Paper short abstract:

Drawing on 5 years of interdisciplinary work I describe the translation of case histories from a respite shelter into a set of epidemiological indicators and reflect on how they may sharpen influential theories from both anthropology and epidemiology.

Paper long abstract:

I draw on five years of interdisciplinary work with a group of epidemiologists, clinicians, public health officials, civil society organizations as an anthropologist working with street populations in Delhi. I describe the translation of case histories taken in a respite shelter into a set of epidemiological indicators and reflect on how they may sharpen theories from both anthropology and epidemiology.

The case history forms designed by an anthropologist covered questions ranging from a patient’s journey to the street, when they fell sick, where they went for care, and their current forms of social support. While designed to meet the goals of a public health program for street populations, these documents allowed us to generate a set of social factors that influence important epidemiological indicators such as treatment completion, morbidity, mortality etc. These individual case histories read together generate pathways between ill health, social isolation, living conditions and adverse childhood experiences, to name a few. The pathways start to give us an emergent, situated set of ‘structures’, that can give definition to ideas of ‘structural violence’(Farmer 2004), or the constitutive parts of a socio-ecological framework (Krieger 2011). I chart how tensions remain in interpreting a fuzzy social document like the case history—for example, in how to translate different forms of social isolation into numerical form. However, I argue that the case history provides a compelling document that can be produced at scale, which both anthropologists and epidemiologists can use to draw the relationships between unequal social structures and ill health.