Session Summaries

Sessions 1-4 Introductory sessions and analytical frameworks

Introduction to the course and the analytical frameworks


Throughout this course, the underlying assumption will be that health is a human right, based on wide-ranging principles and covenants that are encoded in the aspirations, religions, and laws of many countries, as well as within the constitution of the World Health Organization, part of the United Nations. The right to health is the economic, social, and cultural right to a universal minimum standard of health to which all individuals and peoples are entitled. The right to "the highest attainable standard of physical and mental health" is not confined to the right to health care but embraces a wide range of socio-economic factors that promote conditions in which people can lead a healthy life, and extends to the underlying determinants of health. The rapidly growing field of Health and Human Rights both illustrates these principles and documents some of these actions as well as practical applications of these concepts and the illumination of laws that need to be changed. On the other hand, neo-liberalization doctrine is far-reaching and often incompatible with human rights principles.

[Note: In 2005, the WHO established the Commission on Social Determinants of Health to provide advice on how to reduce persistent and widening health inequities. The report of the Commission and the WHA [World Health Assembly] resolution 62.14 provide specific recommendations on reducing health inequities through action on the underlying determinants of health as part of a human rights approach.]

2 Analytical framework: Structural critiques of capitalism and mechanisms of exclusion I

Capitalism, Racism and Patriarchy are the overarching powerful elements that dictate structural inequalities through classism, racism, sexism at the macro level and several mechanisms that function between the structure and individuals. These mechanisms are largely responsible for health disparities. In this class we will begin with a review of health disparities and then will discuss: discriminatory stress, and micro-aggressions. These mechanisms serve to curtail life chances, maintain power, dominance and privilege and lead to stress which reduces life expectancy through cellular processes, causes low-birth babies, problems with mother-infant attachment and a variety of mental health problems.

3 Analytical framework (cont.): Structural critiques of capitalism mechanisms of exclusion II

Continuing on the subject of exclusionary mechanisms from last class, we turn to stereotype threat and internalized oppression (racism, sexism, and classism).


Analytical framework: Feminism, feminist theory, and inter-sectionality

Shame, silence and secrecy: The case of menstrual health

As we know, healthy living requires access to quality information. But certain taboos complicate, and even prevent many people from such access. Traced throughout the Historical record, enduring shame, silence and secrecy surrounding menstruation is still present in diverse sociocultural contexts and the consequences can be profound. Here, we interrogate the case of menstrual health as a window to how cultural norms themselves can and do shape health outcomes with particular attention to emerging consumerist interventions into menstrual health care.

5 Corporate obstetrics and care-less maternity; or how childbirth went to the industrial north What if just about everything you thought you knew about childbirth was wrong? Most U. S. women believe their mothers and other women's stories, that giving birth is excruciatingly painful, that delivering babies is a science best left to medically trained experts, with large hospitals the only really safe places for birth. Most Global Health experts promote these beliefs across the world. Most rely heavily on Obstetrics, a surgical specialty of medicine, for trusted information. This authority and expertise is part of "the best health and medical care in the world" as we're often told. It's hard to listen to clear evidence that midwives' outcomes are comparable to or better than usual care, or that birth center or home births can be safe. Evidence that corporate practices or institutional rules can and do affect clinical judgments, or that media propaganda may influence "scientific" studies or our own opinions is even harder to take seriously. Today's middle-class US women pay willingly for the world's most expensive maternity care while U. S. overall Infant and Maternal Mortality rates keep rising higher than in all other industrialized countries, while cesarean sections now exceed one-third of all births, increasing risks to both mother and newborn. Non-white maternal outcomes continue worsening—four times higher than those of white women. Yet most mothers interviewed claim satisfaction with their maternity care, happy to pay even more for ever more invasive technology, while poor women have virtually no choices. Why do European countries do better? How can we explain all these paradoxical facts, against the backdrop of western industrial, capitalist, and racist societies, while exporting most of these failing policies and practices to the Global South?
6 Reproductive justice and the abortion wars: The color of resistance Everyone recognizes that abortion rights remain among the most contentious issues of "second wave" feminism's reproductive justice agenda worldwide. Women from every kind of background continue to need and to obtain abortions, regardless of enabling legislation, yet media and public focus remain fixed on dominant white women's concerns, ignoring the inseparable links between economic, social, and reproductive justice for all women. We analyze multiple sources of controlling power over different women's reproductive decision-making, especially capitalist state power used to discriminate against and punish the most vulnerable, powers and laws derived from patriarchal religion, racism, culture, and medical ideology.
7 Where fat phobia and public policy meet: The case of the "obesity epidemic" The cultural fat panic, some argue, is potentially more damaging than the so-called obesity epidemic itself. Why are fat people considered a legitimate target, and how does size discrimination intersect with both racist and classist constructions of the 'good body?" Furthermore, why are many scientists and policy makers alike prone to collapsing ill with size and shape? What are the alternatives to the sloppy science and fat phobia that shapes the current discourse? Finally, what can we learn from the burgeoning Health At Every Size Movement and other fat activist interventions that urge a more nuanced and less shaming dialogue that promotes health and inclusion.
8 Student presentations of Op-Eds No summary for this session.
9 When bodies don't fit: The case of intersex How can pressures toward normalization actually cause physical and psychological harm? Today in the U. S., it is standard medical practice to "correct" anatomical differences detected in newborns, but are such protocols in the best interest of the non consenting newborns? For many intersex children and later adults, humiliating exams, a dearth of information, countless invasive procedures, and heteronormative directives can and often do produce unnecessary suffering in service of our ever-rigid gender / sex binary.
10 Violence against women: The case of harassment Violence Against Women [VAW] has now risen near the top of virtually all agendas for women's rights and women's justice across the globe. UN NGOs and government agencies have amassed data and reports, calling at last year's UN Commission on the Status of Women for an end to all the practices identified and demanding greater accountability from individuals and institutions. Reports of violence cut across all socioeconomic and social class lines and every nuance of "race," ethnicity and religion. VAW covers every kind of act from simple whistling, hate speech or threats, to Intimate Partner Violence {IPV} and the most violent brutalities of rape, "honor killings" / murder, or "femicide" as it is called in some parts of the world. Unwanted acts of harassment and violence occur in government offices, within international agencies, in workplaces and the street, in schools and universities, in war and within the military, in prisons, hospitals, nursing homes and doctor's offices, and in private homes and bedrooms. Men also experience gratuitous violence and harassment, and rape, in ways that may also be unlawful assault, but in vastly fewer numbers than women do. Children, too, are violated, often by their own parents or relatives. The resulting psychological damage from these acts may be greater for many than any physical harm done. Hope begins when women and men and children tell their stories and are believed. Laws may help, but until institutional accountability increases and the sense of impunity among perpetrators is taken away, prevention will be slow. We all need deeper insights to understand and organize around these issues.
11 Marginalization gender and violence The United States is a violent country with a well-ingrained culture of violence. Inequality through mechanisms of exclusion discussed previously produce conditions that breed violence and lead to health disparities. Low-income minority populations are assaulted through structural violence, which is imbedded in poverty, symbolic violence that thrives through negative beliefs systems about ethnic subpopulations and interpersonal violence resulting in minority youth homicides and sexual and physical assaults against women.
12 Bottom lines over better lives? The case of big pharma's role in shaping mental and physical health diagnosis and treatment. Increasingly, consumer advocates and progressive health activists are calling for an end to industry-promoted disease-mongering that manipulates health concerns and causes harm through practices of hypermedicalization. The negative effect of such practices is especially acute in the treatment of mental health, an effect typically exacerbated for those who already exist on the margins. Examples of corruption, ranging from conflict-of-interest driven research and publication through marketing campaigns, demonstrate the ways that corporate health is often a greater priority than the health of individuals-at-risk.
13–14 Presentations of / discussions of research paper No summary for this session.