Health Policy, Media, Politics, Public Health

Conservatives Win the Healthcare Messaging War

For many left-leaning Americans, little is more important aside from the state of the economy right now than healthcare reform – and they’re inextricably linked. Coverage of healthcare reform is pretty high this week, with the expectation that the Supreme Court will hand down their decision regarding the constitutionality of the Affordable Care Act this Thursday. This hasn’t always been the case.

Interestingly, while this is being considered a flagship of the Obama Administration, in his first year as President, healthcare reform ranked third in terms of media coverage mentioning Obama:

Media Coverage of Stories Featuring Obama in First Year of Term – Courtesy of PEW Research Center

One would think that covering healthcare reform – and specifically, the details of the Affordable Care Act, and what the law really means – would be imperative after the passing of the ACA. Ensuring that the law was really understood by citizens would seem to be fairly essential, but what happened instead was a decline in media coverage of HCR after Obama’s first year as President – as shown by the Pew Research Center:

HCR Coverage Over Presidency – Courtesy of PEW Research Center

So what does that mean? If coverage goes down, and little has been done to ensure that people truly understand the law (for example, understand what the mandate really means, and what the implications are if it is struck down, which was recently elegantly laid out by the NY Times), the short messaging around the issue becomes even more important.

Cable news can be inflammatory, reactionary, harsh, exaggerated, and at times, unsurprisingly infuriating. They often preach to their respective choirs on the political spectrum, and because of this, I worry that they’ve become so comfortable with their audience that the arguments aren’t as sharp, or clear, as they could be. The brief messaging lacks context and nuance, and headlines or key phrases can substitute for deep understanding of one’s understanding of an issue (and taking today’s ruling on the Arizona immigration law, one can see how brief messaging can create some confusion – one headline read that SCOTUS struck down three components of the immigration law, and the next one I saw trumpeted that SCOTUS had upheld a key component of the immigration law – both were true, neither were particularly informative)

In the context of the fight for comprehensive health care, conservatives seem to have won this messaging game. The new study from the Pew Research Center shows that while liberal talk shows spent more time talking about healthcare reform –

Liberal Versus Conservative Talk Show HCR Coverage – Courtesy of PEW Research Center

– certain select terms used by healthcare reform opponents that really emphasized negativity were used at rates nearly twice that of terms used by supporters that underscored positive elements of healthcare reform:

Terms Used in HCR Debate – Courtesy of PEW Research Center

Take a look at these terms – which would you say were more compelling? Phrases that would incite more visceral, gut reactions from listeners? I can see how “insuring pre-existing conditions” would actually appeal to both sides, but this barely stood a chance against “more taxes with health care reform” which was mentioned nearly twice as many times and can certainly appeal to the financial fears of viewers. “More competition” would seem to appeal to many free-market espousing conservatives, but is trumped by “more government involvement,” which is the base fear of many Republicans. “Rationing health care” just isn’t true, but instead of rebutting that with facts about the law, HCR supporters shot back with “greedy insurance industry,” which likely wouldn’t win over any opponents to the law, who can claim that insurance agencies are just businesses, trying to capitalize on profits. And that’s where I think the HCR supporters had an in that they didn’t take – commenting on the prioritization of profits for a specific industry over the health of our communities and country as a whole.

Is the assumption that compassion is not an effective communication tool? If so, why is that? I find myself deeply moved by stories of people who are in desperate need of health care but lack the resources – insurance, financial, proximity to quality affordable care  – to get it. And I’m certain that I’m not the only one. New York Magazine today touched on the alarming fact that the moral argument – the empathetic position, the community cares idea, the position that healthcare is a fundamental human right – has been remarkably absent from the healthcare debate. I fear that it mostly plays into the uniquely American mentality that regardless of circumstance, each individual has to be able to fend for themselves. While this concept underscores certain types of resiliency and determination that are I think are overly-admired, the fact of the matter is that disregarding the circumstances is not possible. Disregarding the impact of staggering inequality of access to care and financial resources is short-sighted and, more importantly, I would say rather cruel.

If the discussions had focused more on why everyone deserves healthcare – why everyone deserves to be treated with dignity, receive comprehensive care, understand how to care for themselves – since healthcare is an essential component of our right to life (not to mention the pursuit of happiness), would the results have been different? If we appealed to our humanity and illustrated the absurdity of someone dying from a treatable illness, when people who could have helped them essentially stood by just because…they didn’t have any money? Because that’s essentially what this is – the inability to personally protect oneself and one’s family because of dearth of resources. If we had made it more personal, and less political? If we focused less on the greedy agencies, the so-called rationing of care, the increased business competition, if we had actually responded to the claim of too much government intrusion with the response that the government should in fact be intervening when doing so can save the lives of its citizens? Does the punishment of death really fit the ‘crime’ of not getting oneself health insurance, if one was not able to do so because they couldn’t afford it?

Is that the legacy we want to leave?

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Education, Media

Social Media and Higher Education

Interesting infographic of the use of social media in higher education. Courtesy of the Online Universities and Columbia Teachers College EdLab:

I think this is interesting for a few reasons. What role does social media have in the administration of universities? How can they utilize social media to promote their in-house programs for students? What actually prompts students to follow higher education institutions on social media sites (aside from loyalty to their alma mater)?

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Advertising, Child Development and Child Health, Education, Health Education, Media

Shame Won’t Make You Healthy. Really.

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.

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Education, Feminism, Health Education, Media, Public Health, Sexism, Women's Health

Looking for More Attention? Drop Some lbs.

At least that’s what Skinny Water is promising in their latest advertisement, which I spotted yesterday. The ad shows a woman facing a throng of cameramen snapping her picture, elegant earrings dropping to the top of the headline which says: “Skinny Always Gets the Attention.” Take a look:

Thinspiration, thanks to Skinny Water

A close-up, to see all the text:

Close-up, for good measure.

Below the headline and photo of the various flavors, it also says “Zero calories, Zeor sugar, Zero Carbs, Zero Guilt.” With all that’s not in this water, you might wonder what it does offer. The website tells me that depending on the flavor of water, they’ve added vitamins B3, B5, B6, B12, C, A, and E. They’ve also thrown in magnesium, folic acid, calcium and/or potassium.

Despite trying to market itself as healthy, Skinny Water is instead perpetrating the cultural message that the best – nay, only – way to ensure that you get attention is by being skinny. This of course positions them well to try to push their product on those women who have been pulled into this lie. This ad tells us that the best way to skinny is not through healthy food choices and exercise and an understanding of what “skinny” means for our particular body type and shape, but essentially through fasting – which is what zero calorie drinks are the equivalent of.

In fact, Skinny Water is doing precisely the opposite of what a health-conscious company and product should be doing. Promoting the idea that those who are skinny deserve attention more than those who are not creates communities that support harmful diet-related behaviors and disordered eating for the goal of a wispy appearance . Not to mention reinforcing the ever-present undercurrent of disapproval of those who are overweight – or even normal weight! – and do not bow to the hierarchy of beauty that says those who are thin are the best. It’s just one more item in the laundry list of products that tell women their size and appearance are what is most important and will attract loyal friends and fans.

In defiance of that, let’s use our brains to remind ourselves why Skinny Water is wrong. While the website details the added vitamins and dietary minerals of each drink, it’s far better to get your needed supplements through a healthy diet rich in cruciferous  and dark and leafy vegetables, fruits, whole grain and lean proteins. Washed down, in fact, by regular old water that keeps you hydrated and helps your body process and absorb nutrients. Skinny Water is telling its buyers that by adding these vitamins and minerals to their product, one can cut out food entirely and survive on a calorie-free but vitamin-rich manipulated water diet. Don’t be fooled! (I know you aren’t. Hopefully, you’re equally horrified.) For example, the“Power,” “Sport” and “Fit” drinks are all fortified with calcium, magnesium, and potassium – to help activate metabolic enzymes, keep your blood regulated, and support strong bones and teeth. Do you know what else can do that?  Bananas, yogurt, kale, almonds and cashews, and quinoa. Frankly, there seems to be little difference between the “Power,” “Sport” and “Fit” drinks despite the claim that they each support different “goals” of the drinker – which lends support to the conclusion that these are madly marketed products that don’t substitute a healthy, well-rounded diet and instead are capitalizing on the now-entrenched notion that women care more about being skinny than anything else.

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Feminism, Media, Politics, Sexism, Violence

The DSK Decision and the Definition of Consent

I have held off writing about the DSK case being tossed out because honestly, I can’t really bear it. Plenty of other news sources and bloggers have reported on the reasons why I feel this is a catastrophic blow to victims of sexual assault, and reiterating it would likely only upset me and readers even more. However, a news story reported in my hometown paper, The Chronicle, got me thinking about the definitions of consent and what it means to be a person worthy of a trial, and I thought I’d tie these two instances together.

According to the DSK decision, if one has lied in the past they are considered unworthy of a trial in the eyes of the DA – whose goal seems to be focused solely on winning as opposed to determining if in this particular instance one is lying. Let’s look at the specific lies in question – namely, the reason behind Diallo’s asylum in the United States and her recounts of the story.

First, the defense is claiming that since she allegedly lied on her asylum application about being gang raped in her home country, she cannot be trusted in this accusation of DSK. Had she lied? Yes, she admitted to that. Does that matter in this specific case of DSK assaulting her in the hotel room when a forensic examination, including a medical exam, proved to be consistent with her story? No. When she lied on her asylum application – as many, many people do (an interesting and poignant piece in the New Yorker recently profiled this in a case example) – she did so to escape a country in which she felt constantly at risk and in danger and wanted to protect her daughter from the same fate. Should the fact that many people do this – and lie about repeated gang rapes in particular – immediately excuse the lie? No. But it does put it in the context of a reality that should not go unexamined. While lying in previous instances can make a case harder to win, and isn’t something I’m championing or condoning, when you look at her reasons for a falsehood on her asylum application, it make no sense that she would then risk a job she was grateful and proud to have gotten as a hotel housekeeper, raising in her daughter in New York, by having what the defense claims was consensual sex in the middle of her cleaning duties.

In regards to the changing of her story, it is well known and understood by trauma experts that women who have experienced sexual assault (and not just sexual assault, but any traumatic event, for both genders) often recall the order of events differently and clarify them as time goes on, due to the effects of the shock, denial, and the coping mechanism of blocking out of painful incidents. This does not mean that the assault didn’t happen, particularly since this reaction has been seen and understood many times over by many other rape and assault victims.

What I also find interesting in these cries about credibility is how gendered they are. DSK has a notorious history in France of being too forward and sexually aggressive with women; in my mind this causes some credibility issues for him as well, as he claims in this instance it was only consensual. It also reminds me of the fact that one of the NYPD officers acquitted this summer had a history of sexually harassing women, unsubstantiated arrest of a woman and blocking the filing of a report of the woman whom he sexually harassed – yet this was not seen as hampering his credibility. Nor was the fact that he made false 911 calls that routed him back to the apartment of the East Village victim and denied ever sleeping with her and then promptly changed his story to one of doing so but using a condom and assuring it was consensual. If we’re saying Diallo has credibility issues, I’d say these two need to join her on that wagon.

In the San Francisco case, we are confronted with a similar – though not the same – situation; one of assessing the validity of the accuser based on previous actions or claims. A SF lawyer (who specializes in sexual harassment cases, interestingly) is accused of raping three women, ages 19 – 36, whom he met over Craigslist while searching for partners interested in dominant-submissive rough sex. Two of the women had consented to having sex with this man on previous occasions before filing specific incidents of assault and rape. The man’s attorney has used this as evidence that the women were consensual partners, interested in engaging in sex and agreeing to what the man proposed in his post.

It seems we need a reminder of the definition of consent.

It does not matter if a woman is a prostitute. It does not matter if a woman had sex with you consensually in the past. It does not matter if in an email a woman expressed interest in specific sexual roles, positions, and activity. What matters is if in the specific encounter at hand, both parties have expressed the desire to go forward, and that if one withdraws that consent at any point it is the responsibility of the other to stop. The women could have easily agreed over an email exchange to engage in dominant-submissive sex, arrived at the man’s home still agreeing to it, and agreed to it right up to the minute they were to begin. But if in that minute she decided she no longer wanted to do this or was hesitant and unsure and wanted to wait, and he went ahead anyway – then it becomes rape.

Rape and sexual assault cases are notoriously difficult to try. They are usually he said/she said situations, at best aided by forensic evidence. Each case is unique, each has elements that are often not introduced or examined until a trial begins – this exemplifies the importance of scrutiny and juries who devote days to understanding the nuances and details of cases that are not reported or perceived by the media.

Setting the precedent that previously engaging in sexual activity, lying, or expressing interest in sexual experimentation eliminates your chances for a fair trial regarding the specific assault case at hand pushes us into the realm of implausibility. It is also worth noting that despite outcries of false accusations, the most frequently repeated results of studies regarding false claims and filings of rape show that the real rate of these is between 2% at its lowest and 7% at its highest (American Prosecutors Research Institute). But the media sheds so much light on the false claims that people presume it is much higher. The vast majority of rape and sexual assault charges never see the spotlight – perhaps because they aren’t dangerous enough or don’t involve high-ranking political figures or people whom media isn’t able to coin as gold-diggers and attention mongers because of their social or socioeconomic status. The bottom line is that each story deserves to be closely and carefully examined, and not discarded because a DA thinks he can’t win the case. District Attorney Vance is quoted as saying “If we don’t believe her beyond a reasonable doubt, we cannot expect a jury to.” I would venture to say that given the outcry over his decision, many people would like to hear the full story (and who do in fact think that the issue of reasonable doubt is in question) from both sides, with all the available evidence and fleshed out arguments. The issue of the truth, and seeking it, should take the precedence over one’s doubt at a courtroom victory.

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Child Development and Child Health, Defining Gender, Feminism, Media, Pop Culture, Sexism

Sexist and Sexualized Advertising: On the Rise

A new study released by University of Buffalo sociologists discovered something truly ground-breaking: there has been an undeniable and increasing hyper-sexualiztion of images of women in popular media over the last several decades.

This is something that I would normally take notice of and file alongside the slew of reports that have similar conclusions and continue to confirm what I’ve always felt to be true about advertising and media presentations of women. Being a major theme of my blog, I occasionally worry that I’m Not Tired Yet will begin to sound like a broken record as I continue to write about how damaging media portrayals of women and girls truly are, and how it impacts human development, sense of self-worth, and definitions of beauty for both sexes.

That being said, as long as women and girls continue to be hyper-sexualized in images, videos, and advertisements, there have to be just as many consistent criticisms of them. Creating a chorus of opposition that shows growing girls this is not normal, not healthy, and that they have much, much more to offer than what our culture’s media is telling them they do through a ceaseless blasting bullhorn.

In this particular study, researchers’ conclusions did offer a concrete example of gender disparity in this realm. While representations of men and women have become increasingly sexualized, it was the intensity of the sexualization of women which was particularly shocking and far exceeded that of men. A scale was developed to rate the intensity of the level of sexualization of images, which showed evidence of women being far more likely to be in positions of submission or of offering pleasure as tools of hetero-male sexual desire. This sets a dangerous precedent – women are those who satisfy, men are those who are satisfied.

In the grand scheme of things, media not only influences our decisions and impacts our thinking, but is a reflection of these things as well – it’s a circuitous pattern of reinforcement and ever-heightening intensity. The more these images are sexualized, then the more it is socially expected for women to act as sexualized as they are portrayed, then the more sexualized the images become, building upon themselves as viewers need increasingly overt sexualization to feel excited or as though advertisements are pushing boundaries – which is what advertisements do to draw in a receptive audience. This causes two immediately obvious problems – first, that this pattern leads one down a path that ends in unquestioned and irrelevant nudity and commodification of the sexual identity of girls;  secondly, we move farther and farther away from the objections that this kind of imagery is entirely inappropriate, sexist, pedophilic, and harmful.

A couple of weeks ago, I was invited to guest speak on a radio show about the effects of sexualization and violence in video games and media. One of the last questions the host asked me was, “So, what’s the solution? Should we censor these video games and movies?”

My response to this was no, of course I am against censorship. The free speech I advocate protects the video game developers (and advertisers, fashion labels, films, etc etc) as well as my criticism of them – which I will stop as soon as I see the egregious violence against women, forced sex acts and trivialization of women stop. That being said, there is an element of self-censorship — editing, if you will — that could certainly happen on the part of the creators. Until the developers want to change the games, they aren’t going to change – which is why I said that the ‘solution’ as it stands is keeping up the constant conversation, the constant writing, the constant research, that refutes the idea that these games (images, advertisements, movies, etc etc, that send the same messages) are just harmless entertainment. We know they aren’t. But the games (images, advertisements, movies, etc etc) keep selling and people keep buying because it’s seen as normal, and the media’s bottom line – $$ – is different than that of a parent, educator, coach, sibling, etc, who have concerns (hopefully) centered around the health of their children. So the ‘solution’ is to keep up the commentary, keep up the research, keep up the discussions about why these media messages are harmful, and ensure that parents, teachers, siblings, and, of course, anyone who are concerned about healthy children growing into healthy adults, are aware of why media matters and the kind of influence it is having.

Curbing the effects of non-stop media is difficult, but not impossible, and involves even more talking – this time directed at the kids. Getting media to change its tactics can feel damn near impossible, but keeping up a constant dialogue with children about the kind of messages they’re on the receiving end of can certainly help.

In the end, it comes down to what kind of society we want to cultivate – for us and our future generations. The kind of culture we want to look upon as having created – the definitions of gender, success, individual expression, and love – and having fostered. Is it one in which the bottom line is comprised strictly of financial and monetary goals, with little regard as to what happens to members of our communities and how our actions impact children and youth in pursuit of that goal? Or the opposite?

Wanna answer that question on Twitter? Follow me here!

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