276 Review Essays norms exhibit a strong correlation over the of opportunity and cultural cultivation, pre- course of an entire decade net of structural paring disadvantaged students to success- factors, suggesting strong independent cul- fully navigate and leverage resources from tural continuity in features of a neighbor- middle-class institutions. hood’s local culture. Based on 18 months of ethnographic field- A New Agenda? work with young men involved in street vio- lence, Joseph C. Krupnick and Christopher Like any innovative piece of scholarship, The Winship examine the social norms of street Cultural Matrix raises as many questions as it encounters that help these young men to answers. What does it mean to say that cul- avoid violent confrontations. They ask why ture has an independent effect on black there is not more violence in inner-city neigh- youth in a world in which culture and struc- borhoods. Their micro-sociological analysis ture are so closely intertwined, and how proposes that the answer is that well- would we isolate an independent effect if it established norms for casual street encounters exists? What new data need to be collected, provide a structure to such interactions that and new measurement strategies developed, allows individuals to substitute verbal play in order to fully leverage cultural concepts for physical altercations. In so doing, Krup- (whether they be values, norms, scripts, nick and Winship illustrate the power of frames, narratives, repertoires, or symbolic a detailed study of micro-level social norms boundaries) in the study of poverty, inequal- for explaining individual behavior and ity, and race? What are the processes of cul- patterns of violence in poor neighborhoods. tural diffusion and cultural isolation that Drawing on a novel analysis of inner-city either constrain or enable opportunities for students bussed to suburban schools and black youth? The theoretical and methodo- a comparison group of those who were not, logical challenges of an intellectual agenda Simone Ispa-Landa shows how schools can that can make progress on these questions act as agents of socialization and cultural are deep, but The Cultural Matrix provides transmission for poor students. She finds an exciting point of departure. that the bussed students developed middle-class understandings of authority References structures and strategies for navigating these Patterson, Orlando. 2014. ‘‘Making Sense of Cul- authority structures, providing them with ture.’’ Annual Review of Sociology 40:1–30. the cultural tools to more successfully inter- Small, Mario Luis, David J. Harding, and act with authority figures. Specific school Miche`le Lamont. 2010. ‘‘Reconsidering Cul- ture and Poverty.’’ Annals of the American Acad- personnel were instrumental in such sociali- emy of Political and Social Science 629:6–27. zation efforts. Ispa-Landa’s findings suggest Wilson, William Julius. 1987. The Truly Disadvan- that, under the right circumstances and with taged: The Inner City, the Underclass, and Public deliberate effort, schools can be institutions Policy. Chicago: University of Chicago Press.

Stem Cell Initiatives as a New Window into Health Disparities

JILL A. FISHER University of North Carolina at Chapel Hill [email protected]

At a time of profound social inequalities in the United States, high-tech medicine is People’s Science: Bodies and Rights on the nonetheless touted for its potential to save Stem Cell Frontier,byRuha Benjamin. all lives through miracle cures. The fact Stanford, CA: Stanford University Press, that these types of advances would likely 2013. 272 pp. $24.95 paper. ISBN: be available only to people who are already 9780804782975. privileged by the best health care is rarely

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Downloaded from csx.sagepub.com at PRINCETON UNIV LIBRARY on June 10, 2016 Review Essays 277 woven into the narrative about medical cell science, Benjamin points out that the progress. In her book People’s Science: Bodies NIH had awarded less than $25 million in and Rights on the Stem Cell Frontier, Ruha Ben- funding to stem cell researchers in 2003. jamin critically examines California’s 2004 This positioned California as a ‘‘colleague stem cell initiative as a so-called populist and competitor’’ to national governments project. By using a lens of health disparities around the world (p. 13). to understand the role of stem cell science, One key question that People’s Science Benjamin deftly analyzes what such funding tackles is how Proposition 71 won ballot priorities mean for those who are systemati- approval. Benjamin effectively describes cally disadvantaged in society. For those of the irony of this massive funding bill win- us working in the sociology of science, ning at the polls. The state of California knowledge, and technology—or science and was already deep in a severe budget crisis, technology studies (STS) more generally— grappling with a housing crisis marked by this approach to the topic is an innovative high rates of foreclosures and a growing and refreshing empirical and conceptual gap between the state’s richest and poorest choice. Whereas many STS scholars might residents. In the same election, another bal- select a laboratory for their ethnographic lot measure, Proposition 72, sought to work, Benjamin brackets the science of extend health care coverage to address the stem cell research to instead trace how a pub- increasing number of residents who were licly supported ballot measure engaged, un- or underinsured. Unlike the stem cell eschewed, and intersected with multiple bill, however, California voters defeated stakeholder groups within and beyond Cali- Proposition 72. In other words, California fornia. As a result, the book contributes not voters effectively expressed their support only to STS but also more broadly to the field for research purported to bring about future of sociology for those with interests in medi- medical advancements while simultaneous- cine; race, class, and gender; disability stud- ly rejecting attempts to expand access to ies; political economy; and poverty and present-day, proven therapies to patients in inequality. need. Benjamin further situates Proposition The context for Benjamin’s study is the 71 within the commercial interests intrinsic politically contentious domain of funding to stem cell science, with the initiative for U.S. stem cell research. Given that some explicitly promoting the commodification of this research utilizes human embryos, of research by promising investigators the stem cell science is entrenched in moral ability to profit from state-funded discover- debates about what constitutes human life ies, citing this as the only viable pathway and is, thus, deeply influenced by abortion to encourage therapeutic innovations. In politics. Trying to navigate these fraught spite of all this, Proposition 71 was able to waters, the government had enacted restric- succeed in large part due to its ‘‘populist tions on embryonic stem cell research packaging,’’ setting up the semblance of through regulations associated with the a participatory movement in opposition to receipt of federal funding. Specifically, in President Bush and establishing a ‘‘right to 2001 President George W. Bush made it ille- research’’ that putatively could take the pol- gal to use federal funds to produce new itics out of science (pp. 15–16). embryonic stem cell lines and allowed While Benjamin tells a fascinating—even funding from the National Institutes of if at times somewhat cursory—story about Health (NIH) to be granted only for research the political machinations undergirding using existing cell lines. In this restrictive California Proposition 71 and the rollout of environment, California proposed to create its subsequent stem cell agency, the strongest its own source of funding for stem cell contribution of People’s Science is in Benja- research through a bond measure allocating min’s detailed analysis of two of the constit- nearly $300 million per year to such science. uent groups that are implicated in the stem Through Proposition 71, California citizens cell initiative: disabled people and racial voted to approve this massive and unprece- minorities. In her chapter on disability, Ben- dented initiative. To help illustrate the mag- jamin beautifully compares the perspectives nitude of California’s commitment to stem of two advocates. The first, a father whose

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Downloaded from csx.sagepub.com at PRINCETON UNIV LIBRARY on June 10, 2016 278 Review Essays adult son suffered a spinal cord injury and is known risks that were higher than standard wheelchair bound, supports the stem cell (non-research) therapies. Highlighting one initiative as a patient advocate because of caregiver in particular, Benjamin writes, the promise of science to cure people who ‘‘What might be regarded as her ‘distrust’ are victims of their disabilities and to return toward medical studies, in other words, them to ‘‘normal.’’ The other, a disability could be understood otherwise: as her trust rights and racial justice activist with muscu- in something other than an experimental lar dystrophy, criticizes Proposition 71 for its method’’ (p. 122, emphasis in original). Ben- contribution to the devaluation and margin- jamin then makes a powerful case for ‘‘depa- alization of people with disabilities while thologizing’’ distrust in the medical realm. simultaneously noting that ‘‘there are a lot She argues that framing African Americans of people that make money off of disability’’ and others as ‘‘hard to reach’’ populations (p. 69). By contrasting these two perspectives blames those groups as if they are self- through the narratives of two impassioned selecting rather than systematically margin- advocates, Benjamin illustrates the complex- alized by mainstream biomedicine. It also ity of what is at stake as stem cell research is leads to ‘‘medical racial profiling’’ as constructed as a biomedical solution to what researchers scramble to meet federal and state many individuals perceived as disabled guidelines mandating they enroll minority would instead consider a civil rights problem. patients in their clinical trials. In this environ- Benjamin’s exploration of the intersection ment, distrust is perhaps warranted, Benja- of race and the stem cell initiative weaves min asserts, given the context of unequal together an empirically grounded portrait free-market medicine that structures health of existing stem cell therapies for sickle cell care in the United States. disease and an astute analysis of the biomed- People’s Science is a thoughtful exploration ical community’s claim that African Ameri- of how public support for research can con- cans are distrustful of research. In spite of tribute to longstanding social and health both the populist rhetoric of Proposition 71 inequalities. By connecting the dots between and the calls for attention to diversity in state politics, clinical treatments, and the the rollout of the initiative, sickle cell disease lived experiences of disadvantaged minori- was excluded from any funding in the first ties in the United States, Ruha Benjamin grant cycle and was not represented on the offers her readers something truly novel state’s governing board, unlike 29 other dis- here. It is also important to note that she ease conditions. In clinics, researchers note does so through clear and accessible writing that there is a high rate of African American that integrates her ethnographic work with families consenting to store cord blood after myriad secondary sources documenting the birth of an unaffected child because of its California’s stem cell initiative. Although it potential therapeutic use for a sibling with is not an in-depth ethnography, People’s Sci- sickle cell disease. Yet, as Benjamin docu- ence delivers a keen social analysis that inte- ments, only 6 percent of sickle cell patients grates the approaches of disability studies, or their caregivers agreed to a cord blood gender studies, and critical race theory into transplant when there was a good match the study of science policy. between affected and unaffected siblings. This indicates that many African American families may not be eager to undergo exper- imental stem cell procedures. While researchers seem to interpret this as a sign of African American families’ distrust of research, Benjamin persuasively argues that this should instead be thought of as ‘‘ambivalence in action.’’ Detailing stories from families with whom she met, she illus- trates how caretakers perceived the research options as having uncertain benefits to sickle cell patients yet exposing their loved ones to

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