Academic books usually have terrible titles ¨C the kind that could only attract the attention of a desperate PhD student looking for that elusive last bit of information, or analysis, or theory, in order to make sense of their own data. They are usually bland, and at best a book does what it says on the tin. Academics, despite their acknowledgement of complexity, like their own lives to be ordered and simple, which means that their book titles are almost always dull.

When I was asked to review this book, I was sceptical. I groaned. addicted. pregnant. poor: let me guess what this is about. Here we go, another US ethnographic study of poor people. Truthfully, I have had my fill of the crass, simplistic and prurient. I¡¯m thinking in particular about Sudhir Venkatesh¡¯s unbelievable rise from upper-middle class student to Gang Leader for a Day, and more recently Alice Goffman¡¯s On the Run, the tale of a white middle-class member of the sociological elite traumatised by her experiences in a black Philadelphia neighbourhood.

So as you can imagine, I just couldn¡¯t wait to read this especially badly titled study, set in the Mission District of San Francisco, of women who were pregnant, living in daily rent hostels and engaged in sex work to fund their drug addictions. But against the odds, as I started to read, the book engaged me ¨C it really did. Kelly Ray Knight, a medical anthropologist, worked in a women¡¯s outreach centre in San Francisco where she engaged with clients and formed relationships through the network of the voluntary sector, and she continued that voluntary work throughout the four years of research that informed her book. This approach, I would argue, is essential to good ethnographic work in poor neighbourhoods, and with people you may have no connection with apart from their being the subjects of your research. I always advise students to go down this route; with good reason, I don¡¯t like the ¡°deep hanging out¡± type of tourist ethnography.

The narratives of the women in this book are matched with Knight¡¯s strong and critical comment on the state of social policy and the way poor women are known and dealt with by the US government. Her focus on the specific trappings of this particular kind of poverty ¨C the constant stress of having to live in a room you pay for daily and having to find that daily rent through street hustling, and prostitution, and at the same time having to deal with a drug addiction ¨C is handled well. Knight¡¯s unpicking of the concept of time is especially useful, as she looks at how these women must somehow manage the temporal aspects of their lives: the time the rent is due, the time they need to work, and the time their bodies and their minds consume whatever narcotic they need to get through the day, and ultimately the impending time of the birth of their child. Some of the narratives are truly harrowing, and as an ethnographer I understand the difficulties in telling these stories without sensationalism or prurience. Knight achieves this challenging feat by shifting repeatedly between ethnographic narratives that describe these women¡¯s lives clearly and without melodrama, and her well-informed and critical discussion of the wider politics of poverty in America.

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The Mission District is very much a part of this narrative. Knight understands that individual women¡¯s stories do not exist in a vacuum within the city; they speak volumes about the gentrification to the area unhinted-at in the book¡¯s title, the new people moving in, the private ¡°Google buses¡± that shuttle tech workers to their well-paid jobs. It makes me think of a visit I made to the city for the American Sociological Association¡¯s annual conference in 2014; as I checked in at the Hilton hotel, the receptionist gave me a map, adding ¡°As you come out of the door, don¡¯t turn left¡±. I am an ethnographer, so it was the first thing that I did. It was in the Mission District that I saw the day rent hostels ¨C a block away from the Hilton but a different world. What Knight does is bring context to that world, with understanding and respect. Despite the terrible title, this is a sobering, poignant ethnography that affords dignity to women whose lives are stripped of it by a system that has let them down.

Lisa Mckenzie is research fellow in the department of sociology, London School of Economics, and author of Getting By: Estates, Class and Culture in Austerity Britain (2014).

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addicted. pregnant. poor
By Kelly Ray Knight
Duke University Press, 328pp, ?66.00 and ?17.99
ISBN 9780822359531 and 9968
Published 30 October 2015