Ethical Considerations in Population Health Research With Vulnerable Communities and the Added Value of Community-Engaged Methodology

Abstract

Working among vulnerable communities poses unique ethical challenges when conducting biocultural research. When communities face dire poverty and social injustice, simply observing and documenting stressors and related health outcomes may be considered exploitative by vulnerable and already overburdened residents. As biocultural researchers, our responsibility is to work toward solutions addressing differential impacts of social injustice. Here, we highlight work amongst the Comcaac, an indigenous group native to Sonora, Mexico. Today, they experience significant resource insecurity secondary to historical marginalization and structural violence. Employing ethnographic methods (participant observation, focus groups, unstructured and semi-structured interviews), we investigated social and ecological stressors likely affecting members’ health. First, we determined visible themes encompassing resource insecurity (e.g., water, food, power, medicine etc.) and struggles with poverty, racism, and associated feelings of injustice. Through deep engagement, we also discerned community members’ frustrations with what they see as exploitative research – obtaining information but failing to work actively toward solutions or remain invested in participants’ well-being. To begin addressing their most severe issues, we first documented substantial needs within the community, then obtained outside donors and organized a weekly food bank delivery of fresh foods. Now, these are distributed weekly by community leaders in culturally appropriate and locally embedded ways. Thereby, we were able to address an immediate need in a manner that will have continuing impact even while not actively conducting fieldwork. To have real meaning for our research communities, as biocultural researchers we must create ethically based long-term relationships to develop meaningful scholarship.