The Effect of the COVID-19 Pandemic on Unemployment Rate: Implications for the Gender Gap

by Farah Hasan, September 27, 2022

Abstract

The recent COVID-19 pandemic has brought on unprecedented disruptions to global economies resulting in income loss and high unemployment rates that have disproportionately affected women. Existing research on COVID-19 and the economic effects of a pandemic on gender-based employment are limited, though rapidly growing, and a literature review providing a holistic overview is needed to advise and inform policymakers on important factors to consider when working towards reparations and economic recovery. Prior empirical work, particularly case studies, will be used for a primarily qualitative analysis, along with the presentation of some important statistics in regards to unemployment. Unemployment rates are exceedingly high for women compared to those for men in both developed and developing countries, with several female-dominated occupations (such as beauticians and cabin crew) being most severely affected by the pandemic due to closures and discontinuation of service. Policymakers should take several factors into account when working towards economic restoration such as a country’s status as developed or developing, type of occupation, and type of unemployment. Additionally, more focus should be given to implementing certain standard practices in promoting gender equality in work outcomes. Such policies will aim to revive employment while improving occupational gender equality in the long run.  

Keywords: COVID-19; pandemic; unemployment; gender gap; developed/developing countries

1. Introduction

This paper seeks to discuss general trends in global unemployment rates after the COVID-19 pandemic took hold, to highlight patterns in the types of occupations most severely affected, and to evaluate potential changes in labor outcomes in regards to gender. As a novel occurrence, the COVID-19 pandemic has impacted individuals and nations from a variety of different angles (such as healthcare, political standpoints, research and development, growing reliance on virtual settings, etc.) and has thus given rise to an immense amount of unknown territory for research. While extensive research is available on economic recessions, not as much is known about the unique impacts of a pandemic, especially as it relates to gender gaps. Most existing literature consists of case studies looking at unemployment rates and demographics within specific countries. It has been observed that the unprecedented disruptions to the global economies brought about by the pandemic in which diversified economies were providing job opportunities for women in different sectors has led to income loss and high unemployment rates. A literature review providing a holistic view of general trends in unemployment and relations to gender on a global scale (synthesizing the information from case studies on various countries) is needed to have a more comprehensive understanding of the true extent of the impact of the COVID-19 pandemic on unemployment and gender gaps. Understanding how the pandemic affected labor markets in both the developed and the developing worlds is crucial as governments continue to develop responses. 

Most evidence used will consist of prior empirical work, such as case studies. The analysis will be mostly qualitative, but will provide valuable statistics and graphical data to highlight comparisons of unemployment rates in different countries and percentage breakdown of labor outcomes by gender. Current literature suggests that the pandemic has widened gender inequality in the labor market. Changes in the gap must be investigated in order to address the potentially growing inequality by enacting and strengthening policies to support women and prevent a possible increase in female unemployment and worsening of gender inequality. The purpose of the present literature review is to highlight various determinants of occupational segregation in regards to COVID-19, such that policymakers will have a clear understanding of factors to consider when formulating policy responses to alleviate the impact of the pandemic and take preventative measures against similar future crises. This will be achieved by discussing general trends in global unemployment rates after the COVID-19 pandemic took hold, highlighting which types of occupations and industries were most often and most severely affected by the pandemic, and evaluating the gender demographics of workers affected in both developed and developing countries across the globe. Failure to investigate this would leave governments and economists in the dark regarding any potentially exacerbated gender gaps due to the pandemic, obscuring the urgency of mitigating any harmful changes. 

In the next section, I will present background on gender inequality and its connection to the pandemic. Section 3 is a literature review on COVID-19 and unemployment rates, types of jobs affected, and demographics of the worker population most severely affected. Section 4 synthesizes findings from the literature review and highlights salient determinants of occupational gender equality in regards to the pandemic, such as the status of a country (developed or developing) and type of occupation, that policymakers must pay heed to. Section 5 summarizes findings and discusses implications for COVID-19-related employment policies, limitations regarding scope of analysis, and recommendations for future research. 

2. Background

Gender inequality is an issue in both developed and developing countries, with 18% of women having experienced physical and/or sexual violence in the previous 12 months (United Nations (UN), 2019). This percentage is even higher in developing countries. A greatly embraced solution to this issue is empowering women financially in finding productive employment opportunities (Dang & Nguyen, 2020). Despite these efforts, the gender gap in employment still exists to significant extents in countries around the world, both developed and developing. This occupational segregation also sheds light on the differences in types of occupations that women and men choose, differences in employment status, and differences in hourly wage. The gender gap is especially important to address, as this impacts lifetime earnings, retirement pension payments, and potentially the educational level and earnings of their children (Bächmann et al., 2022). 

While there is extensive research on the impact of recessions on gender-based employment, knowledge on the impact of pandemics in particular on the gender gap is limited. Studies conducted after the Great Recession in the United States suggest that historically, women have suffered higher unemployment rates than men and that their employment tends to be less cyclical than that of men (Hoynes et al., 2012; Doepke & Tertilt, 2016). It is especially important to focus on gender inequality as a pandemic may differ from a typical recession; it more strongly affects sectors with high female employment shares and necessitates increased need of childcare for mothers due to school closures (Alon et al., 2020). Indeed, the pattern observed after the Great Recession is thus compounded by the effects of the pandemic, as some studies suggest that the negative effects of COVID-19 may have wiped out the global progress in gender equality and poverty reduction from the past 30 years (Sumner et al., 2020). The research that is available on gender-related impacts of a pandemic focuses mostly on developed countries, but even less is known about such impacts in developing countries, where gender discrimination is more prevalent and women are typically already worse-off than men in labor participation, job security, income, etc. (Hossain & Hossain, 2021).

3. Literature Review

In the following section, various notable statistics on unemployment rates due to COVID-19 in both developed and developing countries will be presented. Then, a closer look at the types of jobs most severely affected will be provided, followed by a breakdown of the demographics of individuals who work these types of jobs and were most affected by the pandemic and related governmental response policies. This section can be segmented into three major questions, which will be answered in the following literature review.  

3.1 How has COVID-19 impacted unemployment rates?

Compared to the unemployment effects of recessions, the effects of the pandemic are staggeringly large in comparison. It is important to note the similarities between developed and developing countries in these skyrocketing unemployment rates, indicating that both types of countries were significantly affected and that a deeper look into the demographics of the workers affected is warranted. 

According to Figure 4, in the United States alone, the unemployment rate rose from 19.3% in February 2020 (the start of the COVID-19 recession) to 41.5% in February 2021 about 12 months later. Looking at unemployment rates during the US Great Recession, the unemployment rate began at 17.4% in December 2007 and climbed to about 23% within the same time span of 12 months (ultimately ending at 40.4% after 24 months) (Figure 4). 

[Figure 4 here]

Thus, the spike in unemployment due to COVID-19 rather than the recession was significantly sharper and more profound within the same time span of 12 months, suggesting that the unemployment effects of a pandemic warrant urgent investigation (Bennett, 2021).

Different countries experienced these increasing unemployment rates in different patterns. Burns & John (2020) highlight unemployment rates from a more global perspective. While some countries experienced relatively constant unemployment rates throughout the pandemic (namely Japan, Germany, and the United Kingdom), other countries experienced large and sudden spikes in unemployment similar to that in the United States (namely Canada, while Spain, Italy, and France experienced smaller spikes in unemployment) (Figure 5) (Burns & John, 2020). 

[Figure 5 here]

Sweden, a country that will be discussed in depth later in this paper, experienced an overall increase in unemployment by 2.5 percentage points from February 2020 (one month prior to the onset of the pandemic) to July 2020 (5 months after) (Campa et al., 2021). 

It is important to note that all of the countries discussed so far are developed countries, but the COVID-19 pandemic also had profound, if not even more significant, impacts on unemployment rates in developing countries as well. Prior to the COVID-19 breakout in Nigeria, Hossain & Hossain (2021) found that overall employment rates for women were lower than overall employment rates for men. It was noted that 80% of the sample Hossain & Hossain (2021) studied from Nigeria were employed before the pandemic. From March 2020 to May 2020, the early period of the pandemic, the employment rate dropped to 43%. Even after the pandemic broke out, the employment rate for women continued to be lower than that for men. Additionally, the overall likelihood of being employed dropped by 13% in Nigeria (Hossain & Hossain, 2021). Furthermore, as a result of the pandemic, a significant restructuring of the distribution of employees by gender in farming and business spheres occurred. The employment rate for women in business declined compared to male employment in business during the COVID-19 period (Figure 3c) (Hossain & Hossain, 2021). However, it is interesting to note that the employment rate for women in farming surpassed male employment in farming during the COVID-19 period (Figure 3b) (Hossain & Hossain, 2021). These findings will be expounded upon in the following sections. 

[Figure 3 here]

3.2 What types of jobs were most significantly affected? 

Several job spheres were impacted by the COVID-19 pandemic in both developed and developing countries, from aircraft operation to agriculture. By studying the types of jobs affected by the pandemic, valuable information about the nature of the jobs, worker skill sets/interests, and demographics can be determined. 

In Sweden, some of the occupations that were most heavily impacted by unemployment were aircraft pilots, masseurs and massage therapists, cabin crew, and beauticians (Campa et al., 2021). Of these, the unemployment impacts range from 30.8% for aircraft pilots and related associate professionals (which was the highest) to 15.2% for beauticians and related workers (which was the lowest) (Table 1) (Campa et al., 2021). 

[Table 1 here]

It is important to note that most of these occupations are service-based and typically require physical proximity, consistent with the expectation that they would be affected by social distancing measures necessary in reducing the spread of COVID-19.   

In Nigeria, the agriculture sector typically hosts a large fraction of women and works as a buffer during economic shocks. Thus in the context of COVID-19, women engaged in agricultural work were more likely to keep their job, and the agricultural sector became an alternative employment option for women who were not already involved in it (Hossian & Hossain, 2021). This is consistent with the above finding that the employment rate for women in farming surpassed male employment in farming during the COVID-19 period (Figure 3b) (Hossain & Hossain, 2021).

3.3 What were the demographics of the employees affected?

After broadly considering general trends in unemployment rate due to COVID-19 and associated affected jobs, information on gender breakdown in these spheres sheds light on the disproportionately large impact of the pandemic on women compared to men. In doing so, it is important to consider the developed or developing status of a country as well as their response to COVID-19, as these also have implications on gender-based labor outcomes. 

An overwhelming amount of evidence suggests that the COVID-19 pandemic has worsened labor market outcomes for both men and women, but especially for women. Women are 24% more likely to lose jobs permanently than men due to the pandemic in China, South Korea, Japan, Italy, the United Kingdom, and the United States (Adams-Prassl et al., 2020; Dang & Nguyen, 2020). Table 2 shows that 5.8% of women and 4.8% of men reported losing their job permanently, while roughly equal percentages of women and men (25%) reported losing their job temporarily (Dang & Nguyen, 2020). 

[Table 2 here]

Broken down by country, the impact of gender on job loss due to the pandemic are larger in China, Italy, and the United States compared to Japan, South Korea, and the United Kingdom. In regards to losing a job temporarily versus permanently, there appears to be no significant effects of gender on the probability of temporarily losing a job in most countries. However, only in the United States and the United Kingdom are women more likely to lose a job temporarily than men (Dang & Nguyen, 2020). 

In Nigeria, women remained unemployed for a longer period of time (about 3.67 months) compared to men (about 2.61 months) after the initial COVID-19 breakout (Hossain & Hossain, 2021). This specifically hurts women because the longer women stay unemployed, the longer it takes and the harder it is for them to reintegrate into the labor force, lowering future prospects of finding work (Hossain & Hossain, 2021). Overall, the employment of women decreased by 8% more than the employment of men during the pandemic (Hossain & Hossain, 2021). In regards to the interesting phenomenon of farming and business, women were 44% less likely than men to engage in business activities during the pandemic, but 52% more likely than men to engage in farming (Hossain & Hossain, 2021). Thus, not only did women experience a significantly greater reduction in employment during COVID-19, but also a large shift from business to agricultural work. This suggests that women in developing countries have lower job security than men. This also hurts the overall level of productivity of women, as women-managed land is typically less productive than land managed by men, indicating lower labor market returns of farming for women in comparison to men, and more generally of farming in comparison to business (Hossain & Hossain, 2021). 

Revisiting the case of Sweden, this country exhibited interesting – and seemingly contradictory – evidence regarding the extent of gender-based job-related impact. Figure 1 shows that unemployment risk exists for all wage levels, but lower-paying jobs (signified by lower wage deciles) were at higher unemployment risk (Campa et al., 2021). 

[Figure 1 here]

Although Sweden has relatively low gender-based wage inequality, women still tend to be concentrated in lower-paying jobs, suggesting a contributing factor to unemployment of women (Figure 2) (Campa et al., 2021). 

[Figure 2 here]

Additionally, most of the heavily impacted occupations in Sweden were female-dominated. According to Table 1, beauticians are 96.7% female, masseurs and massage therapists are 81.2% female, and cabin crew is 78.5% female (Campa et al., 2021). However, it is important to note that although some highly feminized occupations were significantly impacted by unemployment, these occupational fields are relatively small in size in Sweden (Campa et al., 2021). On the other hand, the unemployment risk actually decreased for some occupations, a few of which are female-dominated as well. Some of the notable occupations are clinical and operations managers in healthcare, department managers in elderly care, pediatric nurses (97% women), and anesthesia nurses (74% women) (Campa et al., 2021). Thus, although some female-dominated fields were adversely affected by unemployment, these fields are relatively small, and some larger sectors that are also dominated by women have experienced an increase in the demand for workers (Campa et al., 2021). Thus, Campa et al. (2021) found that women did not suffer higher unemployment rates than men in Sweden and may actually have had a just barely statistically significant lower unemployment risk than men did. From March 2020 to July 2020, the unemployment risk for men was 2.5 percentage points higher, whereas the unemployment risk for women was 0.5 percentage points, or 20% less than the risk for men (Campa et al., 2021). 

However, it is important to note that the findings from Sweden may not be representative of the unemployment impacts of women elsewhere in the world, as Sweden took a unique approach in responding to COVID-19. Sweden never enforced a lockdown where people had to stay home from work and school. Since daycare and childcare centers remained open, Swedish families did not have to make significant adjustments to the time they dedicate to childcare, a responsibility that often falls on women (Campa et al., 2021). Additionally, Sweden generally has a high labor force participation rate for women to begin with and works to provide feasible opportunities of combining work and family life. Thus, at least in the case of Sweden, gender did not have a significant impact on unemployment (Campa et al., 2021). Like Sweden, there is also no evidence of unequal impacts of the pandemic on women and men in Germany (Adams-Prassl et al., 2020) or in Italy (Casarico & Lattanzio, 2020). 

These findings suggest that the type and/or extent of governmental response to COVID-19 may have influenced the extent to which gender-based employment was affected. Sweden took a relatively minimalist approach in addressing COVID-19 and thus did not have to greatly deviate from its “normal” way of life. Sweden also experienced relatively equal impacts of COVID-19 on the unemployment of both women and men. On the other hand, countries such as the United States, China, and Nigeria more strictly enforced COVID-19 protective measures such as mandatory facemask use, social distancing, travel restrictions, and lockdowns (Dang & Nguyen, 2020; Hossain & Hossain, 2021). These countries also experienced a greater extent of gender inequality in terms of unemployment due to the pandemic. The status of the country as developed or developing may also contribute to these findings, as these countries have different labor participation rates, infection rates, and shares of women in the labor force (Dang & Nguyen, 2020). 

4. Results

The findings suggest a general global trend in increasing unemployment rates as a result of the COVID-19 pandemic, with women being particularly hard-hit. Based on the literature review, the following section suggests several factors that policymakers should take into account when working towards economic recovery, such as a country’s status as developed or developing, type of occupation, and type of unemployment, which will be discussed in the following section. Policymakers should also consider implementing certain standard practices in promoting gender equality on a regular basis, as these types of practices appear to be protective factors against worsening gender inequality during economic downturns. 

A comparison of the unemployment rates and types of jobs affected between men and women in developed versus developing countries suggests that the classification of a country as developing has important implications on gender-based employment. As Hossain & Hossain (2021) emphasized, developing countries such as Nigeria are in an especially precarious spot given the lower labor participation rates, inferior and more temporary job types, lack of access to savings and credit, and significant earning gap between men and women that existed even before the pandemic. Thus, when the pandemic took hold, lack of protection against the virus and slow economic recovery rate enhanced the long-term negative outcomes of COVID-19 compared to in developed countries. When working towards economic recovery in developing countries, policymakers must target the root of the turmoil– the preexisting gender inequality– and work toward giving women protected property rights, promote labor reintegration after job loss for women (particularly into the field they were previously working in, as opposed to having to switch to agriculture), and support women’s entry into typically men-dominated fields (such as business). 

Developed countries were undoubtedly significantly affected by the pandemic, but in different ways from Nigeria, as they did not necessarily experience gender-based restructuring of the distribution of employees and related effects. Campa et al. (2021) shows that Sweden was able to maintain a state of “normalcy” during the pandemic, did not witness drastically disruptive changes in lifestyle patterns that affected jobs, and experienced a relatively even distribution of negative effects on employment outcomes between men and women. While Sweden’s minimalist approach to COVID-19 may have played a major role in preventing drastic lifestyle changes, this approach was certainly not ideal for every country. It is important to consider Sweden’s preexisting high labor force participation rate for women and the availability of feasible opportunities of combining work and family life. Using Sweden as an example, policymakers in other countries should aim to establish family-friendly measures that allow families to balance work and home life (especially working women, as the shared responsibilities typically fall on them more than men). Implementing such policies would promote gender equality as a part of a country’s regular work culture and may prevent the exacerbation of gender inequalities during economic downturns. 

Other important factors to consider for policy making include type of occupation and type of unemployment. As evidenced by the specific job types that were impacted by the pandemic, such as masseurs, cabin crew, beauticians, healthcare workers, and agriculture, policymakers should aim to help women reintegrate into these industries and establish greater job security in the future in the event of another major economic downturn (Campa et al., 2021; Hossain & Hossain, 2021). Since many of these jobs tend to be service-based and require physical proximity, special sanitary precautions may be taken to reduce the risk of laying off such workers if another future public health crisis occurs. In regards to type of unemployment, policies aiming to help women who lost jobs permanently may be more urgent as there are higher rates of women losing jobs permanently compared to men than losing jobs temporarily (Adams-Prassl et al., 2020; Dang & Nguyen, 2020). Policies facilitating access to education and job training, urging communities to hold networking opportunities and job fairs, and promoting job advertisement on social media may help women diversify their skills and facilitate job match.

5. Conclusions

5.1 Summary and Implications

The purpose of this literature review is to highlight some of the major determinants of occupational segregation during COVID-19 for policymakers, giving them a clear understanding of what factors to consider when formulating policy responses to alleviate the impact of pandemic and take preventative measures against similar future crises. This literature review highlights the increasing unemployment rates that arose as a result of the pandemic, both in developed and developing countries. In both cases, women were disproportionately affected and experienced higher rates of unemployment and difficulty reintegrating into their former jobs, especially since several female-dominated, service-based industries were adversely affected. This is largely attributable to the inability to continue several service-based jobs during the pandemic and the closure of daycare and childcare centers, causing much of the responsibility of childcare to often fall on mothers, who as a result, were more likely to leave their jobs.   

To combat this growing gender inequality, economic policymakers must consider a country’s status as developed or developing, type of occupation, and type of unemployment in crafting the appropriate policies to facilitate economic recovery and gender equality. Potential policies worth pursuing include those regarding job security, training, and family-friendly policies that enable a realistic work-home balance. Although this is a holistic overview of global unemployment rates, Sweden and Nigeria provide particular guiding examples that policymakers can look to in regards to developed and developing countries, respectively. Each country responded to COVID-19 differently based on their unique circumstances and faced varying effects as a result. 

5.2 Limitations 

While this literature review is one of the first in providing a broad overview of the pandemic’s impacts on unemployment, there are a few limitations that must be considered. Firstly, unemployment was measured in different ways in different studies. These numbers were not adjusted before including them in this paper as one purpose of this literature review was to simply outline general trends in unemployment rate globally due to COVID-19. Additionally, although several countries were mentioned in this overview, particular attention was given to Sweden and Nigeria to highlight notable differences between developed and developing countries. However, it is unrealistic to assume that Sweden is representative of all developed countries’ methods of handling gender inequality and COVID-19, and likewise, that Nigeria is representative of all developing countries in this regard. Lastly, this literature review does not advise on specific policies that should be pursued, but rather, simply guiding factors that policymakers should consider. 

5.3 Future Directions

For future direction, reports on unemployment rates (particularly meta-analyses conducted with more gathered data) should be standardized such that rates are measured using the same metrics and calculation methods. More developed and developing countries should also be highlighted to compare and contrast gender-based job outcomes, COVID-19 responses, and policy efficacy. Additionally, unemployment in regards to disparities in race, education level, and location (urban, suburban, or rural) may be studied. Lastly, an analysis of changes in the gender wage gap due to COVID-19 may be included, as these have important implications on earnings and retirement pensions. 


References

Adams-Prassl, A., Boneva, T., Golin, M., & Rauh C. (2020). Inequality in the impact of the coronavirus shock: Evidence from real time surveys. Journal of Public Economics, 189, 104245.

Alon, T. M., Doepke, M., Olmstead-Rumsey, J., & Tertilt, M. (2020). The impact of COVID-19 on gender equality. National Bureau of Economic Research Working Paper No. 26947.

Bächmann, A., Gatermann, D., Kleinert, C., & Leuze, K. (2022). Why do some occupations offer more part-time work than others? Reciprocal dynamics in occupational gender segregation and occupational part-time work in West Germany, 1976–2010. Social Science Research, 104, 102685–102685. https://doi.org/10.1016/j.ssresearch.2021.102685 

Bennett, J. (2021, March 22). Long-term unemployment has risen sharply in U.S. amid the pandemic, especially among Asian Americans. Retrieved March 23, 2022, from https://www.pewresearch.org/fact-tank/2021/03/11/long-term-unemployment-has-risen-sharply-in-u-s-amid-the-pandemic-especially-among-asian-americans/ 

Burns, D., & John, M. (2020, December 31). Covid-19 shook, rattled and rolled the global economy in 2020. Reuters. Retrieved March 23, 2022, from https://www.reuters.com/article/us-global-economy-yearend-graphic-idUSKBN2950GH 

Campa, P., Roine, J., & Stromberg S. (2021). Unemployment inequality in the pandemic: Evidence from Sweden. Covid Economics, 83(2), 1-24. 

Casarico, A. & Lattanzio, S. (2020). The heterogeneous effects of COVID-19 on labor market flows: Evidence from administrative data. Covid Economics, 52, 152–174.

Dang, H. & Nguyen, C. (2020) Gender inequality during the COVID-19 pandemic: Income, expenditure, savings, and job loss. World Development, 140, 105296.

Doepke, M., & Tertilt, M. (2016). Families in macroeconomics. Handbook of Macroeconomics, (2). 

Hossain, M. & Hossain, M. A. (2021). COVID-19, employment, and gender: Evidence from Nigeria. Covid Economics, 82(23), 70-98.

Hoynes, H., Miller, D., & Schalle, J. (2012). Who suffers during recessions? Journal of Economic Perspectives, 26(3), 27–48.

Sumner, A., Hoy, C., & Ortiz-Juarez, E. (2020). Estimates of the impact of COVID-19 on global poverty. WIDER Working Paper, 43

United Nations (UN). (2019). Report of the Secretary-General. Special edition: Progress towards the sustainable development goals. https://undocs.org/E/2019/68 

Appendix

Figure 1: Unemployment impact by wage decile in Sweden, (2021). 

Table 1: Occupations with the highest unemployment impacts in Sweden (2021). 

Figure 2: Share of female workers by wage decile (2021).

Figure 3: Job participation rates of males and females in Nigeria in various occupations (2021). 

Table 2: Gender differences in job loss, expected income reduction, weekly expenses, and savings (2020). 

Figure 4: Percent of US unemployed out of work for more than 6 months. US workers are 16 years or older, seasonally adjusted. The Great Recession was from December 2007 to June 2009. The COVID-19 recession began in February 2020 (2021). 

Figure 5: Global view of unemployment rate during the COVID-19 pandemic (2020). 

The Impact of Audre Lorde

by Zarya Shaikh, May 8, 2022

My central guiding question is “how can the impact of Audre Lorde as a catalyst for women’s liberation be itemized?” This question can be answered by examining Poet Audre Lorde’s work in the Women’s Liberation Movement during the late 1960s going into 1980. Audre Lorde (1934-1992) championed equality through her work as a Black lesbian cancer survivor and mother (Brandman, n.d.). She was a daughter of immigrants and was cognizant of issues in systems of oppression including racism, sexism, classism, and homophobia (Poetry Foundation, 2020). Lorde’s early works, including those discussed in the accompanying presentation, were the roots of her cumulative contributions to feminist theory, critical race studies, and commitment to inclusivity. Her words existed as a response to the second wave of the feminist movement during the 1960s and 1970s. This second wave was intended to help women pivot into roles beyond the private sphere and into the public sphere (Kang et al., 2017). This included motions for women to join more predominantly male workspaces and positions. Birth control and reproductive justice were also significant aspects of the second wave. 

Lorde, seeing that the challenges affecting BIPOC women were not at the forefront of (or even close to) the movement’s agenda, decided to empower women of underrepresented and marginalized communities. The women she hoped to help were the same ones who were taught that their needs were not as important as the needs of the white middle-to-upper class women that the second wave embraced (Aviles, 2019). Lorde outright criticized the flagrant discrimination against BIPOC individuals in systems of injustice (Veaux, 2006). Audre Lorde was similar to other Black feminists in that she not only advocated for women’s rights but also fought for equality within the Black liberation movement. She enabled others to change their own futures on a national scale. Lorde is unique in that her vessel of change was her poetry and she focused on her battle with breast cancer as opposed to reproductive health. With respect to her LGBTQ+ advocacy, she was unapologetic for defying heteronormative standards in addition to beauty standards for what was considered feminine. 


References

Aviles, G. (2019, June 3). Pride #50: Audre Lorde – activist and author. NBC News. https://www.nbcnews.com/feature/nbc-out/pride-50-audre-lorde-activist-author-n1007551

Brandman, M. (n.d.). Audre Lorde. National Women’s History Museum. https://www.womenshistory.org/education-resources/biographies/audre-lorde. 

Kang, M., Lessard, D., Heston, L., & Nordmarken, S. (2017). Introduction to 

Women, Gender, Sexuality Studies. Amherst, Massachusetts: University of Massachusetts Amherst Libraries.

Poetry Foundation. (2020). Audre Lorde. https://www.poetryfoundation.org/poets/audre-lordeVeaux, D. A. (2006). Warrior poet: A biography of Audre Lorde. W. W. Norton. 

Interview With a Female Fibroids Patient: How One Woman’s Story Speaks Volumes About the US Healthcare System

by Vineeta Abraham, May 6, 2022

Disclaimer: This paper was written for Dr. Marci Lobel’s Psychology of Women’s Health class in Spring 2022. This paper is intended to analyze the real experiences of a woman suffering from health issues. It should be noted that the use of the word “female” in this paper refers to the sex assigned at birth rather than the gender of “women” in general. Name of the interviewee has been changed for confidentiality.

In discussions of menstrual health, we often neglect to pay enough attention to the less apparent changes occurring in our reproductive organs. While one may focus their knowledge of reproductive processes in the female body on the phenomena of menstruation, reproduction, and menopause, there are other symptoms and diagnoses that can impact a female’s menstrual health. 

I was fortunate to have been able to interview Sarah [pseudonym], a 53-year-old registered nurse living on Long Island, about her recent experiences with uterine fibroids, which she identified as noncancerous growths in the uterus. Sarah has been married for 25 years and has three children ages 21, 18, and 16. She is originally from India and moved to the United States in 2003 after receiving her bachelor’s degree in nursing. She follows a Protestant-Christian religious practice and works overnight shifts at Queens Hospital Center. 

Sarah reported finding out about her uterine fibroids at the age of 51, about two years before this interview was conducted. She was lucky enough to have received the diagnosis before experiencing any serious side effects or symptoms. She claimed, “I went in for a regular check-up at my doctor’s office. We had been discussing my anemia for a few visits, so she recommended that I consult with my gynecologist to rule out fibroids.” Unfortunately, the opportunity for a “rule-out” never came. I asked Sarah whether she looked into treatment options upon hearing of her diagnosis of fibroids. She responded grimly, “Yes. The only treatment option is surgery to remove [the fibroids]. That or ablation, which is to block blood supply to the fibroids to shrink them.” Unsurprisingly, Sarah was not eager to undertake such invasive treatment, so after a few weeks of contemplation, she carefully declined. “Temporarily,” she clarified in our discussion. “I won’t be getting any further treatment unless serious complications arise.” She described how having uterine fibroids was not impacting her day-to-day activities any more than other related health concerns that previously existed before this diagnosis. For example, Sarah described how, although 53, she has not yet reached menopause, which is a great cause of concern for her. She also suffers from menorrhagia, which she described as having “severe anemia.” In an afterthought, she added that the fibroids may be adding to this.    

I then asked Sarah about any support or lack thereof she had received from friends and family regarding her diagnosis. She explained that the least support seems to come from her husband: “I asked him to ask around or look into other solutions, if he knows any other doctors, to ask if there are options other than surgery.” He did not follow through with the task, but Sarah did not comment any further on this. On the other hand, she claims better support came from other women, friends or co-workers who had either experienced similar problems or knew of others who had. Sarah described often talking with these women about gynecologist recommendations or side effects in her hunt for more information. When asked if she had felt any financial boundaries inhibiting her from receiving treatment, she said she did not think so, and does not think it would be an issue if she decides to get treatment in the future. 

I also made sure to ask Sarah about how living with this physiological health concern has impacted her mental or psychological health. Fortunately, Sarah replied that she did not experience any psychological differences as a result of her diagnosis. She explained that she is not particularly stressed about having fibroids, as it “doesn’t run in the family, doesn’t give [her] any side effects, and there are no hormonal changes.” She claimed that her lack of distress is one of the reasons she is okay with waiting before jumping into treatment. 

Much of what Sarah discussed with me in our conversation relates to topics discussed in Dr. Marci Lobel’s Psychology of Women’s Health course. For example, Sarah was clear in her explanation of limited options presented to her in terms of treatment for her uterine fibroids. The option of invasive surgery and not much alternative seems drastic and frightening for patients like Sarah. This reminded me of a concept discussed in the “Introduction and Overview” reading excerpted from the Physical Health, Illness, and Healing textbook, in which the authors explained how doctors show “more interest in restricting [women’s] reproductive potential than in treating their illnesses.” Although Sarah has decided she will not be having any more children, she described that she is not comfortable with getting rid of all her reproductive organs, an option presented to her through the discussion of surgery. She mentioned that although she may not want to have kids, she needs those organs to produce hormones for the rest of her life (she also demonstrated a distaste for taking external hormone supplements). The thought of invasive surgery comes with many risks and potential side effects, and is therefore understandably less appealing to women who are caretakers or full-time employees or, like Sarah, both. 

Perhaps this is one of the many reasons Sarah has decided to wait on the decision to treat her fibroids. As she mentioned multiple times in our conversation, Sarah’s fibroids are not an obvious hindrance to her day-to-day routine. In the midst of her hectic work schedule and household responsibilities such as childcare, home maintenance, or cooking, her fibroids are therefore being metaphorically “pushed to the backburner.” This information came as no surprise to me after hearing Dr. Lobel’s lecture on women’s cardiovascular health on February 1, 2022 during which she described how there is often a delay in women seeking healthcare services. Dr. Lobel attributed this delay to factors such as having various other responsibilities or a general lack of knowledge. Sarah’s own testimony relates closely with this concept, as she claimed that her hesitancy to receive treatment came from her desire to learn more information instead of jumping hastily into a decision. This idea of not receiving adequate information was also discussed in the “Introduction and Overview” article, in which the authors described how female patients sometimes receive less information than male patients or report feeling dissatisfied with the communication they had with their healthcare providers. This could come from providers being biased and assuming that male patients are better able to understand their diagnoses or treatment options compared to their female counterparts. However, this lack of strong communication can cause women to feel disrespected or underserved, further discouraging them from seeking healthcare services in the future. True to this idea, when I asked Sarah when the last time was that she went to her provider to check on the status of her fibroids, she responded, “about a year [ago].” Sarah admitted to understanding that the fibroids could grow exponentially in that time frame, and claimed that she will go in for a checkup soon, although she did not clarify when that would be. 

In Sarah’s defense, she has made attempts to remedy her lack of knowledge regarding her diagnosis and treatment options. Sarah described going to her husband primarily to help with the situation. “I asked him to ask doctors that he associates with about other options or if they knew of good places to go for the surgery or ablation.” Sarah’s husband also works in a hospital, and she wished to take advantage of his access to multiple healthcare providers and professional opinions. However, she was disappointed to find that he soon forgot about her situation and never followed through with an inquiry. The lack of support Sarah received from her husband was a theme discussed in Dr. Lobel’s lecture on autoimmune disorders, where she discussed how social support from family and friends can play a large role in the recovery process for female patients. In Sarah’s situation, lack of support from the husband has been a contributor for the delay in her treatment, which may lead to more serious consequences if her fibroids grow.

On the bright side, Sarah claims that she has received better support from her friends and co-workers. Dr. Lobel’s lecture mentioned the benefits of having a support group for patients to connect with individuals who have similar diagnoses or experiences. While Sarah did not attend a formal support group for her diagnosis, she was able to discuss her diagnosis with female friends and co-workers who have experienced reproductive complications. These discussions resulted in sympathy and advice in the form of treatment alternatives or gynecologist recommendations that helped Sarah to feel less alone in her journey. While Sarah, unlike many of the women we learned about in lecture, did not report having serious psychological effects as a result of her diagnosis, she was grateful for the support she received from her friends. This type of support, as we’ve learned, can help women feel less alone in their journey of recovery. 

As seen in our lectures and readings, many of the factors impacting Sarah’s experiences are not unique to her. Female patients are often put in difficult circumstances in which their reproductive organs and menstrual health are endangered, often being placed in situations that male patients and physicians cannot personally relate to. Because of this, it is easy for women to feel isolated or unsure about their treatment options. Women are also disproportionately placed in social frameworks that label them as caretakers or being tasked with other social responsibilities, which adds to the delay in proper treatment. This delay can put them in riskier situations as their conditions may either worsen or become more complicated without proper resources. As in Sarah’s case, there may also be circumstances in which treatment options are available but not ideal, which can also lead to delays and uncertainty in patients. Healthcare services should therefore strive to improve their communication and flexibility in treatment options for females with menstrual and other health related complications. Female patients should feel well supported by both their providers and their social structures throughout their healthcare journeys. 


Oversharing on Social Media: The Dangers of An Overly Transparent World

by Ean Tam, May 6, 2022

In contemporary media culture, the more information we get and the faster we get it, the more satisfied we are. But at some point, we have to consider the consequences of sharing too much about ourselves. Oversharing is when someone excessively broadcasts personal information over social media.

What kind of information can be overshared?

A prime example is location—where you are and who you are with. Most social media platforms enable users to share location. For some platforms, location sharing has to be done manually by the individual. On Instagram, you can make a post and tag your location, so everyone who sees your posts can see where you are. On the other hand, sometimes your location is shared simply by using the app. For instance, if you enable the map feature on Snapchat, your followers can see where you are whenever you open the app again.

Another example of overshared information is family information. Family information includes birthdays, names of siblings and parents, or major family events (like a family member moving into a new house). Social media has its advantages in that it connects families and friends. However, posting family information becomes an act of oversharing if you let the public know the details of your family dynamics or personal information.

A third form of oversharing is indulging your followers with your personal thoughts and emotions. A study published in 2017 calls this “self-disclosure” because you are voluntarily disclosing your inner sentiments to the world (Zhang, 527). In these situations, an individual uses social media to convey their mental state to the public. Often, this happens spontaneously and in the heat of the moment. For example, a user may negatively comment on people they know such as coworkers or make an impassioned statement involving politics. 

A fourth form of oversharing is sharing the private conversations you have with others. This can be done by screenshotting direct messages and then posting these conversations elsewhere. For example, you can screenshot text messages with one person and then share this screenshot on Snapchat for your followers to see. This is oversharing because you would be violating the trust of the person you were having the private conversation with. By sharing private messages on social media, you are in effect, allowing others to eavesdrop on your conversation. You consented to this because you were the one who shared the conversation, but the others involved in the conversation may not have. 

Virtually any social media app allows for oversharing. This is because social media is inherently made for sharing information. The complication is that social media has become so advanced that information can be shared more easily. If you overshare information about yourself (such as your location), this may be considered primary overshared information because it’s about you. However, if you overshare information about someone else (like their birthday, or their child’s name, or a private message you received from them), this may be considered secondary overshared information because you are revealing information about someone else via social media.

Why do people overshare?

A prominent reason is stress sharing. A study found that adolescents may feel inclined to overshare information because it gives them a sense of freedom (Radovic et al. 7). There may be a variety of circumstances in a person’s life that make them depressed and bogged down, but being able to post whatever they want on social media grants some sense of freedom. It is a form of expression.

In addition, the urge to overshare may be triggered when a user observes something on social media that incites them into posting a passionate retort (Radovic et al. 10). We can think of politics as a prime example of sensitive subject matter that may trigger people to overshare their emotions.

We should also consider that people may overshare to seek attention. This is more complicated, because attention-seeking behavior may be the result of narcissism, or simply because someone is genuinely seeking help. In the former case, a person may overshare information about themselves to brag, or they might overshare information about others at the expense of other people’s privacy. On the other hand, if a person is genuinely seeking help, they may overshare information about themselves in order to attract the right support groups (Newman et al. 344; Zhang, 527). The more information they share about themselves, the more likely people will come to their aid and give positive reinforcement.

Goal-setting and a competitive spirit are also reasons people will overshare on social media (Munson and Consolvo, 26). People are more likely to achieve their goals if they make their goals public and well-known. A study has found that a person’s motivation increases if they believe their goals are known by people they deem to be superior (Klein et al. 372). For example, in college, there is a lot of competition and students may feel compelled to overshare their goals in order to increase their motivation to accomplish them.

Lastly, people may overshare in order to create a perfected persona of themselves. In one study, a participant displayed a lot of her athletic information on social media, including many pictures and statistics, because it helped her create a new brand for herself (Newman et al. 346).

What are the consequences?

The first consequence of oversharing is putting yourself in danger. This can be in the form of robbery or stalking (Velempini and Nyoni, 4). If you overshare your location, daily routine, and social activities, people can track you and have a good idea of where you will be and when. This happened to social media influencer and entrepreneur Kim Kardashian in 2016, when thieves reportedly used Kardashian’s social media activity to find her location in Paris and confirm when she was alone. With this information, they broke into her residence, restrained her, and robbed her.

Another consequence is damaging your professional prospects. If you decide to go on a rant on social media about your employer, you can be held responsible for whatever you say, because after all, you decided to post it. If your post is discovered by a colleague or your employer, you could potentially lose your job. 

In terms of reputation, some things are better left private, and oversharing can cause your private and public lives to collide. For example, Jeff Bezos, the founder of Amazon, had personal texts with his girlfriend released to the public. Reportedly, it happened because his girlfriend shared screenshots of their conversation with her brother. While Bezos didn’t lose his job, he went through public embarrassment as a result of his girlfriend’s oversharing.

How do we avoid oversharing?

Avoid posting on social media when you’re angry. Your judgment will be clouded, and your overshared information may not represent you at your best. Double check your privacy settings. If you want to post things like family-related content, make sure only close friends and family can see it, not the general public. Lastly, when crafting a social media post, be mindful of who sees your posts. But remember, people can always screenshot your posts and share it elsewhere, so take that into consideration. Unfortunately, private information doesn’t always stay private, but taking the steps outlined above as precautionary measures may lessen the likelihood of risky oversharing in a growing digital world.

Works Cited

Klein, Howard J., et al. “When Goals Are Known: The Effects of Audience Relative Status on Goal Commitment and Performance.” Journal of Applied Psychology, vol. 105, no. 4, 2020, pp. 372–389., doi.org/10.1037/apl0000441. 

Munson, Sean and Sunny Consolvo. “Exploring Goal-Setting, Rewards, Self-Monitoring, and Sharing to Motivate Physical Activity.” Proceedings of the 6th International Conference on Pervasive Computing Technologies for Healthcare, 3 July 2012, pp. 25–32., doi.org/10.4108/icst.pervasivehealth.2012.248691.

Newman, Mark, et al. “It’s Not That I Don’t Have Problems, I’m Just Not Putting Them on Facebook: Challenges and Opportunities in Using Online Social Networks for Health.” Proceedings of the ACM 2011 Conference on Computer Supported Cooperative Work, Association for Computing Machinery, March 2011, pp. 341–50, doi.org/10.1145/1958824.1958876.

Radovic, Ana, et al. “Depressed Adolescents’ Positive and Negative Use of Social Media.” Journal of Adolescence, vol. 55, 2017, pp. 5–15., doi.org/10.1016/j.adolescence.2016.12.002. 

Velempini, Mthulisi and Phillip Nyoni. “Privacy and User Awareness on Facebook.” South African Journal of Science, vol. 114, no. 5-6, 2018, pp. 27–31, https://doi.org/10.17159/sajs.2018/20170103.

Zhang, Renwen. “The Stress-Buffering Effect of Self-Disclosure on Facebook: An Examination of Stressful Life Events, Social Support, and Mental Health Among College Students.” Computers in Human Behavior, vol. 75, 2017, pp. 527–537, doi.org/10.1016/j.chb.2017.05.043.

The Judgement of Judge Ketanji Brown Jackson: Its Implications and An Analysis of the Future of the Supreme Court

by Abbie Cawser, April 26, 2022

One of the most recently reported-on events are the confirmation hearings of Judge Ketanji Brown Jackson, as she becomes the first ever African American female nominee to the United States’s highest judicial court. Her hearings are currently being discussed everywhere from mainstream news shows to TikTok, highlighting the trend of increased public interest in the Supreme Court and increased personality politics that have breached the Court in recent years.

Unlike many similar institutions around the world, the Supreme Court of the United States is an inherently political one, where Justices are easily placed on the Liberal-Conservative scale. It is now seen as an accomplishment of the President to place someone on the bench– not because it is an opportunity for greater education and stronger debate, but because it increases the likelihood of the President’s policies passing easily through the judicial branch. Retirement of Justices is now strategically planned, with Justices of a certain political leaning delaying or expediting their retirement in order for it to occur under a President they support, so that their replacement would be of a similar ideology. When Justice Ruth Bader Ginsburg passed away, Republicans rushed to pass Justice Amy Coney Barrett’s appointment, as it was just a month before the 2020 election and former President Donald Trump risked losing the opportunity. This is an inherent risk with lifetime appointments, as electing Justices of roughly similar ages means that there are often multiple vacancies opening up all at once, and some Presidents are given the opportunity to appoint multiple Justices. In four years, Presidents Trump and Richard Nixon appointed three and four SCOTUS Justices, respectively, whereas both Presidents Barack Obama and George Bush Jr. each appointed just two in their eight years (and no vacancies opened up during President James Carter’s term). The opportunity to elect a Supreme Court Justice was a rare one, so Presidents needed to take the chance to appoint someone who will support as many of their policies as possible.

Never before has such scrutiny been placed on a Supreme Court nominee as that on Ketanji Brown Jackson. Her initial naming was controversial, as many took issue with President Joseph Biden’s campaign statement that he would appoint “the first Black woman ever nominated to the United States Supreme Court,” with some claiming that this undervalued the Court, arguing that “a nominee’s race or gender should not play a role in Biden’s selection process.” However, this argument is not unique in 2022, as in 1980, President Ronald Reagan made a promise to elect a female Justice, stating that he would appoint “the most qualified woman [he] can possibly find.” Whilst he failed to do so, with the first female Justice coming 13 years later with President William Clinton’s appointment of Justice Ruth Bader Ginsburg, Reagan’s campaign promise was not dissimilar to Biden’s, as it suggests nomination based on an underrepresented demographic (in this case gender). It is also important to remember that Reagan’s statement crosses party lines, and whilst not all of the outrage against Biden’s statement came from Republicans’, they were certainly the leading voice. Parties have become so polarised that they are now disagreeing with issues that their own party championed just 40 years ago, and this has concerning implications for the future of bipartisanship.

However, the arguments over Biden’s decision limits Judge Brown Jackson’s candidacy to a discussion just about race. Senator Ted Cruz questioned her on children’s books such as “Antiracist Baby” by Dr. Ibram X. Kendi, asking questions such as her opinion on critical race theory and if she “thought babies were racist.” Whilst critical race theory is a widely debated issue across the country right now, it is important to note that neither Justices Brett Kavanaugh nor Amy Coney Barrett were questioned on this topic, and certainly neither of their confirmation hearings involved scrutiny of children’s books. Senate Minority Leader Mitch McConnell said he would vote against Brown Jackson’s appointment, as she has refused to comment on the issue of adding seats to the Supreme Court, in agreement with Justice Coney Barrett, as she too had refused to comment on the issue. However, when speaking of Amy Coney Barrett, Mitch McConnell stated that she was an “incredibly impressive jurist and highly qualified nominee.” Whilst it is far from surprising that a Republican leader would denounce a Democratic pick for the Supreme Court, it is vital that the arguments made against her are scrutinised and understood, just as those made against Republican picks must be as well. In a similar vein, there has been little discussion within mainstream news of how she is the most qualified lawyer of all those sitting on the Court. The following graphic has gone somewhat viral on social media, which compares Judge Brown Jackson’s legal history with the 9 other Justices.

Whilst there is no expectation of having to agree with Judge Brown Jackson, and indeed it would be both problematic and damaging to democracy if the Court only contained members who represented one ideology, experience is something which cannot be misrepresented or denied. In the same debate speech in which he announced his intention to elect a Black woman, Biden stated that “if I were Black, my success would have been a lot harder to achieve. And I know a lot of black people that if they were White it would have been a lot easier for them.” Not only does Judge Brown Jackson’s race not undermine her experience, but it may actually show more experience; she has worked in so many areas of the legal system because she was unable to skip stages, due to barriers in place due to her race. It would be unjust to minimise her nomination to a mere diversity pick with little standing, as her experience outweighs any discussion of her race.

The Supreme Court as an institution works best when it is diverse and varied. At its very core, its function is to scrutinise the workings of the government, and this will never work when unbalanced and biased. Whilst legal systems in other countries work with the core foundation of neutrality, the entire government of the US was created with the idea of ambition challenging ambition. Every Justice, just like every President and every Congressman, has their own personal views, and the system operates best when each opinion is challenged and picked apart by an equally represented, but opposite opinion. The presence of Brown Jackson, as a left-leaning voice on the Court, would merely replace Justice Stephen Breyer, who is leaving the Court, and therefore the Court would still be politically unbalanced, with six of the nine Justices – Clarence Thomas, Samuel Alito, Neil Gorsuch, Amy Coney Barrett, Brett Kavanaugh, and John Roberts – representing Conservative ideals. Whilst it would be politically beneficial for Biden to appoint a liberal Justice as he has done, it will still have little effect on the Court’s overall ideology. What Judge Brown Jackson does provide, however, is a wealth of knowledge and experience, and this can only improve the Court, as the healthiest thing in a democracy is well-educated representatives. Whilst her race undoubtedly allows her to have an important voice for a consistently underrepresented group, it would be unjust and unrealistic to say that she represents the views of every Black woman, just as it would be incredulous to think that race places a role in every decision she would make on the Court, especially considering the wide range of issues they rule on each year. 

The intention of this essay is not to suggest that Ketanji Brown Jackson is a perfect candidate, or even that scrutiny of her should be easy. Senate confirmation hearings are supposed to be of great substance and hard questioning, as this is the only way to achieve the most accomplished Court possible. However, the questioning placed upon one Judge should be equal to that of another, and this is not being done. President Biden’s criticism that race should not be important when choosing nominees can only remain valid when it coexists with fair treatment under questioning, and therefore Judge Brown Jackson’s questioning should not be entirely centred around her race. By asking questions about antiracist babies and asking her to rate her religion on a scale of 1-10, we dismiss the real debate that should be occurring in regards to the Supreme Court– by having a highly politicised Court in which Presidents can only effect change in the instance of retirement or death, are we rendering the judicial branch of government inoperable and imbalanced, and how can we protect the Court from this? Will set term limits allow for a more structured and less random appointment process, so that Presidents use their appointing powers in equal measures, or will this defeat the Founders’ intentions when creating an effective Court?

Bibliography

Barabak, Mark Z. “Column: The architect of Reagan’s pledge to put a woman on the Supreme Court says it was all political.” Los Angeles Times, Feb 2022

Burtt, Kristyn. “Ketanji Brown Jackson Faced Some Astonishingly Stupid Questions About Racism From Ted Cruz.” SheKnows, March 2022

CBS News. “Full Transcript of the South Carolina Debate.” CBS, Feb 2020

Kaslovsky, Jaclyn and Andrew Stone. “Biden vowed to nominate a Black woman to the Supreme Court. It might be good politics.” The Washington Post, Feb 2022

McMillion, Barry J. “Supreme Court Nominations 1789 to 2020.” Congressional Research Service, March 2022

Mitch McConnell Senate Website. “McConnell Praises Judge Barrett and Denounces Attacks on Judicial Independence.” The Newsroom Remarks, Sept 2020

Quinn, Melissa. “Mitch McConnell says he opposes Ketanji Brown Jackson’s Supreme Court nomination.” CBS News, March 2022

Schwarz, Frederick A. “Saving the Supreme Court.” Brennan Center For Justice, Sept 2019

Empathy: Why its Facilitation is So Important and How to Foster it in Our Youth

by Grace Sargent, April 22, 2022

Introduction

Humans as a species are empathetic by nature, though modern society seems to hinder its widespread development. Surrounded by technological advancements and automated machines, we have become immersed in a robotic world that fails to illustrate the countless emotions we experience daily. This is quite prevalent among children, who are incredibly susceptible to the mindless behaviors associated with technology. It is extremely common for parents to immediately produce an electronic tablet for their crying child instead of taking more lasting measures. In this digital age, it is increasingly important for children to maintain a healthy relationship with books, as they provide an authentic way to facilitate empathy and to ensure that such important characteristics are nurtured instead of lost or forgotten.

What is empathy?

In order to argue for the value of empathy to individuals and society, a definition of empathy itself must first be understood. American cognitive scientist and author J.D. Trout explains that “empathy is the capacity to accurately understand the other’s position, the feeling that ‘this could happen to me’” (Pohoată 9). As humans, we have a multitude of emotions that we are subject to, not only throughout our lives but fluctuating during our days as well. However, the fascinating thing about these emotions is that we all experience them, whether it be at the same time over the same things, or at different times over different things. It is through these experiences that we can come together and empathize with each other; we know what it feels like to be sad, happy, anxious, or excited, and so we are, consequently, able to gather a general idea of what someone else is currently feeling. Another crucial part of the definition of empathy is the involvement of cognitive comprehension and emotional reactions. To be fully empathetic, both of these characteristics must be developed for long periods of time (Good 1).

Why is empathy important?

Following the comprehension of empathy as a concept, we need to also understand its importance, which has been illustrated through a study conducted by Ph.D. student of Psychology Greg Depow. This study involved questioning 246 participants from the United States seven times a day for one week regarding their levels of happiness, sense of purpose, and overall well-being. The purpose of the study was to track the frequency of participation in situations where empathy could be called upon, whether that meant offering or receiving it. Once the study was completed and the collected data was analyzed, encouraging conclusions were drawn. Firstly, the study found that we empathize often in our everyday lives, as we frequently find ourselves in situations that could benefit from it. On average, over a span of twelve hours, people found nine opportunities to empathize and six opportunities to receive empathy. More notably, the analysis concluded that those who recognized more empathy opportunities and empathized more reported greater happiness and well-being. It is important to remember that empathy does not need to always involve the experience of negative emotions. In fact, according to Depow, we experience positive emotions three times more often than negative ones, which could contribute to why participants reported empathizing more with positive emotions during the study. Relating to the study, Depow reported that at the times when people in the study experienced more empathy, they practiced more kindness towards others (“How Small Moments”). This study demonstrates empathy’s cyclical nature: the more empathetic we are, the better we feel, and the more we want to be empathetic towards others. If we as a society can maintain this healthy cycle, the empathy we share is central to our humanity and can allow us to live in a decent society, characterized by citizens that willingly and voluntarily understand and take care of each other (Pohoată 15).

The development of empathy

One last important note about empathy is that although it is an innate characteristic of humans, it can be improved upon through education about what it is made up of and how those parts relate to one another. Empathy heavily relies on the parts of our brains that deal with an emotional connection with others (“Why the World Needs an Empathy Revolution”). We experience arousal in our pain pathways when witnessing someone else in pain. Psychiatrist Helen Reiss explains that our neurological systems allow us to observe the hurting of others while also giving us a fraction of that pain as motivation to help them out (“Why the World Needs an Empathy Revolution”). However, empathy also involves a level of concern, which complicates its effectiveness in each individual; while we are all “programmed” to empathize with others, not all of us will necessarily empathize to the same extent. Thus, the behavior of people directly correlates with education and self-education (Pohoată 11). It is important to recognize that empathy has multiple parts, and, therefore, it develops over time rather than all at once. Additionally, it is during our adolescent years that our empathy develops the most, given our impressionability. It is understood that children as young as two-years-old can comprehend and talk about specific emotions along with the actions that accompany them (Good 2). This is why attempts at facilitating empathy in children must be made as early as possible and with lots of consideration and thought.

How to effectively cultivate empathy in children

One of the most important parts of teaching children empathy is firstly emphasizing understanding the emotions they and those around them can face, as well as explaining the actions that accompany them. Fortunately, a common thread throughout children’s literature is the discussion of emotions and the ways they are displayed (Berliner). A wonderful way to foster these ideas is to allocate reading time during school, thereby encouraging storytime as a method of enhancing empathy in children. 

Another useful aspect of literature involves the characters that make up the stories. Characters provide a space for emotions to be felt and displayed for children to digest while reading. A useful technique for teachers is to first explicitly explain the events of the story and then circle back to the children themselves. For example, teachers can ask questions in the following format: “This child was angry when his toy was taken away from him. How do you feel when someone takes your toy?” (Berliner). The value of this question lies in how it encompasses multiple important learning points. The child who was asked this question can now understand what anger is, associate it with a certain situation, and even identify that emotion within their own life. This example relates to psychiatrist Helen Reiss’s explanation that better perception of others’ emotions is associated with a strengthened sense of empathy (“Why the World Needs an Empathy Revolution”). They can then take this newfound knowledge and apply it to situations that may arise, ultimately allowing them to be more empathetic. 

These kinds of techniques have proven very effective within a classroom setting, and teachers have shared their approaches and experiences in incorporating them into their curriculums. High school English teacher Jennifer Ansbach discusses how she brought these kinds of methods into her classroom in an attempt to combat bullying and its harmful, long-lasting effects. She called upon the collection of personal essays called “Dear Bully: 70 Authors Tell Their Stories.” The essays come from the perspective of bullies, victims, and even witnesses to bullying. All of them are written in the first person, which is important because first-person writing allows for the explicit expression of specific emotions and feelings during relatable situations. Following the conclusion of these readings, Ansbach asked her students if, before the essays, they would recognize the discussed situations as bullying. Only a handful raised their hands. She then inquired if they now understood those actions as bullying and reported that every student raised their hand. Ansbach continued speaking about this over a few weeks, and by the end, there were positive results seen in the actions of students. After the conclusion of this teaching plan, she explains that it successfully raised awareness on the matter, created empathy in the students, and created “a desire to change their own behavior” (Ansbach 92). Ansbach noticed her students discussing ideas of damage control for bullying victims more often, as well as how they can play a part in ameliorating this ongoing issue. This simple exercise alone demonstrates the empathetic nature of first-person narrative stories and how it can challenge preconceived notions of students.

Emotional transportation and how it relates to empathy

Another idea surrounding the importance of characters in stories deals with empathy facilitation, and it is called emotional transportation. Emotional transportation involves the reader of a story and allows their emotions to truly dive into a story and, therefore, form a more thoughtful connection with the content they are consuming (Bal). When an individual reads a story, their emotions are triggered in a way that can be reflected upon. One of the best ways to relate this reflection to empathy is through emotional transportation, which works most efficiently with relatable characters. When a reader indulges in a story and can identify with a character, they can take it a step further and vicariously experience the events in the story as if they were happening to them in real life. The valuable takeaway of these processes is that the reader practices empathy through reading a story (Bal). The reason emotional transportation carries such importance is because of the individual benefits: the higher the emotional transportation into a story is, the higher the probability of personal change is (Bal). 

As previously mentioned, the best way to encourage emotional transportation is by creating relatable characters. This sense of familiarity allows readers to venture into unfamiliar situations with greater ease and ultimately helps improve their empathetic capabilities. A 2013 study by Matthijs Bal and Martijn Veltkamp was conducted at Erasmus University Rotterdam where students read stories in their free time for a few hours each week and subsequently answered questions about their emotional transportation and empathetic measure. Following the completion of the study, the conclusions supported the idea that emotional transportation plays a valuable role in facilitating empathy. The main verdict of the experiment was that highly transported individuals had increased empathy over the weeks, and those who reported low transportation experienced a decrease in empathy (Bal). This is because low transportation is associated with “defamiliarization,” which is when a reader fails to connect emotionally with a story and its characters, and therefore is unable to relate to the people and situations presented to them. This not only prevents transportation, but it inhibits their ability to empathize (Junker). Thus, children need to have access to books that not only offer situations that pertain to their lives but books that also contain relatable characters.

Conclusion

In closing, empathy and the way it is brought into the lives of children is invaluable. Our society seems to be straying away from the colorful emotions we have to offer and is instead creating a more monotonous lifestyle ridden by the robotic automation of the digital age. It is up to us, however, to ensure that these innate, important characteristics we share don’t disappear. Empathy is central to our humanity and maintains the power to cultivate a healthier, more humane world (Pohoată 10). It is therefore important to instill these ideals into the minds of children and begin intervention as early as possible. Additionally, it is crucial to recognize the most effective method: reading. Through the consumption of novels and narratives, children gain helpful insight into not only what emotions are, but what they look and feel like. Education on these topics early in childhood can be carried into adulthood, and consequently spread throughout our society.


Works Cited

Ansbach, Jennifer. “Long-Term Effects of Bullying: Promoting Empathy with Nonfiction.” The English Journal, vol. 101, no. 6, National Council of Teachers of English, 2012, pp. 87–92, http://www.jstor.org/stable/23269416. 

Bal, Matthijs and Martijn Veltkamp. “How Does Fiction Reading Influence Empathy? An Experimental Investigation on the Role of Emotional Transportation.” PLOS ONE, Public Library of Science, 2013, https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0055341. 

Berliner, Rebecca and Tracy Loye Masterson. “Review of Research: Promoting Empathy Development in the Early Childhood and Elementary Classroom.” Taylor & Francis, 2015, https://www.tandfonline.com/doi/full/10.1080/00094056.2015.1001675. 

Good, Jasmine S., et al. Fostering the Development of Empathy in the Classroom. https://research.avondale.edu.au/cgi/viewcontent.cgi?article=1055&context= teach. 

Junker, Christine R. and Stephen J. Jaquemin. “How Does Literature Affect Empathy in Students?” Taylor & Francis, 2017, https://www.tandfonline.com/doi/full/10.1080/87567555.2016.1255583?scroll=top&needAcces s=true.

Pohoată, Gabriela and Iulia Waniek. “Do We Need Empathy Today?” Euromentor Journal, vol. 8, no. 3, 2017, pp. 7-16, http://proxy.library.stonybrook.edu/login?url=https://www.proquest.com/scholarly-journ als / do-we-need-empathy-today/docview/1986130844/se-2?accountid=14172. 

Suttie, Jill. “How Small Moments of Empathy Affect Your Life.” Greater Good, 2021, https://greatergood.berkeley.edu/article/item/how_small_moments_of_empathy_affect_y o u r_life. 

Suttie, Jill. “Why the World Needs an Empathy Revolution.” Greater Good, 2019, https://greatergood.berkeley.edu/article/%E2%80%8Bitem/why_the_world_needs_an_e mpathy _revolution.

What Does it Mean to be Free: Sartre’s Take On Human Freedom in the Face of the Nazi Regime

by Gina Koch, April 15, 2022

Jean-Paul Sartre is undeniably one of the most prominent philosophers of the twentieth century and the chief founder of existentialism. The works he published influenced various ideologies spanning philosophy, politics, literature, and cultural studies. Sartre, like most philosophers, had his moments of being subject to public disappointment and outrage. After living through World War II as a French prisoner of war, he sparked outrage when he published the essay, “The Republic of Silence,” which he started with the infamous line “Never were we freer than under the German Occupation” (Sartre, 1).

In  “The Republic of Silence,” Jean-Paul Sartre explores the concept of true freedom amid the Nazi German occupation of France. Extreme conditions often breed unique schools of thought for many thinkers, and Sartre was no different. Being a witness and victim of the brutal Nazi regime resulted in profound ideologies coming to light, especially regarding the concept of freedom as evidenced by his essay “The Republic of Silence.” Sartre explains that the essence of true freedom materialized during times of oppression. When people are condemned to extreme conditions of suffering, the sanctity of every thought and every right becomes apparent, and they are faced with the question of their freedom. There exists no force or authority that is capable of taking away one’s freedom because it is inherent and essential to the human condition. However, some forces can place physical limitations on one’s freedom, and it becomes a grave situation when these limitations go so far beyond as to attack one’s rights, beliefs, and principles. Under such an attack, people have the choice to exercise their freedom and resist such oppressive forces or partake in bad faith and give up on such beliefs and principles. This concept of freedom was different from other ideologies circulating at the time. For example, French philosopher Albert Camus, known for his contributions to the absurdist movement, maintained that human freedom is not inherent to humans but rather a state of mind achieved when people understand the absurdity and meaninglessness of life; thereby stopping themselves from constructing some greater meaning from it (Camus). Many differing ideologies regarding human freedom circulated during this war-torn era, but Sartre’s ideas managed to stand out among them. 

During the Nazi era in Germany, which lasted from 1933 to 1945,  particular groups of people such as the Jewish, gypsies, homosexuals, and any other groups not considered a part of the superior Aryan race were targeted as part of the ethnic cleansing scheme initiated by political leader Adolf Hitler. These groups faced oppression, suffering beyond imagination, and witnessed their inherent and basic rights being stripped away from them. They were stripped of their citizenship, denied interactions with those considered part of the Aryan race, and sent to concentration camps, often to be killed. Sartre, being a philosopher who means to seek meaning in everything that happens around him, found hope among the brutality that surrounded him. In his essay, he claims, “never were we freer than under the German Occupation” (Sartre, 1). It is quite a wonder that Sartre was able to find such freedom when the majority of people around him were arrested, sent to concentration camps, or killed. He is not talking about physical freedom, but inherent freedom; the freedom that governs the human condition and is an essential part of existence. He compares the manner people think in during peaceful times and during atrocious ones, similar to that of Nazi occupation. 

As Sartre says, “In this way, the very question of freedom was posed, and we were on the verge of the deepest knowledge human beings can have of themselves” (Sartre, 5). During times of oppression, people tend to question the limits of their freedom and their character questions that were neglected during peaceful times. Would they resist the torture and hold on to secrets and information about the resistance movement or would they give in to the pain and reveal secrets that can lead to numerous arrests and deaths? It is during moments like these that people question their freedom and existence because the choices they make can have profound effects, many times concerning life or death. Sartre also discussed “resistance was a true democracy” (Sartre, 6). There was solidarity in how they resisted the Nazi regime. During such difficult times, there is a sense of equality and responsibility among the people that is not palpable in society during peaceful times. Sartre claims he witnessed the strengthening of the Republic because everyone shared the same freedom regardless of their rank or position within the movement. The freedom they experienced while under the ironclad rule of the Nazi regime was one that was true, absolute, and equal. 

The freedom that Sartre discusses in his essay is distinct from the conventional idea of freedom that many may have. The freedom to do anything one wants is separate from the true and absolute freedom that Sartre refers to. True personal freedom is one’s ability to express their beliefs and principles regardless of the forces that govern them. It is the ability to make choices regardless of any rewards or material possessions one may obtain as a consequence of their choice. In an oppressive society, personal beliefs often start to take precedence over any material possessions and sometimes, over their own life. In other words, people are willing to die at the hands of their oppressors rather than give up on what they believe in. In his essay, Sartre explains that people often made the authentic choice in the presence of death, and it was through this act that they were able to exercise true freedom. Many of those who were tortured at the hands of the Nazis resisted revealing any information they had on the resistance movement because they stayed true to believing that their people should be freed from the oppressors. This choice may have cost them their lives but they did so as part of exercising their freedom. If they had instead chosen to spill information as a means to keep themselves alive, they would have continued living a limited life; one in which they sacrificed their freedom and lacked any meaning or purpose because they abandoned any beliefs they had. People are more than their situation so they should be able to transcend the situation and stay committed to their beliefs. 

The attitudes that Sartre shared in his essay forces us to think about the manner in which we live. Initially, society seems to be guilty of stripping freedom away from the people, and then forcing them to obey laws in order to keep their freedom. In fact, it may seem quite ironic how we are rewarded with freedom, which is something inherently ours, for giving up a certain level of our autonomy. However, this outlook on society in freedom is not accurate. Since freedom is something that is inherently ours and essential to our existence; it cannot be stripped away from us by external forces or authority. However, as members of society, we agree to accept some limitations placed on our freedom. For example, we agree to obey the laws of society as a means to maintain order in our lives and fulfill our potential as social creatures. However, we do not lose our freedom because everyone has the ability to break the law. The fact that we are still capable of committing terrible acts but choose not to proves that we still maintain our freedom. 

However, one would have to face the consequences of committing any terrible and unlawful acts. Therefore, it is important to distinguish between the consequences of an act and freedom. People have the freedom to commit any acts but they may not be successful or satisfied with the consequences, but this does not mean they do not have the freedom to commit an act. The German occupation placed limitations on people’s freedom that conflicted with their rights and beliefs. At this point, it becomes a clear case of oppression as opposed to society maintaining order. During peaceful times, it is not obvious if something is lacking in the manner they live their lives but during oppressive circumstances, it becomes very apparent. Once, it becomes apparent that their lives are not to be lived in the way that it is supposed to be, the urge to fight for their lives materializes and it results in a strength that ultimately empowers them to exercise their freedom. The absolute freedom that they experience under the regime is one that was born out of the shackles that they were bound to. 


Works Cited

Camus, Albert. “The Myth of Sisyphus.” The Myth of Sisyphus, and Other Essays. Translated by Justin O’Brien, Hamish Hamilton, 1955, pp. 3-119.  

Sartre, Jean-Paul. “The Republic of Silence.” Lettres françaises, 1944, pp. 1-7.

Hidden Costs, Dirty Lies, and The Illusion of Choice: The Worst of American Healthcare

by Vignesh Subramanian, April 12, 2022

The headlines are the same every year, and have been so for the last half-century: U.S. Health Care Ranked Worst in the Developed World (TIME, 2014); US health spending twice other countries’ with worse results (Reuters, 2018); U.S. health-care system ranks last among 11 high-income countries (Washington Post, 2021). The United States spends more on health care expenditures – both as a proportion of its gross domestic product and on a per capita basis – than any other developed nation, with annual accelerated growth rates in health spending exceeding those of OECD counterparts (Tikkanen and Abrams, Schneider). It is increasingly being understood that the U.S.’s outlier status is the result of higher prices and cost barriers rather than comparatively greater service utilization, with higher payments to hospitals and physicians as well as administrative overheads largely driving the outsized differences in spending (Kurani and Cox). Exactly how egregious the bills sent to American patients can be, however, is hidden in the fine print – an abusive doctrine formulated by medical bureaucracies and providers alike to obscure the truth about how far they are willing to go for profit.

Among the most obvious and decried examples of deceptive charging practices by providers are the various forms of surprise billing that often follow already costly care. Patients who unknowingly receive treatment from physicians who are not in their insurance network are prime targets for additional charges that may amount to tens of thousands of dollars (Kliff and Sanger-Katz). These patients typically do not choose the treating doctors themselves and are not made aware in advance of their out-of-network statuses (usually because of the urgency of required treatment or the availability of specialized providers, as is the case with emergency care or complex surgeries); some may have even sought care at an in-network hospital or urgent care center, reasonably assuming that these facilities employed providers that were similarly covered by their insurance. Nevertheless, these patients end up faced with the prospect of their insurance company refusing to pay an out-of-network balance bill, while collection agencies abandon good-faith protocols as they move to seize debt (Weber). Surprise billing often involves high initial reimbursements demanded by providers, procedures intentionally being redirected to more expensive ‘affiliated’ or ‘consolidated’ sites, and separate facility fees being tacked on; it can also affect non-emergency routine or scheduled care, making the issue a common woe for patients who cannot ‘shop’ for more affordable provider options while under any degree of duress.

The contributions of such bills to soaring healthcare spending cannot be overstated, but represent just the tip of a larger iceberg of unnecessary and inexplicable costs to the average American patient. Surprise bills would not be possible if not for deliberate schemes characterized by so-called “chargemasters” – the comprehensive, hospital-specific compendiums of all services said hospitals may charge for – to keep the realized costs of care hidden until after delivery. Such measures work to withhold, clutter, or bury procedure price lists from or on hospitals’ public sites and web search queries, while selectively publishing ‘starting point’ and ‘prospective’ rates far below those used for Medicare reimbursements and private insurance payments with little basis in market transactions (McGinty). They quietly tuck arbitrarily applied fees, such as those for basic consultation, testing, and diagnostic procedures (e.g. blood draws) or for care that was ‘seriously considered’ or ‘activated’ but not ultimately provided (e.g. trauma response fees), into final bills without patient notification (Gold and Kliff). They enshrine refusals to bring sticker prices for the use of certain technologies (e.g. MRIs) or operative procedures (e.g. hip replacements) in line with those of lower-tier doctor’s offices or otherwise justify or address variation and make comparison feasible across emergency departments, trauma centers, and surgery centers in a given geographic area (Pflanzer). Hospital systems are even willing to charge patients for minimal labor costs (fees charged to new mothers who have just given birth for “skin-to-skin contact” with their newborns are an infamous example), for basic health products like over-the-counter pharmaceuticals, toiletries, and first aid supplies that cost far less at neighboring pharmacies, and for services supporting other parts of the continuum of care at exorbitant levels (e.g. transport services like ambulance rides, despite the fact that EMS crews themselves are not reimbursed for patients not transported to emergency rooms) (Earl, Reed). Collectively, these ‘grab-every-last-dollar’ tactics take gross advantage of the necessity of critical care to bleed American patients dry, making every step into treating facilities as financially punishing as possible while denying them even the fundamental privilege of foresight to predict the final bill.

In a legitimately free market – indeed, of the kind defenders of the U.S. healthcare model contend it is and must remain – the ‘consumer’ is assumed to be able to make choices of free will, with the most accurate information possible on the prices of the goods and services available to them. This premise holds that such informed decisions will in turn guarantee a higher quality of service provided, improving consumer satisfaction while reducing costs as providers compete in a ‘race to the bottom.’ Yet neither that transparency of information nor that freedom of choice are available for U.S. healthcare’s consumer, the American patient. Deliberate and disingenuous attempts by hospital associations and physicians’ groups to bury costs and coerce acceptance of their terms instead take options away from the average American while triggering even more adverse reactions from elsewhere in the market. Insurers, supposedly the representatives of patients’ financial interests, have felt compelled to respond to providers’ effective price gouging by abruptly terminating physician contracts and leaving marketplaces (leaving many patients out in the cold with smaller networks), or else by secretly negotiating with hospitals to establish ‘adjusted payment rates’ and so-called “anti-steering clauses” (long-term agreements to avoid moving policyholders to other providers with lower costs), all without providing adequate notice to policyholders (Miller, Allen, Mathews). Governmental interventions, meanwhile, leave a lot to be desired in substance; recently enacted federal legislation that bans surprise billing and mandates that out-of-network cost sharing must match in-network provider rates, for example, only covers emergency services (and even then does not cover ground ambulances), meaning surprise billing is still possible in a large range of healthcare settings (Mensik). Other promulgated rules requiring hospitals to post price lists and insurers to inform members of discounted rates upfront fail to establish guidelines on making the provided information decipherable, while coming under sustained legal assault by healthcare and business groups seeking to shield their dealings from public view (Chiwaya and Kimelman, Weixel).

The hidden costs and false illusions of choice of service perpetuated by U.S. healthcare providers amount to a dirty lie – one that paints the patient’s inability to find affordable care as a personal failing rather than a carefully constructed outcome. The American system is not broken, but rather working perfectly as designed: to maximize profits by harassing and charging patients to the point of bankruptcy, by any and all means. It is despicable that those means have come to include openly deceiving patients about the true value of costs incurred, rendering them less willing consumers and more cash cows on which any number of charges may be whimsically levied. As our white coat-adorned saviors in operating rooms and I.C.U.s become existential threats to the pocketbook, it becomes extraordinarily difficult not to ask the question: was I, the patient, really the priority?


Works Cited

Allen, Marshall. “Why Your Health Insurer Doesn’t Care About Your Big Bills.” ProPublica, 25 May 2018, propublica.org/article/why-your-health-insurer-does-not-care-about-your-big-bills

Chiwaya, Nigel, and Jeremia Kimelman. “You Can Now Get Your Hospital’s Price List. Good Luck Making Sense of It.” NBC News, 15 Jan. 2019, nbcnews.com/news/us-news/hospital-price-list-chargemaster-rules-trump-mandate-2019-n959006.

Earl, Jennifer. “Doula Explains Why Hospital Charged Parents $39 to Hold Newborn in Viral Post.” CBS News, 13 Oct. 2016, cbsnews.com/news/doula-explains-why-hospital-charged-parents-39-to-hold-newborn-baby-in-viral-post/.

Gold, Jenny, and Sarah Kliff. “ER Bills: A Baby Was Treated with a Nap and a Bottle of Formula. His Parents Received an $18,000 Bill.” Vox, 28 June 2018, vox.com/2018/6/28/17506232/emergency-room-bill-fees-health-insurance-baby.

Kliff, Sarah, and Margot Sanger-Katz. “Surprise Medical Bills Cost Americans Millions. Congress Finally Banned Most of Them.” The New York Times, 21 Dec. 2020, nytimes.com/2020/12/20/upshot/surprise-medical-bills-congress-ban.html.

Kurani, Nisha, and Cynthia Cox. “What Drives Health Spending in the U.S. Compared to Other Countries.” Health Spending, 20 July 2021, healthsystemtracker.org/brief/what-drives-health-spending-in-the-u-s-compared-to-other-countries/

Mathews, Anna Wilde. “Behind Your Rising Health-Care Bills: Secret Hospital Deals That Squelch Competition.” The Wall Street Journal, 3 Oct. 2018, wsj.com/articles/behind-your-rising-health-care-bills-secret-hospital-deals-that-squelch-competition-1537281963.

McGinty, Tom, et al. “Hospitals Hide Pricing Data From Search Results.” The Wall Street Journal, 22 Mar. 2021, wsj.com/articles/hospitals-hide-pricing-data-from-search-results-11616405402.

Mensik, Hailey. “Ground Ambulances, Excluded from Surprise Billing Ban, to Get Scrutiny from Federal Committee.” Healthcare Dive, 22 Nov. 2021, healthcaredive.com/news/federal-committee-ground-ambulances-no-surprises-act/610451/.

Miller, Andy. “Patients Are Getting Stuck out-of-Network Due to Rifts between Insurers and Hospitals.” Fortune, 16 Nov. 2021, fortune.com/2021/11/16/out-of-network-insurance-companies-health-care-systems-hospitals-contracts/.

Pflanzer, Lydia Ramsey. “The Cost of an MRI Can Vary by Thousands of Dollars Depending on Where You Go.” Business Insider, 28 Mar. 2017, businessinsider.com/how-much-an-mri-costs-by-state-2017-3.

Reed, Tina. “Ambulance Rides Are Getting a Lot More Expensive.” Axios, 22 Feb. 2022, axios.com/ambulance-rides-are-getting-a-lot-more-expensive-cee897fe-63b7-4412-aa67-718109773e79.html.

Schneider, Eric C., et al. “Mirror, Mirror 2021: Reflecting Poorly | Health Care in the U.S. Compared to Other High-Income Countries.” Improving Health Care Quality, Commonwealth Fund, 4 Aug. 2021, commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly.

Tikkanen, Roosa, and Melinda K. Abrams. “U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?” U.S. Health Care from a Global Perspective, 2019, Commonwealth Fund, 30 Jan. 2020, commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019.

Weber, Lauren. “Patients Stuck With Bills After Insurers Don’t Pay As Promised.” Kaiser Health News, USA Today, 11 Feb. 2020, khn.org/news/prior-authorization-revoked-patients-stuck-with-bills-after-insurers-dont-pay-as-promised/.

Weixel, Nathaniel. “New Trump Policy Will Force Insurers to Disclose Prices up Front.” The Hill, 29 Oct. 2020, thehill.com/policy/healthcare/523328-new-trump-policy-will-force-insurers-to-disclose-prices-upfront/.

Nanotherapy: Small Particles for a Big Issue

by Aviram Nessim, April 8, 2022

The incidence and mortality rates of cancer remain at an unreasonably high rate despite the existence of cancer therapies. In 2018, nearly 10 million lives were lost as a consequence of some form of cancer (NIH, 2020). That same year, almost 20 million novel cases of the pernicious disease arose (NIH, 2020). While anticancer treatments, such as chemotherapy and radiation therapy, are credited with increasing survival rates of cancer patients in the last 50 years, these anticancer therapeutics are coupled with unintended consequences. More often than not, survivors are free from malignant cells, but are left to manage chronic, adverse side effects. Maladies caused by the central treatment often require further medical care. Additional ailments arise because these anticancer agents are nonspecific in their targeting, leading to an inability to distinguish between healthy cells and their rapidly dividing, malignant counterparts. This has led to the development and engineering of drugs with the ability to identify healthy tissues while destroying the cancer, furthermore diminishing side effects. 

Over the past decades, nanotherapy has emerged at the forefront of cancer treatment by offering the means to target tumors in a safer and more effective manner through its accuracy and selective delivery. This report will argue for the utilization and prioritization of nanotherapy by explaining how it works, how it has displayed significant benefits in early trials, and why it has the potential to be the superior option for cancer treatment.

The prefix “nano” describes one-billionth of a unit. Nanotechnology is the science that deals with a range of a few nanometers (nm) to several hundred nm, depending on its intended use. A “nanoparticle” is a suitable name as its sheer size can fit one-thousand particles end-to-end within the diameter of a single human hair. Other molecules quantified as nanoparticles include viruses and DNA. Nanoparticles fall under the umbrella of nanotechnology, expressed on an atomic, molecular, and supramolecular scale. Nanoparticles are applied as a cancer treatment, with precise, minimal side effects made possible by nanotechnology. When used to treat ill humans and animals, the nanomedical term for this manipulation of matter on a near-atomic scale becomes known as nanotherapy. 

Three categories of nanoparticles exist: metal, non-metal, and composite. The ideal nanoparticle is based on conditions such as size and shape of the cancerous cells. Once the precise nanoparticle is determined, it is prepared using two delivery methods. Yu et. al state:

All the preparation methods of nanoparticles can be classified into two methods: bottom-up approaches and top-down approaches. The bottom-up approach is essentially through basic units (atoms, molecules and even smaller particles can be used as the basis for assembling the required nanostructures) stacked on each other to form nanoparticles, while the top-down approach is essentially where a whole solid material begins to decompose into nanoparticles (Yu et. al, 2021, 2).   

Nanotherapy adopts a complex and unique ideology that begins with the loading of the nanoparticle to the patient. The different nanoparticle sizes and modes of delivery hit their greatest success rate once the patient’s needs are determined. The approach for nanoparticle synthesis calls for the optimum loading of either a drug, gene, or targeting ligand, which is “fired” at the cancer cell. The most common and aggressive nanomedicines include Abraxane (albumin nanospheres) and Doxil (PEGylated doxorubicin) which prevent cancer from dividing in the lungs, breasts, and ovaries. However, because each patient’s treatment is tailored to his or her diagnosis, nanomedicines and their dosage are unique to each patient. This is the essence of nanotechnology’s engineering: making anticancer agents that specialize in targeting the tumor while mitigating harmful side effects.

Nanotherapy has opened the door for a new era of cancer treatment thanks to numerous studies that demonstrate its great potential for combating cancer. Magnetic nanoparticles to treat mice with brain tumors revealed remarkable and promising findings. First, researchers discovered that the cancerous brain cells were eliminated with a 100 percent success rate, a result current therapies have never achieved. Second and most astonishing, the nanotherapy did not cause any adverse side effects in any of the mice. This outcome was reached through proper antibody loading, correct particle usage, and appropriate preparation methods (Northwestern, 2016). Employing this method also allows the receptors to be recognized and destroyed, thus eliminating threats to healthy cells and reducing side effects. The researchers’ work was praised, namely by lead scientist Dr. Maciej Leśniak. Dr. Leśniak suggested that nanotherapy could possibly be a panacea for a range of cancers. Leśniak stated, “I think this has applications to many types of cancers, from brain tumors to breast cancer. As long as there’s a specific target, you can take advantage of the nanoparticle’s mechanical properties” (Northwestern, 2016). Regardless of the anatomical location, tumors possess unique receptors which can be destroyed with the correct treatment. The research proved that when nanoparticles are properly chosen, loaded, and prepared, the cancer cells are specifically targeted, and unwanted side effects are slim. 

Nanotherapy has also been shown to prevent specific cancerous outcomes from occurring. Researchers created a table showcasing positive outcomes of nanotherapy in malignant tumor patients. In the study, by adhering to the proper nanoparticle guidelines, loading, and preparation, the researchers discovered that nanoparticles in the subject cancer patient were found to have high enhancements of drug accumulation in the tumor (Sutradhar & Amin, 2014). In another patient where the cancer had metastasized, the secondary tumor was successfully destroyed with effective nanotherapy. The research clearly demonstrates the great potential for nanotechnology to be used to defeat cancer varieties.

Nanotherapy is unlike chemotherapy in that side effects are rare, and when they do occur, they are usually not caused by the nanotechnology itself (Zhang, et. al, 2019). Nanotechnology reduces traditional therapies’ side effects since its tailored style of treatment attacks soley the afflicted cells. Although nanotherapy’s side effects are not as common as its chemotherapy counterpart, patients who have been treated with Abraxane and Doxil, the only approved nanomedicines, have reported post-nanotherapy side effects of weight loss, nausea, and diarrhea. While Abraxane has shown to be efficacious and generally safe, Doxil has had many reports of unwanted adverse effects (Wu, et. al, 2017). “Adverse reactions are common after doxorubicin administration, including fatigue, alopecia, nausea and vomiting, and oral sores…Doxorubicin is also associated with significant cardiac toxicity, which limits the long-term use of the drug” (Johnson-Arbor & Dubey, 2021). However, a valid suspicion is that these problems may be from the chemotherapy drugs they contain. One explanation for chemotherapeutic drugs producing side effects is that cancer cells do not differ greatly from healthy cells. Because of their similarity, chemotherapeutic drugs like Abraxane and Doxil that kill cancer cells may also attack normal cells despite the implementation of a different mode of delivery. Therefore, conventional chemotherapeutic drugs could be phased out by less harmful nanotherapeutic agents to eradicate the causation of such unwelcome side effects.

Many cancer patients are recipients of chemotherapy and the incidental effects caused by the chemotherapeutic agents. Unlike nanotherapy, chemotherapy has little ability to be tailored to the patient’s specifications as it has adopted the proverbial “one size fits all” treatment. Patients generally receive the same prescribed conventional chemotherapy with little to no variation.  Chemotherapy is engineered to be arbitrarily fired into the body and kill rapidly dividing cells, which subsequently results in a high mortality of healthy cells. Chemotherapy is not a guaranteed cure and is often shown to be ineffective in combating certain types of tumors. This is due to chemotherapeutic agents being too weak to reach the core of solid tumors and failing to eliminate any of the cancerous cells. Numerous “cycles” of treatment are performed in an attempt to destroy the cancer cells. Chemotherapy drugs are highly toxic and with each “cycle,” greater doses of radioactive particles enter the patient’s bloodstream. This can reduce life expectancy as well as produce possible deleterious side effects.

While many praise and are grateful for the life saving results of chemotherapy, in the long run, the often undesirable side effects may do more harm than good. I personally have seen the effects of chemotherapy through the experiences of one of my closest childhood friends that went to both my elementary and middle school. Thankfully, chemotherapy cured Jon of aggressive leukemia. While we all celebrated, his parents were mindful of the potential side effects they were advised of prior to their son’s treatment. Shortly after his final chemotherapy treatment, Jon began attending routine appointments, tests, scans, and procedures, the effects of which would remain with him for the rest of his life. Now in his late teens, Jon routinely visits many specialists to ensure his cancer does not return or metastasize, as well as making sure that his chances of reproduction are not being affected. The chemotherapy that was a blessing over a dozen years ago has also caused Jon high levels of anxiety, irrational behavior, mood swings, body image disorder, learning issues, and clinical depression. One cannot help but wonder: had Jon had the benefit of nanotherapy, would he perhaps not be facing these issues today?

Although cancer is one of the most dreaded and lethal diseases, there is a lack of awareness of current treatments for the cancer patient (WHO, 2022). Nanotherapy has strong potential to eliminate the lethal disease and decrease side effects that are produced by conventional therapies. Supported by research, nanotherapy could lead the way to the widespread implementation of the less harmful remedy for cancer patients. As further research and clinical trials are conducted, I am confident that these small particles will develop into safer, more effective life saving solutions.


References

Dunne, N. (2016, February 19). Nanoparticles destroy cancer with mechanical force. Northwestern University Feinberg School of Medicine News Center. https://news.feinberg.northwestern.edu/2016/02/nanoparticles-destroy-cancer-with-mechanical-force/

Johnson-Arbor, K., & Dubey, R. (2021, August 16). Doxorubicin. StatPearls [Internet].  https://www.ncbi.nlm.nih.gov/books/NBK459232/

Miller, Wilkes, Wahab, O’Connell, Legha, Ruddy, & Griffiths. (n.d.). Side effects of cancer treatments. CancerQuest. https://www.cancerquest.org/patients/side-effects

National Cancer Institute. (2020, September 25). Cancer statistics. https://www.cancer.gov/about-cancer/understanding/statistics 

Sutradhar, K. B., & Amin, M. L. (2014, January 16). Nanotechnology in cancer drug delivery and selective targeting. International Scholarly Research Notices, 2014, https://doi.org/10.1155/2014/939378

World Health Organization. (2022, February 3). Cancer. https://www.who.int/news-room/fact-sheets/detail/cancer

Wu, D., Si, M., Xue, H. Y., & Wong, H. L. (2017, August 16). Nanomedicine applications in the treatment of breast cancer: Current state of the art. International Journal of Nanomedicine, 12, 5879–5892. https://doi.org/10.2147/IJN.S123437

Yu, Z., Gao, L., Chen, K., Zhang, W., Zhang, Q., Li, Q., & Hu, K. (2021, May 20). Nanoparticles: A new approach to upgrade cancer diagnosis and treatment. Nanoscale Research Letters, 16(1), 88. https://doi.org/10.1186/s11671-021-03489-z

Zhang, Y., Li, M., Gao, X., Chen, Y., & Liu, T. (2019, December 17). Nanotechnology in cancer diagnosis: Progress, challenges and opportunities. Journal of Hematology & Oncology, 12(1), 137. https://doi.org/10.1186/s13045-019-0833-3

Silly Rabbit, Trix Aren’t for Kids!: How General Mills’ Trix Cereal Targets Young Audience

by Divya Jagnarain, April 5, 2022

It’s 7:15 AM on a Monday morning. Your bus will arrive outside your house in fifteen minutes. Half asleep, you reach into your cabinet and grab a vibrantly colored box of General Mills’ Trix cereal. The nutrition label sticks out, but as usual, you don’t care to read it. It’s colorful, grabs your attention, is easy to prepare and tasty. Many of the cereal boxes advertised on the shelves of grocery stores are designed in such a way to grab the attention of loud, demanding children. While making parents out to be the bad guys, who can say “no” to this brightly colored box of sugar?

What is it about the color of the box and the details of the illustrations that draw children in? According to Leatrice Eiseman, director of Eiseman Center for Color Information and Training and executive director of Pantone Color Institute, “Children are inevitably fascinated by brighter colors from early infancy” (Parpis, 4). Studies have shown that the eyes of growing children will be attracted to the primary colors, red, blue, and yellow (Parpis, 4). Marketing companies, such as those of General Mills’ Trix use this to their advantage. 

Since their eyes are not fully developed yet, from an early age children have a preference for bright colors. These colors are much easier to perceive than faint shades. The bright colors typically used by companies targeting children stand out more in their field of vision (Pancare, 3). On Trix cereal boxes, one can find an abundance of reds, greens, yellows, purples, etc. The combination of these contrasting colors is inviting to a bored child strolling through the aisles of a grocery store. 

Plastered on cereal boxes all over America, the Trix Rabbit, illustrated by Joe Harris has captivated the minds of youths. The Trix Rabbit, commonly referred to as Tricks, has a way of connecting to children. “And, of course, what we feel connected to—which happens when someone, even a cartoon character, makes eyes at us—we’re more likely to buy,” states Alice G. Walton of Forbes Magazine (Walton, para 1). Having a character representing one’s brand that is inviting and entertaining bodes well to grab the attention to young minds. 

The Trix Rabbit is more than meets the eye, however. In the Journal of Popular Culture, author Thomas Green contends that Trix the Rabbit bears more than a passing resemblance to a “trickster” (Eisenberg, 118). Green writes, “Tricksters are often depicted as participating in some kind of trick, theft, or sacrifice that results in the gift of the useful technology or plant to humanity” (Eisenberg, 118). Similarly, on television commercials, Trix the Rabbit is willing to cheat or deceive to acquire the toothsome cereal from unsuspecting children. That’s where the famous slogan, “Silly rabbit, Trix are for kids,” comes into play. 

From the 1970s to the present day, this harmless rabbit has been trying to get a taste of the eye-catching cereal but has failed to do so due to “selfish children” refusing to share. Trix the Rabbit has to resort to concealing his identity in costumes in order to trick the children. From disguising himself as an astronaut to a breakdancer, Trix the Rabbit takes on the costume of whatever advertisers perceive as popular with children at that time (Eisenberg, 120). In doing so, advertisers succeed in their goal to captivate young audiences. On the contrary, Trix the Rabbit, when he is nearing his goal of acquiring the delicious fruity goodness, his ears always spring free, exposing his true identity (Taylor, para 2). This iconic, well-known television commercial has been planted in the memories of many generations. 

To understand how television companies advertise to specific consumer segments such as children, teenagers, and adults, one must assess the nutritional quality, packaging, and co-branding of the product (Berning et al., para 4). In other words, a cereal’s nutritional profile, package attributes, and co-branding correspond to television advertising targeted at specific audiences. Often, breakfast cereal packaging is “covered in brand characters, promotional opportunities, nutritional claims, and other engaging marketing strategies” (Berning et al., para 13). As mentioned beforehand, Trix the Rabbit is an identifiable character which entices young consumers. In other popular brands, children are drawn to Toucan Sam and Cap’n Crunch in the same light. 

The attractiveness of brand profiles are heightened with the addition of “games on the box, toys in the box, and other forms of brand enhancements” (Berning et al., para 14). On the rear of a General Mills’ Trix™ Cereal box, one can find an abundance of enticing activities. Such activities include “Tumblin’ in Trix,” “Name the Rabbit,” “Hurray for Fruity Shapes,” and so on and so forth. These activities can range from short, adventurous stories to mini puzzle games to full-blown challenges. By putting different activities on these boxes, it begs consumers to buy often to complete the next set. 

Furthermore, breakfast cereal packaging is used to promote product co-branding. For instance, a child walking down the cereal aisle in a grocery store would be drawn to the cereal box with a famous athlete or character from a movie. According to Qu Rao et al, “co-branding can help gain increased access to new markets and can signal reputation and quality” (Berning et al.,  para 15). Television or movie themes, athlete endorsements, or cartoon endorsements are effective ways of targeting new consumers. 

In order for the product to be picked up from the shelves, taken to the register, bagged, taken home, and consumed, advertisers must be able to win over the hearts of both the child and parent. In regards to breakfast cereals, manufacturers are aware that sugar appeals to children. According to statistics, “a third of U.S. consumers buy one box of cereal per trip, 41% buy two and 19% buy three or more” (Sherred, para 3). Chief marketing officer of Shopkick, Kristy Stromberg says “We’ve seen that people are loyal to the brands and tastes they love, and despite a movement towards incorporating healthier options, consumers will always love classic favorites” (Sherred, para 15). At the end of the day, taste is the deciding factor when it comes to choosing breakfast cereals. 

Of the millions of Americans that shop every day, only 18% of consumers look at the nutritional values before purchasing. On the side of a box of General Mills’ Trix is the “Nutrition Facts.” The nutrition facts are clearly visible with the mass and percentage of its ingredients. Many consumers overlook this nutrition label as it is hard to understand. Having it written very plain and simple, one chooses not to question the “healthiness” of the cereal. Additionally, right below the concentrations of cholesterol, sodium, potassium, carbohydrate, and proteins are the percentage of vitamins, irons and calcium listed. It’s general knowledge that these minerals are pivotal to one’s diet. Minerals help our bodies develop and function. For instance, iron is important for cell growth, development, and normal body functions. According to Robert Earl et al, “the prevalence of iron deficiency anemia among young children has been declining, and the decline is attributed to the use of iron-fortified formula and cereal, appropriate supplementation of breastfed infants, and later introduction of cow’s milk to infants’ diets than had been typical in the past” (Earl, 3). Having these minerals listed on the boxes of cereal in clear and readable font further persuades one to purchase said cereal, whether they read it or not. 

As insignificant as it seems, the font displayed on these cereal boxes do make a difference. A brand’s chosen typeface reflects the personality of the brand. Trix™ cereal utilizes fonts such as Franklin Gothic Heavy, Helvetica Regular, Helvetica Black, and other plain fonts. In accordance to UX design student Liz Fu of University of Michigan, “The typefaces were categorized according to their personality traits and typographical features such as x-height proportion, ascender and descender proportion, font weight, stroke design, and counter design, as well as the kerning of the letter pairs. These typographical features give typefaces their personality” (Fu, para 6). These fonts are characterized with the personality traits of directness, gentleness, cheerfulness, and fearfulness. Using fonts of such that have a very familiar, legible, plain, and straightforward personality is agreeable to consumers. 

How can advertisers get this sugary goodness into the household of roughly all Americans? The answer is simple: Box Tops. Popular among cereal boxes are the inclusion of “Box Tops,” which are used for educational purposes. Trix™ cereal is in participation with the “Box Tops for Education” program. Not only on Trix™ cereals, but many popular cereal brands have the words “Every valid Box Tops clip is worth 10¢ for your school” printed on their products as well. In collecting box tops to raise funds for one’s school, children are taught the importance of giving back and how small actions can impact others in a fun way. By doing so, they earn the school’s funds that can be used towards things like school supplies, books, and field trips (Hanawalt, para 2). This characteristic on cereal boxes is appealing to parents along with their children. Many parents want to contribute to their children’s education in one way, shape, or form—whether that is through the donations of box tops or staying up late at the dinner table to complete their child’s science project on time. 

By understanding how the minds of their target audience works, marketing companies are able to play to their advantage. Through the usage of vibrant colors, large fonts, simple words, and enticing games, General Mills’ Trix™ Cereal has stolen the hearts and money of Americans all across the country. Many companies recognize that children are easy targets to sell to. The demanding voices of children bodes well for their products to sell. Where nagging children go, frustrated parents follow.


Works Cited

Berning, Joshua, and Adam N. Rabinowitz. “Targeted Advertising In The Breakfast Cereal Industry.” Journal of Agricultural and Applied Economics, vol. 49, no. 3, 2017, pp. 382–399. doi:10.1017/aae.2017.1. 

Earl, Robert O., et al. Iron Deficiency Anemia Recommended Guidelines for the Prevention, Detection, and Management Among U.S. Children and Women of Childbearing Age. National Academy Press, 1993.

Fu, Liz. “How Typefaces Affect Consumer Perception of Brand Personality.” Medium, 15 Dec. 2017, medium.com/@lizfu/how-typefaces-affect-consumer-perception-of-brand-personality-a8ba928fbad4.

Hanawalt, Zara. “Parents Can Now ‘Clip’ Box Tops Using an App.” Motherly, 30 July 2019, mother.ly/news/box-tops-program-is-going-digital.

Pancare, Rachel. “How Do Bright Colors Appeal to Kids?” Sciencing, 2 Mar. 2019, sciencing.com/do-bright-colors-appeal-kids-5476948.html.

Parpis, Eleftheria. “The Color of Money: The Art, Science and Psychological Appeal of Bright colors.” Brandweek, vol. 51, no. 17, Apr. 2010.

Sherred, Kristine. “Shopkick Survey: 96% of US Consumers Buy Cereal Every Time They Shop, Sweet Brands Still #1.” Bakeryandsnacks.com, 5 Mar. 2019, bakeryandsnacks.com/Article/2019/03/05/96-of-US-consumers-buy-cereal-every-time-they-shop-survey-reveals

Eisenberg, Lee. Shoptimism: Why the American Consumer Will Keep on Buying No Matter What. Free Press, 2009.

Taylor, Heather. “Silly Rabbit! The Trix Rabbit Celebrates His 60th Anniversary.” POPICON, 5 Aug. 2019, popicon.life/silly-rabbit-the-trix-rabbit-celebrates-his-60th-anniversary/.

Walton, Alice G. “The Sticky Methods Of Marketing Cereal To Kids.” Forbes, 4 Apr. 2014, forbes.com/sites/alicegwalton/2014/04/04/the-sticky-world-of-marketing-cereal-to-kids/#18a7bdac7562.