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Social Components. Society. Gender Media. Gender Differences. Mortality vs. Morbidity Behavioral Profiles Gender-linked Sex-linked. Mortality: risk of death. Higher in men Lower in women. Morbidity: Risk of Illness. Higher in Women Lower in Men. Behavioral Profiles.
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Society Gender Media
Mortality vs. Morbidity • Behavioral Profiles • Gender-linked • Sex-linked
Mortality: risk of death • Higher in men • Lower in women
Morbidity: Risk of Illness • Higher in Women • Lower in Men
Behavioral Profiles • Gender-linked • Differences attributed to cultural/social factors • Jobs • Likelihood to seek medical help • Risk-taking behaviors • Media Images • Sex-linked • Differences due to biological differences • Testosterone and heart risk • Childbearing • Risk-taking behaviors
Examples • Ambien: metabolized differently in Women • Aspirin cuts risk of heart attack in men, not women
“While breastfeeding is natural, the act has been marginalized and stigmatized in American culture, said Dr. Alison Stuebe, assistant professor of obstetrics and gynecology at University of North Carolina Health Care. “[And] at the expense of the health and well-being of mothers and babies,” said Stuebe. “By bringing breastfeeding into the mainstream, Beyonce can help break down barriers so that mothers and babies can breastfeed in peace.”
Television/Movie Depictions of Health Behavior • Advertising/commercials • Celebrity Endorsements • Soap Opera Advocacy
Celebrity endorsements • Does Celebrity Involvement in public health campaigns deliver long-term benefit to the public? • For: despite focus on celebrities and quack cures, many important issues are highlighted • Against: celebrities are not experts, advice may not be accurate, even harmful. May have outsize impact due to fame
An increasing number opt to have the healthy, unaffected breast removed in a procedure called a contralateral prophylactic mastectomy (CPM) to prevent the disease from spreading. • In the 1990s, about 4% to 6% of women who got a mastectomy opted to have the other breast removed as well; in more recent years, researchers estimate the rate has tripled or even quadrupled.
But Is ContralateralProphylatic Mastectomy Effective? How does celebrity example influence decision-making and evaluation of evidence?
Summary • Surveyed 123 women aged 40 or younger who were diagnosed with cancer in one breast but opted to get both breasts removed. • Most of the women had stage 1 or stage 2 cancer, and 60 percent of their tumors were estrogen receptor-positive, meaning the tumors grew more in the presence of estrogen.
98 % : said that they had both breasts removed because they wanted to decrease their risk of cancer spreading to the other breast. • 94%: said they believed removing the healthy breast would give them a better chance at overall survival, and 95 percent said the procedure would give them "peace of mind."
doctors don’t agree • Women greatly overestimated risk of getting cancer in other breast • Were told by doctor that CPM wouldn’t help their survival • Women said doctor was most important source of information yet only 33% followed doctor recommendations
90%: said they did not regret their decision and would do it again. • Still, many did point out that the outcomes of the surgery were worse than they were expecting. • 33%: underestimated the number of procedures and surgeries they would need • 28 %: didn't expect the numbness or tingling in the chest they experienced.
"Additional clarification of conficting responses -- specifically, the inconsistencies between the importance of improved survival as a reason for choosing CPM and the acknowledgment that CPM is not associated with better survival outcome -- would be helpful,” • The editorial suggested there is a "teachable opportunity" for doctors to help their patients make informed decisions based on accurate data.
All American Speakers: On its Web page, it lists a broad array of medical conditions -- dialysis, disability awareness, diverticulitis, double bypass surgery, on and on -- and explains: • "Let us help you find the right spokesperson, handle all of the details in locating and negotiating your celebrity endorsement or special event. You will get the most competitive prices for your celebrity talent.” • Rx Entertainment: a "celebrity procurement agency that works exclusively with the healthcare industry. Our primary focus is to match products and services with celebrities and entertainment properties to create credible, performance-driven endorsement campaigns."
“The Dr. Oz Show” frequently focuses on essential health issues: the proper ways to eat, relax, exercise, and sleep, and how to maintain a healthy heart. • Some of the advice Oz offers is sensible, and is rooted solidly in scientific literature. “
Promotes “magic bullet” mindset • Oz is an experienced surgeon, yet almost daily he employs words that serious scientists shun, like “startling,” “breakthrough,” “radical,” “revolutionary,” and “miracle.” There are miracle drinks and miracle meal plans and miracles to stop aging and miracles to fight fat. Last year, Oz broadcast a show on whether it was possible to “repair” gay people (“From Gay to Straight? The Controversial Therapy”), despite the fact that Robert L. Spitzer, the doctor who is best known for a study of gay- reparation therapy, had recanted. (Spitzer last year apologized to “any gay person who wasted time and energy” on what he conceded were “unproven claims.”) Oz introduced a show on the safety of genetically modified foods by saying, “A new report claims they can damage your health and even cause cancer.”
Questionable Claims • But both the show and his Web site concentrate on the type of weight-loss plans more commonly found on infomercials in the middle of the night: “Dr. Oz’s Three-Day Detox”; “Eat Yourself Skinny”; “Oz-Approved Seven-Day Crash Diet”; “Stairway to Skinny Workout.” Cancer, Oz told me, “is our Angelina Jolie. We could sell that show every day.” Typical themes have included “Five Fast-Moving Cancers”; “Four Body Pains That Could Mean Cancer”; “Three Cancer-Preventing Secrets”; and “What You Can Eat to Defeat Cancer.” Last year, in a show about weight loss, Oz introduced raspberry ketones, an herbal supplement, as “the No. 1 miracle in a bottle to burn your fat.” That set off a wave of panic buying throughout the nation.
In each of those instances, and in many others, Oz has been criticized by scientists for relying on flimsy or incomplete data, distorting the results, and wielding his vast influence in ways that threaten the health of anyone who watches the show. • Last year, almost as soon as that G.M.O. report was published, it was it was thoroughly discredited by scores of researchers on both sides of the Atlantic.
Advocates Pseudoscience • Studies of energy forces in our bodies have routinely shown that Reiki adheres to no known principles of science. In perhaps the most famous such review, a nine-year-old girl conceived and executed a test in which she demonstrated that twenty-one people who claimed to be skilled in the techniques of Reiki were nevertheless unable to detect her “energy field” more often than they would have by guessing. The study was eventually published in the Journal of the American Medical Association. In 2009, even the U.S. Conference of Catholic Bishops urged Catholic health- care facilities and clergy not to promote or support Reiki. • I told Oz that I was aware of no evidence showing that Reiki works. He cut in: “Neither am I, if you are talking purely about data.
A similar buying frenzy followed his embrace, a few months ago, of “the miracle” of green coffee beans. “You may think that magic is make-believe,” Oz said at the beginning of the show. “But this little bean has scientists saying they have found a magic weight-loss cure for every body type. It’s green coffee beans, and, when turned into a supplement—this miracle pill can burn fat fast. This is very exciting. And it’s breaking news.”
“We did our own study on this,” he said when I asked him about it. “It wasn’t a classical medical study, of course, but for a television show it was pretty darn good. We took a hundred people, randomized them, and showed what academic studies have showed: you are not going to lose a ton of weight, but you will probably lose a pound a week for a few weeks. That’s better than placebo.” Even those assertions are debatable, but his measured answer was almost exactly the opposite of the hyperbolic message he had broadcast into American living rooms.