Shame and blame can create barriers to vaccination
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Understanding the stigma surrounding infectious diseases like HIV and mpox may help community health workers break down barriers that hinder access to care.
Looking back in history can provide valuable lessons to confront stigma in health care today, especially toward Black, Latine, LGBTQ+, and other historically underserved communities disproportionately affected by COVID-19 and HIV.
Public Good News spoke with Sam Brown, HIV prevention and wellness program manager at Civic Heart, a community-based organization in Houston’s historic Third Ward, to understand the effects of stigma around sexual health and vaccine uptake.
Brown shared more about Civic Heart’s efforts to provide free confidential testing for sexually transmitted infections, counseling and referrals, and information about COVID-19, flu, and mpox vaccinations, as well as the lessons they’re learning as they strive for vaccine equity.
Here’s what Brown said.
[Editor’s note: This content has been edited for clarity and length.]
PGN: Some people on social media have spread the myth that vaccines cause AIDS or other immune deficiencies when the opposite is true: Vaccines strengthen our immune systems to help protect against disease. Despite being frequently debunked, how do false claims like these impact the communities you serve?
Sam Brown: Misinformation like that is so hard to combat. And it makes the work and the path to overall community health hard because people will believe it. In the work that we do, 80 percent of it is changing people’s perspective on something they thought they knew.
You know, people don’t even transmit AIDS. People transmit HIV. So, a vaccine causing immunodeficiency doesn’t make sense.
With the communities we serve, we might have a person that will believe the myth, and because they believe it, they won’t get vaccinated. Then later, they may test positive for COVID-19.
And depending on social determinants of health, it can impact them in a whole heap of ways: That person is now missing work, they’re not able to provide for their family—if they have a family. It’s this mindset that can impact a person’s life, their income, their ability to function.
So, to not take advantage of something like a vaccine that’s affordable, or free for the most part, just because of misinformation or a misunderstanding—that’s detrimental, you know.
For example, when we talk to people in the community, many don’t know that they can get mpox from their pet, or that it’s zoonotic—that means that it can be transferred between different species or different beings, from animals to people. I see a lot of surprise and shock [when people learn this].
It’s difficult because we have to fight the misinformation and the stigma that comes with it. And it can be a big barrier.
People misunderstand. [They] think that “this is something that gay people or the LGBTQ+ community get,” which is stigmatizing and comes off as blaming. And blaming is the thing that leads us to be misinformed.
PGN: In the last couple years, your organization’s HIV Wellness program has taken on promoting COVID-19, flu, and mpox vaccines to the communities you serve. How do you navigate conversations between sexual health and infectious diseases? Can you share more about your messaging strategies?
S.B.: As we promoted positive sexual health and HIV prevention, we saw people were tired of hearing about HIV. They were tired of hearing about how PrEP works, or how to prevent HIV.
But, when we had an outbreak of syphilis in Houston just last year, people were more inclined to test because of the severity of the outbreak.
So, what our team learned is that sometimes you have to change the message to get people what they need.
We changed our message to highlight more syphilis information and saw that we were able to get more people tested for HIV because we correlated how syphilis and HIV are connected and how a person can be susceptible to both.
Using messages that the community wants and pairing them with what the community needs has been better for us. And we see that same thing with COVID-19, the flu, and RSV. Sometimes you just can’t be married to a message. We’ve had to be flexible to meet our clients where they are to help them move from unsafe practices to practices that are healthy and good for them and their communities.
PGN: You’ve mentioned how hard it is to combat stigma in your work. How do you effectively address it when talking to people one-on-one?
S.B.: What I understand is that no one wants to feel shame. What I see people respond to is, “Here’s an opportunity to do something different. Maybe there was information that you didn’t know that caused you to make a bad decision. And now here’s an opportunity to gain information so that you can make a better decision.”
People want to do what they want to do; they want to live how they want to live. And we all should be able to do that as long as it’s not hurting anyone, but also being responsible enough to understand that, you know, COVID-19 is here.
So, instead of shaming and blaming, it’s best to make yourself aware and understand what it is and how to treat it. Because the real enemy is the virus—it’s the infection, not the people.
When we do our work, we want to make sure that we come from a strengths-based approach. We always look at what a client can do, what that client has. We want to make sure that we’re empowering them from that point. So, even if they choose not to prioritize our message right now, we can’t take that personally. We’ll just use it as a chance to try a new way of framing it to help people understand what we’re trying to say.
And sometimes that can be difficult, even for organizations. But getting past that difficulty comes with a greater opportunity to impact someone else.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Decoding Hormone Balancing in Ads
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Time!
This is the bit whereby each week, we respond to subscriber questions/requests/etc
Have something you’d like to ask us, or ask us to look into? Hit reply to any of our emails, or use the feedback widget at the bottom, and a Real Human™ will be glad to read it!
Q: As to specific health topics, I would love to see someone address all these Instagram ads targeted to women that claim “You only need to ‘balance your hormones’ to lose weight, get ripped, etc.” What does this mean? Which hormones are they all talking about? They all seem to be selling a workout program and/or supplements or something similar, as they are ads, after all. Is there any science behind this stuff or is it mostly hot air, as I suspect?
Thank you for asking this, as your question prompted yesterday’s main feature, What Does “Balancing Your Hormones” Even Mean?
That’s a great suggestion also about addressing ads (and goes for health-related things in general, not just hormonal stuff) and examining their claims, what they mean, how they work (if they work!), and what’s “technically true but may
be misleading* cause confusion”*We don’t want companies to sue us, of course.
Only, we’re going to need your help for this one, subscribers!
See, here at 10almonds we practice what we preach. We limit screen time, we focus on our work when working, and simply put, we don’t see as many ads as our thousands of subscribers do. Also, ads tend to be targeted to the individual, and often vary from country to country, so chances are good that we’re not seeing the same ads that you’re seeing.
So, how about we pull together as a bit of a 10almonds community project?
- Step 1: add our email address to your contacts list, if you haven’t already
- Step 2: When you see an ad you’re curious about, select “share” (there is usually an option to share ads, but if not, feel free to screenshot or such)
- Step 3: Send the ad to us by email
We’ll do the rest! Whenever we have enough ads to review, we’ll do a special on the topic.
We will categorically not be able to do this without you, so please do join in—Many thanks in advance!
Share This Post
-
Fasting Cancer – by Dr. Valter Longo
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We’ve previously reviewed Dr. Longo’s “The Longevity Diet”, and whereas that one was about eating, this one is (superficially, at least) about not eating. Nor is this any kind of dissonance, because, in fact, it’s important to do both!
That said, he discusses not just fasting per se, but also the use of a personalized fast-mimicking diet, to accomplish the same goal of not overloading the metabolism—as overloading the metabolism results in metabolic disease, and cancer is, ultimately, a metabolic disease of immune dysfunction with genetic disorder*—which makes for quite a deadly trifecta.
*not in the sense of “hereditary”, though certainly genes can influence cancer risk, but rather, in the sense of “your gene-copying process becomes disordered”.
The first three chapters (after the introduction, which we’ll comment on shortly) are devoted to explaining the principles at hand:
- Fasting cancer while feeding patients
- Genes, aging, and cancer
- Fasting, nutrition, and physical activity in cancer prevention
In those chapters, he details a lot of the science for exactly how and why it is possible to “feed the patient and starve the cancer” at the same time.
After that, the rest of the book—another nine chapters, not counting appendices etc—are given over to fasting and nutrition in the context of nine main types of cancer, one chapter per type. These are not hyperspecific, though, and are rather categorizations, such as “blood cancers”, and “gynecological cancers” and so forth. It’s comprehensive, and while it could be argued that it may mean chapters feel irrelevant to some people (à la “I have never smoked and have no pressing concern about my lung cancer risk” etc), the reality is that it’s good to know how to avoid them all, because if nothing else, it’d be super embarrassing to get a cancer you “thought you couldn’t get”. So, it’s honestly worth the time to read each chapter.
In the category of criticism, he did open the introduction with a handful of anecdotes to defend the consumption of (well-established group 1 carcinogens) red meat and alcohol as “secondary concerns that might not be such a big deal”, even discussing how surprised his colleagues in the field are that he has this view. Suffice it to say, it’s contrary to the overwhelming body of evidence, and reads suspiciously like a man who simply doesn’t want to give up his steak and wine despite his own longevity diet forswearing them.
The style is self-indulgently autobiographical and very complimentary, and (in this reviewer’s opinion) it can be tedious to wade through that to get to the science, but at the end of the day, his self-accolades might be needless fluff, but they don’t actually remove anything from the science in question.
Bottom line: as you can see, there are good and bad things to say about this book, but the information contained in the good makes it well worth reading through the stylistically questionable to get it.
Click here to check out Fasting Cancer, and starve cancer cells while nourishing your healthy ones!
Share This Post
-
Every Body Should Know This – by Dr. Federica Amati
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
This book is very much a primer on how to eat healthily. The science is high-quality (the author is the head nutritionist at ZOE) and well-explained, and the advice is reasonable.
Limitations: this book is not very deep, which we might expect from a book with this title. So, if you’ve been a long-time 10almonds reader, you might not learn a lot here, and this book might make a better gift for someone else.
In particular, the book may be well-suited for someone who is thinking of having children soon, as there is an unusual amount of focus on fertility and young motherhood—perhaps because the author herself has young children and so was preoccupied with this when writing. For those of us who are definitely not having any more children, the focus on young motherhood is a little superfluous.
The writing style is very readable pop-science, and nobody who is able to read English is likely to struggle with this one. It’s also quite conversational in parts, as the author discusses her own experiences with implementing the science at hand.
Bottom line: if you want a good, solid, primer of how to eat well for a lifetime of health, especially if you are (or are thinking of becoming) a young mother, then this is a very good book. Otherwise, it’s probably a better to give it as a gift.
Click here to check out Every Body Should Know This, and know the things!
Share This Post
Related Posts
-
Shedding Some Obesity Myths
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Let’s shed some obesity myths!
There are a lot of myths and misconceptions surrounding obesity… And then there are also reactive opposite myths and misconceptions, which can sometimes be just as harmful!
To tackle them all would take a book, but in classic 10almonds style, we’re going to put a spotlight on some of the ones that might make the biggest difference:
True or False: Obesity is genetically pre-determined
False… With caveats.
Some interesting results have been found from twin studies and adoption studies, showing that genes definitely play some role, but lifestyle is—for most people—the biggest factor:
- The body-mass index of twins who have been reared apart
- An adoption study of human obesity
- Using a sibling-adoption design to parse genetic and environmental influences on children’s body mass index
In short: genes predispose; they don’t predetermine. But that predisposition alone can make quite a big difference, if it in turn leads to different lifestyle factors.
But upon seeing those papers centering BMI, let’s consider…
True or False: BMI is a good, accurate measure of health in the context of bodyweight
False… Unless you’re a very large group of thin white men of moderate height, which was the demographic the system was built around.
Bonus information: it was never intended to be used to measure the weight-related health of any individual (not even an individual thin white man of moderate height), but rather, as a tool to look at large-scale demographic trends.
Basically, as a system, it’s being used in a way it was never made for, and the results of that misappropriation of an epidemiological tool for individual health are predictably unhelpful.
To do a deep-dive into all the flaws of the BMI system, which are many, we’d need to devote a whole main feature just to that.
Update: we have now done so!
Here it is: When BMI Doesn’t Measure Up
True or False: Obesity does not meaningfully impact more general health
False… In more ways than one (but there are caveats)
Obesity is highly correlated with increased risk of all-cause mortality, and weight loss, correspondingly, correlates with a reduced risk. See for example:
So what are the caveats?
Let’s put it this way: owning a horse is highly correlated with increased healthy longevity. And while owning a horse may come with some exercise and relaxation (both of which are good for the health), it’s probably mostly not the horse itself that conveys the health benefits… it’s that someone who has the resources to look after a horse, probably has the resources to look after their own health too.
So sometimes there can be a reason for a correlation (it’s not a coincidence!) but the causative factor is partially (or in some cases, entirely) something else.
So how could this play out with obesity?
There’s a lot of discrimination in healthcare settings, unfortunately! In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
True or False: to reduce obesity, just eat less and move more!
False… Mostly.
Moving more is almost always good for most people. When it comes to diet, quality is much more important than quantity. But these factors alone are only part of the picture!
But beyond diet and exercise, there are many other implicated factors in weight gain, weight maintenance, and weight loss, including but not limited to:
- Disrupted sleep
- Chronic stress
- Chronic pain
- Hormonal imbalances
- Physical disabilities that preclude a lot of exercise
- Mental health issues that add (and compound) extra levels of challenge
- Medications that throw all kinds of spanners into the works with their side effects
…and even just those first two things, diet and exercise, are not always so correlated to weight as one might think—studies have found that the difference for exercise especially is often marginal:
Read: Widespread misconceptions about obesity ← academic article in the Journal of the College of Family Physicians of Canada
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
The Worry Trick – by Dr. David Carbonell
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Worry is a time-sink that rarely does us any good, and often does us harm. Many books have been written on how to fight anxiety… That’s not what this book’s about.
Dr. David Carbonell, in contrast, encourages the reader to stop trying to avoid/resist anxiety, and instead, lean into it in a way that detoothes it.
He offers various ways of doing this, from scheduling time to worry, to substituting “what if…” with “let’s pretend…”, and guides the reader through exercises to bring about a sort of worry-desensitization.
The style throughout is very much pop-psychology and is very readable.
If the book has a weak point, it’s that it tends to focus on worrying less about unlikely outcomes, rather than tackling worry that occurs relating to outcomes that are likely, or even known in advance. However, some of the techniques will work for such also! That’s when Dr. Carbonell draws from Acceptance and Commitment Therapy (ACT).
Bottom line: if you would like to lose less time and energy to worrying, then this is a fine book for you.
Click here to check out The Worry Trick, and repurpose your energy reserves!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
What is reformer pilates? And is it worth the cost?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Reformer pilates is steadily growing in popularity, with new studios opening regularly in major cities all over the world.
But what exactly is reformer pilates? And how does it compare with regular pilates and other types of exercise?
Classes aren’t cheap so let’s look at the potential benefits and drawbacks to help you decide if it’s right for you.
Ahmet Kurt/Unsplash Pilates with special equipment
Pilates is a mode of exercise that focuses on core stability and flexibility, while also addressing muscular strength and endurance, balance and general fitness. At first glance, it might look a bit like yoga, with some more traditional weight training components thrown in.
Reformer pilates uses a piece of equipment called a “reformer”. This looks like a narrow bed that slides along a carriage, has straps to hold onto, and has adjustable springs that add resistance to movement. You perform pilates on the reformer to target specific muscle groups and movement patterns.
The reformer was first designed to help people recover from injuries. However, it has now become common for general fitness and even sports performance.
Unlike normal pilates, also known as “mat pilates”, which only uses your body weight, the reformer adds resistance, meaning you can change the difficulty according to your current level of fitness.
This not only provides a way to overload your muscles, but can make the exercise session more aerobically demanding, which has been proposed to improve cardiovascular fitness.
Mat pilates uses your body weight. Kampus Productions/Pexels What are the benefits of reformer pilates?
Despite being around for decades, there is surprisingly little research looking at the benefits of reformer pilates. However, what we have seen so far suggests it has a similar effect to other modes of exercise.
Reformer pilates has been shown to help with weight loss, cause some small increases in muscle mass, and enhance cognitive function. All of these benefits are commonly seen when combining weight training and cardio into the same routine.
Similarly, among older adults, it has been shown to improve strength, enhance flexibility and may even reduce the risk of falling.
From a rehabilitation perspective, there is some evidence indicating reformer pilates can improve shoulder health and function, reduce lower back pain and increase flexibility.
Finally, there is some evidence suggesting a single session of reformer pilates can improve two key markers of cardiovascular health, being flow-mediated dilation and pulse wave velocity, while also improving cholesterol and insulin levels. This suggests reformer pilates could lead to long-term improvements in heart and metabolic health, although more research is needed to confirm this.
Reformer pilates was first designed to help people recover from injuries. Kampus Productions/Pexels However, there are some key things to consider when discussing these benefits. Most of this research is quite exploratory and comes from a very small number of studies. So we do not know whether these findings will apply to everyone.
Very few studies compared reformer pilates to other types of exercise. Therefore, while it can improve most aspects of health and function, it’s unlikely reformer pilates provides the optimal mode of exercise for each individual component of physical fitness.
Traditional weight training, for example, will likely cause larger improvements in strength than reformer pilates. Similarly, stretching will probably make you more flexible. And running or cycling will make you fitter.
However, if you want a type of exercise that gives you broad overall health benefits, it could be a good option.
What are the downsides of reformer pilates
Reformer pilates is not for everyone.
First and foremost, classes can be expensive compared to other fitness options. You need to be doing at least two to three sessions per week of any type of exercise to maximise the benefits. So even if you can find a class for A$20 or $30, paying for two or three classes a week (or buying a weekly or monthly subscription) is a significant outlay.
Second, it’s not as accessible as other exercise. Even if you can afford it, not every town or suburb has a reformer pilates studio.
Cost and access are major barriers. Or you might get better results with specific modes of exercises. Karolina Grabowska/Pexels Third, the effectiveness of your workout is likely to be impacted by how competent your instructor is. There are a host of different pilates qualifications you can get in Australia, and some take much less time than others. With this in mind, it might be best to look for accredited pilates instructors, although this will further reduce the number of options you have available.
Finally, there is a learning curve. While you will get better over time, the exercise will likely be less effective during those first few weeks (or months) when you are getting used to the machine and the movements.
Is it right for you?
Reformer pilates can be a great addition to your fitness routine, especially if you’re looking for a low-impact way to build strength and flexibility.
But if you have more specific goals, you might need a more specific mode of exercise. For example, if you need to get stronger to improve your ability to manage your daily life, then strength training is probably your best bet. Likewise, if your goal is to run a marathon, you will get more specific benefits from running.
The cost and availability of reformer pilates make it less accessible for some people. With this in mind, if you are after similar benefits at a lower price point, mat pilates might be a better option. Not only does it have evidence suggesting it can improve strength and fitness, but it is something you can do at home if you find a good resource (YouTube could be a good starting point here).
Hunter Bennett, Lecturer in Exercise Science, University of South Australia; Jacinta Brinsley, Exercise Physiologist and Postdoctoral Researcher in the Alliance for Research in Nutrition, Exercise and Activity, University of South Australia, and Lewis Ingram, Lecturer in Physiotherapy, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: