Tag Archives: health/medicine

Chart of the Week: We Have Less Control Over Our Reproductive Bodies Than We Think

This week the New York Times published an interactive that illustrates the likelihood of pregnancy despite contraceptive use. Risk is divvied up by method, for perfect and typical use, and added up over ten years. The results are a little terrifying (click to see larger or go here to explore):

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Somewhere around half of all pregnancies are unintended.  This is why. It’s hard enough to use contraceptives perfectly but, even when we do, the risk of failure is very real.

Male condoms are the safer sex favorite. But, even when used perfectly, almost one in five women will get pregnant over a ten year period. With typical use, more than four out of five. Withdrawal, one primary foil against which male condoms are usually recommended, is only slightly less effective at preventing pregnancy, as typically used.

The favorite of Americans — The Pill, as well as some other hormonal methods — is more effective than the condom, but not nearly as much as we think it is. Under ideal conditions, only three in 100 will get pregnant over ten years; in reality, almost two-thirds — 61 in 100 — will end up pregnant.

Only the most human-error resistant methods — the IUD, hormonal implants, and sterilization — near 100% effectiveness. These are permanent or semi-permanent and not real options for a large proportion of sexually active Americans during at least some parts of their lives.

Discussions of the right to an abortion and the ease with which they can be attained needs to be had with this information at the forefront of the discussion. Unintended pregnancies happen all the time to everyone.

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

How Prohibition Put the Cocaine in Coca-Cola

You may be familiar with the fact that the coca in Coca-Cola was originally cocaine. But did you know that the reason we infused such a beverage with the drug in the first place was because of prohibition? Cocaine cola replaced cocaine wine. In fact, when it was debuted in 1886, it was described as “Coca-Cola: The Temperance Drink.”

The first mass marketed cocaine product was Vin Mariani, a cocaine-infused Bordeaux introduced in the 1860s. Legal and requiring no prescription, it was believed to “restore health and vitality” and I’m sure it felt like it did. Wikipedia reports that it included 7.2 mg of cocaine per ounce; comparatively, a line snorted is about 25 mg.

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Yes, Vin Mariani was good for men, women, and children. The “tonic of kings!” Even the Pope! He loved it so much he called it a “benefactor of humanity” and gave it a Vatican Gold Medal:

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But he was just the most eminent of its fans. Mariani’s media blitz included endorsements from Sarah Bernhardt, H.G. Wells, Ulysses S. Grant, Queen Victoria, the Empress of Russia, Thomas Edison, and the then-President of the United States, William McKinley. Jules Verne reportedly joked: “Since a single bottle of Mariani’s extraordinary coca wine guarantees a lifetime of 100 years, I shall be obliged to live until the year 2700!”

Vin Mariani dominated the market, but there was an American chemist, John Smith Pemberton, who made a competing product: Pemberton’s French Wine Coca. He described it as an “intellectual beverage.” Pemberton was located in — you guessed it, Atlanta — and the state enacted temperance legislation in 1885. Hence, Coca-Cola was born.

Cross-posted at Pacific Standard.

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

#InstagrammingAfrica: The Narcissism of Global Voluntourism

2An article in The Onion mocks voluntourism, joking that a 6-day visit to a rural African village can “completely change a woman’s facebook profile picture.”  The article quotes “22-year old Angela Fisher” who says:

I don’t think my profile photo will ever be the same, not after the experience of taking such incredible pictures with my arms around those small African children’s shoulders.

It goes on to say that Fisher “has been encouraging every one of her friends to visit Africa, promising that it would change their Facebook profile photos as well.”

I was once Angela Fisher. But I’m not any more.

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I have participated in not one but three separate, and increasingly disillusioning, international health brigades, short-term visits to developing countries that involve bringing health care to struggling populations.

Such trips – critically called voluntourism — are a booming business, even though they do very little advertising and charge people thousands of dollars to participate.

How do they attract so many paying volunteers?

Photography is a big part of the answer.  Voluntourism organizations don’t have to advertise, because they can crowdsource.  Photography – particularly the habit of taking and posting selfies with local children – is a central component of the voluntourism experience. Hashtags like #InstagrammingAfrica are popular with students on international health brigades, as are #medicalbrigades, #globalhealth, and of course the nostalgic-for-the-good-days hashtag #takemeback.

It was the photographs posted by other students that inspired me to go on my first overseas medical mission. When classmates uploaded the experience of themselves wearing scrubs beside adorable children in developing countries, I believed I was missing out on a pivotal pre-med experience. I took over 200 photos on my first international volunteer mission. I modeled those I had seen on Facebook and even premeditated photo opportunities to acquire the “perfect” image that would receive the most “likes.”

Over time, I felt increasingly uncomfortable with the ethics of those photographs, and ultimately left my camera at home. Now, as an insider, I see three common types of photographs voluntourists share through social media: The Suffering Other, The Self-Directed Samaritan, and The Overseas Selfie.

The Suffering Other

In a photograph taken by a fellow voluntourist in Ghana (not shown), a child stands isolated with her bare feet digging in the dirt. Her hands pull up her shirt to expose an umbilical hernia, distended belly, and a pair of too-big underwear. Her face is uncertain and her scalp shows evidence of dermatological pathology or a nutritional deficiency—maybe both. Behind her, only weeds grow.

Anthropologists Arthur and Joan Kleinman note that images of distant, suffering women and children suggest there are communities incapable of or uninterested in caring for its own people. These photographs justify colonialist, paternalistic attitudes and policies, suggesting that the individual in the photograph…

…must be protected, as well as represented, by others. The image of the subaltern conjures up an almost neocolonial ideology of failure, inadequacy, passivity, fatalism, and inevitability. Something must be done, and it must be done soon, but from outside the local setting. The authorization of action through an appeal for foreign aid, even foreign intervention, begins with an evocation of indigenous absence, an erasure of local voices and acts.

The Self-directed Samaritan

Here we have a smiling young white girl with a French braid, medical scrubs, and a well-intentioned smile. This young lady is the centerpiece of the photo; she is its protagonist. Her scrubs suggest that she is doing important work among those who are so poor, so vulnerable, and so Other.

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The girl is me. And the photograph was taken on my first trip to Ghana during a 10 day medical brigade. I’m beaming in the photograph, half towering and half hovering over these children. I do not know their names, they do not know my name, but I directed a friend to capture this moment with my own camera. Why?

This photograph is less about doing actual work and more about retrospectively appearing to have had a positive impact overseas. Photographs like these represent the overseas experience in accordance with what writer Teju Cole calls the “White Savior Industrial Complex.”

Moreover, in directing, capturing, and performing in photos such as these, voluntourists prevent themselves from actually engaging with the others in the photo. In On Photography, Susan Sontag reminds us:

Photography has become almost as widely practiced an amusement as sex and dancing – which means that…it is mainly a social rite, a defense against anxiety, and a tool of power.

On these trips, we hide behind the lens, consuming the world around us with our powerful gazes and the clicking of camera shutters. When I directed this photo opportunity and starred in it, I used my privilege to capture a photograph that made me feel as though I was engaging with the community. Only now do I realize that what I was actually doing was making myself the hero/star in a story about “suffering Africa.”

The Overseas Selfie


[Photo removed in response to a request from Global Brigades.]

In his New York Times Op-Ed, that modern champion of the selfie James Franco wrote:

Selfies are avatars: Mini-Me’s that we send out to give others a sense of who we are … In our age of social networking, the selfie is the new way to look someone right in the eye and say, “Hello, this is me.”

Although related to the Self-Directed Samaritan shot, there’s something extra-insidious about this type of super-close range photo. “Hello, this is me” takes on new meaning – there is only one subject in this photo, the white subject. Capturing this image and posting it on the internet is to understand the Other not as a separate person who exists in the context of their own family or community but rather, as a prop, an extra, someone only intelligible in relation to the Western volunteer.

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Voluntourism is ultimately about the fulfillment of the volunteers themselves, not necessarily what they bring to the communities they visit. In fact, medical volunteerism often breaks down existing local health systems. In Ghana, I realized that that local people weren’t purchasing health insurance, since they knew there would be free foreign health care and medications available every few months. This left them vulnerable in the intervening times, not to mention when the organization would leave the community.

In the end, the Africa we voluntourists photograph isn’t a real place at all. It is an imaginary geography whose landscapes are forged by colonialism, as well as a good deal of narcissism. I hope my fellow students think critically about what they are doing and why before they sign up for a short-term global volunteer experience. And if they do go, it is my hope that they might think with some degree of narrative humility about how to de-center themselves from the Western savior narrative. Most importantly, I hope they leave their iphones at home.

Cross-posted at Pacific Standard and at Mondiaal Nieuws in Dutch.

Lauren Kascak is a graduate of the Masters Program in Narrative Medicine at Columbia University, where Sayantani DasGupta is a faculty member.  DasGupta is the editor of Stories of Illness and Healing and the author of The Demon Slayers and Other Stories and Her Own Medicine.

A Reluctant Defense of Sunscreen for Men

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Lotion is socially constructed as feminine in the U.S. and so some men, attempting to avoid the prevailing insults of our time — gay, fag, bitch, pussy, douche, girl, and woman – are disinclined to use it.

Eeeew, lotion!

You know who you are, guys.

Sunscreen is a category of lotion and so putting on sunscreen is equivalent to admitting you’re the sun’s bitch.  Men are supposed to let the sun bake their face into a tough, craggy masculinity that says “yeah, I go outdoors and, when I do, I don’t give a shit.”

Because caring about one’s health is for pussies, some scholars argue that being male is the single strongest predictor of whether a person will take health risks.  In fact, thanks in part to the stupid idea that lotion carries girl cooties, men are two to three times more likely to be diagnosed with skin cancer.

So, fine dudes, here’s some sunscreen for men.  For christ’s sake.

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Thanks to @r0setayl0r and @ryesilverman for sending along the product!  Check it out on our truly humorous pointlessly gendered products Pinterest board.

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

Medicare vs. National Health Care: How U.S. Seniors Do in Cross-National Perspective

“We need to get rid of Obamacare,” says Ed Gillispie in a NYT op-ed. The reason: Obamacare’s “gravitational pull toward a single-payer system that would essentially supplant private insurance with a government program.”

Gillespie, who lays out his credentials at the start of the article – he ran for Senate in Virginia and lost – notes that Obamacare is unpopular. But he omits all mention of a government-run single-payer system that happens to be very popular – Medicare. No Republican dare run on a platform of doing away with it. Gillespie himself accused Obamacare of cutting Medicare, a statement that Politifact found “Mostly False.”

So how are seniors doing? Compared to their pre-Medicare counterparts, they are  probably healthier, and they’re probably shelling out less for health care. But compared to seniors in other countries, not so well. A Commonwealth Fund survey of eleven countries finds that seniors (age 65 and older) in the U.S. are the least healthy – the most likely to suffer from chronic illnesses.* 

Over half the U.S. seniors say that they are taking four or more prescription drugs; all the other countries were below 50%:

And despite Medicare, money was a problem. Nearly one in five said that in the past year they “did not visit a doctor, skipped a medical test or treatment that a doctor recommended, or did not fill a prescription or skipped doses because of cost.” A slightly higher percent had been hit with $2,000 or more in out-of-pocket expenses. 

In those other countries, with their more socialistic health care systems, seniors seem to be doing better, physically and financially.  One reason that American seniors are less healthy is that our universal, socialized medical care doesn’t kick in until age 65. People in those other countries have affordable health care starting in the womb. 

Critics of more socialized systems claim that patients must wait longer to see a doctor. The survey found some support for that. Does it take more than four weeks to get to see a specialist? U.S. seniors had the highest percentage of those who waited less than that. But when it came to getting an ordinary doctor’s appointment, the U.S. lagged behind seven of the other ten countries.

There was one bright spot for U.S. seniors. They were the most likely to have developed a treatment plan that they could carry out in daily life. And their doctors  “discussed their main goals and gave instructions on symptoms to watch for” and talked with them about diet and exercise.

Gillespie and many other Republicans want to scrap Obamacare and substitute something else. That’s progress I suppose. Not too long ago, they were quite happy with the pre-Obamacare status quo. Throughout his years in the White House, George Bush insisted that “America has the best health care system in the world.” Their Republican ideology precludes them from learning from other countries. As Marco Rubio put it, we must avoid “ideas that threaten to make America more like the rest of the world, instead of helping the world become more like America.”

But you’d think that they might take a second look at Medicare, a program many of them publicly support.

* Includes hypertension or high blood pressure, heart disease, diabetes, lung problems, mental health problems, cancer, and joint pain/arthritis.

Cross-posted at Montclair SocioBlog and Pacific Standard.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

The Paradox of Women’s Sexuality in Breast Feeding Advocacy and Breast Cancer Campaigns

My sister-in-law Charlotte was recently loudly admonished by a flight attendant on an international flight for allowing her “breast to fall out” after she fell asleep while nursing her baby. A strong advocate for breastfeeding, Charlotte has shared with me her own discomfort with public breastfeeding because it is considered gross, matronly, and “unsexy.”

I heard this over and over again from women I have interviewed for my research:  Women who breastfed often feel they have to cover and hide while breastfeeding at family functions. As one mom noted, “Family members might be uncomfortable so I leave room to nurse—but miss out on socializing.”  This brings on feelings of isolation and alienation. Because of the “dirty looks” and clear discomfort by others, women reported not wanting to breastfeed in any situation that could be considered “public.”

Meanwhile, I flip through the June 2012 issue of Vanity Fair and see this ad:

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We capitalize on the sexualization of the breast to raise awareness about breast cancer. Yet, we cringe at the idea of a woman nursing her child on an overnight flight.

What’s happening here? These campaigns send contradictory messages to women about their breasts and the way women should use them, but they have something in common as well: both breastfeeding advocacy and breast cancer awareness-raising campaigns tend to reduce women to body parts that reflect the social construction of gender and sexuality.

Breast cancer awareness campaigns explicitly adopt a sexual stance, focusing on men’s desire for breasts and women’s desire to have breasts to make them attractive to men. Breast milk advocates focus on the breast as essential for good motherhood. Breastfeeding mothers sit at the crossroads: Their breasts are both sexualized and essential for their babies, so they can either breastfeed and invoke disgust, or feed their child formula and attract the stigma of being a bad mother.

Both breastfeeding advocacy programs and breast cancer awareness-raising campaigns demonstrate how socially constructed notions of ownership and power converge with the sexualization and objectification of women’s breasts. And, indeed, whether breast feeding or suffering breast cancer, women report feeling helpless and not in control of their bodies. As Jazmine Walker has written, efforts to “help” women actually “[pit] women against their own bodies.”

Instead, we need to shift away from a breast-centered approach to a women-centered approach for both types of campaigns. We need to, as Jazmine Walker advocates, “teach women and girls how to navigate and control their experiences with health care professionals,” instead of pushing pink garb and products and sexualizing attempts to raise awareness like “save the ta-tas.”  Likewise, we need to support women’s efforts to breastfeed, if they choose to, instead of labeling “bad moms” if they do not or cannot. Equipped with information and bolstered by real sources of support, women will be best able to empower themselves.

Jennifer Rothchild, PhD is in the sociology and gender, women, & sexuality studies departments at the University of Minnesota, Morris. She is the author of Gender Trouble Makers: Education and Empowerment in Nepal and is currently doing research on the politics of breastfeeding.

Why Did Doctors Stop Giving Women Orgasms?

In her provocative book, The Technology of Orgasm, Rachel Maines discusses a classic medical treatment for the historical diagnosis of “hysteria”: orgasm administered by a physician.

Maines explains that manual stimulation of the clitoris was, for some time, a matter-of-fact part of medical treatment and a routine source of revenue for doctors. By the 19th century, people understood that it was an orgasm, but they argued that it was “nothing sexual.” It couldn’t “be anything sexual,” Maines explains, “because there’s no penetration and, so, no sex.”

So, what ended this practice? Maines argues that it was the appearance of the vibrator in early pornographic movies in the 1920s.  At which point, she says, doctors “drop it like a hot rock.” Meanwhile, vibrators become household appliances, allowing women to treat their “hysteria” at home. It wasn’t dropped from diagnostic manuals until 1957.

Listen to it straight from Maines in the following 7 minutes from Big Think:

Bonus: Freud was bad at this treatment, so he had to come up with some other cause of hysteria. After all, she says, “this was the guy who didn’t know what women wanted.” No surprise there, she jokes.

Cross-posted at Pacific Standard.

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

How Fetal Photography Changed the Politics of Abortion

Flashback Friday.

You have likely seen photographs of fetus’ that seem to float in a dark womb.  The first of these were taken by Swedish photographer Lennart Nilsson. One of his photographs graced the cover of Life magazine in April of 1965.

Nilsson’s images forever changed the way that people think about pregnancy, mothers, and fetuses.  Before Nilsson, the visual of a fetus independent from a mother was not widespread. His pictures made it possible for people to visualize the contents of a woman’s womb independently of her body.  Suddenly, the fetus came to life.  It was no longer just something inside of a woman, no longer even in relationship to a woman; it was an individual with a face, a sex, a desire to suck its thumb.

Once the fetus could be individualized, the idea that a woman and her fetus could have contrasting interests was easier to imagine. In many countries even today, the idea that helping pregnant women is helping fetuses and helping fetuses means helping pregnant women is still the dominant way of thinking about pregnancy. Pro-choice and other fetus-defenders, such as those who want it to be illegal to smoke during pregnancy, used these images to disentangle the interests of the woman and the fetus. The vulnerability of Nilsson’s subjects, free-floating in space, made it easier to portray fetuses as in danger.

There is power in visualization and its technological advance and these images were a boon to the pro-life cause. Ironically, it was abortion that made these images possible. Nilsson posed the fetuses to look alive, and gives no indication otherwise, but they are actually photographs of aborted fetuses.

Although claiming to show the living fetus, Nilsson actually photographed abortus material obtained from women who terminated their pregnancies under the liberal Swedish law. Working with dead embryos allowed Nilsson to experiment with lighting, background and positions, such as placing the thumb into the fetus’ mouth.

– Quote from the University of Cambridge’s history of the science of fetal development

Liberal abortion rights laws resulted in a product that was used to mobilize anti-abortion sentiment.  Today it is par for the course to have been exposed to images like this. And the rest is history.

Originally posted in 2009.

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