Aging changes our relationships to health, caring, and medicine. MCL examines how medical culture shapes experiences of aging as well as how it reflects them. Our research includes three areas. First, we study how diverse communities make sense of health as they grow older. This work includes projects focused on supporting caregivers and improving healthcare decision-making. Second, we study how to safely provide routine healthcare for older adults. We examine how to support primary care clinicians as they grapple with the complex needs of aging patients. We are also exploring how to make surgical care safer and less taxing for older adults. Finally, we examine how to make care humane at end-of-life in hospitals and hospice. Some projects examine the relationship between hospital culture and burdensome care. Other projects seek to make palliative and hospice care more accessible and effective.

Chronic illness re-organizes the lives of patients and drives much of contemporary healthcare. MCL investigators examine medical culture in cancer, dementia, epilepsy, and kidney disease.

Many MCL investigators study experiences with Alzheimer's disease and related dementias (ADRD). Within the healthcare system, we study how primary care clinicians diagnose dementia. We examine palliative and hospice care during the final stages of ADRD. Finally, we examine how people and communities respond and adjust to cognitive decline. In other chronic illness research, MCL investigators examine new and emerging treatments. We have studied how patients with late stage cancer deliberate about experimental treatment. We are tracing the social impact of implantable devices to treat epilepsy. Most recently, MCL investigators are studying how social position affects access to kidney dialysis.

Health, illness, and healthcare experiences reflect their social context and determinants. These include the ability to access resources to support health (such as nutritious food, accessible transportation, safe housing, and quality education) as well as exposure to health-harms such as racism, harassment, labor and consumer exploitation, and environmental toxins.

MCL's commitment to ethnographic and qualitative methods means social determinants are ubiquitous in our research. It is well-known that social position and identity shape access to care; MCL research helps unpack why this relationship is enduring and ubiquitous by examining the myriad social and cultural pathways that make it so. By identifying how social determinants "work," MCL investigators seek to inform policy innovations and practice interventions that might be successful at mitigating their harms.

MCL strives to center justice, equity, diversity, and inclusion (JEDI) in all the work we do. Principles of JEDI include dismantling barriers to resources and opportunities so all individuals and communities can thrive; working to ensure resources are allocated equitably to ensure everyone has access to the same opportunities; acknowledging all the differences between us based on which we experience barriers or advantages to opportunities; and fostering a sense of belonging by amplifying, centering and the voices and perspectives of those who have faced more barriers based on their identities.

MCL supports The Repair Project to address Anti-Black Racism and augment Black, Indigenous, People of Color voices and presence at UCSF. MCL member JEDI research initiatives focus on improving end-of-life experiences among older Black adults and maternal health outcomes among Black birthing people. Nearly all MCL research projects incorporate analyses focused on justice and equity, and MCL centers inclusion in its hiring practices.

Generations of scholars have sought to define culture's role in social life and refine our ability to measure it. MCL methodology initiatives join these efforts to understand culture holistically and measure it rigorously. As humanists, we holistically engage, listen, and witness peoples' experiences. As scientists, we aim to rigorously describe and analyze how culture varies among and across social spaces. The MCL methodology initiative envisions a practical and productive balance between humanistic and scientific understandings of culture.

MCL is in an auspicious setting to pursue this vision. Lab investigators bring diverse disciplinary tools to the study of medical culture including field-based anthropology, micro-analytic conversation analysis, sociological perspectives on professional and institutional cultures, and computational/big data insights from the policy and social sciences. The methodology initiative develops innovative analytic approaches and methodological tools to advance cultural research -- including computational tools to analyze and visualize qualitative data on culture. Through training, mentorship, and technical support, MCL investigators support researchers new to the field of qualitative research on culture.