In the fall of 2020, a US/Mexico border community received national attention because of its high number of COVID cases. Hidalgo county reported over 51,000 COVID cases in 2020 resulting in 2,200 fatalities. Rural communities in Hidalgo were uniquely precarious to the disease because of assemblages constructed by human and material interactions that displaced Latinx/e bodies to unincorporated, underdeveloped communities called colonias. Centuries of interactions between humans and material life in the region had created and sustained an ecology of harm which exploited labor of rural citizens living in colonias. These interactions and the ecology they constitute are grounded in the Rio Grande River, which separates Hidalgo County from Mexico. From its initial arrival to the Hidalgo county region 2 million years ago, the Rio Grande River has assembled together humans and material life into relationships in which human rhetoric brings ideologies and ways of being that determine the precarity of border communities in the 21st-century.

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.

By 2050, almost 95% of the 300 living Indigenous languages are projected to be extinct. Before an Indigenous language goes extinct, the unique medicinal knowledge and practices within each tribe are often already eroded. Native medicine has health-promoting properties unique to aspects of Indigenous health and well-being, yet these benefits have slowly dwindled through the assimilation of Western medical systems. Simultaneously, the connection among Native language, medicine, healing, and cultural continuity is lost. Although the process of ancestral language learning is decreasing across Native tribes, emerging generations within Native tribes are still empowering themselves through the use of language. This commentary explores both a) the complex relationship among Indigenous languages and practices of Native healing, both historically and currently, and b) the processes of rhetorical survivance that are continuing across Native American communities.

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.

This article argues that the field of rhetoric of health and medicine (RHM) needs queer and (trans)formative methodologies to support a disempowered, ignored, and devalued queer community. Building directly from Mohan J. Dutta’s (2022) work, the article 1) addresses that RHM scholarly practices attend to whiteness and neglect to amplify queer and transgender interventional and rhetorical approaches; 2) develops a methodology–institutional critique–for RHM practitioners that crosses disciplinary boundaries to showcase cistematic oppression at infrastructural, structural, institutional, and interpersonal levels; and 3) provides a personal medical story that showcases how institutions fail transgender and queer patients. Through this work, this article argues for the need for rhetorical methodological intervention in RHM research and to mobilize transgender rhetorical agency through coalitional building.

Celebrity-driven wellness ventures are pervasive and often spearheaded by white women, resulting in white-centric health guidance. One such venture is KINRGY, a workout and lifestyle method created by professional dancer Julianne Hough that regularly appropriates and exploits Eastern, Aboriginal, and BIPOC cultural practices. Through a critical rhetorical interrogation of the workout videos and Instagram feed of KINRGY, we assess how this method relies on cultural appropriation and New Age Orientalism to situate spirituality as the crux of universal health, thus establishing a reconfiguration of healthism into what we call “neohealthism”—a phenomenon that further obfuscates structural constraints on health, and expands the individual imperatives of healthful choices by placing metaphysical considerations on consumers’ shoulders. We theorize neohealthism through the following themes: the consumption of the Other via cultural exploitation, the question of expertise in spiritual leadership, and the intensified neoliberal imperatives that individualize health and wellness for self and the universe.

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.

This essay examines the persuasive elements of one of the most influential books of the current era in psychiatry: Peter Kramer’s 1993 Listening to Prozac. That book, a text laden with the value of the hyperthymic (optimistic, charismatic, confident)personality, has been praised for illuminating questions of mood and identity, and blamed for ushering in an era of “cosmetic pharmacology”—and for making Prozac an object at the center of promiscuous prescription. The essay revisits depression, Kramer’s signal concern, in a post/pandemic exigence when millions, perhaps billions, of people come to meet the diagnostic criteria for that “disorder.” In many cases, mental-illness diagnosis, as a rhetorical act and a speech act, shifts a problem from social conditions of precarity and inequity, for example, to personal conditions of pathology. How did Kramer participate in making a capacious and biological view of depressed mood so persuasive, and why does it matter that he did?

America’s individualistic culture is reflected in deeply held beliefs about how people should manage their health and their (lack of) money. In this essay, we trace the ideological discourse of individualism at macro and micro levels, explicating how macro-level discourses surrounding finances and health fulfill key functions of individualism: explanatory and evaluative as well as identity and prescriptive. For each function, we illustrate at the micro level how social adherence to discourses of individualism affects people, relationships, and communities. In particular, we argue, failure to live up to individualistic ideals fosters internalized shame and guilt and worsens mental, physical, and financial health. Grounded in critical rhetorical theory and drawing upon critical interpersonal and family communication and health communication approaches, we illustrate how individualistic discourse is circulated and taken up by people, constituting their identities and relationships. We also showcase the benefits of investigating exigent social issues from multidisciplinary vantage points.

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.

Abstract: Standardized Patient Programs (SPPs) enlist actors to roleplay the symptoms of various diseases and disorders, and to embody a range of personalities. These simulations are used to help improve the communicative practices and professional competencies of future healthcare workers. Focusing on the use of these programs for medical students and doctors, this article establishes a kairology of the SPP to better understand the shifting terrains of patient representation. A kairological account focuses on “historical moments as rhetorical opportunities” (Segal, 2005, p. 23) and, in the case of medicine, illustrates how “changes in [medical] practice are importantly reciprocal with changes in the terms of practice” (Segal, 2005, p. 22). I trace the SPP through various linguistic iterations to reveal how the shifting language of simulated patienthood reflects different orientations towards medical pedagogy and patient populations at significant junctures in time. I conclude my kairology with an examination of the Indigenous Simulated Patient Program, a 2011 pilot program that has the potential to better represent and serve Indigenous peoples in medical pedagogy and practice.

This past decade, the healthcare industry has undergone a transformation with where, how, and why writing happens. For example, what the health and medical professions conceive of as “documentation” or “charting” is writing, even though practitioners call it by another name. Additionally, most writing in healthcare settings is now also multimodal, incorporating textual, digital, visual, and aural content. This essay focuses on the patient decision aid as pedagogical tool that embraces the technological and multimodal changes in health and medicine. Patient decision aids can be understood as a multimodal tool guiding shared decision-making practices. As a genre, the decision aid prompts students to engage in a series of writing modalities – visuals, narrative, texts – as well as the application of user experience and design. Finally, the decision aid as an assignment offers explicit connections between humanities-based students and broader healthcare industries.

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.

In 1907, the National Tuberculosis Association (NTA) began selling Christmas Seals to raise money for the fight against tuberculosis (TB). The decorative holiday stamps quickly became a hallmark of American popular culture throughout much of the 1900s. This project asks how the Christmas Seals, sold between 1920 and 1968, shaped the depiction, imaginary, and understanding of tuberculosis in popular culture. Through visual, rhetorical analysis of the Seals’ presented and suggested elements, I show that the Seals make present normalized images of Whiteness, health, and holiday settings. I argue that the Seals presented elements made absent images of tuberculosis, distancing an invoked, White audience from the realities of the disease and playing on their hope and desire for a world free of TB. This case study considers the rhetorical function and value of popular, non-­medical expert images, adds to the historical literature on tuberculosis, and offers a framework for the continued study of medical fundraising images.

According to a recent study by the Brookings Institution (Reeves & Krause, 2016), vasectomies are safer, more effective, and less expensive than most other voluntary sterilization methods. While the procedure has grown in popularity in recent years, particularly in the United Kingdom and Canada, it is much less common in the United States. This discrepancy can be attributed to both social (a perception that contraception is “women’s work”) and policy-­based factors (lack of coverage under the Affordable Care Act). This paper examines the role and extent to which invitational rhetoric could be a useful communicative lens for both partners and providers considering vasectomies, thus increasing access to and utilization of the safe, effective, and affordable procedure. In this policy brief, we suggest strategies for incorporating invitational rhetoric into health professions education curricula, patient counseling literature, and policy language in order to address some of the social stigma around the procedure.

This manuscript explores the rhetorical coupling of food as a holistic health initiative across two Indigenous organizations—Indian Health Services (IHS) and the American Indian Cancer Foundation (AICF). Drawing upon contemporary literatures of rhetorical ecologies, I position “kincentricity” (Salmón, 2000, 2012) as a particularly provocative framework to reconceptualize the body as its own rhetorical ecosystem, contending that Indigenous dimensions of RHM offer radically creative ways to decolonize the body/body politic. My analysis demonstrates theways in which IHS and AICF engage in kincentric logics to repurpose rhetorics of food within the Native medicine wheel, most notably by emphasizing (1) pre-Columbian diets, (2) traditional harvesting and cooking methods, and (3) spiritual food-based rituals—all of which explicitly link tribal food(ways) to bodily wellbeing. Finally, this essay encourages RHM scholars to reorient rhetorical vocabularies and understandings toward more pluralistic and non-Western accounts of health, medicine, and collective wellness.

The public’s declining trust in health advice from traditional outlets has long been noted by scholars. But what makes alternative sources for health information appear more trustworthy to some audiences? In this analysis, the author traces the use of expertise and experience as forms of multivocality in the textual artifacts of Gwyneth Paltrow and her enterprise, Goop—specifically those that promote clean eating and detox diets. The analysis illustrates how Goop creates a superficially neutral platform for different voices that make the texts seem polyphonic and by extension more trustworthy given that readers can choose which health plan is right for them. But upon further analysis the author illustrates that Goop blends each voice so that they “move in step” as a choir, combining with Paltrow’s own voice, and ultimately creating an illusion of polyphony and masking a dominant homophonic message that ties together mandates to “ask questions,” empower ourselves, and embrace the assumption that young, slender bodies are signifiers of health and wellness.

This manuscript explores the rhetorical coupling of food as a holistic health initiative across two Indigenous organizations—Indian Health Services (IHS) and the American Indian Cancer Foundation (AICF). Drawing upon contemporary literatures of rhetorical ecologies, I position “kincentricity” (Salmón, 2000, 2012) as a particularly provocative framework to reconceptualize the body as its own rhetorical ecosystem, contending that Indigenous dimensions of RHM offer radically creative ways to decolonize the body/body politic. My analysis demonstrates theways in which IHS and AICF engage in kincentric logics to repurpose rhetorics of food within the Native medicine wheel, most notably by emphasizing (1) pre-Columbian diets, (2) traditional harvesting and cooking methods, and (3) spiritual food-based rituals—all of which explicitly link tribal food(ways) to bodily wellbeing. Finally, this essay encourages RHM scholars to reorient rhetorical vocabularies and understandings toward more pluralistic and non-Western accounts of health, medicine, and collective wellness.

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.

In this essay, we interrogate the power of sensory rhetorics to craft what Jenell Johnson (2016) defines as a “visceral public”: a public bound by intense, shared feeling over a perceived threat of boundary violations. Specifically, we situate miasma—that environmental degeneracy produces bad smells carrying disease—as a historical disease etiology overtaken, but not fully displaced, by the insights of germ theory. This sanitary-bacteriological-synthesis is capable of constitutingvisceral publics so adeptly because germ theory’s explanatory power as a disease etiology continues to rely on the rhetoric of sight and smell as a set of publicly accessible sensory engagements. To illustrate the raced, classed, and gendered consequences of this sanitary-bacteriological-synthesis, we offer a comparative analysis of two images of disease capturing the public imagination: the early 20th century typhoid fever and the 2015–2016 Zika virus outbreak.

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.

Patient-OBGYN (obstetrics and gynecology) communication about contraception and reproduction can be fraught with ideological pressures, cultural assumptions, and emotion-based claims and concerns. Specifically, the topic of elective sterilization for women often invokes preconceived notions of femininity and mothering. Based on medical pamphlets and online discussion forums, our analysis reveals how gendered discrepancies exist in medical information about elective sterilization. This persuasion brief aims to invite OBGYNs to understand how cultural and traditional views of gender inform medical decisions and oppress women’s reproductive autonomy. It offers suggestions for OBGYNs, women seeking sterilization, and scholars in the rhetoric of health and medicine.

When considering the material ecologies of the human body, we must consider the bodies within—at least five hundred known species of microbes. We propose the term gut rhetorics to highlight how our guts have become an environment to which we are exposed: a biologically active actant contributing to the physiology and psychology—the rhetorical capacities—of the human body. Gut rhetorics incorporate—bring into the body and, importantly, into the body of rhetoric—the hungry horde within human bodies. First, we trace one probiotic formulation across three scientific studies to show how bodies, affects, and microbes are being “calibrated” at the level of experiment. Second, we stress skilled probiotic experimentation and encourage scholars to play amid environments, give attention to embodiment, and pursue phenomenological inquiry (Gruber, 2018; Melonçon, 2018). Gut rhetorics consider bodies, affects, and microbiota as entangled metabolic intra-actions that affect how the world appears to the body and the body to the world.

This commentary traces, groups, and characterizes the significant body of work done in rhetoric and writing studies on mental health(care) issues from when such work first began to appear in print in the mid-1980s up until July 2017 when the article was completed and submitted to RHM for publication in its inaugural issue.