Anthropology in Action

In this thematic issue we offer anthropologically-informed snapshots of the different forms that wellbeing takes when approached from place-based perspectives. We are interested in highlighting and engaging with the undermining of place in the literature on wellbeing, which has produced a lack of appreciation for the role that culture plays in forming and informing different discourses, understandings and practices of wellbeing, as well as wellbeing scholarship itself. Our articles examine place as part of a project that aims at generating new contexts from which to ‘think otherwise’ about social policy, politics, the creation of knowledge, and, ultimately, existence.

Worldwide, people’s attachments to places are typically ambivalent, and complemented by desires for mobility and scene-changing. So to understand relationships between place and wellbeing, we need to look beyond the simple idea that some kinds of place, local characteristics and place attachments make people’s lives go better. Places matter, but wellbeing is not environmentally determined, it is a complex outcome of lifelong interactions between people and places. Some of these are conscious and deliberate, and some involve deliberate relocation as well as processes of attachment. This article supplements the environmental determinism of ‘good place’ theories, and the social constructionism of ‘healthy place attachment’ theories, with recommendations for a systematic approach to mapping and analysing how wellbeing happens. It pays particular attention to deliberate ‘place appreciation’, which refers to these dynamic interactions through which people actively derive value from places. Ethnographic examples of deliberate ecological self-improvement in later life are explored to highlight three kinds of place-related wellbeing strategies: place-making, local mobility and relocation. A simple analytical system is proposed to highlight the potential relevance to policy and practice of a systematic sociocultural ecology of wellbeing.

This article is based on analysis of a series of ethnographic case studies of midwifery units in England. Midwifery units¹ are spaces that were developed to provide more home-like and less medically oriented care for birth that would support physiological processes of labour, women’s comfort and a positive experience of birth for women and their families. They are run by midwives, either on a hospital site alongside an obstetric unit (Alongside Midwifery Unit – AMU) or a freestanding unit away from an obstetric unit (Freestanding Midwifery Unit – FMU). Midwifery units have been designed and intended specifically as locations of wellbeing and although the meaning of the term is used very loosely in public discourse, this claim is supported by a large epidemiological study, which found that they provide safe care for babies while reducing use of medical interventions and with better health outcomes for the women. Our research indicated that midwifery units function as a protected space, one which uses domestic features as metaphors of home in order to promote a sense of wellbeing and to re-normalise concepts of birth, which had become inhabited by medical models and a preoccupation with risk. However, we argue that this protected space has a function for midwives as well as for birthing women. Midwifery units are intended to support midwives’ wellbeing following decades of professional struggles to maintain autonomy, midwife-led care² and a professional identity founded on supporting normal, healthy birth. This development, which is focused on place of birth rather than other aspects of maternity care such as continuity, shows potential for restoring wellbeing on individual, professional and community levels, through improving rates of normal physiological birth and improving experiences of providing and receiving care. Nevertheless, this very focus also poses challenges for health service providers attempting to provide a ‘social model of care’ within an institutional context.

¹The term midwifery unit was adopted by the Birthplace research programme in place of the more popular term ‘birth centre’ to avoid ambiguity. In a midwifery unit care is not only provided by mid-wives but is also managed by midwives and does not normally include use of obstetric instruments or interventions. If a woman planning birth in a mid-wifery unit develops obstetric complications, or decides she wishes to have a medical intervention such as epidural pain relief, she is transferred for care to an obstetric unit. Some units called birth centres are not managed by midwives in this way.

²Midwife-led care refers to care where the midwife, rather than an obstetrician or other professional is the lead professional, who takes responsibility for a woman’s maternity care through from pregnancy to postnatal. Following the Changing Childbirth report in 1993, this was re-established as the usual model for women classified as at low risk of pregnancy and birth complications.

This article presents the case for a rethinking of the academy’s approach to sacred space through a demonstration of the way that a focus on unskilled actors reconfigures established approaches and interpretations. The article opens with an auto-ethnographic account of the powerful effect of Shimla’s Tara Devi temple on personal wellbeing and from this starting point spirals out to explore how Tara (and her sacred places) are connected to wellbeing both in the Himalayan region of Shimla and beyond. Through this process, arguments that I have previously made, concerning both the relation of sacred places to happiness (2010) and the way that sacred places operate in Himalayan North India (2012), are significantly complicated, leading to a reappraisal of the role that unskilled actors play in the constitution of sacred space. The article concludes by drawing these ethnographic reflections and theoretical considerations together to develop a key set of recommendations that call for policy-makers to engage sensitively with sacred places in the contemporary, post-secular city.

In this article, I argue for a broadening of the conceptualisation of wellbeing in the scholarly and policy literature on the topic. I do so as, despite the calls for the inclusion of place in analyses of wellbeing, the literature on the topic still carries a dominant conception of wellbeing as a measurable index based on Euro-American practices and discourses, with their associated views of humanity and nature. I will advance the discussion on wellbeing’s intimate connection to place and place-based consciousness through an ethnographic engagement with kametsa asaiki (‘living well together’), an ethos of wellbeing pursued by indigenous Ashaninka people in the Peruvian Amazon. This is a revealing context as Peru exemplifies how extractive development initiatives tend to misrecognise or underestimate their socio-natural consequences on local pursuits of wellbeing. I argue that an understanding of the role of place and place-based consciousness in wellbeing is key to enhancing the concept’s utility in policy and practice, especially due to its centrality in the United Nations Sustainable Development Goals. In doing so, I call for further ethnographic explorations of the link between wellbeing models and understandings of humanity and nature.