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‘He Said/She Said’ Journalism: A Growing Threat to Public Health

10:38 am in Uncategorized by RH Reality Check

Written by Tara Murtha for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Jenny McCarthy

Why does the mainstream media give crackpots a voice?

The recent announcement that actress Jenny McCarthy is replacing Elisabeth Hasselbeck on the popular ABC morning talk show The View has sparked an intense wave of backlash.

The problem is that after McCarthy’s son was diagnosed with autism, she became convinced it was because of the measles, mumps, and rubella (MMR) vaccine, and over the last several years she has reinvented herself as the leading celebrity voice of the anti-vaccine movement. Although the study that originally sparked the MMR vaccine-childhood autism panic has since been completely discredited, many parents have stopped vaccinating their children, in part because of anti-vaccine advocacy carried out by McCarthy and others. As a result, measles cases have spiked in recent years.

Critics say that McCarthy’s anti-science views are a public health hazard, and giving her a platform, on a morning talk show or in other media outlets, legitimizes her view. For instance, “Larry King had [McCarthy] debate a doctor, as though her disproven ideas should be given the same equivalence as those of a medical expert,” The Nation editor and publisher Katrina vanden Heuvel wrote recently, adding, “False equivalency is one of journalism’s great pitfalls, and in an effort to achieve ‘balance,’ reporters often obscure the truth.” As Brendan Nyhan, writing at the Columbia Journalism Review, argued, uncritically repeating discredited statements just amplifies the spread of misinformation.

False equivalence is the worst of what New York University journalism professor Jay Rosen and others have called “he said/she said” journalism. It takes much less time—and subject expertise—to frame a story as a “controversy” than to give it informative context. (Not to mention that a non-scientific minority opposition to the vetted facts does not qualify as a “controversy.”)

When it comes to covering health and science, the “he said/she said” short-cut is downright dangerous.

It’s unfortunate then that media coverage of reproductive health issues often falls into this trap as well.

Reproductive Health

Hasselbeck, the former Survivor contestant whom McCarthy will replace, once argued to one of her co-hosts on The View that taking the morning-after pill is “the same thing as birthing a baby and leaving it out in the street.” She said that she believes emergency contraception (EC) disrupts a pregnancy. In fact, EC prevents ovulation from occurring, preventing fertilization in the first place.

Since the medical definition of pregnancy is successful implantation of a fertilized egg, effective use of EC means you can’t get pregnant in the first place.

Yet there was relatively little outrage over Hasselbeck’s remark or the dispute, which was described in many outlets, as usual, as a “cat fight” between hosts.

When it comes to reproductive health, we have a much higher tolerance for hearing anti-science beliefs with serious public health consequences. Of the many fake-science falsehoods published every day on reproductive health issues, only the most obvious draws McCarthy-level heat. Most memorable is the belief, shared by an ever-expanding number of lawmakers, that women’s bodies contain magic lady-venom to prevent pregnancy in cases of rape.

While these legislators draw much deserved public ridicule, it’s the less obvious anti-science and evidence-free statements published every day that are most dangerous.

For example, the federal 20-week abortion ban being pushed by Rep. Trent Franks (R-AZ) and other bans like it are premised on preventing fetal pain, even though scientific studies have consistently found that fetal pain is unlikely before the third trimester.

Rep. Franks has as little expertise about the science of fetal pain or the public health consequence of banning abortions at 20 weeks as Jenny McCarthy does about vaccinations. Yet he’s pressed the issue, despite the fact that the bill has little to no chance of passing the Senate. Why would Franks make such a production of a failing endeavor?

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What Gun Control Advocates Can Learn from the Anti-Choice Movement

11:56 am in Uncategorized by RH Reality Check

No Hunting School Zone

No Hunting School Zone

Written by Carole Joffe for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Here are some things that have occurred in the immediate aftermath of the tragic slaughter of children and their teachers in Newtown, Connecticut: More signatures on a petition calling for gun control than any other petition that has been sent to the White House; conservative politicians from both parties — for example senators Joe Manchin of W. Virginia, and Marco Rubio of Florida — for the first time signaling their willingness to do something about gun regulation; changing poll numbers about gun control among the general population, with support for stricter control at a ten-year high. And perhaps most significantly, total silence for several days about this incident from the National Rifle Association (NRA), considered to be the most powerful lobby in the United States.

These post-Newtown reactions have led numerous observers to feel that this latest mass murder incident may be a game changer. For years, many politicians have been fearful of offending the NRA and the public has been divided about guns, if not largely indifferent. As a result, there has not been a visible or highly effective gun control movement in this country, in spite of the hard work for many years of groups such as the Brady Campaign to Prevent Gun Violence.  Correspondingly, there has been almost no Congressional legislative action to curtail guns during the Obama administration, and at the state level, there have been more efforts to expand gun owners’ prerogatives — for example, concealed carry laws — than to limit then.

To be sure, petitions and expressions of outrage by both politicians and the public do not necessarily lead to a social movement. Even if an assault weapons ban is passed — Senator Dianne Feinstein has pledged to introduce such legislation in January — that might be a one-off event (welcome as it would be), and politicians would then turn their attention to the many other issues on their plates. And recall that there was such a ban passed in 1994 during the Clinton presidency — and then that ban was allowed to quietly expire in 2004. That expiration is a textbook case of what happens when legislation is not accompanied by a vibrant social movement that is able to rally the public and to hold lawmakers accountable.
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Conservative Columnist Supports Family Planning as “Pro-Life”

11:08 am in Uncategorized by RH Reality Check

Written by Editor-in-Chief Jodi Jacobson for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

It’s not often that I agree with Michael Gerson, the conservative former speech writer for President George H.W. Bush, advocate for abstinence-only policies in U.S. global AIDS programs, and columnist for the Washington Post. 

Today, however, I am in near-full agreement with him on a piece he published in today’s Post.

Gerson just returned from a trip to the Democratic Republic of Congo sponsored by CARE during which he and others saw firsthand the struggles of women who live in societies in which they have little control of whether, when and whom they marry, and whether, when and how many children they bear.  In these settings, women bear more children than they want and can afford to raise, infant and child mortality rates are high, and complications of both pregnancy and unsafe abortion are the leading cause of deaths among women ages 15 to 49.  Medical care is largely inaccessible.

Reproductive and sexual health and rights advocates have always argued that ensuring that women have unfettered access to family planning information and counseling and consistent contraceptive supplies is a “pro-life” strategy, because voluntary family planning dramatically improves the quality of life and survival rates of both children and their mothers, and by extension, families and societies.

But the anti-choice movement in the United has moved from opposing abortion per se to opposing all forms of birth control, an agenda it was always suspected to have in the first place.  As such, this movement, led largely by male religious leaders, Congressmen or virulently anti-choice male activists opposes support for family planning services and birth control methods both at home and abroad.

Having a “card-carrying” conservative evangelical columnist support family planning as a “pro-life” intervention not only speaks to reality, it is what I hope to be a welcome first step in pushing back against anti-choice positions that cost far more lives–those of women and children–than they ever “save.”

Visiting the village of Bweremana, Gerson writes:

[T]he correlation between the number of children and the absence of some of their mothers becomes clear. Kanyere Sabasaba, 35, has had 10 children, eight of whom have survived. Her last delivery did not go well. “I delivered the baby without any problem, but I was bleeding much,” she told me. The case was too complex for the local health center, so Kanyere had to pay for her transport to another medical facility. After the surgery, the doctor performed a tubal ligation. “If I give birth again, I could die,” she said. “The last child is the one who could really kill me.”

As Gerson rightly notes, for women in this part of Congo, the complications of childbirth are as dangerous as the militias in the countryside.

One woman I met had given birth to 13 children, only six of whom survived. Women sometimes deliver in the fields while working. Medical help can be a few days’ journey away. Each birth raises the odds of a hemorrhage, infection or rupture. Those odds increase dramatically when births come early in life, or late in life, or in rapid succession. In Congo, almost one in five deaths of women during childbearing years is due to maternal causes.

And, he notes, “While both the pill and condoms are generally available in larger cities such as Goma, access is limited in rural districts. Determining the pace of reproduction is often a male prerogative instead of a shared decision. Sexual violence can be as close for a woman as gathering fuel in the woods.”

These are all absolutely true and I appreciate and admire Gerson for acknowledging these realities.

The women of Bweremana, continues Gerson “are attempting to diffuse and minimize their risk. In a program organized by Heal Africa, about 6,000 contribute the equivalent of 20 cents each Sunday to a common fund. When it is their time to give birth, the fund becomes a loan to pay transportation and hospital fees. The women tend a common vegetable garden to help with income and nutrition. And the group encourages family planning.”

But even this is not enough.  It is estimated that 215 million women worldwide want and need access to basic family planning and supplies but do not currently have it.  These women bear more children than they want or can support.  As a result, they also watch more infants and children die, suffer poor health themselves, and are far less likely to achieve their own educational and economic goals.  That is why investments by nations in their own health care systems, including basic reproductive and sexual health care, and international donors in those same systems, are so critical.

But, as Gerson notes:

The very words “family planning” light up the limbic centers of American politics. From a distance, it seems like a culture war showdown. Close up, in places such as Bweremana, family planning is undeniably pro-life. When births are spaced more than 24 months apart, both mothers and children are dramatically more likely to survive. Family planning results not only in fewer births, but in fewer at-risk births, including those early and late in a woman’s fertility. When contraceptive prevalence is low, about 70 percent of all births involve serious risk. When prevalence is high, the figure is 35 percent.

The United States was once the global leader in funding family planning worldwide.  But U.S. funding of international family planning programs has remained essentially flat for the last 10 years, and is hamstrung by an increasing number of medically-unnecessary and ideologically-driven restrictions that end up reducing, rather than expanding access to this urgently-needed health intervention.

Gerson argues that support for family planning and contraceptive supplies shouldn’t be the ideological lightening rod it has become because:

“[e]ven in the most stringent Catholic teaching, the prevention of conception is not the moral equivalent of ending a life. And conservative Protestants have little standing to object to contraception, given the fact that they make liberal use of it. According to a 2009 Gallup poll, more than 90 percent of American evangelicals believe that hormonal and barrier methods of contraception are morally acceptable for adults. Children are gifts from God, but this does not require the collection of as many gifts as biologically possible.

In fact, more than 80 percent of the U.S. public writ large strongly supports women’s rights to determine the number and spacing of children they have.

So far we strongly agree: It’s a strategy that saves lives, it makes economic sense, and because this is about public health, it should be free from ideology.  If you don’t like contraception, don’t use it. But don’t use religion or ideology to deny it to others, especially when the overwhelming majority of women of all religious persuasions in fact use birth control.

Where I diverge with from Gerson in regard to these issues is on abortion. 

Gerson points to “[s]ome liberal advocates” who think these are intrinsically related.  In regard to self-determination, human rights, and public health, the linkage between a woman’s ability to prevent pregnancy and her ability to safely and legally terminate an unintended and untenable pregnancy are intrinsically linked and women know this. It only becomes ideological when religion and politics intervenes in these basic rights and tries to undermine them.

It is true, as he notes, that “support for contraception does not imply or require support for abortion.”  You can, personally, be a supporter of contraception but decide you would not choose abortion were you to become pregnant, which obviously men can’t.  Where we’ve become lost, however is in politicizing abortion care in much the same way as family planning services and ignoring, for ideological convenience, the same public health and medical evidence on safe abortion services that supports access to family planning.  Safe abortion care makes sense because it saves women’s lives, and ultimately the lives of their current and future children borne through wanted pregnancies.

Notwithstanding religious and ideological beliefs, access to safe abortion is also a well-recognized critical public health intervention.  Moreover, without it, ultimately women can not truly be in charge of their reproductive destinies–and hence can not truly exercise self-determination. Access to safe abortion services is a necessary back up to any unintended and untenable pregnancy, from any cause, including contraceptive failure, interrupted access to contraceptives, and pregnancies resulting from intimate partner violence and rape, rape as a tool of war, stranger rape, or incest.  Access to contraception can dramatically reduce the number of unintended pregnancies and hence the need for abortion, but it can never completely eliminate abortion. So the need for access to safe abortion care is a fact-based medical and public health position, not an ideological one. And by suggesting it is an ideological position, we continue to miss the point.

What Gerson doesn’t clarify is that for the purpose of U.S. policy, contraception and abortion are already kept separate.  U.S. international family planning assistance goes solely to family planning information and supplies; it does not support access to safe abortion care.  Under the Helms Amendment, funding for abortion care is only allowable in cases of rape, incest or the health and life of the mother.  In reality, because of politics, U.S. funding is rarely if ever used even for these “allowable” conditions.  The issue of abortion would come into play if we were talking about repealing the Helms Amendment, an effort I wholeheartedly support, but which has nothing to do with current discussions around the scope of U.S. international funding for family planning, unless you are a Congressperson trying to deflect attention from the fact that you don’t want to support family planning and want to ignore the evidence that it saves the lives of women and their children.

So when we talk about ideological fights around family planning, it really comes down to a majority male GOP Congressional leadership that vociferously opposes access to basic services that would enable women to choose the number and spacing of children they want by using basic family planning services.  Abortion is a red herring here, because it is not in the equation.  Gerson himself would have been more forceful if he had clarified that, and he also would have been more honest if in this piece he had reversed his own earlier position supporting the prohibition of integration of family planning into U.S. global AIDS programs, a position adopted by the Bush Administration and, unfortunately, continued by the Obama Administration that dramatically diminishes access to contraceptive supplies to HIV-positive women who desire not to have any more children.

So I agree with Gerson that family planning is pro-life, as all people who are pro-choice and by definition therefore “pro-life” understand those concepts.  I also agree with Gerson that “women in Congo have enough home-grown problems without importing irrelevant, Western controversies.”  And finally, I completely agree that access to contraceptives do not solve every problem and that women in Bweremana want access to voluntary family planning for the same reasons as women elsewhere: to avoid high-risk pregnancies, to deliver healthy children and to better care for the children they have.”  They want the same happy, healthy families we all strive to have.

This is the best understanding of why the pro-choice movement, based as it is on public health and medical evidence is indeed “pro-life,” and why U.S. support for voluntary international family planning services is one of the single most effective investments we can make.  Let’s keep the funding politics separate from abortion right now, while recognizing that on the ground, in the hut, for the woman, these two things are rarely in neat little boxes.

What Happens to Washington State Women if Title X Falls?

8:51 am in Uncategorized by RH Reality Check

Written by Amie Newman for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

“It is my view that no American woman should be denied access to family planning assistance because of her economic condition. I believe, therefore that we should establish as a national goal the provision of adequate family planning services within the next five years to all those who want them but cannot afford them. This we have the capacity to do.”

– President Richard Nixon, 1970

We need to make population and family planning household words. We need to take sensationalism out of this topic so that it can no longer be used by militants who have no real knowledge of the voluntary nature of the program but, rather are using it as a political steppingstone. If family planning is anything, it is a public health matter.”

– Congressman George H.W. Bush, 1969

Now?

“What is more fiscally responsible than denying any and all funding to Planned Parenthood of America?” demanded Representative Mike Pence of Indiana, the chief sponsor of a bill to bar the government from directing any money to any organization that provides abortion services.

You’d think Rep. Mike Pence’s (R-IN) bill to defund Planned Parenthood, an organization which provides preventive health care to millions of Americans around the country, would be enough of a blow. They are going for the deep, painful cuts leaving many millions of Americans who are already at their most vulnerable even more exposed with a House leadership budget proposal to completely eliminate Title X, one of the most successful federal safety net programs this country has ever seen. It’s not a political game, as much as Live Action hoax video-makers Lila Rose and James O’Keefe seem to think it is. As states grapple with similar budget cutting, our friends, family and community members will find themselves without basic healthcare and as tax-payers we’ll literally pay the price of the decimation of a crucial public health safety net. In Washington State, with a multi-billion dollar budget shortfall, residents are already bracing for the impact of state cuts to family planning, maternity health services, health insurance for lower-income residents, prescription drug benefits for seniors and more. The elimination of the federal Title X program would be disastrous.

This may feel like a swipe out of nowhere but it’s been a long time in the making for the GOP. Read more

The Moral Dimensions of a Freeze in Federal Funding

8:04 am in Uncategorized by RH Reality Check

Written by William Smith for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

In September 2008, then-Candidate Obama, in his first Presidential debate with Senator John McCain, pounced on his rival when McCain raised the hard-hearted suggestion of freezing all government spending with the exception of defense, entitlement programs, and veteran’s affairs, to reduce the deficit.

Obama countered with a now-famous and punchy one liner: “The problem is you’re using a hatchet when you need a scalpel.”

This week, the President seems to have taken up the hatchet and embraced the McCain approach. It’s not quite his “read my lips” moment, but it has – at best – the potential for the most fundamental of disappointments.

The issue is that the President’s retort was not just a really well constructed and pithy punch to McCain’s cold-as-steel demeanor – an appeal from the compassionate candidate who knew and understood the challenges of the everyday American. No, it was, first and foremost, a profoundly moral statement. It was meant to underscore that the President viewed domestic needs as not just important, but a fulfillment of the social contract we have with one another as Americans and he saw a federal government shirking its responsibilities at home. It was the modern equivalent of President Lincoln’s line that the role of government is “to do for the people what needs to be done, but which they can not, by individual effort, do at all, or do so well, for themselves."

Obama’s quip underscored that the government was not performing its primary function in the way Lincoln described. In fact, Obama went on to say that "There are some programs that are very important that are currently underfunded," Obama said.

The real truth is that the President has not really, fully taken up the McCain proposition. Not fully. The President will not propose that everything – every line in the federal budget – get frozen in time for his proposed three-year timeframe. Instead, there will be a mixture of things that are cut, flat funded, or even given increases. And while such outcomes are always the product of the budget process, the 2011 federal budget he will propose next week is unique in that wherever programs fall along the fault lines of the top line spending freeze, it will say volumes about the moral vision of the President and his Administration.

For those of us who work on behalf of sexual and reproductive health who have one hand in public health and the other in social justice, we’re nervous. We’re nervous because the issues we care about most have languished for the better part of a decade as the federal government failed to meet the unmet need to secure sexual health in our country. Instead, STD prevention and services funding has stalled, causing clinic closures and impacting the ability of people to access prevention and treatment. HIV funding has fared a bit better, yet people with HIV or AIDS are once again on lists across the country waiting for government support to access live-saving medications. Family planning funding has limped along but its increases – when they came – paled in comparison to the billion dollars spent on wasteful programs like abstinence-only-until-marriage during the same time period. This has created the most striking lack of adequate services from coast to coast. So no one should wonder why we have 19 million new cases of STDs every year, or an HIV epidemic worse than we ever thought possible, or rising rates of teen and unintended pregnancies.

This week, the President also made one of the most remarkable statements of any President in recent memory when he said, “I’d rather be a really good one-term president than a mediocre two-term president.” I don’t think it was the insincere gesture of a politician struggling for purpose or seeking consolation. This is the real thing. It is character in the truest sense of the word and the same type of self-sacrifice that forces this good man to make the tough decisions for a nation that, in the end, may ultimately cost him another term – including his decision to fix the fiscally bankrupt house of government he inherited from a previous Administration.

But that tough decision needs to recognize that our public health system in states across the country, as well as our sense of social justice, demands that the budget the President proposes not shirk from the moral obligation to do the right thing on sexual health. Sure, discretionary spending is rather small in the overall picture, but it is the critical source of funding for sexual health programs. We simply cannot afford a cut from the budget scalpel anywhere on sexual and reproductive health programs.

Anywhere.