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Against Health

Against Health: How Health Became the New Morality

Jonathan M. Metzl
Anna Kirkland
Copyright Date: 2010
Published by: NYU Press
Pages: 226
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  • Book Info
    Against Health
    Book Description:

    You see someone smoking a cigarette and say,Smoking is bad for your health, when what you mean is, You are a bad person because you smoke. You encounter someone whose body size you deem excessive, and say, Obesity is bad for your health, when what you mean is, You are lazy, unsightly, or weak of will. You see a woman bottle-feeding an infant and say,Breastfeeding is better for that child's health, when what you mean is that the woman must be a bad parent. You see the smokers, the overeaters, the bottle-feeders, and affirm your own health in the process. In these and countless other instances, the perception of your own health depends in part on your value judgments about others, and appealing to health allows for a set of moral assumptions to fly stealthily under the radar.Against Health argues that health is a concept, a norm, and a set of bodily practices whose ideological work is often rendered invisible by the assumption that it is a monolithic, universal good. And, that disparities in the incidence and prevalence of disease are closely linked to disparities in income and social support. To be clear, the book's stand against health is not a stand against the authenticity of people's attempts to ward off suffering. Against Health instead claims that individual strivings for health are, in some instances, rendered more difficult by the ways in which health is culturally configured and socially sustained.The book intervenes into current political debates about health in two ways. First, Against Health compellingly unpacks the divergent cultural meanings of health and explores the ideologies involved in its construction. Second, the authors present strategies for moving forward. They ask, what new possibilities and alliances arise? What new forms of activism or coalition can we create? What are our prospects for well-being? In short, what have we got if we ain't got health? Against Health ultimately argues that the conversations doctors, patients, politicians, activists, consumers, and policymakers have about health are enriched by recognizing that, when talking about health, they are not all talking about the same thing. And, that articulating the disparate valences of health can lead to deeper, more productive, and indeed more healthy interactions about our bodies.

    eISBN: 978-0-8147-5963-9
    Subjects: Sociology

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-x)
  4. 1 Introduction: Why “Against Health”?
    (pp. 1-12)

    How can anyone take a stand against health? What could be wrong with health? Shouldn’t we beforhealth?

    On behalf of the authors, let me reply to these questions by proclaiming that we believe that anyone who feels ill before, during, or after reading this book should seek immediate medical attention. We believe in the germ theory of infectious illness. We believe in penicillin. We believe that physicians should wash their hands between patient visits. We are optimistic about the promise of stem cell research. We believe that the transition from the rigid sigmoidoscope to the lower abdominal MRI...

  5. PART I: What Is Health, Anyway?

    • 2 What Is Health and How Do You Get It?
      (pp. 15-25)

      The title of this book,Against Health, arises out of the same counterintuitive impulse and obeys the same rhetorical strategy that led me to call two of my booksCigarettes Are SublimeandEat Fat. I call that rhetorical strategy “contrarian hyperbole.” When anything has been so debased or so glorified that its value is taken for granted, it becomes rhetorically necessary to exaggerate the value of its opposite in order for skepticism to be heard at all. With these books, I wanted to extol and celebrate the beauty of cigarettes and fat. This is not an easy task these...

    • 3 Risky Bigness: On Obesity, Eating, and the Ambiguity of “Health”
      (pp. 26-39)

      I’m not against health at all, not even a little. But in a time of massive obesityandstarvation, food plentyandfood shortage, health isn’t what it used to be. This chapter is about the obesity epidemic, and the relation of risky bigness to what itfeels liketo eat. My claim is that physical health and mental health are duking it out these days and, as a parent says to warring siblings,somebody’s going to get hurt. Somebody’s already hurt, actually. The obesity epidemic is widely understood to threaten not just all consumers of Western junk food, but...

    • 4 Against Global Health? Arbitrating Science, Non-Science, and Nonsense through Health
      (pp. 40-58)

      Early in the wake of the millennium, the idea of global health began to take hold in the world of international development aid. By 2006, programs in “International Health” throughout the United States began to rename themselves and create subsidiary programs in “Global Health.” The University of California, San Francisco graduated the first class of master’s degree students in Global Health Sciences in 2009. “Global Health,” as distinguished from “International Health,” was meant to encompass the interconnectedness of all countries (rich or poor, North or South) in a mission to create health on a global scale. In so doing, it...

  6. PART II: Seeing Health through Morality

    • 5 The Social Immorality of Health in the Gene Age: Race, Disability, and Inequality
      (pp. 61-71)

      The expansion of genetic research and technologies has helped to create a new “biological citizenship” that enables individuals to take unprecedented authority over their health at the molecular level. Preimplantation genetic diagnosis (PGD), for example, allows parents to select embryos that are shown by genetic testing to be free from hundreds of genetic conditions. Genetic scientists are developing “personalized medicine” which will treat diseases by matching drugs to each individual’s unique genetic profile. Web-based biotech companies already offer to genotype DNA sent to them by customers and provide personalized reports about their ancestry and risk for various conditions. According to...

    • 6 Fat Panic and the New Morality
      (pp. 72-82)

      Medicine is a major institution of social control. The United States is religious, but out-and-out rebukes of “heathen!” or “sinner!” to disorderly behavior don’t exactly fly at the present moment. Instead, the language of health and risk has become a repository for a new kind of moralism. There’s been much talk lately about the extent to which morals are in sharp decline as evidenced by phenomena as disparate as public rudeness, high crime rates, dips in attendance at organized religious services, and our increasing reliance on scientific perspectives in matters of the body. As a researcher of the politics of...

    • 7 Against Breastfeeding (Sometimes)
      (pp. 83-90)
      JOAN B. WOLF

      I am not against health. I’m also not opposed to freedom. Or compassion. But when one person’s freedom to drive her car at any speed infringes on my freedom to travel safely, or when compassion for others leads to a loss of self, I begin to see the merits of restriction and selfishness. I’m troubled by seemingly unobjectionable ideals, including health, when people define them without consideration of the context in which they are pursued, or when they are cultivated with a single-minded zeal that borders on monomania, as in the recent National Breastfeeding Awareness Campaign (NBAC). “You’d never take...

  7. PART III: Making Health and Disease

    • 8 Pharmaceutical Propaganda
      (pp. 93-104)

      Several years ago, I was sitting in my office at the University of Minnesota, trying to avoid work, when I got an unusual phone call.¹ It came from an international advertising agency. The woman on the phone said she had read my book,Better than Well, and wondered if I would talk about it at a meeting in Boston. I had no idea what to make of her invitation. It was hard for me to imagine why anyone in an advertising agency would want to hear about my book, which was not exactly enthusiastic about the marketing business. Besides, this...

    • 9 The Strangely Passive-Aggressive History of Passive-Aggressive Personality Disorder
      (pp. 105-120)

      When psychiatric terms such as “bipolar” and “passive-aggressive” migrate into popular culture and assume everyday meaning, there are several effects that deserve comment and analysis. First, as Georges Canguilhem and others have observed, the boundaries between the normal and the pathological begin to blur. Normality—already a vague, tendentious category—becomes an abstract ideal into which fewer and fewer people squeeze.¹ And what we formally and informally consider pathological behavior expands exponentially, in a process Peter D. Kramer once dubbed “diagnostic bracket creep.”²

      These changes are not merely conceptual. There are tangible outcomes too, such as those borne out of...

    • 10 Obsession: Against Mental Health
      (pp. 121-132)

      Obsessive-compulsive disorder (OCD) was a rare and strange disease before the 1970s. Estimates of its prevalence in the general population at that time were from 0.05 percent to 0.005 percent.¹ If you were a mental health practitioner, you would expect to see, by the former percentage, one person out of two thousand who had the disorder, or by the latter, one person in every twenty thousand. In 1973, a researcher could write that OCD was “unquestionably, one of the rarest forms of mental disorders.”² Consequently, if you were a person with severe symptoms of OCD in the mid-1970s, you would...

    • 11 Atomic Health, or How The Bomb Altered American Notions of Death
      (pp. 133-154)

      What happened to health in the atomic age? If we consider health the absence of illness and thus the opposite of death, the atomic bomb has fundamentally altered, if not totally invalidated, the concept. My dictionary defines health as a “condition of being sound in body, mind, or spirit” involving “freedom from physical disease or pain.” I like this idea, even yearn for the simple purity it assumes about bodies and knowledge. But this concept of health is at best nostalgic, representing a dream image from an age long surrendered to modern technology and the nation-state. The atomic bomb has...

  8. PART IV: Pleasure and Pain after Health

    • 12 How Much Sex Is Healthy? The Pleasures of Asexuality
      (pp. 157-169)

      Physicians, public health practitioners, and “pro-sex” activists may agree that sexual drive is a natural, healthy, and essential aspect of the human. Health risks related to sexual activities are often highlighted by these individuals, but the idea that willingness and capability to have sex reflects and promotes a person’s psychological and physiological health is widespread in Western contemporary culture. A popular news Website proclaims, “Want to get healthy? Have sex.”¹ ANewsweekarticle elaborates, “Sex is good for adults. Indulging on a regular basis—at least once a week—is even better.”² The health benefits of sex listed are increased...

    • 13 Be Prepared
      (pp. 170-182)

      I don’t blame people for not knowing how to engage with a person with cancer. How would they? Heck, I hadn’t either. Despite the fact that each year 70,000 Americans between the ages of fifteen and forty are diagnosed with the disease and that incidence in this age group has doubled in the last thirty years, many of my friends in their thirties have never had to deal with it on a personal level.

      I remember when my cousin Elise was undergoing chemotherapy treatment while in her early thirties. When I met her I couldn’t even mention it, couldn’t (or...

    • 14 In the Name of Pain
      (pp. 183-194)

      To be against health is to be for pain because human beings suffer from sickness. But to suffer from sickness is something of a metaphor. We supposedlysufferfrom diseases and disabilities whether or not they are painful. The man standing on the corner pointing the white cane suffers from blindness, but he has no pain in his eyes or anywhere else. The young woman walking to the local deaf club suffers from deafness, but her body does not hurt and she seems perfectly happy. The Iraq war veteran suffers from quadriplegia, although he cannot feel a thing in most...

  9. 15 Conclusion: What Next?
    (pp. 195-204)

    What should we do after deciding to be against health? What does it even mean to be against health? Should we stop going to the doctor or stop doing things that are supposed to be healthy? We do not conclude from the chapters collected here that it would be a good idea to start neglecting health. Rather, these chapters suggest an array of specific ways to be against certain formulations or political accounts of health. We propose a new recognition of the way health works socially, politically, emotionally, morally, globally, and personally that makes it impossible to invoke health in...

  10. About the Contributors
    (pp. 205-208)
  11. Index
    (pp. 209-217)