How functional medicine leverages systems biology and epigenetic science to treat the microbiome and reverse chronic disease.

Each body is a system within a system—an ecology within the larger context of social, political, economic, cultural, and environmental factors. This is one of the lessons of epigenetics, whereby structural inequalities are literally encoded in our genes. But our ecological embeddedness extends beyond DNA, for each body also teems with trillions of bacteria, yeast, and fungi, all of them imprints of our individual milieus. Nested Ecologies asks what it would mean to take seriously our microbial being, given that our internal ecologies are shaped by inequalities embedded in our physical and social environments.

Further, Rosalynn Vega argues that health practices focused on patients’ unique biology inadvertently reiterate systemic inequities. In particular, functional medicine—which attempts to heal chronic disease by leveraging epigenetic science and treating individual microbiomes—reduces illness to problems of “lifestyle,” principally diet, while neglecting the inability of poor people to access nutrition. Functional medicine thus undermines its own critique of the economics of health care. Drawing on novel digital ethnographies and reflecting on her own experience of chronic illness, Vega challenges us to rethink not only the determinants of well-being but also what it is to be human.

Recent anthropological scholarship on “new midwifery” centers on how professional midwives in various countries are helping women reconnect with “nature,” teaching them to trust in their bodies, respecting women’s “choices,” and fighting for women’s right to birth as naturally as possible. In No Alternative, Rosalynn A. Vega uses ethnographic accounts of natural birth practices in Mexico to complicate these narratives about new midwifery and illuminate larger questions of female empowerment, citizenship, and the commodification of indigenous culture, by showing how alternative birth actually reinscribes traditional racial and gender hierarchies.

Vega contrasts the vastly different birthing experiences of upper-class and indigenous Mexican women. Upper-class women often travel to birthing centers to be delivered by professional midwives whose methods are adopted from and represented as indigenous culture, while indigenous women from those same cultures are often forced by lack of resources to use government hospitals regardless of their preferred birthing method. Vega demonstrates that women’s empowerment, having a “choice,” is a privilege of those capable of paying for private medical services—albeit a dubious privilege, as it puts the burden of correctly producing future members of society on women’s shoulders. Vega’s research thus also reveals the limits of citizenship in a neoliberal world, as indigeneity becomes an object of consumption within a transnational racialized economy.

The first scholarly exploration of the forums, practice, and economics of functional medicine.

Physicians of the Future interrogates the hidden logics of inclusion and exclusion in functional medicine (FM), a holistic form of personalized medicine that targets chronic disease. Rosalynn Vega uncovers how, as “wounded healers,” some FM practitioners who are former chronic disease sufferers turn their illness narratives into a form of social capital, leveraging social media to relate to patients and build practices as “doctor-influencers.” Arguing that power and authority operate distinctly in FM when compared to conventional medicine, largely because FM services are paid for out of pocket by socioeconomically privileged “clients,” Vega studies how FM practitioners engage in entrepreneurship of their own while critiquing the profit motives of the existing healthcare system, pharmaceutical industry, and insurance industry. Using data culled from online support groups, conferences, docuseries, blogs, podcasts, YouTube, and TED Talks, as well as her own battles with chronic illness, Vega argues that FM practices prioritize the individual while inadvertently reinscribing inequities based on race and class. Ultimately, she opens avenues of possibility for FM interlocutors wrestling with their responsibility for making functional medicine accessible to all.