Critical Global Health: Evidence, Efficacy, Ethnography

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Book Pages: 328 Illustrations: 34 illustrations Published: October 2015

Anthropology > Cultural Anthropology, Medicine and Health, Sociology > Urban Studies

For the addicted, pregnant, and poor women living in daily-rent hotels in San Francisco's Mission district, life is marked by battles against drug cravings, housing debt, and potential violence. In this stunning ethnography Kelly Ray Knight presents these women in all their complex humanity and asks what kinds of futures are possible for them given their seemingly hopeless situation. During her four years of fieldwork Knight documented women’s struggles as they traveled from the street to the clinic, jail, and family court, and back to the hotels. She approaches addicted pregnancy as an everyday phenomenon in these women's lives and describes how they must navigate the tension between pregnancy's demands to stay clean and the pull of addiction and poverty toward drug use and sex work. By creating the space for addicted women's own narratives and examining addicted pregnancy from medical, policy, and social science perspectives, Knight forces us to confront and reconsider the ways we think about addiction, trauma, health, criminality, and responsibility. 


"The Mission District is very much a part of this narrative. Knight understands that individual women’s stories do not exist in a vacuum within the city; they speak volumes about the gentrification to the area unhinted-at in the book’s title, the new people moving in, the private 'Google buses' that shuttle tech workers to their well-paid jobs. ... This is a sobering, poignant ethnography that affords dignity to women whose lives are stripped of it by a system that has let them down." — Lisa McKenzie, Times Higher Education

"Addicted.pregnant.poor is a poignant read. Knight describes a range of conflicting emotions elicited throughout the course of her research. She depicts the ambivalent feelings of the array of professionals included in the study; her book evokes similar responses in the reader. Throughout the book, Knight poses reflexive questions for which there are no clear answers. While we see the perspective of pregnant addicts, as well as of those whose life’s work is to aid or manage them, the reader is left confounded regarding viable solutions.Yet, with this thorough treatment of the issues faced by addicted pregnant women and their service providers, there is now more contextualized information for professionals and policy-makers to work with. This book is a valuable resource for all stakeholders and should be a staple for everyone involved in work with pregnant addicts."  — Kalynn Amundson, Journal of Children and Poverty

"Addicted.pregnant.poor is the sort of ethnography you start reading and don’t put down again until it’s finished. ... an honest and often harrowing account of women who have quite literally fallen through the cracks." — Kirsten Bell, Somatosphere

"Knight’s capacity for storytelling is a significant strength of this book. Through a combination of ethno-photography and strategic integration of strikingly vivid verbatim field notes, she adds colorful context to her analysis. The field notes really allow the women’s voices to be heard in a way that enables the reader to vicariously experience the pain of child loss, eviction from the daily rent hotel rooms, public benefit denial, arrests, and the literal highs and lows of cyclical drug use. ... This book clearly highlights the discrepancies between intent and impact so that social workers, as well as other professionals, can reflect on where they have been going wrong and identify new approaches for intervention with women at risk for addiction, poverty, and the lack of good health care when pregnant."  — Janaé E. Bonsu, Affilia

"Knight  has succeeded in focusing an ethnographic lens on a rarely studied group of people: drug-using women who are pregnant and living in daily rent hotels. . . .The author makes excellent use of powerful photos of life in the hotels, wisely not including pictures of the women themselves. Highly recommended. All academic levels/libraries." — I. Glasser, Choice

"This evocative text is a masterful synthesis of sincerity and sophistication, intensely self-reflexive, making for an exemplary text for graduate seminars in qualitative, ethnographic methodology." — Nancy Campbell, Medical Anthropology Quarterly

"Overall, this book is a wonderful contribution to the anthropology of addiction and of homelessness, with a specific focus on gender that is unique and far-reaching. Knight succeeds in humanizing a population that is continually judged, disregarded, and rendered as a failure."   — Parsa Bastani, Association for Feminist Anthropology

"This book dives deeply into a stigmatized population which is often gravely misunderstood, tackling deeply complicated social problems with compassion, honesty, and grace. Knight challenges established social constructs of substance abuse, mental health, and pregnancy amongst vulnerable women in the San Francisco daily-rent hotels." — Cara Kelly, Journal of Sociology & Social Welfare

"Reading addicted.pregnant.poor is stressful, not because the reader can expect the drama of a clear resolution to the women’s troubles, but precisely because she cannot. Knight’s attention to multifaceted truths, to conflict, and to incongruous realities shines in her outright refusal to engage in simplification and reduction." — Andrea Grimes, Women's Review of Books

"Knight provides finely nuanced insights into the nature of everyday violence that characterises the lives of poor women."
  — Narelle Warren, Sociology of Health & Illness

"addicted.pregnant.poor. is a potent and sensitive account of the struggles of these women's pregnancy, poverty and addiction, vividly captured with compelling field note extracts and photographs taken by the author, and will be of interest to the fields of medicine, psychology, anthropology, social work, social policy and sociology." — Naomi Rudoe, Women's Studies International Forum

"...this fully engaging in-depth ethnography provides a compelling story of critically inclusive and self-reflexive understandings of addicted, pregnant, and poor women in the urban area." — Dr. Kwanook Kim, Centre for Medical Humanities

"With its horrifying portrayal of gender, addiction, and reproduction, addicted.pregnant.poor could easily have crossed the border into ethnoporn. Instead, Kelly Ray Knight critiques ineffectual policies to address these issues against the gentrifying Mission District in San Francisco. Knight, a former public health outreach worker who spent four years conducting research there, offers a cogent and detailed discussion of just how ridiculously difficult it is to be pregnant, to be poor, and to be addicted." — Dana-Ain Davis, American Ethnologist

"Knight’s book provides a strikingly honest and well-argued perspective on addicted pregnancy, one that presents these women in all their complex humanity, and should serve as a high standard for other authors, whether they are anthropologists, social scientists, medical researchers, or public health officials attempting to reconsider how we think about the politics of addiction today." — Melina Sherman, Medicine Anthropology Theory

"[T]he book eloquently illustrates the sobering reality for poor women living in daily-rent hotels who face societal pressure, stigma, and legal policies that keep them in a state of uncertainty and varying degrees of stability. Knight’s straightforward writing and carefully thorough documentation capture the complexities, triumphs, and limitations that women encounter." — Erika Derkas, Journal of Anthropological Research

"This is high-quality, feminist research, and it can be held up as an example of exceptional qualitative social science research methods. All at once this book is breathtaking, gritty, difficult to read, yet also hopeful." — Sheila Katz, Contemporary Sociology

"addicted.pregnant.poor is a potent and sensitive account of the struggles of these women's pregnancy, poverty and addiction, vividly captured with compelling field note extracts and photographs taken by the author, and will be of interest to the fields of medicine, psychology, anthropology, social work, social policy and sociology." — Naomi Rudoe, Women's Studies International Forum

"Smartly theorized and thoroughly referenced, easily meeting the desiderata of scholarly production. It is also un?inchingly, instructively re?ective." — Kim Hopper, American Anthropologist

"A passionately and compassionately written and researched ethnography of women who use drugs, even while pregnant, and engage in sex work to support themselves. . . . addicted.pregnant.poor will make a lasting impression on scholars working and teaching in medical anthropology and on their graduate and advanced undergraduate students. In the end, many readers will put it down hoping, with Knight, that this kind of understanding will become the basis of a more informed policy and its humane practice." — Sallie Han, Journal of the Royal Anthropological Institute

"Kelly Ray Knight has the courage to expose eloquently and ethnographically one of the most painful public secrets of addiction and urban poverty (and gentrification) that medicine, public health, science, and society cannot solve. What this book documents ethnographically and explores theoretically must be confronted in all its impossible complexity and violence."  — Philippe Bourgois, coauthor of Righteous Dopefiend

"Kelly Ray Knight writes with compassion and self-reflection, and one of her great strengths is the way she gracefully renders her own doubts and self-ironies into the stories she collects from pregnant addicts, making both her subjects and herself more 'real' and complicated. addicted.pregnant.poor brings the experience of pregnant drug addicts close to the reader, giving them human voices, faces, and fears. Knight's plunge into the dangerous, barely survivable world these women inhabit is tremendously compelling." — Rayna Rapp, author of Testing Women, Testing the Fetus: The Social Impact of Amniocentesis in America


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Author/Editor Bios Back to Top

Kelly Ray Knight is Assistant Professor of Anthropology, History, and Social Medicine at the University of California, San Francisco. 

Table of Contents Back to Top
Acknowledgments  ix

Introduction  1

1. Consumption and Insecurity  33

2. Addicted Pregnancy and Time  68

3. Neurocratic Futures in the Disability Economy  102

4. Street Psychiatrics and New Configurations of Madness  125

5. Stratified Reproduction and the Kin of Last Resort  151

6. Victim-Perpetrators  178

Conclusion  206

Appendix  240

Notes  247

Bibliography  279

Index  297
Sales/Territorial Rights: World

Rights and licensing

Winner, 2016 Foundation for the Sociology of Health and Illness Book Prize (presented by the British Sociological Association

Additional InformationBack to Top
Paper ISBN: 978-0-8223-5996-8 / Cloth ISBN: 978-0-8223-5953-1
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