Tag Archives: health/medicine

Does Abortion Cause Infanticide?

Cross-posted at Montclair SocioBlog.

Does “the abortion culture” cause infanticide?  That is, does legalizing the aborting of a fetus in the womb create a cultural, moral climate where people feel free to kill newborn babies?

It’s not a new argument.  I recall a 1998 Peggy Noonan op-ed in the Times, “Abortion’s Children,” arguing that kids who grew up in the abortion culture are “confused and morally dulled.”*  Earlier this week, USA Today ran an op-ed by Mark Rienzi repeating this argument in connection with the Gosnell murder conviction.

Rienzi argues that the problem is not one depraved doctor.  As the subhead says:

The killers are not who you think. They’re moms.

Worse, he warns, infanticide has skyrocketed.

While murder rates for almost every group in society have plummeted in recent decades, there’s one group where murder rates have doubled, according to CDC and National Center for Health Statistics data — babies less than a year old.

Really? The FBI’s Uniform Crime Reports has a different picture.

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Many of these victims were not newborns, and Rienzi is talking about day-of-birth homicides — the type killing Dr. Gosnell was convicted of, a substitute for abortion.  Most of these, as Rienzi says are committed not by doctors but by mothers.  I make the assumption that the method in most of these cases is smothering.  These deaths show an even steeper decline since 1998.

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Where did Rienzi get his data that rates had doubled?  By going back to 1950.

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The data on infanticide fit with his idea that legalizing abortion increased rates of infanticide.  The rate rises after Roe v. Wade (1973) and continues upward till 2000.

But that hardly settles the issue. Yes, as Rienzi says, “The law can be a potent moral teacher.”  But many other factors could have been affecting the increase in infanticide, factors much closer to actual event — the mother’s age, education, economic and family circumstances, blood lead levels, etc.

If Roe changed the culture, then that change should be reflected not just in the very small number of infanticides but in attitudes in the general population.  Unfortunately, the GSS did not ask about abortion till 1977, but since that year, attitudes on abortion have changed very little.   Nor does this measure of “abortion culture” have any relation to rates of infanticide.

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Moreover, if there is a relation between infanticide and general attitudes about abortion, then we would expect to see higher rates of infanticide in areas where attitudes on abortion are more tolerant.

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The South and Midwest are most strongly anti-abortion, the West Coast and Northeast the most liberal.  So, do these cultural difference affect rates of infanticide?

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Well, yes, but it turns out the actual rates of infanticide are precisely the opposite of what the cultural explanation would predict.  The data instead support a different explanation of infanticide: Some state laws make it harder for a woman to terminate an unwanted pregnancy.  Under those conditions, more women will resort to infanticide.  By contrast, where abortion is safe, legal, and available, women will terminate unwanted pregnancies well before parturition.

The absolutist pro-lifers will dismiss the data by insisting that there is really no difference between abortion and infanticide and that infanticide is just a very late-term abortion. As Rienzi puts it:

As a society, we could agree that there really is little difference between killing a being inside and outside the womb.

In fact, very few Americans agree with this proposition. Instead, they do distinguish between a cluster of a few fertilized cells and a newborn baby. I know of no polls that ask about infanticide, but I would guess that a large majority would say that it is wrong under all circumstances.  But only perhaps 20% of the population thinks that abortion is wrong under all circumstances.

Whether the acceptance of abortion in a society makes people “confused and morally dulled” depends on how you define and measure those concepts.  But the data do strongly suggest that whatever “the abortion culture” might be, it lowers the rate of infanticide rather than increasing it.

* I had trouble finding Noonan’s op-ed at the Times Website.  Fortunately, then-Rep. Talent (R-MO) entered it into the Congressional Record.

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

Who is the Highest Paid Employee of Your State?

Hint from Dmitriy T.C.: he probably wears shorts to work.

Here’s the infographic, sent in also by sociologist Michael Kimmel, revealing the highest paid employee in each state.  Yellow, orange, and green states are all ones in which the most money goes to an athletic coach.  More details at DeadSpin.

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Lisa Wade is a professor of sociology at Occidental College. You can follow her on Twitter and Facebook.

Health Care Costs, Greed, and “Socialism”

Cross-posted at Montclair SocioBlog.

The Washington Post has provided some data on medical costs across a selection of countries (Argentina, Canada, Chile, and India in grey; France, Germany, Switzerland, and Spain in blue; and the U.S. in red). The data reveal that American health care is very expensive compared to other countries.

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No wonder the US spends twice as much as France on health care.  In 2009, the U.S. average was $8000 per person; in France, $4000.  (Canada came in at $4800).  Why do we spend so much?  Ezra Klein quotes the title of a 2003 paper by four health-care economists:  “it’s the prices, stupid.”

And why are US prices higher?  Prices in the other OECD countries are lower partly because of what U.S. conservatives would call socialism – the active participation of the government.  In the U.K. and Canada, the government sets prices.  In other countries, the government uses its Wal-Mart-like power as a huge buyer to negotiate lower prices from providers.  (If it’s a good thing for Wal-Mart to bring lower prices for people who need to buy clothes, why is it a bad thing for the government to bring lower prices to people who need to buy, say, an appendectomy? I could never figure that out.)

There may also be cultural differences between the U.S. and other wealthy countries, differences about whether greed, for lack of a better word, is good.  How much greed is good, and in what realms is it good?  Klein quotes a man who served in the Thatcher government:

Health is a business in the United States in quite a different way than it is elsewhere.  It’s very much something people make money out of. There isn’t too much embarrassment about that compared to Europe and elsewhere.

So we Americans roll along, paying several times what others pay for medical procedures, doctor visits, and drugs.

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

Politicians Overestimate their Constituents’ Conservatism

Dylan Matthews, blogging in the Washington Post, discusses a very interesting paper that provides evidence showing that politicians seriously underestimate the progressivity of their constituents.

David Broockman and Christopher Skovron, the authors of the paper, “surveyed every candidate for state legislative office in the United States in 2012 [shortly before the November election] and probed candidates’ own positions and their perceptions of their constituents’ positions on universal health care, same-sex marriage, and federal welfare programs, three of the most publicly salient issues in both national-level and state-level American politics during the past several years.”  They then matched the results with estimates of the actual district- and issue-specific opinions of those residing in the candidates’ districts using a data set of almost 100,000 Americans.

Here is what they found:

Politicians consistently and substantially overestimate support for conservative positions among their constituents on these issues. The differences we discover in this regard are exceptionally large among conservative politicians: across both issues we examine, conservative politicians appear to overestimate support for conservative policy views among their constituents by over 20 percentage points on average… Comparable figures for liberal politicians also show a slight conservative bias: in fact, about 70% of liberal office holders typically underestimate support for liberal positions on these issues among their constituents.

The following two charts illustrate this bias when it comes to universal health care and same sex marriage.

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As Matthews explain:

The X axis is the district’s actual views, and the Y axis their legislators’ estimates of their views. The thin black line is perfect accuracy, the response you’d get from a legislator totally in tune with his constituents. Lines above it would signify the politicians think the district more liberal than it actually is; if they’re below it, that means the legislators are overestimating their constituents’ conservatism. Liberal legislators consistently overestimate opposition to same-sex marriage and universal health care, but only mildly. Conservative politicians are not even in the right ballpark.

The authors found a similar bias regarding support for welfare programs.  Perhaps even more unsettling, the authors found no correlation between the amount of time candidates spent meeting and talking to people in their districts while campaigning for office and the accuracy of their perceptions of the political positions of those living in their districts.

One consequence of this disconnect is that office holders, even those with progressive views, are reluctant to take progressive positions.  More generally, these results speak to a real breakdown in “the ability of constituencies to control the laws that their representatives make on their behalf.”

Martin Hart-Landsberg is a professor of economics at Lewis and Clark College. You can follow him at Reports from the Economic Front.

Cultural Messages in a Safer Sex Pamphlet for Transmen

The representation of sexuality and safer sex in public health campaigns is fascinating given our simultaneous cultural obsession with yet pathologization of sexual behavior.  Safer sex campaigns and materials not only seek to increase prevention behaviors but also produce a range of social meanings surrounding gender, bodies, and desire.  Most are produced by organizations that fall well within the mainstream; others are not.  This post is about one of the latter (warning: sexual explicitness).

The following resource, titled “5 Reasons tm4mto Fuck a Transguy” was produced and distributed by a collaborative project of the San Francisco-based Asian and Pacific Islander Wellness Center.  tm4m is a group for transgender men whose goal is to “provide information, education and support to transmen who have sex with men (both other transguys and cisguys).”

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This material is interesting for two main reasons.  First, it combines traditional health education with an erotic, sex-positive context that is missing from most public health campaigns.  For the most part, public health approaches to HIV prevention and sexual health promotion utilize a “sex-negative” approach to sexual behavior; in other words, sex is represented as potentially dangerous or problematic and focus narrowly focused on its negative aspects, such as disease transmission.  Even more progressive “comprehensive” approaches to sexual health education (that is, approaches that do not focus solely on abstinence) tend to center on the potentially dangerous outcomes of sex and how to prevent them while ignoring the pleasurable and fun aspects of sexuality.

In contrast, “5 Reasons to Fuck a Transguy” depicts a naked transman with safer sex barriers (condom and a glove) and uses explicit language (“fuck” instead of “sex” and “cock” instead of “penis”) and imagery.  For example, in reason #2 we see two people about to engage in strap-on play and in #5 we see a guy that appears to be receiving oral sex or relaxing in a state of post-sex ecstasy.  This sort of language and imagery is absent from the vast majority of sexual health promotion materials aimed at a wide variety of populations.  Thus, in “5 Reasons to Fuck a Transguy,” safer sex is not presented as distinct and separate from sexual pleasure.

Second, the material uses an embodied approach to highlight differences between trans and cisgender men while at the same time eroticizing that difference.  Starting with reason #1 (“trans guys are hot”) we are invited to see the transmale body as the object of desire.  Reasons #2, #3, and #4 call attention to the physical differences between cisgender and transgender male bodies and eroticizes the latter by emphasizing interchangeable cock sizes, more holes to penetrate, and smaller hands for fisting (or using the whole hand for penetration).  Finally, reason #5 alludes to a fetishization of transmen: the transgender body incites curiosity that will ultimately pay off in enhanced pleasure.

Not everyone agrees this is good.  Some posts on Tumblr challenged the idea that transgender men are a sort of erotic “other” or that they will necessarily consent to the activities depicted in the pamphlet:

You better not assume I’m comfortable using the one that “other” guys don’t have and you better not assume that being a guy means I’d be up for being fucked in the ass, either. Go fuck yourself and make your own goddamn third hole.

The “your dick can be any size you want!” argument is like telling a female-identified survivor of breast cancer who’s had a mastectomy “your tits can be any size you want!”

Just because I don’t have my own natural cock doesn’t make me this insane sex toy thing that’s such an anomaly and such a fetish object and so very very strange and different.

So, despite the disclaimer that “every transguy is unique,” some viewers saw the material’s approach as a problemtic eroticization of their bodies and gender.

In sum, “5 Reasons to Fuck a Transguy” moves beyond typical sexual health promotion approaches to include desire and pleasure, but doesn’t avoid the problem of sending its own cultural messages about gender, bodies, and desire, ones that may be problematic from an entirely different point of view.

Christie Barcelos is a doctoral candidate in Public Health/Community Health Education at the University of Massachusetts Amherst.

Urbanization and the “Baby Cage”

Inequality by (Interior) Design, a blog by sociologist Tristan Bridges, turned one-year-old last month and it is quickly becoming one of my favorites.  In a recent post, Bridges featured a product that reminds us all why history is awesome: the “portable baby cage”:

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As I discussed in a previous post, with industrialization came cities and with cities came crowded, cramped living quarters.  The baby cage kept infants out of harm’s way and gave the family a bit more space.  As Bridges discusses, it also coincided with the idea that babies needed a lot of fresh air to be healthy.  The baby cage seemed like the perfect solution.

Lisa Wade is a professor of sociology at Occidental College. You can follow her on Twitter and Facebook.

Reflections on Racism, Both Individual and Systemic

Cross-posted at Tim Wise’s website.

It’s one of those stories that can leave even the most jaded and cynical critic of racist thinking scratching their head; the kind that manages to shock even those of us for whom acts of bigotry and intolerance seem all-too-typical, and who have, sadly, come to expect them in a culture such as this.

And so it was that in Flint, Michigan recently, a new father — and this is a term he has earned in only the most narrow, biological sense — demanded that when his recently arrived child was sent to the Neonatal Intensive Care Unit of the hospital where she had been born, no African American nurses were to attend to her needs, to care for her, to do what neonatal ICU nurses do, which is to say keep sick babies alive. White hands only for this white, fresh as snow child, whose father, sporting a shiny new swastika tattoo (a Christmas present no doubt from his pathetic skinhead bride) prioritized his own hatreds above and beyond the needs of his precious little girl.  That the future does not bode well for her seems hardly worth saying. To be delivered from an ICU into the arms of one as unhinged as this can only, by reasonable people, be seen as a turn for the worse. Incubators and breathing machines might be preferable to having parents such as she has, through no fault of her own, inherited.

But what is worse, perhaps, than the bigotry of this one neo-Nazi — which is at least to be expected and so, can, despite its irrationality in a case such as this, remain somewhat within the realm of the banal — is that the hospital in question, Hurley Medical Center, actually capitulated to his psychotically racist demands, posting a sign on the little girl’s chart instructing the unit to disallow any black nurses from as much as touching this baby.

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Presumably, were Tonya Battle, a black Hurley neonatal nurse since 1988 the only nurse within arms reach of the girl as she entered cardiac arrest or as her kidneys began to shut down — both of which have been known to happen to those in a NIC-U — Battle was to scream loudly for a white nurse to come and save the child’s life. Because God forbid a black woman with 25 years experience do the job. And if she dies, well, at least her precious white skin wouldn’t have been sullied by black hands.

Hurley’s acquiescence to this insanity, in contravention of all ethical responsibility, not to mention legal obligations to treat their employees in a non-discriminatory fashion, is going to cost them no doubt, as they are apt to discover once the lawsuit currently brought against their witless administrators plays out. They are going to pay, and pay big, as they should, for their enabling of overt white supremacy. But that is hardly the most important part of this story. Just as it was not the most important part of the story back in 2000 when a heart specialist at St. Thomas Hospital in Nashville did a similar thing, agreeing to the lunatic ravings of another racist white man, who demanded that his wife, who needed open heart surgery to save her life, not be attended to by any black doctor, because he didn’t want a black man to see his wife naked.

More interesting, I think, is what this story (and the earlier one from Nashville) says about racism in America, and not just of the sort evinced by one bottom-feeder, troglodytic fan of Adolf Hitler. For while we are too quick to presume racism to be merely an individual pathology manifested by individually bad people, much like the father in the story from Flint, the fact is, an incident like this illustrates as well as anything can, the way that racism continues to operate as a systemic force in the United States, civil rights laws and all our vaunted post-raciality notwithstanding.

To understand what I mean by this, consider something I am often asked as I travel the country, speaking about racism, or in reply to one or another column or book that I’ve written: namely, it is queried, why don’t I ever talk about black racism, or, just generally, racism against white people? Why, it is wondered, do I focus on racism only when it’s deployed by whites?

There are many things I could say, and do, when asked something like this. But for now, let it suffice to say that this story, from Michigan, involving a white institution as respected as a hospital bending to the whims of a fucking Nazi, is more than enough of a reason for my selective attention. And this is true for multiple reasons.

First, what the story demonstrates is how much more potent white racism is than any potentially parallel version practiced by peoples of color. Simply put, there is no way that any bigoted black person, or Latino, or Asian American, or indigenous person, could possibly have made a similar demand in the reverse direction — that no white nurses attend to their newborn — and expect to have that insistence met with approval and acquiescence. Anyone who thinks a hospital would have agreed to such a thing — to actually deny opportunity to white nurses or doctors, and to limit the care of such a child to same-race caregivers because of the expressed bigotry of a patient — is either so overly medicated or mentally damaged as to make further discussion impossible. In other words, even when a white racist who is likely not of substantial economic means makes a racist demand, his desires can get ratified, and in ways that not even the wealthiest person of color could expect to have happen.*

And this is because — and this is what is especially pertinent to the matter of institutional racism — even if a hospital was willing to go along with the ridiculous and bigoted demands of a hateful person of color, that no whites be allowed to touch their black or brown baby, it would be virtually impossible to fulfill such a request. And why? Simple. Because given the history of unequal opportunity in medical professions, from doctoring to nursing — and also just given the demographic and power dynamics within pretty much any institution you can name — to work around white professionals, even if one wanted to, is almost impossible.

Bottom line: the hospital in this case went along with the demand to exclude blacks from attending to this child because they could. Given the history of discrimination in access to the medical profession, including nursing, and the barriers to professional practice faced by too many people of color, there exists today a more limited number of such professionals from which to draw. As such, excluding them from a particular hospital unit or assignment is hardly a huge burden for the institution in question.

But imagine what would happen if the situation were reversed, and a racist black man had demanded the exclusion of whites from caring for his child. Even if there were a doctor willing to agree to such conditions, it would be virtually impossible for him or her to follow through, because whites — having received the opportunities needed to enter the nursing profession in larger numbers — are hard to work around. “No whites” policies would result in a lot of empty NIC-Us, whereas “No blacks” policies require only a small administrative headache at best, so fewer are such professionals in the first place. And so, given the history of racial inequity, the consequences of which we still experience, white bigotry of the individual type is operationalized and activated if you will, by the institutional injustices that have resulted in the over-represantaion of whites and under-representation of black and brown folks in certain jobs to begin with.

In other words, institutional racism is akin to the gasoline, allowing the otherwise stationary combustion engine of individual racism to function: the former gives the latter life, and the ability to impact others in a meaningful and detrimental way. Without the power to enforce one’s racism, or expect it to be enforced or enforceable by others, that racism is largely sterile. Which is why white racism is simply more worthy of our attention and concern than any other form.

Much the same would be true in other realms of life, beyond medical and hospital settings. Blacks who wish to avoid whites in their neighborhoods will typically find themselves limited to the poorest, most crowded areas of town — places whites long ago abandoned — since finding Caucasian-free zones in more prosperous suburbs can be a tough task. Whites can more or less live wherever we wish. If we are not to be found in a particular census tract you can bet it’s because we’ve chosen to be absent. Such cannot be said for why blacks are often absent from more affluent areas, however. Money or no money, good credit or bad, millions face discriminatory barriers in residential opportunity every year.

Once again, even if people of color despise whites and seek to avoid us, their ability to do so will be directly constrained by the larger opportunity structure that has skewed power and resources in our direction. Whites seeking to avoid blacks and Latinos on the other hand, can do so readily, with the help of mortgage discrimination, redlining, zoning laws and so-called “market forces” pricing many blacks out of the better housing markets (even though we only got into those markets because of government subsidies and preferences, both private and public).

So for those seeking to understand what racism is — and the difference between the merely individual as opposed to institutional forms of it — and why white racism is more potent and problematic than any other potential form, you need look no further than the recent headlines. When institutions can and will collaborate with and directly empower the racism of even the most deranged of bigots, you know that we have yet to arrive at that place of racial ecumenism claimed for us by those who would rather gloss over the ongoing injustices we face, and pretend to have attained, as a people, a perch to which we have no ethical right to lay claim.

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*Please note, I wish to differentiate here between those patients whose desire for same-race/ethnic nurses or doctors is motivated by apparent bigotry, on the one hand, and those whose desire for such a thing might be motivated by such things as linguistic familiarity, on the other. So, for instance, a Spanish-speaking, or for that matter, German or Russian-speaking mother-to-be might request a nurse, or anesthesiologist who speaks their language, for reasons of comfort and communication. Additionally, it is possible that given the history of difficulties in cross-cultural communication between authority figures who are white and patients/clients who are persons of color (which has been studied and documented for years), a black patient might prefer, if possible, to have a black nurse or anesthesiologist to wait on them. Although even these cases are likely rare, they would not be remotely comparable to a blatant bigot demanding same-race care for reasons comparable to the facts in this story, or the 2000 story from Nashville.

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Tim Wise is among the most prominent anti-racist writers and educators in the United States.  The author of six books on race in America, he has spoken on over 800 college and high school campuses and to community groups across the nation.  His new book, The Culture of Cruelty, will be released in the Fall of 2013.

Wall St. to the Middle Class: “You’ve Got It Made!”

Cross-posted at Montclair SocioBlog.

The Wall Street Journal had an op-ed this week by Donald Boudreaux and Mark Perry claiming that things are great for the middle class.  Here’s why:

No single measure of well-being is more informative or important than life expectancy. Happily, an American born today can expect to live approximately 79 years — a full five years longer than in 1980 and more than a decade longer than in 1950.

Yes, but.  If life-expectancy is the all-important measure of well-being, then we Americans are less well off than are people in many other countries, including Cuba.

The authors also claim that we’re better off because things are cheaper:

…spending by households on many of modern life’s “basics” — food at home, automobiles, clothing and footwear, household furnishings and equipment, and housing and utilities — fell from 53% of disposable income in 1950 to 44% in 1970 to 32% today.

Globalization probably has much to do with these lower costs.  But when I reread the list of “basics,” I noticed that a couple of items were missing, items less likely to be imported or outsourced, like housing and health care.  So, we’re spending less on food and clothes, but more on health care and houses. Take housing.  The median home values for childless couples increased by 26% between just 1984 and 2001 (inflation-adjusted); for married couples with children, who are competing to get into good school districts, median home value ballooned by 78% (source).

The authors also make the argument that technology reduces the consuming gap between the rich and the middle class.  There’s not much difference between the iPhone that I can buy and the one that Mitt Romney has.  True, but it says only that products filter down through the economic strata just as they always have.  The first ball-point pens cost as much as dinner for two in a fine restaurant.  But if we look forward, not back, we know that tomorrow the wealthy will be playing with some new toy most of us cannot afford. Then, in a few years, prices will come down, everyone will have one, and by that time the wealthy will have moved on to something else for us to envy.

The readers and editors of the Wall Street Journal may find comfort in hearing Boudreaux and Perry’s good news about the middle class.  Middle-class people themselves, however, may be a bit skeptical on being told that they’ve never had it so good (source).

Some of the people in the Gallup sample are not middle class, and they may contribute disproportionately to the pessimistic side.  But Boudreaux and Perry do not specify who they include as middle class.  But it’s the trend in the lines that is important.  Despite the iPhones, airline tickets, laptops and other consumer goods the authors mention, fewer people feel that they have enough money to live comfortably.

Boudreaux and Perry insist that the middle-class stagnation is a myth, though they also say that

The average hourly wage in real dollars has remained largely unchanged from at least 1964—when the Bureau of Labor Statistics (BLS) started reporting it.

Apparently“largely unchanged” is completely different from “stagnation.”  But, as even the mainstream media have reported, some incomes have changed quite a bit (source).

The top 10% and especially the top 1% have done well in this century.  The 90%, not so much. You don’t have to be too much of a Marxist to think that maybe the Wall Street Journal crowd has some ulterior motive in telling the middle class that all is well and getting better all the time.

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