Connecting political ecology of health and disease with ‘structural stigmatization’: Declining use of forest foods and medicines in Kédougou, Senegal

Recent political ecology (PE) frameworks have evolved to identify power disparities that have consequences for human health and disease development. These power disparities can lead to unequal access to health information, natural resources (e.g. farmland, clean water), micronutrients, healthcare, and other elements necessary to maintain healthy bodies and reduce risk of disease. While many PE and political ecology of health and disease (PEHD) frameworks examine access in terms of limitations, few examples highlight effects from increased access to resources. This article uses a PEHD lens to examine how diets and health in rural Kédougou, Senegal are influenced by increased access to globalized foodstuffs and stigmatization of local foods and medicines. A better understanding of dietary decision-making is critical in understudied regions such as Senegal because West Africa has a rapidly expanding population and is projected to be among regions of the world that are most burdened with non-communicable diseases (NCD). We used qualitative methods to: 1) describe current and historic diets in Kédougou; 2) identify perceived changes about diet, health, and access to resources; and 3) understand what might be influencing these changes. Our article shows that increased access and limited access are interconnected because increased, regular access to globalized foods and medicines could factor into reduced access to local foods and medicines. We found that social context strongly influenced use of local forest foods and medicines, even leading to a gradual stigmatization of using these resources.