Tag Archives: medicine

Cancer is Not a Pink Ribbon (part 1)

pink-ribbon-breast-cancer-prevention

http://ideborah.com/

As a belated nod to ‘Breast Cancer Awareness Month’ (October, in the USA), and the plethora of pink, breast-cancer-sponsored items now on sale,  I want to talk about the rise of the pink ribbon campaign and the concept of ‘pinkwashing’.

Breast cancer and the pink ribbon campaign is probably one of the biggest success stories, in terms of its ability to raise awareness and ultimately, save lives. Breast cancer activism started in the 1980′s, in part as a reaction to the patriarchal medicalisation of women’s bodies. Up until then, breast cancer was being silenced: the field was dominated by male surgeons with little information available for individual sufferers, and incidence rates were fast increasing. A huge, grass roots movement began, focusing on empowering and giving voice to suffers and their families. By the 1990′s the focus had been shifted away from the medical profession and onto the empowerment of patients, and this increased attention and exposure increased its status and cultural currency. This was furthered by the launch of the now now iconic pink ribbon in 1992.

This increased focus was incredible in its uptake. It allowed the breast cancer movement to become a prominent focus for the general public, ‘awareness’ was raised, huge amounts of funds were raised, and it was being run by women: by cancer survivors, sufferers and family members. Treatment improved, mortality rates declined.  It was a success. But, as Gayle Sulik notes: “By this time, there were already controversies over the benefits of mammograms, concerns over conflicts of interest, rising competition in pharmacology, and infighting among thought leaders and scientists. Yet cause promotion and the desire to do something for breast cancer held the public’s attention”. (more…)

Fugue as Method: Episode 2 – How Scholars Have Applied a Fugal Method

Source: Northeastern University

Source: Northeastern University

Episode 2

“When I am growing up…we girls, big and little, have at our command four languages to express desire before all that is left for us is sighs and moans: French for secret missives; Arabic for our stifled aspirations towards God-the-Father, the God of the religions of the Book; Lybico-Berber which takes us back to the pagan idols-mother-gods-of pre-Islamic Mecca.  The fourth language, for all females, young or old, cloistered or half-emancipated remains that of the body” (Djebar 1985, 180).

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A sociological understanding of online health behaviours

 

800px-Medicine_Drugs_svg

http://commons.wikimedia.org/wiki/File%3AMedicine_Drugs.svg

The 2006 Online Health Search, a US survey by the Pew Internet & American Life Project, showed that “prescription or over-the-counter drugs” was the fifth most widely searched health topic on the Web.  The most recent study, conducted by the Pew Project in September 2012, found that 72% of Internet users they surveyed say they looked online for health information within the past year. As well as providing knowledge, the Web is also a retail opportunity which allows the buying of medicinal products online. Even if obtaining medicine was not the original intention when visiting the Web, it provides the setting for advertising – including direct marketing such as pop ups. These may enable opportunist impulse buying whereby people do not realise that they are indulging in anything untoward. The issue is further complicated where the medicine is regulated and specified as prescription-only. Although it is not illegal to purchase prescription only medicine rather than obtaining it from a health care professional, using a web supplier exposes the consumer to a plethora of criminal behaviour and health risks. The Web offers no guarantee on the quality and effectiveness of medicines supplied with no legal recourse available, especially if the product was obtained from an unregulated site. SPAM emails that bypass the healthcare system by advertising prescription-only medicines further risks people’s health by encouraging self-diagnosis and self-medication. These also carry the risk of credit card fraud and PC viruses which could be associated with larger criminal associations and organisations.

Beck (1992) has purported that the increased propensity to conceptualise problems in terms of risk has been accompanied by shifts in both the role of the expert and the form and communication of their expert product. While the paternalism of the expert remains an important ‘definer’ (Beck 1992:29) of risks, significantly in terms of where they can be discovered and how they are best avoided, this role has supposedly undergone momentous changes. Beck alleges that expertise has both been ‘demonopolised’ (Beck, 1992:29) and ‘democratised’ (Beck, 1992:191). (more…)

The Good and Bad News about HIV Infections

Source: CDC

Source: CDC

This week, great news emerged out of Mississippi: an infant, previously infected with HIV, has been cured of the virus. This development indicates promise for the future. We have now entered an era with the possibility of curing a once incurable disease. This is certainly a time to celebrate the progress of modern medicine and its ability to save the lives of millions of people. However, alongside this great news, the Center for Disease Control (CDC) has released new data on the rates of new HIV infections among adults and adolescents in the United States. This data reminds us that we still have a long way to go to eradicate this infection; many, many men and women are diagnosed with HIV every day.

Specifically, the CDC reports that southern states, like Texas, Florida, Louisiana, Alabama, Mississippi, North Carolina, South Carolina, and Georgia, have some of the highest rates of new HIV infection among adults and adolescents in the United States. The rates of diagnoses in these states is anywhere from 20.0 to 177.9 new HIV infections for every 100,000 people in the population. While some northern states, like New York and New Jersey, have comparable numbers, the greatest concentration of these astoundingly high rates can be found in the southern half of the United States. Something is clearly going on here.

Some analysts point to the lack of complete and factual sexual education in the disproportionately affected states. None of these southern states require comprehensive and accurate HIV/AIDS education. Two states, Florida and Texas, do not require any sexual education in public schools. While the CDC did not statistically test the relationship between comprehensive sex education and rates of new HIV infection, the link between the two seems pretty obvious: if students learn how to prevent the spread of the disease through safe sex practices, their risk of infection should decrease.

Why, then, are states still resistant to comprehensive sex education in their schools? We have moved past the days when the federal government espoused an abstinence-only agenda and tied education funds to states’ adherence to the “no sex outside of heterosexual marriage” motto. Since President Obama has entered office, an equal amount of funds for comprehensive sex education that teaches about safe sex practices, including abstinence, and about sexualities other than heterosexuality is available for states wishing to educate their students. Yet, some states, like Florida and Texas, do not take advantage of this funding.

Sociologically, we know that a fear of adolescent sexuality underlies many of the concerns about sexual education in public schools. In my first Sociology Lens post back in 2012, I described some of these fears by drawing on Jessica Field’s Sociology Compass article, Sexuality Education in the United States: Shared Cultural Ideas Across the Political Divide. In this article, Fields insightfully points out that regardless of political position on the issue of sex education, most people are motivated by the desire to regulate an out-of-control or dangerous adolescent sexuality. Fields’ argument continues to be relevant today; the new statistics on rates of HIV infection seem to be an unfortunate consequence of these publicfears.

While I am very optimistic about the health of the Mississippi baby, I am hesitant to say that this medical progress is enough. Can the same procedure be used to cure older individuals infected with HIV? Will the procedure be widely available at a reasonable rate? In the absence of these answers, we need to remember that one of the ways to eradicate HIV is to spread knowledge about safe sex practices so that new infections decrease. In addition to new medicine, we need to continue to raise awareness about safe sex and disease prevention through publically funded education.

Suggested Readings:

Guttmacher Institute. 2013. State Policies in Brief: Sex and HIV Education.

Kirby, Douglas B, B.A. Laris, and Lori A Rolleri. 2007. “Sex and HIV Education Programs: Their Impact on Sexual Behaviors of Young People throughout the World.” Journal of Adolescent Health 40: 206-217.

Women, Sexuality, and the HPV Vaccine Part 3

Source: Wikimedia

In the past month, I have posted about the feminization of the Gardasil, the vaccine that prevents 70% of Human Papillomavirus (HPV)-related cervical cancers and 90% of genital warts. I started with the historical development and approval of the vaccine and continued with an examination of the research guiding girls-only vaccination strategies. In this post, I will conclude my discussion of Gardasil with some observations about the marketing and advertising of the vaccine, the continued focus on girls and women (despite approval for boys and men), and the messages aimed at women through these advertisements.

A number of researchers suggest that the marketing and advertising of Gardasil has been aimed at girls and women. The “One Less” campaign from the makers of Gardasil originally asked parents (well, really mothers) to help their daughters protect themselves against cervical cancer; their daughters would be “one less” to be affected by this disease. The makers of Gardasil now reach out the parents of sons, too, telling them they can help prevent HPV diseases in their sons. Still, scholars suggest that the marketing of Gardasil remains mostly targeted at girls and women. My own google image search confirms these findings. Of the first twenty one photos that appear using the search terms, “gardasil ads,” only two include or reference boys and men.

What I found most interesting about my own google image search was not the lack of advertising for boys and men. Clearly, the makers of Gardasil believe that girls and women are their target demographic and thus aim their advertising accordingly. Instead, I think the strategies and messages in the advertising aimed at girls and women are the more interesting observation.

There were two different types of ads that appeared in my search. The first type of ad focused around the protection of young girls. The makers of Gardasil imply that being a good parent means vaccinating your daughter and therefore protecting her from cervical cancer (an observation also made by Sociological Images). For example, one advertisement read, “How do you help your daughter become one less life affected by cervical cancer?” Another advertisement had a similar sentiment, stating “Your daughter can’t possibly know the importance of the cervical cancer vaccine, but thankfully, she has her mother.” This narrative of protectionism is not surprising. In other contexts, like sex education debates, the discourse about adolescent sexuality, and in particular, girls’ sexuality, reveals a desire to protect their “innocence.”

The other type of ad moves away from the narrative of protectionism and focuses on empowerment and choice. One ad stated, “I chose to get vaccinated after my doctor to me the facts” (emphasis in original). Another ad read, “I chose to get vaccinated because my dreams don’t include cervical cancer.” Instead of focusing on the ways in which girls and women can be protected, the ads suggest that girls and women need to protect themselves. It seems like the advertising department at Merck (the makers of Gardasil) recognize that they needed another strategy if they wanted to appeal to young women who feel empowered about their sex lives.

These two strategies are opposed to one another. One strategy suggests that girls and women need to be protected, while the other strategy relies on the ability of girls and women to be active and educated decision makers. Merck is tapping into two gendered narratives in order to sell to as many people as possible. This is, of course, the way that advertising works. But it does reveal the different, and sometimes contradictory, cultural ideas about women’s sexuality, ideas that advertisers will draw on in order to make a profit.

Suggested Readings:

Habel, Melissa A., Nicole Liddon, and Jo E. Stryker. 2009. “The HPV Vaccine: A Content Analysis of Online News Stories.” Journal of Women’s Health 18(3): 401-407.

Lorber, Judith. 1997. Gender and the Social Construction of Illness. Thousand Oaks: Sage.

 

 

Gender, Sexuality, and the HPV Vaccine: Part 2

 

Source: Consumer Reports

In mid-October, I posted about a recent study that assesses the relationship between rates of sexual activity-related outcomes and the Human Papillomavirus (HPV) vaccination. The researchers found that injection of the vaccine is not associated with elevated rates of sexual activity-related outcomes in young girls, specifically pregnancy, contraceptive counseling, and sexually transmitted infection testing and diagnosis. While removing the stigma around the vaccine will help girls and women, I asked why the vaccine continues to be associated with women, even though Gardasil is approved for men, too.

Gardasil, the vaccine that prevents 70% of HPV-related cervical cancers and 90% of genital warts, was first approved for use in women by the Food and Drug Administration (FDA) in 2006. Soon after, the Center for Disease Control (CDC) recommended that the vaccine become a part of the normal vaccination schedule for girls. In 2009, the FDA approved the vaccine for men, but the CDC initially did not recommend the vaccine as part of the normal vaccination schedule for boys (the CDC changed its mind in 2011, though). In this next post, I will go into more depth about the research guiding the CDC’s initial decision and suggest that the guidelines were only possible when assuming a heteronormative model of transmission, as well as women’s general responsibility for reproductive health. Both of these assumptions continue to perpetuate the link between the vaccine and women.

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The Social Construction of Scientific Knowledge: The New AAP Policy on Male Circumcision

The American Academy of Pediatrics (AAP) recently released a revised policy statement regarding male circumcision. Unlike previous policies on the issue, this one got a lot of media attention, probably because male circumcision itself has been in the news more than usual. The past few years have seen increasing mobilization against male circumcision (for example, intactivists (the term activists fighting for genital integrity have given themselves) tried to ban the practice in the city of San Francisco last year, though the attempt was unsuccessful). And the surgery gained some global attention this year after a German court ruled that it constituted grievous bodily harm against a minor. Many national governments and religious groups/leaders spoke out against the court ruling, the court’s decision has caused many to think a bit more about neonatal circumcision.

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Rosie O’Donnell Reminds Us About Women’s Heart Health

Source: http://www.realage.com/womens-health/hidden-heart-attack-signs-in-women

Last week, media sources reported that Rosie O’Donnell had a heart attack. Though Rosie explained that she did “google” her symptoms, she did not believe she was having a heart attack and never called 911. Like many women, Rosie explained that she did not know enough about female heart issues, specifically identifying the problem and getting immediate medical attention. Rosie hopes she can use her fame and platform to raise awareness about heart attacks and issues in women.

While Rosie lived to tell her story, many women don’t. Researchers estimate that 1 in 4 women in the United States die of heart diseases every year. And, like Rosie mentions, many women don’t know their suffering from a heart attack until it is too late. Many of us know the ways in which heart attacks appear in men: pain in the left arm, pains in the chest. But studies suggest that women may not have the benefit of these tell-tale signs. Notably, women are less likely to present with chest pains when suffering a heart attack.  If heart diseases are common in women, why do so many women lack potentially lifesaving knowledge about the signs and symptoms of a heart attack?

At least part of the answer is historical. There was a time when women’s cardiovascular health was understudied and even ignored by some in the medical community. In the late 1980s, feminists in and around the field of medicine demonstrated that our knowledge about certain health issues emerged from research on the male body. For example, several studies on blood pressure, heart issues, and the “normal” functions of human aging were based almost exclusively on findings from the male population. Now, medical researchers recognize the importance of studying these same issues in the female population, but still, the research for women is years behind that of men.

Though the medical community now recognizes the importance of studying a broader spectrum of diseases in women, it seems that when we think of “women’s health,” we think about issues specific to the female anatomy. Though women may be afflicted with other major medical concerns, a huge amount of money and time is devoted to maintaining the healthy development and stability of the distinctively “female” parts of the body.  Organizations, like Susan G. Komen for the Cure, draw substantial resources to find a cure for breast cancer. Pharmaceutical companies develop vaccines, like Gardasil, targeted at preventing cervical cancer. Physicians and gynecologists recommend that women have their breasts and reproductive organs examined every year (though some have loosened up on this recommended frequency). Yet, heart disease, one of the largest “killers” of women, gets one day of awareness, Wear Red Day.

Don’t get me wrong. All of these developments are good for women. The emphasis on reproductive and breast issues has surely helped many women, who may have died from a disease of these organs or who wish to expand their reproductive options. But this obsession may have left other common problems unexamined and women without the resources or knowledge to combat them. The fact that many women do not know about the signs of a heart attack is evidence of this.

I don’t think that this should mean a decrease in research and outreach for women specific health issues. This needs to continue. Instead, we need an equal amount of research on other issues, as well as public health campaigns informing women of other risks to their health.

 

Suggested Readings:

Moore, Sarah E. H.2008. “Gender and the ‘New Paradigm’ of Health.” Sociology Compass 2(1): 268-280.

Bryder, L. 2008. “Debates about Cervical Screening: An Historical Overview.” Journal of Epidemiology Community Health 62: 284-287.

Morgen, Sandra. 2002. Into Our Own Hands: The Women’s Health Movement in the United States, 1960-1990. New Brunswick: Rutgers University Press.

 

Illness or Deviance: A Contested Space Between Criminal Justice and Medicine

Foucault wrote that the nineteenth century ushered in a new way to inspect the body; recognizing that medical personnel had placed the patient under “perpetual examination” (1975). His interest, however, was on the discourse that produced, maintained, and extended the medical look or “gaze” (1975). The “clinic,” for Foucault, became an apparatus of examination; a site of knowledge production bound by rules and regulations. It became an authoritative institution where the individual became the object of scrutiny (Long, 1992).

Following Foucault, there can be little doubt that the medical field has garnered power and authority in today’s society. Its utility and influence can be found in school immunizations, sports-related physicals, annual check-ups, seasonal vaccinations, yearly shots, and the like. However, as Conrad (2007) notes, this is only part of the picture. He, among others, proposes that the medical field has grown beyond shots and treatment; those in the medical profession now have the authority to define and/or redefine once thought non-medical issues as medical conditions. (more…)

The wide usage of antipsychotic medications may indicate social rather than biological etiology

There are many lessons to take away from the New York Times article linked below that describes a rambunctious little boy whose life was nearly ruined by anti-psychotic medications. Increasing numbers of children have been prescribed this class of drugs as of late for conditions ranging from Tourette Syndrome to bipolar disorder, which psychiatrists have begun to diagnose in children at younger and younger ages. There is controversy surrounding the very ability to diagnose these conditions in young children and certainly over the utility and safety of prescribing the most potent of the psychiatric medications for this population.  The issues associated with medicating children, especially with this class of medications, as well as the dangers to them, their families and society more broadly are innumerable (even if there are benefits in some cases, which most biological psychiatrists argue there is). But for now, let’s take this as an example of the increasing diagnosis of disorders such as bipolar disorder, which is an intriguing phenomenon that needs exploration at the aggregate level.

In the debate over whether any disorders are purely biological entities, sociologists generally adhere to the argument that bipolar disorder and schizophrenia seem to be heavily rooted in biology, since the rates of these disorders are relatively stable over time and place. As opposed to depression, anxiety, substance abuse, etc., the former disorders do not seem affected by culture (though the course of the illnesses are) or the social environment more broadly. In other words, there is fairly wide agreement that bipolar disorder and schizophrenia are in fact organic conditions, not likely to be born of  social or environmental factors alone (or maybe at all). However, as these diagnoses become increasingly common (this does not yet seem to be the trend with schizophrenia but certainly is the case with bipolar disorder), what does this say about the assumption of biological etiology?

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