An Anthropological Approach to mHealth: interview with Professor Daniel Miller
Posted on 28th October, 2024
To mark the publication of An Anthropological Approach to mHealth, which is available to readers all over the world as an open access download, we are delighted to publish an interview with one of the book’s editors, Professor Daniel Miller.
This book proposes a radically different anthropological approach to the development and dissemination of mobile health (mHealth), a rapidly growing sector in healthcare. The studies carried out by the book’s contributors found that many people use their mobile and smartphones for health purposes to a surprising extent. But instead of using bespoke apps created by health and other professionals, they take the communicative apps they have become comfortable with, such as LINE, WeChat and WhatsApp, and are highly creative in turning them into their own health apps.
This body of research also provided many additional insights, and shows how an anthropological approach situated in the observation of everyday life can be the foundation for an alternative but highly promising perspective on the future of mHealth.
Tell us more about your background and experience in this field.
I have worked at the department of anthropology at UCL for 43 years. I have also had a very productive relationship with UCL Press. My book series Why We Post published with UCL Press has now reached 1,800,000 downloads. This book is the eighth in our new series, Ageing with Smartphones.
UCL is surely the leading centre for the study of digital anthropology. We have the first and so far only master’s programme in these studies. We published the first textbook and have a centre for Digital Anthropology, we have the most staff dedicated to such studies etc. This book series arose from a five-year programme of research funded by the European Research Council, with fieldsites all around the world, including Africa, China, Europe and Latin America. What is new about it is that it is our first book in either of these series to focus on how our work can be used to enhance the welfare of populations through a better understanding of smartphone apps used for health purposes.
What do you enjoy most about your work?
I passionately believe in anthropology as an increasingly important discipline. We cannot educate on the basis of ignorance and as life has become more private we need to have the commitment and patience to get to know people and become part of their everyday life such that we really do have direct knowledge of what their lives are like and in our case the actual consequences of digital technologies. All our work involves spending 16 months in fieldwork. Basically, this is the kind of work you do if you really like people and find them endlessly fascinating. Also if you are sociable and enjoy friendship and companionship. My own fieldwork was in a small town in Ireland. I got to spend evenings in pubs listening to Irish trad music, and joining many community activities such as trying (and failing) to play the ukelele or helping the local theatre or men’s shed. Every day consisted of meeting and learning from the people I was living amongst. Of course I enjoy this work immensely, as also the subsequent process of analysis, making sense of what I have observed and trying to convey it to others through writing, making films and other forms of dissemination.
How do you work with authors and contributors to ensure their voices are heard and their work is presented in the best possible light?
This book, as all the others in our series, is a product of teamwork. A group of people who constantly met or discussed each other’s research and then writing. Just as fieldwork is essentially a sociable activity, so is the work that produced this book. Everyone in the team is equally represented in this volume. Anthropology is no longer an ‘us’ studying a ‘them’: the researchers who author this book are themselves from Africa, Palestine, China and Latin America, representing also the range of places where we studied. The style of anthropological writing is to provide empathetic portraits of the people we lived amongst so one has a sense of their individual voice. Often we discuss with them our findings and writings. Thanks to our books being open access and translated into the languages of our fieldsites the people we worked with are able to read them and comment on them. There has been considerable interest in my own writing about this town in Ireland and extracts from my work have been published in the town’s own bi-weekly magazine.
How do you balance the need for academic rigour with the need to make your publications accessible and engaging to a broader audience?
Anthropology has perhaps a special place in balancing scholarship and accessibility, since the foundation of our publications is trying to empathetically convey the lives and feelings of the people we lived amongst. So all our publications include stories of the lives and struggles of individuals, so that we show our humanist acknowledgement that every individual is unique at the same time as presenting analytical and theoretical generalisations that we use to try and explain why people do what they do and think what they think. The nearly two million downloads of our publications with UCL Press suggest that this does lead to the kind of engagement with audiences we hope for. As well as our books our UCL website includes short videos, cartoons, brief descriptions of our findings and other multimodal forms that complement our work. What was unique to much of the recent series, though not included in this particular book, is the inclusion of short videos within the UCL books.
What advice would you give to aspiring editors, and what do you think are the key skills and attributes required?
Editing is hard and responsible work. Often our books include authors who are just starting out on their career and welcome detailed commentary on how best to improve their work. Often papers will go back and forth between authors and editors many times before we are jointly satisfied with the result. Editors also have to balance the desire by some authors to continue working on their papers with the need to publish quickly in order not to let down those who sent in their papers early and need the publications for their career. Often I find myself writing passages to authors that try to exemplify what we are aiming for and provide concrete examples, rather than just criticising a submission.
Surprise us with something unexpected you encountered in your work on this book.
Before we started this work hardly any of the authors had experience in trying to shift from purely academic work to actually getting engaged in activities designed to directly improve people’s welfare. So it was really great that everyone managed to make that transition and provide so many interesting insights as a result. For example I had never imagined prior to this that I would actually jointly produce a game that can be downloaded on your smartphones (Trini Food Quiz) to help people in Trinidad and Tobago learn about hypertension and diet. But others found themselves involved in chemotherapy clinics or the work of nutritionists and a broad range of other medical activities which again was entirely new to us.
What do you think are the biggest challenges facing academic book publishing today, and how do you see the industry evolving in the future?
I feel passionately committed to UCL Press in particular. Thanks to open access, ethnographic monographs that used to sell around 600 copies might now be downloaded to 200,000 people. As well as the agreement to publish our books in translation that ensures we reach people in the places where we do our fieldwork. For an anthropologist, the global reach of the Press aligns closely with our own ethical commitments. So my main concern is that universities in general should combine together to take back publishing from commercial concerns and as an aggregate provide the business model that ensures that universities will actually save money, by no longer paying exorbitant fees to other publishers but as with UCL Press undertake the publishing ourselves. In a way I am just surprised that this is taking so long to achieve.
About the author
Daniel Miller is Professor of Anthropology at UCL. He has specialised in the anthropology of material culture, consumption and now digital anthropology. He recently directed the Why We Post project about the use and consequences of social media. He is author/editor of 47 books including The Comfort of Things, Stuff, The Global Smartphone, Ageing with Smartphones in Ireland (with Pauline Garvey) and his most recent book The Good Enough Life.
Charlotte Hawkins is Postdoctoral Researcher in Social Anthropology and author of Ageing with Smartphones in Uganda. Her work focuses on social economies of mental health and wellbeing.
Patrick Awondo is a lecturer at the University of Yaoundé 1, Cameroon. He is the author of Le sexe et ses doubles. (Homo)sexualités en postcolonie.