health/medicine

Click here to see a flickr slide show of dozens of people, starting with those below, with their BMI label (“underweight,” “normal,” “overweight,” “obese,” and “morbidly obese”). There’s something about seeing all these nice looking people with these judgmental labels applied to them that reveals that the BMI is a social construction. Also it’s a good illustration of the Foucauldian idea that knowledge (discourse, or even “science”) is used to label and control people, especially when it is internalized.

Erin Nieto’s project, How Much Do You Weigh, also puts the body front-and-center, challenging us re-think what numbers mean.  She counterposes photographs of volunteers with the number on the scale.  These women model a refusal to be embarrassed by their weight and show us the imprecision of the number itself.

See more images at Nieto’s tumblr.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

Cross-posted at The Sociological Cinema.

Back in 2007, Dr. Oz stood on the set of The Oprah Winfrey Show and infamously promoted to an audience of 8 million viewers the idea that African Americans experience higher rates of hypertension because of the harsh conditions their ancestors endured on slave ships crossing the Atlantic. This so-called “slave hypothesis” has been roundly criticized for good reason, but I was struck that it was being promoted by such a highly educated medical professional.

The episode got me thinking about the sociologists Omi and Winant’s notion of a racial formation as resulting from historically situated racial projects wherein “racial categories are created, inhabited, transformed, and destroyed” (p. 55-56). These projects take multiple forms but in at least one version, there is an attempt to collapse race—a socially constructed concept—into biology. Such projects are similar insofar as they suggest that the socially constructed distinctiveness between people of different racial categories roughly approximates a meaningful biological distinctiveness. Scientists have been centrally involved in this effort to establish a biological basis for race. In the middle of the 19th century Dr. Samuel Morton attempted to show that average cranial capacities of people from different racial groups were significantly different. Today, many people scoff at the misguided racism of the past, but I think Dr. Oz’s promotion of the slave hypothesis demonstrates that the search for a biological, and therefore “natural,” basis for race continues.

So how do proponents of the slave hypothesis explain hypertension? In 1988 Dr. Clarence Grim first proposed the theory, which is the idea that the enslaved people who survived the Middle Passage were more likely to be carriers of a gene that allowed them to retain salt. Grim argued that this ability to retain salt, while necessary for a person to survive the harsh conditions of a slave ship, would ultimately lead to hypertension as the person aged. Thus Grim proposed that African Americans living in the United States today are the descendants of people who have this selected feature. As I mentioned above, this theory has been soundly refuted but reportedly still remains in many hypertension textbooks. Looking at the clip above, which is from January of this year, it seems that medical professionals like Dr. Oz may be still promoting it.

I think it is important to recognize that this particular racial project persists in many forms, and one final example is from 2005, when the FDA approved BiDil as a customized treatment of heart failure for African Americans. The approval was based on highly criticized research, but the approval also implicitly makes the case that a racial group might be so biologically distinct from others as to warrant its own customized medication. Much like the search for different cranial capacities, the propagation of the slave hypothesis, and the marketing of drugs designed for different racial groups, BiDil’s emergence can be seen as an attempt to deploy racial categories as if they were immutable in nature (see Troy Duster’s article in Science).

Criticizing this racial project is more than an academic exercise. As a social construct, race is already a central principal of social organization, which benefits whites at the expense of other racial groups. It is already a powerful basis upon which privileges are meted out and denied. In my view, the effort to loosen race from its moorings as a social construct and anchor it again as a biological fact of nature is an attempt to fundamentally alter the discussion on racial inequality. If this project prevails and race comes again to reflect a biological truth, then fewer people will acknowledge racial inequality as the result of a human-made history. It will instead be seen as the result of humans being made differently.

———-

Lester Andrist is a Ph.D. candidate at the University of Maryland, College Park, specializing in the role of social capital and personal networks in finding jobs in India and Taiwan and cultural representations of groups in indefinite detention. He is a co-editor of the website The Sociological Cinema.

If you would like to write a post for Sociological Images, please see our Guidelines for Guest Bloggers.

Cross-posted at Family Inequality.

Americans about my age and older all seem to have stories about how we survived our school playgrounds without today’s cushy soft surfaces, safety-oriented climbing structures, and running water.

Here is a picture of the playground at my elementary school. I myself survived a fall off one of those seesaws onto the broken-glass-strewn asphalt, with nothing but a scrape to show for it (attended to by the school secretary — there was no “school nurse” back then either).

In the safety craze in recent decades, sadly, real seesaws were one of the first things to go.

Go back another few generations, and you’ll find stories like this — about 200 children killed in the streets of New York in 1910 (from the NYT Jan. 1, 1911):

Most of those kids weren’t in cars or wagons; they were playing in the streets, doing work for their families, or just wandering around unattended — there were no public playgrounds. In contrast, in 2009 there were about 10 pedestrian or cycling children killed by vehicles in New York City. Ah, the good old days.*

Nowadays

As things have gotten safer for America’s children, of course, parents have become ever more concerned with their safety, as well as with their learning and development. Somewhere in America on a Sunday a few weeks ago, in an affluent community, a public playground was bubbling with activity. Every child seemed to be enjoying a rollicking good time on the latest safety-designed play equipment, cushioned by a luxuriously deep bed of mulch.

Also, each child seemed to be within a few feet of a parent or other adult caretaker — coaching, encouraging, spotting, supervising.

In recent years, concern about the physical fitness of children has increased, especially among poor children. Some researchers have asked whether the proximity of safe neighborhood playgrounds is one cause of the social class disparity in obesity rates. That would make sense because obesity rates are lower among children who play outdoors. But the relationship between social class and playing outdoors is not clear at all. Rich children have more access to some kinds of facilities, but poor children have more free time — and, where there is public housing, it usually includes playgrounds, like this one photographed in the 1960s:

In Annette Lareau’s analysis of family life and social class, Unequal Childhoods, children of middle class and richer parents spend more time in organized activities, and poorer kids spend more time in unstructured time (including play and TV). But as these pictures show, there’s play and there’s play. Are middle class parents hovering more than poorer parents do, and with what effect?

Consider a recent article by Myron Floyd and colleagues (covered here), which attempted to assess the level of physical activity among children in public parks by observing 2,700 children in 20 public parks in Durham, NC:

[The] presence of parental supervision was the strongest negative correlate of children’s activity… the presence of adults appears to inadvertently suppress park-based physical activity in the current study, particularly among younger children… This result should be used to encourage park designers to create play environments conducive to feelings of safety and security that would encourage rather than discourage active park use among children. For example, blending natural landscapes, manufactured play structures, and fencing in close intimate settings can be used to create comfortable environments for children and families. Such design strategies could encourage parents to allow their children to freely explore their surroundings, providing more opportunities for physical activity.

Interestingly, park in the pictured above has a fence around it so that parents can hang around at a distance with little fear for their children.

Under social pressure

In Under Pressure, one of many books bemoaning the excesses of over-parenting, Carl Honoré wrote:

Even when we poke fun at overzealous parenting… part of us wonders, What if they’re right? What if I’m letting my children down by not parenting harder? Racked by guilt and terrified of doing the wrong thing, we end up copying the alpha parent in the playground.

The point is not just that some parents have overzealous supervisory ambitions, driven by unequal investments in children and a threateningly competitive future. I think there is a supervision ratchet that feeds on the interaction between parents. In an article called “Playground Panopticism,” Holly Blackford summarized her observations:

The mothers in the ring of park benches symbolize the suggestion of surveillance, which Foucault describes as the technology of disciplinary power under liberal ideals of governance. However, the panoptic force of the mothers around the suburban playground becomes a community that gazes at the children only to ultimately gaze at one another, seeing reflected in the children the parenting abilities of one another.

This plays out in everyday interaction, whether one wants to engage it or not. If everyone else’s kid is closely supervised while yours is running around bonkers on her own, what is a parent to do? If the other parents insist that their kids not go “up the slide” and yours just scrambles past them, you feel the pressure. (You also put the other parent in the position of violating another taboo — supervising someone else’s child.) So it’s not just fear of underparenting that drives parents to hover — it’s also the cross-parent interactions. These are the moments when contagious parenting behavior spreads.

—————————

*I started looking at this after reading about it in Viviana Zelizer’s Pricing the Priceless Child, in which she writes, “The case of children’s accidental death provides empirical evidence of the new meanings of child life in twentieth-century America.”

Reminder: This blog post does not constitute research, but rather commentary, observation and recommendations for reading and discussion. The description of my childhood playground, and of one recent afternoon at one park, are anecdotes, something that stimulates reflection on wider issues, not empirical evidence or data.

Today cheerleading can be an incredibly athletic and risky sport. Because it is associated with women, though, and serves a sideline function for football and other male-dominated sports, cheerleading is often not considered a sport at all. Less than half of U.S. high school athletic associations define high school cheerleading as a sport and neither the U.S. Education Department or the National Collegiate Athletic Association categorize it as one.

Instead, cheerleading is frequently labeled an “activity,” akin to the chess club.  Accordingly, cheerleading remains unregulated by organizations responsible for ensuring the safety of athletes, leading to rates of injury among cheerleaders higher than even those among American football players.

A similar logic appears to be at play regarding the Lingerie Football League, 12 teams of women that play live tackle football in underwear.  Here are some highlights from a game:

So, here’s the thing.    Last month 16 of the 26 players on the Triumph, a team in Toronto, resigned over safety concerns. From a story at the Toronto Star sent in by Emily M.:

…four players described the ill-fitting hockey helmets and one-size-fits-all shoulder pads designed for young males that they had to wear.

“We would have headaches during practice… They made a hockey helmet a football helmet, and that’s not what it’s for.”

…

Sprained ankles, concussions and pulled hamstrings were among the injuries sustained by Triumph players in their first game… their team had no medical staff.

One of the players reported that, when they brought their concerns to the coach, he shrugged and said: “You know, it is what it is.”

“You know, it is what it is.”  In other words, “You’re women in underwear. It doesn’t matter what you do, you’re not really playing football.”  Ideology triumphing over reality.

Lisa Wade, PhD is an Associate Professor at Tulane University. She is the author of American Hookup, a book about college sexual culture; a textbook about gender; and a forthcoming introductory text: Terrible Magnificent Sociology. You can follow her on Twitter and Instagram.

Last month I wrote about gender differences in notions of health in a 1922 public health campaign designed to teach American teens about sex.

Today, we might not recognize that any of these recommendations had anything to do with sex. But in fact, they many of them were about masturbation.  At this time, fewer physicians thought that it would cause madness, epilepsy, homosexuality, or gout, but they still believed that it would encourage depravity and a lack of self-discipline.

To encourage a healthy sexuality, they advised lots of exercise. Exercise was believed to teach self-control. It was also considered a good outlet for “energy,” leaving one to worn out to masturbate.

TEXT:

Can you walk 20 miles in a day? Can you work an 8-hour day in the field? Can you “chin yourself” 8 times? Can you run 100 yards in 12 seconds?

They promoted a healthy diet.  Too much meat and too much spice were thought to encourage masturbation.

TEXT:

1. Eat fresh vegetables, cereals, bread and butter, eggs, fruit and a little meat or fish. 2. Eat slowly and thoroughly masticate (chew) your food. 3. Use judgment in amount and choice of foods. 4. Drink 6 to 10 glasses of water a day. Do not drink much water after supper. 5. Use your tooth brush at least twice a day — in the morning and at night.

People were also advised to sleep in well-ventilated rooms and to wear loose clothes that did not cause any friction:

TEXT:

Sleep with the windows open. “Turn in” at regular hours. Get 8 to 9 hours sleep every night.

Interestingly, only the boys’ posters actually discuss masturbation directly (self-abuse).

TITLE: Outdoor Life (avoid self-abuse)

TEXT:

1. Athletics. 2. Abundant outdoor life. 3. Wholesome companions. 4. Lots of good fun. 5. Constant employment. 6. Will power will help a boy break the habit called “self-abuse” (in case he has acquired the habit) and recover from any harm it may have done. This habit does not produce the terrible effects some ignorant people say it does. Most boys who have abused themselves stop before any great harm is done. Self-abuse may, however, seriously hinder a boy’s progress toward vigorous manhood. It is a selfish, childish, stupid habit. The strong boy will “cut it out.”

The posters are held at the Social Welfare History Archives at the University of Minnesota Libraries.

——————————

Christina Barmon is a doctoral student at Georgia State University studying sociology and gerontology.

If you would like to write a post for Sociological Images, please see our Guidelines for Guest Bloggers.

Gay men and bisexual men still represent a disproportionate number of HIV cases in the United States (CDC).  In addition, African-American and Latino men are significantly more likely than white men to be diagnosed with HIV and die from AIDS-related illnesses.  Numerous HIV prevention campaigns are thus aimed at these populations.

It’s important to try to reduce the HIV among these populations, but we also need to think critically about how prevention strategies reinforce stigmatization.

For example, this ad from a western Massachusetts clinic uses the phrase “man up, get tested” — taking care of yourself by getting tested for HIV is linked to your masculinity.  What’s interesting is that by including only men of color in the photo, the ad suggests that black and Latino men are particularly obsessed with their masculinity, more so, perhaps, than white men.  It also potentially reinforces stereotypes about black men as hyper-sexualized and Latino men as machismo.

Cross-posted at Jezebel.

At least that’s what Skinny Water is promising in their latest advertisement. The ad shows a woman facing a throng of cameramen snapping her picture, elegant earrings dropping to the top of the headline which says: “Skinny Always Gets the Attention.” Take a look:

Below the headline and photo of the various flavors, it also says “Zero calories, Zero sugar, Zero Carbs, Zero Guilt.” With all that’s not in this water, you might wonder what it does offer. The website tells me that depending on the flavor of water, they’ve added vitamins B3, B5, B6, B12, C, A, and E. They’ve also thrown in magnesium, folic acid, calcium and/or potassium.

Despite paltry efforts to market itself as healthy, Skinny Water is instead perpetrating the cultural message that the best — or only — way to ensure that women get attention is by being skinny. This of course positions them well to try to push their product on those women who have been pulled into this lie.

In fact, Skinny Water is doing precisely the opposite of what a health-conscious company and product should be doing. Promoting the idea that those who are skinny deserve attention more than others creates communities that support harmful diet-related behaviors and disordered eating for the goal of a wispy appearance. Not to mention reinforcing the ever-present undercurrent of bias against the overweight — or even normal weight! — it reinforces the idea that women’s size and appearance is the most important thing about them.

In defiance of that, let’s remind ourselves why Skinny Water is wrong. While the website details the added vitamins and dietary minerals of each drink, it’s far better to get your needed supplements through a healthy diet rich in cruciferous  and dark and leafy vegetables, fruits, whole grain and lean proteins. Washed down, in fact, by regular old water that keeps you hydrated and helps your body process and absorb nutrients. Skinny Water is telling its buyers that by adding these vitamins and minerals to their product, one can, perhaps, eschew a calorie-free but vitamin-rich manipulated water diet. For example, the “Power,” “Sport” and “Fit” drinks are all fortified with calcium, magnesium, and potassium – to help activate metabolic enzymes, keep your blood regulated, and support strong bones and teeth. Do you know what else can do that?  Bananas, yogurt, kale, almonds and cashews, and quinoa.

These are madly marketed products that don’t substitute for a healthy, well-rounded diet. Instead, they capitalize on the now-entrenched notion that women care more about being skinny than anything else.

UPDATE: Jezebel reports that this advertisement has been retired by Skinny Water, thanks to objections from consumers.

——————————

Larkin Callaghan is a doctoral student at Columbia University studying health behavior and education. She is particularly concerned with gender disparities in access to healthcare and prevention services, and has done research on adolescent female sexual health, how social media operate as an educational platform, and differences by gender in the effectiveness of brief health interventions. You can follow her on Twitter, Tumblr, and at her blog.

If you would like to write a post for Sociological Images, please see our Guidelines for Guest Bloggers.

Last month I posted a video from the PBS series on U.S. inequality, showing the misperceptions many Americans have about the level of economic stratification in the U.S. In a new segment in the series, PBS looks at the often hidden health impacts of this economic inequality:

Watch the full episode. See more PBS NewsHour.

Full transcript available here.