The New Health Insurance Model: In the first of a three-part series, the L.A. Times looks at the changing insurance scenario — where once working Americans could rely on employer-based benefits, now more people are being forced into the individual market, where coverage is costly, bare-bones and precarious.

Part two looks at the business side of managing health savings accounts, and part three covers the battle between doctors and insurers. Meanwhile, health care costs continue to rise.

Plus: Read more about how the individual health insurance market fails women. It’s a great report from the National Women’s Law Center.

No Candy or Condoms: Divine Mercy Care Pharmacy in Chantilly, Va., drew attention this week for becoming at least the seventh pharmacy in the United States to refuse to sell contraceptives of any kind, even if a person has a prescription. The decision, say owners, is guided by Roman Catholic teachings, though the pharmacy is not affiliated with the Catholic church. Still, it did receive a blessing from Arlington Bishop Paul S. Loverde. From the AP:

“This pharmacy is a vibrant example of our Holy Father’s charge to all of us to wear our faith in the public square,” said Loverde, who sprinkled holy water on the shelves stocked with painkillers and acne treatments. “It will allow families to shop in an environment where their faith is not compromised.”

Too bad everyone can’t shop in an environment where their health is not compromised. In Virginia, pharmacists can turn away any prescription — for any reason.

Prop What?: Heather at Scarleteen gives a good overview of several important ballot measures that will be up for vote Nov. 4 in states from Arkansas to South Dakota, “such as parental notification laws for minors who want an abortion, age of consent laws, same-sex marriage, civil rights, stem cell research, education issues, even a proposal to lower the voting age for primaries in one state (whoohoo!) and another to ban abortion outright (grrrr).”

Plus: Look up ballot measures for your state here.

2009 Sheroes: Next year’s Sheroes Womyn Warriors calendar is now available for sale (check out the beautiful cover art by Ekua Holmes!). The calendar honors change agents, rebels, radicals and revolutionaries of different times and places around the globe.

“This is definitely not a ‘great women of history’ celebrity calendar,” reads the back cover. Instead, this is a calendar “of womyn who have challenged their societies and who have advanced the struggle of the oppressed and exploited.”

Proceeds support the Gustavus Myers Center for the Study of Bigotry and Human Rights at Simmons College.

Plus: Send in suggestions for who should be included in the 2010 calendar.

Seen But Not Heard: Jeannine Stein at the L.A. Times writes: “Researchers at Texas Tech University Health Sciences Center in Lubbock interviewed eight overweight women ages 20 to 61 to learn about their experiences with the healthcare system, then published their findings in this month’s Journal of Advanced Nursing. During interviews about their experiences, four themes became apparent: struggling to fit in, feeling not quite human, being dismissed, and refusing to give up.”

Scary Sexy Costumes for Kids: “Halloween costumes are reflecting an increasingly sexualized childhood. They often reflect the stars and starlets and popular culture role models that girls have, starting with Disney princesses or Hannah Montana when girls are young. But even traditional favorites, like witches and pirates are sexier every year. And French maids are quite the thing for tweens and teens,” said Diane E. Levin in a Q&A about Halloween costumes and gender roles.

Levin is co-author with Jean Kilbourne of “So Sexy So Soon: The New Sexualized Childhood and What Parents Can Do to Protect Their Kids.”

Life’s Lessons: On the other side of what’s good for kids, “Free to Be You and Me,” which has never gone out of print since its 1973 debut, was reissued this month with a new, expanded edition, reports USA Today.

Jessica Reaves of the Chicago Tribune, who also made her debut in 1973, writes about the book’s appeal and the lessons that have remained incredibly relevant for more than three decades:

Some critics of “Free to Be” accused Thomas of advancing a radical feminist agenda. They pointed to the book’s co-producer (the Ms. Foundation for Women) and Thomas’ role on “That Girl,” the first television program to shamelessly promote the career girl lifestyle. (I mean, really: Ann Marie strung that poor Don along for four years before she finally agreed to marry him!)

As a feminist born into a family of feminists, I’m biased: I happen to think adopting a feminist agenda is the best thing that could ever happen to this country. (Trust me, it hasn’t happened yet.) But those long-ago critics were right about one thing. The witty, wise lessons of “Free to Be” do underscore feminism’s fundamental tenet: namely, that everyone — male, female, black, white, brown, young, old and in between — should be treated equally and empathetically. Yes, even the jerks.

You only need to glance at the headlines to know we’re not quite ready to cross that particular item off our collective to-do list. Which isn’t to say we haven’t learned a lot in the 35 years since “Free to Be” was published. It’s just that we may need another 35 years for it all to sink in.

Prisoners of a Hard Life: Women and Their Children

PM Press has recently published “The Real Cost of Prisons Comix,” three comic books produced by the Real Cost of Prison Projects in one volume. The book includes:

“Prison Town: Paying the Price” tells the story of how the financing and site locations of prisons affects the people of rural communities in which prison are built as well as urban communities from where the majority of incarcerated people come from. Illustrated by Kevin Pyle; written by Craig Gilmore and Kevin Pyle.

“Prisoners of the War on Drugs” includes the history of the war on drugs, mandatory minimums, how racism creates harsher sentences for people of color, stories on how the war on drugs works against women, three strikes laws, obstacles to coming home after incarceration, and how mass incarceration destabilizes neighborhoods. Illustrated by Sabrina Jones; written by Ellen Miller-Mack, Sabrina Jones and Lois Ahrens.

“Prisoners of a Hard Life: Women and Their Children” includes stories about women trapped by mandatory sentencing and the “costs” of incarceration for women and their families. Illustrated by Susan Willmarth; written by Ellen Miller-Mack, Susan Willmarth and Lois Ahrens.

The book also features more than 30 responses from activists, teachers, health practitioners, prisoners and others about how they have used the comic books in their organizing.

The number of incarcerated women has risen at a rate nearly double that of men in recent decades, in large part due to mandatory sentencing and draconian drug laws. There is now believed to be about 200,000 incarcerated women in U.S. prisons, jails and immigration detention centers. 

In an article published at Our Bodies Ourselves, Ellen Miller-Mack, a co-author of two of the comics, describes the work of numerous anti-prison activists addressing problems faced by women prisoners, especially around issues of family preservation and reproductive rights. For instance, in 2000, the Illinois legislature prohibited the shackling of women prisoners while in labor — something that The Advocacy Project had been working on for years.

Shackling a woman who is giving birth sounds so ridiculous, like something from a different era done with no understanding or respect for a woman’s health, or the health of her infant.

Except that it’s still happening today. In fact, California and Illinois are the only states with laws on the books regulating the use of restraints on pregnant women.

Just this past July, Rachel wrote about an immigrant woman in Tennessee who was pulled over by police as she was leaving a prenatal clinic with her three children. Juana Villegas DeLaPaz did not have a current driver’s license and was subsequently jailed. She was taken to a local hospital when she went into labor that night, but the prison guard disconnected the phone so DeLaPaz couldn’t make outgoing calls and she didn’t see her husband. She was ankle-cuffed to the bed at all times except for a bathroom break. (Read an update of her case here.)

According to a report from Amnesty International, “Abuse of Women in Custody: Sexual Misconduct and Shackling of Pregnant Women,” 23 states and the U.S. Bureau of Prisons specifically permit shackling women in labor. And Louisiana and the U.S. Bureau of prisons have no restrictions on restraints other than specifying that pregnant women should not be restrained face-down in four-point restraints.

I’ll pause while you digest that sentence.

Sexual abuse is also a widespread concern. Last year Nicole Summer, writing at RH Reality Check, looked at how the prison system addresses sexual abuse against incarcerated women — most of which is perpetuated by prison guards — and prisoners’ access to contraception and abortion.

“Surviving a sexual assault and then navigating the health care system to receive adequate counseling and reproductive medical attention is daunting enough for those who walk freely on the outside. For women in prison, these hurdles can seem insurmountable,” writes Summer.

Miller-Mack’s article identifies a number of organizations working to address these and other issues, as well as resources for learning more about the conditions and realities of women in prison.

Plus: Miriam at Feministing recently live-blogged the Critical Resistance 10 conference. Check out her entries, particularly this one on prisons as a tool of reproductive oppression.

In the Sunday New York Times Magazine, media columnist David Carr bares all about his drug addiction 20 years ago. He lost just about everything, including, temporarily, custody of his two young daughters.

The article was an excerpt from Carr’s book, “The Night of the Gun,” which will be published in August.

What I was most drawn to was the confusion over memory — who did what, and what were the consequences — and Carr’s attempt to go back and reconcile the truth about his past, during which he was also abusive toward his then-girlfriend.

But in one place Carr is very clear. Toward the end, he acknowledges how attitudes toward his attempts at recovery and raising his daughters cast him in a very different light than women in the same situation:

When a woman, any woman, has issues with substances, has kids out of wedlock and ends up struggling as a single parent, she is identified by many names: slut, loser, welfare mom, burden on society. Take those same circumstances and array them over a man, and he becomes a crown prince. See him doing that dad thing and, with a flick of the wrist, the mom thing too! Why is it that the same series of overt acts committed by a male becomes somehow ennobled?

I’m not saying that raising children, especially by yourself, is a trip to Turks and Caicos, but single parenting is as old as reproduction. Families declare themselves in all sorts of versions, and ours happened to be two adorable toddlers stapled to 250 pounds of large, white male. Still, people who knew our circumstance marveled at its idiosyncrasy. And people who knew me before the twins wondered all the more.

Read the whole story here.

The Chicago Foundation for Women today published a list of recommended books for summer reading, including such notables as “The Girls Who Went Away: The Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Roe v. Wade,” by Ann Fessler (Penguin Books, $15), and “Undivided Rights: Women of Color Organize for Reproductive Justice,” by Jael Silliman, Marlene Gerber Fried, Loretta Ross and Elena Gutierrez (South End Press, $20), with the comment, “The history of women of color’s leadership on reproductive health is underappreciated, but this book seeks to remedy that.”

The image on the left includes those and some of the other titles. CFW also recommends a title you should skip: Kathleen Parker’s new book on the rise of “slut culture” called “Save the Males: Why Men Matter, Why Women Should Care.”

Every week, CFW includes “What’s Missing” — a feminist analysis of media omissions — and this week they write:

In an excerpt printed in the New York Daily News, Parker blames women and girls — including pre-pubescent girls — for “Save the Males” cover with international “No” sign arousing boys and men, then insisting on freedom from sexual violence. Sexual innuendo on young girls’ clothing is “part of a larger trend in which children are being sexualized at ever-younger ages” — fair enough. But Parker blames the girls’ mothers for “pimping” their daughters and again turns her attention to boys and men: “Once women sexually objectify themselves, it becomes harder to insist that others not.”

What’s missing: Sexuality is a fundamental, life-long part of the human experience, and children deserve to learn about it in a positive and respectful way. Yes, the commodification and sexualization of girls is a problem, but we don’t use it to demean people of any age or gender — and we don’t use it to excuse rape. Parker articulates a central premise of the rape culture: If women and girls choose to wear certain clothing, it is an invitation for men to harass, assault or rape. But a skirt is not a white flag surrendering human rights. Once we shame women and girls as “asking for it,” we absolve those men who choose to be violent — and ignore all the well-meaning men who stand up to the rape culture and respect women.

They also point to Jeff Fecke’s funny takedown at Shakesville and Broadsheet’s Tracy Clark Flory, who writes: “To recap: Girls are being sexualized before they even know what sex is, but it’s males that need the rescuing. Quick, save them from these succubi in training bras!”

So, readers, what books do you recommend?

It’s thrilling any time Our Bodies Ourselves receives a positive mention. But we admit to total giddiness over the beginning of Linda Gordon’s article in The Nation:

“The progressive social movements of the last half-century produced millions of pages of print, from manifestos to journalism to novels, but nothing as influential as Our Bodies, Ourselves. The feminist women’s health manual is the American left’s most valuable written contribution to the world. This claim is meant to be provocative, of course, but it’s true. The publication of an excellent book about the book, Kathy Davis’s The Making of Our Bodies, Ourselves: How Feminism Travels Across Borders, makes this a good time to examine its impact.”

Gordon, an author and professor of history at New York University, does a terrific job of summarizing Davis’ book, which features the stories of women’s groups throughout the world that have adapted “Our Bodies, Ourselves” and highlights the work of OBOS’s Global Translation/Adaptation Program:

If Our Bodies, Ourselves had retained its original authorship, the homogeneity of the original Boston-based CR group — in class, race and nationality — would have limited its appeal. The group’s concern with women’s concrete experience led them to gather many personal reports, so the book’s sources grew increasingly varied. As activists in other countries discovered the book, they asked for versions in their own languages. As Davis recounts in her history of the book’s global expansion, the original authors soon came to understand how saturated their book was with the perspective of educated, middle-class, white American women.

In fact, the group’s initial chutzpah in challenging medical authority was partly a product of these women’s privilege. As their global sophistication increased, the Boston group came to a new understanding of what “translation” requires: Words, sentences, images and anecdotes have different meanings in different contexts. What was oppositional and radical for the Boston authors, such as challenging mainstream medicine, made no sense to women who lacked access to medical care.

The authors realized that you could not just hire a translator, or allow publishers in other countries to hire translators. The non-English versions of Our Bodies, Ourselves were adaptations, and they could emerge only from protracted discussion. The authors work closely with “translators,” discussing how to present controversial material and providing help with publishing arrangements, information resources, graphics, fundraising and connections with activists worldwide.

And Gordon’s conclusion, which follows an important discussion of women’s health in poor and developing countries, is as inspiring as the intro:

As the feminist slogan goes, “Women deliver.” In other words, when women control resources, the social gain is greater than when men control resources. Improving health for the poor is as likely to produce progressive change as any other strategy, because health activism these days requires challenging the world’s most powerful and destructive forces. Matters of the body are politically fundamental. If Our Bodies, Ourselves contributed even in a small way to activating women globally, American feminists can feel proud.

Please read the full article, available online and in the June 16 issue of The Nation. You can also read the final chapter of Davis’s book, “Transnational Knowledges, Transnational Politics” (PDF), at our website.

Our Global Translation and Adaptation program is currently facilitating adaptations in Turkey, Nepal, Israel, Nigeria and Bangladesh, among other countries. To find out more, or to read excerpts or contribute to these projects, visit the program homepage.

Beyond Rape - A Survivor’s Journey: Cleveland Plain Dealer reporter Joanna Connors has written a five-part story about being raped 24 years ago when she was on assignment for the paper.

The story is notable not only for Connors’ reach in describing how her life (and by extension her husband and children) was affected by the rape, but she also sets out to learn more about her rapist — and in doing so peels back the layers on a family trapped in a cycle of violence and abuse toward women. While exploring the related race and class issues, Connors raises many questions as she sets about trying to answer them.

All the sections to the series are available here, along with an introduction by the paper’s editor and resources for victims of rape.

Plus: Editor & Publisher looks at responses to Joanna Connors’ story.

Are Doctors Shilling for Drug Companies on Public Radio?: Check this out — as Shannon Brownlee and Jeanne Lenzer write at Slate:

A few weeks ago, devoted listeners of public radio* were treated to an episode of the award-winning radio series The Infinite Mind called “Prozac Nation: Revisited.” The segment featured four prestigious medical experts discussing the controversial link between antidepressants and suicide. In their considered opinions, all four said that worries about the drugs have been overblown.

The radio show, which was broadcast nationwide and paid for in part by the John D. and Catherine T. MacArthur Foundation, had the air of quiet, authoritative credibility. Host Dr. Fred Goodwin, a former director of the National Institute of Mental Health, interviewed three prominent guests, and any radio producer would be hard-pressed to find a more seemingly credible quartet. Credible, that is, except for a crucial detail that was never revealed to listeners: All four of the experts on the show, including Goodwin, have financial ties to the makers of antidepressants. Also unmentioned were the “unrestricted grants” that The Infinite Mind has received from drug makers, including Eli Lilly, the manufacturer of the antidepressant Prozac.

Continue reading ….

For Prospective Moms, Biology and Culture Clash: Just before Mother’s Day, NPR’s “Morning Edition” looks at the rising age of first-time mothers and the “clash” between culture and biology.

The average age of first-time mothers in the United States has been rising steadily over the past four decades — up from 21.4 in 1970 to a little over 25 in 2005, the National Center for Health Statistics reports. [...]

“Women are no longer marrying the boy they met in high school,” [Rutgers anthropologist Helen] Fisher says. “They’re concerned with getting a career before they marry. This takes time.”

But this is time on the biological clock that cannot be recaptured. …

I appreciate that the story includes a couple sharing household duties while both work, and Fisher notes that businesses are recognizing women want to keep their careers, but there’s still a tone of women should know better — and should get on with making babies.

A story on, say, the glacial speed of government and business to provide adequate paternity and maternity leave and to accommodate breastfeeding moms returning to work — along with the lack of access to quality childcare and the advocacy work of groups like Moms Rising — would be a more welcome and appreciated “Mother’s Day” story.

Plus: This Wall Street Journal’s Heath Matters column focuses on unplanned pregnancies later in life. Close to 40 percent of pregnancies among women over 40 are unplanned, according to a 2001 survey by the National Center for Health Statistics in Atlanta, the most recent data available.

Public Citizen Calls on FDA To Withdraw Ortho Evra Patch From Market: Public Citizen’s Health Research Group called on the FDA this week to withdraw the birth control patch Ortho Evra from the market, citing studies that found an increased risk of dangerous blood clots, reports Reuters.

“The considerable safety concern of high-dose, variable estrogen exposure tips the balance of risks and benefits against the availability of Ortho-Evra as a contraceptive,” wrote Sidney Wolfe, head of the research group.

A Better Method for Handling Rape Kit Evidence: Jessica Voorhees Norris, a Ph.D. candidate in forensic chemistry at University of Virginia, has created a method for handling rape kit evidence that reduces part of the DNA analysis time from 24 hours to as little as 30 to 45 minutes and improves the sperm cell recovery rate by 100 percent, according to this university release.

If her method was to be adopted by forensic labs — and the results accepted by courts — the backlog could potentially be reduced within months.

“There is an overwhelming demand for DNA analysis of sexual assault evidence, but laboratories have neither the funding nor the manpower to handle the caseload in a timely manner,” Norris said. “Juries have come to expect DNA evidence in sexual assault cases, but forensic labs are not able to perform in a timely and efficient manner due to limitations in the currently used technologies.”

“Homosexuality,” “Sexually Explicit” Most Common Reasons for Challenging Books: For the second year in a row, “And Tango makes Three,” a children’s story by Justin Richardson and Peter Parnell about two male penguins caring for an orphaned egg, was the most “challenged” book in U.S. public schools and libraries, according to the American Library Association.

Other books in the top 10 cited as “sexually explicit” include “The Color Purple” by Alice Walker; “It’s Perfectly Normal,” by Robie Harris; and “The Chocolate War,” by Robert Cormier.

“Overall, the number of reported library challenges dropped from 546 in 2006 to 420 last year, well below the mid-1990s, when complaints topped 750,” reports the Associated Press. “For every challenge listed, about four to five go unreported, the library association estimates.”

National Women’s Health Week: We here at OBOS like to think of every week as Women’s Health Week, but next week it’s official: National Women’s Health Week runs May 11 - May 17, and the push this year is to encourage women to make their health a top priority and take simple steps for a longer, healthier and happier life.

Federal Agencies Can Now Offer Secret Input on EPA Chemical Reviews: The Washington Post reports on changes the Bush administration has made to Environmental Protection Agency reviews of chemicals — changes that officials with the Government Accountability Office say will delay scientific assessments of health risks and open the process to politicization.

Richard Wiles, executive director of the Environmental Working Group, called the EPA process a “bureaucratic quagmire,” adding, “With these rules in place, it’s now official: The Bush White House is where all good public health protections go to die.”

Death in Childbirth a Health Scourge for Afghanistan: Reuters takes a close look at the staggering maternal death rate in Afghanistan, where about 1,600 Afghan women die in childbirth out of every 100,000 live births.

“In some of the most remote areas, the death rate is as high as 6,500. In comparison, the average rate in developing countries is 450 and in developed countries it is 9,” writes Tan Ee Lyn. “Virtually everyone in Afghanistan can recount a story about a relative dying in childbirth, often from minor complications that can be easily treated with proper medical care.”

Plus: Read our previous posts on Afghanistan and maternal health — and how the United States has mismanaged funding and programs intended to improve hospital conditions.

The Disney Hyprocrisy: From Slate: Forget Miley Cyrus. Check out Disney’s Chinese underwear ad. Just go.

Plus: There’s a new book out on the sexualization of ‘tween girls: “The Lolita Effect,” by Gigi Durham, a University of Iowa journalism professor.

“I’m criticizing the unhealthy and damaging representations of girls’ sexuality, and how the media present girls’ sexuality in a way that’s tied to their profit motives,” said Durham in this release. “The body ideals presented in the media are virtually impossible to attain, but girls don’t always realize that, and they’ll buy an awful lot of products to try to achieve those bodies. There’s endless consumerism built around that.”

Divorce Leads to Job Loss: So imagine you’re a professor and you’re going through a divorce. Your college requires that you talk with a staff member to see whether the grounds for divorce meet Biblical standards. If you don’t, you’ll lose your job. Yep, that’s what happened to a popular English professor who has taught at Wheaton College in Illinois for 20 years. From the Chicago Tribune:

Many theological conservatives say the New Testament permits divorce only in cases of adultery or desertion. Wheaton requires faculty and staff to sign a faith statement and adhere to standards of conduct in areas including marriage, said Provost Stan Jones.

Still, every year, the college has dealt with several cases in which it must evaluate the divorce of a job applicant or a staff or faculty member and consider whether it matches the exceptions laid out in Matthew 19 and the writings of the Apostle Paul.

I admit I’m not up on Bible readings, but what about, say, domestic abuse — along with a host of other very good reasons?

Genetic Link to Osteoporosis: “Researchers have identified two common genetic mutations that increase the risk of osteoporosis and related bone fractures, according to a study released Tuesday,” reports Reuters.

U.S. Federal Funding for HIV/AIDS: The Kaiser Family Foundation has released a new fact sheet on federal funding for HIV/AIDS in the President’s Fiscal Year 2009 budget request, and comparisons over time, with key funding highlights for domestic and global HIV/AIDS programs. It also includes additional information on federal funding for global TB, malaria and other global health efforts.

Can I Get A May Day for Immigrant Women’s Health?: “May Day, May 1st, has come to hold the promise of rallies for immigrant rights staged across the United States. And this year is no different. But with McCain’s more-of-the-same health care plan having just been released, it’s a perfect time to focus on why women’s reproductive health care must be a crucial part of any discussion about immigration reform,” begins Amie Newman’s essay at RH Reality Check.

Rescue Us From Our Bodies: Here’s a nice round-up of responses to Midol’s new “Reverse the Curse” campaign.

Stop the Mommy Madness: Salon talks with feminist activist Amy Richards, whose new book is titled “Opting In: Having a Child Without Losing Yourself.”

Plus: Rachel Fudge reviews “Opting In” for Mother Jones.

More Mothers Breast-Feed, in First Months at Least: “About 77 percent of new mothers breast-feed their infants at least briefly, the highest rate seen in the United States in more than a decade, according to a government survey released on Wednesday,” reports The New York Times. Enthusiasm, however, was tempered.

Breast-feeding experts said that they were cheered by the report’s numbers but noted that rates of breast-feeding at 6 months of age have remained unchanged and are significantly lower than goals set by government agencies. The most recent C.D.C. survey did not report breast-feeding rates at 6 months because of a lack of data. [...]

In the most recent survey, breast-feeding rates increased among non-Hispanic black women to 65 percent from 36 percent in 1993 and 1994. Eighty percent of Mexican-American infants and 79 percent of non-Hispanic white infants had been breast-fed.

The age and income of mothers played important roles. Just 57 percent of poor mothers and only 43 percent of mothers under 20 breast-fed their infants, the survey found.

Dr. Barbara L. Philipp, associate professor of pediatrics at Boston University, said the C.D.C. survey had not asked mothers whether they breast-fed exclusively. “One sip was positive, so they set the bar very low,” Dr. Philipp said.

There are a number of interesting stories in The New York Times, so let’s do a mini-double dose …

Pain as an Art Form: Well’s Tara Parker-Pope does a nice job describing how art is used to communicate physical pain, from some of Frida Kahlo’s self-portraits (now on exhibit at the Philadelphia Museum of Art) to a new online gallery called the Pain Exhibit.

The gallery is the brainchild of Mark Collen, 47, a former insurance salesman who struggled to explain his chronic back pain to a new doctor.

“It was only when I started doing art about pain, and physicians saw the art, that they understood what I was going through,” Collen said. “Words are limiting, but art elicits an emotional response.”

Taking it a step further, Collen started soliciting art from pain patients around the world. He teamed up with James Gregory, a 21-year-old college student who suffers from chronic pain following a car accident, and together they created the Pain Exhibit.

Parker-Pope writes:

Finding ways to communicate pain is essential to patients who are suffering, many of whom don’t receive adequate treatment from doctors. In January, Virtual Mentor, the American Medical Association Journal of Ethics, reported that certain groups are less likely to receive adequate pain care. Hispanics are half as likely as whites to receive pain medications in emergency rooms for the same injuries; older women of color have the highest likelihood of being undertreated for cancer pain; and being uneducated is a risk factor for poor pain care in AIDS patients, the journal reported.

Some of the images from the Pain Exhibit, like “Broken People” by Robert S. Beal of Tulsa, Okla., depict the physical side of pain. Others, such as “Against the Barrier to Life,” convey the emotional challenges of chronic pain. “I feel like I am constantly fighting against a tidal wave of pain in order to achieve some quality of life,” wrote the work’s creator, Judith Ann Seabrook of Happy Valley in South Australia. “I am in danger of losing the fight and giving up.”

The art is connecting with medical professionals. The journal of the International Association for the Study of Pain features an image from the exhibit on the cover of its November issue, which focuses on women and pain.

Quieting the Demons and Giving Art a Voice: Like sculpture and painting, writing is also a form of expression and release. This review looks at “Madness: A Bipolar Life,” a new memoir by Marya Hornbacher, whom writer Abigail Zuger, MD, describes as “a virtuoso writer: humorous, articulate and self-aware. She is also, as she has now documented in two books, incurably mentally ill.”

Zuger continues:

For scientists trying to parse the mystery of brain and mind, she is one more case of the possible link between mental illness and artistic creativity. With all our scans and neurotransmitters, we are not much closer to figuring out that relationship than was Lord Byron, who announced that poets are “all crazy” and left it at that. But effective drugs make the question more urgent now: would Virginia Woolf, medicated, have survived to write her final masterpiece, or would she have spent her extra years happily shopping?

Ms. Hornbacher brings to the discussion more than the usual pairing of disturbed brain and talented mind. Her talent has created a third self, an appealing, rueful narrator who can look back on three decades of manic-depressive illness, much of it untreated, and spin a story that is almost impossible to put down.

Zuger also considers “Poets on Prozac: Mental Illness, Treatment and the Creative Process,” edited by Richard M. Berlin, M.D. Essays were solicited from published poets with psychiatric illness.

“Most of the 16 contributors are decades older than Ms. Hornbacher, but while they may lack her vivid prose style, they do supply a long-term perspective on the terrain,” writes Zuger.

Genes Explain Race Disparity in Response to a Heart Drug: This is a fascinating story. Researchers at Washington University and the University of Maryland found that patients who are non-responsive to a beta-blockers used in the treatment of heart failure may be making what amounts to their version of the drug, all the time, due to a gene variant.

What’s also surprising is that as many as 40 percent of blacks have this altered gene, compared to 2 percent of whites. The website of the journal Nature Medicine published a paper explaining the study.

“Something that occurs with a 40 percent frequency is not something that was a blip on the radar screen,” said Dr. Gerald W. Dorn, a cardiologist at Washington University and principal investigator for the study. “It must have given a survival advantage.” — Though what that advantage is is still the big unknown.

Gina Kolata writes:

The discovery raises questions about whom to treat with beta blockers and how to decide, researchers say. But, they add, its implications go beyond heart failure.

For example, the gene variant may help explain why some healthy people cannot exercise vigorously — they may be making chemicals that act like beta blockers, making their hearts beat less forcefully. And variations in other genes might explain why some people with different conditions, like depression, do not respond to drugs used to treat it. It is possible that those people are already making their own versions of antidepressant drugs, and that adding more may not help.

But researchers say that people who make their own beta blockers are not protected from developing heart failure. That is because beta blockers are helpful only after the disease is established. And beta blockers can slow the disease’s progress but not cure it.

Through Sickness, Health and Sex Change: Finally, here’s a story from the Sunday paper about a married couple in New Jersey who are concerned about the legal status of their relationship, since the male partner underwent a sex change in 2005. The couple, who have three children, are still very much committed to each other. Tina Kelley writes:

Massachusetts is the only state to have legalized same-sex marriage, and the Brunners are two women married to each other in New Jersey. As this state (along with Connecticut, Vermont and New Hampshire) confronts challenges over whether its civil unions fulfill the mandate of providing same-sex couples equal rights and benefits, the Brunners offer themselves as Exhibit A on how the nation’s dizzying patchwork of marriage laws, which include the domestic partnerships of California and other states, may be out of step with people’s lives.

And here’s another mind-blowing breakdown of the complexities state by state:

The Brunners were already married when Donald became Denise. Transsexuals who marry after surgery pose a different set of questions, and there have been a number of custody, probate and other cases with decisions all over the legal map.

Urging the United States Supreme Court to tackle the issue in 2000, lawyers for Christie Lee Littleton, a Texas male-to-female transsexual suing her husband’s doctors for wrongful death, noted the confused landscape: “Taking this situation to its logical conclusion, Mrs. Littleton, while in San Antonio, Texas, is a male and has a void marriage; as she travels to Houston, Texas, and enters federal property, she is female and a widow; upon traveling to Kentucky she is female and a widow; but, upon entering Ohio, she is once again male and prohibited from marriage; entering Connecticut, she is again female and may marry; if her travel takes her north to Vermont, she is male and may marry a female; if instead she travels south to New Jersey, she may marry a male.”

The Supreme Court declined to take the case.

Ethics Worth More Than Financial Payments: “With little fanfare, a small number of prominent academic scientists have made a decision that was until recently all but unheard of. They decided to stop accepting payments from food, drug and medical device companies,” reports The New York Times.

No longer will they be paid for speaking at meetings or for sitting on advisory boards. They may still work with companies. It is important, they say, for knowledgeable scientists to help companies draw up and interpret studies. But the work will be pro bono.

The scientists say their decisions were private and made with mixed emotions. In at least one case, the choice resulted in significant financial sacrifice. While the investigators say they do not want to appear superior to their colleagues, they also express relief. At last, they say, when they offer a heartfelt and scientifically reasoned opinion, no one will silently put an asterisk next to their name.

Blogging Against Disablism Day: Coming May 1. Last year, more than 170 people took part. Diary of a Goldfish has the details: “You can write on any subject, specific or general, personal, social or political. In the previous two BADDs, folks have written about all manner of subjects, from discrimination in education and employment, through health care, parenting, family life and relationships, as well as the interaction of disablism with racism and sexism.”

Plus: Tips on language.

“My Beautiful Mommy”: “Oh I just can’t think of enough bad things to say about this book but for starters…” begins Lucinda Marshall’s critique of a new children’s book written by a plastic surgeon to help kids age 4-7 get with the whole “mommy makeover” (tummy tuck and breast augmentation). It’s emblematic of reactions read ’round the web (though EW surprisingly feels the need to ask, “a practical solution for a well-defined demo, or pure evil?” Hmmm. Let me think.)

The book got a lot of attention this week after this Newsweek story came out. Making Light has good info on how a self-published vanity-press book made major league headlines … including a mention on Wait, Wait …. Don’t Tell Me” this morning.

Plastic Surgery on TV: When Botox, face lifts and reconstructive surgery gets in the way of acting, is it appropriate for a critic to call it out? Mary McNamara at the L.A. Times writes:

People should be free to look as they choose, and this town is tough on women — don’t talk to me about Judi Dench and Helen Mirren, they’re British. Would an American woman ever get away with anything approaching Nicolas Cage’s hair or James Spader’s increasing portliness? Of course not.

But television is a visual art, and if people are going to significantly alter the way they look in ways not directly connected with the roles they are playing, it can affect not only their performance but the whole tone of the show.

So you tell me, what is a critic supposed to say when part of the problem with a show is that the leading lady’s face seems incapable of movement or her eyes appear to be moving toward the sides of her head or her lips just look weird?

Plus: Maureen Ryan on women keeping it real: “In future, I’ll not only attempt to acknowledge when a plastic face impedes the enjoyment of a show, but I’ll also make it my business to congratulate the women who look like they’ve lived, for hanging on to what’s made them distinctive individuals.”

Remember the Controversy Over Contraceptives in Portland, Maine?: “For all the firestorm surrounding the decision to make prescription contraceptives available at King Middle School, only one girl has used the service in the six months since the program began, officials say,” reports the AP.

As of Thursday, the only student to obtain a prescription for contraceptives was a 14-year-old girl, the city reported in response to a Freedom of Access request from The Associated Press.

“If it helps one student who otherwise might be in a position of being at risk, then it’s worth it,” said Lisa Belanger, who oversees Portland’s student health centers.

Falling Breast Cancer Rates Prevalent Only Among White Women: “New research shows a sharp drop in U.S. breast cancer cases in recent years was limited to white women, possibly because they abandoned hormone replacement therapy in greater numbers than minority groups,” reports Reuters.

White women had been more likely to use hormone therapy, and were also the most likely to abandon the drugs after U.S. regulators warned about the cancer link in 2003, according to Dr. Dezheng Huo of the University of Chicago and the study’s lead investigator.

“The sharp reductions seen in Caucasians aged 50 to 69 years were not seen among other ethnic groups,” Hou told the American Association for Cancer Research.

The researchers said the decline has been mainly among women older than 50 with estrogen-receptor positive cancer.

Why We’re Fatter: This Slate article isn’t new — in fact, it was published in 2006 — but it was just brought to my attention and it’s definitely an interesting read. Writer Sydney Spiesel reviews five of the 10 explanations for obesity identified in a study by David Allison and Scott Keith of the University of Alabama at Birmingham.

“In all likelihood, the rise in obesity results from a combination of several of these factors, each making its own contribution and perhaps interacting with other causes in some yet-more-complicated way,” writes Spiesel.

History As Appetizing As Tater Tots: I admit I fall hard for history texts that bring in the social and cultural implications, which is why I’m putting this on my summer reading list: “School Lunch Politics: The Surprising History of America’s Favorite Welfare Program” (Princeton University Press, 2008) by Susan Levine, a University of Illinois at Chicago professor of history.

“The National School Lunch Program has outlasted almost every other 20th century federal welfare initiative and holds a uniquely prominent place in popular imagination,” Levine said in this UIC release. “It suggests the central role food policy plays in shaping American health, welfare and equality.”

Levine, by the way, is also the author of “Degrees of Equality: The American Association of University Women and the Challenge of Twentieth Century Feminism,” and “Labor’s True Woman: Carpet Weavers, Industrialization and Labor Reform in the Gilded Age.”

Strategic Spending on Organic Foods: With the price of organic foods rising, here’s some good advice for shoppers who want to prioritize spending on those organic fruits and vegetables that have a high pesticide residue when grown conventionally. Check out the The Environmental Working Group’s list of 43 fruits and vegetables tested for pesticide residue.

Photographer Rosanne Olsen has just published “This Is Who I Am: Our Beauty in All Shapes and Sizes,” a book of nude photographs of dozens of women age 19 to 95.

Each woman’s photograph — and there does seem to be a good mix — is paired with her words describing how she feels about her body.

You can preview excerpts here (PDF). And here’s a review from the Seattle Post-Intelligencer.

I poked through the book a bit and wanted to share a favorite entry. These are the words of Constance (left), who is 80:

In a restroom on the university campus, a handwritten sign on the mirror reminds the user that “Everyone Is Beautiful,” as if trying to counteract the negative feedback most of us feel on viewing our own image.

Though I tend to avoid mirrors, I like catching a glimpse of my shadow in action when I’m walking or riding my bike. Most of the time I’m pleased that my body works pretty well, bore healthy children, and is relatively slow to break down as it ages. I try to give it what it needs: water, food, exercise, sleep. Since I retired, I can take a nap whenever I want, and I’ve had fewer long-lasting colds. I’d say menopause is God’s gift to women. I rejoice in freedom from the responsibility of reproduction.

It’s clear to me that I would have had more professional opportunities as an astronomer if I were a man. I like to imagine a system where everyone is reincarnated, switching gender at each reincarnation but retaining some memory of what it’s like to be the opposite sex. When I tried to deal with an egotistical colleague or a pompous administrator– almost invariably male in my day — I found it entertaining and soothing to visualize his next incarnation, maybe in the ninth month of his fifth pregnancy.

Happy Monday.

Alabama’s Response to Pregnant Drug Users: “Two worlds are colliding in this piney woods backcountry in southern Alabama: casual drug use and a local district attorney unsettled that children or fetuses might be affected by it. The result is an unusual burst of prosecutions in which young women using drugs are shocked to find themselves in the cross hairs for harming their children, even before giving birth,” reports The New York Times. The story continues:

Over an 18-month period, at least eight women have been prosecuted for using drugs while pregnant in this rural jurisdiction of barely 37,000, a tally without any recent parallel that women’s advocates have been able to find. The district attorney, Greg L. Gambril, acknowledges the number puts him at the “forefront,” at least among Alabama prosecutors. Similar cases have come up elsewhere, usually with limited success. But Alabama, and in particular this hilly, remote terrain just above the Florida Panhandle, is pursuing these cases with special vigor.

The National Advocates for Pregnant Women has published an excellent, comprehensive response that begins: “We were pleased that it did not use such stigmatizing and scientifically baseless terms as ‘crack’ and ‘meth’ baby. We were disappointed though that the story did not quote any experts in the field.”

Birth Control for Others: In a review of Matthew Connelly’s new book, “Fatal Misconception: The Struggle to Control World Population,” Nicholas Kristof writes that Connelly, an associate professor of history at Columbia University “carefully assembles a century’s worth of mistakes, arrogance, racism, sexism and incompetence in what the jacket copy calls a ‘withering critique’ of ‘a humanitarian movement gone terribly awry.’”

Kristof adds:

Critics of family planning programs will seize gleefully upon this book, and that’s unfortunate, because two propositions are both correct: first, population planners have made grievous mistakes and were inexcusably quiet for too long about forced sterilization in countries like India and China; and second, those same planners have learned from past mistakes and today are fighting poverty and saving vast numbers of lives in developing countries.

“Fatal Misconception” is to population policy what William Easterly’s “White Man’s Burden: Why the West’s Efforts to Aid the Rest Have Done So Much Ill and So Little Good” (2006) was to foreign aid: a useful, important but ultimately unbalanced corrective to smug self-satisfaction among humanitarians. Connelly scrupulously displays a hundred years of family planners’ dirty laundry, but without adequately emphasizing that we are far better off for their efforts. One could write a withering history of medicine, focusing on doctors’ infecting patients when they weren’t bleeding them, but doctors are pretty handy people to have around today. And so are family planners.

An Epidemic No One Wants to Talk About: “A much-publicized study from the Centers for Disease Control and Prevention this month highlighted the high rates of sexually transmitted diseases among teenage Americans. But for those of us who work in public health, this ‘news’ is already old,” begins this Washington Post op-ed by three medical experts who argue convincingly for discussions that address race and poverty and other social conditions underpinning high rates of HIV and STIs in some communities.

For one thing, women in poor African American communities who engage in the lowest levels of risk behavior are dramatically more likely to acquire STDs than higher-risk women in communities with low background rates of infection. Where you live and choose sexual partners has an enormous impact on your risk, particularly if it is in a community with high incarceration rates. Imprisonment changes community male-female ratios, and these unbalanced numbers contribute to low marriage rates, a reluctance to negotiate “safe sex,” formation of concurrent partnerships and the maintenance of STDs within the networks in which members choose partners.

Simply put, we will never rid the United States of HIV and other STDs if our only weapon is medical treatment. And if we are unable to engage in a national dialogue about the sexual health of our youths and the social dynamics that drive STDs, this epidemic will go largely ignored, and many more lives will be lost.

The CDC study is covered here. Read the full op-ed at the Washington Post.

HHS Challenges ACOG Ethics Opinion: Daily Women’s Health Policy Report has a nice round-up of information concerning an NPR report on the Bush administration’s criticism of an ethics opinion released last year by the American College of Obstetricians and Gynecologists that calls on physicians to provide referrals for patients seeking abortions, emergency contraception or other procedures if they are opposed to providing the service themselves.

NPR’s “Morning Edition” covered the issue in two parts last week.

Voices from the Sidelines: “To begin with, both those of us who oppose and those who support legal abortion agree that there’s unbearably little nuance in the public conversation on reproductive rights,” writes Anna Clark at RH Reality Check. “But that’s only the beginning of our common ground. While not one national anti-choice organization supports contraception or science-based sexuality education, many individuals who oppose legal abortion are making the connections on their own: birth control and education reduce the rate of unintended pregnancy and abortions.”

Targeting Health Disparities: What’s the connection between living in disadvantaged neighborhoods and early onset breast cancer? University of Chicago researchers are trying to find out. According to a release, “researchers are studying 230 black women with newly diagnosed breast cancers living in predominantly black Chicago neighborhoods to learn about environmental factors, such as neighborhood features that might lead to social isolation.”

Who Wants to Work in an Attractive Field?: “As thousands of medical students await word this week on residency programs, two specialties concerned with physical appearance — dermatology and plastic surgery — are among the most competitive,” reports The New York Times. “The vogue for such specialties is part of a migration of a top tier of American medical students from branches of health care that manage major diseases toward specialties that improve the life of patients — and the lives of physicians, with better pay, more autonomy and more-controllable hours.”

A Plea for Reading the Original Sources: Or, a manual to ending poorly researched stories about the differences between men and women’s brains. Mark Liberman has the breakdown. Via Feminist Law Professors.

Announcing “It’s a BOOK!” doesn’t have the same ring as “It’s a girl!” or “It’s a boy!”

But we here at Our Bodies Ourselves are bursting with the pride of new parents. After a two-year gestation involving the work of many doctors, doulas, midwives, birth activists, nurses, educators and, of course, mothers, “Our Bodies, Ourselves: Pregnancy and Birth” has arrived.

The new book addresses the questions and needs of women during pregnancy, childbirth and the “fourth trimester” — early motherhood. Topics include: choosing a provider and birth setting; making decisions about prenatal testing; arranging for continuous labor support; exploring options for pain relief; recovering from birth; and adjusting to life as a new mother.

“Our Bodies, Ourselves: Pregnancy and Birth” also provides an overview of U.S. maternity care practices and examines why some aspects of the care most women receive are not based on the most reliable research on what is safe and effective.

Check out the hot advance praise from other authors and educators. The first review, from Library Journal Reviews, calls it “a superlative guide” and says, “The information goes beyond the usual pregnancy self-help material by placing childbearing and parenting within a psychosocial and political context …”

At the OBOS website you’ll find excerpts from the book plus additional online content and recommended links. There’s also information about parenting and information on childbearing loss.

In this Q&A, OBOS Executive Director Judy Norsigian answers questions about the state of pregnancy and childbirth today and explains why this book is needed:

This book challenges the status quo of maternity care when it is not serving the best interests of women, babies, and families. We present the best available evidence about t