Tuberculosis: It's all the fashion rage!

In last night's epidemiology class, my professor said something very insightful. We were talking about Victorian era public health, and somehow beauty standards were tossed into the equation. To paraphrase, he said:

The Victorian beauty ideal, at least for Caucasian women, was thin, frail, and waif-like. This, coincidentally, described a woman with tuberculosis.

That comment sparked a massive internal dialogue for me. So much that I could barely even focus during the rest of class. It was as though all of the ridiculous beauty standards to which women are upheld were suddenly flashing before my eyes, bolstered by historical precedent. Painful beauty routines for women are ubiquitous throughout cultures and geographical distributions. These aesthetic requirements even cause us to compromise our health.

Women's pursuit of beauty could very well kill them.

The Victorians thought you looked great if you had a deadly respiratory disease. Really. That's what they considered "hot." Is it so different in other countries? Not really. The implications of this statement, aside from the obvious eating disorder concerns (which may or may not be related to "beauty," but that's another topic), are massive!

I thought about

• Foot binding: crippled women
• Genital mutilation: dehumanizes women
• Permanent makeup: tattooing our faces! ouch!
• High heels: cripple women still
• Corsets: caused us to faint and put unnecessary pressure on our internal organs
• Waxing: self-explanatory pain. Also, makes us look like pre-pubescent girls if performed on certain body parts (which is creepy!)
• Hair products: exposure to potentially carcinogenic chemicals
• Parasites: to help us lose weight (yep, seriously)
• Lysol: to make our vagina smell fresh (also, yes, seriously)

This list doesn't even include the weird devices we use:

Anyway, maybe you all already knew everything I'm writing about, but the enormity of this topic really just sank in last night. It was like getting hit with a brick wall.

I think those of us in the public health professions have a responsibility to promote healthy beauty ideals, not those that harm us. In light of the recent obesity freak-out, I think it's critical for us to maintain a skeptical perspective about what's "good for us." I'd rather be killed by Teh Dethfatz than an intestinal tapeworm designed to keep me slim and trim. Just saying.

Man denied breast cancer treatment ... because he's a man. Really?

Check out the link here about a man who was denied Medicaid coverage for his breast cancer treatment because he is not a female.

Interestingly, the article points out that the man applied for aid through a breast cancer and cervical screening program that only serves women; that is, the defined mission of the organization is to assist WOMEN with these problems, not men. I find it difficult to swallow that this organization is to blame for his lack of coverage. This is also mentioned in the Jezebel article, so kudos to them.

For example, the Juvenile Diabetes Research Foundation primarily deals with Type 1, or early onset, diabetes in child populations. Suppose the JDRF provided charitable support for individuals with this condition. Now, imagine that someone with Type 2 diabetes, or gestational diabetes, applies for financial assistance from JDRF. The organization is dedicated to a different population, however, and so denies the request. There's really no difference between that and the breast cancer situation described above.

Organizations exist to serve specific populations, and that's OK. The flaw isn't with the breast and cervical cancer screening programs, as the Jezebel article points out. Rather, our system is failing because of its inability to provide comprehensive care to everyone. If the American healthcare system was fortified with more safety nets for populations with health disparities, impoverished men with breast cancer would be less likely to fall through the cracks.

We need to allow organizations to focus on their self-defined mission rather than attempting to dictate morality to them; a women's group doesn't have to provide healthcare to men (just like a fathers' support group doesn't have to allow mothers to join). I'm glad that the editorial attacks the general healthcare structure instead of vilifying the women's health organization.

If those groups weren't allowed to set boundaries, I think it would be a slippery slope into chaotic public health practice. I can see the nature of these conversations:
"You have an AIDS foundation? Give us money to help cancer patients!"
"Um ... no?"

It's not that we shouldn't care about groups with different health problems. Rather, we need to acknowledge and realistically assess the independent ability of non-profit groups to support specific populations, strengthening our overall infrastructure to support these efforts.

Suicide among middle-aged women

A newly released study from the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that middle-aged women's suicide attempts are at what might be an all-time high. (article here).

The majority of these attempts are drug-based, which coincides with most suicide research about gender differences in preferred method of personal dispatch; men are more likely to use firearms, while women are more likely to attempt to kill themselves with drugs or other toxic substances. Not surprisingly, men are generally far more successful, but the incidence of female suicide attempts is significantly higher. I'm not citing this information because I've read so much about suicide and mental health during the past 10 years that I can't even remember where I found all of these facts ... but I'm certain they're out there somewhere. Happy hunting, blog readers.

Anyway, this blog isn't about pointing you to interesting documents and factoids about health (all the time), so today we're going to launch into a discussion about mental health services in this nation and how women's health is grossly neglected. And .... go.

So, middle-aged women make up one of the fastest-growing demographics for newly diagnosed eating disorders. Middle-aged women are also apparently attempting to kill themselves more often. What gives? The linked article talks about hormone problems, "empty nest" syndrome, and other biological/psychological motivators, all of which seem perfectly legitimate. Have we stopped to think, though, that this generation of women might have been left behind by the healthcare system? That we have been carefully ignoring their needs for years?

My mother, for example, has had to practically pull out her doctors' teeth to get them to test her for heart conditions (they run in the family) and hormone problems (yep, I have them, too). These are relatively straightfoward conditions; imagine if my mom was like the woman in the linked article. Schizophrenia? Yep, good luck receiving appropriate treatment for a condition like that.

I imagine that if it's difficult for these women to receive adequate physical care, mental health care must be lacking.

This article is simply another supporting document for the degrading quality of healthcare in our nation (in my opinion). Using carefully collected anectdata (joke), I have found that many of my friends and family members have been ignored, if not flat-out mistreated, by medical professionals at university health centers and specialists' offices alike. Our healthcare system is sick and unable to accommodate physical and mental illness, despite increasing technological power.

This article also states that ONE IN FOUR Americans has a treatable mental illness. That's right. 25% of America is mentally ill (count me in the ranks!). Yet, mental illness is still so heavily stigmatized, and insurance companies are ridiculously hesitant to provide even a small bit of coverage for problems such as eating disorders and depression.

The implications of our social condition contained within this article are just too great to ponder. Gender politics, marginalization of the mentally ill, the cultural traditions of the Baby Boomers .... #head_explosion

I hope you enjoy thinking about these problems, as well. Get back to me when you've come up with a solution.

South Dakota judge rocks a women's health decision ...

Check out Jezebel's analysis of this South Dakota proposition that was struck down by a perceptive judge: Abortion law degrades women

Fat women everywhere ... FREAK OUT!

Something my friend posted today on Facebook: Obese girls face tough career climb

Coming from an eating disordered background, I have to admit that this kind of thing hits a raw nerve for me. Weight loss efforts for PRESCHOOLERS?

Are you serious?

Can you imagine how messed up those kids are going to be if they start developing food issues at that age? I mean, I remember having serious body image concerns at about age 5, but I'm in the minority (one would hope). Why would we want to spark this kind of neurosis in a large (no pun intended) population of youngsters?

I understand that obesity is a problem in our nation today. I really do get it. Obesity, diabetes, yadda, yadda, the dethfatz are going to get you!

But I will say (as I always do) that obesity is not simply a function of what you eat or how much you exercise. Women with PCOS (ahem, moi) experience obesity as a symptom of their illness ... and this condition affects as many as 10% of women. Funny that you never hear about it, right? That's because too many of us are supporting bogus and dangerous diet ventures in an effort to eliminate our socially manufactured shortcomings.

Anyway, I would believe that young women face huge obstacles if they are larger. After all, our culture tells us that our size is a reflection of our self-control, our virtue, our ability, our dedication. How many studies have been done that prove that fat people (not just women) get paid less, are hired less frequently, and generally get the short end of the stick?

Arguing against these researchers' suppositions ... I wonder whether anyone noticed that lower-income women from disparaged populations are more likely to be obese, which is probably why they have a harder time graduating from college and becoming gainfully employed. ETA: The article says that the researchers said "It didn't seem as though economic situation was a factor," but I'm not sure how that's quantified. Another case of correlation being confused with causation. I mean, I know it's a tough concept, but it seems like a lot of researchers just can't stop sensationalizing phenomena that kind of coincidentally happen together. It's hard for me to believe that we can blame all of our problems on being fat.

Here's the crux of the whole thing for me: This kind of article perpetuates the "if only I was skinny" myth that so many eating disordered folks hear playing in their head ALL DAY EVERY DAY.

"If only I was skinny, I would get a better job."

"If only I was skinny, I would have more friends, and maybe even a partner."

"If only I was skinny, I could feel good about wearing a size ____ "

"If only I was skinny, everything would be better."

This is a dialogue that none of us deserves to hear. It's a bunch of baloney. Being skinny doesn't make your life easier if all you think about is remaining thin. In the case of folks like me, the push to be super thin can endanger your life.

It won't be until we, especially as public health practitioners, start to respect all types of bodies (including those that are naturally thin, fat, whatever) that we will truly begin to find a solution to the obesity problem. Treat these people with dignity, for heaven's sake.

One final thing: "He himself has studied the connection between body image satisfaction, and obesity and anorexia. People who have poor self esteem have difficulty controlling their eating habits, he said."

Yes, because obesity is analogous to an eating disorder? (WRONG ... not everyone who binge eats is fat, and not everyone who is fat binge eats). And the last time I checked, eating disorders weren't because of a lack of control over your eating habits, they're about a need to control something ... so you exert more control over your eating (i.e., not eating anything!). I'm really not impressed with this particular piece.


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http://fatnutritionist.com/
http://danceswithfat.wordpress.com/