Abstract

Although Covid-19 is impacting all communities, the distribution of its harms is not equal. Poor, urban people of color with compromised health are particularly hard-hit. Combining remote ethnographic and epidemiological research methods, we will explore how residents of underprivileged urban communities who suffer from end-stage kidney disease (ESKD) and associated stigmas manage their illness and treatment experiences in the face of Covid-19. Using the lens of syndemics research to conceptualize stigma as a social determinant of health that leads to negative outcomes by intensifying sufferers’ sense of isolation and alienation and thereby magnifying the biosocial harms caused by diseases, we hypothesize that Covid-19 adversely interacts with ESKD patients’ poor health and social status. Beyond biosocial health, this study is designed to gain a deeper understanding of patients’ spiritual and political challenges and sources of support. Collected interview and survey findings will inform policymakers and medical caregivers seeking to alleviate the inequitable conditions suffered by marginalized, chronically ill patients and their family or other caregivers in Greater Boston and beyond, in cities such as New York, Chicago, and Philadelphia.

Principal Investigators

Merav Shohet

Assistant Professor, Department of Anthropology, College of Arts and Sciences, Boston University

Bio

Merav Shohet, PhD, is an assistant professor of anthropology and affiliate faculty in the Women, Gender, and Sexuality Program at Boston University. Integrating psychological, medical, linguistic, and sociocultural anthropology, her research focuses on care, affect, ethics, and gender in relation to eating disorders, family, narrative, and the end of life in North America, Vietnam, and most recently, Israel/Palestine. She is the author of Silence and Sacrifice: Family Stories of Care and the Limits of Love in Vietnam (University of California Press, forthcoming 2021), and articles in American Anthropologist, American Ethnologist, Ethos, and the Journal of the Royal Anthropological Institute, among others.

Insa Marie Schmidt

Postdoctoral Researcher, Boston University

Bio

Insa Marie Schmidt, MD, MPH, is a postdoctoral researcher at the Boston University School of Medicine and Boston Medical Center. She has a broad range of interests in quantitative and qualitative clinical research, and has received instruction in medical anthropology as part of her training in public health and epidemiology. With a focus on chronic kidney and cardiovascular diseases, Dr. Schmidt is committed to linking her interests in care, biomedical practice, and the intersection of medicine with the social sciences and humanities. She has published in the Journal of the American Society of Nephrology, the Clinical Kidney Journal, and Geriatrics & Gerontology International, among others, and currently holds a Daland Fellowship in Clinical Investigation at the American Philosophical Society.

Lauren Dana Stern

Assistant Professor of Medicine, Boston University

Bio

Lauren D. Stern, MD, is an Assistant Professor of Medicine in Nephrology at the Boston University School of Medicine. She enjoys working as a clinical educator and meeting diverse patients as well as working with experts in other medical fields. Some conditions she treats are chronic kidney disease, acute kidney injury, nephrolithiasis, electrolyte abnormalities, hypertension, and glomerular disease. As a clinical nephrologist and medical director of the home dialysis program at Boston Medical Center, Dr. Stern has focused her work on expanding home dialysis services to underserved communities, and will help recruit patients for potential study inclusion.