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Posts Tagged ‘medical education

“I just saw some idiot at the gym put a water bottle in the Pringles holder on the treadmill”*…

 

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Like millions of other people, I put a fair amount of effort into “being healthy.”  I don’t smoke, try to eat a reasonable diet, and so forth.  I do all of this with the backing of a strong scientific consensus that such behaviors are likely to be very good for my health and longevity.  None of this makes me special in any way; I am trying to follow what one might call the medical truth of health.

What I want to suggest here is that there is a dark underside to all that healthy behavior. The underside is that the healthy behavior encourages the view that individuals are largely responsible for their own health outcomes, and that if people end up unhealthy or diseased, it’s their fault for not having engaged in sufficiently healthy behaviors.  Call this a “social truth” of health.  This social truth has real consequences. On the one hand, if individuals are to blame for their poor health, then they should bear a lot of the cost of their disease.  After all, there is a sense in which they “chose” to be sick because of their unhealthy lifestyle.  On the other hand, policies designed to create healthier environments or at reducing structural factors associated with poor health outcomes, like poverty, start to seem less important.

“Healthism,” as a prescient article from 1980 called it, has been a growing part of the American social landscape since the 1970’s, when jogging emerged as a fitness trend.  The rise of healthism coincides with the rise of neoliberalism, a loosely-grouped set of policies that aim at analyzing all parts of society in economic terms, expanding the reach of actual markets, encouraging competitive behavior between individuals, and encouraging people to view their lives in entrepreneurial terms (for example, treating education as an investment the value of which is measured in terms of its probable future returns in the form of higher income). Because of the focus on individuals and market behaviors, neoliberal governance tends not to see systemic or public problems except insofar as they can be reduced to the problems of individuals…

It is in this context that we need to see our healthy lifestyles and the dilemma they pose.  It is obvious that those who have the good fortune and the means can and should want to be healthy, for its own sake.  On the other hand, the effort to be healthy directly feeds a narrative that says that poor health is the product of poor management, in the way that poor returns on financial investments might be.  No one is ever simply “healthy;” even health today may hide illness to come, future illness that must be detected and prevented.

The problem is that the wellness narrative causes us to over-estimate the degree to which it is fair to blame individuals for their health outcomes…

The importance of separating what is an individually-healthy behavior from good health policy: “Is Your Healthy Lifestyle Bad For You?

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As we emphasize empathy, we might recall that it was on this date in 1850 that the first classes were held at The Female Medical College of Pennsylvania, the second medical school in the U.S. exclusively for women.  (The New England Female Medical College had been established two years earlier.)  It soon changed its name to The Woman’s Medical College of Pennsylvania, then much later was renamed as The Medical College of Pennsylvania after opening its doors to men in 1970.

The school’s first building

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Written by LW

October 12, 2017 at 1:01 am

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