Cancer in the Community: Class and Medical Authority

Anthropologist Balshem worked as a health educator in a blue-collar white ethnic neighborhood in northeast Philadelphia, a cancer hot spot she calls ``Tannerstown,'' and she offers some worthwhile reflections on ``negotiating professional authority.'' While Balshem's colleagues emphasized personal health issues such as smoking and diet, Tannerstowners blamed cancer on environmental factors in their industrial neighborhood. Comparing neighborhood attitudes toward heart disease with those toward cancer, Balshem found less rational and more fatalistic attitudes toward cancer. Coupled with Tannerstowners' longtime suspicion of outsiders, this finding frustrated the educators. In one chapter, she traces the efforts of a Tannerstown widow to change medical records that indicated her husband's death from pancreatic cancer was due solely to his drinking and smoking and not to his environment. Balshem's interviews with the attending doctor clearly show how medical professionals both shy away from environmental factors and act in an authoritarian way toward their working-class patients. She argues that health educators should listen more to community critiques. Photos not seen by PW. (Sept.)