Sociological Images

Recently Talking Points Memo posted a 1960s coloring book sent in by a reader, who found it among her grandmother’s things. The coloring book, New Frontier, mocks John F. Kennedy and a number of his policies.

What’s fascinating is how closely some of the arguments in it match rhetoric in the presidential debate today. There’s concern that the President’s programs — in this case, Medicare — will negatively affect the quality of medical care, inserting the federal government between patients and doctors:

And an association with Harvard advisors was worthy of scorn then, too:

Another accuses Kennedy of attacking business at the expense of dealing competently with external national security threats:

It’s an interesting reminder that many of the attacks we see against President Obama today aren’t new; there’s the newest round in an ongoing struggle about social policies and political priorities.

NPR’s Planet Money blog posted this image showing changes in major categories of federal spending over the past 50 years. Notably, though defense spending (which includes veteran benefits) is still the largest category of federal spending, it’s a much smaller proportion of the total budget than it was in the ’60s; spending on interest on our debt has also fallen quite a bit since the ’80s. On the other hand, spending on Social Security, Medicare and Medicaid (which didn’t even exist in 1962), and safety net programs (including food stamps and unemployment) have grown. The somewhat reduced “everything else” category includes everything from education to space exploration to agriculture and more:

Via The Sociological Cinema; data available at the Office of Management and Budget.

Cross-posted at Montclair SocioBlog.

In case you wondered about what we in the U.S. pay for health care compared with those unfree unfortunates who suffer under various forms of socialized medicine, here are some graphs from 2009 showing the advantages of what is sometimes called “the best health care system in the world.”

The graphs are from the International Federation of Health Plans. I’ve selected only four — to show the relative costs* of

• an office visit
• a day in the hospital
• a common procedure (childbirth without complications)
• a widely used drug (Lipitor)

You can download all the charts here, but be warned: it gets boring. We’re number one in every chart, at least in this one category of how much we shell out.

Since we have the best health care in the world, this must mean that you get what you pay for. Our Lipitor must be four to ten times as good as the Lipitor that Canadians take.

Hat tip: Ezra Klein.

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*These amounts are what providers are paid by governments or other insurers, not what the patient pays, which in many Eurpean countries is essentially nothing. See the footnotes for the tables in the original document. Or look at the comments on this at Boing Boing, a discussion which is remarkably civil (do they monitor comments?).

If you live in the U.S. you are absolutely bombarded with the idea that being overweight is bad for your health.  This repetition leaves one with the idea that being overweight is the same thing as being unhealthy, something that is simply not true.  In fact, people of all weights can be either healthy or unhealthy; overweight people (defined by BMI) may actually have a lower risk of premature death than “normal” weight people.  Being fat is simply not the same thing as being unhealthy.

The Health At Every Size (HAES) movement attempts to interrupt the conflation of health and thinness by arguing that, instead of using one’s girth as an indicator of one’s health, we should be focusing on eating/exercising habits and more direct health measures (like blood pressure and cholesterol).

A recent study offered the HAES movement some interesting ammunition in this battle. The study recruited almost 12,000 people of varying BMIs and followed them for 170 months as they adopted healthier habits.  Their conclusion? “ Healthy lifestyle habits are associated with a significant decrease in mortality regardless of baseline body mass index.”

Take a look.  The “hazard ratio” refers to the risk of dying early, with 1 being the baseline.  The “habits” along the bottom count how many healthy habits a person reported.  The shaded bars represent people of different BMIs from “healthy weight” (18.5-24.9) to “overweight” (25-29.9), to “obese” (over 30).

The three bars on the far left show the relative risk of premature death for people with zero healthy habits. It suggests that being overweight increases that risk, and being obese much more so.  The three bars on the far right show the relative risk for people with four healthy habits; the differential risk among them is essentially zero; for people with healthy habits, then, being fatter is not correlated with an increased relative risk of premature death.  For everyone else in between, we more-or-less see the expected reduction in mortality risk given those two poles.

This data doesn’t refute the idea that fat matters.  In fact, it shows clearly that thinness is protective if people are doing absolutely nothing to enhance their health.  It also suggests, though, that healthy habits can make all the difference.  Overweight and obese people can have the same mortality risk as “normal” weight people; therefore, we should reject the idea that fat people are “killing themselves” with their extra pounds.  It’s simply not true.

h/t to BigFatBlog.

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

Given our collection of toy make-overs, I was curious when I heard that Quaker Oats had re-vamped their mascot, Larry.  In the toys we’ve covered, the trend is towards greater feminization and sexualization.  Larry, though, is a dude.  And do we really need to sexualize our oatmeal?  (Well, you never know.)

It turns out what prompted the mascot make-over wasn’t an effort to make Larry sexier, but to make him look healthier.  According to the Wall Street Journal, the director of Quaker’s brand-design firm wanted to reinforce people’s association of oatmeal with “energy and healthy choices.”  And by “healthy,” they mean “thin.”   They reduced the roundness of his chin and cheeks.  They also gave him a hair cut in order to expose the sides of his neck.  Another representative of the brand redesign explains: ”It’s the same neck,” but the haircut “makes him look thinner… We took about five pounds off him.”

If it’s tough for you to tell the difference between the two, it’s by design.  Quaker wants the changes to work on a subconscious level.  A fascinating peak into the motives and tactics of brand management.

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

Autism appears to be on the rise. The U.S. Centers for Disease Control and Prevention reports that there are 20 times more cases of autism today than there were in the 1980s.  This figure, from the Los Angeles Times, shows a 200% increase in California:

The rise in cases of autism led scientists to ask whether there was an actual increase in incidence or if we were just getting better at identifying it.  The evidence seems to suggest that it’s (at least mostly) the latter.  Said anthropologist Roy Richard Grinker: “Once we are primed to see something, we see it and wonder how we could have never seen it before.”

But how to explain disparities like this?

Often regional differences in health and mental health can be traced to heavier environmental toxin loads.   In most of those cases, though, clusters of illness occur in poor and often disproportionately non-white neighborhoods.  Autism clusters were happening in class-privileged places.

Sociologist Peter Bearman discovered that these clusters were the result of conversation.  Class-privileged parents had the resources to get their child diagnosed, then they talked to other parents.  Some of these parents would recognize the symptoms and take their child to the doctor and… voila… a cluster.  ”Living within 250 meters [of a child diagnosed with autism], reports the Los Angeles Times, boosted the chances by 42%, compared to living between 500 and 1,000 meters away.”

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

PBS has a gallery of images of oral contraceptives that provides a nice illustration of the way product design can be used as a form of behavior modification, while also needing to adapt to the way people actual use products — or forget to do so, the ever-present problem with the pill.

Initially , the pill came in bottles, like other prescriptions:

Notice the bottle contains 100 pills; there was no effort to package it into quantities for a single month. Women were supposed to take 20 pills in a row, then none during their period. It was up to them to keep track of everything and remember when it was time to start taking the pills again.

In 1962, an engineer created a prototype of a dispenser pack, designed to hold exactly a month’s worth of pills and help women remember to take them correctly:

The first contraceptive in a pack of this type, Dialpak, appeared the next year; oral contraceptives packaging has been designed to help women remember to take them accurately ever since. This became a major selling point, with Dialpak 21 even offering a small calendar you could attach to a special watch band so you could more easily keep track of whether you’d taken the pill:

In 1965, Eli Lilly introduced a new packaging design, with differently-colored pills arranged in a sequence; however, it didn’t label the days of the week, so it didn’t help women figure out if they’d remembered to take their pill on any given day:

Norinyl came in a package that took the sequential design but added several features that enhanced compliance. An extra pill was added, so that pills with active ingredients were taken for 21 days, not 20. Then a row of placebo pills were added so that women took a pill every day of the month, so they were less likely to forget to start a new pack:

When we think about the emergence and success of the pill, we tend to focus on the product itself. But the packaging tells an interesting story on its own. The pharmacological effectiveness of oral contraceptives meant little if women forgot to take them reliably. The design of the packaging helped play a crucial role, increasing users’ ability to follow the prescribed schedule.

Today, there’s an entire trade organization, the Healthcare Compliance Packaging Council, dedicated to promoting attention to the design of packaging as an important element in all areas of healthcare. The pill was the first prescription drug sold in a so-called “compliance pack,” serving as an example of the potential effectiveness of packaging design as a way to encourage patients’ conformity to prescribed medication regimens.