Important Lecture Material not about readings Flashcards
stats on mental neurological disorders
low (ish) mortality 3rd Highest percent DALYs aka high morbidity
distribution of psychiatrists
low in Africa and China low in China bc mao believed it was a pretentious thing
“schizophrenia” in Japan
translation is split mind disease is split mind disease really the same as schizophrenia? is this disorder really the same for westerners and japanese?
critiques of DSM
medicalization of homosexuality gender dysmorphia diagnostic inflation DSM 5 has: “Hypoactive sexual desire disorder” and “Disruptive mood dysregulation disorder question of which comes first, the drug or the disorder
DSM “gender dysmorphia” means…
what we would call transgender- in order to get health insurance to cover sexual reassignment surgery you need to put transgender in the DSM- why is a psychiatrist the one who decides whether transgender should be covered in a specific case-
sarafem
essentially prozac but its targetted at women to treat PMS/PMDD Something like Prozac can treat these conditions but paying 60$/month for a new condition when Prozac only costed 5/month
Martin
cultural valorization of mania (which occurs in bipolar often) mania of guys on Wall Street who work crazy hours aren’t seen as crazy, irrational or out of control while a hoarder is
-also did stuff in reproductive health
percent of resident physicians unprepared to deal with cross cultural issues
at least 1/5 are uncomfortable treating these issues
susto
when a Latino immigrant presents with Susto/soul loss- is labeling with anxiety adequate or is it not the same defined as “fright” or “soul loss” symptoms: sleeplessness, restlessness, depression, loss of appetite, lack of interest in personal hygiene treatment in Latino culture: traditional folk healing
Amafufunyana
in South Africa it is essentially schizophrenia/multipersonality disorder hysteria associated with spirit possession afflicts marginalized people/groups esp during times of social change treatment:excorcism ritual
cross-cultural psychiatry
first formulated in 1970s and 1980s by Arthur Kleinman first formulated in 1970s and 1980s by Arthur Kleinman Kleinman thinks the names of our psychiatric conditions are culture bound and may cause harm if diagnosed in a certain way
what does cross-cultural psychiatry do?
psychological processes are embedded in social worlds need to rethink relationships between culture, biology, and healthcare understanding the sometimes negative effects of posing psychiatric categories as universal and biological does psychology only reside within the individual “mind” – or is psychological reality produced in discourse?
discursive psychiatry
the construction of meaning -not just definition or word, the meaning of something exists in the brain
Lakoff
globalization of western psychiatry need to think about how to diagnose and treat in the context of modernization, etc
Sapolsky
why zebras don’t get ulcers: Zebras don’t get stomach ulcers because they’re not stressed out Need stress to deal with certain things in a savanna which drive us to a fight or flight which bring us to evolve
its the high stress low reward thats worse for us biologically
Whitehall 1
1967-18000 men all different social classes and professions of different levels
all had access to equal levels of healthcare
result: 2x higher mortality rate in lower grade employment ranks risk factors do not account for the majority of this difference
Whitehall 2
1985- 10000 men and women focus on work stress and health
highest likelihood of coronary heart disease in those with lowest job control
low social support at work–>higher liklihood of poor mental health
highest liklihood to develop CHD in jobs with high effort and low reward
issues of job insecurity in women lead to concrete biological issues
impacts of whitehall
dispelled myth of the overworked high income individual getting heart disease
it is the low income people with high job insecurity
access to healthcare does not mean health equality
dynamic relationships between social environment, physiology, and psychology
hot-cold classification of food among a new york puerto ricans
occurs among some new york puerto ricans, USA where hot foods includ tobacco and alcohol and coffee and chocolate etc,
cool foods are honey, raisins, watercress etc,;
cold foods are bananas lima beans, sugar, coconut etc
hot-cold classification of food among some Asians in UK
they only have hot and cold classifications where
hot=fish, chicken, carrots, radish, garlic etc
cold=rice, plantains, peas, bananas etc.
proportion of children under 5 who are underweight
where are they most prevalent?
southern asia with 48% of kids under 5 underweight as of 2007
26% of children under 5 in developing world are underweight as of 2007
angles of problematization of drug culture
moral models
criminalization
spiritual/disease model
disease model
public health model
political and economic models
socio cultural models
angle of problematization-drugs:
moral model
involves family, seen as a vice and temperance can occur
ex-prohibition of alc and tobacco in 20s
opposition only because these drugs “ruin families”
angle of problematization-drugs:
criminalization
tough on crime
law and order
angle of problematization-drugs:
spirtual/disease model
ex: Alcoholics Anonymous
in the 30s alcoholics believe they have an internal incurable sickness
angle of problematization-drugs:
disease model
ex: alcoholism as a brain disease –requires treatment but not necessarily curable
medicalization
angle of problematization-drugs:
public health model
treatment, prevention,education
foccusses on intervention and treatment
angle of problematization-drugs:
political and economic models
rates of use correlate w/ poverty, unemployment and marginalization
dif drugs thrive in dif social groups-all groups are using
we are all illegals
idea is to destigmatize what it means to say someone is illegal-everyone does something illegal even if its just running a stop sign
reason behind opiate/heroin illegalization
because of chinese exclusion-gov wants to arrest and run chinese off property (similar perhaps to illegalization of other drugs?)
cocaine
used to be put in pain relievers and coca-cola
then it became seen as a drug that ruins families and shit
prohibition
occured primarily through push of moral model
“help the mom the keep the kid pure”-slogan to vote against the sale of liquor
mother and children mobilize around movement
domestication pub policy
then prohibition ends
“the strange mexican weed”
weed becomes illegal at the same time that it was problematized as a Mexican drug
drug war
officially begins in the 70s by traces back to racism and exclusion which was occuring in 30s
just another way to target certain parts of the population
Nixon was the one to declare the war on drugs
drug addiction and spending
us drug addiction rate has been releatively constant since the 70s yet our spending on drug control has skyrocketted to 1.5 trillion as of 2010
incarceration
who is incarcerated?
1/10 people incarcerated in THE WORLD are Black American men
Michelle Alexander-The New Jim Crow
argument is that mass incarceration that took off in the 70s doesn’t really havea public health role but simply recodes racism as an issue of crime
shift from “race” as focus of segregation and discrim. to “crim”
it becomes okay to punish someone for a crimeven though that crime has become racialized
crime and drug use rates have declined or stayed same but incarceration has soared
80% of black men in Chicago have a criminal record
felons are disenfranchised and suffer in labor and housing markets and cant get welfare or food stamps–driven to steal so they end up back in jail
70% of prisioners return within 3 years
Nixon 1968
response to street riotos is to be tough on crime
“nixon for law and order”
Reagan and Drug history
used to make tons of money off of selling and advertising cigs but once in office he starts policing marijuana and cocaine
what is he really against here?
Just Say No/DARE
efficacy
DARE- stands for drug abuse resistance and education
just say no doesn’t work and education doesn’t really help
Crack cocaine
and crack babies
problematization of the crack babies and kids born to crack moms
seen as huge issue
kids are born to crack moms but this was actually pretty rare
parents were incarcerated-this doesn’t help the problem (if it even ever was one)
incarceration rates and correlations (that may say why there’s an increase)
they have sky rocketted
started to really pick up when Nixon declared war on drugs in 1971
1984 Sentencing Reform Act
prisoners and private prisons
also huge increase in amount of people in private prisons
private prisons owned by corporations w stocks being traded
investors want a return so they want more prisoners
they are making money off arrests
there has been a huge increase in lobbying in the 5 past election cycles
crack vs cocaine arrests
prison sentence for crack is average of 3 years longer than for powdered cocaine
crack is possibly worse for you but its also seen as a black drug while coke is a white drug
coke is suburban and expensive
faces of meth
linnemann talks about how the campaign:
uses fear as detterent (not necessarily effective)
focus on crime (mug shots)
no stats or context of how it effects life
invites people to participate in ongoing spectacle of white trash
moralization of drug use (why would someone ever do THAT to themselves)
effects of the drug trade
and our ‘war on drugs’ in latin america
as Zirnite mentions in article–
no proof that policies limit the international drug trade
only evidence of increased violence in Latin America
support dicatatorships and human rights abusers
why do we focus on supply rather than demand and treatment?
adderall
20-30% of college students abuse it
no one is ever arrested for dealing or abusing
tobacco and DALYs
leading source of DALYs in US
booming form of consumption esp in China, Japan, Russia India
tobacco crisis
over?
how many deaths caused by tobacco?
def not over
1 million deaths in 20th century and will be 1 billion in this century
Trans-Pacific Partnership-
Tobacco
tobacco is in the TPP because it was believed that senate wouldn’t pass it but if they do we can make money off of it
it has increased the Tobacco consumption in places with low regulation
King James and Tobacco
believed it was horrible and a cause to the scurvy and sacrilegious
US Cig Consumptions
peaked in the 1960s with about 4000 cigs per capita per year
cig advertisement
tobacco ads boomstarting in 20s
only industry that causes harm when used as intended
ads targetted women by playing on the flapper movement
cigs as “sexy”
use doctors and physicians to help advertise (this works)
marketted as the one thats best for you is ___ brand
ads that give consumer power-its your choice for your throat and your tastes
Frank Statement
1953
made by the tobacco institute
- we see health as a responsibility and consider it in our business
- we believe that the products arent bad for your health
- we cooperate with those whose task it is to safeguard health
Tobacco institute 1954
1-no conclusive proof of link between smoking and cancer
2-med research points to many possible causes of cancer
3-those who smoke can be assured that every means will be used to get all facts ASAP
it is a response to wydners findings that tar is carcinigenic
this shows a history of CORPORATE MALFEASANCE AND NEGLIGENCE
notes from inside show that they know what they were doing wrong
(their own notes say cigs are cancer causing, cancer promoting, poisonous but pleasurable and flavorful)
Ernst Wynder findings
1950
1- lung cance in non smokers is rare but possible
2-cig use much higher among lung cancer cases
3-cancer rates consistent across men and women
4-correlation between increase in cig use in US and increase in lung cancer in US
5-impact of tobacco tars in mice (prev. of 44% after just 1 year)
6- analysis of tar shows toxins such as arsenic and other toxins
critiqued for his study being retrospective
all this was the cse in the 50s
Doll and Hill
40,000 doctors over 20 years
found that risk of developing the disase increases in proportion to the amount smoked
CANNOT prove this on an INDIVIDUAL SCALE
smoking rates in doctors vs reg people
physician smoking from 60%->40% in 1959
doctor somking less that 20% by 1970, and about 5% in 2010
everyone else the smoking rate remains about 40% into the 80s-prob because quitting ais hard and marketting isn’t prohibitted
taxes and smoking
as taxes on cigs go up sales go down
shows that people who smoke don’t really want to smoke or else they would be more willing to splurge?
but even with high tax theres still millions of tobacco related deaths per year
phillip morris consumption internationally and globally
profits are continuing to increase globally-theres tons of export
decreasing profits in US
FCTC
WHO Framework Convention on Tobacco Control
success and failures
this is a global treaty
tobacco is a massive and global economy that we need to attack globally
key provisions of framework convention on tobacco control
- taxes
- public smoking bans
- large health warning labels
- ban on terms such as “light” “low tar” or “mild”
strong pub ed
restrictions on youth marketing
corporate paternalism and harmful products
Benson article
corporate paternalistic thing is that they want to help by looking at youth and education and family and youth and what tobacco does there
this is proven ineffective
Tobacco companies (Phillip Morris USA) focusses on education for this reason exactly.
what we should be doing is having a heated debate about the industry itself and we should impose taxes because we know this works
Margaret Lock
research in menopause and cultural views around it
wrote: encounters with againg
menopause history and cultural views around menopause
premodern period: thought to cause disease
now: seen as disease itself
medical view: much disagreement around symptoms and causes of menopause
in Japan menopause is seen as gaining wisdom (when you lose libido)
menopause associated w losing hormones and femininity in US
