Are you still a bit confused by the details? Check out this great paragraph in the Atlantic that details the decision.
A great image from Population Services International‘s most recent issue of their magazine, Impact, from the cover article written by Desmond Chavasse, Ph.D, Vice President, Malaria Control & Child Survival, PSI, about causes of child mortality globally.
One of the purposes of the image, of course, is to show the stark contrast between directed funding for treatment and eradication of certain diseases and the number of children afflicted with these illnesses. How does this impact our understanding of global health and of the marketing around certain hot topic health issues and ways in which donors feel as though they are contributing to a decline in preventable deaths?
When I worked in development for HIV/AIDS organizations, it was fascinating to speak with donors about their reasons for giving and their understanding of the prevalence and incidence (and the general audience grasp of the word incidence, which is the measure of risk of contracting a certain illness or disease within a specified time frame) of HIV. Contrast this with the understanding of malaria, TB, diarrhea, deaths due to childbirth complications (for the mother and the infant), and the gap between perception and reality was startling. In no way do I want to deny the importance of consistent development support for all diseases on a global scale, but I do think there is something lacking in terms of the education around these issues for donors and even some advocates.
Solutions? Come chat with me on Twitter.
My support of a woman’s right to choose has been well-documented. I champion a woman’s freedom to make a decision about whether or not she should be carrying a fetus, and the availability of resources for her to safely and quickly terminate a pregnancy if she sees fit.
We are in troubled, troubled times. Ceaseless efforts to deny women these rights are abound, and I could link to hundreds of articles that document this, but the handful I’ve chosen certainly upset me enough. I, along with scores of women’s health advocates, have tried any number of measurable ways to fight back – raising more money; drafting opposing legislation and striking down initiatives; testifying before hearings; writing op-ed pieces that detail our positions and rationally lay out the reasons why these reproductive rights are essential to women’s health, well-being, and even economic prospects; explaining that abortions and contraception are also necessary for reasons far beyond prevention pregnancy, and that all reasons are valid and worthwhile.
I’m tired. I’m tired of the hypocrisy of the anti-choice wing. Tired of the false rhetoric. Tired of their offensively misguided and false claims to care about women as much as they care about fetuses, tired of the aggressive push to force women to maintain pregnancies that they are unprepared for and do not want, and further impact their educational and economic statuses. Tired of the trumpeting of false information about contraception that is subsequently followed up by happily taking money from the very creators of products that prompted their supposed moral outrage. Tired of their total disregard of the reality of many of these women who make the decision to have an abortion. Tired of total disregard of the statistics that undermine their arguments about the United States valuing children and their yet-to-be-realized lives. Tired of the total disregard and dismissal of real ways that abortions could be prevented – complete and comprehensive sexual health education and easy access to a variety of contraceptives. Tired of the complete disdain for women as sexually independent beings, tired of their disgust of the sexual lives of women while giving men and their sperm an unlimited free pass and the ability to impregnate and take off without even a slap on the wrist. Tired of the inability to empathize and simultaneously mete out punishments to the half of the population they deem fit the ostensible crime of engaging in sexual activity. If you want to harp on the issue of responsibility, then it is essential to ensure that both parties are equally responsible in every way – and as about half of the links I have put in this post show, that simply does not happen. Women are disproportionately – vastly so – shouldered with the entire burden of and the entire blame. That’s the reality, and it can’t be separated from the issue.
I’m tired but not worn out. I remain entirely committed to this cause, and won’t be sidetracked by opponents who use everything from personal insults to false science to shaky numbers to try to distract me. Nancy Keenan, the president of NARAL, recently announced that she is stepping down – largely due to the fact that she feels millennials need to begin steering the abortion rights ship, to combat the intense dedication of anti-abortion activists. Over 50% of anti-choicers maintain that abortion is a primary issue for them in elections, while only about a quarter of pro-choicers say the same. Well, I’m here. This remains my number one issue. Are you with me?
A friend recently sent me yet another HuffPo article, that I certainly enjoyed, but that for some reason was the straw that broke my camel’s back in many ways, as I saw her argument struggling mightily to encompass all of the above reasons why we should protect contraceptive access for all women. I’m so tired, in fact, that my response to these attacks has been harrowingly brought down to the essential core that I never thought I would need to stray from when I first realized what being pro-choice was; stripped of the attempts to rationalize (issues of medical necessity outside of pregnancy prevention aside, issues of risk to the mother aside, issues of childcare concerns and education concerns aside) with those who are, in fact, irrational about these issues. What happens in my uterus is my business alone. If you want the babies that these fetuses become, that women made the decision they cannot care for, then there should be no difficulty in deciding that you should take them. Take them all. Take them lovingly and fully, not cynically or begrudgingly. Cultivate them for 9 months, care for the baby when it’s born, love her, feed him, clothe her, educate him, without any help from me. If your goal is to punish women who you think have made flagrantly immoral mistakes, let us air all of your dirty laundry as well, and dissect every single decision you in your life made, and force you to pay for it as we see fit. And by all means, find a way to keep the men who didn’t use condoms, or bullied their partners into not using contraception and subsequently fled, or who threatened or coerced their partner, sitting firmly next to a baby’s crib. Come up with solutions to the myriad of complex social and economic issues that contribute to reasons women get abortions. Re-educate yourself on the fundamental fact that it is not your right to dictate the decisions of another person, and while that lack of control may infuriate you, it’s the way it is. What happens in my uterus is my business alone. Wherever I go, the uterus goes. You don’t get to stake your judgment flag in my sex organs selectively at will, running “protectively” towards it when it suits you, and fleeing from it (and from what it carries) when it doesn’t. You don’t get to be there at all!
So don’t tell me that we have a collective duty to care for these unborn babies when what you are actually doing is attempting to control the freedom of women while doing everything you can to make sure that no true collectivism actually does benefit women or their babies.
This is a great infographic, courtesy of Mashable, that details the vareity of ways mobile health improves patient outcomes and an individual’s ability to manage their preventitive behavior on their own. It’s a pretty robust outline:
Some of you public health and social marketing gurus have likely already come across the recent slew of ads in Georgia, published by an organization called Strong4Life, that are ostensibly part of an effort to curb childhood obesity. A lofty goal, indeed, but a misguided approach, the criticisms of which have already begun. The images are pictures of overweight and obese children with a variety of captions, including “It’s hard to be a little girl if you’re not,” and “Fat may be funny to you, but it’s killing me,” and “Fat prevention begins at home. And the buffet line.”
Shaming rarely works as a strategy for behavior change. It’s been shown in efforts ranging from drug use behavior to HIV-prevention goals and marketing campaigns. If you click on the images in the Strong4Life campaign you get taken to video spots of these children, who seem burdened by sadness and depression (which can be both causes of and side effects of being overweight – exacerbating these emotional states does not help in weight loss endeavors). Recognizing if one is at an unhealthy weight is an essential step towards healthy weight loss, but the children do not appear buoyed by information, support, and new ideas on ways to be healthy. They seem downtrodden and embarrassed, the very characteristics that a shaming and body-bullying culture easily pounce on and cultivate. The video of Bobby, which portrays a mother who appears shamed by her son’s question doesn’t make me want to hit the gym or eat a platter of vegetables. Instead, the voyeuristic quality of the mock confessions feels more than a bit exploitative and it triggers a gut reaction of sympathy and protectiveness, making me want to yank the camera from the hands of Strong4Life. It’s like they took a message from the Jillian Michaels’ school of adding insult to injury, splashing in an additional dose of fear and intimidation, and expecting that this will result in a lifelong substantial increase in meaningful self-esteem.
The well-developed criticisms of this campaign point out that not only does shaming and negative marketing not induce healthy behavior change, but that these ads do nothing educationally. One girl near-tearfully admits that she gets made fun of at school because she’s fat, and the video slams down a tag line of “being fat takes all the fun out of being a kid” before fading out. While the Strong4Life campaign has a “Get Started” tab offering facts about nutrition and screen time and physical activity, the impact of the original image has already been made. Advertising relies on quick one-liners, on stark imagery, and emotional reactions. In this case, what we see is a tag line reiterating that this girl is not a normal kid, a solitary image of an overweight girl connected to an emotional plea on her part of loneliness and victimization. It’s powerful all right, but not empowering. The ad emphasizes fat loss, heightening the importance placed on size, instead of cultivating an interest in healthy lifestyles and appreciation of the fact that people come in different sizes and can be equally healthy. Critics of the appreciation-of-all-sizes approach say it borders on supporting obesity, which I see as short-sighted. Very high weight status can certainly indicate other problems, like diabetes, early heart and respiratory problems, and difficulties engaging in physical activity. But it’s also essential to make sure that the message that larger sizes are universally unhealthy is quashed, and it’s vital to promote instead that appreciating people of all sizes is essential – and more importantly, that valuing people regardless of size is a priority. This is a topic that deserves that kind of nuance. I would welcome ads that excitedly show kids engaging in active lifestyles, enjoying sports and enjoying healthy, full diets – creating characters in ads that viewers want to emulate, as opposed to characters that viewers are meant to distance themselves from or who are meant to be repelling, is not only good business sense but inclusive and supportive. These ads further emphasize and underscore the cultural norm categories of “normal weight kids are normal” and “overweight kids are not normal and therefore not ok” – this certainly won’t help curb teasing or bullying in this arena. And since we do know that consistent, positive social support is one of the key factors in healthy behavior change, it’s obvious why public health experts met this series with skepticism. And here’s what else we know – healthy lifestyle changes significantly decrease mortality, regardless of baseline body mass index. Changes in fitness level are what alter all-cause mortality, not changes in BMI.
The response that these ads are cultivating “important conversation” is somewhat moot. It may get people talking, and it hopefully it will encourage media platforms with a larger audience than this blog to come out with constructive, evidence-based, supportive tips and strategies for a healthy lifestyle – but the fact remains that these ads are contributing to the negative, body-shaming noise that fuels so much of popular media and it remains that the effect can be really damaging and counter-productive at the outset. Individuals who ultimately are successful at losing large amounts of unhealthy weight (or who more consistently use condoms, for example) do so not merely because someone called them fat (or because they knew someone who became infected with HIV) – this has happened many times over to individuals seeking or needing to enact behavior change. The change happens because they not only begin to see themselves as deserving of these changes, but also because they become helpfully informed with concrete action steps that help move them through behavior change, are supported and consistently cheered on, and because they know what to do if they feel themselves slipping.
The bottom line is that discussions about healthy living need to happen to prevent long-term chronic health problems, and these conversations do need to happen early. But they shouldn’t start with shaming, embarrassment, or the putting on display of children who have weight problems and asking them to broadcast what’s so horrible about it while telling them that their love of the buffet is what got them to this point. We can do better.
The Center for Disease Control’s Division of Adolescent and School Health (DASH) will lose $10 million in funding if the Fiscal Year 2012 Omnibus Appropriations bill, which sailed through the House of Reps, comes to be. And to kick the prevention specialists at DASH while they’re down, the funding for absitence-only “sex education” will make an unwelcome return.
The DASH has proven time and again that the CDC, as well as state health agencies, are capable of creating health education initiatives that teach students and adolescents the best ways to stay healthy and prevent both chronic and infectious diseases. They have worked with school districts as well as other governmental organizations to not only create effective STI-prevention and teen pregnancy prevention initiatives, but also do an incredible job of monitoring the risky behaviors that teens are currently engaging in across the United States – including substance use and abuse, sexual behavior, drunk driving, physical violence, and depression and suicide, as well as tracking the rates of victimization that teens experience in the form of sexual assault and dating violence. Understanding how common these behaviors are, knowing in what areas and regions they seem to erupt more intensely, and determining what demographics on a national level are at greatest risk for some of these behaviors is essential for targeted education and prevention initiatives.
Without these prevention strategies, and without the ability to track the rates of risky behaviors to know how to develop such strategies, we will be left to treat the consequences (STI care, HIV treatement and care, babies born to teen moms), which are of course ultimately far more expensive. The CDC has (or had) the resources as well as the expertise with its impressive body of scientists and researchers, to do so. And lest we forget, abstinence only education? Doesn’t do teens any favors, and in fact leaves them woefully misinformed in how they should protect themselves when they do ultimately engage in sexual activity.