Tag Archives: health/medicine

Liberation and the Sanitary Napkin: One Man’s Journey

1A touching BBC story describes a new documentary, Menstrual Man, that chronicles the trials and tribulations of a humble man in India who sought to offer his wife a sanitary napkin.  After marrying, he discovered that his wife kept from him a secret: the rags she used and re-used to collect menstrual blood.

Only 12% of women in India used pads; they were simply too expensive for most to buy. Nearly three-quarters of all reproductive diseases were caused by poor menstrual hygiene.  A combination of high cost and embarrassment kept women from developing a safe method of managing menstruation.  Nearly a quarter of girls dropped out of school when they started their periods.

Arunachalam Muruganantham was driven to offer women a solution.  He was going to design a machine that would produce low cost menstrual pads.  He asked his wife to serve as an experimental subject, but one woman menstruating once a month wasn’t enough of a sample.  He asked medical students to participate, but the responses were slim.  He fashioned a fake uterus and collected goat blood, trying to experiment himself.

“Everyone thought he’d gone mad.”

His wife left, his mother left, his friends avoided him; it was suspected he was some kind of diseased or possessed sexual pervert, collecting menstrual blood to do god-knows-what.

Figuring out how to make highly absorptive cotton was a significant challenge.  He finally tricked a  multinational company into sending him samples of the raw material: cellulose from the bark of the tree.  Now he just had to design a cheap machine that would turn the raw material into pads.

Four-and-a-half years later, he was producing affordable menstrual pads for Indian women on a cheaply made machine.  He won an award.  His wife came back.

He built 250 machines, which he then took to the poorest areas of Northern India.  He gave them to women, at no profit, who could then produce the pads and sell them to local women.  Each woman now runs her own business.  ”Over time the machines spread to 1,300 villages in 23 states.”

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He is now looking to expand to 106 more countries.

About his success, Muruganantham said:

Anyone with an MBA would immediately accumulate the maximum money. But I did not want to. Why? Because from childhood I know no human being died because of poverty — everything happens because of ignorance…. I have accumulated no money but I accumulate a lot of happiness.

Watch the trailer here.

Cross-posted at Pacific Standard.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

Rethinking a Zero Tolerance Approach to “Female Genital Mutilation”

I’ve written extensively — not here, but professionally — on the ways in which Americans talk about the female genital cutting practices (FGCs) that are common in parts of Africa.  I’ve focused on the frames for the practice (common ones include women’s oppression, child abuse, a violation of bodily integrity, and cultural depravity), who has had the most power to shape American perceptions (e.g., journalists, activists, or scientists), and the implications of this discourse for thinking about and building gender egalitarian, multicultural democracies.

Ultimately, whatever opinion one wants to hold about the wide range of practices we typically refer to as “female genital mutilation,” it is very clear that the negative opinions of most Westerners are heavily based on misinformation and have been strongly shaped by racism, ethnocentrism, and a disgust or pity for an imagined Africa.  That doesn’t mean that Americans or Europeans aren’t allowed to oppose (some of) the practices (some of the time), but it does mean that we need to think carefully about how and why we do so.

One of the most powerful voices challenging Western thinking about FGCs is Fuambai Sia Ahmadu, a Sierra Leonan-American anthropologist who chose, at 21 years old, to undergo the genital cutting practice typical for girls in her ethnic group, Kono.

She has written about this experience and how it relates to the academic literature on genital cutting.  She has also joined other scholars — both African and Western — in arguing against the zero tolerance position on FGCs and in favor of a more fair and nuanced understanding of why people choose these procedures for themselves or their children and the positive and negative consequences of doing so.  To that end, she is the co-founder of African Women are Free to Choose and SiA Magazine, dedicated to “empowering circumcised women and girls in Africa and worldwide.”

You can hear Ahmadu discuss her perspective in this program:

Many people reading this may object to the idea of re-thinking zero tolerance approaches to FGCs.  I understand this reaction, but I urge such readers to do so anyway.  If we care enough about African women to be concerned about the state of their genitals, we must also be willing to pay attention to their hearts and their minds.  Even, or especially, if they say things we don’t like.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

Should Drug Treatment Aim to End Use or Reduce Harm?

In the wake of Philip Seymour Hoffman’s sad death, many are calling for various “harm reduction” approaches to substance use. Proponents of harm reduction have identified lots of ways to reduce the social and personal costs of drugs, but they often require us to shift our focus from the prevention of drug use itself to the prevention of harm. Resistance to such approaches often hinges on the notion that they somehow tolerate, facilitate, or even subsidize risky behavior.

This tension emerged clearly in my new article with Sarah Shannon in Social Problems. We re-analyzed an experimental jobs program that randomly assigned a basic low-wage work opportunity to long-term unemployed people as they left drug treatment. In some ways, the program worked beautifully. The job treatment group had significantly less crime and recidivism, especially for predatory economic crimes like robberies and burglaries. After 18 months, about 13 percent of the control group had been arrested for a new robbery or burglary, relative to only 7 percent of the treatment group. Put differently, 87 percent of those not offered the jobs survived a year and a half without such an arrest, relative to 93 percent of the treatment group who were offered jobs.

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A randomized experiment that shows a 46 percent reduction in serious crime is a pretty big deal to criminologists, but the program has still been considered a failure. In part, this is because the “treatment” group who got the jobs relapsed to cocaine and heroin use at about the same rate as the control group. After 18 months, about 66 percent of the control group had not yet relapsed, relative to about 63 percent in the treatment group. So, there’s no evidence the program helped people avoid cocaine and heroin.

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From an abstinence-only perspective, such programs look like failures. Nevertheless, even a crummy job and a few dollars clearly helped people avoid recidivism and improved the public safety of their communities. So, did the program work? From a harm reduction perspective, a jobs program for drug users surely “works” if it reduces crime and other harms, even if it doesn’t dent rates of cocaine or heroin use.

Chris Uggen is a professor of sociology at the University of Minnesota and the author of Locked Out: Felon Disenfranchisement and American Democracy, with Jeff Manza. You can follow him at his blog and on twitter. This post originally appeared at Public Criminology.

Does Stymied Educational Attainment Lead to Depression?

A popular quote urges us to shoot for the moon: even if we miss, it tells us, we’ll land among the stars. According to new research, there’s more to it than cheesy inspiration. Using data from two waves of the National Longitudinal Survey of Youth, sociologist John Reynolds and Chardie Baird test the common notion that failing to attain as much education as expected is associated with symptoms of depression in early/middle adulthood.

First, their results show that individuals with lower levels of education are more likely to exhibit signs of depression.

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But, further statistical wrangling shows that their depression doesn’t come from the gap between plans and achievement. It comes from the low level of educational attainment in itself.

Reynolds and Baird conclude that there are no long-term emotional costs to aiming high and falling short when it comes to educational aspirations. This contradicts decades of research that holds that unmet educational expectations lead to psychological distress. In fact, not trying is the only way to ensure lower levels of education and increased chances of poor mental health. So, go ahead and shoot for that moon.

Hollie Nyseth Brehm is a Ph.D. Candidate at the University of Minnesota.  She is the graduate editor of The Society Pages.  This post originally appeared at Contexts Discoveries.

Black Women 40% More Likely to Die from Breast Cancer than White Women

Thanks to advances in early diagnosis and treatment of breast cancer, white women’s survival rates have “sharply improved,” but black women’s have not.  As a result, white women are more likely to be diagnosed with breast cancer, but black women are more likely to die from it.  Researchers from the Sinai Institute found that Black women are 40% more likely to die from the disease than white women.

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Experts trace the majority of the widening gap in survival rates to access, not biology.  Black women are more likely than white to be low income, uninsured, and suspicious of a historically discriminatory medical profession.

From Tara Parker-Pope for the New York Times.  Hat tip @ProfessorTD.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

Wanna Be in the NBA? It Helps to Grow Up Rich

Part of what makes professional basketball appealing, for kids who love to play as well as fans, is the idea that a person can come from humble beginnings and become a star.  The players on the court, the narrative goes, are ones who rose to fame as a result of incredible dedication and extraordinary talent.  Basketball, then, is a way out of poverty, a true equal opportunity sport that affirms what we think America is all about.

Seth Stephens-Davidowitz crunched the numbers to find out if the equal opportunity story was true.   Analyzing the economic background of NBA players, he found that growing up in a wealthy neighborhood (the top 40% of household incomes) is a “major, positive predictor” for success in professional basketball.  Black players are also less likely than the general black male population to have been born to a young or single mother.  So, class privilege is an advantage for pro ball players, just like it is elsewhere in our economy.

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The richest Black men, then, are most likely to end up in the NBA, followed by those in the bottom 20% of neighborhoods by income.  Middle class black men may, like many middle class white men, see college as a more secure route to a successful future.  Research shows that poor black men often see sports as a more realistic route out of poverty than college (and they may not be wrong).  This also helps explain why Jews dominated professional basketball in the first half of the 1900s.

LeBron James was right, then, when he said, “I’m LeBron James. From Akron, Ohio. From the inner city. I am not even supposed to be here.”  The final phrase disrupts our mythology about professional basketball: that being poor isn’t an obstacle if one has talent and drive.  But, as Stephens-Davidowitz reminds us, “[a]nyone from a difficult environment, no matter his athletic prowess, has the odds stacked against him.”

Cross-posted at Pacific Standard.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

How Do Physicians and Non-Physicians Want to Die?

We’re celebrating the end of the year with our most popular posts from 2013, plus a few of our favorites tossed in.  Enjoy!

A recent RadioLab podcast, titled The Bitter End, identified an interesting paradox. When you ask people how they’d like to die, most will say that they want to die quickly, painlessly, and peacefully… preferably in their sleep.

But, if you ask them whether they would want various types of interventions, were they on the cusp of death and already living a low-quality of life, they typically say “yes,” “yes,” and “can I have some more please.”  Blood transfusions, feeding tubes, invasive testing, chemotherapy, dialysis, ventilation, and chest pumping CPR. Most people say “yes.”

But not physicians.  Doctors, it turns out, overwhelmingly say “no.”  The graph below shows the answers that physicians give when asked if they would want various interventions at the bitter end.  The only intervention that doctors overwhelmingly want is pain medication.  In no other case do even 20% of the physicians say “yes.”

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What explains the difference between physician and non-physician responses to these types of questions.  USC professor and family medicine doctor Ken Murray gives us a couple clues.

First, few non-physicians actually understand how terrible undergoing these interventions can be.  He discusses ventilation.  When a patient is put on a breathing machine, he explains, their own breathing rhythm will clash with the forced rhythm of the machine, creating the feeling that they can’t breath.  So they will uncontrollably fight the machine.  The only way to keep someone on a ventilator is to paralyze them. Literally.  They are fully conscious, but cannot move or communicate.  This is the kind of torture, Murray suggests, that we wouldn’t impose on a terrorist.  But that’s what it means to be put on a ventilator.

A second reason why physicians and non-physicians may offer such different answers has to do with the perceived effectiveness of these interventions.  Murray cites a study of medical dramas from the 1990s (E.R., Chicago Hope, etc.) that showed that 75% of the time, when CPR was initiated, it worked.  It’d be reasonable for the TV watching public to think that CPR brought people back from death to healthy lives a majority of the time.

In fact, CPR doesn’t work 75% of the time.  It works 8% of the time.  That’s the percentage of people who are subjected to CPR and are revived and live at least one month.  And those 8% don’t necessarily go back to healthy lives: 3% have good outcomes, 3% return but are in a near-vegetative state, and the other 2% are somewhere in between.  With those kinds of odds, you can see why physicians, who don’t have to rely on medical dramas for their information, might say “no.”

The paradox, then — the fact that people want to be actively saved if they are near or at the moment of death, but also want to die peacefully — seems to be rooted in a pretty profound medical illiteracy.  Ignorance is bliss, it seems, at least until the moment of truth. Physicians, not at all ignorant to the fraught nature of intervention, know that a peaceful death is often a willing one.

Cross-posted at Pacific StandardThe Huffington Post, and BlogHer.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

Re-Touching the Consequences of Extreme Thinness

We’re celebrating the end of the year with our most popular posts from 2013, plus a few of our favorites tossed in.  Enjoy!

A former editor at Cosmopolitan, Leah Hardy, recently wrote an exposé about the practice of photoshopping models to hide the health and aesthetic costs of extreme thinness. Below is an example featuring Cameron Diaz:


The story about Diaz, in The Telegraph, includes the following description of the image’s manipulation:

  • Face: Cheeks appear filled out
  • Bust: Levelled
  • Thighs: Wider in the picture on the right
  • Hip: The bony definition has been smoothed away
  • Stomach: A fuller, more natural look
  • Arms: A bit more bulk in the arms and shoulders

Another example was posted at The Daily What. Notice that her prominent ribcage has been photoshopped out of the photograph on the right, which ran in the October 2012 issue of  Numéro.

Hardy, the editor at Cosmo, explains that she frequently re-touched models who were “frighteningly thin.”  Others have reported similar practices:

Jane Druker, the editor of Healthy magazine — which is sold in health food stores — admitted retouching a cover girl who pitched up at a shoot looking “really thin and unwell”…

The editor of the top-selling health and fitness magazine in the U.S., Self, has admitted: “We retouch to make the models look bigger and healthier”…

And the editor of British Vogue, Alexandra Shulman, has quietly confessed to being appalled by some of the models on shoots for her own magazine, saying: “I have found myself saying to the photographers, ‘Can you not make them look too thin?’”

Robin Derrick, creative director of Vogue, has admitted: “I spent the first ten years of my career making girls look thinner — and the last ten making them look larger.”

Hardy described her position as a “dilemma” between offering healthy images and reproducing the mythology that extreme thinness is healthy:

At the time, when we pored over the raw images, creating the appearance of smooth flesh over protruding ribs, softening the look of collarbones that stuck out like coat hangers, adding curves to flat bottoms and cleavage to pigeon chests, we felt we were doing the right thing… We knew our readers would be repelled by these grotesquely skinny women, and we also felt they were bad role models and it would be irresponsible to show them as they really were.

But now, I wonder. Because for all our retouching, it was still clear to the reader that these women were very, very thin. But, hey, they still looked great!

They had 22-inch waists (those were never made bigger), but they also had breasts and great skin. They had teeny tiny ankles and thin thighs, but they still had luscious hair and full cheeks.

Thanks to retouching, our readers… never saw the horrible, hungry downside of skinny. That these underweight girls didn’t look glamorous in the flesh. Their skeletal bodies, dull, thinning hair, spots and dark circles under their eyes were magicked away by technology, leaving only the allure of coltish limbs and Bambi eyes.

Insightfully, Hardy describes this as a “vision of perfection that simply didn’t exist” and concludes, “[n]o wonder women yearn to be super-thin when they never see how ugly [super-]thin can be.”

UPDATE:  A comment has brought up the point that it’s bad to police people’s bodies, no matter whether they’re thin or fat.  And this is an important point (made well here) and, while I agree that some of the language is harsh, that’s not what’s going on here.  The vast majority of the models who need reverse photoshopping aren’t women who just happen to have that body type.  They are part of an social institution that demands extreme thinness and they’re working hard on their bodies to be able to deliver it.  This isn’t, then, about shaming naturally thin women, it’s about (1) calling out an industry that requires women to be unhealthy and then hides the harmful consequences and (2) acknowledging that even people who are a part of that industry don’t necessarily have the power to change it.

Cross-posted at Business Insider and The Huffington Post in Spanish, French, and German.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.