Exam #3 Flashcards
(118 cards)
1
Q
DALYs and Mental/Neurological Disorders
A
Mental/Neurological Disorders have high DALYs due to long-term rates of disability and suffering.
2
Q
Critiques of the DSM
A
- Homosexuality was initially medicalized.
- Gender Dysphoria: A transgender individual must be diagnosed with this specific disorder before insurance companies will pay for reassignment surgery.
- Diagnostic Inflation: The DSM keeps expanding; is the scope of disorders expanding to encompass more and more?
- “Hypoactive Sexual Desire Disorder:” Aging (and loss of female sex drive) is medicalized, deems medication necessary
- “Disruptive Mood Dysregulation Disorder:” Young children (disrupt classrooms) are medicated.
3
Q
Bipolar Disorder (Emily Martin)
A
There is a cultural valorization of mania (e.g. athletes or Wall Street workers), yet these populations are not medicalized.
Diagnosis of mania is accompanied by a loss of autonomy and personhood, individual is deemed “out of control”.
4
Q
Susto
A
Folk illness commonly felt by Latino immigrants.
Present with fright or “soul loss”.
Symptoms are also somatic (sleeplessness, loss of appetite).
Treated through folk healing.
5
Q
Amafufuyana
A
South Africa
Form of folk illness associated with soul possession and hysteria.
Affects marginalized populations, specifically during periods of social change - it becomes a means of accessing healthcare.
Treatment through exorcism.
6
Q
Arthur Kleinman and Cross-Cultural Psychiatry
A
Psychiatry is a Western concept bound to Western culture, we need a form of cross-cultural psychiatry that connects psychological processes of all social worlds.
There are negative effects of posing psychiatric categories as biological and universal (e.g. lack of follow-up).
7
Q
Discursive Psychiatry
A
Psychiatry is capable of constructing meaning.
8
Q
Globalization of Western Psychiatry [to Argentina]
A
Globalization of Western Psychiatry [to Argentina] Erodes national tradition of talk therapy.
Created a conflict between treatment through extensive talk therapy and efficient diagnosis by a psychiatrist.
9
Q
Why zebras don’t get ulcers?
Stress in Contemporary Society
A
Today, people experience constant, low-levels of stress (over-experienced), consequently weakening the immune response and causing other health issues.
10
Q
Whitehall I
A
High stratification workplace environment with equal and full access to healthcare.
Higher job control is associated with lower levels of heart disease; there were more deaths among low-level clerics versus executives.
11
Q
Whitehall II
A
Lower social support at work is associated with higher incidences of mental health disorders.
High effort, low reward jobs have the worst heart disease outcomes - they are living in a environment of chronic, low-level stress.
Job insecurity = Higher rates of heart disease
Stress becomes biological, affecting the mind and the body.
12
Q
Impacts of Whitehall
A
Equal access to healthcare does not assure health equality.
Stress can cause physiological changes.
Executives do not experience the most stress.
13
Q
Paradox of over/under-nutrition in modern society
A
Poorer societies = malnourished
Wealthy societies = obesity
14
Q
Where does malnutrition in poorer countries stem from?
A
Historical processes emphasized cash crop economies, which led to the erosion of subsistence farming.
Increased wage labor led to a change in food habits, lack of breastfeeding, snacking, fast food, etc.
15
Q
Epidemiological Transition (Abdel Omran)
A
Mortality and morbidity is [now] made up of chronic, non-communicable and degenerative diseases (not acute, infectious, degenerative diseases).
16
Q
Nutritional Transition
A
Greater urbanization led to industrialization and a nutritional transition.
There is an increase in food availability, cheaper vegetable oils, exposure to advertising and mass media, an eating away from the home.
17
Q
Affects of the Nutritional Transition
A
Dietary changes and rise in rates of obesity.
18
Q
Subsidization
A
Government subsidies provide incentive for farmers to grow corn, but not fruits or vegetables, which become more expensive as a result.
19
Q
“Let’s Move” Campaign (Michelle Obama)
A
Government fosters life by providing arbitrary “categories” of food that must be filled. However, these categories are largely influenced by lobbying of the agricultural industry..
What the government subsidizes is very different from what composes a healthy diet.
20
Q
Critiques of the “Let’s Move” Campaign
A
Focuses on exercise, ignoring the politicization of food and the creation of budgets/subsidies that affect nutritional habits.
21
Q
The Politics of Obesity (Guthman)
A
Obese individuals are not responsible [to blame] for their own health.
There is a contradiction of encouraging mass consumption (binging and mania) in capitalist society, while valorizing thinness, restraint, moderation, and balance.
22
Q
Moral Problematization of Drugs
A
Family, vice, temperament.
Not knowing the harms to the body, drugs harm the family unit.
23
Q
Spiritual/Disease Model [Drugs]
A
Internal sickness is incurable, one must find a higher power that helps you deal with it (Alcoholics Anonymous).
24
Q
Disease Model [Drugs]
A
Disease and mental illness are biological, alcoholism is a brain disease.
25
Public Health Model [Drugs]
Treatment, prevention, education.
26
Political/Economic Model [Drugs]
Rates of drug use correlate with poverty, unemployment, and social marginalization.
27
Sociocultural Models [Drugs]
Cultural context (college campus, urban culture, etc.) informs use of drugs.
28
Marijuana
Weed became illegal at the same time alcohol was permitted again.
Associated with Mexicans, therefore become a crackdown on Mexicans, considered a "Mexican" problem.
29
1970s War on Drugs
Began in the Nixon administration, was largely tied to race.
Spending has hugely increased, yet addiction rates remain the same.
Reagan cracked down on drugs, but advertised tobacco.
The "Just Say No" and DARE campaigns actually led to more experimentation.
30
The New Jim Crow
Current incarceration system is an extension of Jim Crow, just through the law system/crime.
Shift from "race" as a focus of segregation and discrimination to "crime" - race punishment is not okay, but crime punishment is.
31
Affect of Incarceration
Felons are disenfranchised and suffer in labor and housing markets, they cannot receive welfare or food stamps.
70% of prisoners return in three years - incarceration results in further crime.
"Absent fathers" is a byproduct of incarceration.
32
Incarceration in the United States
Rates have increased, though rate of crime remains the same.
Prisons are owned by private companies with shareholdings - these companies are essentially paid to put people in jail.
There is a much larger return in investing in prisons versus regular companies.
33
Crack Cocaine vs. Powdered Cocaine
There is a larger sentence for crack (primarily African Americans) as compared to powdered (wealthy, college students).
RACE
34
"Faces of Meth" Campaign
Campaign uses fear was a deterrent (you don't want to look like this).
Creates a hyperbolic and narrow representation of meth.
There is not statistics or contexts about how they lost their jobs, who uses the drug (no actual information).
Encourages spectacle of "white trash".
Moralization of drug use - "Why would they do that to themselves?"
35
The Drug War in Latin America (Zirnite)
Increased military and intelligence presence in Latin America.
There is no proof that drug control policies limit the international drug flow, only that they increase violence.
36
College Students and Drugs
Rates of abuse are highest at competitive colleges.
| Drugs are abused, but no one is punished.
37
Why ban the sale of cigarettes?
Toll on health
Black market already exists, no need to fear the "emergence" of a new market.
Addictive, cannot be used in moderation.
38
DALYs and Tobacco
Leading cause of DALYs in the U.S.
Causes more deaths then all other drugs combined.
> Legalized forms of consumption cause the most deaths.
39
Trans-Pacific Partnership (Obama)
Tobacco is included in the TPP (a free trade agreement) thus increasing the presence of tobacco in places with very little regulation.
40
King James and the Counterblast to Tobacco
Claimed that tobacco is sinning against God, harming the self, and should not be imported into Europe.
41
James Duke
First produced cigarettes in 1888.
42
Tobacco Advertising and Marketing
1. Weight control for women
| 2. Rationed in WWI/II, globe learned to smoke because of American soldiers abroad.
43
Doctors and Smoking
1940/50s, doctors became key factor in encouraging smoking.
Medical conferences subsidized the tobacco industry, the public was manipulated into picking the "healthiest" cigarette.
*Physician Authority
44
1953 Tobacco Institute
Institute was created to reduce the idea that smoking is problem.
45
"Frank Statement"
The tobacco industry accepted people's health as a basic responsibility, but believes their products are not harmful and do not cause death.
46
Data backing the "Frank Statement"
1. No scientific link between smoking and cancer
2. Medical research points to many causes for cancer.
3. Science will be used to get all the facts as soon as possible.
47
Ernst Wynder
First to discover the link between tobacco and cancer [lung].
Lung cancer is prevalent [but rare] in non-smokers.
48
Doll & Hill
Studied doctors, found that the risk of developing a disease increases in proportion to the amount one smokes [but not a causal relationship, just demonstrates a trend].
49
1964 Surgeon General Report
Claims that smoking causes cancer.
There are now warnings on products, but this transfers the responsibility [and liability] to users.
Smoking rate remained at 40%.
50
Framework Concentration on Tobacco Control (WHO)
Countries came together and decided that tobacco needed to be tackled globally.
Implemented policies: taxes, no public smoking, warning labels, education, restrictions on youth.
Idea is that every country should pass these, but even the U.S. has not.
51
Benson Tobacco Article
Both gun violence and smoking are approached in terms of youth and the family (guns protect the family, and harm youth).
There is a problematization of smoking as a law enforcement issue [youth issue - can only smoke if you are 18].
Education does not always lead to changes in behavior, especially if tobacco companies themselves are warning against the product.
52
Menopause in Japan [Lock]
Menopause [worldwide] is now seen as a disease to be treated.
In Japan, again is valued and loss of libido is not stigmatized.
The narrow view of estrogen imbalance [loss of libido] misses the social and psychological condition associated with aging.
53
Birth Cultures [Helmen]
An inherited system of belief that informs members of a society about the natures of conception, the proper conditions of procreation and childbearing, the workings of pregnancy and labor, and the rules and rationales of pre/post-natal behavior.
54
Abortion Culture
Consists of debates about social and cultural issues, what is "life"?
Categorizing good vs. bad motherhood, rights, responsibility, choice, religion, the body, healthcare, the state, etc.
55
Mayan Midwife, Co-Madre
Takes on the burden of providing quality care, provide a vital resource in a resource-poor setting.
Provides a model for the accompaniment program, because the midwives provide care before and after the birth, for both mother and baby.
NGOs are now incorporating midwives into their practice [specifically in Guatemala].
56
WUQU'KAWOQ
Mayan Health Alliance in Guatemala that uses midwives as a conduit to get to women and children. Local people produce peanuts that are used in nutritional PB bars (Mani-Plus) to reduce the rate of growth stunting.
Nutritional supplement + economic growth
57
Death Without Weeping, Infant Death in Brazil [Nancy Hughes]
Hughes argues that a universal maternal instinct does not exist, and poverty can teach mothers not to grieve the loss of their infant. Mothers favor children whose physical characteristics favor longevity.
58
Modern Birth in South India [Van Hollen]
Colonialism led to caste structures that resulted in unequal access to maternal health services.
Poor, low caste women use labor-inducing drugs, but no anesthesia.
Motherhood is viewed as sacrificial, linked to pain and suffering, but also reproduction.
59
Vali
[South India] Word for pain or ache, but also strength and force - women refuse anesthesia during childbirth.
60
Western Birth Culture
Medicalization of pregnancy and labor.
Technology is supreme, increased use of epidurals and Caesarians.
Use of sonograms have changed birth culture, transforms "fetus" into a "baby"
> Recent rise of home births as women become skeptical of [male] doctors who push for quick Caesareans.
61
Sakti
"Regenerative power"
| Associated with a woman's ability to suffer nobly through the pain of birth, important to self-conception.
62
Impacts of the Amniocentesis
Beliefs about what it means to be a "good" parent.
| Abortion becomes a medical choice when diseases are diagnosed during pregnancy.
63
Declining Birth Rate in South Korea - Why?
Rise in miscarriages.
Shift to industrialization and full public education means that women are working and having children later, increasing the risk of miscarriage.
PH Accommodations: improved prenatal care, better family/sick leave.
64
Infant Mortality in the United States
Segregation/sharecropping led to higher mortality rates for African Americans.
IMR tells us about the quality of healthcare system in total, encompasses almost everything.
Racial disparity in IMR.
65
The Jungle [Sinclair]
Exposé of the unsanitary conditions of the Chicago meatpacking and slaughterhouse culture of the 19th century. Led to the creation of the Food, Drug, and Cosmetics Act, which ultimately created the FDA.
Rise of the food/factory inspector.
66
Asbestos
Fiber used to make insulation in houses.
Rapid increase after WWII, due to the growth of suburbs.
Connection between lung cancer and asbestos - studied in dockworkers who imported it.
Issue because death from asbestos (through cancer) does not occur until decades later.
67
What act did Asbestos lead to?
United States Toxic Substances Control Act of 1976, prohibited the use of asbestos.
68
National Environmental Policy Act of 1969 created...
Environmental Protection Agency (EPA) for regulation of air and water control.
69
Clean Water Act of 1977
Regulates public and commercialized waterways.
70
Lead Abatement and Prohibition
Lead is now illegal.
Unleaded gasoline, nothing in plastics and paint, removal of lead paint from old homes in the case of children occupancy.
71
Motor Vehicle Accidents
Most common injury-cause of death worldwide.
Leading cause of death for those age 1-24 globally.
Prevention: Licensing, training, laws about drinking/driving, seatbelt/cellphone laws, guardrails, speed limits.
All considered a HUGE SUCCESS in public health efforts.
72
Minimata Disease
1968 exposure to mercury a result of industrial dumping, approximately 1000 deaths from acute poisoning.
73
Love Canal
Chemical spill, led to local protest movement.
Case-control study, half of participants from Love Canal, half control population.
Found low birth weights, widespread developmental disorders, and birth defects primarily in Love Canal group.
74
Three Mile Island
Nuclear power plant where radioactive chemicals leaked into rivers leading into the Atlantic Ocean.
No hard evidence of epidemiological costs, but expensive cleanup.
Led to concern about nuclear energy.
75
Life Exposed [Petryna]: Chernobyl
Radiation emitted from nuclear power plant.
After emission, citizenship was recast in biological terms. Sufferers petitioned the government for reimbursements, medical checkups, etc. They identified themselves as "biologically harmed," as a different kind of citizen and sufferer.
Concept of "Biological Citizenship."
76
Biological Citizenship
Making a claim on the state in terms of one's damaged biology.
77
Allan Brandt and Secondhand Smoke
The anticigarette movement was spurred by the recognition of the "innocent victim" of second-hand smoke. Citizens must take responsibility for their own health and their own behavior.
78
Ralph Nadar
Smoking on airlines was a huge part of the stewardess culture to accommodate passengers.
Nadal became an advocate on behalf of stewardesses, he claimed that they were getting unfairly exposed to secondhand smoke as an occupational hazard.
79
Clean Indoor Air Legislation
Gave EPA the power to regulate the air quality of public spaces.
80
Dose-Response Relationship
If there is a linear relationship, an exposure can cause damage (no threshold). If non-linear, there is a threshold at which the dose becomes dangerous.
81
Radon
Causes lung cancer, but exists everywhere, especially in homes. Houses have detectors that measure the environment up to a threshold of 4p/L, at which point it becomes dangerous.
40x the risk when combined with tobacco intake.
82
Burning solid fuels in the home.
Primarily in the developing world, coal and manure are burned for fuel.
DALYs for indoor air pollution are higher in lower-income countries.
Problem of burning potentially dangerous fossil fuels in India. Use of methane burners, which protect the environment, manure is put into sealed vessels.
83
"Fordism"
Pioneered organization structure [in the production of the automobile].
84
Nostalgia and "Fordism"
Nostalgia for moments in capitalism when things seemed easier/simpler, you work for the company, then are able to buy a car, and eventually a house.
But there is a danger to organizing society around certain relationships to the environment, like a dependence on fossil fuels for cars [can be harmful to humans].
85
"Precariousness..."
...Becomes a permanent condition and selling device. Cars create a precarious environment, so sustainable cars are sold to make concerned individuals feel better.
86
"Political Ecologies of the Precarious..." [Weston]
...seduce people into participating in their own demise, often in the guise of working against it.
[e.g. sustainable cars, Prius]
87
What are the architectural styles used by the Nazis in the concentration camps?
Alpine, Japanese, Garage, "No Style"
88
Medical Tourism
Ex. Americans with paraplegia paralysis travel to China where there are related restrictions on stem cell therapy.
89
"Biosociality" [Rabinow]
We come to socialize and identify as social beings around our biologies (online forums, cancer survivor groups, etc.). Increasingly, our sociality takes on the form of biosociality (with increases in technology and medicine).
90
African-American Heart Failure Trial (2004)
BiDil approval in 2005.
| Hailed by the Black Caucus, NAACP, and the Association of Black Cardiologists.
91
BiDil
Medication for heart disease in African Americans.
92
Critiques of the AA Heart Failure Trial
Racializes a specific disease/medical problem.
People who take BiDil come to identify as African Americans.
No discussion of prevention.
93
"Lifestyle" Drugs
Associated with consumption in the global north (not for infectious diseases), for diseases associated with aging, and the nutritional transition.
Ex. Using Testosterone to treat low libidos in middle-aged men.
94
Female Viagra (Addyr)
Is actually an antidepressant, package is pink, pill is pink, medication is gendered.
95
"Me-Too Drugs"
The majority of new drug launches have similar mechanisms of action (SMOA) to preexisting drugs.
It appears as a new drug, but actually uses SMOA as drugs to treat other conditions.
96
OPDIVO
New drug for lung cancer where users only live an average of three months longer than non-users. The advertisement claims to give a longer, fuller life, but actually only minimally extends life.
97
Inflation of Drug Effectiveness
Drug ethicacy is inflated because unfavorable studies were not published or included.
98
Corporatized Medical Research
There is incentive to make drugs that wealthier people will purchase.
Production of "Me-Too" drugs.
99
Clinical Trials
Trials are increasingly happening in middle-income countries, where lives are being exposed to serious risks and side effects.
100
"Treatment Naive" Populations
Trials purposefully seek out populations that don't have access to healthcare (do they have informed consent). People enroll in the trial because it will give them access to healthcare.
Will the subjects have access to the drug once it is put on the market?
101
Pharmaceuticalization
The transformation of something that could be thought of as a public health problem into a pharmaceutical problem.
E.g. BiDil is actually an issue of heart disease and prevention, but is targeted by pharmaceutical companies.
102
HIV in Brazil
Huge pharmaceuticalization of public health.
People become citizen-consumer-patients, the model of public health is more about drug treatment, as compared to prevention.
Lack of prevention efforts and knowledge of structural violence.
103
Where does U.S. Foreign Aid and Development Spending go?
The poorest countries on earth get relatively little foreign aid, most of is goes to Iraq and Columbia (Drug War).
104
Walt Rostow
Advisor to Kennedy
| Essentially invented development.
105
America's Rasputin
Walt Rostow and the Vietnam War
Rostow argued that the US should go to war with Vietnam, and then Vietnam should be used as "laboratory" for implementing development [should be opened to mass consumption].
106
Rostow's Development Paradigm
1. Tradition
2. Pre-Take Off
3. Take Off
4. Drive to Maturity
5. Age of High Mass Consumption
107
Instigators of Development
Starts with independence and decolonization
During the Cold War, the U.S. and Soviet Union raced to colonize/expand/grow.
Rise of Neoliberalism (1980s-2000s) encouraged the work incentive, decline of welfare, and retraction of state.
108
Affects of Development
Global free-trade agreements, decline of states and governments, privatization of resources. South Africa truncated their healthcare systems in the name of free trade, led to the rise of HIV/AIDS, and eventually NGOs.
109
"The Anti-Politics Machine" [James Ferguson]
Huge critique of development.
Some concepts of development remove relationships [between countries] from the discussion (like previous colonization).
Ignores the history of the country.
Makes "undeveloped" places seem intrinsically, naturally, forever poor and famished - even when they are not.
Emphasizes that poor people need more technology, administration, and intervention from the global north - they must be "taught" the right way to live.
110
Bangladesh and Development
Was originally used by wealthier nations [colonization, growth for exports] and as a result have little infrastructure besides what could be used to make money.
The production of an "undeveloped" place often goes in tandem with overdevelopment [through colonization, being used, etc.]
111
Lesotho
Was colonized, but still considered "virtually untouched by modern development."
However, it contained many economic developments characteristic of a developed country:
1. Money economy
2. Lesotho as a market for Western commodities
3. Plough agriculture and cash crops
4. Modern colonial state administration
5. Presence of a national elite
6. Migrant labor system and transformation of Lesotho into labor reserve for South Africa's economy.
112
Gloria Steinem: An Elephant Fence is the Answer to Sex Trafficking
If an elephant fences are built, elephants cannot get into maize crops, so women now have food security, and potentially extra money to send their kids to school - there is no need for them to go into the city, where they may become sex trafficked.
However this solution operates as an Anti-Politics Machine. It is a vertical, technological fix that ignores the history of Zambia, and how the sex trafficking industry came to be.
113
Critique and Affirmation of Development
Huge global economic growth ($)
Higher levels of school enrollment, longer life expectancy.
But also a widening wealth gap.
114
Arturo Escobar
The problem is that "development" is based on outsider assumptions and models.
We need to take seriously alternative methods and models of what is "good" for different populations.
Indigenous people have meaningful things to say about what should happen in the future.
Development is still a problem when it succeeds, it creates more issues with mass consumption.
115
Post-Development
1. NGOs
2. Microfinance
3. Accompaniment
4. "Corporate Social Responsibility"
116
Microfinance
Originated in Bangladesh and India in the 1980s.
Focus is on empowering women through small loans, they can build a business and add value to something they are already doing.
Banks and finance firms, rather than nonprofit groups, serve the majority of microfinance clients (charge high interest rates).
117
Muhammad Yunus
Pioneered micro-loans, believed they could close the wealth gap.
118
Critiques of Microfinance
Increased micro-lending is usually accompanied by cuts in public health, welfare, and education.
Loans used for sickness and education, and cannot be repaid.
Loans increase dowries.
Increase class stratification and gendered hostilities.
Further stigmatization of the poor - what happens when loans cannot be repaid.
Emphasizes individual success rather than broad-scale restructuring or infrastructure building.
