Chole Angyal, a senior sociology major at Princeton University, discusses the complexities of an on-campus campaign to raise money for breast cancer research. This year, the campaign ads turned sexist (and juvenile):
Every year at Princeton University, the student group Princeton Against Cancer Together (PACT) holds an event called Manicure for the Cure, where they bring in beauty school students to do manicures for Princeton students in the days leading up to spring formals. Formals are this weekend, so advertisements for Manicure for the Cure are all over campus.
To advertise, they’re using the slogan “Save Second Base.” The phrase “second base,” in case you don’t know, refers to foreplay involving breasts, as in “I kissed Jenny under the bleachers and made it to second base.” “How far did you let him go, Jenny? To second base?” If it sounds antiquated and ridiculous… that’s because it is.
Anyway, “Save Second Base” is a slogan that’s used nationwide by breast cancer research fundraisers. And it rubs a lot of people the wrong way. After all, curing breast cancer isn’t really about saving breasts, it’s about saving women’s lives. So it annoys people, but there was no reaction on campus when Manicure for the Cure used the slogan last year. I think people mostly made their peace with the slogan, figuring that at least it was raising money for a good cause.
But this year is different. This year, the organizers of the event, in an attempt to include men, are offering massages in addition to manicures. To advertise these services, they made posters that said: “Gentlemen: Save Second Base.”
And that is when the proverbial poop hit the fan.
Keep reading … The comments that follow her essay are a great example of the mindset that needs to be changed. You’ll find more opinions voiced at Equal Writes, a Princeton student blog on feminism and gender.
I was away last week, so no Political Diagnosis, but it’ll be back to business on Monday …
Court Strikes Down Iowa Law Banning Same-Sex Marriage: The unanimous state Supreme Court decision means same-sex couples will be allowed to marry in Iowa by the end of the month — and the doors will be open to couples from other states. The decision seems pretty solid for now. Unlike California, voters in Iowa cannot directly initiate constitutional amendments. Instead, an amendment would have to be taken up by the state Legislature, and Democrats, who control both chambers, show no interest in making it a priority.
Mammogram Benefits Under Debate: “The conventional wisdom about breast cancer screening is coming under sharp attack in Britain, and health officials there are taking notice,” writes Roni Caryn Rabin in The New York Times. “They have promised to rewrite informational fliers about mammography after advocates and experts complained in a letter to The Times of London that none of the handouts ‘comes close to telling the truth’ — overstating the benefits of screening and leaving out critical information about the harms.”
Do People Who Support “Traditional Values” Value Pregnant Women?: Lynn Paltrow writes at Huffington Post – “I have to thank Andrea Lafferty, of the Traditional Values Coalition for her response to a piece I wrote opposing Personhood USA’s efforts to give full constitutional rights to the unborn from the moment of fertilization. In her commentary she hopes to discredit my organization, National Advocates for Pregnant Women (NAPW) by exposing our commitment to all pregnant women, including those who love their children but are unable to overcome a drug problem in the short term of pregnancy …”
Birth Centers Advocacy Update: As we previously mentioned, American Association of Birth Centers was looking for 100 physicians to sign a letter in support of legislation to mandate the facility fee in Medicaid. There are 102 signatures so far and counting …
Women Pay Higher Price For Health Insurance: NPR reporter Sarah Varney writes about a past experience seeking health insurance (a completely frustrating process) and the higher insurance rates women pay in some states. The piece concludes with some important news for workers laid off after Sept. 1, 2008:
If you had employer-sponsored health insurance and qualified for COBRA coverage, under the new stimulus bill, the federal government will pay 65 percent of your premium for up to nine months.
And that even includes laid-off workers who initially turned down COBRA coverage because they thought it was too expensive. They now have a second chance to sign up.
Plus: Also from NPR — the hidden costs of cancer treatment, even with insurance. And The New York Times offers tips for people with pre-existing conditions, whether you’re currently covered or shopping for insurance.
Congress Approves Budget: The House and Senate approved budget blueprints on Thursday that include funding for expansion of health care coverage; now the hard work begins in conference committee.
America Going Quiet on HIV/AIDS: A new Kaiser Family Foundation survey found that the percentage of people in the United States who say that they have seen, heard or read a lot about HIV/AIDS in the United States has fallen from 34 percent five years ago to just 14 percent today. The percentage of African Americans reporting this has fallen from 62 percent to 33 percent.
Global Women & Health Salon: President Obama this year has signed executive orders eliminating the “Global Gag Rule” and restoring U.S. funding for the United Nations Population Fund. “Now that [these two goals] have been met what else should the Obama administration do to promote the health and welfare of women worldwide?” asks Mark Goldberg, in the kick-off post for the After the Gag Rule Salon sponsored by RH Reality Check and UN Dispatch.
Afghan Law Criticized: UN and Western aid agencies are urging Afghan President to repeal a law he signed last month that reverses freedoms won by Afghan women, reports BBC News. Human rights activists say the law legalizes rape within marriage, and women will need permission from their husbands to leave their homes.
The ACLU has taken an interest in gene patents, which allow human genetic sequences and gene tests to be patented, expressing concern that “While the purpose of the patent system is to encourage innovation, the high licensing and diagnostic testing fees that some biotech companies charge for use of ‘their’ genes are inhibiting biomedical research and interfering with patient care.”
Although somewhat technical, this Human Genome Project Information page from the Oak Ridge National Laboratory provides an overview of the topic, including some of the arguments for and against gene patenting, with lots of links to related information.
A freely available article from Nature Reviews Genetics, Patenting human genetic material: refocusing the debate, also provides good background reading on this issue, including a discussion of concerns about patenting from “adversely affecting the research environment to hampering the distribution of useful technologies.” A number of other articles on this topic are also freely available through PubMed Central.
The ACLU is specifically focused on patents related to the BRCA1 and BRCA2 genes relevant to breast and ovarian cancer, explaining that:
“…the Utah-based company Myriad Genetics has patented two genes – BRCA1 and BRCA2 – and certain mutations along these genes that have been associated with an increased risk of certain forms of breast and ovarian cancer. The high licensing and diagnostic testing fees charged by Myriad have forced some researchers to discontinue research on breast cancer and have prevented women from having access to screening for mutations.”
The organization is currently conducting a survey to gather information on women’s experiences with BRCA testing:
We are interested in hearing from you if you have been advised to get the BRCA genetic test and fall into one of the following categories:
1) You were tested, and had problems with or concerns about the testing process (for example, your results were uncertain or incorrect, or you were advised you needed to be tested a second time); or
2) You were tested, and want to be tested again through another lab for verification; or
3) You wanted to be tested, but had financial problems getting the test (for example, you could not afford it or your insurance did not cover it); or
4) You want to determine the BRCA status of a deceased relative.
If your answer is YES to even one of these questions, please take the ACLU’s survey: www.aclu.org/brcasurvey. The ACLU is looking into the legality of patenting human genes, including the BRCA1 and BRCA2 genes, and the effects of gene patenting on research and testing.
Congress Considers Ban on BPA: Senate and House leaders on Friday said they would introduce bills establishing a federal ban on the chemical bisphenol A in all food and beverage containers. Meg Kissinger of the Milwaukee Journal Sentinel writes:
The move comes a day after Sunoco, the gas and chemical company, sent word to investors that it was now refusing to sell bisphenol A, commonly known as BPA, to companies for use in food and water containers for children younger than 3. Sunoco told investors it could not be certain of the compound’s safety. Last week, six baby bottle manufacturers, including Playtex and Gerber, announced that they would stop using BPA.
The bills would immediately outlaw the sale of all food and drink containers made with BPA. Anything on store shelves would have to be removed. It would suspend the manufacture of food packaged in containers that contain the chemical, but items already made could be sold.
For more information, check out the Journal Sentinel’s ongoing BPA investigation “Chemical Fallout,” at www.jsonline.com/chemicalfallout. Great reporting.
Tiller Trial Starts Monday: The L.A. Times previews the trial of Kansas abortion provider Dr. George Tiller, who faces charges stemming from late-term procedures, and the politics surrounding his prosecution.
Pregnant Inmates Denied Abortion Access: Writing at Feministing, Diana Kasdan, staff attorney for the ACLU Reproductive Freedom Project, discusses the limited access pregnant inmates have to abortion.
A new study, “Incarcerated Women and Abortion Provision: A Survey of Correctional Health Providers,” found that only 68 percent of respondents indicated that women in their facilities can obtain “elective” abortions. And a recent investigative piece in the Texas Observer reported, “For pregnant women in immigration detention facilities, it is virtually impossible to obtain an abortion.”
Racial Disparities and Breast Cancer: An article in the International Journal of Cancer points to high blood pressure as a cause for some of the disproportionately higher mortality rates among African American women with breast cancer compared with white women, reports Reuters. Hypertension explained 30.3 percent of racial disparity in “all-cause survival,’ as well as 20 percent of the racial disparity in breast cancer-specific survival. The study abstract is available online.
Dannon Goes rBGH-Free: As we reported earlier, General Mills, which makes Yoplait, agreed to stop using milk treated with artificial growth hormones in its yogurt. Now Dannon has followed suit. The decision makes economic sense: More than 200 hospitals around the country recently pledged to serve rBGH-free products to their patients, staff and visitors.
Writing about the move by both companies, Patty Fisher of the Mercury News notes that Yoplait never acknowledged any concern over rBGH and women’s health, despite promoting breast cancer awareness through yogurt sales. “The ‘rBGH-free’ label will be on the carton because it will sell yogurt. I guess that’s why the pink ribbon is there, too.”
A list of all recent updates is available here. Statehealthfacts.org is part of the Henry J. Kaiser Family Foundation.
Plus: Utah, Hawaii and Wyoming top the nation in well-being in an analysis of more than 350,000 interviews conducted in 2008. Southern states West Virginia, Kentucky and Mississippi have the lowest well-being ratings, according to a new Gallup survey.
The Well-Being Index score for the nation and for each state is an average of six sub-indexes: life evaluation, healthy behaviors, work environment, physical health, emotional health and access to basic necessities.
National Women & Girls HIV/AIDS Awareness Day: March 10th was National Women and Girls HIV/AIDS Awareness Day. Here’s a great post by Veronica explaining why women and girls need to be the focus of an education and awareness effort.
Reproductive Health in Africa: North Carolina Public Radio reports on the high maternal mortality rate in Zambia, where the number of women who die during pregnancy or childbirth is 60 to 70 times higher than it is in the United States. As part of the series North Carolina Voices, Global Health Connections, Rose Hoban traveled to the Zambian capitol of Lusaka to spend time with health care workers who work with Ipas, a global nonprofit organization based in Chapel Hill that helps women get access to the full range of reproductive services.
Targeting Craigslist Over Prostitution: Cook County Sheriff Tom Dart filed a federal lawsuit against Craigslist, asking the website to remove its “erotic services” section, calling it a public nuisance that knowingly facilitates prostitution.
“At a news conference, the sheriff said his office has made hundreds of prostitution arrests, many of them based on ads found on Craigslist,” reports the Chicago Tribune. “But the sex-for-sale ads still proliferate on the site five months after Craigslist promised new safeguards to settle a nationwide lawsuit by the top state prosecutors from Illinois and 39 other states.”
Where Are the Female Coaches in Youth Sports?: University of Southern California sociologist Michael Messner has written a new book about the persistent gender divisions in youth sports, especially at the coaching level. He expands on his findings at Moms Team and shares tips from women coaches.
Overlooking Evidence: “When it comes to breast cancer, why is it so hard to get the most influential media to pay attention to the possibility that, in addition to better-understood risks, unnatural substances entering women’s bodies might also be a factor?” That’s the million-dollar question in this Fair! analysis on the surprising dearth of news coverage on environmental hazards and breast cancer. An excellent report by Miranda Spencer.
Skimping on Care: More than a third of people surveyed have skipped medical check-ups or dental visits over the past year due to concern over health care costs, and 27 percent have put off getting needed health care, according to the Kaiser Family Foundation’s first health care tracking poll of 2009.
Supreme Court: No Legal Shield in Drug Labeling: The Supreme Court on Wednesday ruled that people injured by drugs can sue the drug manufacturer in state courts, even if the drugs were approved by the Food and Drug Administration.
“The ruling could have significant implications beyond drug manufacturing,” writes Adam Liptak at The New York Times. “Many companies have sought tighter federal regulation in recent years in part to shield themselves from litigation.”
The case involved a Vermont woman, a musician, whose arm had to be amputated following an injection of the anti-nausea drug Phenergan. Levine sued the drug maker Wyeth because Wyeth had not changed the label indicating that one method of administering the drug had a small risk of error which caused irreversible gangrene. Nina Totenberg did a good report on the ruling. The NPR link also includes excerpts from the oral arguments heard last November.
Sunshine State Keeps Teens in the Dark: The Healthy Teens Campaign of Florida and the Sexuality Information and Education Council of the United States (SIECUS) have released a report on failed abstinence-only sex education programs in Florida’s public schools: “Sex Education in the Sunshine State: How Abstinence-Only-Until-Marriage Programs Are Keeping Florida’s Youth in the Dark” (pdf).
“[O]ur research has exposed both the state’s appalling indicators of poor outcomes for young people and the equally appalling nature of how abstinence-only-until-marriage programs have become pervasive throughout the state,” writes Adrienne Kimmell at RH Reality Check.
Him/Her/They: Elizabeth Landau at CNN reports on the history of the search for gender-neutral pronouns, an issue that has recently been taken up on Twitter. An interesting story.
Moving Reproductive Services Off-Site (Six Feet Away): From Women’s eNews: For more than a decade, a hospital merger in New York state was held up by abortion politics. Last week, community activists gathered for a ribbon-cutting ceremony marking their hard-fought compromise. Rebecca Harshbarger reports.
Plus: Emily Douglas points to this Albany Times Union op-ed on the implications of a possible merger between two secular hospitals and one religious hospital in Rensselaer County, New York. The merger raises questions about reproductive health care for patients and employee health insurance benefits, since Catholic directives prohibit coverage for contraception.
In Translation: Over at Sociological Images, a blog sponsored by the American Sociological Association, there’s been some debate over the English and Spanish versions of a pamphlet for pregnant women offered by Kaiser Permanente. Kaiser provides a response.
The Economic Future and Women’s Roles: The Chicago Foundation for Women looks at how the stimulus package affects women’s economic security.
Teaching Domestic Violence Victims Safe Use of Technology: Via this press release, I learned about a Washington state program designed to help victims of domestic violence by increasing their knowledge of how to use technology safely.
“Domestic violence is built around control, not anger, and an abusive partner often limits a woman’s access to information and support. Monitoring computer activity is one of many ways to control a spouse,” said Jerry Finn, a University of Washington Tacoma professor of social work who also evaluates the effectiveness of human services programs.
The training covers how to prevent such things as identity theft; concealing browser history; how to be safe in a chat room; how to set up an e-mail account without using a real name; and how to prevent being followed with a GPS device. What a smart idea.
Welcome Particle, Wave, Astarte and …: To apologize for the late Double Dose, I offer some cute overload, via feminist poet and performance artist Diana Tigerlily, who also raises goats.
Meet the newest ones — five in all, if my counting is correct. Makes me think two dogs and two cats may not be enough : )
Yoplait yogurt will soon be free of artificial bovine growth hormone (rBGH), a synthetic hormone that has been linked to a number of health concerns, including breast cancer.
General Mills announced Monday that it will stop using milk produced from cows injected with rBGH (also known as rBST) in all Yoplait yogurts by August 2009.
“While the safety of milk from cows treated with rBST is not at issue, our consumers were expressing a preference for milk from cows not treated with rBST, and we responded,” Becky O’Grady, General Mills’ vice president of marketing for the Yoplait brand, said in a statement.
The hormone is already banned in Canada, Australia, Japan and the European Union. In the United States, corporations like Wal-Mart and Starbucks do not use milk from rBGH-treated cows in their products.
Breast Cancer Action launched a consumer campaign last year to encourage General Mills to follow Wal-Mart and Starbuck’s lead.
In a guest blog post at OBOB, Pauli Ojea, a community organizer at BCA, explained the connection between rBGH and breast cancer and criticized Yoplait for “pinkwashing” — a term used to describe companies that participate in breast cancer fundraising or awareness campaigns but manufacture products that may be linked to the disease.
BCA’s “Think Before You Pink” campaign warned that Yoplait’s donations to breast cancer (10 cents for every lid consumers mailed in) came from sales of yogurt made with milk from cows treated with rBGH.
“We’re delighted that General Mills has decided to do the right thing in response to consumer demand,” said Barbara Brenner, BCA executive director of Breast Cancer Action, said in a statement released today. “When a company uses the pink ribbon to sell their products, they are making a promise to support women’s health. We want them to keep that promise — and we’ll monitor the company to make sure they do.”
When women have an abnormal mammogram and a biopsy is recommended, there are two basic options – a needle biopsy in which a sample is collected via a needle, or an open, surgical biopsy in which an incision is made and part or all of the tissue of interest is removed. Not surprisingly, surgical biopsies generally require a longer recovery time and can result in more complications, such as scar tissue that may interfere with future breast imaging.
In a study published in the January 2009 issue of the Journal of the American College of Surgeons, “Quality Assurance Initiative at One Institution for Minimally Invasive Breast Biopsy as the Initial Diagnostic Technique,” researchers looked at every patient undergoing a surgical biopsy for benign or malignant disease at a single teaching hospital during 7 months in 2007. While some of these biopsies were performed to treat malignancies, the study focused on diagnostic surgical biopsies, performed to determine whether or not the sample tissue was cancerous.
The authors note that their study took place after the American College of Surgeons Consensus Conference and the American Society of Breast Surgeons issued statements supporting diagnosis prior to (instead of through) surgery and encouraging minimally invasive biopsies – i.e. needle biopsies – whenever possible.
Despite these recommendations, the authors found that fully 36% of the surgical biopsies performed in the study were for initial diagnosis.
In a commentary in the same issue of the journal, surgeon Melvin J. Silverstein asks, “Where’s the outrage?” and reminds his colleagues that “the operating room is for treatment, not diagnosis.” Silverstein explains that “open diagnostic biopsies only add unnecessary costs to our already overburdened and compromised health care delivery system and much inconvenience, morbidity, and scarring for the individual patient.”
Maryann Napoli, of the Center for Medical Consumers, conducted an interview with Dr. Silverstein for the February issue of their HealthFacts newsletter. In it, Silverstein suggests that many surgeons may do invasive surgical biopsies because they simply don’t know how to do the less invasive needle biopsies, and offers other insight into the breast biopsy “market.” He also calls the nearly 40% surgical biopsy rate of the study “outrageous” and proclaims, “Once women all over America know about this, that number will drop precipitously.”
The Center for Medical Consumers also interviewed study co-author Susan K. Boolbol, who reinforced the idea that women need to be educated about this issue, and also “need to ask the question: Is there another way to do the biopsy?”
What I Learned From Breast Cancer Memoirs: “Breast cancer memoirs have become such staples — reliably displayed during Let’s Wave Pink Ribbons for Breast Cancer month — that it’s hard to remember a time when women didn’t document their journey from onset through the catalog of treatments to restored health, stabilization, or imminent death. But it wasn’t always thus,” writes S.L. Wisenberg in the Chicago Reader.
She continues:
True, British author Fanny Burney wrote to her family about the agonizing mastectomy she underwent — without anesthetic — in 1811. And Katharine Lee Bates (whose poem “America the Beautiful” became the famous hymn) wrote to friends in 1915 about her partner’s breast cancer and death. But neither of these works was published in the author’s lifetime. It was only after World War II that prominent American women went public with their tumors. Marion Flexner, wife of a well-known doctor, wrote “Cancer — I’ve Had It” for Ladies’ Home Journal in May 1947, breaking a taboo by refusing to euphemize her condition — and even inserting a little slapstick with a passage describing “roving boozies”: prosthetic breasts that escaped the confines of a bra and fell to the floor.
It’s a terrific essay, and it makes this reader eager to read Wisenberg’s own story, “The Adventures of Cancer Bitch,” due out in March from University of Iowa Press. In the meantime, visit her blog.
Healthcare Overhaul: “Mindful of how delays sapped the political will to overhaul healthcare during the Clinton administration, health advocates hoped to get a major bill during the new administration’s first 100 days,” reports the Boston Globe. “Now, it looks like it will take longer, and some observers fear that a historic opportunity could be missed.”
Family Planning Nursing Program Saved in Washington: “A campaign by Planned Parenthood to save a program that provides family-planning services in welfare offices has apparently worked, for now,” reports the Yakima Herald. “The Community Service Office (CSO) Family Planning Nurse program, which houses 70 nurses statewide at 58 Department of Social and Health Services offices, will stay open through June. Previously, DSHS planned to shut down the service Jan. 30.”
Split Over Abortion-Reduction Tactics: “The election of a pro-choice administration and a Democratic Congress has divided the pro-life movement, between those who are preparing for the fight of their lives and those who see an opportunity to redefine what it means to be pro-life,” reports Newsweek.
Plus: Red Sex, Blue Sex: Back in November, The New Yorker looked at another type of divide:
During the campaign, the media has largely respected calls to treat Bristol Palin’s pregnancy as a private matter. But the reactions to it have exposed a cultural rift that mirrors America’s dominant political divide. Social liberals in the country’s “blue states” tend to support sex education and are not particularly troubled by the idea that many teen-agers have sex before marriage, but would regard a teen-age daughter’s pregnancy as devastating news. And the social conservatives in “red states” generally advocate abstinence-only education and denounce sex before marriage, but are relatively unruffled if a teen-ager becomes pregnant, as long as she doesn’t choose to have an abortion. A handful of social scientists and family-law scholars have recently begun looking closely at this split.
Lawsuit Takes on Higher Insurance Rates for Women: “California insurers are discriminating against women, charging them more for individual health insurance than men, the city of San Francisco maintained in a lawsuit filed Tuesday against the state regulators who govern them,” reports the L.A. Times.
Gender rating is health insurance is also the focus of two bills have been introduced in the California state Legislature to address the issue. If either of the bills is signed into law, the suit may be dropped.
Study Says Common Chemicals May Affect Fertility: HealthDay News reports on a study that suggests chemicals known as perfluorinated chemicals, which are pervasive in food packaging, pesticides, clothing, upholstery, carpets and personal care products, may delay pregnancy. The study appears in the Jan. 29 edition of Human Reproduction and is available online.
These chemicals are being phased out in the United States because of their toxic effects, and are expected to be completely gone by 2010. However, they remain in the environment and in the body for decades, and have been linked to developmental problems.
“These widespread chemicals apparently lower the fertility in couples trying to get pregnant,” said lead researcher Dr. Jorn Olsen, chairman of the Department of Epidemiology at UCLA’s School of Public Health.
Danish women in the study who had with high levels of perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) took longer to get pregnant, Olsen said.
Almost two years ago we pointed to a story about Kay Yow, the Hall of Fame women’s basketball coach at North Carolina State, who continued to coach as she received treatment for Stage 4 breast cancer.
Yow died today in Cary, N.C. She was 66. Read The New York Times obituary of this truly amazing woman and one of the greatest coaches in women’s basketball history.
Well, it Wasn’t All Bad: “Although the number of uninsured and the cost of coverage have ballooned under his watch, President Bush leaves office with a health care legacy in bricks and mortar: he has doubled federal financing for community health centers, enabling the creation or expansion of 1,297 clinics in medically underserved areas,” reports The New York Times. Kevin Sack writes:
For those in poor urban neighborhoods and isolated rural areas, including Indian reservations, the clinics are often the only dependable providers of basic services like prenatal care, childhood immunizations, asthma treatments, cancer screenings and tests for sexually transmitted diseases.
As a crucial component of the health safety net, they are lauded as a cost-effective alternative to hospital emergency rooms, where the uninsured and underinsured often seek care.
Despite the clinics’ unprecedented growth, wide swaths of the country remain without access to affordable primary care. The recession has only magnified the need as hundreds of thousands of Americans have lost their employer-sponsored health insurance along with their jobs.
In response, Democrats on Capitol Hill are proposing even more significant increases, making the centers a likely feature of any health care deal struck by Congress and the Obama administration.
(Another) Survey Says: Abstinence Pledges Ineffective: “The new analysis of data from a large federal survey found that more than half of youths became sexually active before marriage regardless of whether they had taken a ‘virginity pledge,’ but that the percentage who took precautions against pregnancy or sexually transmitted diseases was 10 points lower for pledgers than for non-pledgers,” reports the Washington Post.
“Taking a pledge doesn’t seem to make any difference at all in any sexual behavior,” Janet E. Rosenbaum of the Johns Hopkins Bloomberg School of Public Health, whose report appears in the January issue of the journal Pediatrics, told WaPo. “But it does seem to make a difference in condom use and other forms of birth control that is quite striking.”
Abortion Battle Brewing in South Carolina: “Abortion foes in the Legislature have sown the seeds of what could develop into another battle over regulating abortion in South Carolina,” reports The State. “Seven S.C. House lawmakers have prefiled a bill that would require women seeking abortions to be given a list of clinics and other facilities that provide free ultrasounds. That list could include pregnancy crisis centers — many run by antiabortion groups — that actively discourage abortion and encourage women to choose other alternatives.”
Genetic Testing and Ambiguity: “‘Information is power,’ has become a common mantra. But for many people seeking answers through genetic testing, all the DNA probing ends in this twist: Less certainty, not more,” begins this NPR report. The story focuses on Nashville novelist Susan Gregg Gilmore, who sought testing for mutations in the genes BRCA 1 and BRCA 2, which are associated with an increased risk of breast and ovarian cancers.
Cut Costs, Not Care: The L.A. Times has published the first installment of an ongoing feature on reducing health care costs. Part one covers drugs, doctor visits, surgery, flexible spending accounts, preventive care and insurance. Scroll down for links to online resources.
The Year in Medicine A-Z: Time magazine offers its annual alphabetical roundup of health stories and breakthroughs that made the news. (Ed. note – reading through it all requires clicking through 37 pages. “Single page” feature, anyone?)
Don’t Blink: Via Feminist Peace Network: “As we come to the final stretch of 2008, plagued as we are with the usual collection of horrors–Gaza burning, Tennessee buried in toxic ash, women and children being raped and killed in the Congo, and on and on, I’m sure y’all were just as relieved as I was to know that the FDA is considering approval of a glaucoma drug for eyelash enhancement, an idiocy I would have previously thought would be confined to the cable shopping networks.”
Missing on TV: GLBTQ Women: “Though 2008 comes to a close with word of possible new queer female characters on the horizon in the coming year, the prospects for lesbians and bisexual women on television over the last twelve months have been somewhat grim,” writes Karman Kregloe at AfterEllen.com. “This has been particularly true for lesbians, whose numbers on scripted network television have now dwindled to zero.”
Deep Thoughts for the New Year: “As the country plunges into recession, will financial hardship demote the pursuit of physical perfection?” asks The New York Times. A classic response:
“There comes a point when you are putting too much time and money into your vanity,” said Peri Basel, a practice consultant in Chappaqua, N.Y., who advises cosmetic doctors on marketing strategies. “For me, the vanity issue is: Where does it stop? If you are going for buttock implants, do you really need that?”
New Reconstructive Surgery Options Not Discussed: Women undergoing reconstructive breast surgery are often not told about the full range of options available to them, reports The New York Times.
For instance, there is a new procedure that involves transplanting a wedge of fat and blood vessels from the abdomen or buttocks, which would be refashioned to form new breasts. This procedure is more complex and less profitable for doctors than breast implants.
The story also mentions this language appropriation:
To raise awareness of breast reconstruction and to market it to patients, the American Society of Plastic Surgeons has adopted the vocabulary of the movement to support a woman’s freedom to choose an abortion, adjusting it for women with breast cancer. Although women “don’t choose their diagnosis, they can choose to go ahead with reconstruction or not, and with the aid of a knowledgeable plastic surgeon they can choose what their options might be,” Dr. Linda G. Phillips, a plastic surgeon in Galveston, Tex., said in a telephone news conference organized by the plastic surgery society to mark Breast Cancer Awareness Month in October. “Then they have that much more power over their lives if they have that power to choose.”
But for many patients, the options may be limited because their doctors are not proficient in the latest procedures. Dr. Michael F. McGuire, the president-elect of the American Society of Plastic Surgeons, said it is not unusual for surgeons to omit telling patients about operations they do not perform.
Single-Payer Health Care Unlikely: “President-elect Barack Obama said at a town-hall meeting in August that he would ‘probably go ahead with a single-payer system’ if he were designing a system from scratch. But that’s not anywhere close to what he’s been advocating,” reports NPR. Congress seems to feel the same way.
That frustrates single-payer health plan advocates like David Himmelstein, an associate professor at the Harvard Medical School and co-founder of Physicians for a National Health Program, which has been advocating for a single-payer model since the late 1980s.
HHS Rule Could Override Plan B Protections: “New federal regulations, set to take effect Jan. 18, could override Connecticut’s law requiring all hospitals to offer rape victims emergency contraception, according to Attorney General Richard Blumenthal,” reports the New Haven Register. “Blumenthal said he plans to fight the federal rule, issued by the U.S. Department of Health and Human Services. It reinforces protections for health care workers and institutions that refuse to provide certain services, such as abortions, for personal reasons.”
FDA to Reconsider Plastic Bottle Risk: In August, the FDA concluded that bisphenol-A, a chemical found in numerous plastic products, including baby bottles, water bottles and metal can linings, is safe, despite the fact that many scientific studies have found otherwise.
But that wasn’t the end of the story. As The New York Times reports, the FDA’s science board subcommittee on BPA found that the FDA was wrong to disregard research showing health effects even at extremely low doses. The FDA is now reconsidering its position — which it reached after relying on studies funded by the American Plastics Council.
“This was the F.D.A. finally acknowledging that its assertion that BPA is safe may not be correct,” said Dr. Anila Jacob, a physician and senior scientist at the Environmental Working Group. “Still, we don’t think it’s enough. With millions of babies being exposed to this chemical on a daily basis, every day we continue to delay removing this chemical from baby products is another day millions of infants continue to be exposed.”
And now, 2008 top stories …
RH Reality Check spotlights the top 10 reproductive health stories, as chosen by readers. Amanda Marcotte’s podcast looks at the year’s top 10 major stories in sexual and reproductive health — and good news may actually outweigh the bad.
A quick summary of a few papers in the recent medical literature:
Ford J, Grewal J, Mikolajczyk R, Meikle S, Zhang J. Primary cesarean delivery among parous women in the United States, 1990-2003. Obstet Gynecol. 2008 Dec;112(6):1235-41.
This paper used U.S. birth certificate data from 1990-2003 to figure out how many women who had previously given birth vaginally had a first-time c-section (of a single infant) during a subsequent birth. Most existing literature focuses on c-sections for first deliveries or repeat c-sections. The authors found primary cesarean rates of 7.1% in 1990, 6.6% in 1996, and a steady increase to 9.3% in 2003. They found this general trend across geographic areas, despite variations from 4-17% between regions. An increased c-section rate with increasing maternal age was also observed.
Hall AG, Khoury AJ, Lopez ED, Lisovicz N, Avis-Williams A, Mitra A. Breast cancer fatalism: the role of women’s perceptions of the health care system. J Health Care Poor Underserved. 2008 Nov;19(4):1321-35.
Data from a 2003 survey of 1,050 Mississippi women at least 40 years old was analyzed for the women’s breast cancer knowledge, attitudes, and behavior (excluding women who had previously had breast cancer). The women indicated whether they believed a diagnosis of breast cancer represented a “death sentence;” the authors express concern that this “fatalism” may contribute to women from marginalized populations not seeking breast cancer screening and often presenting with advanced-stage breast cancer.
The authors report the following findings:
“Older women, African American women, and women with no college education were more likely than younger women, White non-Hispanic women, and women with a college education to agree that breast cancer was a death sentence.”
“Women who rated their quality of care as fair/poor and women who believed that physicians hid information from patients of their race were twice as likely as other women to agree that breast cancer was a death sentence.”
“Women who believed that breast cancer could not be cured if found early and that treatment could be worse than the disease were more than twice as likely as other women to have fatalistic attitudes.”
It is no big surprise here that women who received limited or poor health care, who believed they couldn’t afford treatment, and who believed treatment would not be effective would be less optimistic upon receiving a breast cancer diagnosis. The authors express hope that their research will be used to “suggest strategies for addressing fatalistic beliefs towards breast cancer and for improving attitudes towards breast screening and treatment, particularly among vulnerable women,” and encourage incorporating “positive survival experiences” into health promotion and education programs. They also call for health care systems to “work towards improving overall perceptions of the delivery systems.”
In other words, these women’s “fatalistic” attitudes are not so much the inherent problem, but a reasonable reaction to the problematic economic and other factors that discourage them from seeking care in the first place.
Fergusson DM, Horwood LJ, Boden JM. Abortion and mental health disorders: evidence from a 30-year longitudinal study. Br J Psychiatry. 2008 Dec;193(6):444-51.
Yes, it’s another study on abortion and mental health. In this case, the authors followed women in New Zealand over time, and from about ages 15-30 they reported their pregnancy histories and also completed mental health assessments.
As usual, I’m cautious about the findings because there is a bit of a “chicken and egg” problem with studies of this nature – which came first, having an abortion, or existing mental health or other struggles? If a woman is experiencing distress, is it because she had an abortion, or because she has had to cope with an unwanted pregnancy?
It’s not terribly surprising, however, that the authors found higher rates of mental health concerns among those who had abortions, those who lost pregnancies, and those who experienced unwanted pregnancies that were carried to term (compared with those who did not become pregnant); those who gave birth following a wanted pregnancy showed no increased rates of any mental health concerns.
After 5 years, those who had abortions and those who lost a pregnancy were still more likely to have mental health concerns. However, the authors explain: “Although exposure to abortion was associated with significant increases in risks of mental health problems, the overall effects of abortion on mental health proved to be small. Estimates of the attributable fraction suggested that exposure to abortion accounted for 1.5–5.5% of the overall rates of mental disorder in this cohort.”
The authors note that there may be unknown factors they failed to account for. Of particular concern but not well addressed in the paper is that in New Zealand, for women of any age, two certifying consultants must agree that the pregnancy will seriously harm a woman’s physical or mental health in order for the procedure to be legal. The authors do not attempt to analyze how this legal status or cultural expectations may have affected the respondents reports of mental health issues. They have not examined, for example, whether a woman who obtains a legal abortion based on mental health concerns might be more likely to feel compelled to report mental health problems when surveyed on these two issues together. Studies such as this one also fail to reflect or address the expectation that women faced with a wanted pregnancy may be socially expected to report associated happiness or emotional well-being (similar to difficulties in recognizing and acknowledging post-partum depression).
The authors conclude:
“Specifically, the results do not support strong pro-life positions that claim that abortion has large and devastating effects on the mental health of women. Neither do the results support strong pro-choice positions that imply that abortion is without any mental health effects. In general, the results lead to a middle-of-the-road position that, for some women, abortion is likely to be a stressful and traumatic life event which places those exposed to it at modestly increased risk of a range of common mental health problems.”
I’m not personally aware of many “strong pro-choice” folks who claim that all abortions are always without mental health effects. Most seem to believe that stressful and mental health factors may contribute to the abortion choice in the first place and some women may have mental health concerns after abortion (as they may after pregnancy loss or birth), but that the decision should remain a woman’s choice to make. Just as important, the potential mental health concerns related to unwanted pregnancy should be examined.
Her Body, My Baby: Here’s an article sure to spark some discussion about class, privilege and maternal desire. Writing in the Sunday New York Times, Alex Kuczynski explains why – and how — she chose a surrogate mother and describes the relationship that developed between them.
Feminist Lens on Adoption: More on reproductive rights and who has access to those rights … Katie Leo, who was adopted from Korea, writes in Minnesota Women’s Press that her personal story and research on adoption inform her perspective on international adoption: “Could I call myself a feminist and social justice advocate and still adopt? I realized that for me, the answer was no.”
What is Terror for Women?: The fall issue of On the Issues magazine is about violence against women in all its forms. Included are stories on how anti-immigrant fervor translates to terror for women; the violence and stigma that continue to drain abortion patients and providers; and the dangers of giving birth in Somaliland, where maternal mortality rates are high and access to safe care is limited.
There are some inspirational stories as well. Ariel Doughtery looks at how women are using media to tell their own stories and as a vehicle for finding peace and reconciliation.
“To counteract these war horrors, media women armed with video cameras and other media tools have taken up the struggle to bring the women’s stories to larger audiences. They serve as a means of healing, and also as witnesses to the crimes against women,” writes Doughtery.
Woman Sues Radio Station After “Prize Date” Assaults Her: “A Lake County woman who won a date with a man a radio station called a ‘great’ catch is suing the station for promoting the man, who had a criminal history and allegedly sexually assaulted her on the date she won,” reports the Chicago Tribune. Here’s more from the Daily Herald.
According to the civil suit, Travis Harvey, 46, drugged and raped the 23-year-old woman. Harvey didn’t confess to the rape, but last week pleaded guilty to a criminal sexual abuse charge last week in connection with the assault. He received 24 months probation. According to the woman’s attorney, she didn’t seek medical attention right away so there was no physical evidence to pursue more serious charges.
It’s amazing that the radio station didn’t do a basic background check of Harvey, who had prior felony and misdemeanor convictions for violating domestic violence orders of protection, according to the civil suit. As one friend put it, it’s also amazing that Harvey initiated the contest himself by emailing the station for help getting a date. Hope no one else gets the idea.
A Closer Look at the Healthiest Cities: CDC survey results put Burlington, Vt., at the top of the list of healthiest cities, but a number of other cities are statistically tied for the honor. This L.A. Times story looks at the rankings, as well as the regions where pressure to be thin is tied to looking good (think California) and where there’s a culture of being active (think Boulder, Colo.).
Rate of New Cancer Cases Declines: The rate of new cancer cases is on the decline among Americans for the first time. Less smoking and an increased use of preventative measures is credited.
The findings come from the annual report on cancer produced by the American Cancer Society in conjunction with the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries. Here’s an excerpt from NPR’s coverage:
Part of the decrease in cancer incidence is due to the fact that lung cancer rates among women have leveled off in recent years. Lung cancer incidence among men has been decreasing for several years.
“Everybody’s been waiting for the lung cancer incidence and death rates in women to begin to go down,” says Dr. Michael Thun of the American Cancer Society.
Experts see signs that this is beginning to take place. It might have happened earlier, Thun says, except for something that occurred more than three decades ago: the advent of cigarette brands targeted to young women.
“The big marketing of Virginia Slims that caught the people who were passing through adolescence in the ’60s really boosted smoking rates in that age group,” Thun says.
The decline in the number of menopausal women taking hormone replacement therapy is partly responsible for the decline in the number of new breast cancer cases. A leveling off the number of mammograms may also be contributing to the decrease, said Thun.
Dr. Tim Byers, a cancer epidemiologist at the University of Colorado, tells NPR the “most striking thing about lung cancer in this report is the enormous variation between states in getting lung cancer and dying from it.”
“One of the questions that this observation raises in my mind is whether or not we should be thinking about the control of tobacco as more of a federal or national program,” said Byers. “Up to now we’ve left it to the states, which is why we’re seeing this enormous state-by-state disparity.”
In separate news, a study published Tuesday in The Archives of Internal Medicine found that breast cancer rates increased in four Norwegian countries after women began undergoing mammograms every two years instead of every six, suggesting that some cancers might have gone away on their own had they not been discovered and treated. Here’s the press release summarizing the study.
Not everyone is convinced by the results, reports The New York Times, but Robert M. Kaplan, chairman of the department of health services at the School of Public Health at the University of California, Los Angeles, said the implications are enormous:
If the results are replicated, he said, it could eventually be possible for some women to opt for so-called watchful waiting, monitoring a tumor in their breast to see whether it grows. “People have never thought that way about breast cancer,” he added.
Dr. Kaplan and his colleague, Dr. Franz Porzsolt, an oncologist at the University of Ulm, said in an editorial that accompanied the study, “If the spontaneous remission hypothesis is credible, it should cause a major re-evaluation in the approach to breast cancer research and treatment.”
Plastic Surgery Procedures Are Down: “Half of plastic surgeons report their practices were down last year,” writes Margaret Morganroth Gullette at Women’s eNews. ”That was before the worst of the recession, so it’s not just a matter of cost or insurers who only cover operations that fix ‘deformities’ or improve healthy functioning.”
From 2004 to 2005, liposuction was down 5 percent; eyelid surgery down 20 percent. Even less-invasive procedures such as microdermabrasion and chemical peels were down in that same time period, by 7 percent and 50 percent respectively, according to the American Society for American Plastic Surgery.
It’s also a matter of growing cultural aversion toward the results. “Scary” is emerging as an increasingly common adjective for the surgeons, procedures and — more frequently — the results.
Meet My New Hero: Milan Simone Tuttle. She plays basketball. She’s 5 years old. And she’s awesome. Milan appeared on the Ellen Degeneres Show on Thursday. Be sure to check out the video below (via Because I Played Sports).
Our Bodies Our Blog has invited the folks at Breast Cancer Action to write monthly guest posts on breast cancer and related issues.
by Barbara A. Brenner
As everyone familiar with breast cancer knows, there is no available cure for metastatic breast cancer (breast cancer that has spread beyond the breast to life-sustaining organs). In fact, metastatic breast cancer will kill a woman who has it unless something else kills her first.
The good news is that some treatments can extend the lives of some women with metastatic disease, and additional treatments are available that may keep metastatic breast cancer from advancing, at least for a period of time. These treatments are not without side effects, however –- some of them devastating.
What I find most interesting about this moment is that advances in treatment have led the cancer industry — the oncology community, the pharmaceutical and biotech industries, and the big cancer charities — to begin to talk of breast cancer as a “chronic disease.” While this might be seen as a positive trend, reflecting the fact that some people with breast cancer are living longer, the use of the term “chronic” conveys a misguided attitude about the deadly disease.
A chronic disease is a disease that is long-lasting or recurrent. The term chronic describes the course of the disease, or its rate of onset and development. A chronic course is distinguished from a recurrent course; recurrent diseases relapse repeatedly, with periods of remission in between.
By this definition, metastatic breast cancer is recurrent, not chronic. While this might seem like an academic dispute, it isn’t. Using the term chronic implies that breast cancer is a manageable disease, and downplays the reality that it is far too often fatal. It also diminishes the fact that we are in desperate need of better treatments.
Breast cancer is also sometimes referred to as a chronic disease because the risk of recurrence never completely disappears. Women with early stage disease are followed in medical care for long periods of time (sometimes for as long as they live, even though they may well live a long life and die without a breast cancer recurrence).
In this context, the push to view breast cancer as a chronic disease seems to be an effort by the cancer establishment to turn attention away from the fact that there are still millions of women diagnosed with breast cancer every year. Urging the public to accept the notion of early breast cancer as a chronic disease undermines the demand for true breast cancer prevention.
How we think and talk about breast cancer and other cancers clearly has implications for how we address the disease. We all need to move beyond accepting the notion of breast cancer as a chronic disease if we are to have any hope of truly ending the epidemic.
Barbara Brenner is the executive director of Breast Cancer Action. More on BCA’s view of cancer policy issues can be found here.
A new report criticizes the FDA for ignoring studies questioning the safety of bisphenol A, a chemical found in many household products. From the Washington Post:
The Food and Drug Administration ignored scientific evidence and used flawed methods when it determined that a chemical widely used in baby bottles and in the lining of cans is not harmful, a scientific advisory panel has found.
In a highly critical report to be released today, the panel of scientists from government and academia said the FDA did not take into consideration scores of studies that have linked bisphenol A (BPA) to prostate cancer, diabetes and other health problems in animals when it completed a draft risk assessment of the chemical last month. The panel said the FDA didn’t use enough infant formula samples and didn’t adequately account for variations among the samples.
Taking those studies into consideration, the panel concluded, the FDA’s margin of safety is “inadequate”. The panel is part of the Science Board, a committee of advisers to the FDA commissioner, and was set up to review the FDA’s risk assessment of BPA.
The FDA’s findings were at odds with a report released in September by The National Toxicology Program, which found that there is “some concern” that BPA can affect neural and behavioral development in fetuses, infants and children. Another study found an association between BPA and cardiovascular disease, Type 2 diabetes and liver-enzyme abnormalities in adults.
The possible connection between chemicals such as BPA and cancer was the focus of a Boston Globe op-ed this week. Rita Arditti, one of the founders of the Cambridge, Mass.-based Women’s Community Cancer Project, writes that “because we still do not know what the causes of breast cancer are, primary prevention remains an elusive goal while mammography and early detection are the focus of attention.”
Here’s what we do know:
Since World War II, the proliferation of synthetic chemicals has gone hand-in-hand with the increased incidence of breast cancer. About 80,000 synthetic chemicals are used today in the United States, and their number increases by about 1,000 each year. Only about 7 percent of them have been screened for their health effects. These chemicals can persist in the environment and accumulate in our bodies. According to a recent review by the Silent Spring Institute in Newton, 216 chemicals and radiation sources cause breast cancer in animals.
Nearly all of the chemicals cause mutations, and most cause tumors in multiple organs and animal species, findings that are generally believed to indicate they likely cause cancer in humans. Yet few have been closely studied by regulatory bodies. There is concern about benzene, which is in gasoline; polycyclic aromatic hydrocarbons, which are in air pollution from vehicle exhaust, tobacco smoke, and charred foods; ethylene oxide, which is widely used in medical settings; and methylene chloride, a common solvent in paint strippers and glues.
There is also broad agreement that exposure over time to natural estrogens in the body increases the risk of breast cancer, so it is important to consider the role of synthetic estrogens in breast cancer development. Many other chemicals, especially endocrine-disrupting compounds – chemicals that affect hormones, such as the ubiquitous bisphenol A, which is found in plastic bottles and cans – are also thought to raise breast cancer risk. Endocrine-disrupting compounds are present in many pesticides, fuels, plastics, air pollution, detergents, industrial solvents, tobacco smoke, prescription drugs, food additives, metals, and personal-care products including sunscreens.
There’s no definitive evidence that these substances cause cancer, but all the information acquired so far makes a strong case for more research and precautionary measures as this research develops. The Massachusetts state Senate this year passed the Safer Alternatives Bill, which would create a program to replace toxic chemicals with safer alternatives when feasible. The bill was not taken up by the House. Advocates for the bill, under the umbrella group Alliance for a Healthy Tomorrow, continue to work on its passage.
First, An Important Announcement: Don’t burn the gift-wrapping paper. In case you didn’t know, 
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