Tag Archives: health/medicine

Where Americans’ 2014 Tax Dollars Went

Every year the National Priorities Project helps Americans understand how the money they paid in federal taxes was spent. Here’s the data for 2014:

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Since the 1940s, individual Americans have paid 40-50% of the federal government’s bills through taxes on income and investment. Another chunk (about 1/3rd today) is paid in the form of payroll taxes for things like social security and medicare. This year, corporate taxes made up only about 11% of the federal government’s revenue; this is way down from a historic high of almost 40% in 1943.

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Visit the National Priorities Project here and find out where state tax dollars went, how each state benefits from federal tax dollars, and who gets the biggest tax breaks. Or fiddle around with how you would organize American priorities.

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.

Chart of the Week: Male Nurses Outearn Female Ones Every Which Way

According to the U.S. Bureau of Labor Statistics, fully employed women earn $0.81 for every dollar men make. Some of this discrepancy is due to women working in male dominated occupations, but when men work alongside women in female-dominated occupations, they still earn more.

Nursing is this week’s example. According to a new study in the Journal of the American Medical Association, male nurses out earn female nurses in every work setting, every clinical setting, and every job position except one.

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On average, male nurses make $5,100 more a year than female ones. In the specialty with the biggest discrepancy, nurse anesthetists, they out earned women by $17,290. More at NPR and the New York Times.

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.

Is Marijuana a Gateway Drug? Findings Lean from Mixed to No

All politicians lie, said I.F. Stone. But they don’t all lie as blatantly as Chris Christie did last week in repeating his vow not to legalize marijuana in New Jersey.

Every bit of objective data we have tells us that it’s a gateway drug to other drugs.

That statement simply is not true. The evidence on marijuana as a gateway drug is at best mixed, as the governor or any journalist interested in fact checking his speech could have discovered by looking up “gateway” on Wikipedia.

If the governor meant that smoking marijuana in and of itself created a craving for stronger drugs, he’s just plain wrong. Mark Kleiman, a policy analyst who knows a lot about drugs, says bluntly:

The strong gateway model, which is that somehow marijuana causes fundamental changes in the brain and therefore people inevitably go on from marijuana to cocaine or heroin, is false, as shown by the fact that most people who smoke marijuana don’t. That’s easy. But of course nobody really believes the strong version.

Nobody? Prof. Kleiman, meet Gov. Christie

Or maybe Christie meant a softer version – that the kid who starts smoking weed gets used to doing illegal things, and he makes connections with the kinds of people who use stronger drugs. He gets drawn into their world. It’s not the weed itself that leads to cocaine or heroin, it’s the social world.

That social gateway version, though, offers support for legalization.  Legalization takes weed out of the drug underworld. If you want some weed, you no longer have to consort with criminals and serious druggies.

There are several other reasons to doubt the gateway idea. Much of the evidence comes from studies of individuals. But now, thanks to medical legalization, we also have state-level data, and the results are the same. Legalizing medical marijuana did not lead to an increase in the use of harder drugs, especially among kids. Just the opposite.


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First, note the small percents. Perhaps 1.6% of adults used cocaine in the pre-medical-pot years. That percent fell slightly post-legalization. Of course, those older people had long since passed through the gateway, so we wouldn’t expect legalization to make much difference for them. But for younger people, cocaine use was cut in half. Instead of an open gateway with traffic flowing rapidly from marijuana through to the world of hard drugs, it was more like, oh, I don’t know, maybe a bridge with several of its lanes closed clogging traffic.

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

Chart of the Week: Big Pharma Spends More on Marketing than Research

Pharmaceutical companies say that they need long patents that keep the price of their drugs high so that they can invest in research. But that’s not actually what they’re spending most of their money on. Instead, they’re spending more — sometimes twice as much — on advertising directly to doctors and consumers.

Data from the BBC, visualized by León Markovitz:

2“When do you cross the line from essential profits to profiteering?,” asked Dr Brian Druker, one of a group of physicians asking for price reductions.

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.

Why Are There So Many Mardi Gras Parades?

The first Mardi Gras parade wound its way through New Orleans in 1856, over 150 years ago. Today there are, by my count, sixty-eight official Mardi Gras parades in New Orleans and the vicinity. No doubt there are many more informal groups. Each is a private organization, typically still called krewes, wholly funded by its members.

In this sense, Mardi Gras is truly a product of local New Orleanians who choose to play a role in creating its magic every year. That is, unlike other spectacles — like the city of Las Vegas or the Macy’s Thanksgiving Day Parade — Mardi Gras in New Orleans is a non-corporate holiday facilitated, but not put on by, the city or state government. Even in light of it’s oppressive past and present, it is truly one of the most purely generous, creative, and authentic things I have ever had the pleasure to observe.

Understanding why there are so many parades is part of the story.

First, krewes have traditionally been segregated by race and gender. New krewes have formed to enable the participation of excluded groups (Zulu 1909, Iris 1917) or integrate the tradition (e.g., Orpheus 1993).

Iris:

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Krewes have also emerged as commentary on this sort of exclusion. The Krewe of Tucks was started by two white male Loyola students in 1969. They wanted to parade as flambeaux carriers — a nod to the original form of parades in which slaves or free men of color carried flames through the streets to illuminate the floats — but were denied. No white person had ever carried the flambeaux.

Annoyed, they started their own parade aimed at mocking the whole parade tradition. Their king sits on a toilet throne and to this day they TP the city in toilet paper as they parade through the streets.

Tucks, 2014 (New Orleans Advocate):

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Other parades simply reflect the unending creativity and ingenuity of the people of New Orleans. Responding to the increasing grandeur of Mardi Gras floats over time, ‘tit Rex (as in “petite”) decided to go miniature. Every year, members build tiny floats on a theme and parade them through the Marigny neighborhood. The theme in 2013? “Wee the people.”

‘tit Rex, 2013:

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Not enough sci-fi in the super krewes? There is the Krewe of Chewbacchus — riffing off the famous Krewe of Bacchus. These BacchanAliens offer an intergalactic parade, tripping down the streets of New Orleans with a Bar-2-D2 and other creations.

Chewbacchus, 2013 and 2014:

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Other parades came about to serve neighborhoods or individuals who were isolated geographically or by mobility. The Krewe of Thoth (1948) was founded in order to offer a parade to the residents of 14 institutions, off the typical parade route, that served people with illnesses or disabilities, bringing Mardi Gras to those who couldn’t come to it. Other krewes emerged simply to serve neighborhoods that tourists rarely visit.

Thoth, 2014 (notice the Tucks TP in the tree on the left):

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So there are the stories of a few Mardi Gras krewes, helping to explain the bounty of parades available to enjoy in New Orleans. If you have any favorites, please add them in the comments!

Cross-posted at A Nerd’s Guide to New Orleans.

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.

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.

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 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.