Cancer in the Community

August 30, 1993
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.

August 1, 1993
Anthropologist Balshem joined Project CAN-DO early in its second year. Set up to study city dwellers' current knowledge about cancer, the project also carried out a health education program in Philadelphia. Balshem worked with Tannerstown, a community in one of the city's river wards. Her book describing--with both understanding and humor--her formal and informal dealings and relationships with Tannerstowners is fascinating and thought-provoking. Showing clearly that the relationship between patients' families and physicians is a class-based phenomenon, Balshem explores community residents' feelings that health education is an outsider's attempt at control; the many stories she heard about the "defiant ancestor" who stonewalls or overcomes medical authority underline the power of this conception. So her book is not only a report of a project but also a guide and a warning to those setting up similar programs. ((Reviewed Aug. 1993))(Reprinted with permission of Booklist, copyright 1993, American Library Association.)