Health Discourse Research Articles

Fearful Intimacies

This article explores how COVID-19 could be reshaping human–microbial relations in and beyond the home. Media sources suggest that intimacies of companionability or ambivalence are being transformed into those of fearfulness. While a probiotic sociocultural approach to human–microbial relations has become more powerful in recent times, it seems that health and hygiene concerns associated with COVID-19 are encouraging the wholesale use of bleach and other cleaning agents in order to destroy the potential microbial ‘enemies’ in the home. We provide a brief background to shifting public health discourses on managing microbes in domestic settings over recent decades across the industrialised world, and then contrast this background with emerging advice on COVID-19 from news and advertisement sources. We conclude with key areas for future research.

Hidden Subjects of Henna: Health Discourses Underlying the Memory of the Senses

Lokman Hekim Dergisi, 2020; 10 (1): 124-137 DOI: 10.31020/mutftd.650931 ile basılan makalenin 134. sayfasının 7. paragrafının 5. satırındaki “dilimin sınırları dünyamın sınırları değildir”33 cümlesinde yazan “değildir” ibaresi kaynakta yer alan anlam farklılığından dolayı yazar tarafından aşağıda belirtilen şekilde düzeltilmiştir.Bu bize, Wittgenstein’ın “dilimin sınırları dünyamın sınırlarıdır”33 cümlesini hatırlatmaktadır. Orijinal Makale: https://dergipark.org.tr/tr/pub/mutftd/issue/51847/650931

‘Complexity’ as a rhetorical smokescreen for UK public health inaction on diet

ABSTRACT ‘Complexity’ is theorised as a characteristic of modern food systems that poses a challenge to improving population diets. This paper seeks to explore the discursive deployment of ‘complexity’ in the context of public health. Doing so helps inform a more critical assessment of commercial and political determinants of health, and of ‘complexity’ as a prevailing frame for public health issues. Qualitative methods were used to explore ‘responsibility’ for healthy eating in the food system in the United Kingdom. Discourse analysis was conducted on corporate and government documents, and interviews with industry and government stakeholders. The aim was to examine the implications of ‘complexity’ within discourses of dietary public health. ‘Complexity’ was used not only to characterise dietary public health problems but also as a rhetorical device in public health narratives. It performed two main discursive functions: firstly, to represent diet-health problems as so multi-layered and difficult that they are intractable. Secondly, and despite this acknowledged complexity, to deflect from food system actions for improving diet to ‘simpler’ and non-food interventions, by industry and government. These uses of ‘complexity’ serve to attribute primary responsibility to individuals for dietary choice and to obscure inaction by government and industry, who have most control over the determinants of those choices. In short, ‘complexity’ can be used discursively to generate a smokescreen masking policy inaction in addressing public health problems.

Use of a Kinyarwanda-Based Edinburgh Postpartum Depression Screen in a Maternity Ward of a Major Referral Hospital [37K

INTRODUCTION: Maternal mental health has often been relegated to the margins of global women's health discourse despite mounting evidence of the disproportionate burden of common mental health problems among pregnant women in low-and middle-income countries. The Edinburgh Postnatal Depression Scale (EPDS) is a validated tool used to screen for perinatal depression. We developed a version of this screening tool in Kinyarwanda and administered it to 105 women receiving prenatal and postnatal care at the University Teaching Hospital of Kigali (CHUK). METHODS: IRB approval was obtained for this prospective study was obtained at Albert Einstein College of Medicine and CHUK from 2016 to 2017. An English version of the EPDS tool was translated to Kinyarwanda and administered to 105 women who consented to participate in this survey project. Descriptive and comparative analysis was performed using STATA 16. RESULTS: The majority of women completing our survey were young, multiparous, with at least a primary school education (59%). Most of the women completed the EPDS while postpartum and 85% had an EPDS score less than 10. Higher levels of educational attainment were significantly associated with an EPDS score less than 10 (P<.05). 55% of women surveyed felt that postpartum depression is an issue affecting their communities, with over 60% of women agreeing that stigma prevents pregnant women from seeking help for mental wellness. CONCLUSION: We identified level of educational attainment as a factor associated with a low EPDS score among women admitted at a maternity ward in a large referral hospital in Rwanda.

DOES LEADERSHIP STYLE INFLUENCE HEALTH STATUS OF LEADERS, AND IS IT A NEW DETERMINANT OF HEALTH?

Introduction: The discourse of health and leadership has not empirically established whether leadership styles (transactional, transformational, and laissez-faire) is a health determinant.
 Objective: This study seeks to examine whether selected demographic characteristics and leadership styles are factors of self-reported general health status.
 Methods and materials: A standardized questionnaire was developed to evaluate whether or not leadership styles are correlated with health status and if this should be included as a new health determinant. This was administered between August and September 2019. The population for this research was leaders who serve in Seventh-day Adventist Churches in Central Jamaica. Statistical significance was determined a p-value less than or equal to five percentage points (≤ 0.05)– two-tailed test. Multivariate analyzing (logistic binary regression) was used to model factors influencing the good health status of the sampled respondents, and exploratory factor was used to determine the suitability of the indexations such as leadership styles and self-reported health status.
 Results: Three variables emerged as statistically significant predictors of self-reported good health status of leaders (transformational leadership: OR=19.241, 95%CI: 3.225-114.8, R2=47.6%; Transactional leadership: OR=0.143, 95%CI: 0.31-0.664; and age of respondents: OR=0.954, 95%CI: 0.911-0.999). Based on the Nagelkerke R Square, 48% of the variance in good health is explained by age, transactional and transformational leadership styles.
 Conclusion: Leadership style is a potential determinant of health (social determinant) that offers further explanation of people’s well-being (health) that cannot be discounted any longer.
 Keywords: Health determinants, transactional leadership, transformational leadership, laisses-faire leadership

Using photovoice to identify sexual health needs in Latina early adolescents

ABSTRACT Adolescence is a period of exploration of sexuality and of its integration into personality. Existing research on Latina adolescents, however, has been largely limited to disease and pregnancy prevention, ignoring the integration of sexual well-being with other aspects of health. Accordingly, this paper presents findings from a photovoice project with 11–12 year old Latina students, implemented to investigate topics related to cultural identity, gender and sexual health. The data were generated over a 12-week period in an urban middle school in Central Texas by 17 youth collaborators. Findings provide a platform for discussion of how Latina young people’s ideas align with or diverge from current sexual health discourses within a racial/ethnic context. We highlight opportunities and constraints with regard to identifying sexual health needs from young Latina students’ own perspectives, in an attempt to contribute to the body of literature on sexual health in middle school students, as well as the lessons learned through our efforts.

From Sacred to Secret: Tracing Changes in Views of Menstruation in Japan

This paper examines understandings and experiences of menstruation in Japan, by tracing shifts in views of menstruation throughout Japanese history and analyzing ethnographic interviews conducted with college-aged Japanese women in 2018. Once considered a mystical phenomenon, menstruation came to be seen as a source of pollution, surrounded by various taboos and proscriptions. Then, around the turn of the twentieth century, views of menstruation shifted again; menstruation was no longer a cause of spiritual defilement. Instead, ideologies of moral and physical hygiene that dominated education and public health discourse in twentieth-century Japan positioned menstruation as an issue of hygiene that should be managed through proper bodily comportment and careful use of commercial menstrual products. While hypothetically ‘free’ of connotations of impurity and pollution, women still were not – and are not – free from stigma surrounding menstruation. Today, public discourse on menstruation is virtually nonexistent outside of menstrual product commercials, and menstruating women carry out vigilant routines of concealing their menstrual status, creating an illusion of absence. Young women’s reported experiences of compulsory swim class in grade school, as well as recent news articles discussing the topic, are used in this paper to highlight both the social and health issues currently surrounding young menstruators in Japan.

Food and Mood: Exploring the determinants of food choices and the effects of food consumption on mood among women in Inner London.

Introduction: The aim of this study was to explore the relationship between food and mood against the backdrop of increased mental health and nutrition cognizance within public health and scientific discourses. Mood was defined as encompassing positive or negative affect.
 Methodology: A constructionist qualitative approach underpinned this study. Convenience sampling in two faith-based settings was utilised for recruiting participants, who were aged 19-80 (median,48) years. In total 22 Christian women were included in the research, eighteen were in focus groups and four were in individual semi structured interviews. All were church-attending women in inner London. A thematic analysis was carried out, resulting in four central themes relating to food choice and food-induced mood states.
 Findings: Women identified a number of internal and external factors as influencing their food choices and the effect of food intake on their moods. Food choice was influenced by mood; mood was influenced by food choice. Low mood was associated with unhealthy food consumption, apparent addiction to certain foods and overeating. Improved mood was associated with more healthy eating and eating in social and familial settings.
 Discussion: Findings indicate food and mood are interconnected through a complex web of factors, as women respond to individual, environmental, cultural and social cues. Targeting socio-cultural and environmental influences and developing supportive public health services, via faith-based or community-based institutions could help to support more women in their struggle to manage the food and mood continuum. Successful implementation of health policies that recognise the psychological and social determinants of food choice and the effect of food consumption on mood, is essential, as is as more research into life-cycle causal factors linking food choice to mood.

The fantasy of healthy food: desire and anxiety in healthy food guide magazine

ABSTRACT Healthy Food Guide (HFG) has been a hugely successful magazine, both dominating the health magazine market and becoming deeply imbedded within the public health discourse, sanctioned and legitimated through a range of State apparatuses. Central to this has been an ability to differentiate itself from ‘restrictive diet programs’ and other forms of ‘misleading’ health advice, which they claim, unlike their magazine, are ungrounded in the latest scientific evidence. Through a qualitative analysis of the lead article in every issue of HFG from 2005 to 2017, we question its endorsement by New Zealand public health agencies, arguing that it acquires revenue through the intensification of health anxiety within its target readership. It does this through constructing its ideal reader as a health entrepreneur within the discourse of new public health, able to collect the right information to make the appropriate consumer choices, within a risk-saturated marketplace. A key contribution of this article is bringing a Lacanian psychoanalytic theory to the broad area of public health, which has been so far under-applied. By linking Lacanian theory to the health entrepreneur, we developed that concept by foregrounding the roles of desire and anxiety in healthism discourse. We argue that the consumer of HFG is bound to its libidinal economy in a relation of domination, whereby they are given the task of allaying anxiety through the collection of data on their bodies, information which only produces more anxiety.

Identity and Hooking up at a U.S. “Party School”

ABSTRACT “Hooking up” encompasses an array of definitions, embodies a multitude of implications, and is an almost unavoidable part of college life. The present study applies identity theory to patterns of casual sex and dating at college, more predominantly known as hookup culture, to examine how the “partier” identity shapes drinking, partying, and hooking up. More specifically, we incorporate structural and perceptual control aspects of identity theory, expecting to find that commitment to, salience of, and endorsement of meanings associated with the “partier” identity will increase hookup likelihood. In doing so, we move beyond a public health discourse of hookup “risks” and frame this sexual behavior as a form of identity verification deeply embedded in social relationships and the self. We utilize two waves of data collected six months apart from 19- to 27-year-old college students at a large, southeastern public university (n = 197). Path analyses were conducted in which we control for characteristics typically associated with hookup culture, finding limited effects of demographic characteristics (e.g., race, drinking, and Greek life membership) on behavior. Instead, we largely find support for the proposed direct and indirect effects of identity theory’s concepts, collected at Wave 1, on hook up behaviors at Wave 2.

Political discourse, military and securitization of health nexus: contemporary security challenges and the military role in public health security

The purpose of this paper is to provide answers to the questions why health is viewed through the lens of national and international security, and what might be the potential role of the armed forces in strategic response to health security challenges. Relying on theoretical settings of Foucault’s discourse studies and securitization concept developed by the Copenhagen School of security studies, authors will try to illuminate the nexus between political discourse, military and securitization of health. The analysis of the political and academic discourse has found that with regard to security the most important health challenges are considered the occurrence and spread of infectious diseases, especially HIV/AIDS, and the ability to make use of biological agents as weapons. As the most important reasons why health is viewed through the lens of security are considered to be major economic losses incurred due to health crises, high mortality rates, migration, the impact of health crises on the armed forces and peacekeeping operations. The paper concluded that the armed forces play a role in the public health security through monitoring and early warning, through epidemiological and laboratory opportunities for early detection of new epidemics or pathogens, as well as through providing assistance after major natural disasters. The paper analyzes the public health and security in the Republic of Serbia, and it was concluded that it is necessary to undertake more efforts in recognizing health as a field of national security, and health risks as the risks of security.

Using Facebook to tell stories of premature ageing and sexual and reproductive healthcare across the life course for women with cerebral palsy in the UK and USA

ObjectiveTo enhance understanding of the bodily and lifestyle effects of ageing with cerebral palsy (CP) for women, with a particular focus on experiences with sexual and reproductive healthcare (SRH) services...

Hidden Subjects of Henna: Health Discourses Underlying the Memory of the Senses

Giriş: Bu araştırmada kınanın sağlık söylemleri altında yatan duyuların belleği çalışılmak istenmiştir. Sağlık söylemleriyle örtülü olan bu anlatıların altında, kişilerin kendine özgü kına ile ilgili duyuların belleği yatmaktadır. Araştırma kına ile ilgili sağlık söylemlerinin içine gizlenmiş olan duyu belleklerini çalışmaktadır. Yöntem: Bu araştırma, 2017 Nisan - 2019 Haziran yılları arasında çeşitli aralıklarla yapılarak devam etmiştir. Araştırmada kınayı sağlıklı bulduğu için saçlarına, el ve ayaklarına yakan ve bu yüzden gündelik yaşamının bir parçası haline getirmiş olan on kadın ve dört erkekle derinlemesine görüşme yapılmıştır. Saçlarına düzenli kına yakan iki kadın katılımcımla birlikte, saçlarıma kına yakarak hem sağlık açısından olan etkilerine bakılmış hem de bir ritüel olarak deneyimlenmiştir. Bir süre devamlı uygulayarak katılımlı gözlem yapılmıştır. Aynı zamanda kınanın sağlık açısından önemli olduğu vurgusunu yapan bir fitoterapistle derinlemesine yapılandırılmamış görüşmede bulunulmuştur.Bulgular: Sağlık anlatılarının içine gizlenmiş olan duyuların belleği, kendini kınanın kokusunda, renginde ve ritüelinde açığa çıkarmaktadır. Maddi kültür öğesi olan kınanın, kokusu, rengi ve ritüelleri, kişilere geçmişte yaşamış oldukları anılarını hatırlatmaktadır. Bu anılar, onlara kendilerine iyi gelen bir takım duyguları hissettirmektedir. Kınayı sağlıklı bulduğu için gündelik yaşamında sıklıkla kullanan bu kişiler, kınanın kendilerine hatırlattığı bu duygu ve hisleri bedeninde cisimleştirmektedirler. Ancak kişiler bunu bilinçli olarak değil; içselleştirilmiş bir sağlık davranışı örüntüsü olarak gerçekleştirmektedirler. Bu görüşmelerden çıkan bulgular, sağlık açısından kına yakmanın doğrudan tıbbi bir iyileştirici etkisi inancının altında; kınaya yüklenen duyusal algıların güçlü bir bağı olduğu görülmüştür. Bu bağın arka planında ise “kültürel bellek” yatmaktadır. Bu durum, “duyuların belleği” (the memory of the senses) kavramı üzerinden söylem analizi yapılarak yorumlanmıştır. Kınanın ‘koku’sunun, ‘rengi’nin ve ‘dokusu’nun, kişilerin duyusal hafızasına kazınarak duygularına nasıl yerleştiği ve bedenlerinde nasıl cisimleştiği, kişilerin sağlık söylemleri üzerinden tartışılmıştır. Sonuç: Dolayısıyla kına bazı durumlarda iyileştirici olarak, tıbbi bir ilaç yerine geçen alternatif olmaktadır. Bu alternatifin kendilerine hem ruhen hem de bedenen iyi geldiğini söylemektedirler.Düzeltme:https://dergipark.org.tr/tr/pub/mutftd/issue/54355/707166

Monitoring the 'diabetes epidemic': A framing analysis of United Kingdom print news 1993-2013.

The view that we are in the midst of a global diabetes epidemic has gained considerable ground in recent years and is often linked to the prior 'obesity epidemic'. This research explored how the diabetes epidemic was represented in United Kingdom (UK) news over the same time period that the obesity epidemic was widely reported. The research was motivated by a sociological interest in how postmodern 'epidemics' synergise with each other amidst broader political, economic, moral and sociocultural discourses. We analysed three time-bound samples of UK news articles about diabetes: 1993 (n = 19), 2001 (n = 119) and 2013 (n = 324). Until now, UK media has had the least attention regarding portrayal of diabetes. We adopted an empathically neutral approach and used a dual method approach of inductive thematic analysis and deductive framing analysis. The two methods were triangulated to produce the findings. Framing of diabetes moved from medical in 1993 to behavioural in 2001, then societal in 2013. By 2001 obesity was conceptualised as causal to diabetes, rather than a risk factor. Between 2001 and 2013 portrayals of the modifiable risk factors for diabetes (i.e. diet, exercise and weight) became increasingly technical. Other risk factors like age, family history and genetics faded during 2001 and 2013, while race, ethnicity and culture were positioned as states of 'high risk' for diabetes. The notion of an 'epidemic' of diabetes 'powered up' these concerns from an individual problem to a societal threat in the context of obesity as a well-known health risk. Portraying diabetes and the diabetes epidemic as anticipated consequences of obesity enlivens the heightened awareness to future risks in everyday life brought about during the obesity epidemic. The freeform adoption of the 'epidemic' term in contemporary health discourse appears to foster individual and societal dependence on biomedicine, giving it political, economic and divisive utility.

Refugee Articulations of Health: A Culture-Centered Exploration of Burmese Refugees’ Resettlement in the United States

ABSTRACT Grounded in the culture-centered approach that emphasizes dialogic engagement with communities at the margins to disrupt mainstream health discourses, this article explores articulations of health by the Burmese refugee community in the United States post resettlement. Due to forced migration, often fleeing violent political regimes in their home countries and surviving itinerantly in refugee camps and host countries, they face further disenfranchisement upon resettlement as a subset of immigrants who are thrust into an unfamiliar sociocultural setting with marginal federal support. Against this backdrop, the present research explores the narratives of Burmese refugees in the United States through in-depth interviews focusing on their meaning-making practices surrounding health and displays of agency in the face of structural healthcare barriers. The participants’ narratives articulate health as communal and familial safety in contrast to the mainstream discourse of disease prevention and individual lifestyle choices. They describe structural barriers to healthcare access in the form of the employment-insurance nexus, and also an intricate web of lack of access to health services resulting from linguistic isolation. Within such constraints they locate agency by utilizing community networks as mediators for infrastructural and cultural access and engage in practices seeking out providers with interpreters from within the Burmese community, as well as utilizing technology such as listservs and e-mails through informal networks often ignored by mainstream healthcare providers in the community.

“Can naughty be healthy?”: Healthism and its discontents in news coverage of orthorexia nervosa

Orthorexia nervosa was first proposed as a diagnosis in 1997, referring to a pathological obsession with healthy food. While not formally accepted by the medical establishment, since its inception, it drew the attention of news outlets around the world. This paper examines almost two decades of news coverage about orthorexia to understand how writers have made sense of the proposed diagnosis. Based on an inductive thematic analysis of 492 articles, I find news stories have overwhelmingly framed orthorexia as a medical problem but relied on narratives that mix moral and medical beliefs to explain what is problematic about it, depicting it as absurd, obnoxious, paradoxical, and dangerous. I also examine how shifting explanations of orthorexia's causes differentially allocate responsibility, presenting it as a matter of personal choice when associating it with diets, while presenting orthorexics as victims in technology-focused explanations. I compare orthorexia coverage with discourses about obesity and eating disorders to show how the label simultaneously draws from and contests preceding health discourse. While narratives about orthorexia demonstrate the pervasiveness of medicalization, I suggest they can also be read as a backlash against healthism, relying on metaphors of mental health, illness, and risk to speak to healthism in its own language.

The Discourse of Climate Change and Womens Health: Some Insights on Gender Mainstreaming

Climate Change has an overwhelming health impact on all, especially on the women, constituting around 49. 58% of the global population. There is ample literary evidence in support of the claim that a changing climate has a differentiated impact on humanity and that it is not “gender neutral”. Climate driven food scarcity, poor air quality, rising temperature and extreme weather events (floods, droughts, heat waves etc. ), acute water shortage, increasing incidence of vector borne diseases make the situation all the more dreadful for women in particular. And this vulnerability gets even more critical because of various biological, political, social and cultural factors that historically contributed against women and their empowerment. Though women are reservoirs of indigenous knowledge about how to deal with the aftermath of climatic changes, yet they remain largely untapped. However the importance of gender based climate action plan was long absent in arena of international climate negotiation. It was only in COP7 (2001) where women’s involvement in climate action had first caught global attention and subsequently nodal international bodies are working on formulating programmes and appropriate policies for promoting gender balance. However, the progress on this has been limited in comparison to the magnitude of impacts of climatic changes on women’s health and hence much more needs to be done on the policy front so as to promote gender equity and women’s participation in various adaptation and mitigation policies.

The Wild and the Toxic: American Environmentalism and the Politics of Health. By Jennifer Thomson

Jennifer Thomson’s The Wild and the Toxic is a concise, pointed, and sometimes provocative intervention into the history of environmentalism. Thomson examines how an amorphous and shifting discourse of health has shaped environmental politics over the past half century. In four main chapters—each a case study of individuals and organizations well-known to environmental historians—Thomson illustrates how the tension between ecological and human health played out in several important campaigns and issues. As Thomson shows, environmental activists and scholars conceptualized health in different ways and drew different lessons about how individuals and governments should act to achieve desirable environmental health outcomes. Focusing on Friends of the Earth, the Love Canal Homeowners Association, bioregionalists and Earth First!, and James Lovelock and Bill McKibben, Thomson sets out to “illuminate how health entered environmental politics and what claims about health offered to political activists” (11). As she demonstrates in her chapter on Friends of the Earth, conceptions of health and the environment did not always remain consistent or static, even within one organization. Throughout its first decade or so, FOE took a holistic approach toward environmental health and argued that a regulatory state should be responsible for protecting society from the pollution and environmental despoliation that results from industrial capitalism. By the mid-1980s, however, FOE gravitated toward a more reductive and individualistic framing of health that was in line with the rise of neoliberalism. Similarly, Thomson argues, renowned environmental thinkers such as James Lovelock and Bill McKibben found it difficult to develop a vision of ecological health that was not influenced by, in Lovelock’s case, his work with NASA and Shell, and in McKibben’s case, his white, middle-class liberalism.

Identification of dimensions and indicators of spiritual health: A qualitative study.

INTRODUCTION:Spiritual health is considered one of the important dimensions of health and has been given serious attention by the scientific community, World Health Organization, health discourse, and medical education. However, despite these considerations, there is a controversy in defining the nature of this category and its dimensions and indicators. The purpose of this study is to identify the indicators and dimensions of spiritual health for medical students.MATERIALS AND METHODS:This qualitative study with exploratory approach utilized conventional content analysis and individual in-depth interviews with experts in the area of spiritual health and spirituality in medical sciences selected through purposeful sampling. The study was conducted at Aja University of Medical Sciences in Tehran in 2018. The semi-structured interview was a tool used to achieve data saturation, that interviewed with 19 experts. Member check, credibility, and reliability were measured to increase the validity and reliability of the results. Inductive content analysis was used for the analysis of data in three main phases: preparation, organization, and categories and creating categories.RESULTS:Based on the findings of the interviews, 52 indicators were identified.Then, the indicators of spiritual health were identified in the following four categories) relationship with God, relationship with himself, relationship with others, relation with the environment (and these categories were divided inthree dimentions (cognitive, attitudes and emotions, behavioral)CONCLUSION:The findings of the present study showed that in order to have spiritual health, it is important to pay attention to one's relationship with God and one's relationship with oneself, one's relationship with others, and one's relationship with the environment, and it is necessary to pay attention to it in medical science curricula.

Probiotics Potential of Yeast and Lactic Acid Bacteria Fermented Foods and the Impact of Processing: A Review of Indigenous and Continental Food Products

Probiotics have become essential in food safety and health discourse with interest in their availability, stability, nutrition, and health implications. In this paper, an overview of probiotics of yeast and lactic acid, bacterial fermented food is presented. Probiotics of Lactobacillus spp. and Bifidobacterium spp.’s activities and processes within the human intestinal system are examined. Yeast and lactic acid bacterial (LAB) fermented foods from classified food groups such as vegetables, cereals, and grains, soybean, milk, fish, meat, and beverages are examined. This paper focuses on probiotic (microorganism) strains identified with food and their potential health and nutrition benefits. Finally, the impact of processing parameters and non-process factors on probiotics potential in fermented food is investigated.