I wonder if it would have been considered acceptable to anchor a medical report on heart disease solely in terms of its costs to employers – to headline a news story on cancer treatment with the words “working days lost to cancer”. I suspect not. While economic reporting on various vaguely defined patient groups is certainly becoming prevalent, I believe both medical professionals and news editors would feel compelled to include a more patient-based approach when reporting on what a friend has astutely called “X-rayable diseases”. I certainly hope they would not dream of telling the nation on the first page of the report what percentage of “the national disease burden” they form – which is what the CMO does, lumping all mental health issues together. It would be considered inexcusably insensitive.
Coping with mental illness can include feelings of self-blame, inadequacy and failure. It did for me, and does for many people I know. The economic commoditisation of human pain is dangerously close to victim-blaming. Such an approach can send the destructive message: see how much money you cost everyone, you broken person? Its dark heart is that the state’s only interest in its citizens is as economic units, occasionally broken and in need of quick and efficient repair, in order to slot back into the corporate design.
The crux of the issue is this: How can any study, let alone one that intends to make sweeping generalizations about the impact of sexual orientation on an entire populations’ BMI, consider 87 people a reasonable and adequate sample size? How can 87 women possibly stand to represent ALL lesbians in the USA?! I just can’t figure how in the hell is it considered academically sound, and moreover, deemed legitimate by a peer-review board of scholars, to compare 87 lesbians to 5,460 straight women??!!?!?!
…The real question we should be challenging these researchers with is this: Why is homosexuality being isolated as the indicative factor of one’s failure to thrive? If the National Institute of Health (NIH) is funding studies based on this claim (and it is), it’s terrifying to imagine how often baseless statistics are disseminated as truth, and how misleading our public health policies and initiatives most likely are — especially those that single out, and arguably stigmatize, sexual-minority populations.
Also, people can be fat and be healthy, so what does this fat statistic really tell us? That people need to conduct better research that serves the interests of the populations they are studying - and people need to take more care when reporting about studies.
“Addiction is, at its core, a chronic disease,” he said. “We must do for this disease what we do for cancer, diabetes, heart, and other chronic illness: first, aim for prevention, and then eradicate any disease that develops with aggressive treatment.”
In the months since then, Vermont has built a kinder, gentler blueprint for tackling the heroin epidemic. Bloomberg Businessweek announced last week, that Vermont had “quit the war on drugs to treat heroin abuse as a health issue.” Rather than locking up addicts, the state is attempting to provide them opiate replacement drugs like Methadone and Suboxone and place them in treatment. Even addicts who are currently incarcerated will have better access to prescription drugs to help kick the habit. Meanwhile, the state is pouring more money into opening and operating rehabilitation centers and increasing prevention efforts in medical offices and schools. Vermont, as the governor’s words promised, is treating heroin addiction like a disease, rather than a crime.
In the medical field, the bias impacts both patients and professionals. Patients report that they don’t trust an overweight doctor; in the UK, 54% of doctors stated that they should be allowed to refuse treatment to the obese. Another Yale study surveyed 84 medical professionals and found that “physicians associated obese patients with poor hygiene, non-compliance, hostility, and even dishonesty,” while “nurses believe that obese persons are overindulgent, lazy, experience unresolved anger, and are less successful than their average-weight counterparts.”
Housing, adoption, welfare, education — all these areas reveal a persistent bias against fat people and a preference toward thin. Even Instagram keeps flagging fat women’s bikini photos as “inappropriate.” So, when thin people decry bullying and discrimination, they’re not always wrong, but they’re deliberately avoiding the bigger picture.
One-off discrimination is different than systemic discrimination. Sometimes, it may suck to be skinny, but being skinny is certainly a more privileged position than being fat in a skinny person’s world.
The first time it was an ear, nose and throat doctor. I had an emergency visit for an ear infection, which was causing a level of pain I hadn’t experienced since giving birth. He looked at the list of drugs I was taking for my bipolar disorder and closed my chart.
“I don’t feel comfortable prescribing anything,” he said. “Not with everything else you’re on.” He said it was probably safe to take Tylenol and politely but firmly indicated it was time for me to go. The next day my eardrum ruptured and I was left with minor but permanent hearing loss.
…If you met me, you’d never know I was mentally ill. In fact, I’ve gone through most of my adult life without anyone ever knowing — except when I’ve had to reveal it to a doctor. And that revelation changes everything. It wipes clean the rest of my résumé, my education, my accomplishments, reduces me to a diagnosis.
I was surprised when, after one of these run-ins, my psychopharmacologist said this sort of behavior was all too common. At least 14 studies have shown that patients with a serious mental illness receive worse medical care than “normal” people. Last year the World Health Organization called the stigma and discrimination endured by people with mental health conditions “a hidden human rights emergency.”
This state of affairs is awful. Our medical programs need to focus more on stigma reduction and inclusion of people living with mental health challenges. Check out Columbia’s Narrative Medicine program.
When new immigrant Dr. Deepak Chopra discovers his Indian medical degree isn’t recognized in Canada, he starts driving a cab. One night, he heroically delivers a passenger (Natalie’s) baby in his backseat. Footage of the delivery accidentally goes viral. Now famous, Deepak gets nicknamed ‘Dr. Cabbie’ as passengers flock to his cab for treatment.
It’s great to see this film taking on the issue of barriers faced by international medical graduates (IMGs) seeking accreditation in Canada. Chose this trailer because trailer #2 has some seriously sexist cat-calling. Looking forward to watching this film! Would love to see more mobile taxi clinics or cabbies sharing health and wellness advice with clients (and fewer barriers for IMGs seeking accreditation)!
In 1864, the year before the Civil War ended, a massive study was launched to quantify the bodies of Union soldiers. One key finding in what would become a 613-page report was that soldiers classified as “White” had a higher lung capacity than those labeled “Full Blacks” or “Mulattoes.” The study relied on the spirometer—a medical instrument that measures lung capacity. This device was previously used by plantation physicians to show that black slaves had weaker lungs than white citizens. The Civil War study seemed to validate this view. As early as Thomas Jefferson’s Notes on the State of Virginia, in which he remarked on the dysfunction of the “pulmonary apparatus” of blacks, lungs were used as a marker of difference, a sign that black bodies were fit for the field and little else. (Forced labor was seen as a way to “vitalize the blood” of flawed black physiology. By this logic, slavery is what kept black bodies alive.)
The notion that people of color have a racially defined deficiency isn’t new. The 19th century practice of measuring skulls, and equating them with morality and intelligence, is perhaps the most infamous example. But race-based measurements still persist. Today, doctors examine our lungs using spirometers that are “race corrected.” Normal values for lung health are reduced for patients that doctors identify as black. Not only might this practice mask economic or environmental explanations for lower lung capacity, but the logic of innate, racial difference is built into things like disability estimates, pre-employment physicals, and clinical diagnoses that rely on the spirometer. Race has become a biologically distinct, scientifically valid category despite the unnatural and social process of its creation.
In her recent book Breathing Race into the Machine, Lundy Braun, a professor of Africana studies and medical science at Brown University, reveals the political and social influences that constantly shape science and technology. She traces the history of the spirometer and explains its role in establishing a hierarchy of human health, and the belief that race is a kind of genetic essence. I spoke with her about the science of racial difference, its history, and its resurgence.
Such a fascinating read - and all the more reason to incorporate more social sciences within medical education. Scientists and physicians must fully understand the social production of health disparities - these disparities are not innate but a product of the interplay between genes, the physical environment, and our social world.