests that even medical professionals working in reproductive
health have gaps in their knowledge about U.S. health policies and how
these affect their day-to-day professional lives. For example, Dodge et al.’s
(2013) analysis found that reproductive health providers were knowledge-
able on some, but not all, restrictive laws in their state. In this particular
study, providers were well-informed about the different types of health-
care coverage available for abortion services and spousal permission
22 A. MEJIA AND D. BALANGOY

guidelines (Dodge et al. 2013). However, they were less confident in their
knowledge of parental notification and consent laws when a minor needs
an abortion and guidelines around state-mandated counselling before ter-
minating a pregnancy (Dodge et al. 2013).
Finally, we were guided by Ludlow’s argument (2008) on how repro-
ductive health experiences, such as abortion, are complex and multifaceted
issues that “extend beyond the limits of the [abortion] debate and thus
simultaneously embody “pro-life” and “pro-choice” values” (2008, 32).
Thus, the use of performance and reflection to educate audiences on the
real-life consequences of restrictive policy on historically oppressed and
institutionally underserved people would not position learners for right
versus wrong conversations. Instead, the focus would be on understand-
ing these laws’ socio-political outcomes on groups of people they may
soon interact with as health professionals.

Context and Overview of the Learning Activity


This chapter’s authors are an assistant professor and a student who recently
completed an degree. Both write from their positions as Women of Colour
teaching and learning at a small campus connected to a larger public uni-
versity system in the Midwest. As of 2021, the campus serves around 600
students; 40% of these identify as Students of Colour. This campus is also
connected to the Mayo Clinic and our practices as teaching and learning
scholars are known for innovative approaches to learning and teaching
from its health sciences faculty.
The learning activity is a two-part assignment, consisting of an in-class
performance and a written research portfolio, which was carried out within
the context of Community Collaborative, an upper-division community-­
engaged learning course offered year-round at our institution. Community
Collaborative introduces students in their last year of undergraduate stud-
ies to participatory and other qualitative research methods to explore
community health topics. The course also has a community-engaged
learning component that pairs students with organizations and agencies
for service-learning projects ranging from volunteering directly with
agency clients to working on long-term projects, including research using
participatory and arts-based methods.
2 MAPPING REPRODUCTIVE HEALTH POLICY USING ARTS-BASED… 23

The Assignment: Performance and Written Portfolio


The assignment is divided into two parts, an in-class role-play, and a writ-
ten research portfolio, and is worth 10% of the class’s total grade. Students
start by participating in the in-class performance during the second half of
the semester and have until the end of term to complete a research port-
folio consisting of two written memos (one reflective, one analytical) and
two dramatic scenes (with accompanying instructions for performers and
post-performance discussion questions for audience participation).

In-Class Role-Play
The students will spend the whole session creating a role-play performance
using briefs developed by the Guttmacher Institute, a policy research
organization focused on advocating for reproductive health rights in the
United States and transnationally. These short summaries outline impor-
tant points and policy analyses on specific pieces of restrictive state-based
reproductive and sexual health legislation. Groups of four to six learners
are given a brief and asked to spend 20 minutes creating a dramatic scene
that portrays the real-life consequences for institutionally underserved and
marginalized individuals. The scene is meant to prime the audience (often
their peers and future colleagues) to reflect on the many barriers that
engender unequal health outcomes for different groups of people.
Collective discussion follows each performance. This exercise spans two
class sessions to give each group plenty of time to perform and lead the
conversation.

Written Portfolio
This part of the assignment requires students to individually research two
pieces of restrictive state-based reproductive and sexual health legislation.
To receive full points, the portfolio must include two written dramatic
scenes depicting the real-life consequences of said policies on marginalized
individuals. These scenes should be accompanied with instructions for the
facilitator and the performers and a list of questions for a post-­performance
audience discussion. The portfolio also contains a 500-word memo out-
lining the researching and writing of the dramatic scenes and a 500-word
reflection exploring the student’s emotional responses and reactions.
Students could also integrate another artistic medium into the
24 A. MEJIA AND D. BALANGOY

assignment. While this was optional, a few undergraduates chose to sub-


mit short stories, poems, drawings, photo-essays, video animations, or
artistic mixed media collages.
Most of the students enrolled have already taken a sociology class or
public health elective (or both) and been introduced to intersectionality.
However, the first author spent two class sessions focusing on intersec-
tionality as both a concept and an analytical approach to map out health
and other social inequities. The assignment not only asks students to map
the different reproductive health outcomes associated with various minori-
tized groups but requires them to demonstrate knowledge of the dimen-
sions of power within Hill Collins’ framework to show an understanding
of reproductive health inequities within institutional, cultural, interper-
sonal, and structural contexts.
Since the assignment incorporates discussions about the potentially
controversial topic of abortion, students are sent an email about the details
in advance. Students are informed that they will not be asked to share their
views on sexuality or reproductive health. Instead, we will ask them to
engage in a group-based, in-class exercise tied into a more extensive writ-
ten portfolio to learn how health services researchers communicate find-
ings in novel ways and further engage in an intersectional analysis of health
inequities. Those students uncomfortable with abortion would be given
the choice of using legislation pieces that did not include it. For example,
they could be assigned summaries outlining laws like Kentucky’s 2018
Senate Bill 71, which mandates schools to implement an abstinence-only
curriculum when providing sexual education to K-12 students.

Methods
We conducted a thematic qualitative analysis of the students’ written
reflections and our observational classroom notes. Reading through these
assignments, we began by creating a set of initial codes to find patterns
and common themes. By codes and coding, we mean textual data (via
words and phrases) being “symbolically assign[ed] a summative, salient,
essence-capturing, and/or evocative attribute” (Saldaña 2021, 3). As
qualitative researchers, we created initial codes from reading the academic
literature on health providers’ reproductive health knowledge and per-
spectives, scholarship of teaching and learning in reproductive and sexual
health in the post-secondary classroom as well as those that “jumped out”
during our first reading (Seidman 2006). (For example, some of these
2 MAPPING REPRODUCTIVE HEALTH POLICY USING ARTS-BASED… 25

codes focused on students’ pre- and post-sources of reproductive health


knowledge, while others centred on their sources of knowledge.) As a
second step in qualitative analysis, these codes were then grouped into
categories, which allowed us to add, adjust, merge, or eliminate some.
Using this initial set of codes and categories, we went back and individu-
ally coded all of the reflections to assure the reliability of our coding struc-
ture. We met again to code the rest of the writings using the qualitative
research software package Atlas.ti. The categorization process led to our
interpretation of the salient themes, which we expand upon in the findings
section. The paper was also read by two alumnae who had completed the
assignment to ensure the trustworthiness of our analysis.
Due to our campus’s small size and how recent the exercise’s imple-
mentation was, we do not identify the students by their preferred gender
pronouns. Instead, we use the plural “they” and limit the use of other
descriptors when using quotes or segments of their written work. This is
under a campus-wide Institutional Review Board (IRB) human subjects
research protocol covering analyses of students’ written assignments and
other data collected via teaching and learning products of coursework.
Students are given the opportunity to opt out of having their classroom
work being used in research studies.

Findings
In addition to introducing methodological processes of reflexivity, data
collection, and dissemination (Lapum 2019) facilitated by an arts-based
exploration of controversial and difficult to discuss topics in the health sci-
ences, we found the assignment impacted students in various other ways.
The in-class exercise encouraged more productive conversations around
socially polarizing reproductive justice topics. Both the in-class role-play
and the written assignments helped students understand U.S. state-based
and federal reproductive health policy as related to their career aspirations.
Our analysis also demonstrated how the in-class exercise and the written
portfolio helped students more confidently distinguish the analytical
dimensions of intersectionality theory. We use presentative excerpts from
the students’ written reflections and ethnographic notes to illustrate these
findings.
Our findings suggest many students became more aware of state law’s
complexities when forced to analyse the many social implications for those
living in more restrictive states. Their knowledge of a specific reproductive
26 A. MEJIA AND D. BALANGOY

health legislative practice might have consisted of what a law prevented or


allowed a health provider to do or not do. After reading texts looking at
the intersectional barriers, some students might have even begun under-
standing the underlying ideological substrates of particular reproductive
health laws as connected to the political players creating and supporting
them. However, as the individual below states, they did not imagine how
norms and personal perspectives around reproductive and sexual health
practices would impact a provider’s duty of care:

Prior to this exercise, I hadn’t thought about how much these policies could
influence patients, simply because I didn’t really know about these policies.
I knew that for myself, I had to have permission to be seen by a doctor from
my mom when I was a minor, though I hadn’t thought too much about
what would happen if someone couldn’t get permission… I was aware that
some doctors do not perform abortions, but I had never thought to think
about why this was. It honestly had not even occurred to me that this was
for personal reasons that they would do this. I think this activity was very eye
opening for me.

The student above also chose to create a dramatic scene based on


Tennessee’s Senate Bill 1556, a 2016 legislation that offers protections to
mental health therapists who decide not to serve clients whose lifestyles
and identities conflict with their own “sincerely held principles” (Grzanka
et al. 2020). Like others who selected similar legislative examples, they
were also unaware of the extent to which medical providers’ ideological
stances could affect the care they provide and the way policies in place
protect care decisions based on moral or religious grounds. “If the law
protects such behavior,” one student stated during class discussions, “then
it can only mean that [the behaviour] is more widespread.” Many students
nodded in agreement with their peers. Two students even stayed a few
minutes after class to ask us for help in making sense of “how this [pro-
vider’s moral stances protected by policy] be allowed to happen.”
The assignment also forced students to see how restrictive state laws
could bear upon their specific career trajectories. One student chose sev-
eral bills affecting dispensing of medications used for pregnancy termina-
tion. Below, they expand upon how legislative efforts to restrict access to
abortion would affect how they went about their job duties:
The Idaho law is especially interesting to me since I work in a pharmacy:
2 MAPPING REPRODUCTIVE HEALTH POLICY USING ARTS-BASED… 27

Some of the medications that are routinely used for abortions have other
uses such as treatment of miscarriages and chemotherapy. Requiring phar-
macies to complete additional paperwork for these medications would be
very difficult to do. Additionally, not all physicians include their reasoning
or diagnosis for prescriptions so the pharmacist would have to call every
physician they receive a prescription from taking more time from both the
pharmacist and physician.

Several undergraduates work part time as healthcare technicians, nurs-


ing assistants, or patient care associates to supplement their income or gain
experience. Like the student above, many focused on how these laws
would affect how they went about their duties, even when they were not
planning to provide reproductive health services as part of their future
obligations.
The exercise made students consider the difficulty of doing their work
in environments where state laws “seem to be made complex almost on
purpose,” subjecting those working with patients “to a host of problems
that have nothing to do with providing health care.”
For some, the in-class dramatization, and the development of written
scenes made them worry about how uninformed they were about state
laws that could affect more than their career. Below, a student reflects on
how the assignment urged them to think more deeply about how health
policy affected them personally and professionally:

Being in a school where all my peers are pursuing a career in healthcare and
science, I think that it is important to get an understanding of what the
world we are stepping into. I think that many of us cruise by our educational
career and don’t think about how policy changes can have an impact on the
careers we are pursuing. … [P]olicy changes impact not only our careers but
also our lives.

During our analysis of the written work and assessing of other class
products not connected to this exercise, we noticed some students devel-
oping a deeper understanding of intersectionality theory regarding the
differences between interpersonal and structural effects of oppression,
domination, and power. We use a segment from Mejia’s ethnographic
notes on an encounter outside class (below) to demonstrate how a student
verbalized her understanding of the analytical dimensions of Hill Collins’
Matrix of Domination:
28 A. MEJIA AND D. BALANGOY

S was excited to tell me that they finally “got” the “whole matrix thing.”
“What helped?” I asked. “Getting into the roles!” I remember this student’s
performance as the scared high schooler seeking permission from the courts
to get an abortion. They said that the dramatization and then writing other
scenes helped them think of how “the law affects the clinic and then all of
the people involved.” They remarked that the exercise made it much easier
to realize how “a hospital worker, the place where they work in, and the
people they care for are all connected to laws.” When legislation eventually
passes, they continued, it forces a “clinic to change how one goes about
patient care” even when “the people working there are not necessarily try-
ing to be racist.” I remarked that they got it; “it” meaning the chapter in
Patricia Hill Collins’s Black Feminist Thought, which some of my students
experienced as a moderately difficult read. (Field notes, 10 November 2019)

S demonstrates her understanding of three dimensions in Collins’


framework—structural, disciplinary, and interpersonal—and how these
interact to create a unique experience of oppression. Just like S, students
stated that the in-class dramatic role-play (“getting into the roles”) and
subsequently researching and developing dramatic scenes with different
audiences in mind, allowed them to come back to Patricia Hill Collins’
concept of power as present structurally (via legislation), within institu-
tional formations (via hospitals and clinics) culturally, and during interper-
sonal encounters.
The combinations of in-class performance and reflective written exer-
cises allowed individuals to develop a deeper understanding of how restric-
tive reproductive and sexual health legislation was more detrimental to
racially and ethnically minoritized populations. The student below pro-
vides examples of how these laws operate to limit access to adequate
reproductive healthcare for members of racial/ethnic marginalized com-
munities in these states.

[P]olicymakers know that these populations will not have the money to pay
for an abortion out of pocket or two separate appointments with the time to
do so. This is a direct target towards these populations and is just one of the
racist acts of many within the laws set in place within our country.
Aside from pushing students to reflect on the blatant racism behind these
laws, the performance and written assignment allowed students to map out
the mechanics of this legislation on the ground. Just like the student above,
others spoke of the additional burdens, whether emotional or material, con-
nected to the implementation of restrictive reproductive health legislation.
2 MAPPING REPRODUCTIVE HEALTH POLICY USING ARTS-BASED… 29

This was evident after mapping out the inadequate care or lack of access for
someone living in a specific state.

Though some students stated holding more conservative stances on abor-


tion, in the end, they reflected that the experience helped them be more
conscious of how laws affect others with different views:

Even if you are pro-life, it’s still important to know the laws that contradict
your beliefs. I didn’t know about the situation specific law being passed in
Wisconsin, but I knew that it was an option available. This is something that
everyone should know so that they can know the rights they have in
their state.
It’s easy to state your opinion without much thought after reading a pas-
sage about a certain issue, but it’s so different if you can actually experience
the feelings and emotions that are involved. As for me, someone who has a
certain set of rules and values that I was raised with, I have always had strong
opinions about issues like abortion and other issues. But using drama to
present the reality of not being able to decide what to do with your own
body is indeed terrifying and … [makes it] clearer to the audience what the
issue looks in real life and how serious it can get sometimes. Also, you can
try to picture yourself in place of the actors and decide what would you have
done if you were that person and this was all real.

Finally, students indicated that using a sociodrama approach, due to


performance’s ability to both communicate and evoke an emotional reac-
tion from others, might be a more productive way to deliver health infor-
mation. As one student indicated, “these topics… although uncomfortable
to discuss with others…” might be best delivered using “drama or drama
with personal experience,” rather than just delivering the same informa-
tion via “a pamphlet that the patient is not going to want to read…”.

Choosing to Not Choose, or Bravely Choosing


to Stay: Opt-Outs and Outliers

Using arts-based methods as pedagogical tools to explore controversial


topics, when carefully developed and implemented, may be beneficial to
most learners, even those who show initial hesitancy or resistance to either
the subject (reproductive health inequities) or the method (humanities-
based approaches.) The majority in this class took a chance by engaging in
performance, reflection, and praxis to take a deeper look at health
30 A. MEJIA AND D. BALANGOY

inequalities connected to restrictive U.S. reproductive health policies.


However, we would be remiss not to discuss those few students that
decided to opt out of the assignment and those who probably did not find
value in the learning activity.

Opt-Outs: The Choice Not to Engage with a Pro-Choice Topic


From 83 students enrolled in both semesters (Fall 2019 and Spring 2020,)
excluding those that did not give a specific reason for being absent or who
failed to turn in the written assignment, nine students opted out from
participating. Some claimed to feel “uncomfortable with the topics dis-
cussed,” shared how the exercise “did not align with [their] faith,” or
perceived the assignment as “biased” against “conservative students.”
These students agreed to complete the alternative assignment and write a
1500-word paper focusing on U.S. policy not connected to reproductive
or sexual health inequities.
Some of the students that opted out from the in-class performance, or
the written reflection were also resistant to using an intersectional lens
when exploring issues affecting the overall health of racially minoritized
groups. One indicated feeling like the class was “all about racism and
nothing else.” Another student expressed that the exercise was not created
with people “who do not see race in everything” in mind. Another indi-
cated not “understanding the importance of this assignment” since stu-
dents had “already talked about racism.” While there is no way that we can
connect these undergraduates to the first author’s negative end-of-term
evaluations, some of those ratings did refer to this exercise (as well as oth-
ers that looked at intersectional barriers of healthcare) as not beneficial
and as “biased” or “too political.”
Most of the written reflections showed that engaging in the perfor-
mance exercise and completing the research portfolio gave students a
more nuanced understanding of how state laws affect people’s ability to
get adequate reproductive healthcare in the United States, especially along
intersectional lines. As previously highlighted, even those claiming “pro-­
life views” found value in using performance, intersectional analysis, and
autoethnographic reflection. They engaged in meaningful acts of
perspective-­taking when mapping out the effects of restrictive reproduc-
tive health policies on marginalized individuals and groups. However, a
small number of students showed resistance to exploring intersectional
issues in light of state-level reproductive health laws. One completely
2 MAPPING REPRODUCTIVE HEALTH POLICY USING ARTS-BASED… 31

removed the issue of racism and focused on developing scenes with very
unclear roles and outcomes. Their written reflection argued that “race is
not really an issue here, since it is an insurance issue” when referring to
Wisconsin’s legislation restricting state employees’ insurance coverage for
abortion services.

“Being Brave:” Focusing on the Pros of “Pro-Life”


Unlike the rest of the class (excluding those who opted out) who used
their scenes to explore issues of reproductive oppression along intersec-
tional lines, one student chose to use the assignment as a way to further
reflect on their “pro-life beliefs,” in general, and their ideological stance
on foetal personhood, in particular. Additionally, this student’s written
scenes did not explore the intersectional barriers nor expand upon “the
real-life consequences” of these laws on historically marginalized individu-
als. Instead, their reflection emphasized and argued for the “positives” of
restrictive reproductive health policies:

I chose the South Dakota law about the language of abortion, naming the
fetus as a human being, as I thought that it was very powerful. It seems that
this was in place to illicite [sic] a response in the patients being seen. I think
by having it be mandatory, would create more thought when in an abortion
situation. It personally doesn’t seem right to me that it takes language for
people to see that a fetus or baby is a human being or an eventual person,
but that is my own opinion. I think both policies can have massive effects on
those seeking these types of care, possibly negatively emotionally, but I think
one could argue that a decision that would alter a women’s [sic] life and the
potential life of another person, is massive in itself. In my scenes, I was try-
ing to show why these laws might have been planned or been supported. I
wanted to shed light on the positive side of them, rather than just a nega-
tive. … The language of the abortion scene was meant to show how power-
ful the language of the policy is. I thought that it was important for a person
going through with an abortion to hear the language of the fetus as a human
being and living person.

This student’s choice of “naming the fetus as a human being” and focus
on how the legislation works to emotionally influence a person seeking an
abortion exemplifies scholarly work on the power of restrictive abortion
laws in the United States. Ludlow, for example, argues that the language
used in these policies creates and solidifies “a discursive separation of a
32 A. MEJIA AND D. BALANGOY

foetus from the body that must sustain it… [where] the fetus becomes the
person (patient) and the pregnant woman becomes a ‘body’” (Ludlow
2008, 33). In the case of this future health professional, “the positive
side” of this particular law is connected to its moral power to dissuade
(and if we read more into their written reflection, to discipline) an already
distressed patient from asking for health services. Thus, the student that
developed this sociodrama scenario helped us envision how a small but
nevertheless influential group of future professionals may use the discur-
sive force of restrictive reproductive health law during their clinical
interactions.

Discussion
This chapter outlines an applied health humanities pedagogical model
about reproductive oppression via restrictive state laws in the United
States for health sciences undergraduates. Initially designed by the first
author to introduce how non-mainstream qualitative research approaches
are used to communicate health inequities and policy topics to others, this
activity positioned students to apply an intersectional analysis to another
inquiry area, the reproductive and sexual health arena. We believe this
applied health humanities exercise can help meet the needs of undergradu-
ates and engage other groups of health and medical professionals in trans-
formative conversations about controversial or complex topics. For
example, Jones (2001) demonstrates the value of using sociodrama to
nurture a space for providers “to recognize issues based on their own clini-
cal and personal experience,” which in turn might help them develop new
ways to deliver care (Jones 2001, 390).
An analysis of students’ written reflections on writing and performing
dramatic scenes for an audience, classroom observation notes, and stu-
dents’ written artefacts showed how using performance, reflection, and
other forms of artistic expression benefitted learners in additional ways.
First, it allowed undergraduates the opportunity to engage in a discussion
of a controversial topic without devolving into an either-or conversation.
Second, it helped focus on the effects of policy on their future careers by
assisting them to see the differences between state and federal laws and
their impact on racialized communities. Third, it provided students with
an exercise to explore intersectional barriers to health and how these bar-
riers look when taking contexts of power and domination into account.
Finally, it positioned students to wrestle with the complex relationship
2 MAPPING REPRODUCTIVE HEALTH POLICY USING ARTS-BASED… 33

between ideology and U.S. state law pertaining to health inequities at the
interpersonal level of power.
The use of performance and other arts-based pedagogical tools to
explore reproductive oppression at the structural level allowed students to
visualize difficult situations that they might encounter as providers at the
interpersonal level. As Lake et al. (2015) indicate, “utilising the arts to
provide a vehicle for critique of the dominant paradigms in medicine offers
a route to engagement and professional agency” (2015, 770) for future
healthcare professionals. Many of the assignments in this class illuminated
how the praxis at the intersections of dramatic performance and reflective
writing made students contemplate the additional consequences of restric-
tive reproductive health laws on their future professions, even when some
stated that they were not likely to find themselves working directly with
patients needing reproductive health services.
For many of the students, thinking intersectionally, developing, and
performing dramatic scenes depicting experiences under restrictive state
reproductive health policies put them in a state of cognitive disequilib-
rium. Kumagai and Wear (2014), when reflecting on the role of the
humanities to teach future medical professionals, describe this as an expe-
rience of “discomfort … when encountering a person, an experience, or a
perspective which is unfamiliar” (2014, 974) to the learner. Since repro-
duction and sexuality are controversial classroom topics that touch upon
“politicized issues, issues easily personalized, [or] issues easily magnified
by extremism or lack of diversity” (Burkstrand-Reid, Carbone, and
Hendricks 2011, 678), the exercise was also a way to place learners, and
the instructor, in a state of emotional imbalance. In turn, the experiences
of and reactions to melding performance and analysis became for everyone
(including both authors, in their respective roles) “compasses”—a word
used by Bresler (2019) to envision the pedagogical possibilities of using
arts-based research methods in the classroom. For all involved, the educa-
tional space as a stage, and the use of arts-based research activities with an
intersectional lens to explore discomfort, became that cognitive and emo-
tional compass that “orient[ed] us toward that which we encounter[ed]
and simultaneously enhance[d] understanding of who we are and who we
aspire to be” (Bresler 2019, 651).
As we highlighted earlier in this text, one of most reflected upon parts
of the learning experience was reproductive health policy affecting how
students would engage with their patients. And, for the instructor? Well,
for the first author, her unease is connected to the many difficulties this
34 A. MEJIA AND D. BALANGOY

new generation of providers will encounter as they graduate and start their
professional lives in a contentious second half of 2020, where U.S. politics
are informed not only by the continuous neoliberalization of healthcare
(Laster Pirtle 2020; Ahlbach et al. 2021) but by politically inflamed cul-
tural practices founded on science denialism (Gonsalves and Yamey 2020;
Yamey and Gonsalves 2020; Rudolph et al. 2021). For the second author,
who plans to train as a physician and eventually provide reproductive
health services to Black women, the political elements are painfully per-
sonal and equally distressing.
We also need think of the possibility of learners’ resistance to explore
reproductive oppression along the lines of race and gender and the effects
of students’ political ideologies on pedagogical exercises exploring health
inequities. The authors are both racially minoritized women navigating a
social context influenced by regionally unique affective economies of racial
resentment (Bonilla-Silva and Forman 2000) and White fragility (Nichols
and Wacek 2019; Evans-Winters and Hines 2020). Thus, the findings pre-
sented here take into consideration this limitation.
A small minority of students decided to opt out of the assignment due
to their religious views on abortion and sexuality, as noted earlier in the
section “Choosing to Not Choose, or Bravely Choosing to Stay.” Some of
these students also remarked that the class was focusing too much on rac-
ism and racialized oppression. There are two social dynamics we ask facili-
tators to take into consideration if replicating or modifying this applied
health humanities exercise. First, it is vital to understand the role of reli-
gious attitudes at the smaller socio-political and geographic level of the
population (instead of attitudes at the level of the state) when discussing
reproductive health. Adamczyk and Valdimarsdóttir (2018) argue that
analyses at the county level (in the United States, the second-level of
administrative division within a geographical area) gives us a more com-
plex understanding of societal perspectives on abortion than analyses
based only on primary-level/state-level data. Their analysis of the General
Social Survey (GSS), a survey that has captured U.S. public perspectives
on socially relevant issues since 1972 (Erikson and Tedin 2019), found
that an increase in religious attendance at the county level pointed to
“both religious and secular residents [having] more disapproving views
about abortion” (Adamczyk and Valdimarsdóttir 2018, 140, empha-
sis ours).
While there is no way for us to determine individual religious practices,
we can imagine how students’ spiritual practices might affect how they
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Houston, Co. Sgt.-Mjr. D., D.C.M. and Bar.


Birkett, Co. Sgt.-Mjr. J., D.C.M.
Cooke, Pte. J. L., D.C.M.
Entwistle, Sgt. J., D.C.M.
Evans, Sgt. H. E., D.C.M.
Gowers, Sgt. G. W., D.C.M.
Greenhalgh, Cpl. W., D.C.M.
Hargreaves, Cpl. T., D.C.M.
Harrison, Pte. J., D.C.M.
Harrison, Co. Sgt.-Mjr. J. H., D.C.M.
Haslam, R. Sgt.-Mjr. J., D.C.M.
Jolly, Cpl. J., D.C.M.
Jones, Pte. E., D.C.M.
Kehoe, Pte. W. H., D.C.M.
Kinsella, Sgt. W., D.C.M.
Marshall, Sgt. J., D.C.M.
Pratt, Co. Sgt.-Mjr. W. H., D.C.M.
Spiers, Sgt. J., D.C.M.
Steele, Co. Sgt.-Mjr. R. J., D.C.M.
Stezaker, Co. Sgt.-Mjr. A., D.C.M.
Swarbrick, Cpl. W., D.C.M.
Waterworth, Pte. A., D.C.M.
Whitehead, L.-Cpl. G., D.C.M.
Whittaker, Pte. F., D.C.M.
Wilkinson, Sgt. J., D.C.M.
Littlewood, Sgt. R., M.M. and Bar.
Airey, Pte. G. F., M.M.
Baldwin, Pte. E., M.M.
Bannister, Pte. H., M.M.
Baxter, Co. Sgt.-Mjr. E., M.M.
Berry, L.-Cpl. H., M.M.
Brierley, Pte. E., M.M.
Brindle, Sgt. T., M.M.
Brotherton, Pte. T., M.M.
Burnett, Pte. W., M.M.
Cain, Pte. M. H., M.M.
Chadwick, Pte. E., M.M.
Clarke, Pte. J. T., M.M.
Cole, Pte. R., M.M.
Connolly, Pte. J., M.M.
Cooper, Pte. G., M.M.
Cox, Pte. H., M.M.
Farrell, Pte. J. A., M.M.
Gillibrand, Pte. G., M.M.
Gorse, Pte. E., M.M.
Green, Pte. J., M.M.
Greenhalgh, L.-Cpl. A., M.M.
Gregson, Sgt. G., M.M.
Haffner, Sgt. G. C. A., M.M.
Hardman, Pte. G., M.M.
Hargreaves, Pte. D. E., M.M.
Hargreaves, Sgt. W., M.S.M., M.M.
Hartley, Pte. W., M.M.
Higgins, Pte. J., M.M.
Horne, Pte. H., M.M.
Hurley, Sgt. J., M.M.
Kneale, Pte. J. W., M.M.
Lewis, Pte. A., M.M.
Livesey, L.-Cpl. C., M.M.
Longworth, Pte. H., M.M.
Maloney, Pte. J., M.M.
McGlynn, L.-Cpl. T., M.M.
Moden, Sgt. A. W., M.M.
Partington, Pte. J., M.M.
Patefield, Pte. W., M.M.
Potter, Pte. H. G., M.M.
Sarginson, Pte. H., M.M.
Singleton, Pte. J. H., M.M.
Smith, Pte. G., M.M.
Steele, Sgt. R. J., M.M.
Sullivan, Pte. J., M.M.
Ward, L.-Cpl. C., M.M.
Whittaker, Sgt. A., M.M.
Wilson, Pte. J., M.M.
Yegliss, Pte. H., M.M.
Yoxall, Pte. W., M.M.
Hudson, Co. Sgt.-Mjr. H., M.S.M.
Oliver, Sgt. W. J., M.S.M.
Stezaker, R.Q.M.S. W., M.S.M.
Haffner, C.Q.M.S. G. C. A. (F.).
Hargreaves, Cpl. T. (F.).
Harrison, Co. Sgt.-Mjr. J. M., D.C.M. (F.).
Jones, Pte. A. H. (F.).
Marshall, Pte. F. (F.).

1/9 BATTALION MANCHESTER REGIMENT

Officers

V.C. Forshaw, Lieut. W. T.


Lloyd, Lt.-Col E. C., D.S.O. and Bar.
Connery, Q.M. and Hon. Maj. M. H., M.C.
Stephenson, Capt. D. B., M.C.
Wood, Lieut. R. G., M.C. (F.).
Cooke, 2nd Lieut. C. E., M.C.
Hunt, 2nd Lieut. G., M.C.
Sutton, 2nd Lieut. O. J., M.C.
Howorth, Maj. T. E. (F.).
Nowell, Maj. R. B. (F.).
Welbon, Capt. F. W. (C.F.), M.C.
Other Ranks

Bayley, Cpl. S., D.C.M.


Christie, R. Sgt.-Mjr. J. C., D.C.M.
Davies, L.-Cpl. A., D.C.M.
Grantham, Sgt. H., D.C.M.
Greenhalgh, Sgt. J., D.C.M.
Hibbert, Pte. J., D.C.M.
Horsfield, Sgt. J., D.C.M., M.M.
Latham, Pte. A., D.C.M.
Littleford, Pte. S., D.C.M.
May, Cpl. R., D.C.M.
Moss, Cpl. J., D.C.M.
Pearson, L.-Cpl. S., D.C.M.
Pickford, Pte. T., D.C.M.
Sylvester, L.-Cpl. G. J., D.C.M.
Thickett, Sgt. F., D.C.M.
Holden, Pte. J., M.M. and Bar.
Adshead, Pte. A., M.M.
Allen, Sgt. G., M.M.
Atherton, Sgt. J., M.M.
Byrom, Pte. T. H., M.M.
Chadderton, Pte. H., M.M.
Chadderton, Pte. W., M.M.
Eastwood, Cpl. A., M.M.
Garside, Pte. H., M.M.
Gorman, Pte. F., M.M.
Hall, Cpl. R., M.M.
Horton, Pte. A., M.M.
Howard, Pte. T. M., M.M.
Kinsella, Pte. J., M.M.
Longson, Pte. J., M.M.
Metcalfe, Sgt. H., M.M.
O’Donnell, Cpl. R., M.M.
Pemberton, Pte. F., M.M.
Price, L.-Cpl. R., M.M.
Radcliffe, L.-Cpl. F. D., M.M.
Ratcliffe, Pte. F. E., M.M.
Roberts, L.-Sgt. H., M.M.
Shelmerdine, Pte. J., M.M.
Simister, Pte. N., M.M.
Tipton, L.-Sgt. T., M.M.
Vause, Pte. J., M.M.
White, Pte. F., M.M.
Howard, Cpl. J., M.S.M.
Andrew, L.-Cpl. R. (F.).
Christie, R. Sgt.-Mjr. J. A., D.C.M. (F.).
Horsfield, Sgt. J., D.C.M. (F.).
Sheekey, Pte. W. (F.).

1/10 BATTALION MANCHESTER REGIMENT

V.C. Mills, Pte. W.

Officers
Robinson, Brig.-Gen. G. W., C.B.
Peel, Lt.-Col. W. R., 2 Bars to D.S.O.
Wilde, Maj. L. C., D.S.O.
Taylor, Capt. J. A. C., D.S.O., M.C. and Bar.
Bletcher, Capt. T., M.C.
Butterworth, Capt. A., M.C.
Hampson, Capt. H. J., M.C.
Hardman, Capt. F., M.C.
Cook, Lieut. F. E., M.C.
Howarth, Lieut. F., M.C.
Shaw, Lieut. W. D., M.C.
Hassall, 2nd Lieut. H., M.C.
Whitehead, 2nd Lieut. J. B., M.C.
Williams, 2nd Lieut. W., M.C.

Other Ranks

Toogood, Co. Sgt.-Mjr. K., D.C.M. and Bar.


Ayre, L.-Cpl. C., D.C.M.
Baddeley, L.-Cpl. F., D.C.M.
Brown, Sgt. D., D.C.M.
Darby, Pte. E., D.C.M.
Haskey, Sgt. M., D.C.M.
Langley, Sgt. C., D.C.M.
Lees, Sgt. S. R., D.C.M., M.M.
Leigh, Cpl. R., D.C.M.
Lloyd, Cpl. O., D.C.M.
Owen, L.-Cpl. E., D.C.M.
Revell, L.-Cpl. W., D.C.M.
Rigby, Cpl. R., D.C.M.
Schofield, Pte. F., D.C.M.
Seddon, L.-Cpl. J., D.C.M.
Spedding, Cpl., D.C.M.
Sugden, Sgt. J., D.C.M.
Taylor, Pte. T., D.C.M.
McNamara, Pte. W., M.M. and Bar.
Ashurst, Pte. W., M.M.
Bradbury, Sgt. M. R., M.M.
Bradshaw, L.-Cpl. J., M.M.
Bridge, Pte. J., M.M.
Brimelow, Pte. J. L., M.M.
Brookes, Cpl. H., M.M.
Butterworth, Sgt. E., M.M.
Carroll, Cpl. H., M.M.
Clutton, Sgt. T. H., M.M.
Cooke, Pte. H., M.M.
Creswell, Sgt. F., M.M.
Critchley, Pte. F., M.M.
Davies, Pte. J., M.M.
Dukenson, Pte. G. R., M.M.
Fisher, Cpl. A., M.M.
Hancock, Pte. A., M.M.
Hayes, Pte. J., M.M.
Hayes, Pte. J. R., M.M.
Heslop, Pte. R. W., M.M.
Hulme, Pte. S., M.M.
Hutchins, Pte. E., M.M.
Matthews, Pte. F., M.M.
Milner, Sgt. J., M.M.
Newton, Sgt. H., M.M.
Nicholson, Pte. W., M.M.
Parker, L.-Cpl. W., M.M.
Radcliffe, Pte. W., M.M.
Robinson, Cpl. B. B., M.M.
Silverwood, Pte. T., M.M.
Smith, Pte. G. A., M.M.
Smith, Sgt. R. S., M.M.
Spink, Pte. E., M.M.
Squires, Sgt. W., M.M.
Stockton, Cpl. E., M.M.
Storey, Pte. J., M.M.
Sugden, Sgt. J., M.M.
Ward, Pte. R. B., M.M.
Weston, Pte. T., M.M.
Whittaker, Pte. H., M.M.
Dransfield, Cpl. J., M.S.M.
Gartside, Sgt. J., M.S.M.
Hollingsworth, Sgt. J. E., M.S.M.
Keighley, Cpl. J. H., M.S.M.
Robinson, L.-Cpl. B. B., M.S.M.
Scholes, Cpl. J., M.S.M.
Trevitt, R.Q.M.S. J. P., M.S.M.
Coulson, Pte. J. (F.).
Hammond, Pte. J. (F.).
Haslam, Sgt. S., (F.).
McHugh, Sgt. M. (F.).
Whitehead, L.-Cpl. R. (F.).
Wilde, Pte. S. (F.).

127th INFANTRY BRIGADE


1/5 BATTALION MANCHESTER REGIMENT

V.C. Wilkinson, L.-Cpl. A.

Officers

Darlington, Lt.-Col. H. C., C.M.G.


Cronshaw, Lt.-Col. A. E., D.S.O.
Woods, Capt. W. T., D.S.O.
Welsh, Lieut. R. H., D.S.O.
Simpson, Lt.-Col. A. W. W., O.B.E.
Frost, 2nd Lieut. C. E., M.C. and Bar.
Bryan, Maj. J. L., M.C.
Bryham, Maj. A. L., M.C.
Fletcher, Maj. B. L., M.C.
Burrows, Capt. E. J., M.C.
Burrows, Capt. M. K., M.C.
Clayton, Capt. P. C., M.C.
Dickson, Capt. S., M.C.
Douglas, Capt. R. A., M.C. (U.S.A.)
Ellis, Capt. R. R., M.C.
Frost, Capt. M., M.C.
Greer, Capt. J. M., M.C.
Just, Capt. L. W., M.C.
Sanders, Capt. J. M. B., M.C.
Woods, Capt. W. T., M.C.
Fletcher, Lieut. P. C., M.C.
Fox, Lieut. J., M.C.
Taylor, Lieut. S., M.C.
Barker, 2nd Lieut. J. P., M.C.
Bootland, 2nd Lieut. F. R., M.C.
Lockyer, 2nd Lieut. H. R., M.C.
Rourke, 2nd Lieut. T., M.C.
Cronshaw, Lt.-Col. A. E. (F.).
Darlington, Lt.-Col. H. C. (F.).
Simpson, Lt.-Col. A. W. W. (F.).

Other Ranks

McCartney, Sgt. J., D.C.M. and Bar.


Andrews, Pte. F., D.C.M.
Barnes, Sgt. C., D.C.M.
Bent, Pte. R., D.C.M.
Blythe, Co. Sgt.-Mjr. G., D.C.M.
Casey, Cpl. A. E., D.C.M.
Chadwick, Cpl. F., D.C.M.
Christy, R.Q.M.S. W. H., D.C.M.
Davies, Pte. A., D.C.M.
Greensmith, Sgt. W., D.C.M.
Gregory, Cpl. R., D.C.M.
Grimshaw, L.-Cpl. J., D.C.M.
Hibbert, Pte. J., D.C.M.
Hills, Pte. S. L., D.C.M.
Hilton, Pte. A., D.C.M.
Lever, C.Q.M.S. J., D.C.M.
McCarty, Co. Sgt.-Mjr. T., D.C.M.
Moore, Pte. W., D.C.M.
Morrisin, R. Sgt.-Mjr. J., D.C.M.
Oldham, Cpl. A., D.C.M.
Seddon, Pte. T., D.C.M.
Smith, Sgt. J., D.C.M.
Stockton, Cpl. S., D.C.M.
Stott, L.-Cpl. J., D.C.M.
Stridgeon, Co. Sgt.-Mjr. J., D.C.M.
Trousdale, L.-Cpl. F., D.C.M.
Ward, Pte. R. W., D.C.M.
Cunningham, L.-Sgt. J., M.M. and Bar.
Abrahams, Pte. J. W., M.M.
Atherton, Sgt. J., M.M.
Barker, Cpl. J., M.M.
Barker, Cpl. J., M.M.
Bevan, L.-Sgt. J., M.M.
Bowers, Pte. J., M.M.
Brennan, Pte. F., M.M.
Britton, Pte. E., M.M.
Carroll, Pte. J., M.M.
Carter, Pte. W., M.M.
Chadwick, Pte. A., M.M.
Coogan, Pte. H., M.M.
Creed, Pte. J., M.M.
Drouthwaite, Sgt. T., M.M.
Flavill, Cpl. H., M.M.
Florendine, Cpl. J., M.M.
Hamer, Sgt. F., M.M.
Hayes, L.-Cpl. H., M.M.
Hewitt, Pte. J., M.M.
Hooley, Pte. H., M.M.
Hosler, Pte. T., M.M.
Kane, Pte. R., M.M., M.S.M.
Lee, Pte. F., M.M.
Lee, L.-Cpl. J. E., M.M.
Lomas, Pte. W., M.M.
Lowe, Pte. T., M.M.
Melling, Cpl. J., M.M.
Millward, Pte. H. S., M.M.
Molyneux, Pte. C., M.M.
Morgan, Pte. G., M.M.
Newcombe, Pte. C., M.M.
Parrott, Pte. W., M.M.
Pattison, Pte. C., M.M.
Penkethman, Cpl. H., M.M.
Poole, Pte. E., M.M.
Radcliffe, Pte. W., M.M.
Ralphs, Pte. T., M.M.
Reynolds, Pte. J., M.M.
Roberts, L.-Sgt. H., M.M.
Rooke, Pte. J., M.M.
Rowe, Pte. A., M.M.
Smith, Cpl. J., M.M.
Stamper, C.Q.M.S. P. A., M.M.
Stuart, Sgt. T., M.M.
Teague, Pte. A. E., M.M.
Turner, Pte. J. H., M.M.
Valentine, Pte. H., M.M.
Walsh, L.-Sgt. S., M.M.
Webb, Pte. J., M.M.
Whitehead, Pte. J., M.M.
Whittle, Pte. W., M.M.
Wilde, Pte. W., M.M.
Hyde, Pte. T., M.S.M.
Jones, Cpl. R., M.S.M.
Leake, Sgt. G., M.S.M.
Owen, Co. Sgt.-Mjr. J., M.S.M.
Seddon, Cpl. W., M.S.M.
Stone, Sgt. H., M.S.M.
Taylor, C.Q.M.S. F., M.S.M.
Gill, Co. Sgt.-Mjr. G. (F.).
Grimes, Pte. J. (F.).
Dandy, Pte. H. (F.).
Lomas, Pte. W. (F.).

1/6 BATTALION MANCHESTER REGIMENT

Officers

Pilkington, Lt.-Col. C. R., C.M.G.


Holberton, Capt. and Adjt. P. V., to be Brevet Major.
Worthington, Lt.-Col. C. S., D.S.O. and Bar.
Blatherwick, Lt.-Col. T., D.S.O.
Wedgwood, Lt.-Col. G. H., D.S.O.
Benton, Capt. F. C., M.C.
Blatherwick, Capt. T., M.C.
Kershaw, Capt. G. G., M.C.
Kershaw, Capt. G. V., M.C.
Molesworth, Capt. W. N., M.C.
Norris, Capt. A. H., R.A.M.C., M.C.
Till, Capt. G. F., M.C.
Wilson, Capt. H., R.A.M.C., M.C.
Wood, Capt. J., M.C.
Collier, Lieut. S., M.C.
Crossley, Lieut. F., M.C.
Hammick, Lieut. H. A., M.C.
Maule, Lieut. R., M.C.
Warburton, Lt.-Qr. Mr. W. R., M.C.
Heyhoe, 2nd Lieut. S. G., M.C.
Martin, 2nd Lieut. H. R., M.C.
Lane, 2nd Lieut. W. J., M.C.
Holberton, Maj. P. V. (F.).

Other Ranks

Roberts, Sgt. W., D.C.M. and Bar.


Ashley, Pte. E., D.C.M.
Cutter, Pte. G. R., D.C.M.
Davies, Pte. T. J., D.C.M.
Dennerly, L.-Sgt. R., D.C.M.
Doig, Pte. A. M., D.C.M.
Farthing, R.Sgt.-Mjr. J., D.C.M.
Gill, Sgt. R. W., D.C.M.
Hartshorn, Cpl. E. P., D.C.M.
Hashim, Pte. R., D.C.M.
Hay, Co. Sgt.-Mjr. F., D.C.M.
Holden, Sgt. H., D.C.M.
Hurdley, Co. Sgt.-Mjr. J., D.C.M.
Ingham, Pte. J. R., D.C.M.
Kent, R.Sgt.-Mjr. W. A., D.C.M.
Martin, Co. Sgt.-Mjr. J. R., D.C.M.
McDonald, L.-Sgt. A., D.C.M.
McDowell, Sgt. A., D.C.M.
Moores, Pte. S., D.C.M.
Murphy, Pte. J., D.C.M.
Roberts, Co. Sgt.-Mjr. W., D.C.M.
Senior, L.-Cpl. W. A., D.C.M.
Sturgess, Sgt. S., D.C.M.
Whitford, Co. Sgt.-Mjr. H. D., D.C.M.
Wignall, Sgt. A., D.C.M.
Wilson, Co. Sgt.-Mjr. S. H., D.C.M.
Wood, Sgt. G. H., D.C.M.
Jarvis, Pte. H. W., M.M. and Bar.
Shea, Cpl. M., M.M. and Bar.
Stubbs, Pte. B., M.M. and Bar.
Aldridge, Pte. J., M.M.
Allen, Pte. G., M.M.
Atherton, L.-Cpl. E. A., M.M.
Baker, Cpl. W., M.M.
Barker, Pte. W., M.M.
Beresford, Pte. T., M.M.
Berry, Sgt. A. J., M.M.
Brooks, Pte. A., M.M.
Butterworth, Pte. S., M.M.
Clarke, Pte. J., M.M.
Crowther, Pte. J. C., M.M.
Dugdale, L.-Cpl. F., M.M.
Dutton, Pte. G., M.M.
Farrand, Pte. W., M.M.
Farrell, Pte. J., M.M.
Fearn, Pte. M., M.M.
Fletcher, Pte. W. S., M.M.
Foster, Cpl. J. M., M.M.
Fox, L.-Cpl. W. H., M.M.
Gibbons, Sgt. W. G., M.M.
Gorman, L.-Sgt. D. W., M.M.
Griffiths, Pte. W. H., M.M.
Hadfield, Pte. E. G., M.M.
Hallworth, Pte. W., M.M.
Halstead, Pte. G., M.M.
Hancock, Pte. H., M.M.
Houghton, Pte. W. S., M.M.
Irwin, Pte. S., M.M.
James, L.-Cpl. W. H., M.M.
Johnson, Sgt. R., M.M.
Jones, Pte. J. N., M.M.
Kennedy, Pte. P. J., M.M.
Kent, Sgt. G., M.M.
Lockett, Sgt. P., M.M.
Maskell, Sgt. C. H., M.M.
McCarthy, Pte. D., M.M.
McDermott, Pte. J., M.M.
Mitton, Cpl. S. H., M.M.
Mullins, Cpl. P., M.M.
Parkinson, Pte. G. V., M.M.
Parry, L.-Sgt. E. E., R.A.M.C., M.M.
Potts, Cpl. A. V., M.M.
Pounder, Pte. W., M.M.
Ralphs, Pte. T., M.M.
Richardson, Pte. N., M.M.
Saxon, Pte. C., M.M.
Sellers, Pte. J., M.M.
Senior, Pte. W., M.M.
Sidebottom, L.-Cpl. W. J. H., M.M.
Smith, Pte. N. S., M.M.
Smith, Pte. W. E., M.M.
Tomkinson, Pte. W., M.M.
Tomlinson, Pte. S., M.M.
Warburton, Pte. H., M.M.
Whitehead, Pte. E., M.M.
Whittaker, L.-Cpl. O., M.M.
Williams, L.-Cpl. R. D., M.M.
Chadwick, C.Q.M.S. A. R., M.S.M.
Dale, C.Q.M.S. T. R., M.S.M.
Lee, R.Q.M.S. S., M.S.M.
Taylor, Sgt. V., M.S.M.
White, R.Q.M.S. J., M.S.M.
Wills, L.-Sgt. N. T., M.S.M.
Featherstone, Sgt. (F.).

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