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Lecture 13

Lecture 13 - The Framing of Health Problems.docx

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Dalhousie University
Soc & Social Anthropology
SOSA 2503
Emma Whelan

 Food Activism: ½ credit next semester. TR, 230-4pm  Final Assignment handed out this Thursday, Pink Ribbons Inc., this lecture should give some background nd  2 last lecture by Emma  Also a guest lecture by Brendan  + Question time about grad school The Framing of Health Problems: Media, Movements, Money – November 19 Intro: How health issues are presented as moral issues. How public health has prevented health threats and how to deal with health threats over time. How drugs and people who use them have been presented differently over time. All these topics have in common: how health can be framed in different ways. Framing  Goffman – symbolic interactionism, dramaturgy  Sociologist  Working in symbolic interactionist tradition, very fun in sociological theory.  All about the way we make sense of our lives.  Social psychee focus.  Symbolic meanings we make of social interactions.  Working w/in tradition, looked at society as a kind of play (theatre), used dramatelogical model.  Had roles in it, would behave differently in front stage vs. back stage, public vs. private.  How to people make meanings and how to they become social, are there clashes between people‟s views.  Way we make sense of social lives and events is from frames.  Use frames to make meaning of our experience.  Frames:  Culturally shared, socially specific schemata  Organize experience  Provide context and meaning  Multiple frames possible for same action  “Frames are principles of selection, emphasis and presentation composed of little tacit theories about what exists, what happens, and what matters.” – Todd Gitlin  Eg. Cultural frame that tells us how to behave in a classroom  Use frameworks to decipher and organize our experience.  Context to enable interpretation of events.  Social shared and culturally specific. Eg. Culture shock – not knowing what the frames are.  Frames are socially shared and culturally specific.  Frames are like scripts that help us put on a play called social life.  Same section or strip of film of experience can use different frames.  Different frames give experience different meaning. What seems to be happening here? Falling, going down stairs quickly - More defensive, holding a weapon, person coming up the stairs, in a house - Jack Nicholson coming up the stairs, know it‟s a movie since actor is in the shot - Crew changes the meaning of the photograph - Standard frame in horror movies: going to the basement = something bad is going to happen Injections: - different needles, one may be IV or blood draw vs. injection - Different images: one self administered, one w/ health care professional. One legal and health related, other may be a junkie. Healthcare setting = gloves and equipment (props). Dark, bad lighting - Use stock frames to make assumptions for what is happening in the photos. - Frames used in all social processes. Most framing for Goffman is tasid, out of conscious awareness Applications of Framing  Media studies: framing as a deliberate process  “[t]o frame is to select some aspects of a perceived reality and make them more salient in a communicating text, in such a way as to promote a particular problem definition, causal interpretation, moral evaluation, and/or treatment recommendation.” (Robert Entman 1993: 52)  Social movements: use of frames to mobilize support  How social movements mobilize support for a cause. Framing in Health Movements  Framing issue in particular kinds of ways. Unjust, requires urgent action, unfair, etc.  Film looks at breast cancer movement and consequences of it, presumably not intended Eg Breast cancer movement (Erin Fredericks)  How breast cancer movement affects the way women with breast cancer can “do” breast cancer.  Looked at their involvement in breast cancestmovement had unintended consequences. Explicitly feminist, when 1 emerged challenged women with breast cancer as victims  Interviews and online discussion group with NS women with breast cancer  Movement promotes fighting, strength etc.  Reinforces traditional femininity and status quo (pink, „look good, feel better‟ campaigns)  Framing of „ideal‟ breast cancer patient  Positive, volunteers, is feminine  Those who don‟t conform can be punished  Don‟t have to have breast cancer to be part of the movement.  Angelina Jolie and her “brave” choice of a double mastectomy: seen as protecting herself.  Change body image of the “ideal” body.  Protect her children from losing their mother.  An everyday person may be seen as hypocondriac,  Angeline Jolie‟s breasts are special. Afterward she got plastic surgery, would it have been a less brave choice to live with the gene and see if she got cancer.  Focus on women‟s breast in sexual imaging.  Framed as fighters and survivors.  Maternal fighting, or to look good and feel better.  Makes movement more socially acceptable but doesn‟t challenge the status quo. Inadequacies of treatment, sexism in breast cancer, corporations using breast cancer to sell product etc.  Frame acceptable ways to have the illness, if you don‟t conform, may be consequences.  Feminine “thrivers”, better than a survivor.  Fear, depression, vulnerability, didn‟t volunteer in movement was seen as negative. Had to be idealized woman with breast cancer. Social Problems and Framing  Social Problem: an alleged situation that is incompatible with the values of a significant number of people or significant people who agree that action is needed to alter the situation  How to analyze social problems? (Carol Bacchi) 1. What is the problem represented to be? 2. What presuppositions or assumptions underlie this representation of the probme? 3. What effects are produced by this representation of the problem? 4. How would „responses‟ differ if the „problem‟ were though about or represented differently? 5. How/where are dominant problem representations produced, disseminated and defended?  Allowing us to think more critically of what counts or gets to count as a problem in society.  Way we define problems is in part based on the framing we do.  Term social problem is an interesting term.  Someone has to call it a social problem and has to be incompatible (moral judgment attached to it), something that is wrong.  Seen as a problem by a significant # of people, or significant people.  Call attention to social process by which something becomes a problem.  More interested in how something came to be seen as a problem. How argument was made, by whom and why? Societies norms, politics. Oxycontin Research:  Emma Whelan was lead investigator.  Interest grew out of interest in pain medicine and how medicine tries to treat pain.  Pain as cultural and historical issue.  Emma was only Canadian at US pain conference, struck by how much of conversation focused on American culture and the war on drugs and how affected access to opioids.  Research Questions  How is Oxycontin being represented as a social problem that needs to be fixed? (the problematisation process)  How do those who favour access to opioids for people with pain respond? - How oxy was being framed as bad drug, how affected pain medication etc. - How it was seen as a social problem that should be fixed. - Purdue – close relationship to pain medicine. Close relationship between pain medicine and pharm companies. What is OxyContin? Opioid (narcotic) analgesic  Manufactured by Purdue Pharma  Approved in US in 1995, Canada in 1996  Used to treat moderate to severe pain  Contains oxycodone, found in other prescription painkillers, BUT…  …Continuous-release formula  Consistent relief – desirable for chronic pain  Can be crushed and then ingested or snorted, or diluted in water and injected  Used in this way, it produces euphoric effects and can lead to addiction  Black market for drug has developed ‘Oxy’ in the New  High-powered painkiller „poor man‟s heroin‟  OxyContin crime wave hits nursing home  „Hillbilly Heroin‟ ravaging remote Maine; OxyContin‟s potent, heroin-like high traps drug abusers in poor, rural areas  Addicted to „Oxy‟: One Man‟s Struggle  8 deaths linked to OxyContin  A Prescription for Ruin: Illicit trade in the painkiller Oxycontin is brining crime, addiction - - and death - - to the Atlantic provinces  Hillbilly heroin heads downtown Data Sources/Methods - Problematisation:  920 news stories from 27 papers across North America, 1995-2005 - Responses  182 medical journal articles (pain, addictions, general medicine)  Interview with 11 „experts‟ – pain and addictions  Interview/focus group with 11 „advocates‟ – pain advocacy leaders and pain support group members - Purdue and conflict of interest issues - Didn‟t reach out to Purdue pharma, but they would call and send things in the mail etc. - Most pain experts receive some funding from pharm, pain clinics also receive funding - News media
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