Humanities and Environmental Sciences
Disciplinary Head: John Manton
History, literary and critical studies, geography, and environmental sciences study cultural, spatial and temporal dimensions of human activity, investigating continuity and change in social and ecological relations, from the supra-national to the local.
How does this field of study encounter AMR?
Anti-microbial resistance is commonly encountered and addressed in its epidemiological and pathological dimensions, which are presented in policy terms as urgent technical and social problems. However, shifts in human land use, animal husbandry, and population distribution which underlie epidemiological intelligence and the pathological signs of AMR have broader cultural, spatial and temporal contexts, which are not always apparent in the policy field.
Environmental sciences foreground ecological dimensions and ramifications of human activity, and help us to imaginatively resituate our vision of AMR within a network of human relations with animals, plants, pathogens and terrains. Geography provides a critical and comparative lens on spatial inequality, and the often concealed or poorly understood spatial dimensions of health and environmental policy. It undermines stereotypical associations of the emergence of resistance with specific social practices, usually associated with indicators of poverty.
History investigates our changing techniques, emphases, and political means of dealing with human health, both in particular locations and situations, and in its broadest social and ecological global contexts. It links these changing politics to shifts in our understanding of poverty and in the social reproduction of inequality. Literary and critical studies demonstrate how discourse on health is deeply interwoven with culture-bound and culturally specific interpretations and expectations. Together, these disciplines help us to understand and assess the long history of social and technical interventions in human health and the burden of disease, to outline recurrent patterns, trace the impact of shifting behavioural and policy responses, and highlight local contingencies.
How is this field of study addressing AMR?
Historians have long had an interest in the processes through which existing therapies are adopted, disseminated, and come to succeed and fail. They recognise that therapeutic failure is an emergent process, in which technical, social, and biological processes are intermingled. Crucially, historians demonstrate that the distribution of blame or responsibility for therapeutic failure is an inherently political process, whose resolution is not always directly attributable to scientific assessments and outcomes. Its potential is shown in key recent work focusing on the history of hospital infection control, demonstrating how infection management practices emerged and disseminated across professional and administrative networks in the UK.
Geographers seek to understand how conflict over practices which seem to amplify AMR (notably farming and animal husbandry, and health rationing) can be mapped, and related to other aspects of spatialized identities and polarisations (as urban and rural, or expert and technician, agronomist and farmer, for example). It shows us how the politics of environmental change is complicated by local concerns with employment, occupational viability, and intermeshed rights in health and economy.
Using quantitative and qualitative methodologies, environmental sciences demonstrate how ecological processes contain, strain at, and amplify the impact of human activity. Ecologists show us that our explanations for emerging AMR are often insufficient, and overlook specific deficits in our understanding of environmental factors. Taken in combination with history and geography, these sciences outline conceptual gaps which need to be addressed to fully engage with the politics and history, the distribution and emergence, as well as the biology and ecology of anti-microbial resistance.
What are the major issues, concerns and research questions in this field of study?
There is a growing awareness that holistic and context-aware solutions are required in response to the technical and policy problems posed by AMR. However, there is little awareness of how to factor contextual components into policy processes. History, geography and environmental sciences possess key technical and methodological skills in discursive, spatial and ecological analysis of crucial contextual dimensions of anti-microbial resistance.
The disciplines share a concern with honing and mainstreaming these skills, but are also concerned with key research questions highlighted by growing concerns with AMR. Historians investigate the politics of this ‘growing concern,’ in relation to its entanglements with histories of expertise, professionalization, scientific prestige and access to funding and technical apparatus on the one hand, and its relation to changing social and behavioural norms, foodways and patterns of consumption, and questions of class formation and inequality on the other. Geographers are also centrally concerned with the formation and distribution of expertise, its spatial ramifications and the failures of its range and vision, and the propagation of spatial inequalities in access to resources, knowledge, and redress. Environmental scientists pose a range of questions about ecological residues, contaminants, and impacts of human relations and practices which are as yet poorly understood and under-investigated.
What are the policy / larger picture issues that this field addresses?
Geography has a long history of critical engagement with policy, while the Centre for History in Public Health at LSHTM has been a prominent participant in the History and Policy network, as well as leading discussion of relations between environment, health and history (see volume edited by Berridge and Gorsky). The field as a whole seeks to bring into prominence a critical awareness of broader ecological, spatial and temporal contexts and potential consequences of the policy process. From the perspective of impact, these disciplines are centrally concerned with open dialogue with policy makers, in the interest of developing sensitive, responsive and fair policy apparatus in response to what is a deeply-rooted, widely distributed, and often poorly understood environmental, social and biological problem.