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Ethnography is a core methodology in anthropology and other disciplines. Yet, there is currently no scholarly consensus on how to teach ethnographic methods—or even what methods belong in the ethnographic toolkit. We report on a systematic analysis of syllabi to gauge how ethnographic methods are taught in the United States. We analyze 107 methods syllabi from a nationally elicited sample of university faculty who teach ethnography. Systematic coding shows that ethics, research design, participant observation, interviewing, and analysis are central to ethnographic instruction. But many key components of ethical, quality ethnographic practice (like preparing an IRB application, reflexivity, positionality, taking field notes, accurate transcription, theme identification, and coding) are only taught rarely. We suggest that, without inclusion of such elements in its basic training, the fields that prioritize this methodology are at risk of inadvertently perpetuating uneven, erratic, and extractive fieldwork practices.

Historically, ethnographic methods were learned by cultural anthropology students in individual research projects. This approach creates challenges for teaching in ways that respond to the next generation’s calls to decenter anthropology’s White, heteropatriarchal voices and engage in collaborative community-based research. Analyzing syllabi from 107 ethnographic methods training courses from the United States, we find the tradition of the “lone researcher” persists and is the basis of ethnographic training for the next generation. There is little evidence of either active reflection or team-based pedagogy, both identified as necessary to meet career opportunities and diversification goals for the wider field of cultural anthropology. However, we also find that, by centering the completion of largely individual research projects, most ethnographic methods courses otherwise adhere to best practices in regard to experiential and active learning. Based on the analysis of syllabi in combination with current pedagogical literature, we suggest how cultural anthropologists can revise their ethnographic methods courses to incorporate pedagogy that promotes methodologies and skills to align with the needs of today’s students and communities.

Anthropological approaches to "immigrant mental health" as an object of ethnographic inquiry can illuminate how psychosocial well-being - or decline - and the therapeutic realm of mental health is always enacted by a variety of institutions and social actors. The ways that mental health is understood and approached across different geographical and social settings are constitutive of a range of cultural meanings, norms, and social relations. The authors in this special section provide crucial insights into the landscape of immigrant mental health and how the experience of multiple exclusions influences collective psychosocial well-being. They also illustrate the extent to which narratives shape the production of knowledge around immigration and health, engendering direct effects on public policy, social imaginaries, and community health. Future research in the anthropology of immigration and mental health will need to further elucidate the structural underpinnings and racial capitalist origins of psychosocial decline.

Unmet needs can impede optimal care engagement, impacting the health and well-being of people living with HIV (PLWH); yet, whether unmet needs differ by care engagement status is not well understood. Using surveys and qualitative interviews, we examined and compared unmet needs for PLWH (n = 172) at different levels of care engagement. Unmet needs varied only slightly by care status. Survey findings revealed that provision of housing, emergency financial assistance, employment assistance, and food security were the greatest unmet need; for those in care, housing was the greatest unmet need, whereas for those sporadically in care or out of care, employment assistance was the greatest unmet needs. Qualitative interviews likewise illustrated that a lack of financial resources including insurance, housing, employment, and transportation presented barriers to care engagement across all care groups. Our findings indicate that unmet needs among PLWH are complex and multi-faceted across care engagement status.

In 2011, Maryland established the Marcellus Shale Safe Drilling Initiative to determine whether and how gas production in the state could be accomplished without causing unacceptable risks to public health, safety, natural resources, and the environment. This initiative required a statewide health impact assessment of unconventional natural gas development and production via hydraulic fracturing (i.e., fracking). Increasing number of studies have shown that fracking has significant potential to impact health and non-health outcomes. However, because of its rapid development, there is a lack of substantive research related to the public health effects of fracking. I discuss my firsthand experiences as a medical anthropologist and public health researcher on a multi-disciplinary research team tasked with conducting Maryland’s first health impact assessment to determine the potential public health impacts associated with fracking. I focus on how fracking, as a relatively new economically viable source of energy and an emergent focus of study, brings about public and scientific anxieties, and how these anxieties shape subsequent environmental and health policy decision making processes. I reflect on the potential role of social scientists in matters of scientific knowledge production and resulting policy decisions and the broader implications of such engagement for public social science.

HIV/AIDS exceptionalism promoted compassion, garnered funding, built institutions, and shaped regulatory and research agendas under emergency conditions. Globally, however, HIV/AIDS exceptionalism has further fragmented fragile health service delivery systems in vulnerable, marginalized communities and created perverse incentives to influence seropositive individuals' behaviors. Even where HIV epidemics are viewed as "controlled" or "resolved" (as in the United States), ending AIDS requires eliminating exceptionalism, normalizing justice-based approaches to HIV care, and explicitly acknowledging how power dynamics shape popular narratives and practices.

Little progress has been made to advance U.S. federal policy responses to growing scientific findings about cumulative environmental health impacts and risks, which also show that many low income and racial and ethnic minority populations bear a disproportionate share of multiple environmental burdens. Recent scholarship points to a “standard narrative” by which policy makers rationalize their slow efforts on environmental justice because of perceived lack of data and analytical tools. Using a social constructivist approach, ethnographic research methods, and content analysis, we examined the social context of policy challenges related to cumulative risks and impacts in the state of Maryland between 2014 and 2016. We identified three frames about cumulative impacts as a health issue through which conflicts over such policy reforms materialize and are sustained: (a) perceptions of evidence, (b) interpretations of social justice, and (c) expectations of authoritative bodies. Our findings illustrate that policy impasse over cumulative impacts is highly dependent on how policy-relevant actors come to frame issues around legislating cumulative impacts, rather than the “standard narrative” of external constraints. Frame analysis may provide us with more robust understandings of policy processes to address cumulative risks and impacts and the social forces that create health policy change.

The COVID-19 pandemic has changed how we live, work and communicate. Global health teaching is no exception. Across universities, professors like us have had to quickly redesign our courses, and deliver them virtually, even as the pandemic continues to bring new challenges every day. Out of that struggle, new learning opportunities have emerged. This editorial, coauthored by 20 professors in seven high-income countries (HICs), aims to synthesise our learnings and insights from over 25 courses we taught (or are currently teaching).1 We acknowledge upfront that our insights might not transfer to global health teaching in all contexts, especially in settings where the digital divide is worsening educational inequities. We hope to learn from similar articles on how our colleagues in low/middle-income countries (LMICs) have adapted and innovated with their teaching during this crisis. Our collective experience suggests that despite the pandemic chaos and fatigue, global health teaching can be improved (box 1) by using COVID-19 as a teachable moment to focus on equity and human rights as a central theme, and by integrating anti-racism and anti-oppression as core content and orientation in our curriculum. The online format allows instructors to centre voices from the Global South, Indigenous scholars, and individuals with lived experience of oppression and resilience. Remote teaching also helps us reach wider and diverse audiences, including groups that may not be enrolled in traditional degree programmes. Learning from COVID-19, which is widening disparities within and across countries, global health teaching must educate students to address health disparities wherever they occur, not just in LMICs. While the online format offers many challenges, we believe there are ways to increase student engagement and reduce fatigue (box 2). Box 1 ### Adapting content and scope of global health teaching during the pandemic

Author(s): Primiano, Samantha J; Krishnan, Ananya; Sangaramoorthy, Thurka | Abstract: Funded by a Teaching Innovation Grant designed to transform traditional in-person courses into engaging and equitable online spaces, we designed the introductory anthropology course, Plagues, Pathogens, and Public Policy. The course is 15 weeks and is organized thematically around pressing topics and conversations concerning the social, political, and cultural dimensions of pandemics. While the COVID-19 global pandemic has intensified the pertinence of the course’s content, recent discourse on systemic racism and police brutality in the United States has also drawn renewed attention to the lack of inclusivity and accessibility within anthropological academia. Thus, with the design of this syllabus, we sought to decolonize our course content and pedagogy as a means of contributing to ongoing efforts towards inclusivity in academia. Our approach to a decolonized and inclusive syllabus included diversifying course content as well as constructing accessible language, assignments, and course policies. The following commentary outlines our goals for this endeavor and describes the process of creating this course. We detail our experiences with employing a decolonizing framework and present a guide for reading our completed syllabus so that we may encourage the development of more spaces where students can engage with and understand the benefits of decolonized scholarship.

This commentary addresses the possibilities and pitfalls of putting intersectionality and syndemics into conversation with each other. We engage with two studies published in this issue: the first on the health-related vulnerabilities among LGBTQ + Latinx men in Orlando after the Pulse nightclub shooting, and the other on syndemic health issues brought about by social and structural inequities among young Black gay, bisexual, and other men who have sex with men (GBM). Both manuscripts suggest that intersectionality and sydemics can be integrated or possibly merged to build effective health equity focused interventions for marginalized populations. We, however, argue that there are several methodological, ontological, and epistemological challenges in bringing together intersectionality and syndemics. Our argument coalesces around three key points. First, we contend that while it is feasible to think of their integration as useful to the study of health disparities, syndemics offers no added benefit to health scholarship grounded in intersectional analysis. Second, we argue that assumptions of common ground between intersectionality and syndemics rest on equating theories of interaction and additivity with critiques of mutual configurations of ideology, power structures, and social categories. Finally, we maintain that if intersectionality and syndemics are to be in conversation with each other, it must be done with the recognition and examination of where each framework situates itself relative to methodology, praxis, and power. Using our own work and those of intersectional feminist scholars, we demonstrate how the stakes of intersectionality diverge radically from those of syndemics, and how syndemics has the potential to undermine the significance of intersectionality for addressing issues of health equity.

Stigma is recognized as a barrier to the prevention, care, and treatment of HIV, including engagement in the HIV care continuum. HIV stigma in older Black women may be compounded by preexisting social inequities based on gender, age, and race. Using semi-structured interviews and survey questionnaires, we explore experiences of HIV stigma, retention in care, and antiretroviral therapy (ART) adherence in 35 older Black women with HIV from Prince George's County, Maryland. Study findings indicated that older Black women experienced high levels of HIV stigma, retention in care, and ART adherence. Findings suggest that experiences of HIV stigma were intensified for older Black women due to multiple stigmatized social positions. Participants also reported experiences of marginalization in health care that hindered retention in care and ART adherence. Interventions aimed at improving HIV prevention, care, and treatment outcomes should incorporate HIV stigma reduction strategies as core elements.

HIV-related stigma is a barrier to the prevention and treatment of HIV. For midlife and older Black women, the nature and intensity of HIV-related stigma may be compounded by their multiple marginalised social status based on gender, race, and age. We examined the perceptions and experiences of HIV-related stigma among midlife and older Black women living in Prince George's County, Maryland, USA. Between 2014 and 2015, we conducted semi-structured interviews with a sample of 35 midlife and older Black women living with HIV. Using a modified grounded theory approach, we explored emergent themes related to the manifestation and experience of intersectional stigma and changes in stigma experience over time. Our findings suggest that intersectional stigma is a central feature in midlife and older Black women's lives, with women reporting experiences of intersectional stigma at the interpersonal/familial, community, and institutional/structural levels. Although women acknowledged gradual acceptance of their HIV-positive status over time, they continued to experience negative responses related to gender, race, age, and disease. Our findings indicate that a more robust understanding of the impact of HIV-related stigma requires work to consider the complex manifestations of intersectional stigma among an increasingly aging population of Black women in the USA.

We examined community perspectives and experiences with fracking in Doddridge County, West Virginia, USA as part of a larger assessment to investigate the potential health impacts associated with fracking in neighboring Maryland, USA. In November 2013, we held two focus groups with community residents who had been impacted by fracking operations and conducted field observations in the impacted areas. Employing grounded theory, we conducted qualitative analysis to explore emergent themes related to direct and indirect health impacts of fracking. Three components of experience were identified, including (a) meanings of place and identity, (b) transforming relationships, and (c) perceptions of environmental and health impacts. Our findings indicate that fracking contributes to a disruption in residents' sense of place and social identity, generating widespread social stress. Although community residents acknowledged the potential for economic growth brought about by fracking, rapid transformations in meanings of place and social identity influenced residents' perceptions of environmental and health impacts. Our findings suggest that in order to have a more complete understanding of the health impacts of fracking, future work must consider the complex linkages between social disruption, environmental impacts, and health outcomes through critical engagements with communities undergoing energy development.

Evidence suggests that racial disparities in the HIV care continuum persist in older age groups, particularly among African Americans. The objective of this systematic review was to identify factors that facilitate or hinder older African Americans’ engagement in the HIV care continuum. For studies published between 2003 and 2018, we: (1) searched databases using keywords, (2) excluded non-peer-reviewed studies, (3) limited findings to older African Americans and the HIV care continuum, and (4) retrieved and summarized data focused on barriers and facilitators of the HIV care continuum. Among the 1023 studies extracted, 13 were included: diagnosis/testing (n = 1), engagement in care (n = 7), and antiretroviral adherence (n = 5). Barriers included lack of HIV risk awareness, routine testing, and healthcare access, stigma, and multimorbidities. Social support, health/medication literacy, and increased self-efficacy facilitated engagement. A targeted focus on older African Americans is needed to achieve national goals of improving HIV care and treatment outcomes.

It is widely recognized that Americans are exposed daily to multiple chemical compounds in our air, food, water, and consumer products, and that many low income and racial and ethnic minority popul...

Recent studies have documented frequent use of female sex workers among Latino migrant men in the southeastern United States, yet little is known about the context in which sex work takes place or the women who provide these services. As anthropologists working in applied public health, we use rapid ethnographic assessment as a technical assistance tool to document local understandings of the organization and typology of sex work and patterns of mobility among sex workers and their Latino migrant clients. By incorporating ethnographic methods in traditional public health needs assessments, we were able to highlight the diversity of migrant experiences and better understand the health needs of mobile populations more broadly. We discuss the findings in terms of their practical implications for HIV/STD prevention and call on public health practitioners to incorporate the concept of mobility as an organizing principle for the delivery of health care services.

Mexican women constitute an increasing proportion of labor migrants to the United States. They are segregated into a handful of low-wage occupations, disadvantaged by global economic forces and the social construction of gender within employment relations. Drawing on ethnographic research from Maryland's Eastern Shore, I explore experiences of everyday injury, disability, and instability among Mexican migrant women who work in the commercial crab processing industry, which is increasingly dependent on the H-2B visa program to fill seasonal, non-agricultural jobs. By focusing on the daily lives of Mexican migrant women who are part of this labor force, their health and social needs, and the gendered dimensions of labor migration, I document how temporary work programs institutionalize liminality as permanent mode of being. I suggest that migrant women, amid the extraordinary uncertainty brought about by the processes of recurrent migration, reorient and recalibrate themselves through modes of conduct to make life more ordinary.