Episode 130 Transcript

You're listening to The Fierce Fatty Podcast Episode 130. "Mistakes well-meaning dieticians make that can hurt fat folks”. I'm your host, Vinnie Welsby. Let's do it.

I'm Vinny Welsby TEDx speaker, Best Selling Author, and fat activist. I have transformed my life from hating my body with desperately low self esteem to being a courageous and confident fierce fatty who loves every inch of this jelly. Society teaches us living with a fat body is bad. But what if we spent less time, money, and energy on the pursuit of thinness and instead focused on the things that actually matter? Like if pineapple on pizza should be outlawed? Or if the mullet was the greatest haircut of the 20th century? So how do you stop negative beliefs about your fat body controlling your life? It's the Fierce Fatty Podcast Let's begin.

Hello, fatty Welcome to this episode. How were you? How's live, you're doing good. I realized that I have not ever done a land acknowledgement. For the podcast, I'm thinking about the new podcast, Intro music, whatever, I need to change it because it's got my old name in it. And in that I'm going to put a land acknowledgement but just an FYI. You may know that I live in Canada in Vancouver, which is the traditional ancestral and unceded territory of the Coast Salish people, the People's Squamish slaver tooth and Musqueam nations. Yes, and that's where I live. And I've been thinking about this and how it needs to be part of every episode so I thought in the in the intro would be great if I'm gonna put it out. So anyway, that's the First Nations community lands here that I live on in what is currently known as Vancouver. So today, I am talking about her Oh, hello, health. And I'm doing this episode because someone asked me someone asked me to and I was like, That's a great idea. You You're you clever a lot. You know what, because I forget what I talk about on I forget what episodes I've done and not done. And I know that I've talked about health being a social construct before but I looked and I was like, Oh, shit, I've never even done an episode on it like Episode Episode dedicated to it. Because I had shared a post on the Instagrams and someone said, oh, you should do an episode focusing on this. And the post that I shared was the social determinants of health. This is a caption that I wrote, there are so many things that influence health, and most are not in our control. Weight is not a behavior. And it is not in our control. For the vast majority majority of people. The moralistic value that society places on quote, healthy bodies, is ableism health ism, and not helpful for anyone. Health is largely a social justice issue. Health is not attainable for many healthy the temporary state health is a social construct. And someone left left a comment saying you need to talk about that more. And I said, in my brain, you got it. You got it. I'm gonna do it. I'm gonna do it. Because you know what, sometimes I like these points that I think that I've made. Because I've spoken about them, like briefly on the podcast in different posts, and whatever. And really, actually have I spoken about them? Have I made an episode so someone can Google Health as a social construct and find my stuff? No, I have. No. So yeah. Today's Friday fitting good. Dude, you just got back from a spa day. Don't get the dog he has had his hair cut for the first time in his whole life actually, well, I've cut his hair before but professionally, I mean, he went to the groomer for the first time and normally I just groom him myself but

Unknown Speaker 4:47

something good that happened in the pandemic was that did he have to go into the vet on his own? Obviously, I drove him there. He didn't just you know, make an appointment himself and go, I would drive him there and then pass them on to the The vet because COVID wasn't loaded. And they reported back saying he's an angel when you're not there. So this motherfucker has been going around growling and snapping up people. He doesn't bite. He just snaps which is scary, though, right? And he's a little dog, but he's still scary. And seems to be really stressed out. And so I was like, Well, I can't ever take him to the groomer, because he's just going to one like, scare the groomer. And to, he's going to be really upset and terrified. Yeah, that's what that's like. That is fine. He's like, wanting cuddles. It's like you tricky little motherfucker. So yeah, so I've made an appointment for him to go to the groomers. I just, we just started out last week. We've just London now clip just to see how I liked it. And he didn't want to leave afterwards. Yeah, so I had to go in, go grab him because the groomers is just half a block away. And she was going to take it back. But anyway, he, he didn't want to leave. And today he's gone for the full, full spa treatment. And now he looks like a fucking teddy bear. So get out. I want to murder him because he looks so cute, his little bomb. Because nobody has what I call his skirt on the back. Because he has really long hair. And I was like that needs to go. And they made it into like a teddy bear bomb. And yeah, so he might be murdered by the end of the day, because I'm gonna be loving on him so much because he looks so cute. Yeah. So if your dog is like, doggy, maybe, maybe they just do it when you're around? Maybe not. You know? Who knows? And he can't tell for sure he enjoyed it. But I'm guessing he did. Because he seemed pretty happy and excited. So, yes. Okay, so talking about this, today's Health is a social construct. I'm going to just define what is health? And what is social construct? what do what do they mean. And they get into the concept of health being a social construct. And that related to fatness and ableism, and health ism, and all that type of job so, so even Google Health, we just did a little Google, which I did. And the word health is a noun and the state of being free from illness or injury, or a person's mental or physical condition. And that's pretty limited, right? So that's a DEC dictionary definition to being free from illness or injury. But we have other definitions. And so this is from the Government of Canada, who is quoting the World Health Organization, who says the World Health Organization offers a simple definition of health as a state of complete, physical, mental and social well being, and not merely the absence of disease or infirmity. social well being is an important aspect of this desh definition that may not always occur to us in thinking about health. So what does that mean? What does that mean? A state of complete physical, mental social, well being a state of complete physical, mental and social well being and not merely the absence of disease. So well, beingness is what the what who says it is, okay, so well being well being pneus. Or if we look at the simple definition, being free from illness or injury, Injury is a social construct. So let's look at the the dictionary definition the Merriam Webster says that it is an idea that has been created and accepted by the people in a society. So an idea that has been created and accepted by the people in a society. Well, I hear you, I hear you. Isn't that everything? Yeah, it's a lot of it's a lot of things, a lot of things.

Unknown Speaker 9:34

So what is a social construct? We're gonna go to another site that gives us some examples. So this is what they say social constructs developed within a society or group. They don't represent objective reality, but instead are meaningful only because people within the society or group accept that they have meaning. Simply put social Your constructs do not have inherent, meaning, the only meaning they have is the meaning given to them by people. For example, the idea that pink is for girls and blue is for boys is an example of a social construct related to gender, and the color of items. The collective perception that a particular color can be associated with a certain gender is not an objective representation of truth, or fact. Instead, it is a social convention that came to have meaning within the context of society. And so they go on to list some examples. There are many examples of social constructs. Most common practices and behaviors that are generally accepted within a societal group represent social constructs. These societal norms don't have to be accepted by every single person in order to be social construct constructs, they can and often do change over time. So some examples here, there's lots of different exams, but I'm just going to read out the ones which are related more to what we're talking about today. So adulthood, the specific of when a person is considered to be an adult is a social construct. In the United States, and most of the EU people are considered to be adults at the age of 18. However, in Scotland, people are considered to be adults at the age of 16. And in reality, so if we're talking about reality, if we were to define adulthood, as the time where our brains are more developed, where we are at a certain level of maturity, then it will probably actually be 25. But then we have to think about like, well, do we let people who are under 25 do stuff, even though maybe their brains aren't totally fully developed? Well, yeah. And so it's kind of like, we have to come to a decision about what being an adult means by society standards. I mean, like, you know, for some things, I think it's appropriate to say 16, or 18, but other things, I think, maybe not. So gender behaviors, the concept of certain behaviors, being specific to a person's gender is a social construct. This applies to the idea that men should keep their emotions bottled up, or the notion that women are overly emotional. It also applies to the belief that boys should play with trucks and girls with dolls. Gender roles are also social constructs associated with gender roles, such as formally widely held belief that women should stay at home and men should work. This also relates to the belief that certain types of jobs are women's work, while others represent men's work. Disability, the concept of disability is a social construct. The social construct of disability often relates to visible indicators of disability, such as using a wheelchair or missing a limb. People who have less visible disabilities are often misunderstood because their conditions don't fit into the social constructs of others. Like you hear many stories of people parking in the disabled spot, and someone rushing out being like this is for disabled people, because they're not in a wheelchair, and then the person you know, being like, well, you know, and they take their, you know, they take their leg off or whatever to reveal that. They're using a leg to help them walk or, or they have a disability, which is not visible. It gets on my tits that really gets on my tits when people are saying, you know, you can't use that washroom because it's for disabled people who's on what how can you tell whether your eyeballs that someone is disabled or not? It's none of your fucking business. You know? But I can see why people do that because they want to protect disabled people, but in that they are harming disabled people.

Unknown Speaker 14:03

Yes, and if we think about like with disability, everything about glasses, whereas you wouldn't, if you will, glasses probably describe yourself as having a disability. Whereas maybe a few 100 years ago, before we were able to access glasses, or I don't know when glasses were invented. I know sunglasses were invented a really long time ago. Yeah, so then if you depending on your level of sight, that would be a disability. So it like if I didn't have my glasses, I couldn't I couldn't drive I you know, sometimes struggle to get around. My mom it really has very limited vision without her glasses and she could barely get around the room and so then that would be classed as a disability. But now, this this age that I have that I wear glasses are seen as cool, right? Not everyone thinks they're cool I do but But it's just no big deal. You wouldn't think, Oh, look at that, look, that's that person to say, well, because they're wearing glasses, it's just a normal thing. And that's, that's a social construct to say that that wearing glasses is not a disability, whereas using a wheelchair, or mobility aid is a disability. And so some folks with disabilities don't see themselves as disabled. And some do isn't, you know, disabled people are not a monolith. But anyway, it's a social construct is what we're talking about. And some people buy into that construct, and some people don't. Illness. Illness is also a social construct. The word illness doesn't mean the same thing to everyone. Some only perceive medical medical conditions as illnesses, if they would cause a person to be, I don't know this word, bedridden, I don't like that. That's like, a negative thing to be in bed, or contagious, while others perceive a wide variety of medical circumstances to represent illness. Yeah, so for example, illness and let's like, extend this to health. I've used this example before, but one time that really made me think about this was going to the doctors, and had had like an annual checkup, or whatever, had my blood work done. And the doctor says you Oh, absolutely healthy. And she handed my script for all the different various things that medication I need to take to make sure that I can live, you know, I won't die without the medications removed before we would. But I should be saying I am healthy. But am I healthy, is the way that I'm I and she is perceiving these conditions, because they are easily, somewhat easily remedied remedied with medication means that they are no longer a barrier to so called health status, or health status. But then if say if I had no i didn't have access to medication or couldn't afford to pay for medication, because I have to pay for my medication in Canada. would then I not be healthy? is health. Only for those who are able to manage their health condition? Does that then make someone healthy or unhealthy? Like am I healthy? Because I can take antidepressants that make my depression symptoms? Mostly go away? Does that then mean I'm healthy? But then you might say yes, but then if say if a week I didn't take my antidepressants, then maybe then I would not. But the difference is between me medicating it or not. So is what. It is complicated, right? It is complicated. I get the last example of a social construct here that they're giving is time. Time is a social construct that isn't meaningful only in the context of human created systems that are used to describe time, seconds, minutes hours, and make it meaningful in some places. Daylight Savings Time is not observed. Oh, I want to be one of those places. The concept of seasonal time changes does not exist where they are not practiced. Yeah, we need to get rid of daylight savings that shifts away. We're not farming anymore. Anyway. Yeah. So other examples of social constructs money, governments. They mentioned gender here. Yes. So it's anything that which is not a fact, I would argue that, you know, how much of stuff is factual? It's as factual as we know it, according to science today, right. And that's the thing is, you know, like science, scientists will always say like, this is the best we know today.

Unknown Speaker 19:05

And, and so we're with a lot of things like it's pretty much very well established. So uncertain things, but other things. We've just kind of made it up. And everyone said, Oh, that sounds about right. Yeah, yeah. Even though maybe at the time it sounded about right. You know, women have to stay in the home and have to do this and your men, men or men's personality traits are this and all that type of stuff may have worked. I mean, did it ever work? No. But maybe it may have been more relevant 200 years ago, but it's no longer such. So you know, we could change, you know, 200 years and we'd be like, lol, remember, in the olden days when they used to think that women should stay at home. So yeah, so yeah, so yeah, so yeah, also, let's just finish off there. He's here. For this, this this bit, by the way, links in the show notes, this is episode 129. So facebook.com, forward slash, one to nine finishing off this this little bit is expand your understanding of social constructs, expanding your understanding of social constructs involved considering, which are the things that you know, actually have objective meaning, versus which ones are meaningful only because people in a group, assign meaning to them, and continue to allow that assigned meaning to persist. Explore your perceptions versus those of others by reviewing some examples of sociological imagination. This will allow you to consider situations from other points of view and will come to appreciate perspectives other than your own. So another example is religion. So this line here they're saying, people in in group assign meaning to them, and continue to allow that Mitt that assign meaning to persist. And so I was watching something on Netflix. I started watching it last night about the the Mormon group that's led by Jeff, what's his name? They are called the Latter Day Saints of fundamental Latter Day Saints. flts. Anyway, religious group, very conservative, and they had the Prophet which was this guy, Jeff's dad, and the Prophet was meant to live forever because he was a prophet and what up see he died. And so they're like, What the heck, we're not prophet was in live forever. And so then the son was like, huh, one of they had what, how many? How many children did this guy have? Because they believe in plural marriages. This guy had like hundreds of hundreds of children. Um, so one of the favorite sons, who was who was said to be magical in some way was like, Well, turns out dad's dad's come back, he's in my body now and I'm the Prophet. And so then the group had to get behind that idea. And then you anyone who was a threat to the idea that there's this guy, Jeff was actually the Prophet reincarnated. The dad reincarnated in his body was ousted. And then that became, you know, the new group belief, the that the prophet had reincarnated into the son's body, and, and that you had to do certain things and wear your hair in a certain way and wear underwear down to your ankles, and up to your wrists and lalalalala because that's what they all believed, right? And still believe.

Unknown Speaker 22:45

So let's look at sociology. Because we can also look at this from a sociological frame. And I'm looking at the social construction of health, from open texts BC, which is open text off of a sociology course. And so I'm going to read a few quotes from here. So medical sociology is the system systematic study of how humans manage issues of health and illness, disease and disorders, and health care for both the sick and the healthy. The social construction of health explains how society shapes and is shaped by medical issues. The social construction of health is a major research topic within medical sociology. At first glance, this concept of a social construction of health does not seem to make sense. After all, if disease is measurable, physiological problem, a measurable physiological problem, then there can be no question of socially constructing disease, right? Well, it's not that simple. The idea of the social construction of health emphasizes the socio cultural aspects of the disciplines approach to physical, objective definable phenomena. Sociologists Conrad and Barker. 2010 offer a comprehensive framework for understanding the major findings of the last 50 years of development in this concept. Their summary categorizes the findings in the field under three subheadings the cultural meaning of an illness, the social construction of the illness experience, and the social construction of medical knowledge. Many medical sociologists contend that illness has both a biological and an experiment, experimental component and that these components exist independently of each other. Our culture, not our biology dictates which illnesses are stigmatized, and which are not which are considered disabilities and which are not, and which are deemed contestable, meaning some medical professionals may find the existence of this ailment questionable As opposed to definitive illnesses that are unquestionably recognized in the medical profession, Conrad and Barker 2010. For instance, sociologist Erving Goffman 1963 Describe how social stigmas hinder individuals from fully integrating into society. In essence, Goffman suggests we might view illness as a stigma that can push others to view the ill in an undesirable manner. The stigmatization of illness often has the greatest effect on the patient, and the kind of care they receive. Many contend that our society and even our healthcare institutions discriminate against certain diseases like mental disorders, AIDS, venereal diseases, and skin disorders. I think for those that don't think you say VD anymore. And that's from Satorious 2007 facilitator, these diseases may be subpar, they may be segregated from other health care areas, or relegated to a poorer environment, the stigma may keep people from seeking help for the illnesses making it worse than it needs to be. So. So if you want to learn more about like the sociological side of looking at that, and how, how we view conditions and how doctors or healthcare professionals view conditions, then there's a whole whole field of study that's been going on for a very long time, because health is a social construct. Because it's not just as we're saying, in this, this, this bit, I just read out, it's not just this definable thing, it's this thing, it's, it's something that changes depending on how society and individuals who adhere to the social constructs in society interact with health, and what they think health is, and different types of illness, conditions, etc, etc. So I like to think about this concept. And the, the construct of health in regards to health as a destination, and health as a status and its influences. So what I'm talking about when I say one health as a destination,

Unknown Speaker 27:48

thinking about how society views, health is something that you can arrive at, like it's the terminus station. And that if you do do certain things, and you're going to arrive, just hop on the health train, and we're going to get to that station, and the station is called Health. And if you maintain taking certain actions, and those actions being being thin, exercising, and eating the quote, right food, then you're going to get to that destination of health is what largely we believe in society and what kind of the average everyday person believes. And it boils down to it, it boils health down to a very simple, unlimited equation, or definition. You know, like, you get your you get your luggage, you got your luggage, which is eating right, exercising, right, and being thin. Now we can jump on the train and the train is gonna get us to the destination of health. So, that's a construct in regards to that is what many of us in design a society have decided, is the reality of what health is. And and yes, there's some nuance in there. Like I'm boiling it down to the very simplest ideas, but you know, people were like, oh, yeah, you know, you do need to also get a good night's sleep and drink water and, you know, all of those types of things and or maybe maybe you should do some yoga as well, you know, we want to be holistic about it, but then we can jump on that train and, you know, maybe the train might hit some some, you know, leaves on the ground, like happens in the UK leaves on the track and it needs to have maybe, maybe there's a little stop or, you know, a delay, but basically we've put those, we've got the luggage we've the inputs are there. Therefore we know that health is going to be out the outcome and That's just not the reality, right? That's just not reality. So when we think about health as a destination, something that you can put in a little bit input stuff, you're going to arrive that, you know, there might be a little bit of, you know, things that might pop up from time to time that is out of your control, but you've done the quote, right things, therefore, you're going to get to the destination, or you're at the destination, we're going to stay at the destination. So this concept and the construct of this is it says that health or lack of health is totally down to an individual and what they do, what control they have, because why would someone not be healthy when it's so easy, all you need to do is eat quote, right? Exercise. And be thin. Easy peasy, lemon and lime. So So you know, you've got this choice to be healthy. Why wouldn't you do it if it's so easy. And the reason is, because people who decide, quote, you know, decide to be unhealthy. They're bad in some way, they are lazy or unintelligent, or poor. And it says, if you get sick with some with some things, then it's okay. But something else, that's a moral failings or an example, if you get sick, because or you have an illness injury, because you're doing something that supports the idea that health is being thin, exercising, and eating right, and you come up against something, that means that you get an illness or an injury from that, then that's good, that's okay. But if it's outside of that, then it's not good. Okay. So an example would be an injury that I have had is I went skiing,

Unknown Speaker 32:01

I used to go skate all the time, fell to a couple of ligaments in my knee. And I need surgery to have time off work. But never once did I think, or come into the kind of like, oh, well, if you weren't so so much of a skier, you never would have encountered that. What is your own fault for skiing? No, because I was doing an activity I was exercising, therefore I was being a good fatty I was doing the things that I needed to do to do. According to this construct that we have currently around health, the things I needed to do to be at that destination of healthy. But what if someone is diagnosed with something that we associate associate with fatness and they're a fat person, for example, the classic one is type two diabetes. And what we know about type two diabetes is it is predominantly a genetic condition. And the you cannot eat your way into getting diabetes. It is not anyone's fault if they have type two diabetes, but that is not the message that we get. That's it's an inevitable, inevitable because you did something bad, which is being fat, you weren't doing the things you want, you are adhering to the inputs, being thin, eating the right foods and exercising. So therefore you are not going to arrive at the destination of health. And the idea that, you know, when a thin person gets sick, and oh, that's just the way life is maybe they were unlucky. It wasn't because of something they did or didn't do. But when a fat person gets sick, it's because they're fat. What can we expect? Is what society says. So, and then outside of fatness we think about fatness we have other things which are, you know, something that's seen as good or bad. So say if you got you had the flu, that's fine. You know, no stigma around that. Maybe you know, people don't want you to go make out with them if you've got the flu, but people are not like what type of person gets the flu? Mm hmm. Whereas say if you got an STD, you had syphilis. Well, then that's bad. That's shameful. But both are equally morally the same with engaging properly in similar types of behavior contact with other human beings. You know, so then why is one devastate bitingly shameful, potentially for people and stigmatized, but the other is just part of being a human being. And that is because we view health in a certain way, right? This, this, this also the definition of, you know, the, the idea of health as a destination, it positions fat people as being so willfully ignorant of the very easy Health Formula. And according to this fat people, we stick our fingers in our ears and are determined to make other people and the government pay for our recklessness. The formula is so simple. Why don't you just do it, then you'd be healthy, is what we know about this version of health? And the answer to that is because, you know, isn't it? That's not the reality. This construction of health that we currently have in society is almost exclusively exclusively exclusively focused focused on physical health. And it's super super laced with white supremacy, and ideas from white culture of what health is. And I'm gonna be talking about First Nations ideas about health shortly, just to show how different it can be their constructs around health. It also denies, you know, that's the holistic way, you know, many cultures, think about health, not even just some First Nation cultures, many cultures like this is this is a very Western, you know, American view of, of what health is. And in many cultures, right, you know, but then also in many cultures is different.

Unknown Speaker 36:59

But this is our perception. This is our perception of what health is and differences, sometimes can even be hard to imagine, because we all know is that we'll know if you do this and that then you're going to be healthy probably. It also implies health is a choice, and denigrates, those who do not, quote, choose health. It disregards those who can never be healthy or able bodied and leaves them at the sidelines. as second class citizens, you're disabled. Well, sorry. So well. And it's all about how people view your health, which in turn affects your health negatively, right. It's, you know, if you are on a desert island, and you've got type two diabetes, you and you and your doctor on a desert island together, and the doctor says, Sorry, you got type two diabetes, would it seem as devastating if you didn't have anyone to? To judge you? If you didn't have anyone to view or make assumptions about who you were as a person? It would probably be a lot easier to deal with. Because of the way that society view certain conditions. And what if we removed shame from health? What if we did remove all of that kind of learned shame from health and we might go to the doctors more, we might be connected with the community more because we realize that we have more health conditions in common. You know, like, I bet, the health condition that you feel shameful about loads of other people have it and because no one's talking about it. You know, we feel shame. And it's like, oh, well, actually, who knew that? Brad Pitt has HSV genital herpes? Oh, well, if Brad Pitt came out and said, Hey, I have genital herpes. Maybe we wouldn't be viewing it so negatively. As an example, I need to get a new fucking, I would say Brad Pitt. I think it's showing that kids are talking about Brad Pitt, as in the most like the idol of celebrities nowadays. I need to get like a new one. No, Hugh Jackman. No, he's like, I bet you're the kids with like, oh, Brad Pitt is like an old man or something. When in my mind, like Brad Pitt is the epitome of hunky Hollywood celebrity. I don't know. I don't even I don't even I don't even know. Yeah, so. So. If we remove that shame, then we'd also probably get better treatment. We wouldn't be shy about talking about sexual health and other types of health which would would protect protect our health and other people's health. Yeah, so So let's look at the health as a status, and what influences health. So if you think about society, think of how society thinks of what makes someone healthy is that then exercise, eating healthy food. And in reality, it's pets way more complex, and is influenced by the social constructs we have in place currently, never repeat that. Health is super complex, and is influenced by the social constructs we have in place currently, is influenced health is influenced by the way we view health. And so I have a post that I first created a few years ago, but then I reshard it recently on Instagram, and it is the social determinants of the sorry, the determinants of health. And so you can go and look at go and you can go and look at I'll also put in the show notes. The, the so I've, I've summary, summarize it down into the big components, okay, so I'll read them out, okay. So we've got in our mind that if you if you're thin, you eat the right food, you exercise, maybe a sprinkling of some other things,

Unknown Speaker 41:37

things that are in your control, and maybe a little bit of genetics, then you'll be healthy. But really, the determinants of health, two thirds of it is not our behavior, two thirds of it is other things and so 24% is social circumstances. 22% is genetics and biology 11% medical care, 7% environment, and 36% individual hate behavior. And so individual behavior, aha, okay, so that is eating the right food being thin. And exercising, isn't it? Question mark? No, not necessarily. Okay, so in individual behavior, but so that the if you go to the where I got this information from, it's this huge thing that you could not fit on Instagram. And so I've summarized it to to the main points. And then the main points are then go into other points of what that means. So individual behavior, psychological assets, negative mood and affects other risk related behavior, like gun behavior, sexual activity, motor vehicle behavior, physical activity, sleep patterns, and diet patterns. And when we think about diet patterns, is it that we're getting enough food? Did we get a variety of food? Right? It's not, did you ever eat a Twinkie? No. It's so so those two things are 6% Right. But hang on a minute, I thought it was simple. You just input this and then an output is the destination of health. So yeah, I mean, like when you think of individual health, are you thinking about so negative mood and ethics and so that is, anxiety level, depression level, hopelessness, level and stress level, psychological assets, conscientiousness level, self efficacy, optimism levels, life satisfaction level, cognitive function in late life. risk related behavior, gun behavior, sexual activity, motor vehicle behavior. So you know, we're not we're not saying listen, I'm really interested in becoming healthy. So I am going to not go to the gun range next week. I doubt that there's a lot of people who who are gun users listening, listening to the show, but we don't think that right and that is like our individual behavior.

Unknown Speaker 44:11

Right, we're not gonna We're not like, you know what, I really want to be healthy. So I am going to work on my optimism level and that's remember that's just like, that's 36% Right. And so, the other the other parts of what health are in you know, so if we look at social circumstances, so if we go in deeper in that is is gender identity, military service, sexual orientation, citizenship status, race and ethnicity, social status, history of incarceration, culture and tradition, social connectedness, early childhood education and development, discrimination, work conditions, I am going to improve my health and so I I'm gonna make some more friends wouldn't probably wouldn't say that right. And each of these things has like lines underneath them, you know, like religious involvement, cultural norms, quality of friends, civic participation. Oh, I really want to be improved my health, so I'm going to engage in civic participation. But what you know, is that the CLO it's part of what makes up health. And, you know, this, the so called social circumstances, are on par with all of these other things that we're talking about. So, genetics and biology. So, that includes genetic body structure, body function, oh, look at that, this is look at this body structure is under genetics and biology. And that is weight. Notice how weight is not under a behavior. So yeah, yeah. And so this information by the way, this this information is, let me read out quote, information in this pie chart is from go in vo 89% of health occurs outside of the clinical space, through genetics, behavior, environment and social circumstances. These factors are known as social determinants of health. Despite their importance attempts to integrate the determinants into a single visualization visualization have been limited because there's so many go in vote identify a gap based on their extensive work as a healthcare design studio and conducted a literature review of sources the World Health Organization and the Kaiser Family Foundation and face to face interviews with public policy analysts health IT experts and Clinical Professionals relying on the experience of mapping complex systems within healthcare go in vo created a comprehensive open source visualization of the social determinants of health. Yeah, so insane, all these different strands on this, you know, there's many many, many different things right? Many different things. We also you know, medical care. So underneath that is health literacy, quality of health care, access to health care, patient engagement, distance to resources, provider availability, vaccinations and immunizations, quality of insurance, under physical environment, pollution, location, exposure to firearms, allergens, walkability, water quality, air quality, crime level, crowding conditions, job opportunities. Right. So hang on, this doesn't this doesn't align with what we view health as the social construct we can't we currently have of what health is. So someone's health status, which is a social construct is going to be affected by the social constructs they come into so example, because a part of the

Unknown Speaker 48:24

social circumstances affect health, right? So your gender identity, if you're if you're gender diverse, then for example, trans folks, average life expectancy is 30 to 35 years, if you're a black trans person, then it's even lower. And so we're thinking about gender identity and someone's health status. And and then we also look at the social circumstances, someone's race, and then we can throw in their like sexual orientation. If they're also queer, then it's going to affect their health outcomes. Because are they going to be able to then we look over the other things, we look at the medical care, are we are they going to get quality of health care? Are they going to get access to health care? Are they going to be able to engage with that healthcare? Right, so all of these things are playing off each other. And so the way that we perceive as an example transvenous in our society affects the health outcomes of trans folks and even, you know, people's perception of health and what house health this is, this is not universal, so, and it changes from individual to individual, like for example, experiences that we think are universal to are not necessarily universal. If we think about the pain scale, you know, like how much pain are you in from a scale of one to 10 which was developed by who was the company? Basically it was developed by a opioid manufacturing company so that people could be prescribed opioids, opioids more in hospital because we couldn't be letting people stay in pain, we need to give them opioids. And so anyway, so anyway, pains girl, my perception of pain is different from other people's, you know. And even like your own perception of your own health, my aunt who lives next door to my mum, she's like 75 or something, and has has not been to the doctor in anyone's recent memory. And she's she's hard of hearing, and she has signs of dementia. And she talks all the time about how healthy she is. An issue is a ishi Ishee issue though. I don't know the answer to that. You know, she walks her sheepdog for hours every day, all day, every day she walks to the beach with a dog. She gets on with her life fine. Does my perception of her health and my perception of her age change? Her health status? What even is her health status? What if she does have some unchecked illness or condition? Does that then mean she's unhealthy? And what does my perception of her being unhealthy mean? And so my mom's perception of her being unhealthy in whatever way means that my mom go my mom who's 70, right? My mom 70 goes around and does gardening for her

Unknown Speaker 51:48

sister. She does the weeding and stuff. Even though the sister is absolutely capable of doing it, but

Unknown Speaker 51:54

because my perceives her as she hasn't gone to the doctor in many, many years, therefore, she's probably sick, I must go around and do a reading for her. And so then how does that impact her health? If people are perceiving her as unhealthy? I mean, she's very, she's happy with for my mom to go around and do the weeding, you know, but everyone went to her and said, Listen, you need to go to the doctor, you've not been to the doctor in years, you're probably really unhealthy, you're probably about to die, would that then actually affect our health? Which could be potentially a okay. But then again, what is? What is it? You know, so let's look at, I'm just going to have a look at the First Nations perspective of health and wellness. And so again, link in the show notes. So this is from the First Nations Health Authority, says health through wellness. And they've got a visual depiction of what health is. And what we have here as we've got like a bullet like a target type shape, and in the middle, we have the word human being. And so the center circle represents individual human beings, wellness starts with individuals, taking responsibility for our own health and wellness, whether we are First Nations or not. The second circle illustrates the importance of mental, emotional, spiritual, and physical facets of a healthy, well balanced life. There it is critically important that there is a balance between these aspects of wellness, and that they are all nurtured together to create a holistic level of wellbeing in which all four areas are strong and healthy. The third circle, so this is going out from the middle, the third circle represents the overarching values that support and uphold wellness, respect, wisdom, responsibility, and relationships. All other values are in some way essential to the four below which is respect, wisdom, responsibility and relationships. And so then the fourth circle depicts the people that surround us and the places from which we come, land, community, family and nations are all critical components of our healthy experiences as human beings. And so the fifth circle depicts the social environmental, cultural and economic determinants of our health and well being. And so like for example, cultural cultural cultural determinants include language, spirituality ceremonies, traditional foods and medicines, teachings, and a sense of belonging. Environmental is land, air, water, food, housing, and other resources that need to be cared For and considered in order to sustain healthy children, family and communities, and then we've got the outer circle, which is the people, people who make up the outer circle represent the vision of strong children, families, elders, and people in the community. The people are holding hands to demonstrate togetherness, respect, and relationships, which in the words of a respected BC, elder can be stated as one heart, one mind, children are included in the drawing, because they are the heart of our communities, and they connect us to who we are and to our health. So see how it's different, right, and even like talking about the land, and land being connected to, you know, respect of the land connected to our health. And so that the way that most of us if we're not a part of communities who have diverse, more diverse

Unknown Speaker 56:11

understandings of what health is and what contributes to health, we wouldn't think of these things, right. Because the construction, the construct, of what health is, to us, to us, our perception is different. And because our perception is our perception, we view it as the right perception, when it's just one way to view something. And there are actually many different ways to view something. And, and when we're viewing health as this limited, black and white input output type of thing. It's, it's ignoring the current information that we have about what health is that, that construction, that construct of health is old fashioned, right, you know, like, apple a day to keep the doctor away? And where does that come from? And you know, like, oh, drink milk for healthy bones, and it was the milk industry that, you know, lobby to get children to have milk at school. And so where do these ideas of health come from? What are they influenced by? Do we want to look at different different people's views on health and and see how how they are more holistic and and look at the actual science and evidence and see what is it telling us now? And is it helpful for us to view health in that way? And, and not question things and not not be like, the fuck even is health? What is going on? And why are we so so single mindedly in the pursuit of this narrow definition of health, when it damages our mental well being and, you know, other maybe physical aspects of health? You know, the, the current definition we have of health isn't leading us to be as health full, whatever the fuck health means, as we could potentially be, you know, and I mean, is it helpful to we can we can stick with this, you know, we can stick with our, you know, health, the way that we view health the way that we've, we've, we understand how we can stick with that if that's working for you, and it feels good for you, then you mean do it. I don't think it's going to be the reality of what we believe health to be. You know, in the future, I think it's going to become more nuanced. Because we're going to have collective understandings that will change with with new knowledge and information. But I mean, if it works for you, go for it, but I think it probably will help a lot of people to expand their understanding of what health could look like and and can I even be healthy? What does it mean if I'm not healthy? What does it mean if I'm not able bodied? What does it mean if I value able bodied people over disabled people? What does that mean for me and my own well being what does it mean for me as I age what does it mean for me? Now that I temporarily able bodied when if I'm lucky enough, I will get old enough and will need to have assistance? and mobility aids and, and does that mean then I am a worthless person because I'm older. If I adhere to this idea of what health is, and what human bodies are valuable, then that's not going to help me as my health changes, if I'm lucky enough to live longer, you know. So I just I just don't think that it's helpful for us, for all of us collectively and individually to not think about this in a more nuanced way. And again, like, I started the show with Mike, like, what I was talking about healthcare being a social justice issue, a lot of what would help people be more quote, healthy is ending racism and sexism and, and stigmatization and marginalization of different people. And paying people more or giving people more more vacation days. free health care, gun control,

Unknown Speaker 1:01:06

right? That is, things that we can control or, you know, and, and even if, you know, the idea that even if we did do those things, you know, say if magic happens, and we live in utopian society, it's held still might not be attainable for many people. Right? And so it's kind of like there is no train that we can get on with certain sets of luggage and arrive at healthy you might do that and the train may never leave the station. And that's okay. It doesn't mean that you're less than or that people who are able bodied, quote healthy whatever the fuck it means are better. Although society today gives us a different measures, but the reality is, that's not true. Okay, I'm gonna leave it here for today. Um, yeah, hope you have a nice, nice rest of your day. And I want to remind you to stay first fatty, and I will see you in a while. Alligator Okay, bye Thanks for listening to the episode and if you feel ready to get serious about this work and want to know when the doors open to fears fatti Academy which is my signature program, where I teach all about how to overcome your fat phobic beliefs and learn to love your fat body. Then go to fifth fatty.com forward slash waitlist again, that is first fatty.com forward slash waitlist to get your name on the waitlist. For when first party Academy my signature program opens.