This essay investigates the contemporary association between attention-deficit hyperactivity disorder (ADHD) and delinquent behavior. Long before its diagnostic appearance as ADD in the DSM III (1980), youth behavior associated with hyperactivity and impulsivity was rhetorically situated within an ecology of delinquency science which yoked these behaviors to criminality. Because rhetorics of criminality are profoundly racialized in the U.S., a close study of ADHD and delinquency must contend with the ways racial discourses have determined conceptualizations of juvenile behavior, particularly in educational contexts.  Through an analysis of two rhetorical case studies, I demonstrate how hyperactivity and restlessness were initially associated with delinquency by proponents of the mental hygiene movement in the 1920s. The same behaviors were later imbued with sinister and antisocial meanings by a white public responding to school desegregation in the late 1960s and early 1970s. Seen from this perspective, the contemporary rhetoric of ADHD can be understood as a type of delinquency rhetoric from its inception.

One of the root causes of health disparities in Louisville, Kentucky, is air pollution, a disparity rooted in the city’s history of environmental racism. Residents who engage in local environmental justice efforts face other systemic barriers, all of which intersect in the jargon-filled public notices about air pollution that circulate throughout the city. This article discusses a feminist environmental health literacy coalition formed to promote health literacy and create translations of public notices in plain language. Our preliminary theory of Air Justice maintains that health literacy is a social practice and that intersectional coalitions provide rhetoric of health and medicine (RHM) scholars with a local approach to scholarship that mirrors the diverse and multiple situatedness of the communities in which they work.

This study aims to examine online contraception texts as a way to interrogate the intersections of identity, inclusivity, and access in contraception and reproductive health discourses. At the center of this project is the understanding that, while many contraceptive technologies are designed for and marketed towards "women" for the sole use of preventing pregnancy, the actual users of contraception and their purposes for its use are diverse and involve considerations of sexuality, gender identity, socioeconomic status, ability, cultural and religious norms, and access to healthcare. By examining the genre of contraception texts through systematized coding and rhetorical analysis, this study examines how the constitutive genre features of these texts do and do not recognize the diversity of users, with a particular focus on users in the trans community.

In this commentary, we reflect on a study investigating how young people living with HIV navigated the COVID-19 pandemic and offer concrete methodological approaches to studying health inequity. We describe how participatory and narrative-based methods helped us develop five specific study protocols that reflected our commitments to equity in research: revising questions to account for local conditions of risk; intervening in histories of extractive research practices leveraged against communities at the margins; phrasing demographic questions to account for the complexity of identity; incorporating consent iteratively across the study; and offering incentives that were consistent with participants’ expertise of their own lived experiences. We use these reflections to further ongoing conversations about integrating equity into rhetorically inflected health research.

This essay examines how medical rhetorics helped justify the recent torrent of anti-trans legislation. Beginning with the “legitimacy wars” between psychiatry and psychology, I trace how competing disciplines established their own expertise by denying trans patients’ agency and self-knowledge. After identifying the “trans trickster” trope that emerges from these rhetorics, I trace how the trans trickster haunts arguments used to ban gender-affirming health care and sports participation for trans youth. I draw from sociologist Ian Hacking’s “looping effects” to explain how medical logics affect public perception and how those understandings loop back into medical research. The binary, linear models of gender transition established by trans medicine helped justify cisnormative policies around transgender identity, which in turn restricted further scientific inquiry such that more imaginative gender formations remain illegible. To conclude, I argue that medical paradigms work in relation with trans imagination would expand scientific explorations of human diversity, and that those understandings too could loop through public policy and perception.

The included infographic describes P.A.C.K, guidelines that are a starting point for creating public health tweets that better meet the needs of African American users:• Provide inclusive charts;• Avoid poor timing;• Communicate to individuals; and• Know your potential biases.

Drawing from interviews conducted as part of a study of older African Americans with multimorbidity, we argue how various forms of racism work together to shape communication between doctors and patients. By focusing on what patients say about pain, we highlight patient descriptions of their relationships with pain management, their interactions with healthcare providers, and how they navigate understanding their chronic conditions. Our documentation of patient experience with stigmas and biases suggests what is needed for more empathetic and effective communication within the doctor and patient relationship. We conclude by using the interview data to propose addressing racial inequality in health care in the United States through educational reform and training initiatives grounded in rhetorical research.

Women of color are more likely to experience infertility compared to white women. Despite this likelihood, infertility continues to be associated with whiteness. This study examines the historical and modern influences of the hyperfertility narrative, a pervasive master narrative linking race and reproduction. Studying Instagram posts about infertility and race, McCann argues that women of color have had to fight for their very inclusion within infertility identities, illustrating the continued rhetorical salience that dominant narratives of race and reproductive enforce within support-seeking environments like Instagram. Specifically, this study demonstrates how WOCr rhetors counter hyperfertility by co-constructingnew counternarratives that frame experiences of infertility through experiences with race and racism. These counternarratives involve three empowerment strategies: witnessing, visual counterstorying, and attribution. By studying how marginalized rhetors counter hyperfertility narratives, the study illustrates a kind of invitational knowledge-building that occurs within histories of race and reproduction. Overall, this work pushes scholars and practitioners in reproductive care to acknowledge how racial identities, and perhaps personhood itself, is de/valued around and through reproductive abilities.

Introduction to the Special Issue In Living Color: Amplifying Racial Justice Work in RHM

While there have been tremendous advancements in HIV prevention, treatment, research, and care, vast health disparities still exist across race and ethnicity, as Black and Latinx people continue to have disproportionate rates of new HIV cases. Despite this fact, funding toward and implementation of policies that meet the needs of most impacted communities are virtually non-existent. Moreover, meaningful and impactful discussions about HIV have always required analyzing interlocking systems of privilege and oppression. Thus, in 2017, a group of scholars and activists of color developed HIV Racial Justice Now!, a nationwide grassroots coalition dedicated to advancing a racially just framework for the domestic HIV epidemic. In addition to developing The Declaration, a framework that can be used to push for racial liberation, HRJN disrupts traditional notions of HIV rhetoric, racial justice, and public memory by decentering whiteness in the domestic HIV movement.

Radical doulas are often on the frontlines supporting multiply marginalized birthing people. In providing emotional and physical support to people in labor, doulas are uniquely positioned to witness, to respond, to intervene in the obstetric racism and other forms of injustice unfolding in birth settings—an invariably rhetorical process. In this interview, we talk with Stevie Merino—medical anthropologist, full-spectrum doula, and the co-founder/executive director of the Birthworkers of Color Collective in Long Beach, California. Merino discusses how reproductive, racial, and queer justice informs her birthwork. This interview highlights the discursive and material strategies queer birthworkers of color deploy to support multiply marginalized clients, and the ways they navigate and challenge the existing medical system.

In the context of narcotic drug epidemics, racist logics can shape policy deliberation and delimit uptake. While critical public health scholars have situated the U.S. opioid epidemic as demonstrative of such logics, in rhetoric the opioid epidemic has failed to register as an important deliberative context for representational contestation regarding race and racism. Drawing on Jürgen Habermas’ (1985) steering mediums (steurungsmedium) and Michael Omi and Howard Winant’s (2015) racial formation theory, this essay analyzes the U.S. Anti-Drug Abuse Act of 1986 and Purdue Pharma executive J. David Haddox’s testimony before Congress to show the extent to which racial hegemony saturates juridical engagements at the federal level. Where wide-scale opioid use is concerned, this analysis demonstrates that disparate policy outcomes are largely a reflection of structural and representational inequality along racial lines. This essay thus invites scholars of health and medical rhetoric to consider how processes of controversy and medicalization function to preserve racial hegemony.

This short article offers examples of how rhetoricians of health and medicine (RHM) can employ user experience (UX) design principles and practices to enhance student learning in courses that focus on scientific, health, and/or medical communication. More specifically, we propose a participatory health communication pedagogy that can help RHM educators leverage UX principles to meaningfully incorporate students’ experiences into the classroom as both content creators and content users. We argue that by framing students as both creators and users, RHM educators can enact classroom practices and approaches that more fully account for diversity and inclusivity, a process that better accounts for “racism and other forms of injustice [that] permeate health and medicine” (Scott, Melonçon & Molloy, 2020, p.vii). Drawing from two RHM courses as case studies, we demonstrate how a participatory health communication pedagogy can help educators become innovative, UX practitioners who center students’ learning experiences as they design content for health and medical contexts.

This essay explores changes to an upper-division writing course Writing for Health Professionals in the context of the Covid-19 pandemic and the events that propelled Black Lives Matter into the media spotlight. Although instructors were required to move courses online with little time to prepare, I describe my efforts to incorporate the topics surrounding the pandemic and racial inequality into the course curriculum. The course consists of a medical ethics unit and a professional dossier; I found that both units became richer and more helpful to students by incorporating the context and kairotic moment in readings, class discussions, weekly forum posts, and major assignment options.

In this article, I analyze the trigger warning, a pedagogical practice often framed as student-responsive and trauma-informed, to elucidate the ways in which trauma-informed pedagogy functions rhetorically to pathologize and individualize experiences of racism and other societal inequities that cause collective trauma. I draw upon original interview data and rhetorical analysis through a systems framework to explore how reductive pedagogical practices developed within the confines of a white, western notion of trauma may subsequently perpetuate students’ marginalization. Finally, I highlight the potential for more comprehensive, inclusive pedagogies to address student trauma, acknowledge societal conditions that impact individual experiences, and shift popular discourse that pathologizes trauma.

This dialogue piece provides scholars of the rhetoric of health and medicine with a close examination of vegan and vegetarian diets/lifestyles through the perspective of several scholars, activists, and/or medical practitioners. Through these conversations, the authors illuminate many key areas of interest and future examination related to vegan and vegetarian diets through the lens of several subtopics including health impact, ethics, cultural influence on diet, gender, medical advice, emerging “meat” technologies, and societal rhetoric about vegans and vegetarians.The dialogue participants provide a discussion on how vegetarian diets—and vegan diets in particular—can progress individual and public human health, liberate non-human animals, improve the environment, and provide a vehicle in which several important social justice movements (for both humans and animals) can take root, all the while recognizing the many reasons reasons people might choose a vegetarian or vegan diet.

This article examines the rhetorical effects of a rape accusation on the survivor and on the survivor’s community of social justice activists. Relying on interviews with the survivor and with the community affected by the allegation, the article analyzes responses to the allegation, articulates how those responses are informed by rape culture, and illustrates how those responses affected the survivor and her rhetorical agency. The article argues that rhetorical agency can be productively distributed across various allies to assist survivors and help restore the rhetorical agency that rape erodes. Establishing sexual assault as a public health issue, the article recommends broad education in rhetorical listening to improve how those entrusted to hear assault stories listen, respond, and, when appropriate, help survivors speak or act.

When we began drafting this issue introduction, extending from a previous introduction in which we committed “to do more and better in cultivating, sponsoring, publishing, and promoting scholarship that addresses racism and interlocking systems of oppression as public health (and/or other health or medical) issues,” we knew we wanted to continue to foster a space in which RHM scholars could ask new and newly exigent questions born out of the rupture of our current moment of swirling, interconnected crises, some longstanding and others novel.

Weight-inclusive approaches such as Health at Every SizeÒ (HAESÒ) that once were used primarily by scientists or other health experts are more frequently being taken up by lay audiences. Most notably, popular members of online communities known as social media influencers rely on principles of HAESÒ to spread weight-neutral rhetoric across platforms like Instagram. Analyzing how influencers domesticate, or make their own, the specific science-based principles of HAESÒ warrants exploration. In this study, I draw from an analysis of 20 Instagram accounts run by influencers to explicate how domestication occurs within the body positive and weight-inclusive community. The findings suggest three primary patterns through which domestication occurs: anecdotal narratives and personalization, science and education, and social justice. I argue these influential users domesticate HAESÒ by drawing on their own education, life experience, and personal identity while upholding the core norms of the influencer industry: authenticity and credibility.

This essay assumes that the design and use of surveys is a fundamentally rhetorical act. It provides suggestions for employing and designing health-related surveys intended for research participants who might be characterized as inhabiting one or more precarious positionalities. We use “precarious positionality” to signal when research participants self-identify as one or more of the following: a racial and/or linguistic minority, economically disadvantaged, disabled, former or current drug user, undocumented, un(der)educated, oppressed, sexualized, disenfranchised, criminalized,and/or colonized. Drawing on the research team’s experiences with piloting what we hope will eventually become a nationwide survey, the essay describes how to avoid several survey-designpitfalls; it also makes recommendations for how to improve survey-based health research that enrolls participants who inhabit one or more precarious positionalities. Our recommendations attend to rhetorical complexities related to survey ethics, inclusion criteria, privacy, stigmatized and misleading language, variations in discursive repertoires, accessibility, and liability.

editors intro

In April 2017, Minnesota experienced the state’s largest measles outbreak since 1990. The outbreak primarily affected Somali children and was attributed to declining vaccination rates in Minnesota’s Somali population, specifically. Examining empirical data from ethnographic interviews with Somali parents who experienced the outbreak, this article identifies four themes that shaped participants’ vaccination decision-making: 1) an experience-informed belief in vaccine effectiveness, 2) concerns about non-inclusive clinical research, 3) belief in personalized, flexible immunity, and 4) experiences of structural vulnerability. Findings show that race and ethnicity, migration history, and structural precarity in resettlement influence Somali parents’ vaccination decisions and should inform existing explanations for vaccine hesitancy and models for responsive public health outreach. Participants’ practices of vaccine hesitancy are often refusals: constrained and embodied acts of resistance and generative openings to collaboratively re-envision healthcare relationships and communication. Refusals can redirect public health efforts from vaccine compliance toward institutional change and resource redistribution as means of disease prevention. This possibility has yet to be fully explored, and this article uses rhetorical publics theory to study medical refusal as a public participation strategy.

In this persuasion brief I suggest how rhetorical-historical insights into the scientific and medical discourses of female hormones are relevant to current organizational and institutional diversity initiatives, especially those that aim to increase the number of women in leadership positions. Many of the examples I cite in the essay make specific reference to hormones, and as I argue, hormones often serve an enthymematic function in these expert arguments, both past and present. More specifically, I argue, discourses about hormones allow people who do not possess any scientific expertise to make authoritative-sounding claims that resonate with popular beliefs about women’s bodies and brains. Uncovering these historical tendencies in scientific and medical discourse offers new perspectives on the obstacles that women face in today’s workplaces. In this persuasion brief I aim to discuss these perspectives in ways that make the findings of rhetorical-historical research relevant to the many different stakeholders, leaders, and policymakers who are currently working to help women rise to leadership positions in many different fields.