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Untimely Sacrifices: An Interview with Daena Funahashi

Published September 20, 2023

For most people, Finland is not the first place that comes to mind when imagining a nation dealing with an epidemic of occupational burnout. American media frequently portrays the country as a near-utopia, with strong social welfare systems and communitarian values. In the World Happiness Report published by the UN, Finland took the number one spot for the sixth year in a row.

In 2006 and 2007, Daena Funahashi, Assistant Professor in the UC Berkeley Department of Anthropology, conducted ethnographic work in Finnish rehabilitation programs for occupational burnout. Experts at the Finnish Institute of Occupational Health (FIOH) see occupational burnout as arising out of a shift in people’s orientation to work that negatively impacts stress coping mechanisms. Rehabilitation programs, sponsored by the Finnish government, allow victims of burnout to take multi-week breaks from work in order to engage in a series of recreational and psychological therapies.

In her newly published book, Untimely Sacrifices: Work and Death in Finland (Cornell University Press 2023) Funahashi brings classic anthropological scholarship on exchange and sacrifice to bear on contemporary concerns of state welfare, capitalism, and labor’s attrition. Turning to Finland in the early 2000s, when health experts identified occupational burnout as a symptom of Finland’s new economy, Untimely Sacrifices asks what moves individuals to give their time and energy to the point of pathological – and sometimes lethal – levels of stress.

For this interview, Nataliya Nedzhvetskaya, a Matrix Communications Scholar, asked Professor Funahashi to give readers an overview of her new book. [Responses have been edited.]

How did you get started researching this topic?

Specifically, burnout became a hot topic in Finland in the late 1990s and the early 2000s, both as a new crisis of this new economy, but also as an untimely response to contemporary challenges of the workplace that needed to be diagnosed, prevented, and managed. I became interested in what escapes from this managerial perspective, in the stories – or silences – surrounding burnout and its attendant regimes of excess, sociality, and sacrifice.

The centers themselves were interesting to explore. They had a diverse variety of experts involved. Psychologists definitely played a prominent role but so did physical and occupational therapists. There was a lot of craftwork and an emphasis on making aspirations visible by creating vision boards. There were activities that promoted how to say no and lots of relaxation therapies. A day in the forest. A day of silence. Meditation exercises. Mindfulness exercises.

Why did you choose Finland as your research site?

Nordic welfare has often been explored via a utopian lens. I wanted to explore further to see what collective regimes of labor do to our ideas about what we owe to others – and how we interact with them. Finland caught my attention because when I was looking for a place to base my project in 2006-2007, the country was in the process of making a collective effort to re-calibrate the responsibility of citizen-workers to the state.

The economic crisis of the late 1990s really hit Finland hard, as it lost the USSR as its main trading partner. It came at a bad time because Finland had been trying to join the European Union, as well as European Economic and Monetary Union, for a long time. When the economic crisis happened, it was imperative for Finland to get out of the recession quickly. The focus then, was on being “timely,” as in knowing how to act in the here and now not just as Finns, but as “Europeans” – a title with, in the context of the EU, a distinct orientation towards competitiveness.

As you see in the title of my book, timeliness –being timely – knowing how to be, knowing how to spend and save your time and energy under the exigencies of the present – became imperative. That’s when “burning out” became a national issue. Burnout came to mark those individuals who were not “timely,” individuals who were not expending themselves in ways that made sense in the workplace today, in a competitive market economy. In the book, I make the point that while Finnish health experts understood burnout as an effect of advanced capitalism, I see the condition instead as a disorder that inaugurates the rules of the economic present rather than as an effect of it. Burnout is not an unintended side effect of advanced capitalism but is part of the nature of work under advanced capitalism. Workers must be timely in order to transact in the market and receive the highest return on their labor.

When the new economy came into being, it laid out “common sense” for workers. Those who didn’t adapt to the new economy had burnout, and were “sick” workers who needed rehabilitation. This explanation, used by psychologists and economists, tries to make burnout into a coherent medical condition that can be fixed. Rather than making sense of burnout and trying to cure it, I instead use burnout as an entry point to understand the “common sense” assumptions that came with the new economy.

You use this term “martyr worker” throughout your book. Why do you use this term and how do you understand it?

Absolutely. Martyr workers, in short, are workers who fail to make their sacrifice “count” in the self-interested, economic sense. If advanced capitalism is about economic rationalism, doing something because you feel like you should or because you dare not do it, is irrational, right? It doesn’t make any economic sense. Burnout gains currency as the disorder associated with “martyr workers” in Finland, because the presumption is that those experiencing burnout are driven by ideology – the ideology of welfare and of an older work ethic that is defunct in the present.

The provocation that I’m making in the book is that, contrary to the supposed healthiness and timeliness of expending yourself based on a reasoned calculation of what time and energy you should save or spend, the individuals who attended rehabilitation programs for burnout highlighted instead the very illegibility of sociality, how the self-evident aspects of social exchange can’t be put into words. It was not what you can enumerate and put down like, “Okay, I did this. So I should be getting this back,” this tit-for-tat mentality of exchange, that moved them. It was not that which drove them to work. They revealed to me that there was something beyond what they could name that pushed them to give. In trying to track down what moved them, they found themselves unable to claim their actions as their own. This is what I found that was so different from the discourse of “self-management” that was prevalent in these rehabilitation programs. And, this is where I believe turning to anthropological scholarship on the voluntary and involuntary nature of gift exchange could broaden our understanding of the animus behind work.

We have spoken so much about the Finnish context and things that are in some ways unique, and in some ways not unique, to Finland. What do you think generalizes to other parts of the world, or to other advanced capitalist societies?

Happiness has become part of what counts toward productivity now. Rather than disciplining bodies to work harder and longer hours, we’ve now turned to the management of affect, of happiness. Being healthy is no longer enough; you have to be happy, vibrant, enthusiastic, and empowered. These are all affective words. Under advanced capitalism, what makes us “burn,” what sets us on fire, becomes the very thing that we must bring under calculative control. The demand to be happy affects post-industrial societies everywhere. It’s not enough that you are interviewed and have all the skills. You have to be extra-vibrant, chirpy, a go-getter. You’ve got to bring that X-factor.

That X-factor leads to conditions like burnout because you have to commit affectively. It’s an experiential commitment. It’s giving your all. How could you not go into overdrive and go into excess? And worse, it’s no longer an external being, an entity saying “You have to do this. You have to do that.” You have to self-start. So you become your worst enemy.

You’re asked to do two different things. You’re supposed to keep yourself in equilibrium but you’re also supposed to give your all.

Exactly. And if you burn out, you’re a spendthrift. Why couldn’t you save time or spend time in a more managed way? You’re wayward in your self-management. You don’t know yourself. You’ve overcommitted.

It strikes me that a lot of the burden here has moved from society to the individual. Individuals are increasingly tasked with knowing and communicating their own limits within a stressful work environment. Turning burnout into an individual medical condition and treating it as such stops us from considering the social conditions that create it more critically.A lot of countries all over the world are really interested in burnout and are starting to medicalize it, similar to Finland. What do you think the outcome of that will be?

In one rehabilitation program I studied, there were so many different experts involved. They have the psychologist, the social worker, the nutritionist, and the activities leader, because you have to be happy. You must have fun [laughs] – you must. So happiness becomes part of the productive economic process. It’s harnessed into the very mechanisms of capital. But then it’s not happiness anymore though, is it?

If you only think about well-being in terms of utility and productivity, you are thinking about humanity as a tool of capital. Happiness as a means to an end. If you say that happiness is a resource, you are instrumentalizing affect. That very enigmatic, human, singular condition that gives meaning to life is twisted and perverted for the sake of capital.

Together with this attention to stress and stress-related conditions like burnout, I see a rise in the clinical discourse of “self-management.” For instance, in Finland, rehabilitation for burnout was based on an “empowerment paradigm” that promoted self-awareness. Becoming self-aware was to be a pathway for clients to recognize their untimeliness and to re-conceptualize their personal and professional goals within the limits of the present. While you may not see Finland’s rehabilitative program take root in the US, for instance, we still do share a lot in terms of the growth in “happiness” and “mindfulness” industries all built on the power of the self to control itself.

How do you think your findings will shake up preconceived notions about stress and stress management?

Remember that my point here is that my interlocutors were those who were convinced that what they felt no longer made sense – what they took as the givens of social reciprocity at work no longer took on the self-evidence they once did. That’s why my focus has been on speechlessness and what focusing on that space of absence allows. In rehabilitation programs, psychologists focus on questions like, why did you do work the way you did? Why did you volunteer to help so much? Why did you do that? And what are your limits? It is as if there is this coherent you-as-a-resource that you can map out. You have the resource of your energy and time that people could translate into some kind of spreadsheet.

What was really interesting ethnographically for me was how people fell speechless exactly at those moments, when asked, “why did you do it?” Not just “why do you do it,” but, “why do you continuously do it?” The seriality of their supposed senseless, energetic waste. That’s the aspect that psychologists would call an illness. It’s ill. It’s sick to be repetitively doing something knowing that it will hurt you, that you are going to burn out from it.

You can’t stop yourself.

Exactly. Like some kind of compulsion to the point where your fire burns out. For me, as an anthropologist, witnessing these individuals in the setting of these rehabilitation centers, I saw it not as an illness but as this space of silence opening up a new question about sociality. I saw it as some kind of negativity at play in the way we engage socially.

That’s why I focused on the question of the name. What is it to confer a diagnosis? What is it to name something as an illness in a way that gives you a handle on that issue? It gives you a technique, a method, a center. And it’s productive, at least in terms of the state and the economy. The state throws money at it, you make use of all these rehabilitation centers, you populate those centers, you give jobs to experts, and you give birth to more expertise. Now you have experts on burnout. It’s very productive!

But I’m saying that such a framing doesn’t really touch upon that space where those who burn out fall speechless. A psychologist might say, “Hey, you should be doing this. You need to empower yourself. Do this. Do that.” As an anthropologist, I would say “No, we need to learn from these moments.”

This is a testament to what I witnessed. This book is really trying to give significance to these moments where we actually question why we do things. These seem to be simple and fundamental questions, almost silly questions. But I think those are the questions that touch upon philosophical, anthropological examinations of what drives us. Who authors our actions?

Based on what you find in the book, how might we rethink this public health orientation towards occupational burnout?

Rather than think about rehabilitation, we might rehabilitate work. If the problem is that these syndromes – stress and overwork and suicidal ideation – emerge because of shifts in economic policy or shifts in workplace demand, then maybe it is not the people who must be rehabilitated. Maybe we should learn from those who fall speechless, who fall “sick.” I learned from working with them the unreason of reason that tells us how we are to find happiness in an undoubtedly unreasonable world.

Alumni

Gender and Political Gatekeepers: A Visual Interview with Melanie Phillips

Published September 8, 2023

How do we understand the barriers that women face in becoming political candidates? Melanie L. Phillips, who completed her PhD in the Charles and Louise Travers Political Science Department at Berkeley in 2022 and is currently a Lecturer in the Political Science Department and a Research and Evaluation Associate at School-to-School International, suggests that the problem is more complex than adding more women candidates or increasing the number of women in political power.

Phillips examines the biases of the “selectorate,” the party gatekeepers who pick each party’s candidate for the general election. Her research analyzes the gendered ways that candidates are judged based on such factors as their family and wealth. Her work shows how women’s political representation in African countries is shaped by the intersection between the rules governing candidate selection and the norms associated with gendered family roles.

For this Matrix Visual Interview, Julia Sizek, Matrix content curator and postdoctoral scholar, asked Phillips about her research, for which she used a novel dataset from the election process in Zambia between 2015-2019.

Your research on women’s access to political office focuses on Zambia. What are some of the key issues that you research, and why did you decide to focus your research on Zambia?

National Assembly Building, Lusaka, 2017. Image by Melanie Phillips.

I decided to focus my research on women and their experience with candidate selection in Zambia because of an interview I had conducted during a prior research trip with Honorable Josephine Limata, a member of the Zambian Parliament.

In 2015, Limata managed to win the parliamentary seat in Luampa constituency, in Western Province, as an independent candidate — an incredibly difficult feat in Zambia, which has seen the dominance of a two-party majority system since the beginning of multi-party democracy in 1991. Despite clearly being a strong candidate who had the support of the voters, she was not selected as the candidate by either the Patriotic Front (PF), the incumbent party, or the United Party for National Development (UPND), the opposition party.

Her problem was Zambia’s candidate selection process. In order to become a candidate for Member of Parliament in Zambia, aspirants (individuals who want to become politicians) must be selected by a political party. This process of selection is called “candidate selection,” and the individuals in charge of evaluating the aspirants are the “selectorate.”

When asked about the puzzle between her clear electability and both PF’s and UPND’s decision not to support her candidacy, she stated that “the majority of political parties don’t adopt [select] women. We are undermined by men…. There are plenty of women who stand, but, the way they are chosen, men are the majority who get adopted [selected].”

Women in Zambia face an array of barriers when attempting to stand for political office, such as gender-based gaps in financial resources, education, household responsibilities, and autonomy. The barrier highlighted most often is financial resources (or lack thereof). Financial resources are key to any successful election campaign, especially in developing countries, and are necessary to mobilize political support. Candidates must often finance and orchestrate their campaigns, and have to mobilize massive amounts of personal support and financial resources to hold popular rallies and travel across the electoral district where they are campaigning. As scholar Dominika Koter showed through her research in in Benin, elections are incredibly expensive due in large part to voters’ expectations that candidates will provide goods such as food, petrol, or cash during their campaign — and Eric Kramon’s research in Kenya from 2016 highlighted how political parties seldom cover the costs of political campaigns.

My research, however, adds nuance to understanding these barriers. I contend that to truly understand the gendered nature in which party gatekeepers scrutinize women, and how women’s treatment differs from that of men, we must consider how the family unit shapes women’s lives differently in Zambia and around the world. One of the most notable benefits of political families is the collection of resources across generations, as studied by Gary Solon (1992), but women do not benefit equally due to inequalities in inheritance laws and social norms. In my research, I analyze how the perception of access to resources is a major factor in party gatekeepers’ decisions. Women and their ability to compete in elections are heavily moderated by the support and resources of their families.

Drawing on a survey experiment with 1,339 party gatekeepers in Zambia, I show that family backgrounds are one of the strongest predictors of candidate selection for both men and women; they are also the most gendered. I find that women are differentially evaluated. Men are rewarded during candidate selection for being the heads of traditional households. Women, on the other hand, are more likely to be rewarded when their families have histories of demonstrated partisan loyalty, which refers to the level of dedication and loyalty an individual has to a particular political party. I also show that the gender of party selectorates does not substantively change how candidates are evaluated: women selectorates show no gender preference for women aspirants, and like men, punish women candidates who deviate from cultural expectations. However, I demonstrate that an individual selectorate’s level of sexist beliefs does condition how they view more masculine candidate attributes. Selectorates with higher levels of sexism favor men and those with lower levels favor women. Contrary to expectation, women selectorates have higher levels than men of ambivalent sexism, which is a measure that includes both hostile and benevolent forms of sexism.

How did you measure how selectorates examine potential candidates for office? What were your research methods, and what did you do during your fieldwork?

My dissertation is rooted in a mixed-methods approach that combines extensive qualitative fieldwork with survey and experimental techniques. Methodologically, it presents a valuable contribution of new data sources. These include candidate recommendation reports written during candidate selection; survey experiments conducted with over 1,300 party members across Zambia; and qualitative evidence from over 90 interviews with candidates, party members, members of parliament, and women’s groups in Zambia. I collected this data in Zambia between 2015 and 2019.

One of the key contributions of this research is the unique sample I leverage in order to understand the recommendations of gatekeepers, based on the in-person survey I conducted with 1,339 party gatekeepers in both the PF and UPND. Experimentally, the survey used a vignette design, which presents a description of a candidate profile with randomized changes to the description. Each participant was given a randomized profile of a hypothetical candidate that included their name, gender, family status, financial capacity, party endorsement, and organizational capacity (defined as their ability to mobilize and the strength of their networks). These hypothetical candidate recommendations were based on actual recommendations that I had collected during my field work. Participants of the survey were very familiar with this task, as each level of the party structure writes and submits these kinds of recommendations to the province and the national executive committee after interviewing candidates during the candidate selection period.

Following the vignette experiment, the surveys asked participants a range of questions to gauge their political experience, candidate preferences, measures of ambivalent sexism, and financial expectations during the multiple phases of candidate selection.

One of your key arguments hinges on the idea that a woman candidate will be judged based on her role in her family, and that the relationship between her family and the political party that she hopes to represent can also determine whether she’ll be selected. What are some of the aspects of family life that are relevant to party selectorates?

As Diana O’Brien showed in her research looking at political systems across 11 different countries, political parties are typically built through networks dominated by men that are unreceptive to outsiders — in this case, women who are not connected to those networks. As a result, as Olle Folke et al have showed, women often need to leverage their families’ political connections to get the name recognition, support, and resources necessary to compete electorally. This is especially the case in countries where citizens prioritize traditional family roles, as illustrated by the research of Alexander Baturo and co-authors. Meanwhile, work from Linda Richter has demonstrated that women who do have politically relevant family connections are more likely to access political positions and opportunities that are closed off to the majority of women.

Parties and the selectorate also use those familial ties as a heuristic for a candidate’s qualifications. Political families provide access to formal and informal advantages such as financial and educational resources or personal connections and positive reputations. And as Timothy Besley and co-authors have shown, party gatekeepers infer the qualities of a candidate based on the success of their family as a whole, assuming that qualifications like resources, education, and training will be similar among those within the family. Olle Folke’s work has demonstrated how these family connections matter more to women, who are at an inherent disadvantage, and show that women can make up for gender-based disadvantages by having dynastic family ties during candidate selection.

In my research, I explain how the family attributes of candidates shape how the selectorate perceives their strengths and weaknesses. To study gendered effects in candidate selection.I specifically distinguish between a family status mechanism (for which I use marital status as a proxy) and a loyalty mechanism, a measure of a candidate’s family political ties.

Family status, or more broadly the composition of one’s family situation, plays a significant role in how political party members evaluate candidates. Through my analysis of the marital status of candidates, I found that members of the selectorate hold a double standard when evaluating candidates based on their family structure. Whereas men benefit from certain family dynamics (for example, when looking at pay gaps, married men are typically paid the most), women are punished for deviating from traditional expectations. Similar mechanisms have been documented by Amanda Clayton and co-authors based on research they conducted in Malawi. This double standard, I argue, is consequential in candidate evaluations. I expect that women are less likely to be rewarded for conforming to normative family expectations than men, while also being penalized more harshly for deviating from them.

I found a contrasting result when studying the loyalty mechanism, which measures a family’s history of political commitments. Women benefit from a form of benign chauvinism that depicts them as more loyal and devoted than men. Women are perceived to be more loyal, and scholars Zetterberg (2021) and Thames and Rybalko (2010) have found that women are more likely to remain loyal within pre-established family networks, such as those based on political partisanship. This expectation leads party members to believe that women will be less likely than men to defect from their political party. In this respect, party gatekeepers are more likely to reward women for having a family history of partisan loyalty.

Walk us through the results highlighted in Figure 2 (below). What does this reveal about the different ways that men and women are judged by party selectorates?

Average Marginal Interaction Effects- Gendered Differences. — Figure 2: Average marginal interaction effects – gendered differences.

Core to my work is the claim that men and women are evaluated differently for the same family-based attributes. Following the analytical approach seen in Teele et al. 2017 and Clayton et al. 2019, I calculate the gender gap: the difference between the treatment of men and women, controlling for other remaining attributes, such as income and experience in politics. Positive coefficients show that an attribute has a gender gap in favor of women, and negative coefficients show a gender gap that favors men.

The results presented in this figure support my claim that party selectorates reward women candidates more than men for familial political loyalty. While both men and women are rewarded for individual invested loyalty, women receive a 4% bonus compared to men for having a family that is loyal and that has previously mobilized in elections, for example through campaigning, holding rallies, or donating.

The results show that party selectorates reward men for demonstrating traditional family status while punishing women who deviate from the norm. Selectorates disproportionately reward men for being married with two kids, which results in a 3% bonus for candidates who are men compared to women. Additionally, women are penalized severely for being divorced, which results in a 4% bonus for men.

While this study finds notable gendered effects, it also highlights some null effects where we might expect to find gendered differences. For example, while men are often more likely to be political brokers and dominate local traditional authorities, the selectorate rewards men and women equally for having local connections.

Individual and family financial attributes also appear to have no gendered effects: they increase and decrease both men’s and women’s evaluations indistinguishably. Still, even though I found a null effect here, women face greater obstacles in obtaining financial independence and/or success in many countries. In research from 2008, Doss,Grown, and Deere showed that women in Latin America and Africa have significantly less access to and ownership of land than do men, and women are also less likely to own or inherit productive forms of livestock. Inequalities in access to financial resources are clear across Zambia. Women and men across numerous interviews highlighted that the role of head of household, and the control of family resources, was specifically restricted to men. So even though women and men may be judged similarly for comparable financial resources, it is often more difficult for women to obtain them.

What needs to be considered here is that the attributes selectorates do evaluate differently for men and women tend to develop or change. One’s family and political history are not an individual choice, nor can a political history be established quickly if an individual decides to enter politics. Therefore, women candidates, regardless of whether they recognize that they have a political advantage, are limited in their ability to act on it: it simply exists as an attribute that is evaluated when they seek office. Further, in new democracies where traditional norms prevail in an individual’s family dynamic, and whether they remain “not divorced,” is often out of a woman’s control. What this tells us is that the number of women in office will not change by focusing on candidate training and increasing the supply of women candidates alone. We must also look toward training the selectorate to eliminate the gendered differences in evaluation practices.

The gender makeup of a selecting committee is often used as a proxy for the committee’s willingness to select a woman candidate. However, in your research, you find that this is not a good means to predict whether a committee will select a woman candidate. What did you find?

Many scholars have suggested that the key to decreasing bias against women during the candidate selection process is to include women in party leadership. But I found that women are not immune from gendered biases. My research finds that an individual’s level of internalized sexist beliefs, measured through ambivalent sexism, determines how gatekeepers evaluate gendered attributes.

To investigate this, I used a modified version of the ambivalent sexism index, which (as described by Peter Glick and Susan T. Fisk) “measures hostile sexism (HS), sexist antipathy toward women, and benevolent sexism (BS), subjectively favorable, yet patronizing, beliefs about women.” I found that an individual’s level of sexist beliefs conditions how they view candidate attributes such as financial resources. Party gatekeepers with higher levels of ambivalent sexism reward men for gendered attributes, whereas those with lower levels reward women.

Figure 3: Average marginal interaction effects

Advocates often recommend that more women should be included in decision-making bodies, arguing that this would decrease biases against women candidates. However, my study suggests that adding more women is not enough: women are not immune to gender biases and have their own embedded biases. Women gatekeepers punish women candidates more severely, and do not appear to reward women for demonstrating family political loyalty. Furthermore, when looking at the degree to which individuals hold sexist beliefs, I find that women score significantly higher on the ambivalent sexism measure than men in the sample. Therefore, the solution to decreasing biases against women may not be as simple as increasing the number of women on selection committees. Instead, we should train gatekeepers on unbiased evaluation techniques and strategies to root out implicit gender biases that ultimately affect the institutionalization of democracies around the world.

How might these findings about the role of the family in candidate selection be applied to other contexts, for example, in considering local or municipal elections elsewhere in Africa or in places like the United States?

While the theory presented in my dissertation is rooted in qualitative fieldwork and tested empirically with data from Zambia, the argument is broadly generalizable. It is not necessarily that the findings discussed in this dissertation are unique to Africa or even to newer democracies. However, the strength of these effects is likely moderated by a country’s level of political institutionalization, the strength of their traditional gender norms, and the level of inclusivity and transparency in their candidate selection mechanisms.

The effects outlined in my work are likely stronger in areas with weaker levels of political institutionalization, where rules, processes, and expectations governing political bodies both formally and informally have not been established. Women, in these contexts, must engage with a higher degree of uncertainty when entering the nomination stage. Additionally, the lack of transparency that often comes with lower levels of political institutionalization likely makes room for gender to have a larger effect on evaluation and selection decisions.

Women in electoral democracies throughout the world must compete within societies that have strict gender roles that establish gender norms and expectations. In turn, these norms and expectations influence how party gatekeepers measure a woman’s political qualifications and competitiveness. Additionally, in some form, gender-based socioeconomic inequalities exist in all electoral democracies. These disparities make women’s ability to meet the qualifications necessary to compete for political office more difficult. Moreover, in countries where gender schema and people’s expected adherence to them are stronger, women are more likely to face barriers in evaluations when vying for political office.

Lastly, in countries where voters are directly in control of candidate selection through primaries, the role of party gatekeepers will be diminished. Nevertheless, voters will continue to evaluate women within and against these gendered expectations, and political parties will still play a role in how candidates navigate this reality.

Article

Language Revitalization in Oakland: A Visual Interview with Tessa Scott

Published August 21, 2023

Mam, a Mayan language spoken both in the highlands of Guatemala as well as in diaspora communities in Mexico and the US, is rapidly becoming one of the most widely spoken Indigenous languages in the San Francisco East Bay region. Mam-speaking migrants are part of a broader trend of Central American migrants in the United States, but they face unique challenges when they move to the US because they often don’t speak Spanish or English. How can linguists support Indigenous language speakers in the United States, and what does starting Indigenous language revitalization programs look like on the ground?

We talked with Tessa Scott, a Postdoctoral Fellow in the Future of Higher Education program at the University of California, Berkeley. She received her PhD in linguistics from UC Berkeley Department of Linguistics in Spring 2023 with a Designated Emphasis in Indigenous Language Revitalization. We spoke with Scott about her work on researching and teaching Mam. Her work spans both formal linguistic theory in syntax and morphology as well as language and cultural learning programs, and she has worked in partnership with native speakers and activists.

Mam has become one of the top ten most commonly spoken languages spoken in U.S. immigration courts. In the East Bay, Oakland Unified School District reports that 1,130 students in their district speak Mam at home. But while their numbers have been increasing, Mam speakers often face challenges receiving services in the U.S. What are some of the challenges that Mam speakers face when they move here?

Many Mam speakers who arrive speak no English, and many times not enough Spanish to communicate clearly or fully understand what they are being told. This is a huge challenge, as without language, they struggle to find transportation to the next city, housing, a job, education, as well as legal help that they have the right to access.

There are three main challenges that Mam speakers face with respect to getting the language services they need. The first is the lack of acknowledgement that a person needs an interpreter to begin with. Indigenous people are often lumped together as a single group with other migrants from Mexico and Central America, and they are often assumed to identify as Latinx and be native Spanish speakers, which are both often not the case. Sometimes Indigenous Guatemalans coming to the US speak very limited Spanish or they are scared and simply say “sí ” (yes) to most questions to avoid potential violence or harm.

The second challenge lies in finding interpreters who speak Mam. A 2019 article in the New Yorker reported that “Mam was the ninth most common language used in immigration courts, more common than French.” There are far more people needing Mam interpreters than there are Mam interpreters, and most interpreting is done over the phone. The last problem with interpreting is that many times the client and the interpreter speak Mam, but they come from different places. While this may not seem like a big issue, significant differences in the language can be present from one town to another, and this can have enormous consequences when interpreting.

Mam is known as a linguistically diverse language, with many dialects, making it difficult to teach in language classes. How did you approach this when you worked with Mam speakers to teach classes at Laney College, and how did you approach these challenges when putting together your teaching guides?

Mam is considered to be the most internally diverse Mayan language, according to Nora England (1990, 2017), and has thus been of interest to linguists studying variation. Two dialect surveys were published around the same time in the 1980s — Godfrey and Collins 1987 and Cojti and England 1986 (an unpublished manuscript) — and together these two works established three major dialect regions of Mam: Northern, Southern, and Western. These are shown in Figure 1, which shows a map of Western Guatemala divided into the three dialect regions.

A map showing the dialect regions in Guatemala — Figure 1: Mam dialect regions (Scott 2023, pg 12, adapted from England 1983, pg 8)

Most recently, in a 2019 paper, Megan Simon argued for a reclassification of Mam varieties on the basis of phonetic distance research (how similar or distinct words sound). Her re-grouping mostly targets the dialect from the town of Todos Santos, Guatemala as distinct from the rest of the Northern Mam varieties, which she renames the Seleguá group. This is important because Todos Santos is very close in distance to San Juan Atitán, and large numbers of speakers from both towns live in Oakland, as well as countless other cities in the US. Although these Guatemalan towns are close to each other geographically, the varieties of Mam spoken within them are very different.

For us, this variation was something important to consider in our teaching. Both of our native Mam speaking teachers, Henry Sales (former teacher) and Silvia Lucrecia Carrillo Godínez, are from San Juan Atitán. This variety of Mam has some unique characteristics but can largely be understood by speakers from the Seleguá region. Our materials are based on this San Juan Atitán variety of Mam. We always make it clear that we are teaching San Juan Atitán (SJA) Mam, and that if someone is also interacting with speakers of Todos Santos Mam, we encourage them to be curious about the differences, and see it as an opportunity to learn more, thinking of their language learning as additive. While this may slow down the learning process slightly, it is worth it on many levels.

The materials used for our Mam language and culture classes are different from the Mam materials published by the Ministry of Education in Guatemala and the Academia de Lenguas Mayas de Guatemala (ALMG), which are based on a “standardized” Mam that was created for purposes of writing and gaining acknowledgment by the government. So if students want to supplement our course with these materials, or even a course in Guatemala, they should be aware that they will find differences.

How is SJA Mam different from “standardized” Mam?

To answer this question, we first need to understand how the grammatical structure of Mam (as a whole) is different from that of English. Let’s start with the order of words. In English, subjects come first in the sentence, followed by verbs, which are followed by nouns. This is illustrated in Figure 2 for the sentence “Silvia saw a bird” in English.

a structured graph showing the sentence "sylvia saw a bird" as "subject verb object" — Figure 2: English sentence

Mam sentences take on a different word order. In Mam, verbs come first, followed by subjects, followed by objects. This is illustrated in Figure 3 for the same sentence, “Silvia saw a bird,” which in Mam is Ma til Silvia jun ch’it.

chart showing "silvia saw a bird" in Mam, which is ordered verb, subject, object — Figure 3: Mam sentence

The difference between standard Mam and San Juan Atitán Mam is in the treatment of pronouns. In standard Mam, when the object is a pronoun (like “me,” for example), it sneaks in and appears in between the two words that make up the verb in Mam. This is shown in Figure 4 for the sentence “Silvia saw me.” In Standard Mam, this is written as Ma chin til Silvia. This grammatical phenomenon is similar to pronoun objects in Spanish: Silvia me vió.

a breakdown of "silvia saw me" in standard Mam - Ma Chin Til - pronoun object in the verb, and silvia as the subject — Figure 4: Standard Mam

In San Juan Atitán Mam, pronoun objects do not need to sneak into the verb. Instead, pronoun objects often stay at the right edge of the sentence, just like the object ch’it “bird” in Figure 2. The San Juan Atitán version of “Silvia saw me,” which is Ma til Silvia qini, is shown in Figure 5.

a breakdown of the sentence in San Juan Atitán Mam - verb, subject, pronoun object — Figure 5: San Juan Atitán Mam

This difference between the two varieties of Mam has major consequences for current understandings of the structure of Mam and other Mayan languages. Virtually all Mayan languages employ the grammar in Figure 4, and the deviation from this structure in San Juan Atitán Mam is the basis of the theoretical syntactic and morphological analyses in my dissertation.

While you’re trained as a formal linguist, you also taught Mam classes in the SJA dialect. How did the program to teach Mam classes get started, and what were the goals?

In Fall 2017, I met Henry Sales, who was the Mam language consultant for our graduate-level field methods class in the Department of Linguistics. The goals of this class are to document and analyze the structure of the language through the methodology of conducting structured and focused interviews, called “elicitation” in the field of linguistics, as well as collecting stories and narratives, often called “texts.” (A KQED article about Henry Sales teaching Mam can be found here.)

We students all quickly got to know Sales and realized how enthusiastic and intuitive he was about Mam, his native language. We recorded word lists and started to figure out the phoneme inventory of Mam, as well as a few other grammar topics.

During this time, I developed an excitement about studying Mam, partly due to its rich morphology and syntax and its phonology that was challenging to learn, and partly due to Sales’s energy and passion about Mam. In Fall 2018, Sales was inspired by the Nauatl program at Laney College and began talking with Professor Arturo Dávila Sanchez about the possibility of starting Mam classes at Laney. By Spring 2019, Sales invited me to join his Saturday Mam lessons on Laney’s campus, and I joined enthusiastically.

During this first semester, we met once a week at the Latinx Center on Laney College’s campus, though we eventually upgraded to a medium-sized classroom. The initial audience was small but passionate about learning Mam. Our first students were a few teachers and volunteers in the Oakland community who found themselves in frequent contact with Mam speakers. They wanted to learn Mam as a second (or third) language to connect more deeply with their students and clients and thus were dedicated to learning the language.

Our initial goals were to equip those students with the basics of Mam – for example, how to greet, how to count, and how to talk about food. This would allow them to show the Mam people in their communities that they care and that the Mam speakers not only have the right to be here, but are joyfully welcomed.

As someone primarily trained in formal linguistics, being a part of these language and culture classes was exciting because I was able to bring my different perspectives on the language to our students. The sounds of Mam and the sentence-level grammar of Mam are so different from English that it can be hard to understand even the simplest of phrases. It was very rewarding to be able to use my research on the structure of Mam to help students learn the language.

Students in a Mam language class at Laney College — Mam language and culture classes, Fall 2020. Photo by Tessa Scott

Your group has been working to provide Mam classes in Oakland and online. Who takes these Mam classes, and what are their goals in learning the language?

Since those first sessions, our class has grown and developed significantly. Many students have returned semester after semester, and this has pushed us to split the class into beginner and intermediate levels, with the latter often splitting into intermediate and advanced learners. Our Mam curriculum has been approved to be used for an official three-level language and culture course at Laney College. Upon completion of the courses, students will receive a certificate of Mam language and culture proficiency. These classes have not yet been offered at Laney, so in the meantime, we have offered the classes online free to anyone who wants to learn Mam. While these online classes are not currently being offered, they may be offered again in the future; updates and all materials can be found at our website: mamclass.com. In the meantime, a new Mam Workshop ran during the summer of 2023 through the UC Berkeley Center for Latin American and Caribbean Studies (CLACS).

One of the things that makes our class unique is our students and their reasons for taking the class. Most of our students are learning Mam as a second or third language. A large majority of our students are lawyers with Mam clients, teachers with Mam students, and healthcare workers with Mam patients. We also have many students with Mam and Mayan heritage who want to reconnect with the language and their knowledge of their ancestors.

One of our students, an elementary school teacher in Washington, encourages her students to speak Mam in the classroom, whether for counting, prayers, or telling stories. Before she took our class, her students tried to teach her words and phrases, but the teacher found it extremely difficult to identify the sounds she was hearing, let alone recreate them or know how to write them. One of the outcomes of taking our class is that now she can more easily hear differences in sounds that we don’t have in English and have a sense of how to pronounce and write them.

An unexpected positive outcome of moving our classes online is that we were no longer limited to only teaching students who live in the San Francisco Bay Area. Students from all across North America and Mexico have taken our Mam classes. Since 2020, students residing in 20 different U.S. states have registered for our classes. This incredible fact reflects the increasing presence of Mam communities across the U.S., and that these communities are spread out across the country, and not confined to one state or region.

During the pandemic, you’ve had to switch to Zoom teaching in Mam. What have been some of the challenges in switching to the online format from an in-person format?

screen shot of a Mam class delivered over Zoom — A screenshot from the online Mam class.

One of the incredible upsides of the COVID-19 pandemic, and thus moving our classes online, was the ability to reach more students. Additionally, we were able to expand our teaching team to include Silvia Lucrecia Carrillo Godinez, a native Mam speaker living in San Juan Atitan, Guatemala. Having her perspective on the language and culture in San Juan Atitan, her training in Mam literacy, her perspective on cultural topics, and her lived experiences and knowledge about life as an Indigenous Mam woman was extremely influential to our classes. In addition, her energy, patience, and passion became fundamental to our joyful class environment. In 2022, we also officially welcomed Cristina Méndez, UC Berkeley PhD student in Education, to our teaching team. She has taken our classes for many years and has become an invaluable partner in this project.

Teaching online does have some challenges, however. For example, it is harder to have one-on-one time with students, practicing pronouncing hard words, answering their questions about Mam grammar, or simply observing their use of Mam. On Zoom, our options are to go around one-by-one or split into breakout rooms. While this can be seen as a challenge, it has also fostered a sense of community by making sure that everyone has the chance to be heard. As a solution to this, our extensive Quizlet library has many decks with audio so that students can practice on their own with native speaker voices.

The other challenge lies in teaching land-based language and Indigenous ways of being. For example, the directions that sometimes get translated to “north, south, east, west” exist in a very different way in Mam. Instead of being centered on the poles of the earth (“absolute” directions), the words in Mam are centered around a mountain located nearby the speaker (see Figure 6). Teaching this by standing on a mountain is much easier and better reflects the true nature of these words than simply relying on translations and images.

a map showing west, south, east, and north as depicted over the city of Oakland — Figure 5: From Mam class materials, “Oakland map”

a diagram showing a mountain as used for directions — Figure 6: From Watanabe (1983): “mountain diagram”

How has the program worked with Mam speakers in Guatemala, and what has that brought to your work in the United States?

The Mam language and culture class meets in San Juan Atitán, Guatemala in June 2022. Photo by Tessa Scott.

In June 2022, we invited our students to join us in traveling to San Juan Atitán, Guatemala to continue learning not only how to speak Mam, but also about the Mam way of life in the Guatemalan context. During the course of the month of June, around 16 students from seven states in the US, as well as parts of Mexico, traveled to San Juan Atitán.

The main event during our visit was the cultural festival. At this festival, groups were invited from numerous Mam towns to perform traditional songs, dances, and cultural enactments, an act of celebrating diverse traditions and uniting as Indigenous Maya people. The students in our class participated in the festival by giving speeches about the importance of continuing to speak and embody Mam language and culture, as well as highlighting their language abilities by performing short, scripted conversations about why they personally are learning Mam and what they had experienced on their trip so far. (A video of the entire festival can be found here, with our group’s presentation beginning at 3:57:30).

In addition to the festival, while our group was in San Juan Atitán, we held classroom language classes, learned to make Mam food, went on hikes, spent some time learning how to weave, and additionally made connections with other Indigenous peoples from across Guatemala and Mexico, including Nahua, Ñuu Savi, K’iche’, and Kaqchikel.

This trip to Guatemala, and the opportunity for our students to not only learn Mam on its ancestral land, but also connect with individuals and groups, has strengthened many students’ commitment to learning Mam, and strengthened their individual connections to families, teachers, and other networks in Guatemala.

Teaching these classes has also allowed you an opportunity to analyze how linguists conceptualize language acquisition. What have you learned from teaching these courses?

San Juan Atitán, Guatemala. Photo by Silvia Lucrecia Carrillo Godínez

The main thing I have learned is the inseparability of learning language and learning the epistemology, land, cultural practices, spiritual beliefs, and history of the people who speak the language. Learning to speak Mam is impossible if it is attempted through translation of non-Indigenous phrases, speaking styles, and ideologies from English or Spanish. It is also impossible to simply study the language alone, removed from culture, traditions, beliefs, and customs.

I also learned that when students have a deep and meaningful reason in their life to learn a language, they can be extremely dedicated and successful in learning that language, even if it is a very difficult language to learn. Our classes have not yet offered course credit, certificate, monetary benefits, or even grades. Some of our students decided to take our class to reconnect with their heritage and to speak the language of their ancestors, who were robbed of the opportunity to freely pass on their language.

I learned from watching these incredible students that, when the reason for learning is so meaningful, students can overcome any challenge they face in learning, whether staying up for classes between 9-10:30pm for students on the East Coast, or trying to produce voiceless bilabial implosives, a type of whispered sound with no vocal vibration that is made with two lips and requires sucking air in, and not pushing air out.

I learned that these meaningful reasons were diverse and did not follow a formula. Some students work in the legal field, and they deal every day with the language challenges that Mam immigrants in the US face. By taking our Mam classes, they make the statement that overcoming such a language challenge includes them taking a step toward their clients, and that it is not the sole responsibility of Mam immigrants to learn the widely used Spanish and English. We have a duty to learn Mam, too.

Some students are teachers themselves, working with youth who question daily whether to wear their traditional traje to school, whether to speak Mam, whether to learn traditional dances and music, or whether to learn traditional prayers in Mam. Some students are healthcare professionals, working with patients who have the right to receive healthcare that they understand in their native language. Some students work for non-profit organizations providing various types of aid to immigrants. Some students are researchers in linguistics, education, anthropology, environmental studies, and psychology. Some students simply want to better communicate with their Mam-speaking friends and neighbors.

Each semester, our students do a final project. Each semester, I am blown away by what they create. In the past, students have developed presentations about their families, translated children’s books and poetry, written original stories and poetry, and created videos about a day in their life or a trip to the zoo with Mam-speaking middle school students narrating their experience and observations, and created presentations about Mam-speaking individuals whom they interviewed. (Examples of final projects can be found on the class website.)

The creativity and heart revealed in these projects were undoubtedly impressive and inspiring, and also illustrative of the use of technology to not only learn and study Mam, but to create art and use Mam as a medium of self-expression. These projects embody the students’ commitment to learning not only the Mam language, but Mam ways of being.

Alumni Interview

How Medical Expertise Shapes Gender-Affirming Health Care: An Interview with Tara Gonsalves

Published August 14, 2023

Increasingly, trans people are seeking out gender-affirming health care, whether counseling, hormone therapy, or surgery. Such care often requires expensive treatments under a health care system that is still figuring out how to respond. How do insurance processes determine who has access to care and under what conditions?

Tara Gonsalves, a recent PhD graduate of UC Berkeley and Assistant Professor of Sociology at Northwestern University, studies how social categories like “transgender” are contested and transformed over time, and the consequences of these transformations. Using quantitative and qualitative tools, she has three primary streams of research: how the term transgender has become an umbrella category for understanding gender variance, how medical experts produce new racialized understandings of gender through surgery and insurance, and how LGBT organizations worldwide emerge and integrate into advocacy networks.

For this interview, Social Science Matrix Content Curator Julia Sizek interviewed Gonsalves about the challenges of the categories of sex, gender, and transgender, and how the term transgender has become an umbrella category for understanding gender variance.

How has the category of trans come to represent gender nonconforming people today?

There are many different ways of thinking about this question. First, we might think about why this is happening. International human rights groups are tasked with making coherent claims at the global level, so they need a global category. Given the enormous violence that people who are gender and sexually variant face around the world, this seems like a crucial task. And the category that is increasingly being used to articulate diverse forms of gender variance is one that has been used in the United States and Western Europe for some time – “Transgender.” And yet, gender variance takes on different forms, however, from hijra and bakla (gender variant groups in South and Southeast Asia) to travesti and muxes (gender variant groups in Latin America). Gender variance takes on different forms in different parts of the world, resulting in diverse configurations of gender, sexual desire, and the sexed body. Some of my research looks at how the category “transgender” is coming to articulate these multiple modes of understanding gender variance and its relationship to sex and sexuality.

Answering this question is further complicated by the fact that the groups described by “transgender” are defined not only through gender identity, but also through diverse gender and sexual practices that are not heterosexual or that do not conform to conventional configurations of sex, gender, and sexual desire, as encapsulated by Judith Butler’s metaphor of the heterosexual matrix. While the term bakla is now often interpreted by scholars and activists in the United States as a Filipino version of “transgender,” for instance, the term can encapsulate both gender variant expression and non-normative sex practices. My work is part of a growing body of work in Transgender Studies that looks at the complicated relationship between postcoloniality, representation, and gender and sexuality. (Other scholars working in this space include Aren Aizura, Aniruddha Dutta and Raina Roy, and Christoph Hanssmann).

In the United States, medical organizations and LGBT rights organizations converged around a three-part definition of transgender, especially in the early 2000s: a gender identity (1) that is different from the sex assigned at birth, (2) that is ontologically distinct from sexual orientation, and (3) that presumes a gender binary. In recent years, this definition is increasingly being contested by trans and gender-nonconforming theorists and activists, though it is still widely used in reports and government documents. My transnational research examines how this category, which comes from a particular place and time, is coming to represent gender variance globally.

When we introduce studies of the social construction of gender in undergraduate courses, we often begin with reproductive organs as a proxy for femininity and masculinity, tracing how early psychology studies influenced our understanding of gender during the mid-20th century. What were those understandings of gender?

Medical understandings of gender and its relationship to sex have changed rather dramatically over the past half century.

Sex has historically been defined based on external genitalia and secondary sex characteristics. Gender, which emerged as a social concept distinct from “sex” in the mid-20th century, was primarily understood to derive from external genitalia and secondary sex characteristics (such as breasts). Femininity derived from the female sexed body, and masculinity derived from a male sexed body. Again, this is Judith Butler’s concept of the heterosexual matrix.

Even before the concept of “gender” had been named, sexologists (mostly writing in Europe) had begun to classify variant sex-based practices, such as style of clothing, mannerisms, voice pitch, preference for decor, etc. That is, if someone had a male body but preferred to wear feminine clothing, stand in a feminine way, and be read by others as feminine, this was considered “deviant.” Magnus Hirschfeld coined the term “tranvestism” to distinguish this group from those who had non-normative sexual desires.

How do scientists consider the relationship between sex and gender today?

Later in the 20th century, medical scientists began to define gender as deriving not from external genitalia or secondary sex characteristics, but rather from genes and neurology. That is, gender identity was understood to have a sort of primacy in genes, or to exist “prior” to the development of the sexed body. Rather than attempting to explain “deviant” or non-normative gender identity — i.e., gender that did not correspond to the sexed body — in early childhood socialization, medical scientists have come to accept gender identity as something that can be explained neurologically or genetically.

Similar to the search for a “gay gene” that has been well-documented (for example, see Conrad 2016, Brookey 2002, and Conrad and Markens 2000), some medical scientists are now searching for the gene that predicts gender identity. “Deviant” gender identity is becoming “normalized” through a turn to genes and brains. In other words, if genes, which some have referred to as the “essence of an individual,” can predict or explain a person’s gender identity, then gender can be understood as “naturally occurring” and therefore deserving of social recognition and rights. In a certain sense, the geneticization of gender identity might help normalize “deviant” gender identity, working as a means to rally around a marker of identity akin to “strategic essentialism,” Gayatri Spivak’s fraught concept that describes how minoritized groups use aspects of their shared identity for their political agendas.

However, it may not be wise to rely on the concept of a “gay” or “trans” gene for making political claims because it forces gender and sexual minorities to rely on a genetic marker to “prove” themselves rather than believing people’s accounts of their own bodies and desires. Additionally, because gender identity and sexual desire are complex and may change over time, manifest differently in different situations, and emerge differently in different people, I wonder whether isolating a “gay” or “trans” gene is even possible in the first place.

Today, trans people often seek gender-affirming medical care, which can include a various array of surgeries intended to help people’s bodies fit their gender. You consider how insurance companies, who often determine access to medical care, have shifted their understanding of what makes a surgery for trans people “medically necessary.” What methods did you use to track the changes in insurance policy over time, and what institutions are responsible for determining the boundaries of medical necessity?

Trans people are often violently sanctioned for embodied gender that does not match their gender identity and have pushed insurance companies to dramatically expanded coverage for gender-affirming care over the past two decades. My research draws primarily draw from qualitative analysis of national health insurance policies from five large insurers, and reviews of appeals for coverage that were completed by state-appointed reviewers. In some of my other research related to the medical field and gender, I also draw from interviews with experts and from my observation at transgender health conferences in the United States.

Medical necessity determinations are complicated. Medical necessity is ostensibly determined by medical experts and medical institutions like the American Medical Association, but variation in coverage suggests that insurers also play a role in determining what care is medically necessary. Federal and state governments often publish guidelines that private insurers then follow. In the unusual case of gender-affirming care, however, private insurers developed their own coverage plans in the late 1990s and early 2000s, before the federal government allowed public funds to be used for gender-affirming care.

In the broadest sense, social categories like “gender” shape what is seen as medically necessary for particular patients, as can be seen in contemporary studies of gender and care. In the book Trans Medicine: The Emergence and Practice of Treating Gender, Michigan State University professor stef shuster outlines how medical providers, rather than drawing from prior medical knowledge, actually produce expertise when caring for transgender patients. (See also Piper Sledge’s work on non-normative gender and cancer care.) This work shows, in part, how gender shapes the kind of care patients receive.

For surgeries like facial feminization or masculinization, medical experts have to determine whether and under what conditions these surgeries are necessary. How do they make these decisions, what kinds of evidence can they use, and how are these decisions shaped by beauty standards?

What I have found is that medical experts are drawing on their understandings of what ideal masculinity and femininity are. In other words, medical experts are tasked with creating boundaries that relate to ideal femininity and masculinity — beauty, in a certain sense. So, when deciding whether or not someone needs facial feminization surgery, for instance, they look at photographs of the person applying for insurance coverage, and compare the person’s face to their own interpretation of a feminine face. These understandings of femininity and masculinity, in turn, are structured by race. The ideal feminine nose, according to one of the reviewers, has thin nostrils and an uptilt at the end. Thin nostrils, of course, are associated with white femininity, as is an uptilted nose. (Check out Eric Plemons’ work on facial feminizations surgery and Jules Gill-Peterson’s work on the racialization and gendering of trans bodies.) I find, in other words, that insurer adjudication of medical necessity flattens differences across race and body size. Expansions in coverage, therefore, are bringing people closer to normative gender based on a thin, white, young ideal aesthetic.

One of the things I found most interesting about your research on insurance policies is how older transgender people interact with the medical system, for example, as they petition to have surgeries like facial feminization surgeries covered under insurance. Although many would have been ineligible for surgeries 15 years ago, some applicants are now ruled as ineligible due to their age. Can you explain this phenomenon?

This is such a great question, and something I would like to think about more. It is certainly the case that many trans people who may have wanted to apply for gender-affirming health insurance coverage a few decades ago were not able to, because insurance companies only started providing coverage in the early 2000s, and public coverage came a decade later. And, as you point out, the irony here is that older people are less likely to get insurance coverage for gender-affirming procedures because of the general assumption that older people “lose” gender as they get older. More broadly, older women are assumed to look less feminine, especially if ideal femininity is defined by young women, and older men look less masculine, as defined by ideal masculinity. Perhaps there is a kind of circle, in terms of social assumptions about femininity and masculinity. Babies are less easily distinguishable based on embodied gender than adolescents, for instance. Parents put bows on girl baby heads to distinguish them from boy babies, since it might be hard to gender them otherwise. Similarly embodied gender is perhaps assumed to become less distinguishable as people get older.

The move toward surgical intervention has been complemented by a turn in in the fields of psychology and biology toward trying to understand gender identity through both genetics and neurology. How has research in these fields changed our understanding of where gender is located in individual bodies and, in turn, how trans people can access medical care?

Genetics has become a subject of enormous interest. We can see this across a variety of social domains, including the number of scholars who are studying the sociology of genetics, and the growth in research institutes on genetics and society. Genetics is coming to be seen as a sort of haven, with endless possibilities for explaining all kinds of human variation. The rising faith in genetic (and neurological) science does not necessarily correspond, however, to increasing evidence that genetics does indeed explain different conditions of illness and wellness.

Despite a lack of evidence, this increasing faith – and the linking of gender identity to the search for genetic explanations – suggests a belief that gender identity is innate. A belief that gender identity is innate, moreover, is compatible with “born this way” political strategies. These strategies claim access to gender-affirming healthcare coverage and other services on the grounds that people do not choose to be non-binary or trans. The increasing faith in genetic explanations for gender identity points to a belief that gender identity is innate (i.e., explainable by genes or neurology) and therefore requires or necessitates health insurance coverage for the body modifications that will enable people to be socially legible (i.e., to be seen by others as) men or women, if they so choose.

The trend toward gender-affirming health care is positive, as trans people have better access to care, but also troubling, as it often reinforces gendered stereotypes. What are the implications of gender-affirming health care for trans people, and for the growing non-binary community?

Legal scholar and activist Dean Spade puts it very well when he writes that saying ‘no’ “to transgender requests for bodily alteration…props up a naturalized version of the sexual binary,” but that saying ‘yes’ “can support and sustain standard forms of gender and embodiment.” My research, echoing Spade, Eric Plemons, and others, has shown that increasing access to and coverage of gender-affirming body modifications brings with it a normalization of particular forms of femininity and masculinity — in this case, white femininity and masculinity. So there are racial implications, in that racialized gender — based on a white, thin-bodied aesthetic — is institutionalized as an ideal form of masculinity or femininity. Some within the growing non-binary community are also seeking body modifications that enable them to be read as non-binary (or, conversely, illegible as “man” or “woman”). As a result, there are a rising number of surgeons who are becoming specialists in non-binary surgery, and with this comes the possibilities for a “normative” non-binary body. Yet there are trans and non-binary people who do not seek body modification and who wish, in the spirit of Sandy Stone’s call over three decades ago, to be recognized as trans and as non-binary, and thereby disrupt conventional understandings of gender and sex with more complex configurations of sex, gender, and the body. A liberatory politics would, perhaps, see both or all of these possibilities, such that people could seek the body modifications they desire (or do not), regardless of the relationship between the sex they were assigned at birth, their current gender identity, or the physical characteristics of their sexed body.

Podcast

Listening to Rwandan Popular Music with Victoria Netanus Grubbs

Published August 7, 2023

This episode of the Matrix Podcast features an interview with Victoria Netanus Grubbs, a Black feminist sound theorist and abolitionist educator. Victoria is currently the Black Studies Collaboratory Postdoctoral Fellow at UC Berkeley. She completed her PhD in the Department of Media, Culture, and Communication at New York University in May 2021.

Her current book project, Kumva Meze Neza: Sounding Blackness in Rwanda, examines how popular Rwandan music worked in the aftermath of genocide to produce a collective social body. Drawing on five years of participant observation among Rwandan music industry professionals and their audiences, her work demonstrates how shared investments in the sensory experience of Blackness produce formations of togetherness that defy traditional organizing categories.

Listen to the podcast below or on Google Podcasts or Apple Podcasts. An edited transcript of the interview is below.

Podcast Transcript

Woman’s Voice: The Matrix Podcast is a production of Social Science Matrix, an interdisciplinary Research Center at the University of California Berkeley.

Julia Sizek: Hello and welcome to the Matrix Podcast, recorded in the Ethnic Studies Changemaker studio. I’m Julia Sizek, our host. And our guest today is Victoria Netanus Grubbs, a Black feminist abolitionist educator and the Black Studies Collaboratory Postdoctoral Fellow. She completed her PhD in the Department of Media, Culture, and Communication at New York University in 2021. Her dissertation examines how popular Rwandan music produces a collective social body in the aftermath of genocide, and it’s based on more than four years of participant observation among Rwandan music industry professionals and their audiences. Welcome to the podcast, Victoria.

Victoria Grubbs: Thanks, I’m really happy to be here.

Sizek: So let’s just start out by understanding Rwandan music in the context of African popular music. What’s distinctive about Rwandan music in the Afropop landscape?

Grubbs: So Rwanda’s popular music is resonating within a global context of Black diasporic music. And there’s two really popular, kind of, broad– I’m using this term intentionally– really broad genres right now. Hip-hop and Afrobeat. Hip-hop drawing on a lot of African spoken word and poetry traditions, and griot storytelling traditions, and Caribbean DJing and toasting, and American emcees and DJs playing funk and R&B hooks, and– It’s a long history.

Localized African subgenres of hip-hop, like an example, Ghanaian hiplife, Nigerian blues and funk especially from the ’70s and ’80s. Coming out of East Africa, Tanzania’s bongo flava was early hip-hop style that was really influential. And Gengetone coming out of Kenya and kapuka also coming out of Kenya. And Ugandan styles, like Lugaflow. So that’s– Hip-hop generally is pulling from a lot of that– It’s still a very transatlantic, still very diasporic sound, but it’s pulling from a more spoken word tradition.

And then there’s Afrobeat, which is dance music. And it’s recognized globally as dance music and extending that pan-African legacy of iconic African artists of the ’60s and ’70s, like Fela Kuti and Miriam Makeba, and incorporating rumba, which is coming out of the major cities in Congo, like Kinshasa and Brazzaville, and major cities in then Belgian-occupied Congo by way of Cuba. So we got early jazz, and electronic house music, and then also house music coming out of Cape Town, Nigerian funk, Nigerian soul.

So you can see they’re like– they’re growing simultaneously, but using different, I think, vocal delivery styles. But also always transferring sounds between these– I don’t want to make them sound like completely independent genres. But those are two styles that popular artists right now can go into a studio and say, I want to do Afrobeat, or I want to do hip-hop, and be immediately understood by the producer of what they need to do.

Also in Rwanda, like parallel, there’s a strong gospel tradition, especially in choirs. And the choirs are also recording a lot of popular music, drawing connections from local spiritual practices of singing, drumming, and dancing, but also influences of the church, whether it be, like the Catholic Church, or Methodist and Adventist and Pentecostal churches, which all have different sonic landscapes of their own. Something that I know less about, but something that I’m definitely interested in, and it’s definitely influential in Rwanda to think about the different kinds of auditory practices, I guess, that the church brought in and placed in relationship to spirituality.

So there’s an obvious, I think, noisiness to perhaps a Pentecostal sound compared to the quietness of a Catholic sound. So I think that there’s a lot of– I don’t know– a really interesting dynamics, even within the gospel tradition, but– and also, I would say that within the gospel tradition, there’s a really localized subgenre of music, which is music for Memorial. Music for memorializing the 1994 Genocide against the Tutsi in Rwanda. And that music is a political project, but also, I would guess, a grief project, a mourning project, also a financial project, because there’s usually money from the state for recording this genre of music also, which makes it something that artists will be– that wouldn’t maybe traditionally be recording gospel music per se might venture into that style to record a memorial song.

Sizek: That’s really interesting. So, I think– and this is part of the broader theme of your work– is that how people think about and listen to and participate in popular music has a lot to do with their national identity. Can you tell us a little bit about how music has become really central for Rwandan national identity or lack thereof?

Grubbs: I think that music is always trying to evade capture by the state, specifically also inherently Black music. So it’s not that the music is producing an investment in national identity, as much as the value of the music is always trying to be taken up by the state, and incorporated into their project of state-making and statecraft. So when you see popular artists performing the narratives of state power, and when you see popular artists performing the narratives of party lines or a particular history, there’s an investment in that that is often monetary. But beyond that, there’s an investment in that that is a recognition of the value of their work, which is something that a lot of artists are looking for. They want to– it’s hard out here for all of us, let me say. So to feel, like as an artist, that somebody sees value in what you’re doing and thinks that it matters is also at play here.

Sizek: Yeah. So let’s dig into one specific example that you look at in your research of precisely this phenomenon of the state trying to capture the value of the work of an individual artist, which is that of Bruce Melodie’s big, I guess, two hits. Do you want to tell us a little bit about these songs before we take a listen?

Grubbs: So I want to move a little bit slower than that. Because I think it’s not that– With the examples that we’re going to listen to with Bruce Melodie– Bruce Melodie re-recorded his song with another studio with a specific intention. So I think we can listen to the first one. And I can give you a little bit of context before we do that.

Sizek: Yeah, let’s do it.

Grubbs: So the song came out in 2017, in May, I believe, and it was produced by a producer named David Pro, alongside a music video that was a widely viewed music producer at that time named Ma-RivA. I just want to shout these people out, because they do great work. And the video was also really popular. And it showed girls shaking and smoking hookah and Bruce Melodie and his friends drinking out of red solo cups and dancing around. And everyone’s just having a great time. Musically, it’s a perfect pop song for Rwanda. So I think that’s a really good place to stop and take a listen.

Sizek: Oh, that’s such an infectious song. It does actually just make you want to go party.

Grubbs: Right? It’s a party vibe. And it was very successful in being circulated on the radio for that entire year. And 2017 was also an election year for Rwanda. And that was a really watched election, because it was Kagame running for a third term, which was– which had required the altering of the Rwandan Constitution, because typically, you were supposed to only take two terms. Typically, as in since he had taken power. And he was the first president also since the Genocide.

So the year was being watched because there was a lot of, I think, Western critique of African presidents taking long presidencies and taking lifelong presidencies, not participating in their idea of democracy, or feigning performances of peaceful transferences of power within the model of state that the West is trying to promote as their own. So it doesn’t necessarily look good from that perspective that he changed the constitution. But it was a election where 98% of the population voted for Paul Kagame to take this third term. And that is also considering that voting in Rwanda is required for everybody over 16. So everybody has to vote. It’s different than here, I think it’s important to note that there are lots of ways that the state can look and operate, but in the same ways, capitalism still finds its way in.

So all of that to say that the song was re-recorded in consultation with some RG Consult Group– is what it says, if you look up the citation. So the song was re-recorded with new lyrics, which changed the original lyrics. So the original lyrics, twaneye, twatsinze– we drank, we got drunk, we were drinking, having a great time. It’s a story of, we didn’t have any problems. We were just hanging out, getting drunk regularly. That was the vibe. The twaneye, twatsinze was changed to we voted, we won. So from we drank, we got drunk to we voted, we won. So we can listen to the second version of the song.

Sizek: Let’s talk about just some of the differences between this version and the previous version, like musically. I’m not a musician. What’s going on?

Grubbs: So this– I feel the citations are obvious to most people. I think you would hear it without being musically experienced or trained and say, that sounds like the same song. So, I think, that a lot of that happens because the rhythms and pitches are the same, even though the songs were re-recorded, perhaps with slightly different instruments, because it was produced in a different studio. You never know what instruments a producer will have around or will have on their computer or their hard drive.

So the basic core of the song is reproduced nearly identically the same kick pattern, snare pattern, the same chord changes, the same vocal melodies. And the really only distinct difference that you would hear is a difference in the vocal performance. It’s got a lot more energy in it. It’s got more forward direction in it. It’s a lot less laid back. It’s a lot more driving and aggressive. And, I think, this tempo of the new one is also a little bit faster, so it gives it a little bit more of that get up and go energy.

And also then there’s this very dramatic lyrical shift. So the lyrics transfer from a message of a memory of, oh, we didn’t have any problems, because we were just hanging around drinking, to we voted, we won, twatoye, twatsinze, we voted, we won and now we don’t have any problems. We’ve solved them all. And I think really importantly, the lyrical shift here goes to calling all of the people together, abanyarwanda. Abanyarwanda are the people of Rwanda. Like calling all abanyarwanda, turishimiye, we are happy. Like all into one feeling about this particular event.

And then saying in the chorus, we’ve done what the foreigners failed to do. So you can form a group around an inside and an outside– a perimeter around success. We, the winners, did what the foreigners failed to do, and we brought everybody together. That being the ultimate goal, a national unity. So we brought everybody together because we chose our old man. And you hear his papa voice. That’s Paul Kagame’s voice at the beginning or the intro to the video, saying, we can do anything together. And he’s speaking in the tone of voice as a father with a child, like it’s very tender and paternal. So, yeah, the song takes a lot of popular inertia and turns it into a very, I think, effective celebration of a state project of national unity.

Sizek: Yeah. And that’s– I think it’s interesting as well because it is sort of a hyper-nationalist song. In some ways– In the same way that, I think, country songs in America have come to serve that same void. Like, I’m proud to be an American. And this is sort of, like, I’m proud to be Rwandan. But you also– one of the things that you’re looking at is how they are not just producing Rwandan identity through these songs. So can we talk a little bit about the other sort of, identity politics or identity formation of these songs?

Grubbs: This is a lot of songs I now listen to. I think that what’s interesting to me about Rwandan music is that it’s being produced in a context that is immediately and specifically, this generation living in a state of reconciliation, let’s say, a post-traumatic state of reconciliation. What that means is that you have experienced some kind of violent rupture in your community, and you are also actively living together. And so any music that comes out of that context and can produce a sense of togetherness or a sense of collectivity, I think, is going to be important for us to listen to and to understand and to take seriously. That’s serious social work. And I think that’s also something that the state recognizes that it’s serious social work that this music is doing.

And arguably, the kind of togetherness that the music that I’m seeing being produced in Rwanda– and maybe we can listen to a couple of these examples of more contemporary songs, even some stuff that just came out this year, even just last month– is that in its sonic landscape, citing a much broader reference point than Rwanda. It’s not citing a specifically localized national history, in the way that the state is. And even the way that the state is citing a specific local nationalized identity, it’s around a particular sort of class status and presentation of royalty. And so there’s a very sort of, narrow state project, I think, in terms of identity. And then there is the multiplicitous broad diasporic project of Blackness that you hear in the songs that are being produced. So maybe play the one by B-Threy.

Sizek: It sounds very of the time. It sounds like it could be playing on American radio in many ways. So what– I guess, one question is what’s the circulation of music that you’re seeing with these Rwandan music producers? Where are they listening to music? How are they getting their ideas? And then how are they putting that together with what they want their songs to be about?

Grubbs: Yeah, that’s a great question. So a lot of artists want their work on YouTube, which is why music videos have become really important. If you can’t get the funds together to make a video, people will make lyric videos, or some put up an image some way to get your content on YouTube. I think, within the country and the region, YouTube is still really accessible to people in ways that paid streaming platforms aren’t. Because YouTube, you can use it pretty effectively for free still– knock on wood. So more recently artists are– Rwandan artists are putting their music on platforms, like Spotify, Tidal, Apple Music, but it’s not as accessible to most.

So I would say other than that, in a local circuit the radio is still very important. And songs travel hand-to-hand on thumb drives, or just bring the whole computer. Bluetooth from your phone to whatever local DJ you can get to play it, maybe add a little soda if you can to get them to play it for you. And DJs– In nightclubs, if you can get your songs to DJs, they’ll play it. So if you are looking for music, you’re probably either listening to the radio or searching on YouTube.

Sizek: And what about this specific song that we just listened to? How does this play into the popular scene? Is this a normal song or sort of, like a typical song on the radio?

Grubbs: Well, you know, B-Threy would like to say that he’s an original artist, and I think he’s really talented. I think he’s really pushing ahead. This is a genre that he and a collective of artists that he was working with out of a studio called Green Fairy Records was calling– is calling Kinyatrap. So this is a reference to trap music, which is an evolution of the southern US hip-hop style of trap music, but in Rwanda’s native language. Kinyarwanda being the native language of Rwanda.

And also, there’s efforts within these diasporic genres to always localize, to always make it feel your own. B-Threy is also coming from a specific part of the capital city of Rwanda that has a very urban, all-night, 24-hour kind of energy, as opposed to other parts of the city, which maybe are a little quieter or sleepier. So, I think, you can also hear his environment in that reference to trap music in the first place. Let’s listen to the one by Double N, Abaswa.

Grubbs: This is an even, I think, more contemporary style, even pulling from the American drill style, which is also a subgenre of trap music. So thinking about how you also hear the umuduri, which is a local traditional Rwandan instrument. Which was, I think, another example of that intention to really try to localize these diasporic genres. And so this artist calls this style rap gakondo. Gakondo meaning tradition, or roots, or culture, so culture rap. And if you want to play just quickly, the track umuziki, you can hear that local instrument just as a solo instrument with a vocalist.

Grubbs: That’s just a lovely example of how the local sounds get incorporated these diasporic styles, which then have the intention of being heard around the world. That’s the desire, to put them on YouTube. You want to put them on the radio. You want the DJ to play your song, because you want this song to travel. And I think that’s also a real characteristic of this diasporic Black music is that it wants to travel. It’s catchy. It’s music that holds on to you. It’s music that you take with you. It’s music that gets in your body. So that’s the intention to make a hit is really that desire to make a song that’s going to grab onto you, and you take it with you and go somewhere with it. Yeah.

Sizek: Yeah. So maybe to turn toward the other side away from the producing music and the intention of producing music to talk about listening and listening practices. Because that’s one of the things that you’re really interested in doing is trying to focus on not only the way that this music gets produced necessarily for an international audience, but how people talk about and embody the practices of listening.

Grubbs: Yeah. I think it’s something that we need to be more intentional about. I think listening is really under-theorized. I think we’re not as reflective about it in our everyday lives, as we need to be. And I think we consistently underestimate the fact that perception know is theory-laden. I think I’m citing somebody there that I should say, but it’s not coming to me at the moment. But there’s an influence of the world on how you might imagine you yourself as an individual to experience sound, for example.

So it’s not natural or inherently instinctual that when you hear a sound you respond a particular way. That’s entrainment. That’s learned in practice. It’s experience in the world and observing the people around you and imitating what you see. So even in the ways that we use our voice, even in the ways that we use our voice to reach out to other people, we’re performing a very narrow set of sounds that– our voice is capable of making all kinds of outrageous noises that we generally don’t make, because it’s unattractive. It’s an appealing.

You will lose social– to the people around you, perhaps in another world in another context, that’s not true. So, I think, it’s important that we really take care to think about where the values that we place upon the sounds that we hear come from, and why things sound a particular way to us, why things feel a particular way, what makes something feel the way that you think it should feel or doesn’t feel the way you think it should feel, what makes you comfortable with your evaluations of what you hear. Because sometimes we’re so confident in what we think we hear, and we can be completely wrong, you know.

So I just think that part of my learning and part of my growth as a theorist in sound and as a scholar in sound is trying to slow down and really take care to think about, why did I hear that that way? What does it mean that I have this reference? What does that mean about me as a referent? I’m participating in this listening, so understanding that in another context, another person might hear such a thing differently. And what would that mean if, perhaps in another context, a person heard it the same as I did? And what might that mean if another person in another context heard that the same as I did, and it moved them in a particular way that was familiar to me? And now I find myself moving in a familiar way with other people, perhaps that I don’t even recognize myself in union with, but moving in union and in chorus nonetheless.

And I think that’s what diasporic music is doing. I think it’s producing a body that can see itself, and feel itself, and hear itself, I think most importantly, as a collective. And it’s not a state project. It’s not a national identity. It’s not something that can be voted upon or claimed to be by some military. It actually just has to be built by these producers in their studios, trying to make beats, listening to what they hear on YouTube, downloading these sounds, sampling these sounds, trying to make a hit, trying to make a song that somebody else is going to listen to, and have a little bit of influence on how the culture grows.

Sizek: Well, great. That’s so– I think it’s so interesting, because it points to both the ways that there are these intended modes of producing music to try to create a community, as well as the ways that people take them up are never the ways that are entirely intended, even if they might resonate with those original ways. And so you have a couple more clips for us. And. I want to listen to them.

Grubbs: Awesome.

Sizek: So can you tell us a little bit about these two other pieces that we have, and what we might be able to learn from them?

Grubbs: Yes. So I have another example of how earlier influences, I guess, of these local artists– So the first one is Miss Jojo. I wanted to just make sure that we hear her, because I think too many times the Rwandan music scene is dominated by male artists, and the women don’t get nearly enough airtime, they don’t get nearly enough money. And I think we just in the culture– I think globally, we just don’t see women in these leading producer roles either. And so, she’s just a really important voice to see. So she was producing songs a little bit earlier than the folks we heard, 2007 to 2012. And we’ll listen to one of her songs.

Grubbs: I think you can hear a lot of the influences in her music from the– Even though she’s a solo artist, she’s pulling from these ’90s girl groups, like SWV. Like having your girls behind you, having these backing vocalists, which I think was something that the other artists weren’t really doing at that time like she was. So I really appreciate her for that reason. And also, she keeps that classic Afrobeat clave in the back to keep consistent with that ’50s, ’60s, ’70s rumba tradition. So it’s also part of a larger African legacy in that way.

I think the last song, by Mavenge Sudi, is a little bit older example. So I like that we’re kind of traveling back in time, but it shows a more traditional solo artist’s style. Maybe with this style would evolve from someone playing this single string umuduri to now a guitar.

Yeah. In that song, Mavenge Sudi is actually citing his teacher, who is a guitar player named Gaetan Kayitare. And he was killed in the Genocide in 1994, but he had played and shared a lot of his songs with Mavenge. And Mavenge keeps those songs as a living tradition by playing them and recording them.

And I think you can hear the African roots of the blues when he plays them. I think it’s a really sort of, lovely, stripped-down, kind of pure example of those sonic elements of Black diasporic sound, because you have just this very repetitive but moving backbeat, and then you have just the two chords being played over and over again, in a circle. And then you have this poetry on top of it.

And so, those are the things that stand out to me when I see that artists from the ’50s– songs like this– to the ’70s, to the early 2000s in Rwanda after the Genocide when the industry was able to rebuild itself, to what’s happening now 25 years later, is that consistency. And that’s what makes me think that they’re invested in this larger global project and less focused on producing music that is specifically or inherently Rwandan. So when you see music, for example, like Ntidukina, it stood out. It wasn’t that that was an expected thing for him to do necessarily, but that it was a very insightful thing for him to do nonetheless. Yeah.

Sizek: Yeah, well that brings us really full circle, all the way from the ’50s to 2017, and beyond. Thank you so much for coming on the podcast.

Grubbs: No problem, thanks for having me.

Woman’s Voice: Thank you for listening. To learn more about Social Science Matrix, please visit matrix.berkeley.edu.

Article

Advancing Computational Psychology: A Visual Interview with Bill Thompson

Published August 1, 2023

How do humans pass on complex concepts and knowledge to subsequent generations? In his research, UC Berkeley cognitive scientist Bill Thompson uses computational methods and large-scale experiments to understand problems like knowledge transmission, the universality of language categories, and the social aspects of human problem-solving.

Thompson is an Assistant Professor in the UC Berkeley Department of Psychology and Director of the Experimental Cognition Laboratory. Thompson is also affiliated with the Institute for Cognitive and Brain Sciences and the Program in Cognitive Science.

In this visual interview, conducted by Matrix Postdoctoral Fellow Julia Sizek, we focus on one of Thompson’s most recent research projects, which considers how humans can become successful at a problem-solving task. The findings from the research were published in Science.

One of the big questions you grapple with is how people learn and what the relationship is between learned traits and “universal” human traits. What new tools and methods have emerged to conduct this research?

Psychological research can help us understand the basic cognitive processes involved in learning, memory, and reasoning, but traditional experiments were often limited to simple judgments of very simple stimuli and to small groups of participants. With modern computational methods, we can study these aspects of the mind ever more precisely. My research tries to make use of these emerging tools, and combine them with large-scale behavioral experiments to learn more about human language and cognition, especially our capacity to learn from and reason about each other.

For example, our recent studies have used machine learning methods such as neural networks to analyze large-scale behavioral datasets, uncovering patterns in the strategies people use to solve problems in groups. Using these methods, we’re able to study entire networks of participants, and leverage this larger-scale data to understand the underlying algorithmic structure of how people reason about more complex problems. That’s significant because it brings us much closer to the kinds of problems people face in the real world; moreover, understanding cognition in computational terms allows us to translate new findings into more human-like artificial intelligence systems.

In a study on cultural learning, you focus on a question about how humans pass along strategies for performing tasks. In an experiment, you asked participants to try a difficult sorting task. Can you describe the task and how the experiment works?

Suppose I lay out six images on the table in front of you. I tell you that each image has a number on the back from 1 to 6. Your task is to put the images in order from left (1) to right (6). If you can get the order correct, I will pay you.

The trick is that you have to do this without ever seeing the numbers. All you can do is choose pairs of images to compare: if the pair you choose is out of order, I will swap their positions. However, every comparison you make reduces the eventual payout.

It might sound like a magic trick, but this is a difficult puzzle to solve. Computer scientists have studied the algorithms capable of solving this kind of problem extensively. Even the simpler algorithms can be quite counterintuitive.

We studied this task because we are interested in how people discover solutions to difficult problems – a key ingredient of all human societies. We asked people to solve the puzzle without any kind of training, and write down any insights they had into what makes a good or bad solution. The messages people wrote were handed to the next group of participants, who also tried to solve the problem and wrote down their own insights.

Over the course of the experiment, thousands of participants tried to solve the problem and transmitted information to each other about their successes and failures. Over time, the strategies people discovered evolved to become more efficient, but also more complex. By the end of the experiment, people had discovered some highly unlikely and very efficient algorithms – even some algorithms that have been discovered and documented in computer science!

In this process, participants were able to learn from others – and choose who to learn from. How did research participants decide who to choose as their teachers?

The key to this process of cumulative improvement, we found, was the ability to be selective about whose advice you seek out. If people were paired up randomly with teachers, there was no way for high-performers to pass on their knowledge. Rare discoveries of innovative solutions often went extinct because people were never exposed to them.

Instead, if people were allowed to choose a teacher based on the solutions the teacher had discovered, then many people were exposed to innovative discoveries, even when they were rare.

algorithmic trees — Algorithm lineages in the experiment. Each row in the trees represents a generation of the experiment. From “Complex cognitive algorithms preserved by selective social learning in experimental populations,” by B. Thompson, B. van Opheusden, T. Sumers, and T. L. Griffiths, *Science*, 376 (6588), DOI: 10.1126/science.abn0915.

How did participants sort between the strategies when they were able to pick between teachers?

One of the most interesting things that the experiment illustrated was a kind of tradeoff in the accumulation of knowledge: as people’s strategies became more efficient over time, they also became harder for the next generation to learn. People at later generations in the experiment inherited more complex algorithms, but this meant that they often had a harder time acquiring this inherited knowledge. Another way of putting this is that as time goes on, we need to invest more and more in mechanisms that support learning and preserve knowledge.

Cognitive psychology has traditionally focused on the idea of fixed, universal cognitive functions such as an innate ability to learn language or distinct types of memory. But there is a greater appreciation now for the role that learning in culturally embedded social contexts plays in the construction of our cognition, shaping the way we conceptualize even basic aspects of the world. The culture we grow up in provides us with counting systems, maps, calendars, categories of kinship relationships, and many other cognitive tools for thought. Our hope is that research like this can help highlight some of the ways that cognition is always evolving, and how we can study aspects of that process experimentally and from a computational perspective.

How might your work have a broader application for explaining how strategies spread that are harder to learn, but more successful?

The trade-off between a person’s ease of learning a strategy and their efficiency and success at completing a task can help us understand the importance of mechanisms that mitigate barriers to knowledge. One area where this is potentially quite important is in the design of computational technologies that capture and transmit knowledge – social networking algorithms, large language models, or educational technologies, for example.

Understanding the tradeoffs that arise when thousands of people start to learn from each other via algorithms is a core challenge for contemporary psychological research in my view, especially in the context of cognitive development among children and young adults. For example, the use of large language models to support education offers significant potential for personalization and increased access to knowledge, but at the same time these systems have the potential to reinforce biases and reproduce harmful content that was present in their training data. More generally, increasing mediation of human interaction by machine learning systems has the potential to amplify misinformation, promote simplification over understanding, and distort our impression of what other people believe.

Here at UC Berkeley, one of my goals is to create the research infrastructure and training that new generations of students in behavioral science need in order to address these challenges with cutting-edge methods, including computational modeling, machine learning, and high-powered, large-scale experiments. Broadening access to these innovations is critical.

Podcast

The Binational Politics of Return Migrant Activism: Interview with Caroline Tracey

Published July 27, 2023

This episode of the Matrix Podcast features an interview with Caroline Tracey, who holds a PhD from the UC Berkeley Department of Geography, and whose research uses ethnographic, archival, and literary methods to study the American Southwest, Mexico, and the US-Mexico border. Tracey’s dissertation, “Binational Politics from Intimate Scales: Motherist, Feminist, Queer and Trans Activism by Deportees and Return Migrants in Mexico City,” responds to existing scholarship that has focused on deportation as a male phenomenon, and argues that women and trans deportees and returnees carry out fundamental community-building and activism on the ground in Mexico that has improved emplacement over the long term for all return migrants.

As a journalist, Tracey’s work has appeared in The New Yorker, The Atlantic, The Nation, and other outlets, and in Spanish she is a frequent contributor to Mexico’s Nexos. She is currently the Climate Justice reporting fellow at the High Country News and an editor-at-large at Zócalo Public Square.

The interview was conducted by Julia Sizek, Matrix Content Curator and a Postdoctoral Scholar at Social Science Matrix. Listen to the podcast below, or on Apple Podcasts. An edited transcript of the interview is included below.

Podcast Transcript

[MUSIC PLAYING]

Woman’s Voice: The Matrix Podcast is a production of Social Science Matrix, an interdisciplinary research center at the University of California, Berkeley.

Julia Sizek: Hello, and welcome to The Matrix Podcast. I’m your host, Julia Sizek. And today, our guest is geographer, Caroline Tracey, whose dissertation focuses on returnees and deportees to Mexico. She argues that motherist, feminist, queer, and trans deportees and returnees carry out fundamental community-building and activism on the ground in Mexico City.

This activism has improved the emplacement over the long term for all return migrants. She also writes about the American Southwest, Mexico, and the US-Mexico border as a journalist for the High Country News and Zocalo Public Square. Thanks for coming on the podcast.

Caroline Tracey: Thank you for having me, Julia.

Sizek: Let’s get started by just understanding the big picture. Your research focuses on women and gender nonconforming deportees and returnees to Mexico. While most research has focused on men who are returnees and deportees, what have they missed by excluding people who are not men?

Tracey: That’s a really important question. I guess I can start maybe to speak about how I came to z project and in that way get to a larger answer. I became aware of deportation, mass deportation, through covering the US Southwest and the US-Mexico border as a journalist and participating in migration activism in the US. And deportation was always talked about as something that was practically unthinkable, like it was something that was such a terrible outcome that no one really talked about what people’s lives were like after it happened because so much of the energy was focused on preventing deportation.

So I had a curiosity about what people’s lives were like after they got back to Mexico. And, of course, this coincided with a large uptick in deportations by the Obama administration and in the early 2000s generally. And something that I found once I got back to Mexico was that it wasn’t just deportations. It was also return migration.

So starting after the 2008 recession, you actually start to see more return migration and deportation than you see net in-migration to the United States. And really it breaks down almost half and half. It’s about 55% deportation and 45% return migration that is bringing people back to Mexico. And the factors that are taking people back, aside from deportation, include following a deported family member or fears of deportation. And then also things like the failure of the DREAM Act to pass and not having a vision of a future in which you can study or work long-term in the United States.

On some level, there is good reason for deportation scholarship to focus on men because about 90% of deportees to Mexico are men. But about a third of return migrants are women. So you do see a slightly higher amount of return migrants that are women. But I think beyond the quantitative, qualitatively what I found on the ground was that women and also queer and trans deportees and return migrants who may or may not identify as women are undertaking fundamental community building and political activism that affects the entire deportee and return migration community.

Sizek: So let’s dive in a little bit into what these people are doing on the ground and how it affects the day-to-day lives of returnees and deportees. What are some of the challenges that deportees or returnees might face when they get back to Mexico?

Tracey: That’s another good question. I think that there’s an assumption that once people get back to their country of citizenship, right? In the case of undocumented immigrants in the US, once they’re in a country where they’re documented, they have fewer problems. But in fact, what happens is that, many times, people have either grown up in the United States since they were small children, or they’ve been in the United States for long enough that they no longer have their Mexican documents.

So they have to go through a process of citizening, essentially. That’s a term that a researcher named Gabriela Pinillos uses, and that I think is very well captures the experience of these return migrants where you have to get a copy of your birth certificate, you have to get a copy of your CURP, which is a unique number that is associated with the population registry, and that is asked for in any instance you can think of that would be associated with something bureaucratic.

So this then becomes a secondary process when you have US-born children who by law are Mexican citizens, but they have to go through a process of registering their Mexican nationality. And so for those children, the bureaucratic process is even more complicated because you have to correctly, bureaucratically prove the Mexican nationality with documents that carry an apostille, which is a seal of authenticity that crosses borders, but that can only be obtained in the United States.

So if a family has returned to Mexico without apostille documents, and they want to register their children’s Mexican nationality so that they can have access to all the basic rights that a citizen would have, they are often– they often face obstacles that can be sometimes insurmountable because of the lack of the apostille and an inability to navigate the system, the US system from the Mexican side to obtain it.

So one of the activities that my research included was helping families to obtain documents from the US side. So, for instance, ordering birth certificates from the state of the children’s birth, arranging for them to be sent from the county to the Secretary of State that would give the apostille, then arranging for them to be mailed to a relative in the United States who then could mail them to Mexico. Those kinds of steps that really require both US bureaucratic know how and English to navigate and that have prevented many families from being able to fully register their children’s nationality.

Sizek: So in addition to challenges to getting your kids registered in school, there are also presumably other bureaucratic problems that people face when they get back. What do those look like, and how do people try to navigate those?

Tracey: Yeah, absolutely. I think that before even the bureaucratic problems, or I guess concurrent with bureaucratic problems, you have non-bureaucratic problems. So something like discrimination, whether by potential employers. So age and gender discrimination in the process of applying for jobs, discrimination because of perceived criminalization for being a deportee, or even a sort of bad sentiments on the part of one’s family because there’s a sense of having failed because of deportation.

There are all these bad feelings, to use Sianne Ngai’s term, wrapped up in deportation, and to a certain extent in return migration, although the experiences are a wider gamut of reasons for return. And so a wider variety I think of sentiments that surround it. But then once you are back in Mexico, there’s the bureaucratic challenge of obtaining all the different documents.

And then again, the problem of discrimination repeats itself in navigating the bureaucracy, because these ideas of criminalization, or of betrayal of the country, or that deportees and returnees are stealing jobs. These all repeat themselves in the way that the– in navigation of the bureaucracy. So one idea that people talk about in Mexico is [SPANISH]. So like window criteria that the agent– the desk agent who’s in charge of your case can have a degree of latitude that can really change your outcome in many cases for the worse if they so choose.

And so what I saw in my research was that a lot of the political organizing by the deportee and returnee community is in order to make these processes easier. So in many cases, that means organizing so that you do not have to have an apostille for certain things such as school registration, or now more recently, the fight is for the registration of children’s Mexican nationality.

Previously and successfully, there was organizing around trying to remove the requirement that transcripts and other documents have a translation by an expert because in many cases there were returnees that had been educated in US schools and could provide a complete and correct translation themselves, and they didn’t need to pay for that service. So that’s something that has actually been successful in the past seven years or so.

Sizek: So you mentioned education as being really a big component of both the challenges of coming back to Mexico as well as in your work for folks who are in the US who might be undocumented and who decide to return to Mexico in part because they don’t have access to educational opportunity, especially college here. Can you tell us a little more about what that process looks like and how someone who might be a dreamer here in the US decides to go back to Mexico?

Tracey: Absolutely. A fairly large subset of the community that I was interacting with in Mexico City and the community that– a large segment of the community that runs the organization Otros Dreams en Acción, which is one of my field sites, are people who would qualify or not qualify, but are in the correct age range for the DREAM Act, which failed to pass many times over the course of the early 2000s before DACA was finally created in 2012.

And I think for many young people who are returnees, the fact that there was this consistent failure of a pathway to residency or citizenship made it very clear that there was not a stable future available. And there were not also immediate options in many states because certain states had or have in-state tuition for undocumented students. But other states, such as Georgia, outright forbid universities from charging in-state tuition to undocumented students from that state.

So there are many young people from states in which the state DREAM Acts did not exist or from states where they did, but who didn’t see a future for them, who ended up returning to Mexico. In many cases before DACA was passed, but also in other cases, people who have DACA but feel like it’s not a long-term option because it has to be renewed so often and because it is at risk of being cut by politicians, end up returning to Mexico.

And one of the theoretical interventions that they’ve made through their activism is demonstrating that while this is not a deportation, it’s also not a choice to return. So the young activists tend to frame their return as necessarily forced return because it’s a situation in which they don’t have an option to remain in the United States and have a future in which they can study and work.

Sizek: So this brings up the question of why they don’t have these options to stay here in California? Where we are, this is often– there’s often an idea that people can stay because there are immigrant friendly policies. But this is obviously not always true in California and also not true across the US. So how has immigration changed and under what conditions are people feeling more forced to move back rather than seeing an opportunity to stay in the US?

Tracey: Yeah, that’s another good question. I think that there are a number of changes to the immigration system that really go into that, to answering that question. One is the way that immigration changed over the course of the 1990s where first you have a lot of new push factors on the Mexican side because of NAFTA and the domestic privatization, privatizing policies that unfolded over the course of the early ’90s.

Much of the rural economy in Mexico collapses in a way that people who were working as small farmers or otherwise living in rural areas can no longer make a living. And so you see a massive immigration to not only the United States where about 11 million people emigrate over the course of the 1990s, but you also see migration to the country’s northern border and to the cities.

So, first of all, you have that big push factor. And then at the same time, you have new increased border security in the United States that makes it very, very challenging to have any form of circular migration. So whereas in the past there was a degree of providers– so one or both parents going to the United States and eventually returning, but leaving the rest of the family behind. Over the course of the 1990, you start to see– 1990s, you start to see increased whole family migration and permanent migration.

So you have the creation over the course of that decade of a permanent class of undocumented families. And I think that’s really significant because it means that you have a lot of young people growing up in the United States without papers, and that’s essentially a novel phenomenon. It’s not that it’s never existed before, but it’s never existed in these kind of numbers.

And so I think that’s why it is novel that you have this organizing by young returnees and deportees back in Mexico, because there just has never been that class of people in the United states, nor that class of people in Mexico historically. And then concurrently with that, there’s also a demographic shift of immigrant settlement within the United States.

So for the first time in 2000, you see that more than half of the non-metropolitan Latino population in the US is outside of the US Southwest. So, for instance, what that meant in my research was that while I would meet older deportees who were from more traditional immigrant communities, Latino immigrant communities, like Chicago, or like California, or other cities or regions that had historic Mexican and other Latinx immigrant populations, many of the young people were coming from states where the Latinx populations had really grown over the course of the 1990s. And really that was from the US Southeast.

So you– because of both changes in immigration policy in the 1980s, for instance, the 1986 IRCA Amnesty of many people who were already undocumented in the US suddenly having work authorization in the traditional Latino communities, there isn’t as much demand for undocumented labor. You also see other communities being saturated with immigrant labor. And so people start to find other regions where the labor is in more demand.

You also concurrently have a restructuring of the US poultry industry. And so you start to see a movement from the Southwest and California to the Southeast. And that’s really where a lot of the young people that I interviewed came from. And that’s something that also has been written about by Perla Guerrero, who is a scholar of the Latinx US South. There’s also a journalist named Alice Driver, who’s right now writing a book about poultry workers in Arkansas.

And so I think that it’s– that demographic shift is something that a lot of people are noticing and researching and that I had a lot of reading material about that shows how significant it was.

Sizek: So you mentioned that the demographic shift is not only to different parts of the US, being the US south, but it’s also the age of the folks who are being forced to return to the US– are being forced to return to Mexico, many of whom are just out of high school. How do they manage and navigate this move to Mexico, which is a place where they may have never really lived?

Tracey: That’s another good question. I would say that in my research I observed a number of people who initially went to places where they had family ties, and then many of them later moved to Mexico City. I should also add here that I originally intended to do multi-sited fieldwork, but I did my fieldwork during the COVID pandemic. So I ended up completing all of it in Mexico City. So that’s really where all my data is from just because of the fact that it all had to be moved to virtual at a moment when that was where all my interlocutors were.

But, yeah. So I think that one pattern I can point to is that people went initially to places where they had family, sometimes extended family they didn’t know very well if they had grown up in the United states. And then they moved to pursue educational and work opportunities, but also places to have community. But at the same time, and this is especially been true in the last few years, Mexico City has a very high cost of living relative to what wages are in Mexico City.

So many of the deportees and returnees in Mexico City are living in the periphery of the city. And I think that it’s probably becoming more and more common that people are moving to other cities in Mexico, not Mexico City, where there is a better balance between salaries and cost of living. And another thing to add is that one of the first ways that many deportees and returnees make inroads into the Mexican economy is by working at call centers.

So American companies have taken advantage of deportees and returnees by nationality in terms of both fluent English– fluent American accented English, and familiarity with American colloquialisms, culture in terms of interpersonal relationships, customer service, and other aspects of American business. And have set up call centers in cities in Mexico that hire primarily deportees and returnees.

And so those places, because they cater to that hiring, often make the hiring process smoother than in other places that would have more requirements that would make it harder for someone who’s been recently returned to the country to get a job.

Sizek: So you mentioned that one of the forms of employment that people go back to when they’re in Mexico are these call centers. And this obviously brings together a whole crew of people who are coming back from the US. So this could include people who are deported for committing crimes. It also includes people who are forced to return for other reasons. What does the call center community and the broader community of folks who are returning or going back to Mexico look like?

That’s another good question. It’s a really big part of many people’s entry into Mexico, and I think that it has a very disparate outcomes and a lot of pros and cons. So I can talk about one deportee whom I accompanied through a lot of different bureaucratic processes and who worked at a call center and who I talked with at length about that experience.

And I think that for him, it was a way to have a social circle in which he could speak English. But that that had pros and cons for him, because on the one hand, he made friends who he felt comfortable socializing with, and on the other hand, it limited his opportunities to feel like he could improve his Spanish and make friends outside of that circle.

And I think that for him there was both like a double-edged sword of like the comfort of working with English speaking people and a feeling of continued isolation after being deported. Other interlocutors of mine talked to me about call centers being a challenging work environment with very high turnover because they’re very hierarchical.

The supervisors are often not understanding of people’s needs or can be very strict. And that because, as one person put it to me, you just throw a whole bunch of people with the same trauma in a big room, there are issues of substance abuse and emotional needs that really go unmet, that are shared by many of the employees.

And so the call centers also gave rise to a lot of the deportee and returnee organizing that now exists. Specifically, the organization Otros Dreams en Accion was founded– co-founded by American researcher named Jill Anderson, who noticed that there were these large English speaking communities surrounding call centers and began to work with them and find out what they needed.

And specifically, that they needed help re-validating their US high school diploma so that they could continue their education in Mexico. And the other co-founder, who was not working in a call center, but was struggling to re-validate her US high school diploma, that she was actually going through the same process as many of the call center workers, whose name is Maggie Loredo.

And together, they founded this organization that works to support deportees and returnees, and that addresses a much wider swath of needs, both bureaucratic and cultural and emotional and creative, beyond that. And so I did a lot of my research with them.

Sizek: So one of the things that really highlights is how people get back to Mexico. And it’s not that they’re simply reintegrating or going back to a place that they already know, but that they’re coming back with a lot of trauma from the experience of being deported or from being forced to return. They might feel cut off from their communities. How does this change the way that we think about scholarship, about deportation, or returning to countries of origin?

Tracey: A lot of the scholarship about deportation has been conducted with very recent arrivals. So people that are in their first few days after deportation. Or if it’s not conducted right at that time, it’s asking questions about that experience. So I think trying to understand– much of the scholarship is trying to understand how deportation fits in to US immigration policy. What is the process of removal like? But I think that there’s much less scholarship about what happens back on the ground.

And so, like I said, that really motivated my initial scholarship– my initial research. But I think that– and I think that there are a number of really interesting conceptual ideas that have come out of the organizing. So one of the main things besides conceptualizing all return is forced return, that my interlocutors really insisted upon was the idea that terms like reintegration or repatriation are really normative.

They signal an idea that you should blindly integrate into the society in which you’re a citizen or that you are, in the case of repatriation, returning to your homeland in like a correct way. And I think that, for many people, that’s not at all their experience. They’re showing up in a place that they barely know, that they don’t want to be in, and that is challenging for them to really settle in. Even if they have had some degree of volition in the return, it’s still a challenging process.

And so a term that I use is emplacement, which is signaling that it’s a long-term process of getting settled in a place that involves both personal settling as well as political activism to help out the entire community, community building, cultural production, and all kinds of different tacks on emplacement.

And a term that I drew on a lot in my dissertation is the idea of diasporic intimacy, which is used by a number of scholars. But I especially drew on Svetlana Boym’s idea of it, which is that there is affection generated through recognizing one another’s alienation and/or trauma, and that community building can come out of that.

And I think that it particularly speaks well to the deportee and returnee community, and especially to the activism of the young people in the community who have really drawn on the idea of being pocha, which is a derogatory term in Mexico that they are reclaiming, that refers to people who don’t speak perfect Spanish or who are otherwise very Americanized, because Boym talks about the idea that diasporic intimacy has an accent in both one’s native language and the language of one’s adopted country.

And so in this– in the case of pocha activism, for many people, they’ve been educated in the United States, even though it’s not their country of citizenship. And so they feel like English might be their more dominant language despite the fact of having Mexican citizenship. And so Spanglish and the right to speak in a non-normative Spanish and the opportunity to participate in creative production that draws on the unique ability to switch between both or to combine both has been a really important part of the community organizing.

Sizek: So in this community organizing, they are obviously bringing together a lot of people who are interested in not only getting together, but in helping out the community and in producing different cultural artifacts, maybe producing art. Can you speak towards some of the events that they have or some of the community building that they’re doing on the ground?

Tracey: Definitely. At Otros Dreams en Accion, the organization that– one of the organizations I volunteered with, poetry slams are a really important part of the community building. And I think that the Spanglish element that I just mentioned in my previous answer has a lot to do with that. That poetry slams are an invitation to experiment with language, but also they are highly political.

And so many people talk about their migration experiences, their deportation and return experiences, the experience of their family, the emotional challenges of re-citizening in Mexico, and other aspects of their experience that tie into the politics of migration. And they use the poetry to creatively re-imagine those experiences.

Sizek: So perhaps turning into a different direction is the question of mothers and motherist activist, an activism that you also look at in your dissertation. Who are the mothers, and what are the forms of activism that they’re organizing around?

Tracey: Yeah. I talk about motherist activism in my dissertation as coming from a line of motherist activism in Latin America. So some famous examples include the mothers at the Plaza de Mayo in Argentina who were demanding justice for their disappeared children. Or more recently in Mexico, there are many small collectives of mothers who are searching for their murdered and disappeared children who are victims of the war on drugs and the general ambiance of violence in the country currently.

And so there is an existing set of scholarship about motherist activism in Latin America. And I also saw this among deportee mothers. And I think that they occupy a really important position in my dissertation, in part because they really strongly challenge the vision of the solo male deportee. And that many of these mothers are single mothers, or they’re divorced mothers.

And so they are having to do the bureaucratic processes, not only for themselves but for their children. And they have really borne a lot of the effort of the political organizing of the deportee community in partnership with migration NGOs, both bi-national ones that have both Mexican and US employees, and also local NGOs that are staffed by Mexicans.

Sizek: In terms of thinking about these motherist activists, so much of being a motherist activist obviously has to do with the rights of your children and what that means. So what are the specific issues that they are mobilizing around? And what are the ways that they came to organize together and to make mothers into a class of people rather than women as a class of people?

Tracey: Yeah, that’s a good question. I think a lot of the organizing by mothers and mothers finding each other came out of seeing that many of the people who work in the civil society in Mexico are men, and finding each other within the larger groups that were mainly men, and then coming together over shared concerns. And a big one was the need of the apostille and the apostille birth certificate to enter into schools.

So one of the first big achievements of migrant organizing, not only deportee, but also in the service of people from other countries coming to live in Mexico, central Americans and other countries, was that Mexico’s public education secretary changed its policy regarding school registration so that schools are now required to accept foreign birth certificates in order to enroll students.

However, in practice, in many cases, they don’t. And this leaves– this leaves mothers of foreign born children in a very challenging spot where they are demanding again and again that a school enroll their child and being denied that, or the school is saying we have enrolled your child, but they are later being denied to continue into the next level of school, either the next grade or the next, like, middle or high school.

And so that the biggest issue there is the CURP– the unique population registry number that schools really feel like they can’t have a student who doesn’t have that CURP. And so getting the citizenship without an apostille has become a big focus for continued organizing because it’s the citizenship process that gives individuals the CURP. And so if they can get that without an apostille, it will be much easier for returnee’s children to enroll in school and stay in school.

And interestingly, the COVID pandemic created a new layer of challenges here, not only because it stymied organizing, but also because for some people who had enrolled their children initially with a temporary CURP generated by the school that had then been able to get their children’s nationality over the course of a year or two, when schools moved to virtual modality, the education secretary’s virtual platform didn’t immediately and didn’t with a lag time of months update its CURP registry. So students who had been correctly enrolled in schools, suddenly on online school were not able to access the resources.

Sizek: That also raises this broader question about the effects of the pandemic on both return migration and deportation. So what have the effects of the pandemic been since you conducted most of your research during the pandemic?

Tracey: That’s a very manifold question, so I’ll try and offer a few different snippets of insight. I think that one on the– looking from the US side, one thing that was true at the beginning of the pandemic was that– not only detention centers, but also prisons– were really places where a virus could spread very fast. And so there should have been a push to release people with alternatives to detention.

So before Trump, for instance, many times people who were not considered risks, which is the majority of people held in detention because it’s mandatory detention for all asylum seekers and people facing deportation currently. Since 1997, that’s been the case. There should have been a push to release people with ankle bracelets or other alternatives to detention, and there wasn’t. And so we saw truly unnecessary deaths from COVID, from people awaiting deportation processes in detention centers.

So I think that’s one major effect of the pandemic that needs to be flagged strongly. A second is that when people were deported during COVID, there was no real reception protocol on the Mexican side. So there was no place for people to quarantine. There were also many small villages that closed completely to outsiders during the pandemic.

And so people who had been deported couldn’t go home because they were an outsider returning to a village that had closed. That was a big problem, not only in Mexico, but in Central America as well. And then, of course, the issues of stigma and criminalization were heightened because of the fear that people had been on a deportation flight that was filled with COVID. But I would say that, at the same time, the deportee and returnee organizing– rather, the deportee and returnee community had in place an organized infrastructure for mutual aid that was really remarkable.

And that really I think had a lot to teach other communities, where they were able to quickly get in touch with large amounts of people– and I helped in this process– sort of assess their needs, prioritize who was the most at risk from loss of income, from complicating health factors that made them need to be more isolated, or more at risk of getting sick, or more at risk of complications were they to get sick, were able to mobilize shared resources and networks of information.

And also because of the fact of being separated from loved ones by a border were already used to virtual technologies. And so I think that, interestingly, despite there being a big digital divide globally, people that one might not have expected to have been particularly digitally literate within the deportee and returnee community were able to actually adjust to the virtual modality pretty readily.

Sizek: Thank you so much for sharing these stories of returnees. And I think that the ways that they were able to connect during the pandemic through all of the virtual modalities is really instructive for us to think about the ways that returnees and deportees actually bring a lot to our understandings of what it means to be connected.

Tracey: Thank you. It was really a pleasure to be here.

Woman’s Voice: Thank you for listening. To learn more about Social Science matrix, please visit matrix.berkeley.edu.

Economy

Balancing Property Taxes for Schools: An Interview with Quitzé Valenzuela-Stookey

Published June 26, 2023

Public education in the United States is profoundly unequal. Many public school systems are highly dependent on local revenues generated by local property taxes, meaning that areas with higher home values have better-funded schools. Wealthier people self-sort into areas with higher property values and better schools, while poorer communities have poorly funded schools. As a result, policymakers have asked: how can we solve the problem of inequality among school districts?

Quitzé Valenzuela-Stookey, Assistant Professor in UC Berkeley’s Department of Economics, has conducted research on how to address this thorny problem. Valenzuela-Stookey came to Berkeley after completing his PhD at Northwestern in 2021 and spending a year visiting Duke as a postdoctoral fellow. His main interests lie in the field of economic theory, and his research has broadly examined market-based policy design, allocation mechanisms, platform markets, and bounded rationality.

In part because of the longstanding effects of racial redlining, school districts in the U.S. have been profoundly shaped by legacies of racial segregation and inequality. While this might seem like a problem that a geographer or sociologist would study, how do you understand this as an economic problem?

It is impossible to understand the current state of geographic and racial disparities in income and education without recognizing the impact of policies such as racial redlining. These policies were designed to segregate people of color, protect the advantages in property wealth enjoyed by White families, and sustain school segregation. Redlining achieved all of these objectives.

Redlining achieved its discriminatory objectives by using the tools of economics. The term refers to a policy that designated homes as “high-risk” for lending purposes due to the presence of Black and immigrant communities in the neighborhood. Homes in these neighborhoods were usually ineligible for federally backed mortgages, and received disadvantageous mortgage terms. Redlining had far-reaching consequences, but one immediate and explicitly economic effect was that it prevented people of color from accessing credit to invest in capital, and thus inhibited their ability to accumulate wealth.

It is important to understand that while, at least in theory, redlining ended with the Equal Housing Act of 1968, the policy continues to impact areas such as housing and education to this day. This is where I think an economic understanding of the problem can play an important role. We need to understand the mechanisms through which the initial impacts of redlining on mortgage availability propagated to other areas of life, and how these effects were preserved and even magnified over time. For example, by reducing property wealth in redlined neighborhoods, these policies diminished the funding available for local schools. My own work touches on this mechanism. There is a self-sustaining process by which high property values support higher-quality schools, which in turn attracts richer people to an area and raises property values. This feedback loop helps perpetuate the discriminatory impact of redlining across generations. I study how tax policy today can be used to help redress some of these inequities.

The broad lesson is that policies do not exist in isolation. People live their lives in a web of economic systems, and changes to any one of these can have wide-ranging consequences. Economics as a discipline is largely about understanding the indirect effects that the actions of one person or institution has on others.

In part, you’re working with an economic theory from Charles Tiebout, who argued that, in efficient markets, people will move to areas with better service provision — in other words, that wealthier people might move to areas with better services. How did you model the ways that people do (or do not) select into different housing?

Tiebout’s theory is generally understood as an argument in favor of local control over the funding and provision of public goods, such as schools. The idea is that if some people really value a particular amenity, say education, they can choose to live in a district that provides it. They pay for the amenity by paying local taxes, which are set at the district level. People who don’t value education as much, or who value some other amenity relatively more, will choose to live in a different district and pay only for the amenities they want.

In essence, the argument is that by giving districts control over the type and quantity of amenities they offer, and giving them the power to tax, they essentially become firms that produce amenities and sell them in a market. The market is “free” insofar as people find it easy to move and, the classical thinking goes, free markets produce efficient outcomes.

While the analogy between location-specific amenities and markets for goods is useful, there are of course many problems with the classical Tiebout argument that this market will produce “good” outcomes. One important shortcoming is that the notion of efficiency, according to which idealized markets perform well, is limited: even if both rich and poor families value education the same in absolute terms, rich families will be willing to spend more to live in a district with good schools. It may be “efficient” for rich kids to go to better schools, but it is not desirable from a societal perspective. Moreover, the market may fail to deliver on even this limited efficiency criterion. This is exactly the problem my paper seeks to address.

In the model that I use, each district has a stock of houses that differ in terms of quality, and each family has a different level of wealth. Unsurprisingly, the model predicts that the richest families move to the best houses in the district with the best schools. The very poorest families move to the worst houses in districts with the worst schools. Middle-income families might choose to live in a better house in a district with worse schools, or a worse house in a district with better schools.

The upside of all this is that when a district raises taxes and increases expenditure on schools, it attracts a wealthier subset of the population. This in turn leads to higher property values in this district relative to what you would expect if there was no change in the wealth distribution of new arrivals. Higher property values benefit current homeowners, who are also the voters responsible for setting tax policy. This effect on property values gives the district an additional incentive to raise taxes, beyond what they would do if there was no mobility in the population.

The flip side of the dynamic I just described is that other districts receive a less wealthy set of new arrivals, which suppresses property values in these districts. This is what is known as a fiscal externality: the actions of one district impact how much money is available to local governments in other districts. Districts must compete with each other for the richest new residents by raising taxes and increasing expenditure. This competition leads to inefficient outcomes, but it also means that there is a policy intervention that can make all districts better off while reducing inequality in access to quality education: tax caps.

What are tax caps, and what would a tax cap look like for a school district?

The solution I propose is to cap tax revenue that the richest districts are allowed to collect. This can help alleviate a wasteful arms race in which rich districts compete for wealthier residents by investing in unnecessary amenities. A school may not need to build a second pool, but it might feel compelled to do so if the school in the next town over has done so. Importantly, the tax caps can be constructed in a way that these districts actually like. While each district would of course like to be free to choose its own tax and expenditure policy, each district also recognizes that they benefit if other districts can’t spend so much to lure away richer residents. At the same time, by reducing the disparity in expenditure between rich and poor districts, the caps imply that more middle-income people will move to the poorer districts. This allows the poorer districts to actually increase their expenditure on schools.

What are some of the other solutions that have been offered to the problem of property taxes determining school revenue?

Interestingly, many states, including California, do impose some type of cap on local property taxes, but these policies have generally not been tied explicitly to reducing inequality in education funding. High property taxes are a salient political issue. Indeed, the fact that many people feel their property taxes are too high is consistent with the idea that rich districts are engaged in wasteful one-upmanship. Tax caps are seen as a way to reduce people’s tax burden.

In California, the best-known legislation related to tax caps is known as Proposition 13, or Prop 13, a law passed by voters in 1978 to limit property taxes across the state. Prop 13 is really two different tax policies rolled into one. The first piece concerns the assessment of property values. Property taxes are specified as a percentage of a home’s assessed value, and this value is determined in different ways in each state. Prop 13 limits how much assessed values can change over time for properties in California.

The second piece of Prop 13 is a cap on the rate at which property can be taxed. Unless voters in the district approve an increase, the property tax rate cannot exceed 1% of assessed value.

Volumes have been written on the various implications of this type of policy. In the context of my work, one important issue with Prop 13 is that the expenditure caps are not tied directly to a district’s wealth or income. Moreover, the cap is in terms of the tax rate, whereas I suggest caps on aggregate tax revenue. The latter approach decouples the tax cap from the assessed value of homes in the area, which makes it easier to balance expenditure levels across districts.

An important piece of my policy proposal is that tax caps should be applied differently to rich and poor districts. The goal, after all, is to increase expenditure on schools in the poorest districts. It is important that poorer districts be able to increase their revenue when property values rise.

A related proposal, which I also discuss in the paper, is that districts be allowed to increase their revenue collection above the cap, but must pay a percentage of this additional revenue to the state government. You can think of this as a “luxury tax” on excessive expenditure. The state government can then transfer this money directly to poorer districts. In fact, Texas already has a system like this in place, which gives me hope that this type of policy could be implemented more broadly.

Another type of policy that has been proposed to deal with inequalities in access to education is simply to do away with the local control of funding altogether. The idea is to centralize education funding, say at the state level, and distribute funds equitably across districts. I think some version of this would be the ideal policy. Unfortunately, it is politically challenging. Rich districts that are currently able to spend only on their own schools will oppose efforts to redistribute funds to poorer districts. This is not to say that reforms along these lines are not possible. Illinois, for example, passed a reform a few years back that both increased state-level funding for education, thus reducing dependence on local tax revenue, and created a formula for equitably distributing these funds across districts.

What is the role of rental markets in your analysis?

This is an important question. The model I discussed above assumes that everyone is a homeowner. An increase in property values makes people who own property richer. This is the source of the competitive pressure toward higher expenditure. On the other hand, if rents increase because of an influx of wealthy residents, this hurts existing renters. In essence, increased expenditure on schools can exacerbate gentrification. If most residents of a district are renters, this means that the district has less of an incentive to increase spending than if most residents were homeowners.

If all districts have mostly renters, competition between districts could lead to expenditure on schools that is too low, and tax cap proposals could be counterproductive. Moreover, we might expect poorer districts to have a higher proportion of renters, and these are the districts where, by design, the tax cap raises property values.

Fortunately, a modification of the tax cap policy still works. One solution when poor districts have a high proportion of renters is to transfer money directly to poorer districts using the “luxury tax” system that I mentioned earlier. This would help offset some of the negative effects of higher rental rates, and still allow poor districts to spend more on schools.

What do you think policymakers can learn from your analysis?

I think there are two important takeaways. First, while people may be used to thinking about tax competition in terms of states or countries cutting taxes to attract investment, in the context of school funding, competition may have the opposite effect. In the fight for richer residents, districts may end up taxing more than is optimal. Second, this inefficiency is something that a policymaker can exploit to construct a policy that delivers on three seemingly incompatible objectives: reduced taxes in the highest-tax districts and increased funding for education in the poorest districts, all while making every district better off. The fact that every district benefits from the policy should make it politically feasible, unlike some other proposals to address these issues.

Podcast

Structural Determinants of Police Violence: Interview with Kimberly Cecilia Burke

Published May 17, 2023

Kimberly Cecilia Burke, a PhD candidate in Sociology at UC Berkeley, researches the relationships between institutional violence and social stratification, utilizing multi-level mixed-methods analysis. Her dissertation uses an interdisciplinary approach to examine how Black-White interracial couples understand and experience police violence in their relationships. Her current research aims to determine how the dynamics of intimate partnerships can perpetuate and challenge patterns of racial inequality structured by police violence. As a scholar-activist, Kimberly is guided by feminist ethics of love and mutuality and seeks to bring insights from social science to the broader public to advance social equity.

For this episode of the Matrix Podcast, Matrix Content Curator Julia Sizek interviewed Burke about her research. Listen to this talk as a podcast below, or on Google Podcasts or Apple Podcasts. An edited transcript of the interview is included below.

Podcast Transcript

Woman’s Voice: The Matrix Podcast is a production of Social Science Matrix, an interdisciplinary research center at the University of California Berkeley.

Julia Sizek: Hello, and welcome to the Matrix podcast. Today, our guest is Kimberly Cecilia Burke, a PhD candidate in sociology at Berkeley. Her dissertation research focuses on examining policing, inequality, and state violence, looking at the ways that these institutions shape romantic relationships. Her research, which is grounded in a feminist ethics of love, mutuality, and respect, is reflected in her scholar activist work in which she seeks to challenge anti-black racism and build equitable solutions to the problems inherent to carceral institutions. Welcome to the podcast.

Kimberly Burke: Thank you for having me. I’m very excited for this conversation.

Julia Sizek: So during the past couple of years, public attention has really turned toward policing and specifically to the negative effects of policing on people being actively policed. But your research turns this around by examining the effects of policing on intimate relationships. Can you tell us a little bit more about why you chose this research topic and what you’ve started to find?

Kimberly Burke: So the research that has been most exciting for me coming out of the policing literature has been those scholars looking at the broader impacts of policing beyond the direct targets of police violence or police activity, to examine the ways that it’s impacting educational outcomes, civic participation, emergency room usage, all of these unexpected spillover consequences of harsh policing tactics.

And so I am taking that to look at how policing is impacting our most intimate relationships, our capacity to love, and connect, and realize our humanity in these most sacred spaces. And that was, I guess, largely inspired by my conversations with police officers themselves. And they, unprompted usually, share with me the challenges that being a police officer has brought to their romantic partnerships, their many divorces and breakups, their experiences of intimate partner violence.

So I wanted to understand how can we love in a punitive society? What does it mean to try to forge relationships of mutuality and respect in the context of policing, which requires a lot of blame, and domination, and control. What does that mean for the people doing the work of policing, but what does it mean also to those people who are living in the context of police violence?

Julia Sizek: Yeah. So you’ve outlined, I mean, sort of an amazing research goal to try to figure out what love looks like in a policing state. And I guess my question is, how do you approach this somewhat capacious topic? Who are the folks who you’re talking to? So you mentioned police officers but also ordinary people whose lives are surrounded by police violence.

Kimberly Burke: So I actually have started with civilians, and I’m looking at Black and White interracial couples. Because police violence in the US is largely painted as a problem for the Black community, I wanted to examine within these relationships where race is a boundary-making process that keeps people separated, and policing is a mechanism of that racializing process.

So I’m trying to understand first how is it that Black and White couples are able to love and connect in the context of police violence? And to ask questions that really try to get at how policing structures their racial identity, how they are resisting and negotiating that within their relationship dynamics.

And just in the few pilot interviews I’ve done, there are some really exciting strategies that couples are employing that really point to a socialist understanding of relationships rather than this transactional, hierarchical, capitalist, punitive dynamic that make me feel as though the strategies these couples are using to love, to enact love, to be in this relationship in a way that garners mutual respect and support could also be a vision for how we can imagine public safety to look differently if that makes sense.

Julia Sizek: Wow. I think that’s really cool because it points exactly to the ways that people are finding ways to resist a structure of domination that is really important in their lives. What are some of the strategies that people are using?

Kimberly Burke: Yes. It’s a re-envisioning of work and a transfer of the kinds of risk that are definitive of the Black experience. So every couple talks about the labor, mental, emotional sometimes physical labor that White partners have to do to show up and support their Black partners, specifically when they are thinking about interactions with police or ways to prevent interactions with police because of the fear of the kind of violence that the Black partner would be subjected to, right?

And so it’s a shift in labor for sure, but it’s a way of thinking about labor, like I said, almost in the socialist lens, where it is what do I need to do to enable my partner to realize their full humanity? And in doing that work, it’s not even work. It’s almost just what it means to be human, what it means to love.

And in turn, the Black partner also has recognized their work in helping the White partner to understand their experiences, right? And so it moves beyond I do this, you owe me this, to just this beautiful understanding of what we need to do for one another, so that we can all be human and experience safety and support in every space that we occupy.

Julia Sizek: That’s really remarkable also because this is obviously a really touchy topic to bring up with your interlocutors. How have you been able to forge a relationship with them and also to bring people into this study, which is about a very personal topic?

Kimberly Burke: So I felt really motivated to do this project because of my past interviews with police officers. And as I said, unprompted, they would share with me details of their personal life, of their marriage, of their intimate partnerships and how becoming a police officer negatively impacted those relationships and distance them from their civilian friends or families.

And that was without me asking. So I thought, OK, if police officers who are notoriously skeptical of outsiders and researchers, right? This is documented in the literature. If they are willing to share with me these stories, then certainly civilians who are perhaps open to participating in social science research would be willing to do so. And I started recruiting just through my network, and it has snowballed.

And already, I’ve gotten 25 participants who want to talk about their relationships and their experiences and what it has meant to love across race during the COVID and George Floyd protests of 2020. Particularly, this time period has been incredibly salient and important for people in navigating these relationships, many of whom were quarantined, locked down together, and couldn’t escape these issues, couldn’t turn away from issues in the way that they had in the past. And they’ve just been really forthcoming. So I get to be pretty direct. And I don’t have to say a lot, and they just share. Yeah.

Julia Sizek: Well, it sounds like it’s really a ripe topic for research and that also relates back to some of the other work that you’ve been doing that specifically with police officers and about police trainings and the use of force trainings. Can you tell us just a little bit about what police use of force training looks like on the ground?

Kimberly Burke: Yes. So I will speak to the use of force trainings that I have participated in because we have thousands and thousands of departments in the US, and they all have a lot of leeway in what their trainings can look like. So here in California, there is a state-level standard, it’s called POST, that regulates trainings. And so I was able to go through a use of force training that was really aimed at de-escalation tactics. And it was shocking.

So what I found was this dynamic where officers are simultaneously trained to be wary of overperceiving threat. So what I mean by that is not seeing threat or reacting to threat where none exists or where they could respond with more minimal force. And also underperceiving threat so not discounting someone as a victim or as non-threatening when perhaps, they could present a safety issue for the officer.

So this presented officers with almost a double bind, right? It seemed inescapable. So if I have to assume that everyone could potentially take my life and also not overreact to the fear that someone could potentially take my life, what tools do I have left to use?

And this is where the department that I observed, I’ll call it Pacific Police Department for anonymity, really trained officers to close the distance between them and the suspect or the person they were interacting with and use basic control holds, gripping, grabbing, handcuffing, to maximize the officer’s control of the person.

And in that way, that person is no longer presenting a threat to the officer, so it’s reducing the risk that officers will respond with potentially lethal force. And it’s also reducing the risk that that person could be a threat and harm the officer.

Julia Sizek: So that raises a question for an ordinary person like me who would say, like isn’t putting someone in a control hold a use of force? How is this portrayed as a use of force or maybe not as a use of force by these officers or by the training?

Kimberly Burke: Yes. So per Pacific Police Department policy, basic control holds, handcuffing, and even brandishing a weapon are not considered reportable use of force incidents or interactions. And so officers really reflected that policy language. The training reflected that policy language. And the law reflected that assessment of those kinds of force encounters as often not meeting a threshold of harmful force. So being treated in the law as a minimal intervention to achieve peace or compliance with the law.

Julia Sizek: Well, so legally, what does that look like? What are the legal standards that we use in the US and in California more specifically to understand what a use of force is?

Kimberly Burke: So all police use of force is adjudicated under the 1989 Supreme Court case Graham v. Connor, which established that police use of force must be objectively reasonable according to a reasonable officer at the time of the encounter, rather than assessed with the 2020 vision of hindsight.

The court also held that objectively reasonable force was not capable of precise definition or mechanical application. So this created the conditions whereby all of these 16,000 plus police departments in the US could create their own specific standards of what reasonable force is. And there are states like Washington who are moving away from the reasonable standard toward a necessary standard. So police use of force when necessary.

But other scholars have pointed to the limitations of the existing laws and actually regulating and constraining police use of force. So a scholar here, Osagie Obasogie, published an article looking at police policies and court decisions when citizens try to sue for excessive force. And he found that overwhelmingly, courts defer to police departments’ own policies and standards in determining whether or not force adheres to the Graham v Conner standard.

So in this way, he uses the term legal endogeneity, which was a concept developed by Laurie Edelman, also here at Berkeley, which essentially means that the law is being defined by the very organizations it’s meant to regulate. And I think that is very much the case here in California as well.

And that’s obviously a big problem for policing in the case that we might want to change some of the standards if they are effectively setting their own rules. What does that look like in the training that you attended for use of force? What would be an example of a kind of situation that a police officer would be put in?

So I actually think that the department I observed is laudable in its interpretation of what reasonable force is. And that their goal is really to reduce officer involved shootings, right? So their number one goals are officer safety and public safety.

And unfortunately, that prioritization is what led to this what I call forceful de-escalation standard in this department, where the best way that they can see to protect their officers while also empowering their officers to protect communities is to use these lower levels of force early in interactions as soon as individuals present any signs of noncompliance as a way to, again, prevent the potential that the officer is going to respond with force, even if the courts would decide that higher level of force would be reasonable, as well as to protect the officers from any sort of harmful behavior on the part of the citizen.

Julia Sizek: So if someone is being noncompliant, how do they define that? Like what does noncompliance I guess look like?

Kimberly Burke: Yes. So noncompliance, again, in the department that I observed, could look like failing to identify yourself . An officer told me a story of an unhoused woman who had thrown water I think at the manager of a Starbucks. And he went to respond to the call from the manager. And the woman would not give the officer her name.

So at that point, he describes it as a red flag. This is a sign that this interaction could go sideways, meaning that it could escalate to something that is harmful for both of them. So the officer decided at that point to grab her, and handcuff her, and remove her from the establishment. And in telling me the story, he said, so that was my de-escalation tactic. I didn’t use any force. I just cuffed her and removed her after she failed to identify herself, right?

So that’s a kind of passive form of resistance or noncompliance. That two officers can mean, OK, this person is not going to go with the program. That’s cop lingo. They’re not going to go with the program. They’re not going to cooperate with me. And that could mean an argument, but it could also mean that this person presents a threat to me or to others.

And so at that point, they can decide to detain the person to maximize their control of this non-compliant person. So again, failing to identify oneself, failing to follow orders even if those orders are not necessarily lawful orders, right? Even if they are not compliant with search and seizure laws or within the scope of an officer’s rights can also signal noncompliance to officers and present this early warning sign of potential threat.

And I think that points to a lot of the conflicts that we’ve seen in terms of, I guess I would say like peoples whose cars are searched and then are subsequently detained by police in ways that result in serious injury or even death. And it points to this real disconnect between what an ordinary person might see as a use of force or compliance or noncompliance and what police officers think as compliance or noncompliance. How do police officers deal with this disconnect because presumably, they feel it too. They’ve also been civilians.

Yeah. I had an interesting conversation with an officer who was born and raised in the town he policed, a predominantly Black and Latinx town. He had experiences with being unhoused. His mom was unhoused for a long time. He was a Black officer in every way the kind of model police officer that’s held up in reform efforts, right?

And he described a traffic stop where the driver, I believe it was a Black man, was not going with the program. He wasn’t doing what he was trying to tell him. He was asking him to get out of the car because I think he didn’t want to have the conversation with the guy with the kids in the car or something. The man refused to get out of his car.

And the officer explained it to me as like, look, if I tell you to do something, you do it because my safety and your safety is on the line. He’s implicitly understanding that he’s assessing this noncompliance as a threat to his safety. And then also when he’s threatened, guess what? You’re threatened, right? Because he can respond with lethal force.

And so he said, if at that point, you feel I’m violating your civil rights, then you pursue actions after the interaction is over. You go and make a complaint. You file a lawsuit. But in the moment, both of our lives are on the line. And that was so striking to me that he was able to articulate that assessment of the interaction, right? That even though I might be violating your rights, and I understand that, you also have to understand that I perceive my job as danger, as potential deadly interactions, every single one. So if I’m telling you to do something, you do it. And that is just the way that they understand how they can do their job safely.

Julia Sizek: And that raises real questions about police reform efforts and efforts for community policing or for moving away from policing altogether. Based on what you’ve learned, how do you think about these efforts to change the system of policing in the US today?

Kimberly Burke: So I think it is very important that I observed these logics among egalitarian minority officers in what I consider one of the departments that’s leading the way in equitable policing standards. Because for me, that signals, OK, if this is kind of the best of the best, right? The best of the best officers and the best of the best departments, and they are still having these problematic interpretations of what reasonable force looks like and how to manage interactions with civilians, then the most effective thing we can do is to reduce police contacts overall. To reduce the footprint of policing.

And we’re seeing agencies implement these kinds of reforms. Right here in Berkeley, Chief Greenwood announced that they wouldn’t be enforcing lower level traffic stops, right? Traffic stops are one of the most fearful interactions with police officers, especially at night because they can’t see in the car. They can’t see the driver. They can’t see your hands. So these are more likely to result in unnecessary uses of force. So that’s one thing.

Norfolk in Virginia, they did something similar, where lower level offenses, misdemeanor offenses are now being handled over the phone or over Zoom calls. So if civilians have a complaint of petty theft or these other misdemeanor-type crimes, officers aren’t going to interact in person. They are managing these cases virtually. And those I think are the most exciting interventions for me right now, is how do we think about reducing policing overall, so that they’re having fewer contacts and fewer opportunities for things to escalate into lethal force?

Julia Sizek: And what are some of the other potential benefits of changing these strategies, which is to say, what are some of the big harms of forceful, what you call forceful de-escalation or other forms of police violence on communities?

Kimberly Burke: So aggressive police encounters or living in a neighborhood where there is high police activity is shown to have really negative impacts on mental health and well-being and all of these spillover effects that I mentioned earlier, right? Reduced civic participation linked to negative educational outcomes, just a myriad. And now I’m looking at how it impacts our personal relationships.

So I think if we can reimagine the scope of policing, we can also refocus on building alternative public safety systems that actually provide people with positive resources for their mental health well-being. It can force us to rethink about the kinds of financial instability that is contributing to some of these crimes. It can force a reckoning with how we think about property and property crimes and how we value that over the well-being of these communities that are subjected to harsh and burdensome policing practices.

Julia Sizek: So this is obviously a very heavy topic. How did you come to start studying policing?

Kimberly Burke: So I am actually trained in women’s studies. I got my bachelor’s in women’s studies and my master’s in women’s studies. And I was broadly interested in issues of social justice, gender, race, class, those intersecting identities and power dynamics in society. And I started working at the Center for Policing Equity following my master’s program, which focused on race and equity in the context of policing.

When I started, I knew nothing about policing. I knew nothing about the social psychology measures they were using to assess what kinds of policing attitudes predicted negative outcomes. And it was really a grad level course in criminal legal systems under Phillip Atiba Goff, who’s the co-founder and CEO of Policing Equity. He’s a professor in African American Studies at Yale now. But he was really kind of my mentor and professor and entree into the world of policing.

And so from 2013 to 2017, I managed various initiatives at policing equity aimed at reducing harms. We were asking the question, how do we make policing less deadly for Black communities? And as part of that, I was the project director at the Department of Justice-funded National Initiative for Building Community Trust and Justice, and we partnered with six police departments across the nation to test out interventions at building community trust, at reducing police use of force in the communities most burdened by policing outcomes.

And so that’s when I was working on issues of implicit bias and these other cognitive predictors of negative policing outcomes. And that’s also when I saw that again, in the best of police departments, there were still these stubborn intractable issues of unnecessary force. And that’s what really got me interested in pursuing my doctoral degree and pursuing my own research that asked these questions.

And I think I’ve come kind of full circle now in these questions of love and mutuality back to my women’s studies and feminist theory background. So I’m seeing a real marriage of those two disciplinary trainings, right? Or three, really. So I have my women’s studies, my social psychology and formal training, and now my sociology training, where I’m really able to study the dyad, the most basic building block of society, the partners, right? And to look at how those dynamics, both create and are created by the structures that define our society.

Julia Sizek: Thank you so much for coming on and telling us about how we can start to reimagine policing.

Kimberly Burke: Thank you so much for having me.

Woman’s Voice: Thank you for listening. To learn more about Social Science Matrix, please visit matrix.berkeley.edu.

Burke won second place in the 2022 UC Grad Slam Competition: watch her presentation below or on YouTube.

Culture

Do Food Labels Work? A Visual Interview with Nano Barahona

Published May 11, 2023

In the wake of concerns about the negative effects of high-sugar and calorie-dense foods on human health, governments have tried to intervene through sugar taxes and changes in food labeling. What changes are most effective in shaping consumer behavior?

For this “visual interview,” we spoke with Nano Barahona, Assistant Professor of Economics at UC Berkeley, who recently examined how a food labeling policy has changed the approaches of both consumers and food producers in Chile. Spanning the fields of industrial organization and public economics, Barahona’s research broadly focuses on studying and quantifying the effects of government policies on individuals’ outcomes and welfare, with an emphasis on health, educational, and environmental policies.

Barahona and his co-authors, Cristóbal Otero, and Sebastián Otero, recently wrote an article about their research for Berkeley Economics, wherein they provided a summary of their recent papers (here and here). “We study the impact of warning labels on nutritional intake in Chile,” they explained. “We partnered with Walmart-Chile, the largest supermarket chain in the country, and accessed scanner data on food purchases between May 2015 and March 2018 in all their supermarkets in the country. We matched each product to its nutritional information, and by connecting transactions to individual shoppers, we were able to compute the impact of the policy on overall nutritional intake.”

Front-of-package labels on selected products.

What are some of the approaches for addressing consumer food choices through food labeling?

The idea that food labels can improve consumer information — and, therefore, consumer choices — has been floating around for a long time. In the United States, for example, the Nutrition Labeling and Education Act mandated nutrition labeling of all prepackaged foods beginning in 1994. Nevertheless, empirical evidence shows that nutritional fact tables have not been effective at improving consumers’ food choices, mainly because consumers don’t use them or do not understand them.

Since then, governments and international institutions have been exploring numerous policies to improve nutritional choice and combat obesity. An increasingly popular policy is providing simplified information to consumers through front-of-package labels (FoPL), which consist of warning stickers placed on the front of packages to clearly signal to consumers when a given product is unhealthy. Today, more than 35 countries – mostly in Europe and Latin America – have voluntary or mandatory FoPL schemes, compared to only 10 countries in 2010.

Some countries have implemented “nutri-scores,” a quantitative value indicating a healthiness index calculated by an external institution. Other countries have labels in different colors, resembling street lights, with green for healthy products, yellow for intermediate, and red for unhealthy. Other countries, like Chile, have opted for binary labels that warn consumers when a given product is above a specific threshold on some particular critical nutrient, such as sugar, sodium, or saturated fat.

What are the aspects of food labeling in Chile that made it particularly interesting to study, and what’s different about the approach that Chile has taken compared to other countries?

In 2016, Chile became the first country in the world to implement a mandatory nationwide food labeling regulation. Since 2016, more than 25 countries have followed Chile and have either implemented or are in the process of implementing country-wide mandatory food labeling policies.

The following table shows the set of countries that have already implemented or are discussing implementing policies similar to the ones in Chile. All of them include warning stickers for high concentrations of sugar, sodium, and saturated fat. Some, like Chile, include an additional label for products with a high number of calories.

Mandatory front-of-package labeling policies implemented or being discussed around the world

This graph shows how sugar and calorie intake changed as a result of nutrition labeling. How did consumers change their behavior when the new policy went in place?

Consumer calories and sugar per dollar spent following the introduction of nutrition labels.

Through tracking shopping data at Walmart locations in Chile, we documented a sharp overall decrease in sugar and caloric intake of 8.8% and 6.5% per dollar spent, respectively, immediately after the policy was implemented. This reduction, which persisted for the two-year post-policy window in our data, is explained by a combination of demand- and supply-side responses. On the one hand, consumers reacted to the regulation by making healthier choices. On the other hand, companies responded to the regulation by reducing the concentration of regulated nutrients in their products, such as sugar, to push them under the threshold of the regulation. To disentangle these mechanisms, we can zoom into the cereal market.

Log-quantities (logarithm of total grams of products) of labeled and unlabeled ready-to-eat-cereal purchased at supermarkets over an eight-week period.

Through tracking sales over time, we found that the policy induced consumers to switch from labeled to unlabeled products. We also found, though, that the total demand for cereal didn’t change much after the policy was implemented. The decrease in demand for labeled products was compensated by a comparable increase in demand for unlabeled products. The figure above shows percentage changes in demand because we used a logarithmic scale. Because the baseline demand was larger for labeled products, the percentage change in demand was smaller. That doesn’t mean that the net change in demand is actually smaller.

You also studied how consumers’ beliefs about these products changed when they saw the new labels. How did consumers respond to this new information, and how did it vary for different kinds of food?

Log-quantities of labeled and unlabeled ready-to-eat-cereal purchased before and after food labeling. Colored lines represent the prior beliefs held by consumers about products that received the high-calorie label.

We conducted a survey to elicit consumers’ beliefs about the nutritional characteristics of a set of cereal and soft drink products in the absence of warning labels. We found that, on average, individuals had relatively accurate beliefs about the concentration of sugar in cereal. However, respondents’ beliefs about the calorie concentrations in cereal (calories per gram) were less aligned with reality. Certain granolas, for example, were perceived as being low in calories while they are actually high.

We then split products between those that were believed to be low in calories but were tagged with a high-in-calories label, and those that were known to be high in calories and also received a high-in-calories label. We found that products that were mistakenly believed to be healthy but ended up with a high-in-calories label saw the greatest decline in sales as a result of the policy. These empirical findings suggest that labels are especially effective for products about which consumers are more misinformed.

Under what circumstances were the food labels most effective in changing consumer demand?

Two important features of a product category determine how much food labels affect consumer demand. First, categories in which labeled and unlabeled products are closer substitutes are more likely to show larger substitution effects, which we found in grocery store data. For example, if a high-in-sugar cereal has an alternative available with similar taste but lower levels of sugar concentration, consumers who were misinformed about its sugar content will be more likely to switch than if an alternative wasn’t available.

Second, food labels are more effective in shaping consumer demand for categories in which they are more informative. In the soft drinks category, for example, consumer beliefs about sugar concentration are relatively accurate, mostly because soft drinks are already categorized as either diet and non-diet drinks. When we estimate the effects of food labels on demand for soft drinks, we find that the relative change in quantities sold between labeled and unlabeled products is half that for products in the breakfast cereal category.

How did different consumers respond to the new labels?

We find fairly similar effects of the policy on consumer responses across the income distribution. On the one hand, you might think that richer consumers care more about the healthiness of the products they buy. On the other hand, richer consumers might be better informed about products before the policy was implemented. This is particularly important when we compare food labels to sugar taxes. Lower-income households tend to eat more sugary products. Then, if we impose a high tax on sugary products, we end up with a quite regressive policy that ends up charging low-income individuals more. Food labels, on the other hand, don’t require transfers from consumers to the government. Moreover, if low-income consumers are less informed about the nutritional content of the products, they may benefit more from food labels as they will provide more useful information to them.

How does food labeling compare to sugar taxes and other strategies for encouraging healthier diets?

When we compare food labels to sugar taxes, we find that food labels present both advantages and disadvantages. In categories such as chocolates and candy, in which all products receive labels and are known to be high in what policymakers called critical nutrients (sugars or fats), food labels are less effective at improving diet quality. Other market imperfections, such as lack of self control, can be important drivers of consumer bias in these categories. Sugar taxes may be a better tool for fighting obesity in these cases.

However, in categories where low-socioeconomic status consumers are more likely to prefer sugary products or have more misaligned beliefs about products’ nutritional contents, food labels present distributional benefits over sugar taxes that need to be considered.

Our findings suggest that the optimal policy is to combine food labels with sugar taxes, with higher taxes on categories in which non-informational biases are larger, and lower taxes in categories that are consumed more by the lower-income individuals than they are by higher-income individuals. For example, a sugar tax might be effective in reducing consumption of chocolate or sugar-sweetened beverages, categories for which consumers are already aware of their sugar content. In categories where awareness is lower, such as cereal, food labels can be a more effective policy.

You also studied the supply-side effects of the new labeling system. How did food manufacturers respond?

To study how firms responded to the labeling policy, we compared the distribution of nutritional content before and after the policy was implemented. In 2016, before the policy was implemented, 55 cereal products were above the threshold for caloric concentration. In 2018, 13 of those products reduced their concentration of calories to just below the threshold. In economic terms, eight of the products bunched at the threshold of 350 kcal per 100 grams.

We observed a similar pattern when we looked at sugar concentration. In 2016, 27 regulated products were above the threshold. In 2018, nine of these reduced their sugar content to be below the threshold, and six reduced it to between 20 and 22.5 grams of sugar per 100 grams of cereal. This suggests that firms chose to respond strategically to the labeling policy, bunching at the threshold to avoid receiving a label.

This behavior by firms resulted in a net reduction in the caloric and sugar concentration of cereal products offered in the market. The average caloric concentration of products decreased from 383.6 to 372.8 kcal per 100 grams, while the average sugar concentration of products decreased from 21.54 to 19.06 grams of sugar per 100 grams of cereal.

Distribution of cereal calorie and sugar concentrations pre- and post-legislation.

How do the supply- and demand-side effects of this policy compare to each other?

To answer this question, we first needed to find a way of quantifying the net effects of the policy. Consumer and firm decisions changed in many different ways due to the policy. Consumers changed their purchasing decisions due to the new information, and firms changed both prices and nutritional content of products, which impacts consumer well-being. We calculated consumer well-being, a dollar-value measure of people’s happiness, by estimating consumers’ willingness to pay for different product characteristics, and we used this measure to value the net gains of the policy. In other words, we calculated how much a consumer would be willing to pay in order to get this policy implemented.

We first quantify the effects of food labels in the absence of supply-side responses. If companies were not able to change their food formulations or change their prices, we find that the regulation reduces sugar and caloric intake in the cereal market by 6.8% and 0.6%, respectively, resulting in average gains in consumer well-being equivalent to 1.1% of total cereal expenditure, or about $0.28 per year. This is the amount that consumers would be willing to pay in order to have the policy implemented.

Second, we asked what would have happened if firms were not allowed to change the content of their food but could still optimally choose prices. We find that prices of unlabeled and labeled products go up and down, respectively, with average prices remaining relatively constant. Gains in consumer welfare relative to the no-intervention counterfactual are 7% lower than in the absence of supply-side responses.

Finally, we allow firms to optimally reformulate their products to avoid receiving labels. This exercise recovers the full effect of the policy. Overall, we find that products that were tasty but unhealthy became now healthier but more expensive due to higher production costs. Consumer well-being gains under this counterfactual are 48% larger than in the absence of supply-side responses.

What implications does your research have for policymakers?

Our research has important implications for the design of food labeling policies. Policymakers choosing regulatory thresholds for labeling policies should take into account several dimensions. First, it is important to target categories that represent a large share of consumers’ intake of harmful critical nutrients like saturated fats and sugars, such as soft drinks and cereal. Second, thresholds must be set to maximize substitutability within targeted categories, which means that the categories need to have both healthy and unhealthy products that are close substitutes — like cereal, where there are both healthy and unhealthy products, and unlike candy, where all products have similar sugar content. The categories should also be categories where consumers are misinformed about the healthiness of their products. Third, thresholds must be tighter in targeted categories in which reformulation is feasible at a low cost, such as liquids, where replacing sugar by artificial sweeteners is relatively easy. In solid categories such as cookies, reformulation is much harder because sugar acts as a bulking agent that is harder to replace without losing consistency of the product.

Our results also shed light on the importance of combining different policies to tackle obesity. In categories such as chocolates and candy, in which all products receive labels and are known to be high in sugar, food labels are less effective for improving diet quality. Other market imperfections, such as lack of self-control or time inconsistency, can be important drivers of consumer bias in these categories. Sugar taxes can be a better tool to fight obesity in those cases. Consequently, food labels and sugar taxes should be seen as complementary policies rather than incompatible alternatives.

Alumni

Understanding the Opioid Overdose Crisis: An Interview with David Showalter

Published April 19, 2023

How does the opioid overdose crisis reshape rural communities? Through their research on opioid use and opioid-related services in backcountry California, David Showalter argues that an ethnographic sensibility can help us understand how drug use both becomes an ordinary part of people’s lives and what policymakers might do to help prevent overdoses.

David Showalter completed a PhD in Sociology at the University of California, Berkeley in 2022, and is now a postdoctoral fellow in the Sociology Department at Harvard University and will be Assistant Professor of Sociology at Harvard starting in July 2023. David’s research has been published in Social Science and Medicine, Theory and Society, International Journal of Drug Policy, Mobilization, and elsewhere. Outside of their academic work, David previously served as President of the Board of Directors for NEED, a harm reduction services organization in Berkeley.

For this visual interview (an interview accompanied by images or graphs related to a scholar’s research), Matrix Content Curator Julia Sizek spoke with Showalter about trends that have defined the opioid crisis in recent decades.

Figure 1, Drug-related deaths in the United States — Figure 1: Drug-related deaths in the United States

As noted in this figure, drug-related deaths have been on the rise across the US broadly. What first interested you in studying this topic?

I’ve been working directly with people who use drugs since 2009, when I started volunteering with a harm reduction organization called Chicago Recovery Alliance. At CRA, we distributed supplies like sterile syringes to help people use drugs more safely. We also gave out naloxone, a medication that reverses opioid overdoses.

I had many conversations with people about overdoses they had experienced or witnessed. These stories were heartbreaking and, in most cases, could have been prevented if people had the resources, information, and support to use drugs more safely. Back then, overdose rates were already at record highs, and they continued to climb almost every year since.

By the time I started graduate school in 2013, the opioid overdose crisis was becoming one of the top news stories. I decided to combine my commitments to harm reduction and my social science research skills to better understand the experiences of people at risk of opioid overdose, as well as the policies that could help prevent overdose deaths.

For my dissertation, I conducted a multi-site ethnographic study of opioid use and opioid-related services in California’s remote and mountainous backcountry. In total, I conducted interviews across a dozen counties and did more intensive ethnographic fieldwork in five counties. I interviewed dozens of people who used drugs, health care and treatment providers, and law enforcement officers to understand what it was like to live in isolated places where “everybody knows everybody,” and how drug use and local government were shaped by those surroundings.

I also spent a lot of time hanging out with people as they bought, sold, and used drugs, and with service providers as they planned new programs. Participant-observation research like this helps us see the complexity of people’s lives and avoid reducing them to their drug use.

What I found is that the social intimacy and geographic isolation of small towns affects almost every aspect of everyday life, including drug use. Looking for drugs meant traversing long distances to cities while avoiding law enforcement officers who might know you personally. Using drugs meant scrounging for scarce supplies and avoiding health care providers who might tag you as an “addict.” And quitting drugs could mean leaving home altogether to access treatment or escape a negative reputation.

This seems like it could be a challenging group to research. How did you gain access to this community?

Building trusting and authentic relationships with the people you are studying is key to ethnographic research. It can be difficult for outsiders entering isolated communities to study stigmatized topics like drug use.

However, I found that, by and large, local officials were easy to meet because they recognized opioid use and overdose as issues in their communities and wanted help with addressing them. They appreciated my interest in their communities, and assumed that I must be an expert if I studied at Cal!

Local officials in rural areas were also more accessible to the public: their offices were small and open, and they were personally acquainted with many of their constituents. For example, in one small town, I called to make appointments with the chief of police and other officials and was told to just stop by the next morning whenever I had time.

When it came to meeting people who use drugs, I got lucky a few times by meeting the right people. I met one key individual because they happened to be friends with the person from whom I rented a room.

But what was really important was my experience with harm reduction programs. Throughout graduate school, I was a member of NEED, a volunteer-led harm reduction organization in Berkeley. We distributed new syringes and other equipment, disposed of used syringes, trained people to use naloxone, and gave out other essential health and wellness supplies.

As a result of my work in harm reduction, I was able to communicate with people about their drug use in a knowledgeable and nonjudgmental way. I didn’t assume that they were “addicted,” for example, or that they viewed their drug use as a problem.

I also didn’t exoticize their lives because they did something most people don’t do, nor did I dramatize their drug use as something edgy, spectacular, or rebellious. If you use drugs every day, it’s a pretty mundane part of your life; sometimes it is almost like another chore to complete. I think recognizing the “normality” of drug use in people’s lives helped put them more at ease.

Because I was connected to harm reduction programs, I was also sometimes able to bring people important health supplies, like new syringes to help prevent transmission of diseases like HIV and hepatitis C, biohazard disposal containers to safely dispose of used syringes, and naloxone in case of overdose. By these words and actions, I convinced people that I viewed them with the same respect and care as I did anyone else, rather than with curiosity or suspicion.

Figure 2: Estimated rates of past-year heroin use in California between 2016-2018. Rates per 100,000 people age 12+.

In this figure, we can see how rural regions in California, particularly in the northeastern part of the state, have higher rates of opioid use. How has this been explained by scholars, and what did you find in your research?

Researchers studying rural opioid use have highlighted both “supply” and “demand” factors. On the supply side, some rural regions were targeted by opioid companies with intense marketing, and doctors there prescribed opioids at high rates.

On the demand side, rural populations are in overall poorer health and are served by weaker health care systems, making painkillers an attractive solution for overworked health care providers and patients suffering from pain. These trends contributed to increases in the number of people using and dependent on opioids.

As awareness of the crisis grew in the early 2010s, policymakers pushed to restrict prescribing; around the same time, rates of heroin use and overdose increased. Researchers were split on whether people were switching because their dependence was growing or if it was because heroin had become cheaper or easier to get than pills.

One of the reasons I focused on rural California is that it had received much less attention from reporters and researchers than other rural regions, like Appalachia and New England. I wondered whether the stories I had heard about those places would translate to another region.

In my fieldwork, I found that because there were few health care providers, changes in their opioid prescribing practices could have broad and unintended ripple effects. Providers reduced opioid prescriptions out of concern that people might overdose, but some people who depended on those pills didn’t quit and instead sought out alternatives, including heroin.

Media attention has focused on the role that pharmaceutical companies have played in furthering the opioid epidemic. Teva, CVS, Walgreens and other companies in the opioid industry have recently settled or been ordered to pay damages for their roles in the crisis. In your research, you challenge this focus on pharmaceutical companies and instead suggest a different history of the crisis. What did you find?

Pharmaceutical companies did introduce and irresponsibly market powerful opioid medications that significantly contributed to the initial rise in overdose deaths. This included targeting physicians in some rural regions in order to increase opioid prescribing.

But the contemporary overdose crisis was not the beginning of rural opioid use. Morphine and opium first took hold in rural California during the 19th-century Gold Rush, when both were used medicinally and recreationally, and concerns about opioid use cropped up repeatedly in the region during the 20th century. This recurring affinity between opioid and rural places is therefore not solely due to pharmaceutical marketing.

Rather, I found that opioids helped address two important preexisting complaints in these places. First, rural health care systems are understaffed and often lack specialized services, and opioids were an easy solution for health care providers who could not comprehensively address their patients’ health concerns.

Second, rural residents frequently complained of boredom and hopelessness due to economic decline, population loss, and lack of local amenities. Opioids, like other drugs, can distract from these conditions and soothe the negative emotions that they provoke. In short, focusing on the actions of pharmaceutical companies can overshadow the reasons why opioids were so appealing in rural areas to begin with.

Age-adjusted opioid-related mortality rates, by urbanization- California, 1999–2019 — Age-adjusted opioid-related mortality rates by urbanization in California, 1999-2019

As noted in this figure, age-adjusted mortality rates have been higher in rural California. In comparison to cities, what social and medical services are available to rural residents, and how do you think this has shaped the opioid epidemic?

I think about opioid overdose (and other drug-related health problems) in two ways. On the one hand, people risk dying from overdose if the drugs they are using are too potent or too inconsistent for them to accurately gauge their dose and tolerance.

But overdose risk is also shaped by the presence or absence of protective factors, such as harm reduction services that distribute naloxone, and treatment programs that offer medications for opioid use disorder, like methadone and buprenorphine. Historically these services have been much more common and accessible in urban areas.

Harm reduction services grew out of urban social movements and until recently were very scarce in rural areas. For example, when I started my fieldwork in 2017, only a handful of rural counties in California had syringe services programs, and community-based access to naloxone was almost nonexistent in many places.

Substance use treatment services in these counties were also scarce, and were in some cases limited to self-help groups like Alcoholics Anonymous and Narcotics Anonymous. Standard-of-care medications like methadone and buprenorphine were unavailable in many communities due to regulatory requirements and because rural providers were hesitant to offer them.

The absence of these services during the first wave of the overdose crisis meant that it was harder for people in rural areas to use opioids safely and to get help managing or reducing their opioid use.

One of your key contributions is the idea of “acquainted marginality,” which you use to describe how people in small towns have enduring connections. How did these forms of acquainted marginality change how people acted in the local drug scene, as well as with local medical practitioners and service providers?

Acquainted marginality is the condition of being marginalized in your community — by poverty, ethnoracial discrimination, or criminalization, for example — yet personally acquainted with those who exercise power over you: the police, health care providers, or even elected officials. In the small towns I studied, it was common for people who used drugs to know sheriff deputies by name, or even to have grown up with them.

Those personal connections multiplied opportunities for law enforcement to gather information, whether through gossip or direct observation. You risked being seen any time you left your home, or your car could be recognized on the road. And any information you shared with others — or any assumption they made about you — could potentially get back to law enforcement. That made people who used drugs cautious about their movements, and reluctant to engage with health care and other services for fear that they would be marked as an “addict” or even reported to law enforcement.

For some people, this even meant refusing to call 911 in emergencies or go to the hospital for serious health problems. I heard stories of people abandoning their friends who overdosed and watched people treat abscesses at home rather than risk being identified in the emergency room. The intersection of dense social networks and harsh punishment of drug use keeps people from getting the help they want and need.

Most research on drug use within sociology has an urban focus. What do you think a return to rural sociology can bring to the field as a whole?

Rural areas and small towns are important for sociological research for several reasons. First, even in urbanized societies like the United States, significant numbers of people live outside of large cities. Their lives are just as complex and their wellbeing is just as important as anyone else’s, and if we truly mean to study society as a whole, we can’t ignore the full spectrum of human settlements.

I have been struck by how perceptions of “rural Americans” have veered from one stereotype to another in recent years. When I was planning this research in 2016, those I talked with tended to express pity for rural areas that were suffering so-called “deaths of despair.” But in the wake of the Trump Administration, I have heard more contempt for rural Americans, even a feeling that they deserve what they get. In-depth research can help counteract these inaccurate and simplistic images.

Second, studying non-urban areas helps to define the “scope conditions” of our theories, to see whether they apply to all people and places, or only to those that receive the most attention. I found that some aspects of rural drug markets were similar to those in urban areas that have been studied more extensively. For instance, people in small towns have to share money, drugs, and other resources to get by, much like poor urban residents do. But other aspects were much different. While urban police often overlook personal drug use to avoid wasting time on an arrest, people I talked to in small towns received comparatively harsh punishment for offenses as minor as being under the influence of drugs.

Third, small populations in rural areas allow us to study “simplified” versions of social groups, organizations, and interactions that take on more complex forms in larger places, which is useful for thinking about fundamental relationships between place, social structure, and inequality. Whereas in large cities interactions between government agencies and residents are innumerable and highly dispersed, in small towns the connections between officials and their constituents are closer and clearer. For example, it’s easier to see how the behavior of prosecutors and judges affects residents’ views of their courts when there are only one, two, or a few prosecutors and judges making all the decisions.

Finally, social dynamics that may seem distinct to more remote and isolated places can reappear in unexpected ways in urban settings. For instance, the experience of being personally acquainted with influential and powerful members of your community is not unique to small towns, but shows up to varying degrees in segregated neighborhoods, insular subcultures, or organizations like schools, universities, and hospitals. Studying rural areas can therefore also illuminate important aspects of other kinds of settlements as well.

What advice would you have for policymakers who are trying to create policies about opioid abuse?

The story of policy responses to the overdose crisis has been one of tragic unintended consequences. Lax oversight of opioid prescribing exposed vulnerable populations to powerful and potentially deadly drugs. But more recently, crackdowns on prescribing have pushed some people who lose access to pills toward more dangerous substances like heroin and fentanyl. With such a potent and dangerous drug supply, we should be very careful to consider whether policy changes risk leaving people in more dangerous situations than they are in now.

With that in mind, here are three directions I think we need to push to address overdose deaths.

First, we need to universalize harm reduction services to reach people who are currently using drugs — not just basic services like distributing new syringes and naloxone, but also overdose prevention sites, where people can bring their drugs to be rapidly tested for fentanyl and other substances, and can use drugs under trained supervision.

Second, we need to make treatment medications easier to get and more appealing than illicit opioids. This means designing low-barrier, flexible, patient-centered programs that reach people directly in their communities, including through mobile and telehealth services. We also need a wider range of treatment medications to address all patients’ needs, such as heroin and hydromorphone, which are sometimes prescribed for opioid use disorder in Canada.

Third, we need to give people who don’t want or need treatment access to safer alternatives to the increasingly dangerous and unpredictable illicit drug supply. To access treatment and other services, people have to stay alive. Compassion clubs in Canada have demonstrated at a small scale the feasibility of sourcing, testing, and non-commercially distributing pure supplies of heroin and other drugs to people who are dependent on them. These efforts deserve serious attention.

Podcast

The Scandal of Access: An Interview with Zahra Hayat

Published February 14, 2023

This episode of the Matrix Podcast features an interview with Zahra Hayat, Assistant Professor of Anthropology at the University of British Columbia. She obtained her PhD in Anthropology at UC Berkeley, and is also trained as a lawyer with a background in intellectual property.

Matrix Content Curator Julia Sizek spoke with Hayat about her research on pharmaceutical access in the global South, particularly in Pakistan, and the regimes of price and property on which such access is contingent.

Listen to the podcast below or on Google Podcasts or Apple Podcasts. A transcript of the interview is included below.

Podcast Transcript

Woman’s voice: The Matrix Podcast is a production of Social Science Matrix, an interdisciplinary research center at the University of California, Berkeley.

Julia Sizek: Hello and welcome to the Matrix Podcast. I’m Julia Sizek, your host. And today our guest is Zahra Hayat, who is an assistant professor of anthropology at the University of British Columbia. She obtained her PhD in anthropology at UC Berkeley this last year and is also trained as a lawyer with a background in intellectual property. Her research focuses on pharmaceutical access in the Global South, particularly in Pakistan, and the regimes of price and property on which such access is contingent. Thanks so much for coming on the podcast, Zahra.

Zahra Hayat: Thanks for having me, Julia.

Julia Sizek: So let’s get started with the big overarching question of your research, which is the scandal of access, the way that pharmaceuticals are easily accessed in the West but are inaccessible in the Global South, and specifically in Pakistan, and the preventable deaths that result from this lack of access. What does contemporary access to pharmaceuticals in Pakistan look like?

Zahra Hayat: Yeah. Thank you for that. So I think– best to start off with why or what I’m trying to gesture at with the title of my dissertation, which is The Scandal of Access. And the idea of scandal is something that emerged very organically during fieldwork for me. A lot of my interlocutors would refer to various things vis a vis pharmaceuticals and people’s inability to access them through the language of scandal.

And over time, I began to think of it as much more than just a figure of speech or something that people would say rhetorically, and think about how conceptualizing scandal might help us understand what is going on vis a vis access to medicines in Pakistan. And so I’m trying to get at a couple of things with this idea of scandal.

First of all that I think the sort of overarching meta scandal that defines the stakes of my work really is that of preventable death. And by that I mean in a country with a population of 220 million people– it’s the fifth most populous country in the world. And people have some of the highest incidences of diseases that are treatable if not fully curable in the West, you know, so-called.

This includes hepatitis C. It includes breast cancer. Pakistan is among the highest rates of breast cancer in South Asia. Now these are all diseases for which medicines exist. And yet, due to lack of these and many other far simpler, far older medicines, Pakistanis are either suffering needlessly or dying prematurely.

And a particular example, I think, that might illustrate this idea of scandal is not a curative substance but a palliative substance, morphine. And I can talk more about morphine later. But I think the idea of scandal really first hit home for me when I started hearing over and over again from the people that I spoke to about how people with late-stage cancer in Pakistan, for whom treatment is now no longer a viable option, and who can only be given palliation at this point, simply do not have access to pain relief medication.

It is almost impossible in hospitals to get either fentanyl or morphine, which is sort of absolute basic standard of care for terminal cancer patients in the West. And the reasons for that are very counterintuitive. Usually, we think of drugs being difficult to access because they are too expensive, right, or they are under patent, and generic manufacture is not allowed in the Global South, which is something we see in India a lot.

In the case of morphine, none of these barriers to access actually / morphine is a drug that’s 200 years old. It’s been used for pain relief for 200 years. It’s not under patent anywhere. And it’s one of the cheapest medicines, even in the Pakistani scale of medicine pricing. And yet it’s almost impossible to get in hospitals.

And there is a very complicated constellation of bureaucratic policies, bureaucratic agencies, which has to do with a phobia of drug addiction and of morphine kind of percolating into the illicit realm, and therefore contributing to the problem of addiction as it’s called, that people who have cancer are not able to get it.

So it’s things like this that I’m trying to get at with the idea of scandal. There’s something egregious about this that you have illicit counterparts of morphine circulating on street corners. And doctors are forced to tell patients to go to the street to use that, figure of speech, and try to find morphine for their loved ones.

So this element of egregiousness, this element of outrage of a violation of some norm of decency or ethics, and also an affect. When people talk about this, there is this affect of this should not be happening, this should be easily preventable.

And yet, as I tried to show and as I’ve learned, it’s anything but easy. So this is sort of the, I guess, a little bit of a texture of what I’m trying to get at with the idea of scandal.

Julia Sizek: Yeah, so let’s talk a little bit more about access to morphine. So let’s say that you or a loved one is in a hospital, and you are trying to figure out how to get access to morphine for palliative care. What do those steps look like, and what are the rules that are governing whether or not you have access to morphine?

Zahra Hayat: That’s a great question. So some of the things that I’m going to say will be specific to morphine, but many of them will not. And they’ll be representative of the larger pharmaceutical landscape.

In fact, you know, ironically, just two days ago, one of my interlocutors at the Drug Regulatory Authority of Pakistan, which one can see as the counterpart of the US FDA, sent me an article in one of the leading national dailies, talking about how patients with cancer, including children, and they were a large focus of that piece, are suffering horrifically because of the pain of end-stage cancer and how it’s just impossible to get morphine.

And there were senior oncologists who had been interviewed for that piece, who spoke about how the entire bureaucratic regime that governs, controlled substances, of which morphine is one, because of the addictive potential, that regime is so complicated and so lengthy that the companies that are trying to supply morphine sometimes have to wait months and months in order to get an approval for a quota of morphine.

So I’ll give you a very specific example of one of, maybe, the two companies that are still supplying morphine in Pakistan. So that in itself is scandalous. We have to 20 million people. We have over 800 registered pharmaceutical companies. And only two of them are actually selling morphine. And there are reasons for this, and there are twofold.

One has to do with pricing, and one has to do with what I’m calling bureaucracy. So I’ll talk about the bureaucracy piece first. I spoke with the CEO of this company in a lot of detail, and she explained to me just how excruciating the process is for them. So they import their morphine from Switzerland because the technology that they need, modified or slow release, they’re not able to make locally.

So it’s imported from Switzerland. Before they can put in an order for import, they have to apply to the drug regulatory authority and a constellation of other bureaucratic agencies, including the anti-narcotics force, for permission. And this permission is not something that’s granted to them as a blanket permission.

You get it once, and then they know that you’re supplying morphine, and that’s it. Every time they want to place an order for morphine, they have to secure this permission. The biggest roadblock here is before they can submit an application for a new stock, their existing stock has to finish. So this seems like such a simple sort of timing-related glitch to fix.

But it has not been fixed for years and years because it’s not just a simple bureaucratic glitch. And this is, I think, what I’m trying to get at as well that these things do not have easy quick techno fixes. So as this person explained to me, she said once we are down to zero for our quota of morphine, that’s when we’re able to submit an application.

Now that application can take anywhere from three months to six months to approve. Once it gets approved, you can place an order with your supplier in Switzerland, and there’s a lead time for that order as well. The consequence of this is that for about six months of the year, this company has no morphine to supply to hospitals. And hospitals simply don’t have morphine.

And so what they end up doing with patients is either just turning them away or saying that heroin, which is the illicit counterpart of morphine, they derive from the same opium poppy plant– or telling them that you can try and go to one of the– they’re called “addas” in Urdu, which is basically a figure of speech, but it sort of refers to– it’s a trope for where drug addicts tend to huddle.

That’s the trope. It’s a caricature. Go to those street corners, go to those drug addicts, try to get heroin from them. Now this undertaking itself is impossible for a lot of people. Sometimes in desperation, they do do this. They do go to addas and get morphine. And I have heard of people who’ve done this. But then, they talk about how you don’t know what you’re getting.

You absolutely have no sense of the purity or the quality of it. But at that point, I think the need is so dire that you’re not even thinking about questions, such as, what is the quality of this material? Anything that will relieve the pain is what will do.

So the second piece that I want to quickly talk about has to do with price. And this is a much broader problem. The bureaucratic control issue is specific to morphine and other controlled substances. And I just want to mention very quickly on that– this is not a Pakistan-specific problem. So across the Global South, access to morphine is a huge issue.

Julie Livingston’s work on cancer in Botswana mentions the same thing. And if you compare the statistics for consumption of morphine per capita in a country like the US and a country like Pakistan, the difference is literally thousands of per cents. And of course, advanced cancer is much more common in places like Pakistan because of late diagnosis. So the need and availability are just completely disjunct.

On the price question, this is a much larger issue that has a very central connection to access and problems of access in Pakistan, and that has to do with state regulation of pricing. And I can talk more about that later. But just very quickly, the Drug Regulatory Authority of Pakistan sets the maximum retail price for every drug that can be sold in the country.

And these price ceilings that they set are unviably low for a lot of corporations. And this is not just something the corporations are saying to me, and I’m taking them at their word. But this is actually from having looked at their detailed cost data.

A lot of my fieldwork was in these pricing meetings of the drug regulatory authority, which was accessed, that I was very lucky to get and to actually see that a lot of these companies are supplying products at a loss. And morphine was actually one of them. And the reasons for the drug regulatory authority being so hesitant to grant price increases has very fraught political reasons.

And we can talk more about the pricing question later. But the disincentive basically for companies to supply medicines is that you’re not going to be making much of a profit. And this doesn’t apply to all drugs, but specifically to morphine, and to many other simple, very cheap drugs. And given that it’s so complicated to get these approvals and quotas, most companies simply don’t want to get into this.

I mean, the CEO of this one company that still does it on a humanitarian basis, in their words, because it’s making a loss for them, was that you’d have to be crazy to get into this business because what are you really getting. So I’ll stop here now. But we can chat more about pricing.

Julia Sizek: Yeah. So I think one of the things, especially in the US, that people think about is that access to pharmaceuticals is limited by ability to pay. We hear conversations about the price of insulin, for example. And this is entirely about people being priced out of buying drugs that they need.

But what you’re describing here is actually a case where low prices are prohibiting access. Can you explain how that’s working, and how that works against how we sort of normally think about this situation?

Zahra Hayat: Absolutely, I mean, that for me was perhaps the biggest surprise of fieldwork. I actually had no idea about this before I started fieldwork. And then literally every person that I met in the pharmaceutical industry would begin our conversation by talking about the problem of prices being too low, and that being the reason for so many drugs not being available on the market.

So it is absolutely a very counterintuitive kind of relationship between price and access here. I just want to make a little caveat and say that there are drugs that are in fact, in absolute terms, too expensive for most people in Pakistan to afford, and these include especially anti-cancer drugs.

However, from the point of view of pharmaceutical companies, the price ceiling that is set for most drugs is unviable. And now that, of course, is a subjective term, for some the complaint is that the profit that we’re making is simply too low for us to be able to continue supplying this drug. For some, as I mentioned in the case of morphine, they might actually be supplying the drug at a loss.

So why is this happening? What is this sort of very rigid regime of price controls that is actually pushing a lot of drugs out of the market? They are pushing drugs out of the market, and then also a diversion of drugs as– in company-speak, which is basically that take the example of something as simple as a thyroid drug, levothyroxine, Synthroid.

It’s one of the most commonly prescribed drugs in the US. In Pakistan, it is perpetually out of stock at pharmacies. And one of the reasons is that it’s an extremely cheap drug. It costs a few rupees for a pack. And as soon as it hits the market, a lot of it gets bought up by these middlemen, as they are called, and diverted to black markets, or gray markets, as a lot of my interlocutors refer to them.

They will either be taken out of Pakistan, sort of sometimes at a small scale on a flight in somebody’s personal luggage, or they’ll be sold on the “black market,” quote unquote. So the drug regulatory authority under a federal law, the drugs act, is authorized to set the price of every medicine in the country.

The rationale, the purported rationale, for setting the prices that they do is that this is a country with a very poor and a very sick population. And in order to give them access to medicines, we have to keep the prices low. That’s the logic that the free market cannot be allowed to run amok in a country like this.

That logic is theoretically sound because we have seen what happens when the free market, quote unquote, “takes over,” and astronomical drug prices in the US being an instance, where the government is really constrained because of the pharmaceutical lobby from controlling or lowering drug prices. But in Pakistan, what seems to have happened is that this has been taken too far in some cases.

And there is so much rigidity even over the granting of a small price increase that might make a product viable for a pharma company. That companies sometimes simply do not want to deal with the hassle, and the months and months of negotiation that they need to do with the regulatory authorities. And they simply withdraw the drugs from the market.

Now I want to say a couple of things about this, one from the point of view of the regulators, and the second from the point of view of the companies. What the regulatory authorities– once you really start sort of probing, you actually find a lot of people who agree that this entire regime is fundamentally not working.

They agree that drug prices should be granted. But they operate under a lot of constraint. And the constraint comes from very unexpected sources. That have absolutely nothing to do with the economics of supply and demand. And one of the biggest sources of this constraint is political pressure. So medicines are a hot button issue in the country because of a large sick population.

And it is something that a propagandist media likes to really hone in on. So any time that a price increase is granted by the Drug Regulatory Authority– for instance, the price of very cheap medicine was raised from 2 rupees, which is some decimal points of a cent, to 4 rupees– that’s just 2 rupees increase in absolute terms.

It was presented as prices of many essential medications increased by 100%, and the national newspapers will carry that news. The drug regulators and the politicians who ultimately are the ones who have to sign off on these price increases– so these price increases are recommended by the regulators, and then they have to go to the legislature for approval.

And I’ve been told by official after official that the legislators will simply not sign off on the price increase because they’re scared of bad publicity, of being the people who approved the price increase.

So we’re dealing again with a very complex constellation of democratic politics in a country that’s also controlled to a very large extent by the military, but where a propagandist media does have a lot of power, I think, to scare people.

And then the second piece of this that actually relates directly to scandal is a history of an anti-corruption agency in the country called the National Accountability Bureau, which is a very activist sort of government department. It is controlled by the military to an extent. Many people think of it as an instrument of political scapegoating.

There was an actual scandal several years ago where price increases were granted to pharmaceutical companies. But then a NAB investigation was begun against those companies and against many officials on the grounds that they must have been– they must have accepted bribes from these companies in order to grant them the price increase.

And that history really, I think, reverberates among regulatory officials even today and acts as a huge constraint. And so there is just a lot of fear among those responsible for granting price increases to actually go ahead and grant them. So this, again, is one piece of a very complex set of issues.

But to me, this was just all completely new and made me realize that demand and supply and economics doesn’t have very much to do with what’s going on with pricing in Pakistan.

Julia Sizek: Yeah. And so I think another big component of what you’re thinking about in your research in addition to this issue of pricing is that of the intellectual property regime. So let’s dive into that a little bit. Let’s say if you’re an American company and you have made this drug, how does a Pakistani company get that ability to process that same drug under intellectual property law?

Zahra Hayat: Yeah. So I guess the first thing that I’ll say is just to set the stage for this is the trade-related aspects of property agreement, TRIPS, which is the instrument of the World Trade Organization that governs intellectual property across most of the world. And the purported aim of which is to harmonize, quote unquote, “intellectual property laws” among all signatory states.

Now there is obviously a very robust body of work that is critical of TRIPS, and that really challenges this euphemism of harmonization as it basically being an instrument of neoliberal control because a lot of pharmaceutical innovation, “innovation” in quotes, but a lot of the new drugs, or the cutting-edge drugs, or especially biologicals are being developed in the West because of the huge resources required for R&D, and clinical trials, and so on.

And what these companies really are wanting is not just to make profits in the Global South, but also to control markets in the Global South. And here I want to point to something, I think, that’s really fundamentally important to understand about how intellectual property works that– and I can do this through the example of a series of very high-profile patent battles that have taken place in India, for instance.

And this is relevant for the case of Pakistan as well. One of the most well known cases was the case of Novartis, leukemia drug GLEEVEC, which Novartis had a patent for abroad, and it was trying to get a patent in India. So one of the most important things to know about TRIPS is that you need to apply separately in every country for a patent.

Novartis went into India and tried to assert its patent. A lot of companies that were already making generic versions of GLEEVEC and selling them for thousands of dollars less and making this life-saving cancer drug accessible to a very poor Indian population, opposed the application for a patent as did many nonprofits and patient advocate groups.

And Novartis really fought hard. And there are scholars like Kaushik Sundarajan, who’ve done very meticulous work on this precise case actually. And what’s really interesting, I think, in– and also, just very revelatory about how intellectual property works is that Novartis was not trying to get the generics companies to stop making copies, as they call them, of the drug because they wanted to be the suppliers to the Indian population, instead, and thus make a profit.

And the reason for this is that even the lowest price that Novartis would be able to charge for GLEEVEC in India would be something that most Indians would not be able to pay. And Novartis was– while it was fighting this case– also giving away a lot of GLEEVEC for free.

And what it said actually as part of its litigation and as part of the public relations fiasco that was happening around this case was that if our patent is not upheld in India, we will withdraw this free GLEEVEC program that we have in place. And so scholars have really asked this question.

They were like, why is Novartis so insistent on protecting its intellectual property, even when it is not making a profit on this drug and cannot make a profit on this drug. And there are two reasons for this, and I think they’re really important to understand because they really tell us how IP now, especially in the pharma realm, works in the Global South.

One reason is that a lowering of the price, which would be represented by generic manufacture, would stir up and has stirred up actually criticism among Novartis’s consumers in America and Europe as to why they are being charged astronomically high prices when people in India can get the drug for a few thousand rupees.

So there’s, of course, the possibility of arbitrage, the drug being smuggled into the West. But apart from this concrete possibility, there are also the optics of a drug that people in the West are really also struggling to be able to afford, as you mentioned earlier, being available so cheaply.

So it is to protect its international scaffolding of prices that Novartis would deprive Indian patients of the drug, even though it’s not going to make a profit there. And a second very important reason is how pharma companies use intellectual property, not just to make profit in that particular country, but as a means of controlling certain markets.

And again here, the Indian example is very instructive because it contrasts radically with Pakistan. India is one of the world’s largest generics manufacturers as we know. And so what Novartis and a lot of other pharmaceutical multinationals fear is that if generic versions of their drugs are made in India, they will then be exported, because these Indian companies are large exporters, to markets, especially in Latin America, which these companies are very interested in actually making profits in.

So what they’re trying to do by preventing generics manufacture in India is not so much preserve their monopoly in India and be able to sell to Indian patients, but to preserve their monopoly in other markets. So we also see how intellectual property– even though normative law says patents are only national in scope.

It basically works as part of this very tangled global web, which has repercussions for patients in the Global South. And Pakistan very quickly falls into this calculus in– I think the clearest way to articulate is that Pakistan does not matter to most pharmaceutical companies. And many of my interlocutors have told me in very evocative language.

They’ve said Pakistan is a decimal point correction in the profits of pharmaceutical multinationals, or the only value Pakistan has for pharma MNCs is its nuisance value. And what they’re trying to get at again is the poverty of the Pakistani population and their inability to afford many of these drugs.

But a crucial difference between a place like Pakistan and India is that big pharma also isn’t particularly interested in preventing generics manufacture in Pakistan because Pakistani companies are not big exporters at all. So it’s not like big pharma’s other markets are under threat from Pakistan.

And so what ends up happening is when a new drug is developed in, say, the US or Switzerland, it will, in most cases, simply not make its way to Pakistan at all. So the pharmaceutical company is not going to go in or even bother applying for a patent on the drug because it knows that it doesn’t really have anything to gain either from selling in this market or from preventing generics manufacture in this market.

And so countries like Pakistan basically tend to get bypassed. And so we end up in this paradoxical kind of situation where, yes, it’s not actually patents on these new drugs that are preventing the population’s access. It’s just that the companies are not even motivated to apply for patents in the country.

And so you see what we have in the case of Pakistan is very, very different from the more standard big pharma versus local generics standoff that has been extensively researched and written about. India being one of the main sites for this because of its generics industry.

But places like Pakistan are just left out of both that narrative and also of, I think, these particular flows of global pharmaceutical capital by just not mattering enough.

Julia Sizek: Yeah. I think it’s both very enlightening and very depressing to think about this intersection of the capital, impulse of these companies to try to make more money, and then at the same time, it’s just not worth it either to protect their intellectual property in a place like Pakistan or to apply to be part of that.

And I think one of the interesting ways that this shows up, and that you analyze in your research, is actually the case of hepatitis C because hepatitis C is something that is quite prevalent in Pakistan. So can you tell us a little bit about hep C specifically and what that looks like?

Zahra Hayat: Absolutely. And hep C is a great example also because the drug for hep C, Sovaldi, is a very, very rare exception to the trend of the newest Western drugs not coming to Pakistan. And I’ll talk about how it made its way to Pakistan. So first of all, yes, the incidence of hep C in Pakistan is extremely high. Unofficial figures put it at as high as 10%, perhaps, but it could be higher.

And before 2015, the treatment for hep C, anywhere, not just in Pakistan, was basically the way that you would treat a chronic disease that you couldn’t really cure. And there were interferon injections. It was an exhausting, and long, and very, very expensive kind of process. And there was a lot of suffering actually in Pakistan because of hepatitis C.

And the spread of hepatitis C is actually also something that is an issue. It’s what a lot of the narrative sort of in the global health landscape tends to focus on, I think, as it does of the population behaviors in the Global South. And there’s obviously a critique of that because it is, I think, redirection of focus from a big pharmaceutical capital and how it works to patient behavior.

And we have obviously seen a trend in anthropology and medical anthropology from directing our attention elsewhere to these larger structures of exploitation and inequality, instead of just talking about how patients or how people have issues with hygiene or compliance, and so on. That said, as part of this structural landscape, there is, for instance, a lot of sharing of syringes among drug users.

And there aren’t any safety protocols in place for them. And so that tends to be a demographic where hep C is very high. But there’s an actual fear among people in Pakistan of contracting hepatitis, if you go to a dentist, or if you go– and have your hair cut. And these are legitimate fears because there have been instances of many, many people contracting hep C in these ways.

And because it is so prevalent in the population, and it can remain latent for a while, chances of getting infected are actually very high. So and at this point, Pakistan actually has, if I’m not mistaken, the highest rate of hep C in the world. Egypt used to be at the top, and then Egypt has largely eradicated the disease.

And that brings me to the story of Sovaldi, which is a drug, and it was hailed by everybody as this path-breaking, paradigm-shifting drug, brought to market by Gilead, which is actually based close to us in Foster City, California.

And it was considered such a transformative kind of drug for hep C, rendering it from a chronic condition to a completely curable condition with a course, I think, of four weeks of taking a pill a day. And there’s obviously much more. It’s more complicated like there are combination therapies, and so on.

But I think with Sovaldi, this shift from chronic management to cure happened very definitively and continues to be the case. And this came out in 2016 the US, if I’m not mistaken, thereabouts. And the FDA actually granted expedited review as it does for really breakthrough therapies, which it knows are also in urgent need.

And it came to the US market and really created a sort of a PR storm in part because of the revolutionary nature of the drug, but also because of the staggering price tag that the drug came with. And this is something that, I think, has become etched in people’s minds, anybody who’s sort of in the pharmaceutical world, that the price of a course of Sovaldi was $84,000.

And of course, when you look at how structures of payment work in America, it’s not that the final patient would be paying this money out of pocket, but somebody would have to pay it. So insurers were hesitant to even authorize this drug. So the $84,000 price tag, and the sticker shock that came with it was a big– it actually stirred a lot of conversation in the US on drug prices getting out of control.

And if you look at the public filings of Gilead, and you look at some of the information about how they actually set this price, which they had to make public because there was actually a congressional inquiry into how the price of Sovaldi was set in the US, you get this insight into how pharmaceutical companies think about pricing, and how radically different this is from the case of Pakistan.

You’re not thinking about what the government will allow. The kinds of things that you’re thinking about are what can we get away without inciting an uproar. And it’s literally couched in language like that. So they did price it. It incited an uproar to an extent, but they also made huge profits. The company made huge profits.

And this is where I think that Gilead also deserves credit. I am trying, even as I write about this, is to not take this very simple black and white– big pharma is evil, or big pharma as sort of this beneficent force in the world– kind of binary because it’s obviously much more complicated than that.

And the case of Gilead really illustrates that because what Gilead did, while it was making these astronomical profits in America and Europe, it also started what is called a Gilead Access Program, and it took Sovaldi to countries like Egypt, to countries like Pakistan, which had very high incidences of the disease, and which could not pay even hundreds of the price that Gilead was charging for Sovaldi abroad.

And in Pakistan, in particular, Gilead entered into a collaboration with a very well-reputed and well-respected Pakistani company called Ferozsons, and they developed this working relationship, a very strong relationship over the years. And they, through this local company, agreed to sell Sovaldi in Pakistan at 2% of the price that they were charging in the US.

They were not going to make a profit with this price in Pakistan, but they were still breaking even, which gives you a sense of their profit margin in the US at the prices that they were charging. And the reason they wanted to do this break-even kind of strategy, and as they pitched their Global Access Program is that this is not corporate social responsibility, this is not philanthropy.

What we want is for a sustainable model whereby drugs can make their way to people who need them the most and can’t pay for them in a way that the company can also sustain. So there is I think good sense to that logic. And so this drug comes to Pakistan. It’s priced as I said at 2% of its US price.

It costs around rupees 55,000 for a course, which now would be something like a little less than $500, I think, if I’m getting my math right, which was still unaffordable for the large majority of people, but still much more so than what the original price was. And then the really interesting thing that happened, has to do with intellectual property.

So Sovaldi then, Gilead then entered into a license with its local partner, Ferozsons, giving Ferozsons permission to make a copy of Sovaldi locally. They gave them the technical know-how, and they basically helped them manufacture this copy, which was much more affordable.

And as part of this license, there were certain stipulations that Ferozsons had to buy the raw material from companies that Gilead had approved. And some of these approved companies were in India. So Ferozsons was able to source the raw material from there, make much more affordable versions, and start selling them in Pakistan.

And then something really interesting happened. Once people– local pharmaceutical companies caught on– and they had already been on top of all of this, they knew that Sovaldi had come out in America, they knew that something huge had happened– they all wanted to jump on the bandwagon. And they applied to the Drug Regulatory Authority of Pakistan for registration and said, we want to make copies, too.

And the Drug Regulatory Authority granted this registration to, I think, about 15 or so local companies. And so what this did was that the price of a course of hep C medicine dropped down to something like a few thousand rupees.

In all of this, Gilead had an option. Gilead could have prevented this. But what did they need to do to prevent this. They, first of all, needed to apply for a patent on Sovaldi in Pakistan. If they were granted that patent, they would then have to go to court and assert that patent, and say, all of these local companies that don’t have a license with us are just making unauthorized copies.

And this is a violation of our intellectual property. And the only company that should be allowed is the company that we’re actually partnering with, i.e. Ferozsons. Gilead did not do this.

And this is something– the next point I think is really crucial to appreciate because what a lot of people say about Gilead is that Gilead chose to relinquish its intellectual property and give this drug for free to people in Pakistan. Now that’s partially correct. And without taking away from Gilead’s initiative– because they didn’t actually have to do this.

So that part is also important to understand. They could simply have sidestepped Pakistan altogether. But another reason, and another way that we can think of this relinquishment, so-called, of Gilead’s intellectual property is the thing that I said earlier, which is that, what incentive does Gilead have to apply for a patent in Pakistan and to follow it through?

And interestingly– I dug around a little bit and found that there was actually an application that was filed but never really followed up. And when you speak with people at Gilead, they just have conflicting stories of why they didn’t apply for a patent in Pakistan. But the upshot of all those stories, honestly, is that it wasn’t in their interest to apply for a patent in Pakistan.

There was no way that they could make a profit on Sovaldi in Pakistan. They couldn’t charge a price high enough to enable them to do that. And they don’t really see any Pakistani company as a threat to them. So this one company that they entered a license with Ferozsons is actually constrained from exporting the local version that it’s making.

But Ferozsons really values their relationship with Gilead, and it is a very important relationship. So they wouldn’t really go against Gilead and try to flout their authority and try to compete with them anyway. So in a way, Gilead is accomplishing the sort of control that it wanted by having this license with the one company that it considers high quality.

And it is bothered by this plethora of local copies. And there is a lot of criticism coming from their end about how we don’t have any idea of the quality of these drugs because we have no control. We don’t know where they’re sourcing their API and so on. But again, they’re not pushed enough to stop any of this because it’s not really affecting their profit numbers.

So I think what this case really illustrates is, again, how intellectual property can bypass certain places. A relinquishment of intellectual property can be seen as an act of great largess. But it can also be seen as a very pragmatic calculation instead of capitalist profit-driven logics. And I think that holding space for both of these is important.

It would be wonderful if more companies did what Gilead did because Sovaldi is one of the very, very rare instances of a brand new drug that is just released in the West coming to Pakistan within a year. This rarely happens. So far, nobody has really jumped on this bandwagon and tried to do this with another drug. But that is the hope that this continues to happen.

But I think while we laud these efforts and while we try to have more of this, it’s just also important to be perhaps clearer on the intellectual property dynamics and what is really at play.

Julia Sizek: Yeah. Well, that is just so fascinating to really think about the intersection of both the profit-making impulse of these companies and then how it intersects with intellectual property and so. With that, I just want to thank you so much for coming on the podcast.

Zahra Hayat: Thank you. This is wonderful to be in conversation with you.

Woman’s Voice: Thank you for listening. To learn more about Social Science Matrix, please visit matrix.berkeley.edu.