Infant mortality in the Chinese health system has been an area of concern for many years.  The current trend shows that a lot of work has been done over the past twenty years, but there is still a long way to go.  An article published by Reuters in March of 2010 discusses a drop in infant mortality by 71%, 64.6 infant deaths per 1,000 livebirths to 18.5, from 1990 to 2008.  In a Wall Street Journal article from September 2011 that produces similar data, they reported a 62% drop from 1996 to 2008, they state the reason is because more mothers are choosing to have their babies born in a hospital setting, rather than at home.  The Wall Street Journal article attributes this to country wide effort in 2000 by China’s Ministry of Health to encourage hospital births and to do this they created a subsidy that allowed for rural residents to afford the trip to hospitals.
Reuters points out that the reason the mortality rate hasn’t dropped further is because of the wide gap in health care between the rich and poor.  The Chinese government’s hope to shorten this gap can be seen with their 2009 reform that put $123 billion into
providing affordable health care to its 1.3 billion person population.

An anthropologist that is working on this issue is Igor Rudan from the Croatian Center for Global Health in Split, Croatia.  He published a paper in March 2010 that looked
at information from obtained from the Chinese Ministry of Health and various other Chinese databases to determine the causes of death in Chinese children younger than 5.  His research showed that there were significant drops in the mortality rates of neonates, postneonatal infants, and children from 1990 to 2008.  Also detailed was the leading causes of death, which include pneumonia, birth asphyxia, and preterm birth complications.

References:

Causes of deaths in children younger than 5 years in China in 2008

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60060-8/abstract

Child mortality highlights China’s urban-rural divide

http://www.reuters.com/article/2010/03/26/us-china-child-deaths- idUSTRE62P01G20100326

Report: China See Dramatic Drop in Infant Deaths

http://blogs.wsj.com/chinarealtime/2011/09/19/report-china-sees-dramatic-drop-in-infant-deaths/

The condition that is heavily medicalized that I chose to discuss is ADHD.  I feel that the reason that this condition is medicalized in the U.S. culture is because people
believe that there is always a cure for something, in this case being hyperactive.  ADHD is defined as “a problem with inattentiveness, over-activity, impulsivity, or a  combination” of the three.  As stated before, it is our culture’s thinking that there is a cure for everything, which in this case is an over-active, inattentive child.  I’m not trying to discredit the condition as a whole, as I know a number of people that have those issues.  I also knew people growing up that went through a phase in their youth of being constantly active and distracted, but grew out of it as they became older.  Some of those kids were given medication and others weren’t, it all depended on their parents and doctors.  What I just previously described is the cultural force of the disease.  Politically and economically there is a lot to gain from the over medicalization of ADHD.  Drug companies that produce ADHD medications have a lot to gain economically with the prescribing of their medications.  Physicians that prescribed medications from specific drug companies often receive kick-backs from those companies.  Politicians that lobby for these drug companies often receive campaign donations in return.

The advertisement that I chose is for the ADHD drug Concerta.  The strategy for this ad
employs the use of a young boy, boys are more commonly diagnosed with the disorder, attempting to concentrate on doing his homework, difficulty concentrating is a common ADHD symptom and complaint.  The ad plays on the ideology that all students should be quite, respectful, under control, and receive good grades.  The medical information is presented in lettering significantly smaller than the rest of the text and at the bottom of the page.  The only method used to draw attention to this information is the bolded statement “Important Safety Information” that comes before it.  There are no doctor/patient interactions found in the text or in pictures, but the ad does state to “contact your healthcare professional about Concerta.”

Concerta Advertisement:

http://depressionintrospection.files.wordpress.com/2009/02/concerta_ad_shape-magazine.jpg

References:

Attention deficit hyperactivity disorder (ADHD)http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002518/

The True Life episode that I chose is I Have Narcolepsy.  This episode follows two young girls, Julie and Katie, and documents how they live their lives while suffering from the medical condition Narcolepsy and Cataplexy, a condition associated with Narcolepsy.  The episode defines Narcolepsy as a neurological disorder that causes powerful, sudden sleep spells and Cataplexy as sudden muscle failure.

MTV uses the True Life series as a quest narrative in an effort to show how those highlighted in each episode overcome their struggles.  The girls in this episode
present a chaos narrative based on the affect the condition has on their lives.  It doesn’t appear that there is a true stigma associated with the disease since it is a neurological disorder beyond their control.  The stigma that I can associate with the disease is the amount of medications that the girls need to take to offset the symptoms the disorder causes.  Both girls have extensive interactions with physicians who prescribe
powerful drugs that are taken in an effort to decrease the severity of the condition’s symptoms.  Each girl’s reaction to their physician’s advice is different.  Julie worries that the side-effects of the drugs will be as debilitating as the condition itself and fights her mother about taking them.  While Katy is taking a growing amount of pills prescribed to her by her doctor but in her case her boyfriend is worried about the pills affects on her health and pushes her to stop taking them.

Illness narratives can be very useful, especially to the patients and those around them.  As described in the lecture, illness narratives provide the sufferer with the ability
to openly discuss their condition with others and educate them about it.  For those  round the patient, illness narratives allow for them to be educated by the patient and share in the suffering the patient has to endure.

The CBS that I chose is the eating disorder bulimia nervosa in the American culture.  This CBS is characterized by an individual’s binge eating, followed by behaviors to
compensate their eating which include vomiting, excessive exercise, misuse of
diuretics, laxatives, or enemas.  It is commonly seen more in females than males with symptoms appearing during an individual’s early teens to early twenties and can follow a chronic or episodic course.  The development of the disorder is psychologically
based with damaging effects seen on a physiological level.  Medical complications associated with the disorder include gastric rupture, nausea, dental erosion, enlarged salivary glands, esophageal damage, heartburn and sore throat, electrolyte imbalances,
fatigue, paresthesias, seizures, and cardiac arrhythmias.  In addition to the mentioned medical conditions resulting directly from the disorder, there are a number of psychiatric conditions that are commonly seen in those with bulimia, these include mood, substance-related, anxiety, and personality disorders.

As I mentioned earlier, the biological dimension of this illness takes a heavy toll, physically and mentally, on the individual suffering from it.  Culturally, we place
great importance on body image, which can be seen all around us as consumers in movies, television shows, and advertisements.  When we find someone that fits this image, we hold them on a pedestal or alter them to remove or enhance the undesired quality.  All this leads into the individual dimension of the illness.  The glorification of
those with what society considers ideal qualities can have a major affect on the self esteem of someone who is suffering from the illness.  This can lead to those individuals taking measures to try and resemble the examples that surround them every day.

Current methods for the treatment of bulimia include pharmacologic and psychotherapy interventions, with the two being used concurrently at times.  Pharmacologic interventions involve the use of medications such as antidepressants and inhibitors.  Psychotherapy helps the individual look at the cognitive aspects of the illness and address the obsession with their body image and their low self-esteem.  Treatment can also be done on a cultural level by showing individuals with body types more common with those in the rest of society.

Reference:

Assessment and Treatment of Bulimia Nervosa http://www.aafp.org/afp/1998/0601/p2743.html

I received a score of 5/10 on the Health Activity Quiz.  As a Public Health student, most of the statistics presented, such as our worldwide life expectancy ranking, the amount
we spend on healthcare, the life expectancy difference between counties, and the amount of park space in different neighborhoods, didn’t surprise me because these are areas that are consistently covered.  The statistic that did surprise me was that non-native Latinos have a better health outcomes on average compared to other U.S. populations and that within 5 years of immigrating to the U.S., their health begins to deteriorate and gets to the level of low-income Americans.

The case study that I chose was In Sickness and in Wealth.  This case study looks at
research presented by scientists on how the health of an individual is largely determined by their income.  The study looks at the lives of a CEO, lab supervisor, janitor, and an unemployed mother that all live in different counties within Louisville, Kentucky.  We get a small glimpse into the lives of each individual to get an  nderstanding of what life is like from their perspective.  We learn that each individual’s life expectancy varies by each county, the CEO’s 2 years more than the national
average, the lab supervisor’s 4 years less than the CEO, the janitor’s 6 years less than the CEO, and the unemployed mother’s 9 years less than the CEO.  Throughout the case study, we are presented with results of various researchers studies.  One such study looked at how the health of an individual decreases as you go down the social hierarchy, such as from the CEO to the unemployed mother.  We were also given the results of a study that showed people who have less stress in their lives have lower
levels of the hormone cortisol and were therefore healthier compared to those
with more stressfully lives.

Politics and economics can play a role in how much income a person has, which has an influence on the environment and culture that they live in.  If that happens to be a
low-income environment, it can have negative biological affect on that person’s
health.  If a large number of people live in an unhealthy environment, it can result in an illness spreading more easily with treatment possibly not being an option due to their income status.