health/medicine

On the heels of our post on food deserts, Family Inequality‘s Philip Cohen posted about “care vacuums.”  In this case the research is referring to the shrinking number of nursing homes in the U.S., leaving people farther and farther away from the nearest nursing home.

Zhanlian Feng and colleagues found that between 1999 and 2008 we lost about 5% of all nursing home beds and these losses were disproportionately in neighborhoods populated by Blacks and Latinos. The maps below overlays the racial composition of neighborhoods (darker = higher percent minority) with open nursing homes (in black) and nursing home closures (in red). Both seem to be disproportionately in minority neighborhoods, but Feng et al. showed that the closures are even more so.

Here’s Chicago as an example:

Just as food deserts make it more difficult for people without access to personal, reliable transportation to get fresh, affordable food, care vacuums make it more difficult for those same people — disproportionately Black and Latino, and disproportionately poor — to visit loved ones in nursing homes.  Ironically, this is despite the fact that use of nursing homes by minorities is rising and, among whites, falling.

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.

Many Americans are familiar with “female genital mutilation.”  The term is typically applied to practices occurring in some parts of Africa, Asia, and the Middle East, but not to genital cutting practices that happen in the U.S. and other Western societies (including cosmetic surgeries on the genitals, surgeries on children with ambiguous genitalia, and transsexual surgery) and, by definition, not to genital cutting practices that happen to men in both Western and non-Western countries (male circumcision and other rare but more extreme practices).  “Female genital mutilation” elsewhere, then, is widely condemned by Americans, but rarely condemned in light of these other genital cutting practices, nor America’s own history of genital cutting.  In fact, it was not unusual to subject women in the U.S. to proper circumcision (removal of the clitoral prepuce, or foreskin) until the 1960s and these procedures remained legal until 1996 (though, as far as I’m concerned, their legality is still up in the air).

In any case, RabbitWrite gives us a glimpse into this era in American history. Reading from a Playgirl published in 1973, she recounts the confessions of a woman who chose to be circumcised and offers a short critique.

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.

All social movements try to frame issues in ways that benefit their cause. Controlling the discourse is an important step towards getting the outcome they want.  Previously, we’ve posted about the way that activists against the genetic modification of food have nicknamed these foods, “frankenfoods.” Recently, Steven Foster, a student at Rensselaer Polytechnic Institute, sent us a pair of images questioning this rhetoric by comparing the imagery with the animals in question.

Frankenfish cartoon:

Images of genetically- and non-genetically-modified salmon:

While we don’t know whether anti-“frankenfood” activists are right about their concerns and it’s certainly true that these animals are genetically modified; it’s also clear that the visuals distort the facts (that is, the modified animals are not nearly as distorted as the cartoon implies).  Thinking through how the tactics by which social movement actors try to influence discourse is a fun and useful application of the sociological imagination.

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 article “In Pursuit of the Perfect Penis: The Medicalization of Male Sexuality” (available for free if you search for the title and Tiefer’s name), Leonore Tiefer discusses the way that the increasing attention paid by the medical community to conditions defined as “impotence,” and the way it has become medicalized, requiring any number of surgical, psychological, and/or pharmacological interventions. While some men have undoubtedly benefited, the largest beneficiary is the medical community itself. The broadened definition of what counts as “erectile dysfunction,” for instance, has created a larger market for drugs such as Viagra and Cialis.

Dmitriy T.M. sent in a trailer for the documentary Orgasm Inc., which documents efforts to medicalize “sexual dysfunction” among women. In the 3-minute trailer, we see cultural commentators and doctors discussing the shocking prevalence of sexual problems among women (43%! 83%! It’s an epidemic!) and some potential medical solutions. It’s a fantastic example of the medicalization of sexuality (and pretty safe for work). Enjoy!

Cross-posted at Ms. and Family Inequality.

In the early 1990s, Arline Geronimus proposed a simple yet profound explanation for why Black women on average were having children at younger ages than White women, which she called the “weathering hypothesis.”

It goes like this: Racial inequality takes a cumulative toll on Black women, increasing the chance they will have health problems at younger ages. So, early childbearing might pose health risks for White women, but for Black women it makes more sense to start earlier — before their health declines. Although it’s hard to measure the motivations of people having children, her suggestion was that early childbearing reflected a combination of cumulative cultural wisdom and individual adaptation (for example, reacting to the health problems experienced by their 40-something mothers).

She showed the pattern nicely with data from Michigan in 1989, in which the percentage of first births that were “very low birthweight,” increased with the age of Black women, but decreased for White women, through their twenties:

Source: My graph from Geronimus (1996).

If the hypothesis is correct, she reasoned, the pattern would be stronger among poor women, who experience more health problems, which is also what she found.

The most recent national data, for 2007, continue to show Black women have their first children, on average, younger than White women: age 22.7 versus 26.0. And the infant mortality rates, by mothers’ age, also show the lowest risk for White women at older ages than for Black women:

Source: My graph from CDC data.

Note that, for White women, mothers have children in the early thirties face less than half the infant-mortality risk of those having children as teenagers. For Black women, waiting till their lowest-risk age — the late 20s — yields only a 14% reduction in infant mortality risk. So it looks like waiting is much more important for White women, at least as far as health conditions are concerned.

The implications are profound. If you base your perceptions on the White pattern, it makes sense to discourage early childbearing for health reasons. But if you look at the Black pattern, it becomes more important to try to improve health problems at early ages — and all the things that contribute to them — rather than (or in addition to) trying to delay first births.

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Cohen’s previous posts featured on SocImages include ones on the recession and divorce data, the relationship between cell phone use and driving deaths, measuring the number of welfare recipients, delusions of gender dimorphism, and the gender binary in children’s books.

Anna J., a student at Rensselaer Polytechnic Institute, sent in this vintage ad for Spirella girdles that provides a good reminder of how women are repeatedly told that our bodies are never, ever acceptable as they are, but are always in need of “improvement” through the use of products (found at The Great Fitness Experiment):

But hey, if you don’t feel like wearing a girdle, perhaps some tapeworms are your solution:

UPDATE: Reader Syd says the tapeworm ad is a hoax, though other readers disagree, and the practice itself definitely occurred. I don’t know how to find out, but since there’s at least some question about it, I’d take it with caution. However, commenter Angela pointed out that Tyra Banks recently had a story on tapeworms on her show:

As Anna points out, “It’s really interesting how ads have changed over time, but the expectation of culture that women be dieting has remained the same.”  Certainly more people wouldn’t tell women to eat a tapeworm — sanitized or not — these days, but plenty of questionable products out there still promise weight loss with “no diet” and “no exercise,” and my bet is you could pick up any women’s magazine currently on the shelf and get a range of advice on how to make sure you lose any weight you might have gained over the holiday season.

In the late 1800s, one suffering from impotence, addiction to morphine, or belly aches might be prescribed John Pemberton’s French Wine of Coca.   The wine concoction contained caffeine and 8 1/2 milligrams of cocaine (equivalent to snorting about 1/2 line).

(source)

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Prohibition’s arrival in Atlanta in 1886 led Pemberton to re-write his recipe to exclude the alcohol.  Pemberton advertised it as the “great national temperance beverage.”  In 1903, when cocaine was outlawed, Pemberton had to rework his recipe again.  Coca Cola, as we know it, was born.

See The Digital Deli Online for more.

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.

As a member of a cattle-raising family, I hear a pretty steady stream of complaints about people eating less beef, which is variously attributed to a conspiracy against the American rancher (possibly by terrorists), the result of stupid city people who get all terrified over every little health concern (Mad Cow Disease is a myth! Unless it’s a terrorist plot to ruin ranching), environmentalists, animal rights activists, and me (I’ve been a vegetarian since 1996 and thus single-handedly nearly destroyed the beef industry).

The National Cattlemen’s Beef Association is similarly concerned about reduced beef consumption. And given that we frequently hear about the connections between red meat consumption and health concerns such as heart disease, and are advised to substitute white meat for red meat (to the point that the pork industry began branding pork as “the other white meat”), you’d probably expect to see a dramatic decline in consumption of beef.

And we do see a decline, but not as much as you might expect, as this graph from the Freakonomics blog, sent in by Dmitriy T.M. and Bryce M. (a student at Rensselaer Polytechnic Institute), illustrates:

Clearly beef consumption has declined since its peak in the late 1970s, when people in the U.S. ate nearly 90 pounds of beef each per year, to closer to 60 lbs. each today. On the other hand, all those health warnings, disease scares, and environmentalist-vegetarian terrorist plots haven’t yet knocked beef out of its position as the most-eaten meat in the U.S. Clearly, chicken seems poised to take over that position, but beef doesn’t exactly appear to be falling off the charts.

So how do we compare to other countries in terms of overall meat consumption? In a 2003 article in the Journal of Nutrition, Andrew Speedy provided data on global meat consumption (defined as “beef and buffalo, sheep and goat, pig meat and poultry”) — note it’s in kilograms, not pounds, and the legend should be read across, not down (so the first bar is for the U.S., the second is for France, and so on):

So insofar as there has been a decrease in beef consumption in the U.S., and more dramatic increase in chicken consumption: what’s going on? The Freakonomics article presents an explanation:

A study by the agricultural economists James Mintert, Glynn Tonsor, and Ted Schroeder found that for every 1 percent increase in female employment, beef consumption sank by .6 percent while chicken consumption rose by .6 percent. Why? Probably because beef takes longer than chicken to prepare, and because poultry producers did a good job marketing cheap and ready-to-cook chicken products. Furthermore, all those working women meant more household income, which meant more families eating in restaurants — where meals are less likely to contain beef than meals at home.

Health concerns do play a part; the authors found that negative media coverage of beef (either recalls due to contamination or general links to heart disease, etc.) reduced consumption, while positive coverage that linked eating meat to getting iron, zinc, and other minerals increased it. But they found that health effects were small compared to the effects of changing family dynamics — that is, women working outside the home and families eating fewer meals at home.

It’s a nice example of how the factors driving social changes are often much more complex than we’d expect. Common sense explanations of changes in beef consumption would, I think, a) overestimate how much less beef Americans eat than in the past and b) assume the major driving factors to be health-related concerns, whether about chronic disease or recalls. Yet it turns out a major aspect of the story is a structural change that doesn’t seem clearly connected at all.

I guess if I were a health advocate hoping people in the U.S. were starting to listen to messages about healthy eating, that might depress me. But I guess I can tell my grandma that the terrorists’ evil plans to infect U.S. cattle herds with Mad Cow or some other disease might not be as catastrophic as they might imagine.

UPDATE: As a couple of readers point out, the increase in chicken consumption can’t be explained just as a result of people eating chicken when they otherwise would have eaten beef; the drop in beef consumption is way overshadowed by the increase in how much chicken people eat. The total amount of all meat eaten each year has increased dramatically.

I don’t know what is driving all of that change, but I suspect a lot of it is marketing campaigns — not just directly to consumers, but efforts by industry groups and the USDA to get more meat into a wide variety of items at grocery stores and on restaurant menus, as they have done with cheese.