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Public-Private Partnerships: A contentious issue that demands discussion

An issue that keeps coming up at conferences I’ve been at lately has been the role of industry in public health. It’s an interesting question, as funding for prevention requires a level of political will and foresight that will not lend immediate dividends, and may not for 10, 20 or even 30 years. Given how many politicians now exist in a perpetual election cycle where any misstep is captured and covered ad nauseum, not having immediate payoffs are a risky proposition. Add to this an aging population that requires immediate and tangible medical care, and (in those countries that have public healthcare) there is a tough decision that has to be made: immediate and tangible dividends, or long term goals that you may not be around to enjoy.

As a result, groups have turned to other partners to acquire funding for public health interventions. These range from other public health groups, NGOs/NPOs as well as industry. While there isn’t much controversy surrounding the first two groups, the third raises no shortage of concerns among both public health people and the public. The basic question is this: Can we partner with industry, and if so, how can we partner with them in a way that keeps both sides happy?

I’ve been mulling this post over for a while now, as there isn’t an easy answer to the above question. As mentioned above, this is an issue that keeps coming up – especially in the obesity area (which comprises one of the focuses of my PhD dissertation). It culminated in an event organized by the Canadian Obesity Network – Student and New Professionals National Executive where they invited 4 speakers to speak on the issue – ranging from those who were profoundly against partnership, to those who were all for partnership, and even those in between. I’m not going to go into whether or not you *should* partner with industry, as both sides of this debate have been covered very well by Dr Arya Sharma and Dr Yoni Freedhoff in their respective blog posts on the topic.

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The Problem with “Fighting” Cancer

B0007784 Lung cancer cells
Lung Cancer Cell by wellcome imagesCC BY-NC-ND 2.0

Last time I spoke to you about wording and public health, and the unintentional impact that can have on people. I want to continue on that theme today, and talk about what is perhaps one of the most pervasive, and more controversial language choices that we as as a society have made: the military language we use around cancer. Often, the media (and by extension, society) describe someone with cancer as a “warrior” who “battles” cancer. This language isn’t rare, and has been around since the mid-70s when Susan Sontag wrote her book “Illness as a Metaphor.” Research by Seale (2001) states:

News stories commonly feature sports celebrities with cancer, as well as sporting activities by ordinary people with cancer, designed to generate a sense of (usually successful) personal struggle.

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#overlyhonestmethods – Reaching out with humour

For a week and a half, I was a minor internet celebrity!

Science has an awkward relationship with the public. There’s a perception that we exist in an ivory tower, and the common media perception (as is evident by shows like The Big Bang Theory) is that we’re somewhat socially inept, with a lack of people skills and an inability to talk about our work in a way that others can understand.

So I was thrilled when #overlyhonestmethods became a thing. There have been many little science in-jokes floating around the twittersphere; one of my favourite was the hashtag #middleearthpublichealth which came out right before The Hobbit released in theatres. Tweets like “Craving the ‘Precious’: Gollum, a case study of the public health impact of severe ring addiction, Lancet 2010” abounded, and they illustrated public health rather nicely (for more, check out Brett Keller’s blogpost). However, they only catered to a niche audience: public health professionals, and public health professionals who got the Lord of the Rings references.

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New Post on PLOS Blogs Sci-Ed: The Power of Words

Words
Words are powerful. Photo courtesy ManchesterMonkey

In public health we’re faced with a dilemma. We want to help people – that’s our goal, that’s why we do what we do. But at the same time, we also need to be careful how we approach public health concerns – the last thing we want to do is further stigmatize the very people we’re trying to help. One of the most subtle, but most powerful ways we can either empower or belittle others is in the language we use.

One area at the forefront of this is the field of mental health research. The “traditional” language would be a “X person,” where X refers to any mental health issue. But this isn’t the best language to use. For one, it defines the person by their illness – not by who they are. They have X, first and foremost. Not their interests, their personalities, their hobbies. They’re labelled and defined.

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New Post on PLOS Sci Ed: Unintentional Benefits of Open Access: The broader impact of making publications free

Library
The Carleton University Library. I spent many hours here, studying, photocopying, sleeping. Photo via Emilybean

When I was in undergrad, we would photocopy articles down in the basement of MacOdrum library at my alma mater, Carleton University. You’d have to find the call number of the journal, head down into the basement, find the right row, then bookshelf, and finally discover someone had already taken the journal to photocopy it. I learned quickly to check the photocopy room first to see if someone already had the article rather than looking for it first.

But now we’ve moved into a world where everything is done electronically. Through the power of PubMed, Google Scholar and numerous others, you can obtain PDFs of many articles via your institution. And now, many of those articles are available under Open Access rules – so anyone can access them, regardless of academic affiliation.

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Movember ends, but the message lives on

https://i0.wp.com/ca.movember.com/uploads/images/Home/About%20Movember/ABOUT_3.jpg

I’m going to get up onto my soapbox and rant a little.

Friends. Movember is drawing to a close, and I thank you all for your support, financial and otherwise. And for those of you mocking me for growing such a glorious Mo, well, you’re just jealous.

But there’s more to Movember than just growing a Mo.

There’s the issue of Men’s Health, which sometimes gets lost in the messaging. While women are very proactive and supportive of women’s health issues, men have a level of indifference that is concerning and don’t seek out help (see references below). One of the major reasons Bros don’t seek out help is due to embarrassment. Why? Because we’re afraid of being made fun of? Because we figure if we ignore it it’ll “just go away”? Because we don’t want to appear “weak”? The consequences of not seeking help could include cancer, depression or worse. What’s weak about tackling those issues? Those are incredibly tough things to deal with – if anything they require more strength. If you’re a Mo Bro, get your annual physical. Get checked out. Go see the doctor if you need it – don’t wait. Talk to a healthcare professional if you need it, and make an informed decision on your future. Many health issues are curable and treatable if caught early – the longer you wait the worse they can get. For all the Mo Sistas and Mo Bros out there, support your Bros. Mo Bros are likely to put off seeing the doctor and ignore health concerns, but with support this attitude can shift.

We’ve all had a good laugh over this month, and it’s a fun month for sure. But let’s not forget the serious health consequences that this month highlights.

For more information, check the Movember page on Men’s Health Issues.

Thanks to Michelle D for the idea for this post and Vanessa V for feedback.

References:
Tudiver F, Talbot Y. Why don’t men seek help? Family physicians’ perspectives on help-seeking behavior in men. J Fam Pract. 1999 Jan;48(1):47-52.
Winerman, L. Helping men to help themselves. Available online.
Vogel, DL, Heimerdinger-Edwards, SR, Hammer, JH, Hubbard, A. “Boys don’t cry”: Examination of the links between endorsement of masculine norms, self-stigma, and help-seeking attitudes for men from diverse backgrounds. Journal of Counseling Psychology, Vol 58(3), Jul 2011, 368-382

Perceived weight status, actual weight status and weight control

Obesity is accompanied by many health risks, including diabetes, heart disease and musculoskeletal problems. Small decreases in weight have been associated with decreases in the risk of these adverse health outcomes, however, sustained weight loss is incredibly difficult to accomplish.

It has been well documented that people underestimate their height and weight (see my previous post on parental perceptions of child BMI). However, does knowledge of one’s weight affect willingness to start weight control behaviours? How much does your perceived weight differ from your actual weight? And more importantly, can health care professionals affect starting weight control behaviours?

More after the jump.

Continue reading “Perceived weight status, actual weight status and weight control”

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