The MBTA should not allow advertising from crisis pregnancy centers

The MBTA is where you’ll usually find ads for Jamba juice and Jansport backpacks, local research studies, and public health campaigns. Currently, though, much of this highly-coveted space is occupied by ads for Daybreakinc.org, an anti-abortion crisis pregnancy center. The ads don’t tell you that Daybreak has an anti-abortion agenda; they claim to offer “compassion,” “empowerment,” “hope,” and most inaccurately, “options.” This is in fact the major criticism of crisis pregnancy centers—that they misrepresent themselves as neutral parties. They are not, and they should not be allowed to advertise their heavily-biased and manipulative services on the MBTA.

The point of a crisis pregnancy center (CPC) is to keep pregnant women from having abortions, often by delaying them with offers of pregnancy tests and ultrasounds until it’s too late. What is truly sinister about CPCs is their use of untrue or misleading information to scare women away from choosing abortion, with false claims such as: abortion causes breast cancer, abortion is psychologically damaging, abortion can lead to sterility, and birth-control pills cause abortion. A 2006 Congressional investigation found that 87 percent of the centers surveyed provided false or misleading medical information.

Daybreak is guilty of this type of misinformation, although they are careful not to appear so on their website. It’s no wonder they are covering their behinds—legal action has been taken against CPCs in a number of states regarding their deceptive advertising in New York, California, Ohio, Missouri, and North Dakota.

According to their website, Daybreak claims to provide “accurate information about pregnancy, fetal development, lifestyle issues, and related concerns” as well as offer “accurate information about abortion procedures and risks.” They say “our advertising and communications are truthful and honest and accurately describe the services we offer.” But when you dig in deeper, you will find a sample if misleading and just plain untrue “facts” on their website:

  • Daybreak claims: “[Plan B] It may alter the uterine lining which prevents the fertilized egg from implanting, resulting in an early abortion.” (This is wrong—the dissolution of a fertilized egg is NOT “early abortion.”)
  • Daybreak claims: “Complications may happen in as many as 1 out of every 100 early abortions,” when according to the Guttmacher Institute, “the risk of abortion complications is minimal: Fewer than 0.3% of abortion patients experience a complication that requires hospitalization.”
  • Daybreak claims: “Women who have experienced abortion may develop the following symptoms: guilt, grief, anger, anxiety, depression, suicidal thoughts, difficulty bonding with partner or children, eating disorder,” when the American Psychological Association’s Task Force on Mental Health and Abortion reported that “the best scientific evidence published indicates that among adult women who have an unplanned pregnancy the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy.”
  • On the particularly appalling “For Men” section of the Daybreak website, they write: “Many women who have had abortions report that they were waiting for their boyfriends/husbands to stop them. Some even say that they sat on the table hoping the father of their baby would ‘rush through the door to rescue me and take me away somewhere safe.’” (Um, citation needed?)

I’m not trying to make the argument that free pregnancy counseling is a bad thing or that the people at Daybreak are “bad” people, but pregnancy counseling, or any counseling for that matter, should be unbiased and informative. No where on the Daybreak MBTA ads are women informed that the the “free pregnancy counseling” is actually anti-abortion counseling, and that is dishonest, manipulative, and ultimately wrong. Women facing unplanned pregnancies need to know all their options, without the implication that one is better than another, and they need real medical information, not the “facts” listed above.

The MBTA is currently under fire for proposed fare increases and service cuts. They may be desperate for funds, but that does not excuse this moral misstep. CPCs are a growing threat to women’s health and the MBTA is the last place Bostonians should be exposed to anti-abortion propaganda.


“Shame and Blame: Facing the Unintended Consequences of Health Messaging” on Huffpost

Today my op-ed on shame and blame in health campaigns was published on the Huffington Post. Check it out!

Shame and Blame: Facing the Unintended Consequences of Health Messaging

A solemn black and white poster shows a picture of an obese girl with copy that reads: “Warning: It’s hard to be a little girl if you’re not.” Another poster displays a woman’s naked legs with her panties around her ankles and the word: “She didn’t want to do it, but she couldn’t say no.” The first is part of the Georgia “Strong 4 Life” campaign to prevent childhood obesity; the other is part of the Pennsylvania “Control Tonight” campaign to reduce excessive alcohol consumption. Though the campaigns are unrelated, they have one thing in common: disregard for the effects of shame and blame — the frequent unintended consequences of health campaigns.

The promotion of health and social welfare is one of those noble causes that attracts people who want to “do good.” Physicians are taught to “First, do no harm,” but health communication professionals take for granted that their work is “doing good” without considering that it might cause unintentional harm. For example, stigmatizing sexually transmitted infection (STI) prevention messages may make people with STIs too embarrassed to seek treatment or too ashamed to tell their sexual partners. Not only can health promotion messages lead to such negative health outcomes, they can also promote destructive social values, like fat stigma and rape culture.

Read the rest at the Huffington Post.


Quick hit: Shaming fat kids doesn’t solve anything

Strong 4 Life campaign

According to the Georgia Strong 4 Life childhood obesity campaign website, “Ignoring this problem is what got us here.”

It’s true that childhood obesity is a big problem, but you know what DIDN’T cause the childhood obesity epidemic?

Ignoring the problem.

You know what did?

  • Income disparity
  • Food deserts
  • Fast food advertising
  • The whole fast food industry
  • Corn subsidies
  • Policies like the one declaring that pizza counts as a vegetable in school lunches
  • Lack of safe outdoor play space for inner city kids
  • Video games
  • Lack of funding for physical education
  • Poverty

You know what this ad does?

  • Help families alleviate/prevent childhood obesity
  • Blame this kid for being a fatty fat.

Know what blaming kids for being fat does?

  • Makes them lose weight
  • Encourages a culture of fat stigma and fat shaming that fuels bullying
  • Increases negative psychological, emotional, and health outcomes among overweight and obese children, such as low self-esteem, body image disturbance, eating disorders, and even suicide.

Way to go, Children’s Healthcare of Atlanta.


Well intentioned Facebook meme misses the point

A ‎15 year old girl holds hands with her 1 year old son. People call her a slut. No-one knows she was raped at 13. People call a girl fat. No-one knows she has a serious disease which causes her to be over weight. People call an old man ugly. No-one knows he had a serious injury to his face while fighting for our country in the war. Re post this if you are against bullying and stereotyping. 95% of you won’t

I keep seeing this Facebook status meme pop up from time to time, and every time, it makes me angry. Sure, I’m against bullying and stereotyping (is anyone really pro bullying and stereotyping?) but I don’t at all agree with the message here.

Sure, it’s important not to assume that all teen mothers became mothers by choice. It’s important not to assume that every teen mother became pregnant through consensual sex or irresponsible behavior. Yes, it’s important to understand and recognize that some pregnancies are the result of rapes, and that some young women are forced to carry their babies to term because of shitty barriers to contraception, Plan B, and abortion access. Maybe she was forced to carry the baby to term because of parental notification laws, or the crowds of anti-Choice protesters outside her local Planned Parenthood, or even simply because abortion is too stigmatizing or incompatible with her family’s beliefs or culture to consider.

But even if a teenage girl did become pregnant through consensual sex – even if she was irresponsible – even if she had consensual, unprotected sex with multiple partners – she still doesn’t deserve to be called a slut. Nobody deserves to be called a slut, ever, for any reason. Because there’s nothing wrong with having sex. Even when you’re young. Even when you’re not married. Even if it’s with multiple partners.

Sure, it’s important to realize that there are a myriad of different reasons why a person might become overweight. It could be the result of an illness, or a medication, or a genetic condition and no fault of her own. But it could also be a result of an eating disorder, or stress eating, or poverty, or a lack of education about nutrition. It could be because she’s too busy working 14 hours a day to shop at a grocery store and prepare healthy meals. It could also be because she loves food and doesn’t really care if she conforms to the unrealistic American beauty ideal of the size 2 supermodel. She might be happy with her body exactly how it is.

But no one deserves to be discriminated against or bullied for being fat, ever, for any reason. Even if their weight appears unhealthy, even if they just fucking love to eat hamburgers. Because fat people deserve respect, even if they’re fat because they’re lazy, even if they’re unhealthy. Because people come in all different shapes and sizes, for all sorts of reasons. Because there’s no wrong way to have a body. And because someone else’s weight is really none of your business.

Yes, it’s important to realize that sometimes people look different and sometimes they were injured while serving our country. But sometimes people look different because they were injured for some other reason. Maybe it was a car accident. Maybe it was a drunken hang-gliding accident. Maybe there was an accident at work because of lax safety standards. Maybe it wasn’t an injury, but an illness, or a condition that developed over time, or maybe they were just born that way. Maybe there’s nothing wrong with a person’s face other than the fact that it doesn’t look like the faces we see in magazines. Maybe it’s not a person’s face, but their body. Maybe they use a wheelchair or a cane. Maybe they sound different when they speak. Maybe they cannot speak, or cannot hear, or cannot see. No one deserves to be called ugly, no matter what they look like or sound like or how they came to be that way.

Though I can recognize that the meme is well-intentioned, it suggests that while some people don’t deserve to be bullied or stereotyped, other people do. Because they “brought it on themselves” by acting irresponsibly or just because they don’t have a “good excuse” for being the way they are. But nobody deserves to be stereotyped or bullied, for any reason.

When someone falls outside the norm, they become a target for bullying and stereotyping just because they’re different. And everyone is different at least some of the time. There’s no point to trying to determine who “deserves it” and who doesn’t. Because bullying and stereotyping is cruelty, and no one ever deserves that.

So if 95% of people aren’t reposting this status meme, let’s hope it’s because they agree that EVERY 15 year old mother, EVERY overweight person, and EVERY person who’s body is in some way “different,” deserves our respect and compassion.


Too big for a stroller?

Today I discovered Walk, a new Tumblr site sharing photos of kids in strollers who are too old to be using strollers. The sentiment behind the site seems to be that kids who are old enough to walk should walk. The friend who posted it on Facebook wrote “Seriously, if your kid can walk without falling, your kid should walk without falling.” I can see how some might be annoyed by the sight of 7-11 year old squeezed into a stroller, but Walk is perhaps saying more than was intended.

As I looked through the photos, I couldn’t help but notice that a fair few of the kids in strollers were overweight. Considering that childhood obesity is a growing problem in the U.S., this may not be coincidence.  According to the CDC, rates of childhood obesity have more than tripled in the past 30 years. The prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008. Childhood obesity is a serious problem because it sets kids up for a lifetime of chronic illness and health issues. It also makes kids more susceptible to bullying and fat-shaming from their peers and society at large. While the causes of childhood obesity are multifaceted and complex, one is undoubtedly a lack of physical activity.

I strongly believe that when it comes to obesity, it is unfair to put all the blame on the individual. Our society promotes and condones unhealthy eating and sedentary lifestyles in a number of ways: the fast food industry, an economy based on office jobs, car-based societies, corn subsidies, food deserts, etc. For those who are low-income, a healthy lifestyle is almost impossible considering the lack of access to safe public recreation spaces, lack of leisure time, and high costs of fresh, healthy foods.

Perhaps another way that our culture unknowingly reinforces unhealthy behaviors is through “stroller culture.” Now, I’m not saying that there’s anything inherently bad about strollers (like Maggie Gyllenhaal‘s character in Away We Go), but that perhaps we use them too often and for too long. Looking at some of the images on Walk, it seems that might be the case. What are we teaching our school-aged children when we don’t expect them to walk alongside us? If anything, we’re reinforcing the idea that walking from the parking lot to the store is an imposition, or that physical activity is separate from the experience of living every day – something we only experience at the gym or playing sports.

My mother came out to Boston to visit on Mother’s Day. We were heading from my apartment in “Camberville” into the city, and I suggested that we could avoid the 18 minute walk to the T stop by taking a bus. She gave me a lecture on how walking was part of the urban experience and part of a healthy lifestyle.  At age 25, is my mom still pushing me out of the stroller?

I’m wary that Tumblr sites like this can often become places for fat-shaming (like People of Walmart) and I would hate for this to happen with Walk. Still, it is a reminder that walking is part of a healthy lifestyle for kids as well as adults.


“Emotional Eating” is more than just emotional

In addition to working full time, I study health communication. You know, how people communicate about their health, how we can better bridge the communication between healthcare providers and everyone else, and how we can use communications to educate and motivate people to live healthier lives. For a class assignment, I was given the charge of making a “lifestyle transformation challenge.” I had to pick a behavior I wanted to change and track my progress towards making it a long-term lifestyle change. The point of this was to gain a full understanding of just how hard making a lifestyle transformation really is – an important thing to know if you are trying to convince others to do it.

So what behavior did I decide to change?  I’m a snacker. A big one. I feel most comfortable when I am eating something. My favorite foods are ones that you can eat over a long period of time – foods like artichokes or tacos that are more of a hobby kit than an actual meal.  I don’t have much of a sweet tooth, but I certainly have a salt tooth. Anything I can munch mindlessly while watching tv, writing or studying is a-okay by me. Anything with cheese is even better.

My lifestyle transformation challenge was to try to cut back on snacking, especially at night.  I came up with what I thought was a really creative way to do it – nothing like any diet plan I had ever seen.  I would give myself an hour-long window to eat dinner, and that would be it for the night.  I would not count calories or stress about what I ate for dinner, as long as I ate it within the hour window and didn’t nosh afterwards. I thought this would be easy.

Long story short: I failed to transform my lifestyle and stop snacking in the evening. But the good news, I suppose, is in what I learned along the way. During this challenge, I read Perfect Girls, Starving Daughters, a powerful book about my generation’s relationship to achievement, perfectionism, and food, by Courtney Martin. I had of course heard of “emotional eating” prior to reading the book, but had never realized what it really meant or considered my snacking habits to fall under that category.

I have come to really hate the term “emotional eating” and all that it conjures up. The idea that millions of women are crying into a bowls of ice cream or “eating their feelings” is a myth. It’s a myth with plenty of moral stigma attached – weakness, gluttony, failure, loneliness. (Cat ladies? Cathy comics?) The reality is that when stressed, depressed, tired, etc., one is more likely to consume more calories for a number of reasons that are much more complicated than just “eating your feelings.”

In Perfect Girls, Starving Daughters, Courtney Martin described a “perfect girl/starving daughter” dichotomy in each of us, and while I’m sure her book resonated more with some than others, it was so true to my own experience that I now consider it gospel. You see, girls of my generation were raised by feminist moms– moms that told us that girls could be or do anything. These were also moms that managed (somehow) to work and raise us and take care of the home at the same time. They were “supermoms” and we grew up observing their busy schedules and overachiever lifestyles. And we became overachievers. We are breaking barriers in the sciences, outnumbering men in colleges, playing competitive sports, and we still look beautiful and feminine and thin. We don’t sleep much because all of this takes time.  We are Martin’s “perfect girls.”

But we are also “starving daughters” – weak, needy girls who are tired and lonely and just want to be cuddled, looked after, and loved. There is a hole in our center – you could call it spiritual, you could call it psychological – that wants to be filled with love and comfort.  Every now and then the break-neck pace of overachieverdom overwhelms us and the “starving daughter” comes out. I can literally hear mine repeating the phrase “I am just so tired” or “I am NOT okay” over and over in my head. These are the days we spend on the couch, watching TV and feeling weepy. And for many of us, these are the days we eat – consciously or not – in an attempt to fill that hole.  Thanks to Courtney Martin, I am now able to recognize my starving daughter self for what she is – my own body telling me I’m putting too much pressure on myself. She’s telling me that I don’t need another resume-builder; I need comfort, rest and love.

But there are other ways to look at the issue of “emotional eating.”  From a more medicalized perspective, there is a strong correlation between obesity and stress, depression, and sleep deprivation.  And let’s remember that according to medicine, stress and depression and sleep deprivation are legitimate medical ailments with diagnoses, treatments – the whole shebang. Overeating is a symptom of these diseases. Eating is soothing, and therefore a quick and dirty method for coping with anxiety or stress. Not to mention the fact that busy (and often stressed) people don’t have a lot of time for grocery shopping or meal prep, and often grab less-healthy foods on the fly. Sometimes their only option is a vending machine. And when you need energy NOW, your choices will reflect that with sugar, caffeine, and carbs. With depression comes apathy and the need to self-soothe. Again, these symptoms make it more likely that one will eat to soothe, and will care less about what they are eating so long as it is satisfying (warm, filling, sweet, salty, etc).

And finally, sleep deprivation is a huge factor in so-called “emotional” eating.  For one, if you’re awake for 19 hours a day, you’re likely to consume more calories than someone who is only awake for 16.  Also, sleep has a big effect on your metabolism and the way you process food. Sleep deprivation can actually cause you to gain weight, or make it harder to lose weight. Also, sleep deprivation makes us tired – and contributes to anxiety and depression, for which we often use food to cope.  I am not going to lie.  The more I learn, the more I realize sleep deprivation is a big part of my problem.

I now understand that the reason my lifestyle transformation failed was that I was trying to treat a symptom instead of the disease. I was trying to stop snacking when I should have been addressing the reasons why I snack. Working full time and being a full time student was just too much for me. I was stressed out and living with more anxiety than usual. And I had physical symptoms too – particularly a sore neck that some days hurt so badly I couldn’t turn my head.  I wasn’t sleeping much, and homework kept me from spending as much time with my friends – the people who give me love.  I also gave up exercise (the great stress-reducer) partly because I didn’t have the time, but also because I didn’t have the energy. I also didn’t have time or energy to go grocery shopping or cook. All of these things were factors in my snacking. There were physical factors, mental factors, and environmental factors contributing to my low level of health, for which snacking was a coping mechanism. Taking away my coping mechanism without making any other changes simply wasn’t going to work.

The irony in all of this is that I have been studying health all semester.  I began this semester as a “perfect girl,” pushing myself to do it all because working full time while I was in school was a smart career move and the financially responsible thing to do. I made it about halfway through the semester before the “starving daughter” took over. But during this difficult time, I managed to learn some things.

There are a lot of messages out there that tell us that success and achievement are more important than happiness, or even one’s health. Those are the messages I pretty much bought into, and despite my new-found perspective, I still have trouble challenging them. After all, we are a nation of workaholics that tends to view illness as weakness, and obesity as failure.  Even though we often view medicalization as a bad thing, this is one of those times that medicalizing an issue can actually be helpful in overcoming the moral stigma attached to it.  And as Courtney Martin showed us, sociology – looking at “emotional eating” on a society-wide level – can also be a tool for overcoming stigma.

Now that the semester is finally coming to a close, I am committed to making a real lifestyle transformation: the decision to drop to working part-time. While my “perfect girl” cringes at my laziness and self-indulgence, my “starving daughter” is hopeful. With the extra 16 hours a week, I will be able to sleep more, exercise more, and get to the grocery store before it closes. I will be able to see my friends on weekends. Surely it will be a financial hit and probably not the smartest career move, but it is a real step towards reaching balance and achieving mind/body health. It is my hope that by treating the real problem, some of the symptoms – like snacking – will clear up on their own.


Medicalization and Machines: Is Bad Breath a Disease?

I’ve been doing some readings for my course in health communication and I have been thinking about the idea of medicalization – how it has changed how we think about our bodies, health, and its implications for health communicators and educators.

In The Body and Social Theory (1993), C. Shilling identified “the body as a machine” as a common metaphor we use to think about our bodies and health. From this perspective, our bodies are a collection of parts that, when functioning properly, work like a, er, “well-oiled machine.” If a part breaks, it can be fixed. For every malfunction, there is a scientific solution. Regardless of whether this metaphor is a good one, it certainly plays a role in what we call “medicalization.” In a medicalized society, the mechanics are doctors who use medicine to repair the body when it malfunctions. So when we talk about medicalization, we’re talking about the idea that every physical “malfunction” has a treatment or remedy. And that works oh-so-well with another hugely prevalent force in our society: consumerism.

If every ailment has a remedy, then someone is going to get rich off of selling remedies. A doctor once pointed out to me that the more options there are to treat an ailment, the less effective the treatment is likely to be. I guess that’s the difference between a “remedy” and a “cure.” When we’re talking about something curable, there’s usually only one cure. If it’s just “treatable” like the common cold, there are likely to be more options. And none of them really “cure” anything, they only treat the symptoms.

Viral illnesses like the common cold are great for people selling remedies; they are malfunctions of the body-as-machine that need fixing, but they aren’t really “curable” so we shell out money hoping for that “magic remedy” to fix the problem and get our bodies back in working order. Rather than put a hole in the body-as-machine metaphor, we accept the remedies as necessary, just as necessary as medical “cures.” The body-as-machine metaphor transcends the reality of the common cold as something that can’t be “fixed” and instead legitimizes our need or demand for products like Advil Cold and Sinus.

But what if you have a product for which there is no medical need? If you’re Listerine, you invent one. Ever heard of halitosis? It’s a term for “bad breath,” which is not, by the way, an actual “disease” or “illness” of any kind. Halitosis is a term invented by Listerine as part of an epically successful ad campaign.

Joseph Lister developed antiseptic at the end of the 19th Century. A similar but less potent form was developed by Jordan Wheat Lambert, who asked the famous Lister if he could use his name to market the product. Thus, Lambert’s Listerine was born. It was used for sterilization, cleaning floors, and even treating gonorrhea. In 1895 it began to be marketed towards the dental profession as they discovered it was good at curing oral germs. And then, Lambert hit on the best idea ever: medicalize bad breath and sell Listerine as the cure.

He and his copywriters all but invented the term “halitosis” and used it in an aggressive ad campaign designed to make everyone self-conscious about our smelly breath. Remember, at this period in history, there were different standards of oral hygiene. This ad campaign is in part responsible for the difference in standards today. The campaign asked, “Always a bridesmaid, never a bride?” or “Could I be happy with him in spite of that?” and stated plain and simple, “Halitosis makes you unpopular!”

(I know there were a few ads directed towards men, but I can’t find them online. It seems as though the majority of these ads were aimed at women.)

Do you remember a time before we had to carry mints or gum, talked about “coffee breath,” or just spoke freely without worrying about the smell of our words? Well, Listerine killed it. James B. Twitchell, author of Twenty Ads that Shook the World (2000), names this advertising strategy “generating constructive discontent,” and Listerine wasn’t the only company to use it successfully.

Body odor came from Lifebuoy soap; athlete’s foot came from Absorbine Jr.; “five o’clock shadow” from Gilette; tooth film from Pepsodent; and split ends from Alberto V05. Americans today spend almost $4 billion a year on products whose only purpose is to alter natural body odors, odors unsmelled a generation ago!

(I wonder what Twitchell would think of vaginal rejuvenation surgery and the Va-J-J Visor…)

The halitosis ad campaign was so successful that most of us know the word, and understand it to be the “medical term for bad breath.” We also consider athlete’s foot a medical condition, and can buy “prescription strength” deodorant that costs over $10 a stick. They say that “sex sells,” but I think health may sell more directly. And as these products are labeled as health remedies or medical treatments, they expand the medicalization of our society and reinforce the idea that our bodies can run like machines if we maintain them properly.

It makes me wonder about my own so-called “health condition”: eczema, or “dry skin.” While some have more extreme cases of eczema, or psoriasis, my eczema is mild. It’s just dry skin that gets worse in dry weather. In a worst case scenario, patches of dry skin become itchy and feel rough to the touch. Yet, I have seen a dermatologist and I have been diagnosed with mild eczema. I was even prescribed a steroid cream to use during “outbreaks,” and it was recommended that I use a “dermatologist approved” moisturizer like Eucerin or Cetaphil every day. A bottle of Eucerin costs nearly $15, compared to something like Jergens, which costs $4. But then again, I think Eucerin is in a different class than “regular” moisturizers, and does a better job with my eczema. Or do I just feel that way because I have developed brand loyalty, and enjoy feeling like I have a medical condition with a simple, successful, medical treatment?

So is my eczema a disease? Or is dry skin, like bad breath, just an occasional annoyance of being human? Would I feel differently about my skin if I had never been diagnosed by a dermatologist?  Would it change the fact that I find comfort in the routine of, literally, “oiling” my body-as-machine?

And if eczema, like halitosis, is just a made up word in order to medicalize a normal physical thing, is the deceit harmful or benign?


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