In his discussion, Dr. Gonsalves showed maps of social geography that demonstrated how political determinants of health contribute to discrepancies in public health. His example visually demonstrated how counties with lower life expectancies correlate with the counties where there were the most slaves present (through the “black belt”). I have always been attracted to maps as a form of learning about the world. I loved geography growing up and was obsessed with memorizing all the states, countries, capitals, seas, etc on the globe. Fast forward to my time in college at Emory, and I have been shown maps in very new perspectives. As an anthropology student, I see how boundaries marking state and country borders are arbitrary and invented rather than indisputably natural. However, as a public health student, I see how these abstract lines are extremely powerful in dictating why some people experience different health outcomes than others. 

Here is another set of maps:

They also show how the black belt corresponds to heightened public issues – in this case, greater rates of deaths from HIV and tuberculosis (in 1994).

Health geography is an important and powerful tool in visualizing how place, environment, and politics can directly impact one’s resources and outcomes related to health. However, it is also important to note the limitations that maps present: they can be heavily biased, and they can contribute towards the reduction of public health issues to stats and numbers rather than impacts on individuals.

I recently read the incredible book Man’s Search for Meaning by psychiatrist and neurologist Viktor Frankl. In the book, Frankl explains the psychotherapeutic field of logotherapy through the lens of his experience in Nazi concentration camps. Both his story and his psychological analysis impacted me tremendously. With the book fresh in my mind as I listened to Dr. Raper’s lecture, I made several connections between logotherapy and mental health during the COVID-19 pandemic.

Logotherapy is an approach that focuses on the future and finding personal meaning in one’s life, even in the face of suffering or hardship. This sense of purpose is different from the broad, cliche “life goal” that I often think of as a college student. Rather, Frankl describes purpose at a smaller scale, arguing that sustaining meaning can be found through the act of creating work, loving someone, or changing one’s attitude towards suffering from futility to persistence.

A large part of our class discussion with Dr. Raper centered around the ideas of helplessness, control, and resilience. We discussed personal strategies for combating feelings of distress and helplessness, such as listening to music or actively practicing gratitude. Turning to these tactics reflect the conscious choice to exert control over one’s emotions and motivations. Rather than giving up all personal agency due to some uncontrollable situation, Frankl would argue that we have the responsibility to exercise the choice to move forward. 

It wasn’t difficult to feel hopeless during the pandemic, particularly in the early months of quarantine when the return to normalcy was nowhere in sight. Many people picked up new hobbies such as baking, sewing, and painting, and these projects to complete were often what fueled people to get out of bed in the morning. We can view this through a logotherapeutic lens, as these “creations of work” were attached to the individual’s daily sense of meaning. Additionally, logotherapy can be used to make sense of attitude changes towards quarantine. The COVID restrictions caused massive disruptions in routine life and led to an abundance of free time, which caused widespread distress and lack of motivation. The idea of “taking advantage” of all this time became the prevalent narrative to get through the emptiness. Now, people had a purpose: try new recipes, learn a new skill, start exercising, listen to that podcast you never had time for, etc.

While I find Frankl’s writing to be very applicable and inspiring, I do struggle with the notion of the simplicity of attitude-shifting. I recognize how significant of a challenge this can be and how reframing one’s situation does not happen overnight. I would love to hear any additional thoughts on this topic.

A main point that stuck out to me from Tuesday’s lecture was the identification of uncertainty as a driving force for shaping behavior during periods of recession. This makes a lot of sense to me, as the desire to understand the world feels intrinsic in our humanity. Lacking the ability to do so would clearly cause mass fear and anxiety, and in turn, the gravitation towards explanations that can rectify this discomfort. In my psychology course last year, we heard a lecture on conspiracy theories that broke down the reasons why people follow them so fervently. The first reason, as Dr. Bianchi mentioned, is epistemic. We are motivated to understand our world and have wired-in needs for predictability and closure. From a sociological perspective, predictability is a huge motivation as to why people ascribe to social structures and constructs; these unwritten rules lay a groundwork for expected interactions between individuals and groups. During a worldwide pandemic, when the typical norms of social and economic life are thrown out the window, it makes sense why people look to conspiracy theories to mitigate the abundance of uncertainty. Another aspect that contributes to this is existential. Humans have the need to feel safe and secure in their environment, and feel like they can exert control over the environment as autonomous individuals. Identifying a cause of otherwise unexplainable societal disorder offers a sense of agency, as it provides a clear line of reasoning that can be intervened with. The last motivation for ascribing to conspiracy theories is social, or the desire to belong. Those who are socially detached are more likely to believe in conspiracy theories, and doing so provides community and purpose within a social society. Dr. Bianchi noted that uncertainty creates a psychological need to associate with others. It provides comfort, sense-making, and a model for normative behavior. During COVID especially, when health promotion required the separation of people, the intrinsic need for community felt even greater. 

Conspiracy theories are dangerous and impactful, yet they can be used to reflect epistemological, existential, and social aspects of human nature. This is demonstrated in interviews with those deeply involved with conspiracy groups, as they often share sentiments of feeling control in the cause-and-effect nature of radical explanations. Understanding how they are rooted in uncertainty during periods of recession provide greater context within which these movements can be analyzed.

I was captivated by Dr. Dube’s storytelling and inspired by her determination to improve the health of communities across Africa. Her experiences are the epitome of what one can accomplish when combining public health movements with cultural awareness and understanding. This is especially true in regards to the Christian community, where friction exists between HIV/AIDS discussion and religious leaders. Dube’s initiatives in local churches included open discussion about sex and sexuality. As she brought up, how are you supposed to ask a pastor to stand at the pulpit and talk about HIV prevention?

To accomplish this, it is critical to thoroughly understand the people and practices of the specific community. I would love to learn more about how Dr. Dube adapted her approach to each of the churches across the continent. Outside of Christianity, I’m interested in other faiths’ attitudes towards HIV/AIDS and the responses of their places of worship, especially with religion being such a central part of people’s community life. Dr. Dube’s visit to our class also left me wanting to know more about her curriculum intertwining theology with the epidemic. What exactly does it look like to read the bible in the context of HIV/AIDS? How did she reshape these discussions into a theology of compassion, when previous readings of the bible from this perspective treated HIV as a punishment for immoral lives? These questions intersecting science, culture, and religion deeply interest me, and I feel so grateful to have heard Dr. Dube’s incredible story firsthand.