The albino people of Tanzania

Slate has some images from photographer Liron Shimoni’s new series White Shadows. Albinism occurs at a far higher rate in Tanzania than the rest of the world and people who have it can be subject to discrimination, abuse, or murder. From the text that accompanies the photographs:

“In the villages, they are viewed as demons or subhuman, and called offensive terms such as ‘zero-zero’ or ‘white meat.’ There is also a widespread belief that getting close to an albino will result in the catching of the disease, or that a pregnant woman who has physical contact with an albino will then birth an albino baby of her own.”

(c) Liron Shimoni

(c) Liron Shimoni


On ice cream, lead, and murder

On this blog in the past, we have looked at some intriguing ways in which social issues such as violence may be considered as epidemics.  We have also looked at some of the problems in public health with confusing correlation with causation; a classic statement of the fallacy is often given as follows: in summer ice cream sales go up, and murder rates go up.  Therefore, eating ice cream causes murder.

The example of ice cream and murder is absurd, but it points out just how difficult it can be to ascribe causation definitively in matters of public health.  Clearly, both ice cream sales and murder rates are independently affected by the same actual cause (heat waves), but one could easily imagine compelling data showing that ice cream sales go up just before each wave of violence.  And in fact, a fascinating new piece in Mother Jones has been getting a lot of attention in public health circles this week because it shows exactly that kind of compelling relationship between violence and a different factor: leaded gasoline.

Through a pretty careful analysis of past publication, the article makes an extraordinary claim: “Gasoline lead may explain as much as 90 percent of the rise and fall of violent crime over the past half century”.  But it has the data to back it up, and what’s really intriguing is that these correlations hold from the macro- all the way down to the neighborhood level.  In neighborhoods where lead is removed, crime rates drop a predictable number of years afterward.  If there really is a causal relationship between lead exposure and violent crime, we should be making the removal of lead from the environment a top priority- and maybe we should also be reconsidering the effectiveness of the police campaigns that are claiming the credit for the tremendous decline in violent crime America has been experiencing in recent decades.

But is this really ice cream and murder all over again? Scott Firestone has an excellent blog post about the MJ piece that does a nice job discussing why we might temper our enthusiasm about these findings somewhat (although he also finds the data very compelling), and it’s worth reading just to think more about how hard it can be to prove anything with certainty, even when the evidence is extraordinary (think of how successful tobacco lobbyists were for so long in creatively interpreting the data on the health effects of smoking).  There’s a brief and well-executed discussion this week in Scientific American about just how hard it can be to establish causation in health on another issue:  whether even very moderate amounts of drinking during pregnancy has any negative effects on babies.  This should be easy to establish, but it isn’t: in part because of ethical considerations (you can’t set up a control for potentially harmful behavior), in part because of the reliability of self-reports, and in part because of confounding variables like “lifestyle” associations (the same arguments tobacco lobbies make).

Infectious homicide in Newark




Sounds like time to call in the anthropologists.

Education for all, and the nature of Violence












Photo: Ajit Solanki / AP

What isn’t an epidemic?

Ben’s post on violence, and my response, have got me thinking about one of the (many) questions we raised in class but never really answered: does it always make sense to think of health concerns driven by behavior (rather than, say, microbes) as epidemics? We see this all the time in the media and in the academic literature: the obesity and tobacco epidemics, most famously.  And then there are a host of “epidemics” of behaviors that have been medicalized or psychopathologized to fit into the disease model, but I’m pretty sure it would have sounded absurd to refer to them as epidemics until fairly recently: sex addiction, for example.

What are the problems with using the label “epidemic”? Should the term be potentially applied to any set of behaviors that lead to adverse health consequences, or are there limits? We have discussed some examples where it seems more productive to think of behavior in terms of epidemics even when we may find that behavior abhorrent: needle exchange programs have been very successful in limiting the spread of AIDS and hepatitis, for example, even if some feel that they condone illegal behavior.  The term is also a useful way of undermining the medical tendency to blame the patient: as we know, behavior occurs within a socioeconomic context (cf. structural violence), pretty much every disease results from a complex interaction between behavior and pathogens, and many forms of behavior have a genetic component.  Maybe there are good reasons to use the blanket term “epidemic” to erase the distinction between passive (victim) and active (deviant or unsanitary citizen) when we talk about health.

But there are political consequences of the “epidemic” label as well: to use a current example, Bloomberg has been using the term to justify his attack on soft drinks in New York.  Whether we agree with the soft drink ban or not, it raises the question of how far government control of the behavior of its citizens should extend in the name of addressing a public health concern… and has some uncomfortable resonances with the state-of-exception, war-on-terror rhetoric used to justify the erosion of civil liberties post-9/11.  If violence is an epidemic, should we get rid of the Second Amendment in order to reduce the virulence of the disease?

Thoughts? Can you think of a recent “epidemic” that you don’t think merits the name? This one, maybe? Where and why do you draw the line?

A Cure for Violence

Hi everyone:

I hope your weekend is going fan-tastic! For my first post, I found a story on violence and an age-old question tied to it… is is possible to stop violence before it occurs? Is there a cure for violence? I find it utterly fascinating, especially coming from a Sociology background. I hope you enjoy it.