Category Archives: health

is obesity a problem?

I started this post as a reply to the OrgTheory thread on obesity but it got long enough I decided to move it here.

With all due respect, I think the claim that “obesity is not the problem” is overstated. I suspect that this overstatement is due in part to medical sociology’s tendency to infer from the “social construction of <condition>” that <condition> is not really real (see here for more on that). (Quick disclaimer: I have not yet read Abigail Saguy’s What’s Wrong With Fat?, though I hope to soon.)
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the contraception mandate and path dependency

There’s much conversation about the so-called conscience issues with the contraception “mandate” under the new health care reform act. The Immanent Frame carries a useful set of statements by scholars on the topic. Kevin Schultz is of course correct that the whole matter is trumped up for election-year politics. Essentially they’ve carved out whole new territory for rights of “conscience”: a right to have one’s money “marked” such that it can’t be used for things one doesn’t believe in, even once that money is committed to nonreligious purposes. This idea validates one of Viviana Zelizer’s theses that the infinitely-fungible character of money fails to protect it from being invested with myriad meanings and distinctions.

The thing I haven’t heard mentioned is that the only reason this is an issue is because of the bizarre, path-dependency-created fact that most health insurance in the United States is purchased by employers. In the context of a national health care program, employers wouldn’t be in the business of purchasing their employees’ health care, so there would be no issue about “conscience.” There is no objection on the part of the Bishops to using public roads to allow people to drive to purchase contraceptives, nor public police and fire to protect the establishments that sell them.

blood pressure, the slavery hypothesis, and social construction

My wife is a physician, and like many doctors was taught in medical schools that African Americans are susceptible to hypertension, and particularly salt-sensitive hypertension, as a result of genetic selection through conditions during the middle passage. I raised this possibility in chatting with Liana Richardson, a postdoc here at UNC, about her very interesting work  on hypertension as a biomarker for stress over the life course, and in particular as a marker for high stress among African Americans. Her response was very interesting, and illustrates an example of cross-disciplinary information flows.

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obesity and life trajectories

This morning NPR had a story about this study, which followed high-school grads to age 40. It uses “growth mixture models” (I’m not sure what these are) to identify two latent classes: one of “normative,” gradual growth in weight from normal weight at high school graduation to higher weight at 35 or 40, the other of “persistent overweight,” i.e., being overweight at high school graduation and staying overweight. There are important differences in health at age 40, which I don’t think is that surprising (though worth demonstrating). But there are also differences in social outcomes, including having “ever had a partner” (romantic, I assume); welfare receipt; and not having pursued education after high school, all of them more likely among the persistently overweight group.

The paper also, though, demonstrates that low childhood SES is a significant predictor of overweight at high school graduation, as is (independently) high school GPA. Read in this way, it strikes me that we ought not understand persistent obesity as a biological cause of social outcomes, as the NPR story (and particularly Kelly Brownell’s commentary therein) suggests, but rather as a mediator between childhood SES and adult SES.

50th anniversary of the pill

Happy birthday, The Pill!

(Also, May the Fourth be with you–I’m sorry; I couldn’t help myself.)

coakley, brown, and health care

I’m not sure how to call today’s Coakley/Brown race in Massachusetts, largely because of the difficulty of predicting turnout and, even more so, the reactivity of polls based on turnout predictions. But I’m intrigued by the thread around talk radio and the ‘net that health care reform is “dead” if Coakley loses. Continue reading

perils of astroturf

Earlier this week I (and, as it turns out, many other North Carolinians) received a postcard from Blue Cross and Blue Shield of North Carolina:

bcbs1(The rest of the mailing is after the break.)

I, like many others, was infuriated that a nonprofit–which, apparently BCBSNC is–was using either my premium dollars or my tax dollars, or a combination thereof, to lobby against legislation that might threaten its business.

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frontiers of polling and interpretation

Today’s NYT features, on the front page nonetheless, a story under the headline “Poll Finds Frustration on War and Health Plan.” Note that on the website they’ve changed the title to “In Poll, Public Wary of Obama on War and Health.” There are several interesting, problematic elements to the poll and the way it’s presented.

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overheard: love in the time of h1n1

“I love you, I miss you, and I can hardly wait until you’ve been without a fever for at least 24 hours.”

the egalitarian u.s. health care system?

Tyler Cowen writes:

Since old, high-bank-account white males have lots of social status and power, [believers in egalitarianism] cannot bring themselves to regard those males as holding very poor overall endowments.

Cowen claims that the poor old rich white guys’ supposedly “poor overall endowments” arise from the impairment of their human capital at the more-or-less imminent end of life. There might be half of an argument here if human capital were the only component of individual wealth. Instead, we have Shorter Tyler Cowen: The rich actually aren’t so rich if you don’t count their money. Whether and to what extent marrying Neutron Jack increased Mrs. Suzy Welch’s human capital as distinct from social and financial capital is left as an exercise for the reader.

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misfortunes highlight how lucky i am

Husband broke his foot on Sunday. Not playing hockey, but having brunch. Unfortunate. We went to the urgent care clinic, which is free (fortunately), because we live in Canada (fortunately), because I got a tenure-track job here (fortunately). While at the clinic, Husband got an x-ray and an air cast (cool!), and he also picked up a flu bug. It wasn’t that flu (fortunately), just the regular old flu. He was only down with that for the day, though, because we remembered to get flu shots this year (fortunately), and because they are easy to get (fortunately), and free for everyone in our province (fortunately).

He is feeling better this morning, but a little tired, and a little blue, especially because it is our hockey team’s playoffs, and he really wants to play. But then again, he has a job where he can work while injured (fortunately), and work from home (fortunately), so everything will be okay.

goodbye, dad

I am out at my parents’ house in California this week, working through some tough times again. My father’s battle with Alzheimer’s came to an end, and as usual, Alzheimer’s won. Memorial services for my dad will be tomorrow. I am so thankful that I arrived in time to see my dad one last time, and to tell him stories about his grandson and tell him how much I love him. He was only awake for about half an hour, and he couldn’t talk at all, even though he had so much to say. He clapped his hands to show me he was happy to see me and the rest of the family. Then, he fell asleep, and his embattled brain continued turning off the light switches and shutting the blinds until he passed away last Saturday night.

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if not thankful, glad

It’s not Thanksgiving up here, and perhaps that’s for the best. I was so sick with a stomach virus that I had to cancel my undergrad class on Thursday, although my grad class could carry on without me. I have been various degrees of horizontal since Wednesday, and every time I feel better, I eat a little something and then I feel a little worse. I guess that’s how stomach viruses go.

Still, I’m glad that Husband was around to take good care of me, and that the 4 or so other people whose help I needed to keep my work obligations together also stepped up. And although I feared the worst when Kid hurled up his oatmeal this morning, a short nap and a day of cartoons on the couch seems to have him feeling much better. I am glad for that.

So, I am missing my hockey game right now, and I really hate to cancel class, but the timing could have been much worse: Monday is our semester review, and after that, awesome travel. I guess I’m glad I am coming up out of it rather than heading into it.

check your poop lately?

The Ontario Ministry of Health has a new public health project that encourages people to screen themselves for colorectal cancer. Ontarians over 50 can get a free home-test kit to check for blood in their stool, an early sign of the disease. Testers collect samples of their own poop for three days in a row, and send it all in to the health department to be tested.

You can imagine how difficult this program might be to promote. Can’t say poo, can’t show the test, can’t make people too worried about dying. It seems impossible, but somehow, they came up with one of my favorite commercials on TV:

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