Chronic homework in emerging borderlands of healthcare

Cult Med Psychiatry. 2011 Sep;35(3):347-75. doi: 10.1007/s11013-011-9225-z.


The task of caring for those with chronic illnesses has gained a new centrality in health care at a global level. We introduce the concept of "chronic homework" to offer a critical reflection on the treatment of chronic illnesses in three quite different national and local contexts: Uganda, Denmark, and the United States. A major challenge for clinicians, patients, and family caregivers is how to navigate the task of moving health care from clinic to home. By "chronic homework," we refer to the work patients and families are expected to carry out in their home contexts as part of the treatment of chronic conditions. Families and patients spend time receiving training by clinical experts in the various tasks they are to do at home. While this "colonization" of the popular domain could easily be understood from a Foucauldian perspective as yet another emerging mode of governmentality, this a conceptualization can oversimplify the way specific practices of homework are re-imagined and redirected by patients and significant others in their home surroundings. In light of this re-invention of homework in local home contexts, we foreground another conceptual trope, describing chronic homework as a borderland practice.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / ethnology
  • Acquired Immunodeficiency Syndrome / psychology
  • Acquired Immunodeficiency Syndrome / therapy
  • Anemia, Sickle Cell / psychology
  • Anemia, Sickle Cell / therapy
  • Anthropology, Cultural
  • Chronic Disease / ethnology*
  • Chronic Disease / psychology
  • Chronic Disease / therapy*
  • Family Health* / ethnology
  • Home Care Services*
  • Humans
  • Kenya
  • Parent-Child Relations
  • Self Care* / methods
  • Self Care* / psychology
  • Uganda
  • United States