Waitlists and Worse: Rebuilding VA Health Care

Amy August on June 3, 2014

Eric Shinseki resigned last Friday as head of the Department of Veterans Affairs, stating that “the VA needs new leadership”. This comes in the wake of scheduling issues at VA medical centers leading to extended delays for veterans’ healthcare—issues he now recognizes as a “systemic lack of integrity” involving a widespread cover-up. According to a new VA audit report prompted by a series of CNN investigations, deadly delays in care were being suppressed by clinics driven to meet performance targets. The VA report concluded that the 14-day wait time performance target was “simply not attainable,” and it called for a “long-term, comprehensive reset” of the broken system. While  Shinseki acknowledges these problems, how reasonable is it to expect his successor to fix them? Research shows that scheduling issues are only one barrier among many to veterans’ accessing care.

When predicting which people will seek care, sociologists take into account patients’ prior experiences with the system such as health outcomes and customer satisfaction. Poor service doesn’t just hurt the veterans who seek care—it may keep them from seeking care in the first place!
Some veterans are eligible for both Medicaid and VA services. The largest group of these vets relies on Medicaid rather than VA care or a combination of the two.
Issues with gender in the military also have an effect. Female veterans have less access to VA healthcare relative to males, with 19% of women reporting delayed health care or unmet needs. Knowledge gaps about VA care, perceptions that providers are not gender-sensitive, and a history of military sexual assault predicted women’s likelihood to delay or forgo treatment.

 

Mass Shootings and the “Man”ifesto

Evan Stewart on May 26, 2014

Last Friday—in another chapter of a tragic pattern—22-year-old Elliot Rodger killed six people and wounded more in Isla Vista, California. Rodger also left a manifesto on YouTube in which he laid out his plan to take revenge on women who “shunned him.” The video sparked national conversation over the weekend, including the twitter hashtag #YesAllWomen to share stories of daily gendered and sexual harassment women face. Mass shootings are rare, but the culture that creates them is not. Researchers find strong elements of masculine gender performance in many of these acts—with young men attempting to assert power through violence.

The kind of attack carried out by Rodger closely matches researchers’ profile of other shooters—a clear, sustained pattern of challenges to their masculine identities. They do not just “snap,” but are shaped over time by the way our society polices gender.
Feelings that lost masculinity can only be reclaimed through violence are tied to a broader pattern of threats against women. While there have been declines in violence against women and other crime over the past generation, violence against women remains an enormous problem in the United States and around the world.

For more on the sociology of mass violence, check out this TSP Roundtable.

How to Give Birth the “Right” Way

Jacqui Frost on May 19, 2014

Mila Kunis recently announced that she will be giving birth naturally, saying “I did this to myself – I might as well do it right.” By “natural,” Kunis means that she will be using a midwife when she gives birth and opting out of the hospitalized, medically-induced birthing experience that dominates in American society today. Kunis is just one, albeit highly publicized, instance in a larger move away from the hospitalized birthing experience to “home birth.” However, this shift is not without its conflicts, and Kunis’ statement that natural birth is “doing it right” points to deeper societal perceptions of the right way to give birth and how those perceptions of what is “natural” might be changing.

The media often frames this increase in home births as potentially dangerous and problematic, but women were giving birth at home long before they started going to hospitals. The medicalized model of childbirth is a fairly recent product of a larger shift in societal acceptance of professional science over local knowledge.
This “medicalization of childbirth” has huge impacts on how society, and women themselves, see women’s bodies and safety. Sociologists argue that this increased medical monitoring during pregnancy is a form of social control that constrains women both physically and emotionally.

For a great history of homebirth and the reproductive rights movement, check out Christa Craven’s 2010 book Pushing for Midwives: Homebirth Mothers and the Reproductive Rights Movement.

#BringBackOurGirls Needs More Than a Media Boost

Molly Goin on May 15, 2014

Last month’s kidnapping of 276 Nigerian schoolgirls was met with a slow response from Nigeria’s state officials, leading activists to turn to social media in hopes of drawing international attention to the crisis. The #BringBackOurGirls hashtag campaign, started by Twitter users in Nigeria, has already been mentioned over one million times on the microblogging platform since its launch three weeks ago.

Social media presents an unparalleled opportunity to form global social movements. With geographic proximity no longer an issue, people around the world are able to have discussions that allow them organize around social issues.
With #BringBackOurGirls, online activists have found common ground rooted in enthusiastic resistance to violence against women. However, as we learned from #KONY2012, widespread enthusiasm and awareness are not necessarily sufficient to spur change.

Though the campaign has garnered support from prominent activist organizations as well as the United States government, critics, namely Rush Limbaugh, have argued that this instance of “hashtag activism” merely illustrates the “powerlessness” of governments to respond to the abductions.  Nonetheless, the campaign was powerful enough to spur action from Nigerian president, Goodluck Jonathan, who recently designated state resources to finding the girls.

Although transnational “hashtag activism” may publicly pressure officials to act, states also face policy barriers for negotiating with kidnappers which can hinder their capacity to respond to activists. Additionally, numerous factors—including the demands made by kidnappers and whether the location of the hostages is known—have significant bearing on the success of rescue.

In the case of #BringBackOurGirls, hashtag activism has effectively brought international attention to the kidnappings. However, calls for awareness need be coupled with the creation of institutional structures that will help states better deal with such crises.

Michael Sam, Sport, and Sexuality

Stephen Suh on May 12, 2014

2014 has been a triumphant year for gay professional athletes. Earlier this year, Jason Collins was the first openly gay player to sign a contract with the NBA. More recently, Michael Sam became first openly gay player drafted into the NFL. In a team sporting culture where camaraderie and success have traditionally been tied to masculine overtones and homophobic gestures, these and other moves have undoubtedly ushered in a new era of professional sports­­–one in which a greater number of athletes, teams, and leagues are willing to take a stance against the exclusion of players based on their sexual orientation.

Collins and Sam are bringing to light a public issue that sociologists have seen coming in a wide range of sports and social settings.
These athletes’ stories are a particularly important development in a social arena which is traditionally dominated by men and masculinity.

These trends also reflect broader shifts in gender and sexuality over the past few years. For more information on shifting norms regarding sexual orientation in other institutions, check out Kathleen Hull’s recent TSP white paper on the changing public perception of same-­sex marriage in the US.

 

Women at Work: When Self Help Isn’t Help Enough

Penny Edgell on May 8, 2014

There have been a spate of new books lately advising women how to turn inward, change their behavior, and remake themselves to be more successful and ‘leap over’ gender barriers in the workplace. If a woman is not paid what she is worth, passed over for promotion, or even harassed, the solution, it seems, is to lean in – because eventually (soon, in fact) everyone will realize that women really should rule the world. The latest is a book by Katty Kay and Claire Shipman, The Confidence Code, in which the authors argue that the primary barrier to women’s success is not sexism but rather women’s own lack of confidence. And in one way, they are right. Confidence is gendered. Women are less confident than men (and men tend to be over- confident relative to their abilities). Of course confidence matters. But trying to solve a problem of structural sexism with a good night’s sleep, a self-help book, and a smile is a losing proposition.

In their focus on the therapeutic and their emphasis on self-help, these books foster the kind of high-cost, alienating emotional labor sociologists have been writing about since the early 1980s.
These books either completely ignore or actively downplay the structural causes of the confidence gap, including the way that primary schools teach girls that their opinions aren’t as valuable as boys’ opinions.
They also turn a blind eye to the fact that rational actors engage in behavior that is rewarded. Women who show the kind of confidence that men show, and who “negotiate like a man,” are often punished, not rewarded, in America’s workplaces.
Thus, authors like Kay and Schipman are encouraging women to fight with the weapons of the weak instead of helping us all to tackle the more difficult task of breaking down the structural barriers to women’s real and durable success.

Penny Edgell is a Professor in the Sociology department at the University of Minnesota. She studies culture, religion, gender, family, symbolic boundaries, and inequality. 

On Being “Basic”

Emily M. Boyd on May 6, 2014
Pumpkin spice latte from Starbucks.

Recently, CollegeHumor released a video clip illustrating the symptoms of being a basic bitch, which they define as “an extra regular female.” Other references to this term within popular culture are plenty: many cite loanthony’s youtube video for popularizing the whispered insult “you’re basic,” and additional uses throughout the past several years. How can we sociologically understand this phenomenon? Is it okay for the term bitches to be used casually within popular culture? What’s the harm?

A term derogatory to all women can be difficult to “reclaim” or use ironically. Instead, when women use “bitch” to refer to themselves or their friends (as in, “what’s up my bitches”) they are experiencing false power. They may feel included by using popular terminology, but they’re actually reinforcing gender essentialism and inequality by doing so.
Categorizing women as different forms of bitches—the bad bitch, dope bitch or boss bitch—creates a typography of all women as bitches, just different kinds. Symbolic interactionists note that the language and phrasing that we use to describe things can dramatically change our ways interacting with them.

For example, scientists working on nuclear weapons use benign terminology—the “exchange” of warheads with enemy countries or the “footprint” for an area of the “delivered” explosion—which allows them to distance themselves from the reality of their work. Using terms like basic bitch to describe a regular woman may allow us to do the same.

However, not all sociological analyses of language find that contemporary use of terminology previously viewed as derogatory is problematic.

Within social movements, collective identities such as “queer” can be seen as functional in drawing a variety of communities together and uniting around a cause.

Emily M. Boyd is an Associate Professor in the Sociology and Corrections department at Minnesota State University-Mankato. She studies gender, social interaction and popular culture.

The Culture of Cosmos II: Space and Race

Stephen Suh on May 1, 2014

Earlier in the week we looked at the new television series Cosmos and the fervor it caused between pro-science and pro-­religion camps. Lost within this science vs. religion debate, however, is the obvious racial angle surrounding Cosmos. Neil deGrasse Tyson—the series’ host—is one of the few widely-recognizable black scientific figures today. He himself has stated that there is a distinct lack of representation of African Americans in STEM (Science Technology Engineering Math) fields. What broader trends in race and science might this show illuminate?

Research affirms deGrasse Tyson’s opinions, showing that there are indeed significant inequalities in career attainments in STEM fields for women and minority groups:
Given the limited ways in which African Americans are typically represented in the media, deGrasse Tyson’s well established media presence as an African American scientist proves doubly important:

 

The Culture of Cosmos

Stephen Suh on April 28, 2014

The documentary series Cosmos debuted in March with as much public opposition as fanfare­­—with some groups openly criticizing the scientific viewpoints covered on the show, and others applauding its attempts to bring science back to the mainstream. A followup to the 1980 series of the same name, Cosmos provides scientific perspectives on a number of ­oft-debated topics, such as the creation of the universe, the evolution of life on Earth, and the importance of scientific knowledge and education. Not surprisingly, much of this controversy surrounding the show has been political and/or religious in its nature. Has the show hit a fault line in American culture?

Sociologists writing about the apparent political divides between supporters of science and religion often find that there isn’t a clean divide between the two. Many scientists are religious, and their findings don’t always challenge religious claims.

Also, in a recent post in Sociology Lens, Huw C. Davies uses theory from Foucault to cut through the “religion versus science” debate and show how both institutions vie for power through “discourses of truth.”

Stay tuned for Part II of our take on Cosmos later this week, where we’ll review work on science and race in the United States. 

 

Affirmative Action and Racial Inequality

Evan Stewart on April 24, 2014

This week’s Supreme Court decision to uphold Michigan’s ban on affirmative action in college and university admissions stirred up a lot of legal controversy, and will likely lead to more court cases about these policies in other states. In the wake of conversations about constitutionality, however, it is often easy to miss the problems that affirmative action is meant to be correcting.

Racial inequality, especially in the workplace, is very real. Employers regularly make decisions based on race which clash with existing civil rights law.
Most Americans tend to think of diversity in very general, open and optimistic terms, but this “happy talk” often makes it difficult to directly address underlying racial attitudes—and the inequalities they produce—with policy changes.

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