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Tag Archives: public health

Remember The Smoking!

15 Oct

beautiful_example_of_imagination_mushroom_cloud

Grab your guns; we’re heading for the Alamo! On October 19th gun enthusiasts will be participating in a “Line In The Sand” armed rally in St. Antonio, Texas. Participants are encouraged to carry their “long guns” and the event is billed as family friendly. It is not a protest in the traditional sense, as Texas has some of the most lenient gun laws in the land; it’s more of a show of arms if you will. The assumed intent is to create a powerful visual of gun slinging American families. To encourage a wholesome atmosphere participants are asked to remove bullets from chambers before marching.

Once one gets past the image of a John Wayne (or Mel Brooks) movie, the conceit is not that strange. People often march to express strong feelings, and clearly people feel very strongly about their guns. What is strange is that as a nation we seem to have bought into that sentiment. We continuously elect representatives who hold gun rights sacred. It’s challenging to conjure any other “right” that directly impacts the rights of others as dramatically as gun rights. We think nothing of restricting individual rights that have little if any impact on larger society. We set restrictions on; who can marry, female reproduction, child safety, and the right to die. In the past few decades we have begun to set limits on individual rights which affect the public. You can no longer drink and drive with impunity. Smoking is so restricted as to be unrecognizable as the American pastime it once was.

Smoking was once ubiquitous. People smoked in movie theaters, buses, planes, and even elevators! Ashtrays were everywhere! Freestanding ashtrays were in doctor’s offices, factories, office buildings, and schools. The smoke cloud emerging from most teachers’ lounges rivaled that of a nuclear test. Once upon a time cigarette smoke was everywhere. About twenty-five years ago C. Everett Koop (U.S. Surgeon General) published a report equating the addictive nature of nicotine to that of heroin. You’d be forgiven for not considering this a “Eureka!” moment. But keep in mind that the tobacco industry was (if not is) one of the more powerful lobbying groups in the country. Shortly after the report’s publication cigarette packaging had to include a warning box. Dr. Koop later published a report regarding the hazards of “secondhand smoke.” The first restaurant smoking sections then cropped up. Some readers might remember the bizarreness of smoking sections; everyone seemed to pretend that smoke doesn’t move. But as behavior change motivation goes, baby steps are often the way to go. Fast-forward to 2013 and most of us live in a practically smoke-free environment. Smoking is considered a private behavior and as such cannot infringe upon the larger population.

So why haven’t we been able to treat gun ownership this way? Secondhand smoke couldn’t possibly kill more people than guns. Why have we not set limits on how many firearms a registered, licensed and certified owner can possess? Where are the laws about which kind of weapons are allowed outside of a registered, licensed and law abiding gun club and which must stay secured? Why do we tolerate gun show loopholes? How can a household that includes children be allowed guns, but apartment residents with children must have window guards? There are gun enthusiasts in favor of reasonable restrictions. Not all gun fans cling to the 2nd amendment like it was an out of context bible passage. Not every person who enjoys guns holds fast to rhetoric and flag waving. So where are those voices? Where is our C. Everett Koop?

People will show up to the Alamo with their guns and children. Even if the showing is paltry the imagery will be startling. Once again we will be lulled into thinking that gun owners are monolithic. Once again the issue will be framed as all or nothing. Color me a pessimist, but once again our capital will be noticeably silent.

 
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Posted by on October 15, 2013 in Cultural Critique

 

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Hoarders

27 May

firehouse

Reality television is at best a cracked lens on society. The percentage of toddlers wearing hairpieces, spray tans, dentures, and artificial nails is in actuality quite small. Most women don’t call themselves housewives, implant faces and bodies beyond recognition and parent so abysmally. Whether the people who participate in these shows are mentally healthy or not is an interesting question. Voguing for a camera (and hoping to land fame, fortune and book deals) is not currently classified as a mental illness. For the official-certified-it’s listed in the DSM-V, display of mental illness you need to turn to the addiction sub-genre of reality show.

That there is an audience at all to watch people struggle with a mental illness is itself disturbing. But evidently there is, and the proof is the shows focusing on obesity, drug and alcohol addiction and hoarding. You’ll note that there are no shows about mental illness that have a less quantifiable or compelling visual behavior. There’s yet to be a “Watch The Narcissist” show, and to be fair it’s probably due to the redundancy factor. There’ll never be a “Depressed Divas” show as depressed people are never entertaining. A “BiPolar Bonanza” would demand a far too attentive director and shooting schedule (dammit his mood just shifted, where is the camera!) We, the audience, are not very interested in mental illness per se, what we like is wacky behavior. And if that behavior stems from a syndrome all the better. We love nothing more than hearing from a person with questionable credentials (‘therapist’ needs a modifier to mean anything) spout psychobabble about the behavior. The hoarding shows center around this very phenomenon. We see a ‘therapist’ gently talking the hoarder into parting with the petrified pet. In the next scene she actively listens to distraught and frustrated family members and explains ‘the process’ to them. We sit in our over-accessorized homes, eating chips and dip out of a chip and dip bowl, as we wear our ‘tv watching’ outfit and snort over the wasteful accumulation. “That’s f*&^ed up” we say as we accidentally tip over the tower of DVDs.

This interest in wacky behavior doesn’t just guide free cable programming decisions. It also seems to guide political policy and expenditure. There are currently 85 communities across this country that consider hoarding to be a serious public health hazard. Hoarding, of course is not necessarily a health hazard. No one has been physically harmed by a Madame Alexander doll or Thomas Kinkade collection. Possibly a more apt description for the kind of behavior with which the authorities are concerned is ‘filth’. There’s a method that’s been used since the dawn of filth for such scenarios; it’s called condemning. There are no soft-spoken ‘therapists’ or understanding fire chiefs necessary. If a home poses a genuine risk to the public, shut it down. Anything else is utterly disingenuous. Hoarding and living in filthy squalor is only the presenting behavior. There’s a reason people engage in barricade building. Convincing someone to part with a few carcasses and some urine soaked newspaper may make the helpers feel better, but dollars to dozens and dozens of donuts, that home is going to fill the hell up again. And why shouldn’t it?! What business is it of anyone’s how someone else chooses to live? This is when someone pipes up and says “It’s a public heath issue”. Is it? Not always. If the person lives rurally it’s not. If it really and truly is then shut it down. But wait, what’s to become of the hoarder? Well, if we really believe that the person is a danger to themselves and others (and if they’re not we have no business bothering them) than they need to live in a protected environment.

That homes are being cleaned out, very slowly and often at taxpayer expense, by community officials is troubling. On its surface it appears that we care about our most fragile neighbors. If that is even remotely true why aren’t the same resources being used to remodel shantytowns? Surely people living in doorways, under bridges and in tunnels are also worthy of a clean dwelling. It stands to reason that people living on the street, presumably without access to health care also pose a public health hazard. It is always better to err on the side of helping, but it is the responsibility of the strong to be clear about who exactly they are helping and why. Wrapping ourselves in rhetoric to impinge on someone’s autonomy is not helping anyone but ourselves.

 
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Posted by on May 27, 2013 in Cultural Critique, Media/Marketing, Well-Being

 

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The Smoking (Gun) Section

04 Mar

Anti-smoking campaign launched

C. Everett Koop made a mark on public health in America. He was a forceful advocate for rational scientific facts that were at times in opposition to his own personal beliefs. He refused to imbue abortion with (unsubstantiated) claims of lasting psychological damage. He forced a (seemingly) reluctant administration into acknowledging and fighting AIDS. He may very well be the only surgeon general whom we can all name and picture and that is in no small part due to his anti-smoking campaign. Dr. Koop was the catalyst for the most dramatic change in social behavior in our time. Alarmed by the effects of smoking Dr. Koop, and without much support from his administration, he went up against the powerful tobacco lobby and took to the podium (in his impressive uniform.) He appealed directly to the nation to change their ways. He issued a report about second-hand smoke and campaigned for smoking restrictions in the workplace and restaurants. Through his efforts, both academic and rallying; Americans began to change their attitudes towards smoking. Smokers gradually went from the freedom to smoke anywhere in a restaurant, to doing so in a designated area, to doing so outdoors. People grumbled and even got angry, but they moved and public health improved. The air quality improved for all and smoking diminished (dramatically) overall.

Smoking became a personal behavior that must stay personal. What if we were to do the same with gun ownership? What if we were to treat guns as we do smoking, as a public health issue? People can own guns, they can shoot guns, but they most do so in the shooting section. Guns must be registered and licensed and be stored at a registered and licensed gun club. The clubs provide shooting ranges and would be allowed to sell ammunition. Licensing and registering a personal (at home) handgun would require the purchase of a gun safe. Gun security in a house in which children are allowed or live would be treated like cars and car seats. Any adult caught having an unsecured gun in proximity of a child would be subjected to the same penalties a person driving with an unrestrained child. Hunting is already a highly regulated endeavor. There are times of year in which a person is allowed to hunt particular animals and there is licensing. Hunting guns would be registered, licensed and stored at a hunting lodge (or a locker in the state police barracks.) Gun owners would be fined and have their license revoked if they don’t abide by the rules.

Would creating a ‘smoking’ section prevent illegal firearm sales or guns ending up in the wrong hands? Maybe, maybe not. But by changing what we consider normative behavior, we do change everything. What Dr. Koop did was shift our society’s perception of smoking. We moved from glamorizing a behavior to recognizing it for the blight on public health that it is. If we no longer accept that an individual’s right to gun ownership trumps that of the public good we will be that much closer to protecting our children and ourselves. If we begin to see that guns, like cigarettes, are a personal choice that must remain personal we are that much closer to controlling gun violence. People who choose to own and use guns responsibly should embrace this notion and extricate themselves from any organization that preaches personal freedoms above that of a safe and secure society. They should tear up their membership cards and visibly step away from an organization whose solution to violence is to arm elementary schools. There is a name for groups whose use of violence creates a general climate of fear in a population.

 
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Posted by on March 4, 2013 in Cultural Critique

 

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Wessonality

20 Jan

I hear that taxi receipts are going to be emblazoned with advertising soon.  In theory, that passes the laugh test, no?  For anyone who has ever been handed a mangled 2-inch receipt with blurry ink, it sounds ridiculous.  Unless it’s an ad for a better receipt mechanism, we might want to rethink this initiative.

Advertisers for the most part are hitting the right note in placement.  The industry has matured and is adept at following (and even predicting) trends.  Traditional platforms are still in the game, but new media has prompted creative delivery initiatives.  With our hand-held devices, web-based platforms and the like, we are bombarded with new forms of ads.  Only the most rural of us leave our homes without entering a technicolor world of advertising.  Those taxis about to get the smudgy receipt ads?  Most of their roofs are festooned with a large (illuminated) table tent of an ad.  Almost all cabs now have advertising (posing as network news) playing on a monitor in the backseat.  There really isn’t much to malign about the ubiquity of advertising.  If it hurts anyone, it’s the product/client not the user/consumer.  How in the world do you make yourself heard above all that noise?

One of the oldest ways to get noticed is celebrity endorsement.  Since there were celebrities there was celebrity endorsement.  If anyone had thought to market apples, I’m guessing they would have approached Eve.  Throughout the years most endorsements and advertisements have been quite obvious.  But what happens when advertising not only becomes more ubiquitous but more embedded?  What happens when a celebrity is famous for selling themselves as a brand (versus being a performer?)  There is a potential for conflict of interest as well consumer confusion.

Let us take a recent example of Paula Deen, a woman whose gimmick has been selling mayonnaise and butter laden dishes.  She is a southern woman who got her start making sandwiches for local workers.  With no culinary training but an innate understanding of showmanship, she is a perfect example of today’s celebrity brand.  She announced her (three year old) diabetes with her drug company endorsement in hand while declaring that her diet has nothing to do with her disease, thereby protecting her brand.  When asked on air if she was a paid spokesperson for the drug company she retorted; “I’m compensated just like you are.”  Well, not exactly.  The newsreader is being compensated by the network to do a good job for the network (and probably to cross promote the network’s other programming.)  Not many people watching the show think he is doing it for free.  The issue with not declaring (in a big black box) that “Miss Paula Deen is a paid spokesperson for this company” is that we are not the most educated of consumers. Sometimes public health has to trump capitalism.  Our country is just getting heavier.  Miss Deen has a loyal rural and southern following who may very well be suffering from diabetes themselves.  To hear a (very healthy looking) famous person declare that “diabetes has nothing to do with what you eat and if you take this lovely drug like I do there’s nothing to worry about,” is troubling.  Miss Deen is allowed to sell whatever she chooses, and the drug company is allowed to hire whomever it pleases.  Hence, the black box.  The drug company could also do themselves a big public relations favor by prefacing all their messaging with “maintaining a healthy weight is proven to have a positive impact on diabetes management.”

Users/consumers are becoming increasingly inundated with advertising, and may be a bit numb.  A million years ago, the novelty of Judy Garland selling Max Factor was so unique the consumer would think; “Look it’s Judy Garland selling Max Factor!” (and most fans knew that Max Factor was the make-up artist for the movie studios.)  Now that everyone is famous and ads are everywhere, being intuitively savvy is a challenge.  The harm is not to the product or advertisers but to the consumers.  Regulating advertising to protect consumers is not new.  You may remember when some paperback books had full-age cigarette advertisements.  Liquor and cigarette advertisements were once on television all the time.  Public health concerns change over time and in my estimation will always trump profit.  A simple black box hurts no one, not the product and not the paid spokesperson.  All it will do is remind the consumer that they are in fact experiencing an advertisement.

 
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Posted by on January 20, 2012 in Cultural Critique, Media/Marketing

 

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Lose Pounds and Inches Fast!

02 Jan

“Eat our processed food and lose weight!”  “Join this gym and lose weight!”  “Take this pill, shake, herb, tea, suppository, and lose weight!”

And they’re off!  New Year’s is the weight loss industry’s black Friday.  Many millions are reaped throughout the year, but it is January that does wonders for the industry’s bottom line.  As our nation has grown in size so has an industry filled with an abundance of promises and zero standards.  How has this happened?

Whether one considers excessive weight to be a health, behavior or public issue is somewhat secondary to the point that the market feels free to exploit the situation.

If you feel that being overweight is a health issue, what do you make of reality television shows featuring obese contestants being humiliated as a means to bolstering their health?  Do we watch smokers and drinkers being humiliated on reality shows?  Do we honestly think that this programming is not solely about the viewer’s entertainment?  How did other people’s heartbreaking struggle with a health issue become fodder for our entertainment?

If you feel that being overweight is the result of an utter lack of self-control, what do you make of products that reinforce that disconnect between outcome and behavior?  The “behavior” camp asserts that maintaining a healthy weight is the result of not consuming more than one is using.  A sensible diet and a moderate amount of exercise is the permanent method with which to control weight.  If the federal government believes this (and they seem to) why then are companies allowed to sell snake oil?  Why doesn’t every advertisement for Nutri-Jenny-Fast have a big black box across it stating “Eating our fake food is not sustainable & your behavior will not be changed by our program.  You may in fact lose weight while you are our customer, but most people gain it back immediately after leaving our program.”   Too big brother?  Remember, we now have warnings on aerosol bottles to dissuade people from huffing.

If you feel that the public health of our nation is at risk, then we really have to talk.  Whether we should start with the corn subsidies or food labeling, or school lunches makes for good dinner party conversation.  But so do dinner parties for that matter.  All of our habits, from the decline of dinner tables to carbo-loaded toddlers while they burn zero calories riding in a stroller, to wheels on sneakers (children don’t even walk anymore, they roll,) it’s all up for scrutiny.  What about processed foods designed specifically for children?  The baby food industry started the trend with “toddler” jarred foods.  Apparently toddlers find real yogurt and bananas to be daunting.  As they get older, the food industry has graciously provided, fake cheese, yogurt with candy, processed breaded chicken nuggets, lunchables and colored flavored drinks.  For those in the public health camp; why is this even tolerated?  We regulate pill bottle caps, cribs, car seats, window blind cords, but not the food sold for our children?  We are cultivating a lifelong appetite for fake food.

It is a terrible burden to feel as if your size is standing in your way.  Feeling as if your own body is the enemy is an exhausting way to go through life.  For anyone pulling on their new sneakers and heading out into the unknown this January, I say Brava!  It is physics; the first steps are the hardest.  Keep at it, and in about six weeks it will be the new normal.  Eat real food, celebrate meals, enjoy life and save your money.  There are no shortcuts and the only magic is discovering your own strength.

 

 
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Posted by on January 2, 2012 in Cultural Critique, Media/Marketing

 

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