Oy, the kids are at it again, and it just gets worse and worse. In fact, this one is so bad that I can barely bear to write about it. Yes, it’s from the ultimate Hierarchical Oppression site, Everyday Feminism, always a way to gauge the Regressive Left Zeitgeist. Since the site loves listicles, this is one of them: “5 social theories that prove health is constructed,” by Melissa A. Fabello, who describes herself on her website as “a feminist writer and speaker who covers issues related to body politics and beauty culture.”
Read the title of her piece again and see if you can guess what the piece is about. Yep, you’re probably right: health is not in any sense “objective”, but a social construct that is sold to us by various Organizations of Power like doctors and Big Pharma. In reality, she implies there are many ways to be healthy. Being sick is one of them.
Now Sam Harris makes the case, in The Moral Landscape, that we can have objective morality—i.e., those actions that promote well being; and he makes his case by pointing to something that he thinks is indubitably objective: health. Health is a kind of well-being, he says, and few of us doubt what it means to be healthy, want to be healthy, or judge someone healthier than someone else. While I disagree with Sam’s general argument on the objectivity of morality, it’s hard to argue with this example.
Unless, that is, you’re Melissa A. Fabello, who, besotted by postmodernism, thinks that “health” is a very complex topic, and, in fact, a socially constructed concept. This is one example of where the Left has gone badly wrong on science.
Well, in one sense the concept of being “healthy” is a social construct since it’s a concept constructed by humans, but if you have the flu, or measles, or a flesh-eating bacterial infection, it’s also a meaningful concept, because you want to be cured, feel better and not to have your nose eaten away. With the exceptions of people who suffer from Munchausen Syndrome and like being ill, doctors and medicine exist for a reason: people want to be healthy and feel good, and they prefer not to be sick. People of all races and genders go to doctors when they have “socially constructed” illnesses.
Not so fast, says Fabello, and lists five “social theories” that support the notion that “being healthy” is purely subjective. All quotes are indented (emphases are Fabello’s); my take is flush left.
Healthism (Crawford, 1980) describes a political ideology wherein a biomedical understanding of health is given social power and individuals are held responsible for their ability to uphold their own health.That is, it’s our cultural belief that meeting the standards of a one-size-fits-all version of health should be a priority for everyone – and that those who don’t meet that criteria can and should be oppressed as punishment.It is, basically, the idea that health is valuable – not just individually, but socially. . .
I get it. It makes sense that we would be evolutionarily drawn to the idea of good health and longevity. But prioritizing health (and especially making it a moral issue) still creates a hierarchy wherein some people are deemed more worthy than others – and that’s an oppressive way to think about our bodies.
Health, sure enough, is arguably a physical experience of biological beings. But our moral obligation to health is something that we, ourselves, created.
She’s talking about “ableism” here—the discrimination against those who are ill or disabled—and that is wrong. But we do have an obligation to health—perhaps not our own, but that of our family and friends, and society as a whole. Why else would Everyday Feminism write article after article about how increase the well being of the disabled, or “heal from toxic whiteness” (that’s a paid course they offer). If nothing else, it’s clear they feel we all have an obligation to mental health.
- Social model of disability
Here she claims that society has a responsibility to ease restrictions for disabled or ill people. To some extent she’s right. A disabled person isn’t usually disabled by their own choice. And we should do what we can to help them and give them access to the same opportunites that others have. But isn’t the notion of “disability” a real one, then, and not a social construct? And if disabled people are disadvantaged, that shows that there is an alternative condition, not involving accommodating the disability, that would render them not disadvantaged, like not being paralyzed.
The biopsychosocial model (Engel, 1977) was created in response to the biomedical lens – the latter of which assumes that all disease and disorder has an organic cause, and therefore, an organic solution, within the body. Using a biopsychosocial lens means recognizing that biology, psychology, and sociocultural factors all play a role in how we develop and are treated for illness.
It’s a way more holistic (and honest) way of looking at health.
Western Medicine hyper-medicalizes health – which seems sensible at first. But only because we’ve been socialized to believe that our bodies should operate like machinery and that with a little fine-tuning from doctors, we can live long and healthy lives.
But no. Our health isn’t only determined by what’s going on in our physical bodies (more on that next), so we need to think more broadly about it. Not because medicine isn’t legitimate – but because it’s limited.
Of course there are psychological and sociocultural factors that cause illness and disability, but this still manifests itself organically. Doctors may not be able to help you, and are limited in that sense, but you won’t get helped by anything that doesn’t have some effect on the molecular makeup of your being, whether it be your body or your brain. If all Fabello is saying here is that not all diseases are purely caused by mutations or microbes, then that’s completely trivial. As is her next “model”:
- Social determinants of health.
What if I told you that the genes with which you were born and the health behaviors in which you choose to engage only account for 25% of your health experience? What if these two factors that we spend so much time and money on understanding and fixing are only a quarter of the problem?
You can learn more from the World Health Organization and the Centers for Disease Control and Prevention, but here’s the gist: There are five factors that determine (un)health: genes, behavior, social environment, physical environment, and access to health services. And guess which are the ones that have the biggest influence. Yup. The last three – also known as the social determinants of health.
And think about it: What affects our social environment (who we interact with), physical environment (where we live), and access to health services (how available healthcare is to us)? Our intersecting social locations.
But if health is a social construct, how can you even talk about what determines health or “unhealth”. There must be a way to measure it, and surely those measurements are in the two links they give. The emphasis on “intersection” in the last sentence gives away the real point of this article:
Our race affects our level of health. Our class affects our level of health. Our gender, size, sexual orientation or identity, documentation status, and ability affect our level of health.
The more oppressed a person is by intersecting systems, the more likely their health is to suffer.
Tell me again that biology is simple.
The whole article boils down to that second sentence, which is “the more oppressed somebody is, the sicker they are.” That may well be true. But again, how does that make health a “social construct”? How can your “health” suffer if it’s a social construct? Can’t you just declare yourself healthy, as a transgender person can declare themselves a member of another gender (gender, too, is a social construct)?
Finally, we get to the conspiracy theories:
- Medical Industrial Complex.
The medical industrial complex (Ehrenreich & Ehrenreich, 1969) is a term used to criticize health as a for-profit industry and how the driving force of money creates an unbalanced, unjust system.
How can we trust anti-“obesity” research findings when the studies are funded by the weight-loss industry? How can we have faith in medical practitioners offering us prescriptions when they’re sponsored by pharmaceutical companies? How can we believe that we really are sick when disease is invented just so that a solution can be sold to us?
When our (lack of) health puts money into big businesses, we need to question the systems telling us that we’re unhealthy.
And when our level of health determines how we’re treated in society, we need to question the validity of “health” as a concept.
Now there’s no doubt that there’s cronyism, biased reporting by the pharmaceutical industry in drug tests, and so on, but not all drugs are useless. And really, are medical practitioners “sponsored by pharmaceutical companies”? Some of them get perks from those companies, or have their research sponsored by them, but #NotAllDoctors!
In the end, this is a profoundly confused article, which, it seems to me, both admits health is real and quantifiable but then argues it’s a social construct. It can’t be both. The whole problem is summed up in the last sentence:
And when our level of health determines how we’re treated in society, we need to question the validity of “health” as a concept.
Seriously? How does that work? Just because society may discriminate wrongly on the basis of something, doesn’t mean that that “thing” is somehow invalid. People are also discriminated against on the basis of ethnicity and gender, but does that mean that “gender” and “ethnicity” are invalid concepts? They may be criteria that aren’t morally or socially relevant, but they’re still real things.
And with that Fabiello displays her profound anti-science views, dismissing something as real if it can be a cause of bigotry. That’s exactly what Heather Heying was talking about this morning, and it’s exactly how the Regressive Left approaches studies of differences in behavior and preferences of different groups, or of evolutionary psychology as a whole. Because they could in principle be used to promote bigotry, they can’t tell us real things.
I have a feeling I’ve just wasted half an hour. . .
