Search Results for: health

Health Care Sponcon: Where Big Pharma Meets Instagram Influencer

Photo via Pexels

I’ve been reading about Instagram influencers of all flavors recently, from kid stars to travel bloggers. Enter the latest type of influencer marketing: health care sponcon. That’s right: pharmaceutical companies and Silicon Valley health startups are teaming up with social influencers to sell new drugs and medical devices.

“There is no doubt that this type of health care advertising-cum-storytelling is effective, and is frequently compliant with federal regulations,” writes Suzanne Zuppello. But is it ethical? For Vox‘s The Goods, Zuppello digs into influencer pharma marketing and investigates how the FDA and FTC are attempting to regulate this type of sponsored content.

Lesley Murphy, a former contestant on The Bachelor and current travel blogger, uses her platform to disseminate information that benefits people like her who are affected by a BRCA genetic mutation, which increases a person’s risk of breast, ovarian, and pancreatic cancers. Murphy, who did not respond to requests for comment, documented her experience of undergoing a preventive double mastectomy on Instagram. Now she advertises ReSensation, a surgical technique launched in October 2018 that may help women undergoing breast reconstruction to retain some or all sensation in their breasts, to her 422K followers. Although ads for most surgical procedures are under the FTC’s purview, ReSensation’s use of human nerves also gives the FDA jurisdiction over Murphy’s Instagram and blog posts.

When asked how the influencer program was developed, Annette Ruzicka, a spokesperson for AxoGen, the company that developed ReSensation, said, “The only request of contributors was to write openly about their breast reconstruction process, and to also share factual information with their followers about the ReSensation technique. We shared publicly available information about the ReSensation technique to ensure that all content shared with the public was accurate. We provided no other content requirements for contributors.”

Murphy, who is not the only ReSensation influencer, has not undergone the procedure herself. But her followers may not realize this detail until they reach the end of her Instagram caption, where she directs readers to a blog post where, at the very end, she discloses her personal inexperience with the technique. Though this does not violate federal guidelines, nor those put forth by AxoGen, it does speak to the ethical obligation an influencer has to their followers.

The reality star’s Instagram post about the technique received almost 11,500 likes, giving ReSensation considerable exposure, yet Murphy omits disclosures required by both the FTC and FDA. She uses the term #partner to disclose that she is a compensated influencer, but the term is considered too vague, even for the FTC, for a user to clearly understand the relationship. She also fails to offer any information about the technique, disregarding federal guidelines to disclose risks and benefits that may impact patient decision-making. Instead, she directs followers to her blog where she discusses “a new technique designed to restore sensation in breasts after surgery,” lamenting the numbness in her breasts since her mastectomy and reconstruction.

Her blog post is where we finally learn the technique was not used on Murphy and cannot be used in conjunction with implant reconstruction, the most common and least complicated form of breast reconstruction, and the type of reconstruction Murphy underwent. Neither Murphy’s posts nor the ReSensation website discloses the success rate of the technique, instead focusing on an insecurity that has plagued mastectomy patients for decades: numb breasts.

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‘Pain is Weakness Leaving the Body’ and Other Lies I’ve Been Told: A Reading List on Mental Health and Sport

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Over two miles into my first Division I cross country race, I felt buoyant. My legs turned over like a well-oiled machine and my chest fluttered with promise: as a freshman, I was in third place for my team. I dug the metal teeth of my spikes into dirt and focused on maintaining an even clip. Lost in the reverie of the race, I almost didn’t see my coach standing on the sideline, her blond hair pulled back, face shadowed in a hat.

“Get your shit together,” she seethed as I ran past. Focused and faster than anyone anticipated, I glanced over at her, unsure whether she was speaking to me or someone else. But I was alone. “Move your fucking ass.”

The feeling of calm in my chest dissipated with her words, as if a balloon had been pricked, all the air let loose. Rather than ruminating on the strength in my legs, the smooth swish of my uniform against inner arm, my mind reeled. What was I doing wrong? I was already on pace for a significant personal record — was I supposed to be running faster? Had I appeared unfocused as I ran past?

When I look back at that first race, I always remember those words, the way the tension crept into my limbs. And the feeling stayed throughout the season. Nothing ever seemed good enough for Coach — she’d tell us we were a fucking shit show as a team when we didn’t run as fast as anticipated or when our outfits didn’t match or when we took too long on warmup. Before a race, we could either be a fucking hero and get our shit together or not. There was no in-between. I was 17 years old at the time, adjusting to life halfway across the country from my family, new food, a new sleep schedule, higher mileage, and learning the contours of socializing with my team, but those were not factored into my performance, nor was there any acknowledgment that adjusting to college — especially as a Division I athlete — can be a difficult, and stress-inducing situation.

My coach’s words were not unfamiliar to me. As an athlete, I’d been told iterations of get your shit together my entire career. In high school, no matter what our emotional state was, we were trained to say every day is a great day! The phrase, one my coach used to yell into the sunrise while he biked next to me, is scrawled all over the margins of my training journals, even when the descriptions of my runs read “hurt a lot,” “windy,” or “bloody toe.” Shirts at cross country meets featured sayings like pain is weakness leaving the body; champions train, losers complain; and seven days without running makes one weak. These slogans, intended to be humorous in some cases, emphasized the mentality that many sports do: athletes should be tough enough to overcome anything. If you don’t, it means you’re weak.

I internalized that way of thinking while growing up. I’ve been competitive as an athlete since I was in third grade, and I learned to ignore my emotions, focusing instead on external measures of time, pace, and mileage. My strategy earned me respect from coaches as someone who would train through anything — sickness, shin splints, a bone that grew threw my big toe — and place well in races, no matter what was happening in my personal life. When I placed well, I told myself I was satisfied. And when I didn’t, my entire sense of self-worth came tumbling down. I’d vow to work harder in practice, and the whole cycle would repeat itself ad nauseam; I was always chasing an invisible goal that remained just out of reach.

Midway through my freshman year, I began experiencing neurological issues. As I’d learned to do throughout my years of training, I tried running through the symptoms. Even when this ended in me collapsing on the track, I’d try and try again. To quit seemed unthinkable, but eventually I did. I experienced an acute bout of depression. Without running, who was I? Why hadn’t I been strong enough to push through? I berated myself for being weak, for symptoms out of my control, for losing a sport that had been my entire identity.

Eight years have passed since then, and I am finally learning to run in a way that honors both my physical and emotional health. I am growing more comfortable talking about my experiences with depression, and the way that running played a role in my self-worth for such a long period of time. In speaking about it, I have also realized that I’m not alone. Many athletes struggle with mental health issues, but the culture of sport — especially at the top tiers of competition — often emphasizes physical performance over holistic wellbeing. The culture is changing in ways, yes, but the rhetoric of athlete’s “overcoming” anything is still deeply ingrained in the language of coaches, and the way athletes speak to themselves.

In the following essays, athletes testify on their experiences with mental illness, factors that exacerbate mental illness in sport, and ways that we as a culture can begin to change our language and training in an attempt to support wellness emotionally as well as physically.

1. When athletes share their battles with mental illness (Scott Gleeson and Erik Brady, August 30, 2017, USA Today)

As Scott Gleeson and Erik Brady report, nearly one in five Americans experience some form of mental illness and, for athletes, because of the stressors of the sport, experiences with injuries, and overtraining, the percentage may be even higher. Testimony from a range of athletes — Michael Phelps, Jerry West, Brandon Marshall, Allison Schmitt, among others — about their experiences with mental illness and sport are featured in this piece, all of them urging athletes to speak up about their experiences, seek professional help, and change the culture of sport for the better.

“Sometimes, I walk in a room and regret being so naked and vulnerable, but this is bigger than me,” Imani Boyette says. “I believe my purpose is to talk about the things that people are uncomfortable or afraid to talk about.”

2. Everyone Is Going Through Something (Kevin Love, March 6, 2018, The Players’ Tribune)

On November 5th, at a home basketball game against the Hawks, 29-year-old Cleveland Cavalier Kevin Love began to experience what he now knows was a panic attack. In the days and weeks that followed, after medical testing and conversations with his team, he began to see a therapist, which is something he never envisioned himself doing, particularly because of his identity as a pro basketball player.

“Nobody talked about what they were struggling with on the inside. I remember thinking, What are my problems? I’m healthy. I play basketball for a living. What do I have to worry about? I’d never heard of any pro athlete talking about mental health, and I didn’t want to be the only one. I didn’t want to look weak. Honestly, I just didn’t think I needed it. It’s like the playbook said — figure it out on your own, like everyone else around me always had.”

In this candid and moving essay, Love breaks the silence surrounding mental health, particularly in regard to sport, and, as the title of his essay makes clear, recognizes that “everyone is going through something.”

3. U.S. Athletes Need Better Mental Health Care (Martin Fritz Huber, May 16, 2018, Outside)

After DeMar DeRozan of the Toronto Raptors tweeted about his depression and Kevin Love of the Cleveland Cavaliers penned a viral essay about his experience with panic attacks, the NBA, as Martin Fritz Huber reports, created a position for a director of mental health and wellness.

“I think that’s the biggest burden on American sport culture,” says Brent Walker, an executive board member with the Association for Applied Sport Psychology. “I’ve heard repeatedly from professional and elite athletes how they don’t want to admit having to having a weakness—mental [illness] being one of those.”

Huber breaks down how other countries approach mental health in relation to sport, and asks what it might take to adjust the current system in the U.S. so that athletes are supported.

4. No, Running Isn’t Always the Best Therapy (Erin Kelly, July 23, 2018, Runner’s World)

“Phrases like ‘Running is cheaper than therapy!’ and ‘I run because punching people is frowned upon,’ are routinely splashed on running-themed bumper stickers, social memes, and apparel, and reinforce the idea that running offers a healthy mental outlet.”

Though studies show that running has positive benefits on wellbeing and mood, Erin Kelly, in this well-researched personal essay, pushes back against the notion that running can cure everything. Instead, she advocates that athletes reflect on why they’re participating in sport, and seek therapy when needed in addition to logging miles.

Related Read: When a Stress Expert Battles Mental Illness (Brad Stulberg, March 7, 2018, Outside)

5. The WNBA Needs Liz Cambage, but She May Not Need It (Lindsay Gibbs, August 20, 2018, The Ringer)

As Lindsay Gibbs reports, toxic effects of systemic racism, unequal pay in the WNBA, and a string of losses left Australian Liz Cambage, who plays for the WNBA’s Dallas Wings, depressed.

“When she returned to Melbourne, Cambage ghosted almost everyone in her life and retreated into a world of depression and anxiety. She said she heavily self-medicated with prescription pills and alcohol. She said that she isn’t surprised by her on-court success this season.”

Cambage credits honesty — with herself and others — as the reason she’s emerged from the dark place where she was.

6. Split Image (Kate Fagan, May 7, 2015, ESPN)

Social media allows us to curate images that tell a certain narrative — one that’s not always the most honest. As Kate Fagan reports, Madison Holleran, formerly a runner at Penn, seemed like she had the perfect life based on her Instagram and texts.

“But she was also a perfectionist who struggled when she performed poorly. She was a deep thinker, someone who was aware of the image she presented to the world, and someone who often struggled with what that image conveyed about her, with how people superficially read who she was, what her life was like.”

After Madison committed suicide, her family and friends scoured old posts and texts for clues about what was wrong and the warning signs they missed. Ultimately, this piece asks us to consider what lurks beneath the surface of social media’s veneer.

Related read: Are Female Long-Distance Runners More Prone to Suicidal Depression? (Emily De La Bruyere, February 3, 2014, The Daily Beast)

7. Talent. A Football Scholarship. Then Crushing Depression. (Kurt Streeter, November 15, 2018, The New York Times)

“What experts know is this: Recent studies place suicide as the third leading cause of death for college athletes, behind motor vehicle accidents and medical issues.

And nearly 25 percent of college athletes who participated in a widely touted 2016 study led by researchers at Drexel University displayed signs of depressive symptoms.”

In this profile of Isaiah Renfro, a top freshman wide receiver at the University of Washington who attempted suicide, Kurt Streeter writes about the pressures placed on NCAA athletes, what it means to quit sport after building an identity as a high-performing athlete, the important role that coaches play in supporting athletes off the field and on, and the hope that Renfro now feels for his life after seeking treatment.

8. Sports Stats May Be an Ideal Measure of Mental Health (B. David Zarley, October 17, 2016, The Atlantic)

At the University of Michigan’s School of Public Health, associate professor Daniel Eisenberg is leading a team of researchers at Athletes Connected in order to help athletes understand mental-health problems and track concrete data on the subject. As B. David Zarley reports, Eisenberg and other researchers collect weekly mental-health surveys which focus on academic and athletic performances and levels of anxiety and depression in order to pinpoint connections between the two.

“I think sports and celebrity are two places where we can begin to lift the mental-health stigma, by showing that real people who perform, and who are well valued by society through their athletic contributions, do also suffer from symptoms of ill mental health,” says Chris Gibbons, a post-doctoral fellow and the director of health assessment and innovation at the University of Cambridge’s Psychometrics Centre.”

***

Jacqueline Alnes is working on a memoir about neurological illness and running. You can find her on Instagram and Twitter @jacquelinealnes.

Our Understanding of Sun Exposure and Health Keeps Evolving

Myung Jung Kim/PA Wire

Controversial new research is upending the narrative about sun exposure and vitamin D: that the most reliable way to avoid skin cancer is to avoid excess sunlight, always wear sunscreen, and to offset these measures by taking vitamin D supplements. As Rowan Jacobsen reports in Outside, D supplements are not very effective, and a group of scientists have discovered that the relationship between sun exposure and skin cancer is far more complex than we thought. One Journal of Internal Medicine article phrased it this way: “Avoidance of sun exposure is a risk factor of a similar magnitude as smoking, in terms of life expectancy.” But don’t call this all counterintuitive.

When I spoke with Weller, I made the mistake of characterizing this notion as counterintuitive. “It’s entirely intuitive,” he responded. “Homo sapiens have been around for 200,000 years. Until the industrial revolution, we lived outside. How did we get through the Neolithic Era without sunscreen? Actually, perfectly well. What’s counterintuitive is that dermatologists run around saying, ‘Don’t go outside, you might die.’”

When you spend much of your day treating patients with terrible melanomas, it’s natural to focus on preventing them, but you need to keep the big picture in mind. Orthopedic surgeons, after all, don’t advise their patients to avoid exercise in order to reduce the risk of knee injuries.

Meanwhile, that big picture just keeps getting more interesting. Vitamin D now looks like the tip of the solar iceberg. Sunlight triggers the release of a number of other important compounds in the body, not only nitric oxide but also serotonin and endorphins. It reduces the risk of prostate, breast, colorectal, and pancreatic cancers. It improves circadian rhythms. It reduces inflammation and dampens autoimmune responses. It improves virtually every mental condition you can think of. And it’s free.

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Alabama May Have Solutions to the Nation’s Black Maternal Health Crisis

Longreads Pick

Group prenatal care led by nurse midwives at a progressive clinic in Birmingham could offer a solution to the crisis in maternal health in the U.S.

Published: Sep 24, 2018
Length: 10 minutes (2,624 words)

Happy, Healthy Economy

Francesca Russell / Getty

Livia Gershon | Longreads | August 2018 | 8 minutes (2,015 words)

In 1869, a neurologist named George Beard identified a disease he named neurasthenia, understood as the result of fast-paced excess in growing industrial cities. William James, one of the many patients diagnosed, called it “Americanitis.” According to David Schuster, the author of Neurasthenic Nation (2011), symptoms were physical (headaches, muscle pain, impotence) and psychological (anxiety, depression, irritability, “lack of ambition”). Julie Beck, writing for The Atlantic, observed that, among sufferers, “widespread depletion of nervous energy was thought to be a side effect of progress.”

Recently, there have been a number of disconcerting reports that one might view as new signs of Americanitis. A study by the Centers for Disease Control found that, between 1999 and 2016, the suicide rate increased in nearly every state. Another, from researchers at the University of Michigan, discovered that, over the same period, excessive drinking, particularly among people between the ages of 25 to 34, correlated with a sharp rise in deaths from liver disease. A third, by University of Pittsburgh researchers, suggests that deaths from opioid overdoses, recognized for years as an epidemic, were probably undercounted by 70,000.

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Waiting for Mental Health Care

Waiting room
(Anthony Asael / Art in All of Us / Getty Images)

Do you need help? Ask for help. Do you need help now? Get in line.

In The Guardian, journalist Hannah Jane Parkinson responds to the many empty refrains encouraging mentally ill patients to just ask for help — a beyond-frustrating suggestion “when you’ve been asking for help and not getting it.”

There is a poster in my local pharmacy that exclaims, “Mental health can be complex – getting help doesn’t have to be!” Each time I see it, I want to scream.

I used to blame the system. Mostly it is the system: those never-ending cuts and closures; the bureaucracy; the constant snafus of communication; the government’s contempt for staff.

But sometimes, that system gets inside the staff, too. It is there when you are asked the same questions by 20 professionals, in a time of great distress, and then reprimanded for anger when you snap the 21st time. It is there when you are asked to fill out a form to assess a service, after being told you won’t receive that service until two birthdays in the future.

The waiting. The offers of therapies that aren’t suitable because there is nothing else. (Throwing a ball of wool to one another in a circle might be helpful for some people, but it absolutely wasn’t for me. I knew it wouldn’t be. But I gave it a go.) The being matched with a therapist who, through no fault of her own, is unsuitable (you have friends in common) but who you don’t ask to change because you know there isn’t another. The 10-minute GP slots that take weeks to secure.

After the sectioning and the 22-hour wait, there was a hospitalisation out of borough. Upon leaving the inpatient ward, there was a two-week stay at a crisis house (which helped), then that was it. I was ill enough to be sectioned, but well enough to have therapy discontinued. I was put on an 18-month waiting list for therapy. I called iCope, an NHS digital therapy service, but because I was on a waiting list, I was ineligible.

It took me about 16 weeks to get back to work – much longer than it should have done – because I had to clamber from a well without ropes. I would run into GP surgeries, suicidal; the receptionist said he would “pass the message on”. I sat in the consulting room, sweater over my head and howling.

Since I was sectioned, I have been hospitalised twice, once after a suicide attempt. I am still on a waiting list, a different one: this one is two years long. My friends and family simply do not understand the delay, cannot believe it when I tell them about the system. So, clearly, the Conversation isn’t as illuminating as it thinks it is.

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‘It’s nothing like a broken leg’: why I’m done with the mental health conversation

Longreads Pick

Hannah Jane Parkinson responds to so many empty refrains encouraging mentally ill patients to just ask for help, a beyond frustrating suggestion “when you’ve been asking for help and not getting it.”

Source: The Guardian
Published: Jun 30, 2018
Length: 14 minutes (3,513 words)

A Frustrating Year of Reporting on Black Maternal Health

Danielle Jackson | Longreads | June 2018 |3370 words (14 minutes)

“It’s in fashion to talk about black women’s maternal care,” Bilen Berhanu, a Brooklyn-based full-spectrum birth doula told me recently. I’d asked her about the outpouring of news stories, from multiple national outlets, about infant and maternal mortality over the past twelve months.

The reporting has added flesh and aching detail to what I’ve come to think of as an embarrassing public health crisis in the United States. Among industrialized countries, our nation has the highest rate of infant deaths. We’ve had dramatic declines since 1960, but we have not kept pace with other nations we’d consider peers. New American moms face similar danger: The rate of maternal mortality in the U.S. has been rising since 2000 while falling for most other nations in our subset.

Deep, persistent inequality — access to safe neighborhoods and hospitals, functioning schools, healthy food — plays a part. But across family income levels and educational attainment, the infant mortality rate for black babies is more than twice than it is for whites, according to data from 2007-2013. Black mothers are also more imperiled than white ones — they are three to four times more likely to die from pregnancy-related causes leading up to or within a year after giving birth. In New York City, black mothers are 12 times more likely to die than their white counterparts. Read more…

Feeding Our Kids, In Fatness and in Health

Illustration by Hana Jang

Lots of public health work in the U.S. focuses on the “obesity crisis” and how poverty and fatness intersect. But what stereotypes are we internalizing about poor parents and fat kids? What does it feel like to be a fat person doing this work? Harmony Cox, a fat food justice activist, tells us in her essay at Narratively.

We were discussing the neighborhood, and how we could help people here get healthier food. Creating access to healthy food is my job, but it’s also my passion. It’s how I pay my bills and find an outlet for my frustration with a society that allows the poor to suffer. I was hoping to hear some optimism. Instead I got this:

“Nobody would eat it. Everyone around here is just so… fat.”

I felt the folds of my belly pushing against the table. I felt familiar shame burn the back of my throat, bitter as a $7 coffee.

She went on, “The kids always eat fast food. It’s like nobody loves them.”

I wondered how she could know what the kids around here always eat, and what that has to do with how loved they are…

In the reality of feeding a struggling family, the food pyramid is irrelevant. Keeping us fed was a source of pride, junk food was a source of joy, and so our diets endured.

I don’t remember parents who didn’t love me. If anything, they loved me too much, and their love language came deep-fried. It may have hurt me in the long run, but that’s never been a sign that something wasn’t borne from love.

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My Life As a Public Health Crisis

Longreads Pick
Source: narrative.ly
Published: May 8, 2018
Length: 9 minutes (2,412 words)