health/medicine

“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, 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.

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, 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.

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.

Right?

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, 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.

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, 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 ideology of intensive motherhood is a cultural approach toward parenting that suggests that competent childcare demands “copious amounts of time, energy, and material resources” and that providing such childcare should take priority over everything else a mother might like or need to do.  In South Korea, this imperative is at work even before babies are born and the practice is called tae-gyo. A reporter for the Korea Herald, a local newspaper, explains:

Since over 600 years ago, expectant mothers in Korea have been practicing taegyo, a series of prenatal routines aimed at nurturing a healthy, virtuous and skilled child. They try to see and hear only the most pleasant things starting from three months of pregnancy.

Koreans believe that a mother’s state of mind and ongoing education during pregnancy determines a baby’s prospects. Their educational and occupational future, even their personality, is dependent on what their mothers do while they’re pregnant. A reporter, below, quotes a South Korean figure who claims that “nine months of prenatal education is more valuable than nine years of post-natal learning.”

Interest in tae-gyo is escalating thanks to declining birth rates and hyper-competition. Fewer Korean couples are having more than one child and they want to give these “single” children an edge by helping them from the womb.  They want their children to survive in a hypercompetitive educational environment.

Accordingly, while the most common tae-gyo used to be listening to classical music, women are facing increasing pressure to do more and more for their child before it is born. During the past 20 years, tae-gyo has incorporated learning calligraphy or floral arrangement, crafts like knitting and sewing, and doing yoga. Expected mothers are doing English and math tae-gyo, meaning that they study English and do math for their unborn children to ensure that they will excel in those skills. Korea’s tourism industry have developed a “taegyo travel package,” which is supposed to be beneficial for babies in the womb.

This can all be quite intensive, as you might imagine, as women are expected to personally practice all of the skills and traits they hope their baby will have. Intensive mothering in South Korea, then, starts before the baby is born.

[youtube]https://www.youtube.com/watch?v=YX2C1ueBxY4[/youtube]

Cross-posted at Pacific Standard.

Sangyoub Park, PhD, is an associate professor of sociology at Washburn University, where he teaches Social Demography, Generations in the U.S., and Sociology of East Asia. His research interests include social capital, demographic trends, and post-Generation Y.

In a previous post, I wrote about a University of Illinois football coach forcing injured players to go out on the field even at the risk of turning those injuries into lifelong debilitating and career-ending injuries. The coach and the athletic director both stayed on script and insisted that they put the health and well-being of the scholar athletes “above all else.” Right.

My point was that blaming individuals was a distraction and that the view of players as “disposable bodies” (as one player tweeted) was part of a system rather than the moral failings of individuals.

But systems don’t make for good stories. It’s so much easier to think in terms of individuals and morality, not organizations and outcomes. We want good guys and bad guys, crime and punishment. That’s true in the legal system. Convicting individuals who commit their crimes as individuals or in small groups is fairly easy. Convicting corporations or individuals acting as part of a corporation is very difficult.

That preference for stories is especially strong in movies. In that earlier post, I said that the U of Illinois case had some parallels with the NFL and its reaction to the problem of concussions. I didn’t realize that Sony pictures had made a movie about that very topic (title – “Concussion”), scheduled for release in a few months.

Hacked e-mails show that Sony, fearful of lawsuits from the NFL, wanted to shift the emphasis from the organization to the individual.

Sony executives; the director, Peter Landesman; and representatives of Mr. Smith discussed how to avoid antagonizing the N.F.L. by altering the script and marketing the film more as a whistle-blower story, rather than a condemnation of football or the league…

Hannah Minghella, a top [Sony] executive, suggested that “rather than portray the N.F.L. as one corrupt organization can we identify the individuals within the N.F.L. who were guilty of denying/covering up the truth.” [source: New York Times]

I don’t know what the movie will be like, but the trailer clearly puts the focus on one man – Dr. Bennet Omalu, played by Will Smith. He’s the good guy.

Will the film show as clearly how the campaign to obscure and deny the truth about concussions was a necessary and almost inevitable part of the NFL? Or will it give us a few bad guys – greedy, ruthless, scheming NFL bigwigs – and the corollary that if only those positions had been staffed by good guys, none of this would have happened?

The NFL, when asked to comment on the movie, went to the same playbook of cliches that the Illinois coach and athletic director used.

We are encouraged by the ongoing focus on the critical issue of player health and safety. We have no higher priority.

Originally posted at Montclair SocioBlog. Cross-posted at Pacific Standard.

Jay Livingston is the chair of the Sociology Department at Montclair State University. You can follow him at Montclair SocioBlog or on Twitter.

Medical professionals often have the final say in deciding what counts as a “defect.” Often, their decisions exceed the bounds of medicine, addressing bodies that may deviate from “normal” or “average,” but do not actually cause medical problems.

An alternative might be to allow the patient to decide if his or her body is acceptable, but in doing so they risk allowing people’s deeply subjective and often dysmorphic perceptions of their own bodies determine whether they undergo a risky procedure.

Is there another way?

Pediatric surgeon Norma Ruppen-Greeff and hers colleagues thought so. Pediatric physicians often correct hypospadias: a condition in which the meatus, or opening of the urethra, doesn’t quite make it to the top of the penis during fetal development, such that the urethra exits the penis somewhere along the shaft. This is generally corrected surgically, but physicians found that some men returned to them as adults with concerns that their penis still appeared abnormal.

Instead of dismissing men’s concerns or jumping with a knife, they decided to ask women if they noticed. They had 105 women fill out a questionnaire and rate which aspects of penile appearance were important to them. And, lo and behold, the shape and placement of the meatus was the least important. No need for surgery, plus they can reassure the guys that they’re okay. (Someone should follow up and ask gay and bisexual men; anyone for an awesome senior thesis?)

This is a great way to measure the sociocultural value of a surgery. Whereas we’re used to thinking about surgical issues as psychological (someone wants it) or medical (someone needs it), these physicians asked a distinctly sociological question. They measured how penises are widely perceived and which parts are socially constructed as important. That’s a pretty neat way to incorporate sociological realities into surgical practice.

Cross-posted at Pacific Standard.

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.