Beyond co-production: The construction of drug checking knowledge in a Canadian supervised injection facility

Drug-checking is an ensemble of different harm reduction techniques providing people the ability to test illegally purchased drugs for strength, the presence of particular substances, and possible adulterants. Drug-checking research has primarily focused on nightlife and festival communities of people who use drugs and has overlooked how it functions as a knowledge forming process, particularly by people whose drug use is more stigmatized. The implementation of Fourier-Transform Infrared Spectroscopy (FTIR) in Vancouver, Canada's Downtown Eastside in response to the overdose crisis has made it possible for people who use drugs to receive information about the drugs that they are consuming. Using insights developed from the 'ontological turn' and approaches to co-production from public health and science and technology studies, we explore the multiple relations that come to produce and contest drug-checking knowledge in this setting. We look at how knowledge is produced by and for people who use drugs, including people who use drugs operating the FTIR. Using rapid ethnographic assessment and semi-structured interviews, participants were recruited from a low-barrier supervised injection facility to explore their experience of drug-checking. Data were coded in NVivo 12 using an initial coding scheme, as well as an iterative coding scheme as the data were explored. We find that the traditional demarcation between lay and expert, or peer and professional, which co-production idioms often rely on, creates barriers to seeing the different knowledge formations of drug-checking knowledge, and instead offer up a new idiom, trans-production, to explore how knowledge and harm reduction services are mutually enacted.

Epidemiological rage: Population, biography, and state responsibility in trans- health activism

This article examines how social movements reconceptualized trans-health in Buenos Aires, Argentina. Looking ethnographically to medical and activist practice, the article analyzes "epidemiological biographies", or activist-produced community-based studies blending quantitative and narrative data. It draws on population health, feminist science studies, transgender studies, and social theory to discuss the circulation and implications of these publications. Specifically, it describes how epidemiological biographies disputed health behavioral models by defining state violence and criminalization as primary conditions endangering health and life expectancy among travestis and trans-people. The article analyzes how activist researchers made state violence legible through logics of population health, even as the concept of "population" also emerged from techniques of state control. In contrast with models that place individual behavior at the locus of health interventions, activists instead advanced interventions that contested state securitization and shifted resource distribution. Epidemiological biographies had a considerable effect on national trans-health politics, providing an evidentiary basis for several regulatory shifts. These studies emerged in part through collective political action that reformulated dominant modes of statistical aggregation. This statistical turn-which I call "statistical collectivization"-produced contradictory effects. At one level, it obscured differential conditions of criminalization and violence. At another, it directed attention to the markedly racialized, sexualized, classed, and gendered forms of subjugation that materialize in landscapes of trans-health, and prioritized materially distributive regulation over and above civil protections. Through these contradictory actions, social movements reformulated dominant notions of health by challenging state securitization and contesting state power.

Contextualizing racial disparities in preterm delivery: a rhetorical analysis of U.S. epidemiological research at the turn of the 21st century

Preterm delivery (PTD), defined as delivery prior to 37 weeks gestation, is a key contributor to persistent racial disparities in infant mortality in the United States. Five major funding initiatives were devoted to advancing PTD epidemiology during the 1990s and 2000s. By examining content and rhetorical features of 94 studies conducted under these initiatives, and published between 1993 and 2011, this paper considers how calls for more "contextual" approaches (focusing on social and environmental contexts) interacted with more "conventional" approaches (focusing on individual-level risk factors) to PTD epidemiology during this period. Contextual advocates initially emphasized complex biosocial reasoning to better connect social adversity with embodied outcomes. Yet responses by researchers invested in conventional approaches, as well as in studies published under new initiatives that explicitly claimed to incorporate contextual insights, often reframed this complex reasoning in biologically reductionist terms. Subsequent contextual advocates then focused on developing statistical methods to support research about social and environmental causes of PTD, and this strategy appears to have gained some traction with conventional researchers. These findings call for closer attention to language and power in both social scientific studies of epidemiological knowledge production, as well as among epidemiologists themselves.