Friday, February 4, 2011

Dissenting Views at HSPH

A thought crossed my mind yesterday in class about the type of atmosphere HSPH promotes. Generally speaking, I feel like my own perspectives are part of the mainstream. I find myself to be more liberal in terms of the role of the government; I believe that intervening in health crises is a responsibility - not just a luxury - for countries such as the US. But something in class yesterday didn't sit quite right as I realized I had an opposing view.  

I'm enrolled in a course called "Society and its Effect on the Child," and overall, I've really enjoyed it. It's based in the Society, Health, and Human Development department, so it has much stronger links to social sciences than global health. If I had taken this course last year, I'm not sure I would have enjoyed it as much. Many of the topics remind me of a less intelligent conversation from my undergrad. (I'll add a disclaimer, however, that the people I had such discussions with in undergrad were "experts" due to 4 years of research while I think the topics are somewhat new to some of my current classmates).  

That notwithstanding, we were talking about a theory in social determinants yesterday that suggested that capitalist models in society are often to the detriment of the disadvantaged. As someone who’s done work on structural barriers including racism, I found this to be an intriguing model. However, the example given was about breast milk vs. formula and how only the multinationals benefit.  

 Now, think about it for a minute. Yes, I agree that the nutrition of mothers should be improved. And yes, I agree that breast milk has substantial benefits for nutrition of children. But there were 3 areas in particular that I thought presented a counterargument to my professor's point: 

1.     Babies born to HIV-positive mothers can benefit from formula. While perhaps recent years have led to developments that make breastfeeding less of a health risk in the transmission of HIV, avoiding breast milk from an HIV-positive mother is a sure bet. (Of course, it's important to identify that not receiving breast milk could have nutritional repercussions for children, hence the need for development if antiretrovirals (anti-AIDS medications) and other technologies. But that doesn't change the fact that not have breast milk has benefits in this respect).  

2.     Formula feeding has reduced discomfort and diarrhea in lactose-intolerant children. Case and point: me! I had difficulty digesting breast milk as a child and often cried due to discomfort. My mom has shared, however, that I seemed more content when drinking lactose-free formula. I cried less and digested more. 

3.     Using formula provides an opportunity for mothers to work, and this has both financial and mental health benefits for the mother. We live in a society now where women have much more access to working. We may still be underpaid and under hired, but the influence of women in the workforce has drastically increased. Being able to use formula as a feeding supplement provides a way to keep children nourished while the mother is at work, particularly in the absence of a breast pump. We could argue whether or not the role of the woman is to be at work or at home, but as someone raised in a "women are equal" environment, I've seen that being able to work is empowering, and this can improve mental health. It can also help bring in additional income to the household.  

While I don't believe that formula use is the end all and be all, or that it should be used exclusively, I do believe that it has some benefits. And what bothered me today was that as the only person with a vocalized dissenting view, I didn't have the opportunity to make my argument. It made me think about a program that we put on in Shattuck not too long ago where we watched the State of the Union address (and made commentary along the way). The assumption was that everyone was a democrat or Obama supporter, but understandably, the one person I knew wasn't in that category was quite silent. I think that while HSPH is often a great place if you're a part of the majority, it can be difficult for those in the minority. 


-From the band Green Day

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