health/medicine

Squee sent in this video on the complexities of the placebo effect. We most often hear about the placebo effect in terms of medicine (the famed “sugar pill” that makes people feel better despite having no known effect on a condition), but as the video points out, we use placebos in other aspects of social life as well, such as buttons at intersections that don’t affect the timing of the “walk” signal but make pedestrians feel better about their wait anyway. And since the placebo effect is based in part on cultural assumptions about what should make us feel better (i.e., an expensive drug must be better than a discounted one, right?), not surprisingly the effectiveness of specific placebos varies cross-culturally.

Fun!

An infographic accompanying an article at the New York Times reveals how “advanced economies” compare on various measures of equality, well-being, educational attainment, and more.  To illustrate this, for each measure countries that rank well are coded tan, countries that rank poorly and very poorly are coded orange and red respectively, and countries that are in the middle are grey.  The countries are then ranked from best to worst overall, with Australia coming in #1 and the United States coming in last.  You might be surprised how some of these countries measure up.

Thanks to Dmitriy T.M. for the link.

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.

The Guttmacher Institute reports that the decades long fall in the rate of surgical abortions has plateaued:

Decreasing abortion rates is something that most Americans support.  Sharon Camp, president and CEO of Guttmacher, suggests that greater availability of cheap effective contraception might help jump start the decrease.  That seems like a politically safe recommendation.  What say you?

Via Michelle Chen at Ms.

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.

At Ms., Amy Williams posted about the pre-conception care movement.  Pre-conception care is health care aimed at making the bodies of fertile women most conducive to a healthy pregnancy.  The movement asserts that women of childbearing age should be receiving care with pregnancy in mind, whether or not the woman intends to get pregnant.  The Preconception Care webpage at Healthy Beginnings, for example, reads as follows:

In a presentation on the topic, Rebecca Kukla,  Professor of Philosophy and Obstetrics and Gynecology at the University of South Florida, explains that preconception care is an “official priority” for the Center for Disease Control and the US Office of Minority Health.   So what’s to be concerned about here?

First, the approach reduces women to their potential to make babies. Concern for women’s health is motivated not by concern for the woman herself, but her “merely imaginary future children.”   What is the value of old women, transgender women, involuntarily infertile women, and women who have been voluntarily sterilized?  What principles guide their health?

Second, treating women as potential fetus carriers sometimes interferes with the best practices for treating women. Kukla explains that doctors driven by this approach may be inclined to choose drugs that are known to improve fertility and enhance pregnancy outcomes, instead of the most effective drugs for whatever condition is at hand.  As an extreme example, consider a woman diagnosed with cancer for whom a hysterectomy is the most aggressive treatment?  Whose interests should the doctor consider?  Hers?  Those of her “merely imaginary future children”?

Third, treating women as potential fetus carriers encourages doctors and others to police women’s behaviors more stringently than men’s. Anything she does that doesn’t maximize her fertility and baby-making condition can be seen as a problem needing fixing.  Men’s life choices are simply not subjected to this sort of social scrutiny.  We already see this sort of intervention against women who are told to avoid alcohol even if they are unaware of being pregnant and have no intention of getting pregnant.

Fourth, Kukla points out that the approach skews women’s health towards those things that we think affect fetal outcomes. Should these conditions necessarily take priority over others?

Finally, this approach makes women, like myself, invisible. I am a fertile woman in my 30s who has chosen not to have children.  I truly hope that my health care is not being compromised by my doctor’s concern for the babies I am never going to have.  Nor do I think it’s cute that her concern for me is driven by my reproductive potential.

UPDATE: Heather Leila, in the comments, critiqued this post.  “Having participating in the Office of Minority Health´s preconception campaign,” she writes, “I can attest that none of the above 5 points speak to the reality of the program.”  She continues:

It´s easy for women commenting on this blog to be offended when it is suggested they are not in full control of their fertility. But the truth is that many women are not. They don´t have the access or the education about contaception. 50% OF ALL US PREGNANCIES ARE UNPLANNED.

OMH´s campaign addresses contraception and avoiding unwanted pregnancy. OMH recognizes that many women don´t want to become pregnant, now and later. The campaign seeks to reduce unwanted pregnancy alongside improving preconception health as a way to reduce infant mortality. The campaign also speaks directly to men – taking some of the pressure off women.

This post failed to mention that the OMH campaign is based on the very racial disparity in infant mortality that SI posted on just a few weeks ago.

Lastly, the campaign is geared towards women, not to their doctors. In no way would this campaign promote doctors valuing fertility over a woman´s life. Never would it suggest witholding a hysterectomy to protect fertility. The campaign is NOT about increasing fertility. It is about decreasing infant mortality. Two very different things.

It seems like neither Dr. Kukla nor Sociological Images has taken the time to fully understand this campaign before criticizing it. I think there is a lot to analyze and criticize within the campaign, but Dr. Kukla´s 5 points do not address true aspects of the program. They are invented.

Heather has posted about pre-conception care at her own blog, A Minha Vida.

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.

In the first five minutes of the clip below, economist Jeffrey Sachs explains to Dalton Conley that ending poverty in Africa requires a demographic transition, one where we move from high fertility and high mortality to low fertility and low mortality.

How to encourage such a transition?

1. Bring down mortality with advanced medicine. Declines in childhood mortality lead families to choose to have fewer children (’cause they don’t have to).

2. Make sure girls go and stay in school; they’ll get married later, and have less babies.

3. Provide free contraceptive services and family planning education.

Also see Dr. Sachs explain why Africa ended up so poor in the first place.

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.

Harmony sent along a set of photographs of a fitness starter kit, a pink one for “ladies” and a green one for, um, “people.”  In any case, putting aside the women-are-women and men-are-people thing for a minute, she also noted that the pink one was breast cancer-themed.  So here is, explicitly, what so many breast cancer awareness-themed items imply: pink = women = breast cancer awareness = boobies = women = pink = pink = pink.  The items, by cultural definition, exclude men from caring about breast cancer.

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.

The CDC has just released a Health Disparities and Inequalities Report with new numbers detailing the uneven mortality and morbidity in the U.S.  Family Inequality‘s Philip Cohen highlighted the data on pre-term birth among whites, blacks, Asians/Pacific Islanders, Hispanics, and some Hispanic subgroups.  It’s nice to see data that includes more than just whites and blacks; studies often do not report data on Hispanics, Asian/Pacific Islanders, and especially American Indians because the number of respondents is considered too low (and they do not over sample these groups).  More, breaking out the different Hispanic sub-groups is also rare.  As Cohen said, it’d be nice to see such detail for other groups as well (though it’s tough to do so for black Americans because those who arrived in the slave trade have often lost track of their national/ethnic origin).

In any case, the data both confirm previous findings and offer an important insight.  In the confirmatory case, it shows that Asians and whites are less likely to give birth to pre-term babies than other groups, with blacks suffering the worst outcomes.  As for the interesting finding: notice the wide range of outcomes for Hispanics of different origin.  Reporting only “All Hispanic” hides important variation. We can be assured that that variation is true for the other racial groups as well.

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.

Alys sent in a photograph of the packaging at her local McDonald’s. It included pictures, not of Chicken Clubs and Big Macs, but of the raw ingredients that these foods are (theoretically) made of… with the notable exception of realistic images of animals. The materials, Alys writes, were…

…adorned with pictures of healthy whole foods, such as a tomato or a head of lettuce. That in itself is interesting — they are clearly attempting to cash in on the whole-foods-are-good-for-you mentality despite the fact that there is hardly anything more processed than fast food — but what I found particularly fascinating was the animals, or rather the lack thereof. My chicken club sandwich package featured not a live chicken, but two little origami chickens. Similarly, the bag the food came in had a tin chicken knick-knack thing. My husband’s hamburger package was even more ambiguous. It’s a little hard to read in the picture, but “two all beef patties” is represented not with a cow, or a picture of the patties, or even an origami cow, but with a spatula. Clearly MacDonalds realizes that while Americans want to be reminded that the ketchup on their sandwich originally came from a tomato — and that means it’s healthy! — they do not want to look into eyes of the live animal that sacrificed its life to provide the main focus of the meal.

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.