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.