Pink Politics

In case you haven’t noticed, there’s lots of pink on display this month, especially in things that aren’t usually pink.  The pink reflects a campaign to “raise awareness about breast cancer”, and I’ve been pondering what about it bugs me the most.

On the surface there’s the fact that it seems women tend to test for breast cancer too often, so that encouraging more testing does net harm. And cancer research has been one of the least productive areas of medical research in recent decades, so donations there may also do very little good. So “doing something” about breast cancer seems one of the least useful causes around.

But I think I’m more bothered by the campaign being less about doing something and more about “awareness”, which translates mostly into social pressure to get other folks to show pink, buying pink products, wearing pink clothes, etc. Much of the money donated goes not to tests or research but to paying celebrities to make more publicity.

Now this social pressure couldn’t really work if it weren’t pretty widely known that showing pink is associated with the breast cancer, which seems at odds with the claim that there is a lack of awareness of breast cancer. Even more at odds is the fact that pink campaigns rarely offer concrete arguments that theirs is an especially worthy cause; it is just assumed that listeners pretty much agree. Really, what fraction of folks don’t know breasts can get cancer, tests might detect it, and academics research it?

But on further reflection, what bothers me most is the underlying politics. Imagine a campaign for exercise awareness. Lack of exercise causes far more harm than breast cancer, and there must also remain a few folks who are not fully aware of this. Yet there would be very little interest in a color campaign for exercise awareness. Same for get-enough-sleep awareness. So why is breast cancer different?

Yes there’s the implicit sex angle in talking about breasts, but you could have a “have sex to get exercise” campaign, or make sexual innuendo about beds in a sleep campaign. And a campaign about testicular cancer wouldn’t be nearly as popular. So this isn’t mainly about sexual innuendo.

One obvious difference is that being anti-breast-cancer is framed as being pro-women. Thus one can insinuate that folks who resist social pressures to support the campaign are anti-women. Since folks fear seeming anti-women much more than seeming anti-health, a breast-cancer campaign can tap into far more social pressure than can an exercise or sleep campaign.

Think pink gets much of its energy by offering a way for folks to be indirectly political; one can seem pro-women, and insinuate that others are anti-women, while only ever explicitly talking about health and medicine. AIDS awareness gets a similar political punch; one can talk only health, yet insinuate that others are anti-gay. Much of medicine is not about health, but about showing that you care, in this case caring about the right political groups.

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  • http://www.phoenixism.net An Unmarried Man

    I’m bothered by the creation of camps A & B and that robotic sense of peer obedience. There is absolutely no discernment and as you pointed out, rather than actively seeking a sense of reason and knowledge, people react from the fear of not being “on board” what society putatively applauds.

    As that great statesman of the very early 21st Century said, “you’re either with us, or against us.”

    • Jordan

      Excellent post, I strongly agree.

      I’ve repeatedly expressed disapproval for “pink” initiatives to many people for many reasons – not least of which because I see it as something which is notable not for how much death could be prevented, but how what death would be prevented would only be prevented for one gender, making it intrinsically sexist. I have had mixed reactions from fellow males; I have never once failed to receive an unambiguous disapproval from every female under 50 years of age.

      I’m not sure what that means, but maybe it’s just that women aren’t very rational and it is indeed all about signaling. (Not that I’m asserting that non-women are necessarily any more rational.)

      • Jordan

        Annnd that wasn’t supposed to be a reply to Unmarried Man, so sorry if that was confusing (although I do agree with him as well).

  • jsalvatier

    Your analysis seems largely true. I should also point out that this is another example of you being particularly bothered by things which try to push up the status of women.

  • Tex

    With you until the very end. It’s asinine to suggest that this is about politics. One of my mom’s friends got breast cancer this spring; mom came back from a conference in the summer sobbing that she’d never see her friend again, and signed… up for the Komen walk. My mother couldn’t care less about politics beyond voting. So many non-political people are involved in these causes – they’re emotional. They affect people we know. We want to get involved because we know the issue matters, we can actually see it in our own lives unlike a starving child 20000 miles away, and these walks and shirts offer us a way to do that. Kind of like giving blood after 9/11 – great, but you’re in Wyoming, you really think a New York fire fighter is going to get that blood? But it’s the only way someone in WY *could* get involved, other than donating to the victims’ fund. Same here – the ways they’re getting involved may not affect the issue much, but they still have an emotional drive and need to get involved.

    Politics has nothing to do with it. It’s very cynical to read that kind of emotion into this. But I’m with you on the ineffective side of things, sadly.

    • Konkvistador

      You are missing the point. Of course people who’ve recently been impacted or know people who’ve been impacted by this particular disease are geniune in their concern and desire to do something.

      Robin Hanson is rightly pointing out that there are people like that for every disease and that considering their relative damage and how much awareness helps the Breast Cancer awareness months is disproportionate and can’t be explained only by its stated goals.

      My sister got sick and lived through liver cancer. I don’t see a liver cancer awareness month. Also if there was one and Robin where to speculate about why there is one and not say a fight heart diseases month I wouldn’t jump and accuse him of (implicitly?) callous cynicism.

  • Dan Weber

    Thus one can insinuate that folks who resist social pressures to support the campaign are anti-women

    Yet, you still made this post!

    What do you mean, you don’t want to wear the ribbon!??!?!?!?!

  • William H. Stoddard

    I’m reminded of the recent campaign to have everyone wear purple to symbolize their support for suicidal GLBT teenagers.

    • Jack

      On is reminiscent of the other, but the ideal behind the purple thing is that signaling support for suicidal LGBT teenagers actually has a causal connection to helping LGBT teenagers in a way that signaling you hate breast cancer doesn’t connect to curing breast cancer. It seems at least plausible that a suicidal LGBT teenager might see someone wearing purple and feel the tiniest bit better. Moreover, awareness that LGBT kids can be driven to suicide by excessive bullying might marginally decrease bullying.

      Yeah, some people are wearing purple as a political thing, but it isn’t nearly as perverted as the breast cancer stuff.

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  • Joshua Nasielski

    I’m curious if you’ve ever read Herodotus’s description of Persian medicine in “The Histories”. It seems the Persians explicitly practiced Hansonian medicine.

    From the Penguin Classics version (page 87):

    “Next in ingenuity to the old marriage custom is their treatment of disease. They have no doctors, but bring their invalids out into the street, where anyone who comes along offers the sufferer advice on his complain, either from personal experience or observation of a similar complaint in others…Nobody is allowed to pass a sick person in silence; but everyone must ask him what is the matter.”

    You’d probably also be interested in Herodotus’s description of their marriage custom, which is like a negative income tax but for wives instead of income.

  • Tontario Davenport

    An organization could take advantage of the over-awareness of breast cancer as long as it did research on multiple things in need of a cure. Just throw all the donations into the general fund and presto everyone feels good about their pro-women stance and research funding gets divvied up more efficiently.

  • noematic

    Someone who had breast cancer told me she hates it because it served as a ubiquitous reminder of her illness. Even after she was better, everything from tyres to water bottles made it impossible for her to move on. This seems like a significant cost to sufferers.

  • bob

    Israeli Apartheid Week and V-day are the same phenomenon.

  • Djohnson

    The NFL uses pink to appeal to potential female viewers. Pure signaling: “Message, we care.”

    • Jack

      Yeah, and the NFL was in desperate need of pro-women PR (Roethlisberger, Favre).

  • http://www.hopeanon.typepad.com Hopefully Anonymous

    Yeah, I think it bothers you more because it’s a display of womanist power.

    I’d analogize it to the major league sports, which are displays of fraternal power.

    The national sport could be mixed doubles tennis, but it’s not.

    Excercise campaigns and sleep campaigns have been tried (like just about every worthy campaign), and they have their natural constitutuencies to prefer those campaigns to become super-powerful, but for a complex of reasons that are best uncovered empirically they’ve failed relative to breast cancer awareness (and for that matter, awareness of the major organized, but deoptimized -from a fitness perspective- sports).

  • http://entitledtoanopinion.wordpress.com TGGP

    Steve Sailer (in a comment I found more interesting than his front-page post) on which diseases can better gain political mobilization.

    Speaking of pink, I heard that the current association of pink with little girls & blue with boys was reversed in the past. Red was considered a manly, vigorous color (and pink a close enough substitute) and blue associated with calmness & purity or whatever.

    • http://williambswift.blogspot.com/ billswift

      I posted a comment somewhere about seeing that blue versus pink difference in an early 20th century etiquette book, and asked if anyone knew when it reversed. Nobody responded then, anybody here know? Or even whether the book was exaggerating the prevalence of blue for girls and pink for boys? I can’t remember the title of the book, I was just browsing at the time, and no other book I have seen mentioned it.

    • Chris T

      I’ve heard this before, but have yet to see anyone actually provide any evidence to back it up.

  • Constant

    It’s a white thing.

  • stephen

    I agree about campaighns to “raise awareness”, especially when awareness has been at %100 for a while. Even if they aren’t about politics per se, they are essentially poilitcal in nature, or more specifically about raising the social status of some paricular group(s).

    I think it is the whole status competion via some proxy that is so annoying. At least it is for me.

    Anytime the Lance Armstrong foundation does anything the last thing that comes to my mind is cancer. The first thing is people who live “active lifestyles”, and don’t smoke. The evangelical kind.

  • http://akinokure.blogspot.com agnostic

    Awareness campaigns are the opiate of the busybody classes. You should be glad they are merely signaling awareness rather than taking action. After you’ve shown how clueless they are, and how little they care about effectiveness, you should be afraid of what would happen if they actually organized a direction action movement, lobbied for greater regulation or diversion of research funds, etc.

    That’s already going on of course, but it’d be even worse if they were men and women of action. If ribbon campaigns keep them from staging sit-ins, etc., and really throwing sand into the gears of society, we should see it as the least potent poison.

  • DK

    And cancer research has been one of the least productive areas of medical research in recent decades

    Hello? A large proportion of the basic knowledge about cells and their interactions with each other we owe to what can be summarily called “cancer research”. These are among cornerstones of modern biology. And even if you somehow don’t believe in the long-term value of basic research, how can you ignore the fact that there are now quite a few cancers that are no longer, for all intents and purposes, lethal? If that’s not productive enough, please list something that is.

    Completely agree on pink being totally political. In terms of the rates, breast cancer is right between the lung cancer (most prevalent) and colorectal cancer (which affects men and women alike). None has seen anything remotely approaching the scale of anti-breast cancer campaign.

    • Curt Adams

      Colorectal cancer awareness is a particularly sad lack, since, unlike breast cancer, it’s more susceptible to prevention via lifestyle changes (better diet) and also, currently, has more of a benefit from more early detection.

  • http://robertwiblin.wordpress.com/ Robert Wiblin

    What makes you think cancer research has not been worth the cost?

    These guys disagree:

    http://www.voxeu.org/index.php?q=node/4476

    • http://hanson.gmu.edu Robin Hanson

      As usual for med advocates, they simply assume that all improvements in health over time can be credited to medicine. Yes our health is way up over the last century, but no one can’t just assume medicine is the reason.

  • blink

    Well, women clearly spend a lot of time thinking about breast cancer, so even if the only benefit is compassion and solidarity — a sort of secular prayer — then maybe it is worthwhile. HA’s sports analogy is probably on the mark.

    Also, I think there is a demand for some cause to latch onto, perhaps to signal group affiliation etc. I much prefer breast cancer awareness to recycling and other environmental causes since they doubly costly. To the extent that supporting breast cancer awareness substitutes for environmentalism, I am strongly in favor.

  • dcardno

    To the extent that supporting breast cancer awareness substitutes for environmentalism, I am strongly in favor.

    Okay. So, to the extent that breast cancer awareness substitutes for -say- prostate cancer awareness, how do you feel? I think the whole campaign is an opportunity to signal “hey, we care about women.” Well, bully for you… but it’s not exactly like breast cancer is unknown, unobserved, or untreated.

  • Jonah

    According to the GiveWell blog entry titled How the American Cancer Society and Susan G. Komen for the Cure spend their money, the largest breast cancer charity namely Susan G. Komen for the Cure spends 46% of its funding on public health education.

    Some commentators on the blog entry express skepticism as to the cost-effectiveness of this activity.

  • Psychohistorian

    An insightful post.

    More generally, it seems like all “awareness” and one-sided opposition campaigns are centered on female issues. In addition to breast cancer, there are often movements/rallies against (most conspicuously) domestic violence and rape. There may be other issues with this kind of one-sided opposition that are not woman-centered (AIDS?), but I don’t think there are many. I wonder why this approach is applied rather specifically to women’s issues, or if I’m missing something.

    • Cyan

      More generally, it seems like all “awareness” and one-sided opposition campaigns are centered on female issues.

      I think that was true in the past, but less so as time goes on. I heard about Movember on the radio on the drive home today. Recently in my hometown there was a run for prostate cancer awareness.

  • http://zatavu.blogspot.com Troy Camplin

    Well, the main way to avoid prostate cancer is to exercise it — meaning, have sex. Imagine the implications of a prostate cancer campaign whose slogal is: “What have YOU done to fight prostate cancer?” Obviously, there is nothing along those lines that help prevent breast cancer, so it ends up desexualized.

    • http://www.hopeanon.typepad.com Hopefully Anonymous

      I thought early child birth significantly reduced breast cancer risk?

    • Faze

      the main way to avoid prostate cancer is to exercise it — meaning, have sex.

      The recently discovered XMRV virus is not only associated with prostate cancer, it has been shown to be transmitted the same way as the HIV virus (here’s the paper). Further research may indicate that prostate cancer is sexually transmitted. Another study has shown that there is NO link between the amount of testosterone a man has and his likelihood of getting prostate cancer. If all this is correct, it would suggest a link between sexual promiscuity and prostate cancer — and explain why all those big machers Steve Sailer mentioned (Giuliani, Norman Schwarzkopf, Bob Dole, Michael Milken, and Arnold Palmer) not to mention Philip Roth, Frank Zappa and others, got prostate cancer. It’s not the testosterone. It’s the alpha males access to multiple partners.

      • http://zatavu.blogspot.com Troy Camplin

        Indeed, there is a positive correlation between number of partners and odds of getting prostate cancer. But there is also an inverse correlation between amount of sex one has with a single partner and getting prostate cancer. The virus is one way of getting it, but it’s not the only way. Like the rest of your body, the prostate needs exercise or else it degrades.

        I will also point out that just because someone is having a large number of sex partners, that doesn’t mean they’re having a lot of sex.

  • http://reprabbits.blogspot.com James Andrix

    Breast cancer is at least somewhat genetic. Someone who for example, lost their mother to breast cancer, suffered through it but survived, and then learned that her daughter was genetically at risk; could be extremely motivated to ‘find a cure’.

    Given the obvious connection with nursing, is it possible this is tapping into a “Think of the children” mode that doesn’t get mentally reviewed for further justification? Though if this were true should we expect other historical breast-friendly fads? I can’t think of any, but I also can’t think of any historical time when breasts were under a potentially solvable threat.

    That was one of the weirdest sentences I’ve ever typed.

  • dcardno

    I can’t think of any, but I also can’t think of any historical time when breasts were under a potentially solvable threat.

    That was one of the weirdest sentences I’ve ever typed.

    If it makes you feel any better, it was among the weirdest sentences I’ve ever read, as well!

  • Robert Wiblin

    What else would push up cancer life expectancy so dramatically?

  • Zdeno

    A test of your hypothesis: Will “Movember” become comparably popular to pink-saturated Octobers?

    Actually though, I suspect that your thinking is correct, and that much of the enthusiasm for prostate cancer awareness month stems from how impossible it would be to maintain the facade of charitable intentions without it – perhaps we could call it “cognitive dissonance awareness month.”

  • Lucia

    After reading all these posts, I was surprised to see that no one mentioned the “Save the Ta-Tas” slogan from the pink campaign. Every time I read this, I get so angry…they sexualize breast cancer (which the forum has decided is pretty non-sexual) in order to make money. I really hate it when women wear these shirts/put these bumperstickers on their cars because it implies that by fighting breast cancer, I am saving what makes me sexually attractive as a woman. IT’s not cute and IT’S NOT FUNNY. There. I said it.

    • adam

      Lucia,
      But that seems to be the main reason women care so much more about breast cancer. It’s fairly uncommon way to die, but women’s pulminary or cardiovascular month doesn’t impact two organs with which women’s sexuality is entwined.

      http://www.fairfoundation.org/factslinks.htm

      To be fair if penile cancers killed any more than a handful of men, it would probably also be a top research priority (men don’t really identify with their prostate).

    • John hedlenssonn

      *********yawn

  • khosi

    There are more emphasis on cancer and cancer prevention but what are we doing about AIDS and HIV which is practically ravaging Africa…

    • http://entitledtoanopinion.wordpress.com TGGP

      Robin’s previous post on AIDS in Africa is here.

  • Rebecca Burlingame

    My beef is: why October? The month that really says fall and the colors of autumn and…pink? Summer would have been better, when I’ve seen all the green I want or perhaps the end of winter….

  • Robert S

    Robin, great article. So here’s the question then:

    Theres plenty of good that could be done with social awareness of health; What would you want a campaign made for; And on top of that, where would you encourage health-research allocation to go to?

    (Which then begs the question: where does the dollar from breast-cancer-research charity campaigns go)

  • Chris T

    There is substantial signaling value in ‘breast cancer awareness’, precisely because it is well known. As you point out, there is little remaining practical value in putting so much effort into spreading awareness about breast cancer, since most people already know about it and significant resources are put towards studying it. There are diseases that are not well known where wider knowledge could significantly improve the lives of those who suffer from it (such as Coeliac). However, because most people are ignorant of them and thus would require a larger time commitment in explaining them, they have little signaling value.

    The cost of wearing pink ribbons to show you ‘care’ is very low; therefore, it’s attractive for signaling.

    • http://entitledtoanopinion.wordpress.com TGGP

      “There are diseases that are not well known where wider knowledge could significantly improve the lives of those who suffer from it (such as Coeliac). However, because most people are ignorant of them and thus would require a larger time commitment in explaining them, they have little signaling value.”
      That’s a neat observed irony.

      • Chris T

        This one is actually somewhat personal. My wife has Coeliac and just putting a label as to whether or not a food product contains gluten or could have been exposed to it would be enormously helpful. It’s getting better, but still has a ways to go.

  • http://www.johndchisholm.com John Chisholm

    I believe Hopefully Anonymous is correct: the demographic segment with the highest incidence of breast cancer is nuns. Without pregnancy and the onset of lactation, breast cells remain undifferentiated and thus more susceptible to cancer.

  • divinryan

    We like tits – we get it. No can I watch football without seeing players in pink? Project awareness is complete. Now get to work on curing it.

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