Chronic conditions are health conditions that have lasted or are expected to last twelve or more months and result in functional limitations and/or the need for continuous medical care (Hwang et al. 2001). In a recent study using data from the 2005 Medical Expenditure Panel Survey, Paez, Zhao, and Hwang (2009) found that 43.8 percent of non-institutionalized civilians in the U.S. live with one or more chronic conditions. Among adults, it was found that hypertension, hyperlipidemia, and diabetes are the most common chronic diseases. The data further indicated that the likelihood of having a chronic condition increases with age. Non-Hispanics were found to be more likely to report a chronic condition than Hispanics, whites were found to be more likely to report a chronic condition than other racial groups, and females were found to be more likely to report a chronic condition than males. The associations between having a chronic disease and ethnicity, race, and sex were found by Paez, Zhou, and Hwang to exist even after controlling for age. A comparison of the 2005 data to 1996 data suggests that the prevalence of multiple chronic conditions is on the rise in the U.S. more...
Earlier this year, many retired football players and their families filed a class-action lawsuit against the NFL. The complaint states that the NFL hid evidence of the dangers of the game, dangers like brain damage from repeat concussions and sub-concussive trauma. New research indicates that the repetitive beatings that football players experience over the course of their career causes irreparable damage to their brains, leading to cognitive, emotional, and functional problems similar to Parkinson’s and Alzheimer’s diseases. Several players committed suicide after repeat concussions left them with depression and mood swings, and many others continue to suffer memory loss, cognitive impairment, and balance problems.
This week, the journal, Pediatrics, published an article on the relationship between rates of sexual activity-related outcomes and the Human Papillomavirus (HPV) vaccination. Specifically, the researchers set out to determine if HPV vaccination leads to increased sexual activity in young girls. Since the vaccine’s inception, some parents, medical officials, religious organizations and others have suggested that giving girls this protection from HPV will promote them to engage in sexual activity; the vaccination is essentially an endorsement for sex in the teenage years. This study puts some of those fears to rest: the injection of the vaccine is not associated with significantly elevated rates of sexual activity-related outcomes in young girls, specifically pregnancy, contraceptive counseling, and sexually transmitted infection testing and diagnosis.
This is great news. This study has the potential to calm the nerves of parents and other individuals invested in preventing adolescent sexual desire and activity, alleviating any anxieties that might prevent girls from getting this preventative medicine. The benefits to the HPV vaccinations are obvious. The vaccine, Cervarix, protects against HPV types 16 and 18, which cause cervical cancer. The other vaccine, Gardasil, immunizes against types 16 and 18, as well as types 6 and 11, which cause cervical warts. These medical advancements stand to have a real and positive impact on women’s health.
While Cervarix is approved for use only in women, Gardasil is approved for use in both men and women. Despite the approval of Gardasil for both genders, some researchers have noted the persistent association of the HPV vaccination with women (see suggested reading below). At least part of this association emerges from the history of the development and government approval of the vaccination. In 2006, after years of pharmaceutical research and development, the United States Food and Drug Administration (FDA) approved Gardasil. Soon after, the Center for Disease Control (CDC) made a formal recommendation that this vaccine should be given to girls, age 13-18. The agency reasoned that this age group could be protected from HPV before they even became sexually active. The benefits to women’s sexual and reproductive health were obvious and so the CDC thought the vaccine important enough to make a strong recommendation—it should be part of a girl’s vaccination schedule.
Yet, Merck, the pharmaceutical company behind Gardasil, had another population in mind: men. Perhaps motivated by profits, Merck began clinical trials of Gardasil in the male population, and by 2009, the FDA was satisfied that the vaccine was safe for men, too. Yet, the CDC wasn’t convinced that this vaccine was as necessary for boys, age 13-18, as it was for girls. And so, the CDC decided that the vaccine may be given to boys, rather than recommending that it should be part of a normal male vaccination schedule. The CDC reasoned that the vaccination of girls and women would be enough; over time, the virus would be eliminated from the population, as vaccinated women would prevent the transmission from one sexual partner to another. The CDC’s decision was backed by medical research, which showed that the costs of vaccinating boys far outweighed the benefits to the entire population. Vaccinating both boys and girls would not only be redundant, but would also drive health care costs up, a particularly undesirable outcome given the falling economic climate and the troubled state of health care in the U.S.
In 2011, the CDC added Gardasil to the normal vaccination schedule for boys, thereby making the requirements equal for both genders. Still, as the research published by Pediatrics reveals, it is not boys’ bodies and sexualities that are at the heart of the concerns over the vaccine. The association of this vaccine to girls and women persists. In my next post, I will consider some of the gendered issues and assumptions that maintain this link. In the meantime, I suggest reading this Sociology Compass article by Sarah E.H. Moore.
Another suggested reading:
Defenbaugh, Nicole and Kimberly N. Kline. 2012. “Gendered Construction of HPV: A Post-Structuralist Critique of Gardasil.” In Challenging Images of Women in the Media: Reinventing Women’s Lives, edited by Theresa Carilli and Jane Campbell, pages 65-76. Lanham, Maryland: Lexington Books.
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.
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.
In a recent article in The Sociological Quarterly, Catherine E. Ross and John Mirowsky of the University of Texas explored the relationship between gender and education in terms of improving health. The two hypothesized that education improves health more for women than men and set out to prove this point through the theory of resource substitution. Essentially, resource substitution implies that any one individual can have multiple resources at their disposal that can contribute to and develop their human capital. In the context of this discussion, human capital is defined as the “productive capacity developed, embodied, and stocked in human beings themselves.” Of course, existing social barriers can often limit which resources an individual can count towards the development of their human capital. more...
Indigenous people residing in Ecuador filed an environmental lawsuit against Chevron Corporation for dumping billions of gallons of toxic waste in the Amazon rainforest between 1964 and 1990. The indigenous people argue that Chevron’s toxic waste disposal resulted in $27 billion worth of damages. For instance, evidence suggests that Chevron’s former oil drilling sites are contaminated with toxic byproducts that cause cancer. The indigenous people drink from water sources contaminated by these toxic byproducts.
Chevron hired twelve public relations firms to address the claims of the indigenous people. Undoubtedly, Chevron also hired the public relations firms to respond to organizations criticizing Chevron for engaging in unethical behavior. Some shareholders disapprove of Chevron’s response to the environmental lawsuit, which includes hiring Hill & Knowlton. Interestingly, this public relations firm represented the tobacco industry during its indictment about tobacco causing cancer.
Recently, the common theme of corporate irresponsibility became apparent. Chevron denied responsibility for its contaminants. Also in the news, Toyota Motor Corporation reluctantly announced a safety recall of several million vehicles with sticking gas pedals. If corporations engage in actions (i.e., dumping toxic waste in Chevron’s case; selling vehicles with faulty parts in Toyota’s case) that result in serious illnesses and injuries, then should they be held accountable? Or, more pointedly, should executives be held criminally responsible for the actions that they endorse while managing corporations? How can we influence executives to place the health and safety of human beings over the corporate bottom line?
By Rachael Liberman
In a recent article published by the LA Times, titled “Watching TV shortens life span, study finds,” Jeannine Stein reports on a study that “found that each hour a day spent watching TV was linked with an 18% greater risk of dying from cardiovascular disease, an 11% greater risk of all causes of death, and a 9% increased risk of death from cancer.” This particular study, which used participants from the Australian Diabetes, Obesity and Lifestyle Study, used both television viewing hours and blood sugar levels as variables to determine their results. As Stein reports, “Researchers found a strong connection between TV hours and death from cardiovascular disease, not just among the overweight and obese, but among people who had a healthy weight and exercised.” Further, “People who watched more than four hours a day showed an 80% greater risk of death from cardiovascular disease and a 46% higher risk of all causes of death compared with those who watched fewer than two hours a day, suggesting that being sedentary could have general deleterious effects.”
The rest of Stein’s article includes quotes from Dr. David Dunstan, lead author of the study, and Dr. Prediman K. Shah, director of the cardiology division of the Cedars-Sinai Heart Institute, who both comment on “sitting posture,” “long periods of sitting,” “long hours in front of the computer screen,” and “couch potatoes.” more...
Dena T. Smith
This week’s Science Times profiled Dr. Francis S. Collins, the recently appointed director of The National Institutes of Health. The article (below) points to clashes between Collins’ belief in God and his identity as a scientist. Collins, who is best known for his involvement in the Human Genome Project, which set out, in the early 1990’s to do just what it sounds like it might – map the human DNA – is also a religious man. Further, Collins believes that his scientific training aides him in an explanation of faith. His colleagues at NIH seem, at the very least, troubled by Collins’ faith, given the nature of his career (and theirs). How can a man who dedicates his days to mapping genes and who now directs the institutes dedicated to health-related research believe that God exists and is responsible for much of what scientists believe to be natural or man-made phenomena? While this is certainly a fascinating example of the clash between science and religion, this saga points to an assumption often made by social psychologists and laypersons alike: belief in God and Science are mutually exclusive. Belief in Science and God seem to be competing ideologies – a belief in one seems to necessarily preclude a belief in the other, especially when we’re talking about issues like the origin of the species. In fact, Darwin’s demise is a perfect example of the fervent debate and even the anger that erupts in both the scientific community, when presented with deep belief in religion and that likewise exists in religious communities when scientists disregard the possibility that God plays a role in our world. But perhaps the clash need not be experienced as something so great.
Member of the World Economics Association – promoting ethics, openness, diversity of thought and democracy within the economics profession
In the United States, many citizens do not have health insurance. Some people cannot afford health insurance. A recent CNN article explains that other people are unable to obtain health insurance because they have pre-existing medical conditions.
People that have group insurance plans are able to receive health care coverage even with pre-existing conditions. However, some people do not have group insurance plans because their employers do not provide health insurance, they are self-employed, or they are unable to work. These people have to apply for individual insurance plans. Twenty-one percent of people who apply for individual insurance plans are rejected, charged higher premiums for insurance plans including coverage for their pre-existing conditions, or offered insurance plans excluding coverage for their pre-existing conditions.
The health insurance industry’s trade association created a proposal to reform health care, which promises to guarantee coverage for people with pre-existing conditions provided that the United States government requires its citizens to purchase health insurance. As sociologists, we should question: If the United States government implements these suggested health care reforms, who stands to benefit and who stands to lose?