Spiritual Etiologies: Metabolic Disorders, Evangelical Christianity, and Well-Being in Samoa.

摘要

This dissertation examines how rising rates of metabolic disorders are interpreted by evangelical Christians in Samoa as evidence of the need for (re)Christianization. Evangelical Christians critique mainline Christianity as a source of suffering, and posit a relationship between church-based exchange and metabolic disorders. Metabolic disorders are particularly difficult to heal in the cultural context of Samoa because they require individuals to change their everyday lives in ways that challenge common Samoan practices of well-being, including food-sharing and feeding. Metabolic disorders also require Samoans to reformulate the associations power and potency have with large body size. This dissertation explores the ways medicalized ideas of food, fat, and fitness travel into evangelical Christian contexts in order to examine the generative intersection of religion and medicalization. While the medicalization of food, fat, and fitness is readily accepted, many Samoans struggle with how to actualize changes to their health behaviors (i.e., to eat differently, to exercise) because of the constraints of church and family obligations, and cash-poverty. Evangelical churches offer new ways to participate in church-based exchange, which are explicitly directed at alleviating cash-poverty, and evangelical Christianity has, through the linking of salvation and healing, developed ways for born-again Samoans to change health behaviors. Through conversion and healing practices, many born-again people also examine the relationships that may be a source of suffering. Data was collected over two years of ethnographic fieldwork between 2008 and 2012; fieldwork included participant observation in biomedical facilities (hospitals and clinics), in churches (Sunday services, healing ministries, Bible study, and prayer groups), and in two households. In-depth interviews were also conducted with a range of Christians and health practitioners. In a time of deepening socio-economic inequalities and increased dependence on cash, this dissertation argues that evangelical notions of well-being, in conversation with medicalization, bring into focus the socio-economic inequalities that cause metabolic disorders---inequalities that medicalization alone tends to eschew. In turn, evangelical Christians come to examine the embodied evidence of disease (e.g., stress, anger, high blood pressure) as evidence of those inequalities.