4One of the first things other academics ask me is “why are you interested in toilets?”

For the vast majority of people, the biological function of waste excretion is an after thought, an activity that nobody wants to talk about, and often times, the mere thought of talking about shit grosses them out. I, however, am fascinated by the human and political dimensions of human waste and the challenges that solving the global sanitation crisis presents. More than excrement itself, I’m interested in a holistic view of sanitation (waste disposal, transportation, removal, treatment and reuse). This interest stems primarily from my training as a chemical engineer, my work experience as a sanitation engineer and researcher, and my interest from my doctoral studies in understanding the politics of policy intervention.

Contrary to what one might think, toilets are political. Owning a toilet will become a necessary prerequisite for politicians to run for office in Gujarat, India. The new Prime Minister of India, Shri Narendra Modi, has made ending open defecation and increasing access to toilets one of his campaign promises and a crucial component of his political and public policy agenda. Modi’s “toilets first, temples later” has been seen as a strong statement in favor of increasing toilet and latrine access in India.

In my own work I have emphasized that even if we have the technical capabilities to increase access to toilets, latrines and sanitation infrastructure, often times we see lack of progress because institutional, cultural, behavioral and societal barriers have been erected through time. I have shown that the behavioral determinants of sanitation governance are complex and multicausal, and also have multiple effects. Not having a toilet in your own home or easily accessible can lead to violence and physical/sexual assault. Lack of toilets affects women disproportionately and leaves them vulnerable to physical violence. Earlier this year I wrote about the complex linkages between menstrual hygiene management, access to toilets, and violence against women.

To end open defecation and increase sanitation access, we need a set of policy strategies that aren’t solely focused (individually) on cultural practices, or access to latrines, or poverty alleviation. All these factors must be tackled simultaneously.

World Toilet Day takes place on November 19th. This year finally the United Nations named World Toilet Day an official UN day, although for all the noise it has been making, we are WAY behind the target for the Millennium Development Goals. If we really want to end open defecation by 2025, as the UN indicates, we are definitely going to need a better approach. In my own research, I have found that institution- and routine-based strategies help increase access to sanitation. I have also argued that access to toilets can be used as a political manipulation strategy. We should be interested in the global politics of sanitation because the crisis is far-reaching and widespread.

Today, I encourage you to reflect on the fact that over 1 billion people defecate in the open because they lack the dignity of a toilet, and that 2.6 billion people don’t have access to improved water and sanitation sources.

Think about it. It IS political. Because we can’t wait to solve the global sanitation crisis.

Raul Pacheco-Vega, PhD is a professor of Resource Management and Environmental Studies with a specialty in the global politics of sanitation. You can follow him at raulpacheco.org, where this post originally appeared, and on Twitter and Facebook.

Flashback Friday.

Joan Jacob Brumberg’s fantastic book, Fasting Girls: The History of Anorexia Nervosa, is an excellent example of the benefits of sociologically-inspired history.  Brumberg begins by explaining that girls who starved themselves have been recorded in many historical epochs, but the way in which societies have made sense of that starvation has varied.

Today we medicalize self-starvation; we call it a mental illness and we name it “anorexia nervosa.”

In Medieval Europe, fasting girls were labeled with the term “anorexia mirabilis”; these girls were seen as miracles, able to survive on spiritual devotion alone. During the Victorian Era, people would pilgrimage to these fasting girls and leave offerings.  A famous fasting girl could be a financial boon to a struggling family.

Fasting Girl Mollie Fancher in 1887:


During the nineteenth century, medical doctors and psychiatrists (who generally saw religion as a threat to their nascent authority) argued that the fasting girls were impossibilities, that no one could survive without food. The competition between medicine and religion became so intense that doctors became intent on proving that these fasting girls were not surviving on holiness, but were sneaking food. In several cases, doctors staked out fasting girls, watching her to make sure that she did not eat, and these girls, relentless in the illusion, sometimes died.

In any case, I thought of Brumberg’s book when I came across a story about Prahlad Jani, an Indian man who claims that he has not had any food or drink for 70 years, surviving on “spiritual life force” instead.

In 2003 and 2010, Jani’s claims were tested by physicians. In the latest round, Indian military scientists held him in a hospital, watching him to ensure he did not eat or drink.  Unlike the doctors in the Victorian era, however, who wanted the girls to fail, these doctors think Jani might hold a secret that will be useful for the military and they’re hoping that, by watching, they will be able to discover it.

They released him after 15 days. As they did in 2003, they said that his tests came back normal despite complete abstinence from food and water.

Originally posted in 2010.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

The 1% in America have an out-sized influence on the political process. What policies do they support? And do their priorities differ from those of less wealthy Americans?

Political scientist Benjamin Page and two colleagues wanted to find out, so they started trying to set up interviews with the richest of the rich. This, they noted, was really quite a feat, writing:

It is extremely difficult to make personal contact with wealthy Americans. Most of them are very busy. Most zealously protect their privacy. They often surround themselves with professional gatekeepers whose job it is to fend off people like us. (One of our interviewers remarked that “even their gatekeepers have gatekeepers.”) It can take months of intensive efforts, pestering staffers and pursuing potential respondents to multiple homes, businesses, and vacation spots, just to make contact.

Persistence paid off. They completed interviews with 83 individuals with net worths in in the top 1%.  Their mean wealth was over $14 million and their average income was over $1 million a year.

Page and his colleagues learned that these individuals were highly politically active. A majority (84%) said they paid attention to politics “most of the time,” 99% voted in the last presidential election, 68% contributed money to campaigns, and 41% attended political events.

Many of them were also in contact with politicians or officials. Nearly a quarter had conversed with individuals staffing regulatory agencies and many had been in touch with their own senators and representatives (40% and 37% respectively) or those of other constituents (28%).

These individuals also reported opinions that differed from those of the general population. Some differences really stood out: the wealthy were substantially less likely to want to expand support for job programs, the environment, homeland security, healthcare, food stamps, Social Security, and farmers. Most, for example, are not particularly concerned with ensuring that all Americans can work and earn a living wage:


Only half think that the government should ensure equal schooling for whites and racial minorities (58%), only a third (35%) believe that all children deserve to go to “really good public schools,” and only a quarter (28%) think that everyone who wants to go to college should be able to do so.


The wealthy generally opposed regulation on Wall Street firms, food producers, the oil industry, the health insurance industry, and big corporations, all of which is favored by the general public. A minority of the wealthy (17%) believed that the government should reduce class inequality by redistributing wealth, compared to half of the general population (53%).

Interestingly, Page and his colleagues also compared the answers of the top 0.1% with the remainder of the top 1%. The top 0.1%, individuals with $40 million or more net worth, held views that deviated even farther from the general public.

These attitudes may explain why politicians take positions with which the majority of Americans disagree. “[T]he apparent consistency between the preferences of the wealthy and the contours of actual policy in certain important areas,” they write, “— especially social welfare policies, and to a lesser extent economic regulation and taxation — is, at least, suggestive of significant influence.”

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

“Future research is needed to identify the process,” write the authors, but it appears that pregnant women have some control over when they give birth. A study of birth incidence on Halloween and Valentine’s Day, by public health scholar Becca Levy and colleagues, showed that spontaneous births dipped on the former and rose on the latter.


The authors suggest that this contributes to growing evidence that culture influences birth timing. Women’s bodies resist giving birth on a day associated with fright and death, but give into birth on a day associated with love. The authors recommend extra staffing on obstetric wards on Valentine’s Day and sending a few more doctors and nurses into the streets on Halloween.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

Flashback Friday.

Two of my favorite podcasts, Radio Lab and Quirks and Quarks, have stories bout how inertia and reliance on technology can inhibit our ability to find easy, cheap solutions to problems.

Story One

The first story, at Radio Lab, was about a nursing home in Düsseldorf, Germany.  As patients age, nursing homes risk that they will become disoriented and “escape” the nursing home.  Often, they are trying to return to homes in which they lived previously, desperate that their children, partners, or even parents are worried and waiting for them.

When they catch the escapee in time, the patient is often extremely upset and an altercation ensues.  If they don’t catch them in time, the patient often hops onto public transportation and is eventually discovered by police.  The first outcome is unpleasant for everyone involved and the second outcome is very dangerous for the patient.  Most nursing homes fix this problem by confining patients who’ve began to wander off to a locked ward.

An employee at the Benrath Senior Center came up with an alternative solution: a fake bus stop placed right outside of the front doors of the nursing home.  The fake bus stop does two wonderful things:

(1)  The first thing a potential escapee does when they decide to “go home” is find a bus stop.  So, patients who take off usually get no further than the first bus stop that they see.  “Where did Mrs. Schmidt go?”  “Oh, she’s at the bus stop.”  In practice, it worked tremendously.  This meant that many disoriented patients no longer needed to be kept in locked wards.

(2)  The bus stop diffuses the sense of panic.  If a delusional patient decided that she needed to go home immediately because her children were all alone and waiting for her, the attendant didn’t need to restrain her or talk her out of it, she simply said, “Oh, well… there’s the bus stop.”  The patient would go sit and wait.  Knowing that she was on her way home, she would relax and, given her diminished cognition, she would eventually forget why she was there.  A little while later the attendant could go out and ask her if she wanted to come in for tea.  And she would say, “Ok.”

Listening to this, I thought it was just about the most brilliant thing I’d ever heard.

Story Two

The second story, from Quirks and Quarks, was regarding whether it is true that dogs can smell cancer.  It turns out that they can.  It appears that dogs can smell lots of types of cancer, but people have been working specifically with training them to detect melanomas, or skin cancers.  It turns out that a dog can be trained, in about three to six weeks, to detect melanomas (even some invisible to the naked eye) with an 80-90% accuracy rate.   If we could build a machine that was able to detect the same chemical that dogs are reacting to (and we don’t know, at this time, what that is) it would have to be the size of a refrigerator to match the sensitivity of a dog’s nose.  When it comes to detecting melanomas, dogs are better diagnosticians than our best humans and our most advanced machines.

Doggy doctors offer some really wonderful possibilities, such as delivering low cost cancer detection to communities who may not have access to clinical care.  A mobile cancer detection puppy bus, anyone?

Both these stories — about these talented animals and the pretend bus stop — are fantastic examples of what we can do without advanced technology. I fear that we fetishize the latter, turning first to technology and forgetting to be creative about how to solve problems without them.

This post originally appeared in 2010.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

According to Nicole Arbout’s youtube video “Dear Fat People,” fat people deserve to be ridiculed and treated poorly. The comedian mocks obese people and accuses them of being lazy, smelly, self-destructive, and a burden to the health care system and those around them.  Fat people, she also suggests, cause heartache and embarrassment to their loved ones and are public nuisances to strangers by taking up too much space on airplanes and getting the closest spaces in shopping mall parking lots. Arbour even compares fat bodies to the Michelin Man and implores those who are overweight to put down the coke and fries, start exercising, and get healthy.

In case Arbour’s point was lost amid her six-minute diatribe, “Fat shaming is not a thing. Fat people made that up.”

But research proves otherwise.

Over a decade ago work supported by Yale University’s Rudd Center for Food Policy and Obesity showed that fifteen percent of respondents would be willing to give up 10 years of their lives to avoid being fat. Nearly one-half of respondents would give up one year of their lives to do the same. About eight percent of these same survey respondents also indicated they would rather have a learning-disabled child than an obese child (source). Such findings illuminate clearly the stigma associated with being obese as well as the fear that people have of being targets of the prejudice and discrimination stemming from it.

These fears are well founded. Obese people continue to face prejudice and discrimination in a wide variety of ways, according to recent research from the Rudd Report. In the educational system, overweight and obese children report being teased and bullied by peers and teachers alike.

Obesity also has consequences in the workplace. Those who are obese can expect to earn lower wages and be promoted less often than their thinner coworkers, despite positive work evaluations.


Overweight and obese people should not expect to find respite from the health care system either. Survey data consistently show that a significant number of doctors and nurses think obese patients are lazy, awkward, and noncompliant. Many of these same medical professionals also report being repulsed by such patients, attitudes which certainly affect the type and quality of care that obese patients receive.

To be sure, obesity contributes to health conditions like heart disease, some forms of cancer, diabetes, among others. It can also lead to early death, conclusions that Arbour’s video also makes. But obese people do not deserve to be ridiculed or discriminated against.

While Arbour now claims that “Dear Fat People” and the humor in it is satire, she perpetuates longstanding beliefs about overweight and obese people, legitimates the unfair treatment that they face on a daily basis, and proves that, yes, fat shaming is a thing.

Jacqueline Clark, PhD is an associate professor of sociology and chair of the department at Ripon College. Her research focuses on inequalities, the sociology of health and illness, and the sociology of jobs, work, and organizations.

Flashback Friday.

The term “fetal alcohol syndrome” (FAS) refers to a group of problems that include mental retardation,  growth problems, abnormal facial features, and other birth defects.  The disorder affects children whose mothers drank large amounts of alcohol during pregnancy.


Well, not exactly.

It turns out that only about 5% of alcoholic women give birth to babies who are later diagnosed with FAS. This means that many mothers drink excessively, and many more drink somewhat (at least 16 percent of mothers drink during pregnancy), and yet many, many children born to these women show no diagnosable signs of FAS. Twin studies, further, have shown that sometimes one fraternal twin is diagnosed with FAS, but the other twin, who shared the same uterine environment, is fine.

So, drinking during pregnancy does not appear to be a sufficient cause of FAS, even if it is a necessary cause (by definition?). In her book, Conceiving Risk, Bearing Responsibility, sociologist and public health scholar Elizabeth M. Armstrong explains that FAS is not just related to alcohol intake, but is “highly correlated with smoking, poverty, malnutrition, high parity [i.e., having lots of children], and advanced maternal age” (p. 6). Further, there appears to be a genetic component. Some fetuses may be more vulnerable than others due to different ways that bodies breakdown ethanol, a characteristic that may be inherited. (This may also explain why one fraternal twin is affected, but not the other.)

To sum, drinking alcohol during pregnancy appears to contribute to FAS, but it by no means causes FAS.

And yet… almost all public health campaigns, whether sponsored by states, social movement organizations, public health institutes, or the associations of alcohol purveyors tell pregnant women not to drink alcohol during, before, or after pregnancy… at all… or else.

The Centers for Disease Control (U.S.):

The National Organization on Fetal Alcohol Syndrome:

Best Start, Ontario’s Maternal Newborn and Early Child Development Resource Centre:

Nova Scotia Liquor Commission:

These campaigns all target women and explain to them that they should not drink any alcohol at all if they are trying to conceive, during pregnancy, during the period in which they are breastfeeding and, in some cases, if they are not trying to conceive but are using only somewhat effective birth control.

So, the strategy to reduce FAS is reduced to the targeting of women’s behavior.

But “women” do not cause FAS. Neither does alcohol. This strategy replaces addressing all of the other problems that correlate with the appearance of FAS — poverty, stress, and other kinds of social deprivation — in favor of policing women. FAS, in fact, is partly the result of individual behavior, partly the result of social inequality, and partly genetic, but our entire eradication strategy focuses on individual behavior. It places the blame and responsibility solely on women.

And, since women’s choices are not highly correlated with the appearance of FAS, the strategy fails. Very few women actually drink at the levels correlated with FAS. If we did not have a no-drinking-during-pregnancy campaign and pregnant women continued drinking at the rates at which they drank before being pregnant, we would not see a massive rise in FAS. Only the heaviest drinking women put their fetus at risk and they, unfortunately, are the least likely to respond to the no-drinking campaign (largely due to addiction).

Originally posted in 2010 and developed into a two-page essay for Contexts magazine.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.

Flashback Friday.

In the talk embedded below, psychologist and behavioral economist Dan Ariely asks the question: How many of our decisions are based on our own preferences and how many of them are based on how our options are constructed? His first example regards willingness to donate organs. The figure below shows that some countries in Europe are very generous with their organs and other countries not so much.


A cultural explanation, Ariely argues, doesn’t make any sense because very similar cultures are on opposite sides: consider Sweden vs. Denmark, Germany vs. Austria, and the Netherlands vs. Belgium.

What makes the difference then? It’s the wording of the question. In the generous countries the question is worded so as to require one to check the box if one does NOT want to donate:


In the less generous countries, it’s the opposite. The question is worded so as to require one to check the box if one does want to donate:

Lesson: The way the option is presented to us heavily influences the likelihood that we will or will not do something as important as donating our organs.

For more, and more great examples, watch the whole video:

Originally posted in 2010.

Lisa Wade is a professor at Occidental College and the co-author of Gender: Ideas, Interactions, Institutions. Find her on TwitterFacebook, and Instagram.