The Rhetorical Making Of An Illness: Medical Refusal, Trope, And Improvisation In A Somali Women'S Health Center

Abstract

This ethnography examines the ways that individuals and communities come to understand autism, specifically, and health and illness, more broadly, and how these understandings influence medical decision-making. This study, developed in partnership with a Somali women's health center, asks how Somali parents understand autism, use services, and navigate divides between biomedical and other forms of care. To do so, I explore and rhetorically analyze three sites of health-related participation: 1.) public health communication outreach during the 2017 measles outbreak in Minnesota. 2.) the provision of a person-centered pilot grant to Somali families with children with autism, and 3.) alternative healthcare relationships and practices grounded in an understanding of autism as caused by imbalances in the microbiome. I offer three concepts--the situated refusal, bureaucratic literacy, and diagnosis as rhetorical trope--that can theorize health decision-making and can inform policy initiatives toward more accessible medical and social service procedures.