Explaining autopsies; sexual, public health in ads; cellphone addiction: Upstate Medical University's HealthLink on Air for Sunday, Sept. 24, 2023
Pathologist Robert Stoppacher, MD, explains the value of an autopsy. Syracuse University associate professor Rebecca Ortiz, PhD, shares research on advertising related to sexual and public health. Psychiatrist Christopher Lucas, MD, gives tips for avoiding cellphone addiction.
Host Amber Smith: Coming up next on Upstate's "HealthLink on Air," a hospital pathologist explains the value of autopsy and why family members may request this type of examination.
Robert Stoppacher, MD: ... The correlation between what we're seeing at the autopsy and what the clinical symptoms and the clinical course of that patient were are very important to look at in conjunction with one another. ...
Host Amber Smith: And an advertising professor discusses how ads about menstruation and sexual health have evolved.
Rebecca Ortiz, PhD: ... Right now, with such a landscape of concern about how do I control my own family planning, it's an opportune time to do that type of advertising. ...
Host Amber Smith: All that, some advice for avoiding cellphone "addiction," and a visit from The Healing Muse, right after the news.
This is Upstate Medical University's "HealthLink on Air," your chance to explore health, science and medicine with the experts from Central New York's only academic medical center. I'm your host, Amber Smith.
On this week's show, a visitor from Syracuse University shares an examination about how ads for menstrual products and sexual health have evolved over the years. But first, hospital pathologist Robert Stoppacher explains the value of autopsy.
From Upstate Medical University in Syracuse, New York, I'm Amber Smith. This is "HealthLink on Air."
The autopsies we see on TV shows are usually forensic autopsies, done when there's a suspicious or violent or unknown cause of death. But there's another kind of autopsy called a clinical autopsy, and these are performed in a hospital to find and better understand someone's cause of death.
Here with me to explain the value of autopsy is Dr. Robert Stoppacher. He's a professor of pathology at Upstate, and he oversees the University Hospital Autopsy Service.
Welcome to "HealthLink on Air," Dr. Stoppacher.
Robert Stoppacher, MD: Thanks for having me.
Host Amber Smith: Let's start with an explanation of what an autopsy is. I know it's an examination of the body after death, but what's included in that exam?
Robert Stoppacher, MD: So, as you said, an autopsy is the process of examining an individual after that individual has passed away. More specifically, I tend to break it down into three different components. One is what we call the external examination, where we look at the outside of the body, looking for any disease that may be evident on the outside of the body, looking for any kind of medical intervention that that individual may have had, and in certain situations looking for any kind of injuries or trauma that may be present on the outside of the body.
After we document all of those findings on the outside through written documentation and through photographs, we perform what's called the internal examination. And that involves performing surgical incisions into the body and looking at all the internal organs, again, focusing on is there any disease that's affecting different organs or the entire body, and documenting that through the course of the examination and also through photographs.
The third part is what I term the laboratory component, and that has a little bit of flexibility depending on the nature of the case, but it will frequently involve examining tissue samples under the microscope because certain diseases, let's say, for example, if someone has a mass that we identify in the lung, for example, it's important to look at that under the microscope and through that means we can determine if it's A, cancer; B, some sort of infection. And if it is cancer, we can then further classify the type of cancer that it may be, just like would be done if someone has a biopsy when they're alive. And it's sent to the pathology department, and it's then examined microscopically to identify the type of cancer, if you will.
In addition to that portion of the examination, the lab portion also might involve doing any kind of laboratory tests. So, for example, if there's an infection, we may take cultures of that area to see what the bacteria is. Or, on rare occasions, we may collect blood samples for potentially toxicology testing, looking for the presence of medications or drugs. The toxicology aspect is really more something that's used more commonly in the forensic setting, as you can imagine. In most hospital-related deaths, medications, or certainly illicit drugs, are not really of significant concern in that situation.
And so we do all three of those components that form an autopsy, ultimately with the goal of trying to establish why that person died, or what we call the cause of death. And in most hospital-based autopsies and deaths, that's a natural process. So, for example, it's some natural disease that might be heart disease, or it might be a stroke, or it might be complications related to cancer or some sort of infection.
In contrast to the forensic setting, where oftentimes those deaths relate to some sort of violence or trauma. At some level, that's one of the big differentiators between what you term forensic autopsies and clinical autopsies. It's a different population that the autopsies are being performed on.
Host Amber Smith: So, for the clinical autopsies, which are mostly natural deaths, it sounds like you have a step-by-step procedure that you follow for each one. But how long does that take?
Robert Stoppacher, MD: It depends on the nature of the case. So, there may be very complex medical conditions that the individual has, that may be further complicated by prior surgery. So anatomically or during the physical process of the autopsy, it may be more intensive with respect to that dissection and identifying diseases and organs and so forth. So I would say, on average, a clinical or hospital autopsy takes approximately 2 1/2 to three hours.
Host Amber Smith: Depending on what you find, I'm assuming?
Robert Stoppacher, MD: Right.
Host Amber Smith: So is it the same for an autopsy for a child versus an adult?
Robert Stoppacher, MD: In general, yes. The steps that are taken are similar. You know, that doesn't change. However, obviously, having a knowledge of infant or child anatomy is important, particularly when we're dealing with neonates (newborns) or other disease processes that may have required some sort of surgical procedure, such as congenital heart disease, or a disease of the heart that the child is born with.
But the general process doesn't change. However, it's having a knowledge of what diseases children are more likely to have. And as you can imagine, most of the time, because these deaths occur in the hospital, or the patients have been in the hospital for some period of time, there's lots of documentation as far as medical records and imaging, so X-rays and CT scans that give us a better understanding of what may be the issues related to that particular case that we need to focus on.
Host Amber Smith: So I know that you're in search of a cause of death, but when the deceased had a multitude of medical problems, how do you tell which of the diseases is the one that killed them?
Robert Stoppacher, MD: Well, that's a good question. And what, as I previously described, as we go through all the different organ systems in the process of performing an autopsy, if there's pathology or disease in a particular organ, and some of that disease may be what we call chronic or may be something that we might expect as someone ages. And that may be different than something that is superimposed on that, that drastically caused a change in their condition.
So, for example, someone with emphysema or COPD, chronic obstructive pulmonary disease, that disease is very evident when we do an autopsy. However, the fact that they may have pneumonia on top of that might give us a better understanding of why that individual died.
I think the other important consideration is, even though we're pathologists and not clinical physicians who deal directly with patients, most of the time, we do have quite a bit of knowledge about clinical medicine and the correlation between what we're seeing at the autopsy and what the clinical symptoms and the clinical course of that patient were are very important to look at in conjunction with one another. And that's probably the best way to determine what actually caused that individual's death, rather than other diseases that may simply be present. And in all honesty, oftentimes, it's some combination of multiple diseases that probably worked in unison to ultimately produce that death.
Host Amber Smith: How common is it to find something that surprises either you or the family during an autopsy?
Robert Stoppacher, MD: It's not uncommon. Many times we will find something that was not identified throughout the life of that patient. Oftentimes those are, some of them may be what we call incidental. For example, it might be a cyst on the kidney or a cyst on the liver or something that's of relatively little significance. That's a relatively common occurrence.
In contrast, finding something that is completely unknown that is going to affect or may have caused that individual's death happens less frequently, but it does happen. I think there is sort of a misconception nowadays that with the imaging that we have -- CT scans, MRIs, and all the additional laboratory and diagnostic tests that are available -- that the autopsy is not useful.
And history has shown numbers wise that the rates of autopsies in teaching hospitals has dramatically decreased over the past two decades, even at the largest academic and teaching institutions. However, study after study has also shown that the autopsy remains the best way to identify diseases that may have been not identified in life or misdiagnosed in life. As I said, that doesn't happen that often, but it does occur on occasion.
Host Amber Smith: So what sorts of things do you look for that might be important for the survivors to know in terms of family medical history?
Robert Stoppacher, MD: So in the process, documenting diseases that exist that, as I mentioned, may not necessarily cause the death, but may be present, in those that did cause the deaths are certainly important pieces of information for surviving family members, in general. So, when you go to your doctor, one of the things that they typically will ask you about is your family history, right? So they want to know about your parents or your siblings. And do they have any diseases, or what medical conditions do they have?
Having that information or obtaining that information through an autopsy is useful for surviving family members to know certain conditions that that individual had. That doesn't mean that all of those conditions are going to appear in family members because there's a lot of factors that play into, let's say, heart disease. There's lifestyle choices that affect how that happens, such as smoking and other risk factors, but there is a family history component to it, or a genetic component, if you will. But it's not an absolute, per se.
There's other, less common situations where a disease has a very clear genetic abnormality associated with it. And I'll try and give you an example. There is an entity called hypertrophic cardiomyopathy. And that's a condition where there is a genetic abnormality in one of the genes that code or that dictate some of the proteins that are involved in the heart muscles. And when an individual has that abnormality, their heart becomes very enlarged and thickened. And that can predispose them for, obviously, problems with their heart, including what we call sudden death or cardiac arrest. That tends to be something that happens in relatively younger individuals. But if we're able to identify something like that, that clearly has a genetic component to it, we can do confirmatory testing and identify that gene and then help surviving family members potentially get tested for that disorder.
Host Amber Smith: Upstate's "HealthLink on Air" has to take a short break, but please stay tuned for more about the value of autopsy with Dr. Robert Stoppacher.
Welcome back to Upstate's "HealthLink on Air." This is your host, Amber Smith. I'm talking to Dr. Robert Stoppacher. He's a professor of pathology at Upstate, and he oversees the University Hospital Autopsy Service.
Well, let me ask you a little more about the University Hospital Autopsy Service. Is this just for people who pass away in the hospital?
Robert Stoppacher, MD: Primarily, that's what the autopsy service does. It relates to or involves individuals that die at Upstate (University) or Community General hospital. However, our policy is that if someone was seen at any of the Upstate hospitals within the past six months, and dies outside of the hospital, let's say, at a nursing home or a rehabilitation facility or at home, for that matter, then we will perform the autopsy in those situations.
We also do a significant amount of what we call private autopsies that are from individuals not from the Upstate system, and those might be individuals that die in a hospital that doesn't perform autopsy examinations, and they're interested in knowing, or simply in situations where the family wants to know more about the processes that resulted in their loved one's death, but they don't have the ability based on where the death occurred or where they lived to have an autopsy done locally.
Host Amber Smith: So can anyone request an autopsy, and how is it paid for? Does insurance cover it?
Robert Stoppacher, MD: So any Upstate patient or recently discharged Upstate patient, those autopsies are done at no cost to the family or the patient. That's part of the quality assurance program that Upstate has, and we do those autopsies at no charge. In contrast, the private autopsies that I talked about, that's usually something that is associated with a fee for performing those.
With respect to who can request an autopsy, there are very strict guidelines as far as consenting or providing authorization to perform an autopsy examination, and those follow what we call the legal next of kin.
So, legally, there's certain individuals that are your next of kin. I don't have a better way to say that. So, for example, a spouse would be the closest next of kin, followed by children, and as you can imagine, you go further out down the line. We follow that process in obtaining consent for an autopsy examination. I do want to point out, it's oftentimes that individuals may have a power of attorney or a medical proxy during their life as far as treatment decisions and so forth. However, those entities, if you will, die, no longer exist when an individual dies. So a healthcare proxy does not exist, if you will, after that individual dies. And that's, in part, the reason why we use the legal next of kin as the individuals that would need to consent for and authorize the autopsy examination.
Host Amber Smith: Do you have advice for relatives who want to understand more about how their loved one died? What do they need to know about seeking an autopsy?
Robert Stoppacher, MD: It's important that patients and their families have an understanding of what an autopsy involves and what it can and can't accomplish. You know, we talked about an autopsy examination in the form, the different components of it and so forth. There are situations where we may do a limited autopsy examination.
So, for example, in a situation where a family's concern is really focused on if their loved one had dementia. And so we may only examine the brain through a specialist neuropathologist that looks at the brain in great detail. Or they may simply want to know if the mass that they found in the lung, shortly before the person passed away, is that cancer? And we don't necessarily have to do a complete autopsy examination, looking at every organ. Certainly that will provide the most information, but there are other opportunities, or other ways to get more focused answers.
And this process, I think, can benefit lots of families. It does not cause any significant delay in services or issues with respect to viewing or funeral services beyond that. So I think there's a lot that can be learned through an autopsy, and if there's questions that someone may have about an autopsy on their loved ones, certainly, first line would be to talk to their doctors that are taking care of them and ask them about it. And if they can't answer it, then they will reach out to us through the autopsy service, who are happy to talk to them or their physicians directly.
Host Amber Smith: That's good to know. Well, getting back to television, what have you seen on TV programs get right about autopsies? And what have you seen them get wrong?
Robert Stoppacher, MD: I mean, I think most of us have seen some sort of TV drama, be it NCIS or CSI, and you can insert whatever acronym you want, but they -- certainly, there's a couple of things that are not accurate in those situations. One, the autopsy takes a little bit longer, and we don't get answers in the half-hour time slot that they're slotted. Same holds true for DNA testing and any other lab work. You can imagine, it has to be a little bit more, some license is given to make it more entertaining.
I think that the bottom line is the basic gist of what is done at an autopsy is relatively accurate. I think there's a little bit of license taken to allow people to explain exactly what happened based on the autopsy findings when it's not quite like that in reality. So, for example, you may see on a TV show that the medical examiner looks at a body and says they died three hours and 22 minutes earlier. When in all reality, that's not possible. And so I think it's a little bit sensationalized for obvious reasons, but the basic tenets of the autopsy aren't that far from the truth.
Host Amber Smith: Well thank you for making time for this interview, Dr. Stoppacher.
Robert Stoppacher, MD: Oh, you're quite welcome. Thank you.
Host Amber Smith: My guest has been Dr. Robert Stoppacher. He's a professor of pathology at Upstate who oversees the University Hospital Autopsy Service. I'm Amber Smith for Upstate's "HealthLink on Air."
Trends in advertising about sexual health -- next, on Upstate's "HealthLink on Air."
From Upstate Medical University in Syracuse, New York, I'm Amber Smith. This is "HealthLink on Air."
Advertising is everywhere. And for many of us, ads shape what we know and how we feel about medical care and health. To examine this concept. I'm talking with Rebecca Ortiz. She's an associate professor in advertising at Syracuse University's S.I. Newhouse School of Public Communications.
Welcome to "HealthLink on Air," Dr. Ortiz.
Rebecca Ortiz, PhD: Thanks so much for having me.
Host Amber Smith: Your doctoral degree is in mass communication. Your expertise is health advertising, and you specifically have done research on campaigns having to do with sexual health.
Since the world has just experienced a global pandemic, I wanted to ask you whether and how the pandemic has affected sexual health promotion during lockdowns and afterward.
Rebecca Ortiz, PhD: Yeah, that's a great question. I think while we were in the middle of the pandemic, we were thinking a lot about health related to contracting the virus and thinking about how do we protect ourselves in that situation, but someone's sexual health is also an important factor through all of that.
And what was really interesting, I think, there's a lot of things that happened, but perhaps for brevity, the most interesting thing that really happened was that we saw some public service announcements that came out specifically talking about sexual health and how one's sexual health might be impacted by the virus.
Some of us may have seen some of these. Some of them may have popped up online, because they were quite surprising, but New York City and then Oregon were two places that really did an interesting thing that we hadn't seen before, which came out with advertising and promotional materials specifically about how the virus could or could not be transmitted through sexual interaction. And so it was really interesting to see them talk really openly about sexuality in a way we hadn't seen in prior public service announcements. So there was a lot of questions, I think, among people about, can I transmit this through sex, like, is this a sexually transmitted virus?
And they really wanted to push away some of those concerns, and so they came out with some messaging specifically about that, and how do you protect yourself in terms of skin-to-skin contact? So that was some of the biggest things that we saw in the pandemic around sexual health.
Host Amber Smith: So, what sorts of ads are included as sexual health advertising?
Rebecca Ortiz, PhD: Yeah, it's a big umbrella term, and I think it can mean a lot of different things to a lot of different people. But if we break it down, and we really think about, OK, what do each of those words mean? So, health, of course, can be anything related to emotional, physical, even spiritual well-being. And then so we're taking that in terms of anything related to someone's sexual well-being. And depending on who you talk to, that can mean a lot of different things.
We can talk about it in terms of one's sexual identity, we can talk about it in terms of communication between partners, of sexual consent. I think more traditionally, we think about things like contraception, (and) menstrual products sometimes fall under that if we start to think about it in terms of reproductive health, but even things (like) messaging, talking around sexual pleasure and how do we make sure that we are living our best, healthiest sexual lives. So then it's advertising that promotes any of those types of products or any of those types of ideas.
Host Amber Smith: The Supreme Court overturned Roe v. Wade last year, and some states have quickly moved to restrict or ban abortion. What impact is this having on sexual health advertising?
Rebecca Ortiz, PhD: This is a really, really big question, and I'll try to answer it in a couple of different ways, and we can go into different paths if we want to.
You can look at it a couple different ways. So, we have seen, especially around the reversal of Roe, that there was some increase in contraceptive advertising -- Plan B (a morning-after pill), for example. We saw an increase in some of the advertising spent around some of those products. I haven't seen recently if that's maintained, but there was a little bit of an increase there.
And then we also have started to see conversations around, well, how do we advertise and promote and talk about abortion services, especially in places where abortion is completely illegal or severely restricted?
And so there's conversations around what does the advertising look like in those spaces, and is advertising appearing in places more readily where you can still get abortions? So there were some of that, and we can talk more about that if we want to, but then there's also some conversations around data and how data is being collected to be used for advertising, especially when you have some of these legal restrictions about being able to talk about abortion.
Host Amber Smith: So, there's a lot of different things. We can go off in any of those different directions. Well, are you seeing abortion providers in blue states advertising their services in red states? Is that happening?
Rebecca Ortiz, PhD: What you have is tricky. So when you talk about advertising abortion services, there are a couple of different limitations.
So first, I'll answer your question to say, no, I haven't seen that exactly. However, there's been some reports, and we've seen some increases in these centers that are trying to convince people not to get abortions, and then they sort of sell themselves as abortion centers. We've seen some increases in the advertising there, and there's been some concerns about those advertisers being allowed and being misinformation around some of these. So they're sometimes are called crisis pregnancy centers is what we'll see. But what we're really talking about is: Are we seeing increases in abortion services in general? And what you have to remember is that abortion is still a generally taboo topic. And so, even if it's legal somewhere, there might still be some restrictions in places who aren't willing to carry that type of messaging. And so, even though places might want to be advertising their services, they're limited where those messages can appear.
So, Google, for example, has gotten a lot of backlash from some activists around allowing crisis pregnancy centers to advertise in their spaces and selling themselves as something that they're not. So, it's a big question.
And abortion services have perhaps increased a little bit in some of their promotion, but they can't always do it in a direct way that we think about when we think about selling something like advertisements for menstrual products or things like that.
Host Amber Smith: Are you seeing ad campaigns, post-Roe, are you seeing those aimed at women or men or both?
Rebecca Ortiz, PhD: I don't think I have the exact answer to that, but I can say generally that, of course, abortion services, when we start to talk about that, or any sort of contraceptive products and things, often are more advertised towards women. What we are seeing is some increase in discussion around how men can be part of these conversations.
And so there have been some advertisers who have tried to include some of that messaging in their advertising. Whether it's actually aimed at women or men, it's not entirely clear.
Host Amber Smith: Do you think that contraceptive makers are going to be boosting their advertising now that we're in a post-Roe landscape?
Rebecca Ortiz, PhD: Yes, and we have seen that some of them have. Again, I don't know, in terms of the most up-to-date numbers, but right post-Roe, we did see some increases, and I think, yes, I think advertisers are always looking not only for the right message, but the right place and time to put their messaging. And so right now, with such a landscape of concern about how do I control my own family planning, it's an opportune time to do that type of advertising. So, yes, I think we'll continue to see increases in that.
Host Amber Smith: There's a new over-the-counter birth control pill that's projected to come out after the first of the year. Have you seen any ads for that yet?
Rebecca Ortiz, PhD: No, I haven't. Not to say that they don't exist, but I would be surprised if they do, because usually there are restrictions about being able to advertise products until they've gone through a full regulation period. I don't know exactly where all of that is, but I would be surprised to see them officially being advertised. But there might be advertisements around people kind of talking about it from a cause issue. So I haven't seen anything where the manufacturers themselves are directly advertising.
Host Amber Smith: This is Upstate's "HealthLink on Air," with your host, Amber Smith. My guest is Rebecca Ortiz from Syracuse University's S.I. Newhouse School of Public Communications.
You were involved in research on how menstrual products are advertised in the United States in a paper that was published in the journal Health Care for Women International. What can you tell us about it?
Rebecca Ortiz, PhD: Well, in a very quick nutshell, we won't get too into the nitty-gritty of the research, we looked at advertising from a 10-year span. So, a couple years ago, and then 10 years prior to that, looking to see what were sort of the general trends and themes among those ads that were advertising menstrual products like tampons and pads, some things like that, and to see, like, what were some of the themes, what were some of the trends, and then what were some of the responses by potential audience members as to how they interpreted those themes and trends?
Host Amber Smith: Have you noticed that the ads have evolved over the years? Have you seen changes in menstrual advertising?
Rebecca Ortiz, PhD: Yeah, you really have. I think, like we always say with any sort of issue that has been previously taboo and still continues to have some stigma and shame around it, there's room to grow. But within the last decade, you've seen a real shift in acknowledgement of the shame and stigma that has often been attached to menstruation and also trying to create more inclusivity within the advertising and showing different body types, race, gender, to ensure that you're reaching audiences with this message more appropriately and trying to reduce some of the stigma and shame that we saw on previous advertisements.
So, menstrual product advertising used to really focus on the shame around menstruation. And I'd say those advertisements still do, but in a sort of trying-to-counter-that way. So we're seeing a lot of shift in that.
Host Amber Smith: Regarding the shame in menstrual product ads, do you see similar shame in ads for erectile dysfunction drugs?
Rebecca Ortiz, PhD: So, this is the thing that a lot of people compare, is we're talking about sort of men's health versus women's health. And how do these two things get portrayed in advertising? Is there equality and respect for these two different areas of people's health?
I would say what's interesting about erectile dysfunction ads is not so much the message, though that is interesting, but it's where it's allowed to exist.
So, let me first start with the message. So, yes, I think you do see acknowledgement of some shame or some confusion that men might be experiencing when they experience this problem or issue. There's acknowledgement in the advertisement, so I think both menstrual product advertising and erectile dysfunction advertising are both engaging in messages around acknowledging some of the shame.
But what I think is perhaps more interesting when you start to compare these two different categories is where they're allowed to live. When we're advertising, we don't just think about what does the message say? We think about where is it going to appear. So where is the media that people are going to be exposed to this message?
And last year there was a really interesting investigative report out of theCenter for Intimacy Justice that looked at advertisements for health care products for women, not just menstrual products, but things around sexual health, and looked to see how often were they rejected by Meta, so, Meta being Facebook and Instagram, how often were they rejected, not allowed to be on the platform, versus advertisements for erectile dysfunction.
Now, there's a lot of factors that play into whether an advertisement is allowed to air, if you will, or be published in those spaces. But there seem to be, and I think they had some good evidence to suggest, that they're much more likely to sensor, not allow and moderate women's sexual health ads, than these erectile dysfunction ads. And some of the argument is well, you can't really talk about sex directly. And some of these women's health ads, try to talk about sex directly, which is why you'll often see advertising that is related to sexual health using innuendos. Or, like, the little peach symbol or the eggplant symbol or things like that, because the ads can get flagged as being sort of pornographic if you don't have some of those more innuendos. But if you look at the ads side by side, you see it's perhaps not just that the women's sexual health ads were using more explicit language. There seems to be another undertone there. So, I know Meta changed some of their policies, and it still remains to be seen whether that has fixed some of the problems. But it does appear that when we're talking about men's health, in example of erectile dysfunction, those ads are more allowed to exist.
So, they're more likely to not get flagged and censored than some of the women's health ads.
Host Amber Smith: So, the ad standards that you mentioned, are these created to protect kids or keep things G-rated? Is that what that's about?
Rebecca Ortiz, PhD: That's the argument, and I would say for some people that is the case. I mean, that is exactly why they feel the need to restrict or sensor or moderate this type of advertising, is they're trying to reduce pornography on the site, as they would say.
But where it becomes problematic to be thinking about that is to assume that children, and we can talk about different age ranges needing different things, but children not needing to get sexual health information as well. So, as they're developing, as they're starting to experience menstruation, or experiencing sexual desire, all these types of things, it's also important that they get the right information.
So, it's this very sensitive dance that happens between how much information can we allow without it stepping into a place where we feel this is inappropriate for children? And I think a lot of people have a lot of different opinions about what exactly that is. And so the media platform ultimately gets to decide, as long as it doesn't actually enter into legal restrictions.
Host Amber Smith: You mentioned racial and gender and body type inclusivity in menstrual product ads. Is that unique to the menstrual product ads, or are you seeing that inclusivity in other sectors as well?
Rebecca Ortiz, PhD: Yeah, definitely seeing it not just in menstrual product advertising. I think it's very welcomed, and I was excited to start to see that appearing more in menstrual product advertising, just because it opens up a wider audience, and we should be speaking to anybody and everybody who would be interested in these types of products. But you are seeing it in advertising across a variety of different products, because the people who are making these ads, I think, are increasingly -- I can see it in my students, and I can see it in my former students -- are increasingly seeing this as an important issue, to make sure that their advertising is reflective of their audience.
Host Amber Smith: Now, another legislative area that's getting attention has to do with medical care and legal protections provided to the LGBTQ population. How are advertisers navigating this topic?
Rebecca Ortiz, PhD: Oof! You know, I think we're sort of in the thick of that, and just like I said about racial, gender, body type inclusivity in advertising, there is a clear attempt by advertisers to be inclusive around gender identity, sexual identity. And so we're seeing attempts to do that.
Unfortunately, I think for many, it becomes a political statement to some audience members that then see it negatively. I think the most obvious example that will come to mind, at least right now, the Bud Light controversy, where, and I hate to even call it that, but where they partnered with a trans influencer to promote Bud Light, and then there was a backlash from people.
And what you have to keep in mind is, there was a backlash, and then there was discussion around, like, "Oh, are they alienating their audience?" When these companies are creating advertisements where they're engaging in inclusive messages, I think the biggest mistake that they can make is not being consistent with that.
So, when they received that backlash from, I don't even know that they were necessarily people that were current customers, but let's just say backlash from people, probably one of the biggest missteps they make was not to continue to support the decisions that they had made. And so you not only alienated -- that word's tricky -- like, alienated, or made a certain segment of the consumer population upset, you then alienated the people who would have been there to support the brand, given that they made that decision. So, it's tricky. It's a space right now that is a political discussion, unfortunately. And a lot of companies, I think, are still trying to figure out how to navigate it.
Host Amber Smith: Well, regarding taking sides, thinking back to COVID-19, public health messaging about the vaccine or masking was seen by some to be taking a side.
Is there any evidence or lessons learned for navigating disinformation during a public health crisis?
Rebecca Ortiz, PhD: So, this is the question that I can tell you many, many bright, intelligent people are trying to tackle, and I think some people feel they have the answers and they may absolutely be right, and others are still in the space of "... don't really know; we're still trying to figure that out."
I'm perhaps one of those that is not entirely sure how we address it because what we're dealing with is, we're dealing with emotions. We're dealing with feelings. People feel certain ways about certain things and where they may be making those decisions based upon what they believe are facts or rational thinking, a lot of advertising and a lot of promotion of messaging is meeting people where they are emotionally. And so I think what you have to consider is, if you're trying to counter misinformation, disinformation, these kinds of things, we, as health communicators, as advertisers, need to remember that just throwing facts at people, just throwing rational thinking at people, is not always going to get at the heart of what is making them feel or believe misinformation or disinformation.
So, I don't have the answer. I think a lot of people are still figuring out what that answer is, but to remember that a lot of decisions that we make as consumers, as people, is emotional, and whether we want to acknowledge it or not, we need to make sure that we're talking to people in respectful ways that don't just sort of question their knowledge or question how they feel, because feelings matter, and emotions are very influential in how we make decisions.
Host Amber Smith: Well, getting back to sexual health advertising, have you given any thought to where it's headed and what the future holds or what the ads will be like in the future?
Rebecca Ortiz, PhD: There's a project that I alluded to earlier about New York and Oregon doing those sexual health messagings during the height of the COVID pandemic, and a colleague of mine who is also at Newhouse, Kyla Garrett Wagner, and I started a project soon after those promotional materials came out, because we wanted to see, so there was this greater openness to talk about sexual health, because it was in conjunction with trying to reduce transmission of the virus, and we were interested to see, like, is this sort of a tipping point? Is this a point where we're going to start talking more openly about sexual health, especially by public health departments? And we're at the point where we don't know the answer yet, because there's still many more years to come to see how it translates.
But it was very interesting to see public health departments making these statements. And we wanted to see: Will that translate over time into healthier discussion and more open discussion around sexuality and sexual health? So my optimistic part of me is hopeful that we will continue that, that we'll continue to be more inclusive, that we'll continue to ask the big questions and make sure that we are engaging in conversations around sexual health.
But I think it still remains to be seen.
Host Amber Smith: Well, this has been very interesting, and I appreciate you making time for this interview, Dr. Ortiz.
Rebecca Ortiz, PhD: Thank you so much. I appreciate it.
Host Amber Smith: My guest has been Rebecca Ortiz. She's an associate professor in advertising at Syracuse University's S.I. Newhouse School of Public Communications.
I'm Amber Smith for Upstate's "HeathLink on Air."
Here's some expert advice from psychiatrist Dr. Christopher Lucas from Upstate Medical University. How can someone avoid becoming addicted to their cellphone?
Christopher Lucas, MD: Well, the most basic step is to try and limit the use so that, maybe set an alarm or a schedule for how often you will check your phone. Sometimes people are already checking it every few minutes. Then say, OK, I'm going to check it every 15 minutes. And then you could move to unchecking it every half hour, then every hour. And then once you set an alarm, then you could spend that time looking through any emails or notifications and then reset your timer. Now people will get anxious about not responding quickly enough, so you could head that off by letting friends or family know that you might not respond to their messages as quickly as you used to.
The phones have been manufactured to do things called push notifications, where you get a little chirp or pop-up screen when something happens. You don't need to be interrupted by every "like" that your Instagram picture gets or that someone has just released a new episode of your favorite podcast. And so turn off push notifications for as many apps as you can, and really leave the notifications only for the ones that you absolutely need, such as an email or a calendar reminder. And then for other things, only have the notifications for when you're using the app themselves.
People tend to use phones in a sort of distracted way. So they go from one thing to another, to another, and they never really planned to go and check the weather, but they see the app for it. So take distracting apps off your home screen. Put them on a secondary screen or within a folder. Someone also had a suggestion of turning the icon from colorful and engaging to boring and gray, and there are options within the accessibility functions on your phone that would allow you to do that. You might actually want to delete certain apps that are particularly time-wasters or ones that seem to affect you negatively in terms of your mood or your self-esteem.
I think one of the most pernicious components of using cell phones is using them late at night whilst you're in bed just before trying to get to sleep. Although there have been some efforts to try and reduce the light emissions and the spectrum of the light that doesn't affect sleep, just using the phone prior to sleep is likely to make it harder to sleep. Phones and bedtime are definitely a danger area. So don't have the phone be the first thing that you check in the morning or the last thing you look at at night. Just use the regular alarm clock. Charge your phone outside of your reach. And you then won't, potentially, get tempted to use your phone first thing and get stuck in a whole bunch of messages.
If you have a smart speaker, such as an Amazon Echo or a Google Home, you might want to use that. You can ask the questions about what's the weather, or what's the traffic, rather than having to go and interact with your phone.
And finally, as in anything where you're trying to monitor or change your pattern of use, you need to keep an eye on how much you're actually doing that. So there are a bunch of apps, like Quality Time or Moment, that can track your smartphone habits. What are you using? How are you spending your time? And then you can set specific goals and then see how well you are sticking to it.
It's obviously a difficult thing to do, and I struggle myself sometimes to put the phone down when I should be doing other things. But it's always a tricky process because all of these phones and all of this software and all of this social media is engineered to try and get you addicted, to keep using so that you'll buy more phones, you'll upgrade your phone and you'll provide more advertising dollars to the various sites that you look at.
Host Amber Smith: You've been listening to psychiatrist Dr. Christopher Lucas from Upstate Medical University.
And now, Deirdre Neilen, editor of Upstate Medical University's literary and visual arts journal, The Healing Muse, with this week's selection.
Deirdre Neilen, PhD: Gaetan Sgro describes himself as an internal medicine doctor, girl dad and assistant professor of medicine at the University of Pittsburgh School of Medicine. His poem "Things I've Dreamed" explores things seen and unseen.
When I was twenty-one and dressed as a patient
My temple prepped and poised
To reveal that mass of milky Jell-O
That conjuress both heaven and hell
The howling craniotome and stench
Of sizzling collagen curdled my sleep.
Besides a few jags of bone that click and catch
On humid days it's hard to say how I've changed.
I've always passed my idle time
Imagining catastrophes, but who isn't
Always bracing? Whenever I drive on highways
I understand the world as a windscreen
Myself a juicy insect hurtling. One spring
I spent a day in lush Savannah
And afterwards itched for weeks even though
My skin was clear and I'd never had allergies.
One-third of patients with Hodgkin's disease experience
Itching. I'm an internist. Of course I was worried.
Everyone knows where there's smoke there's fire
But at that point isn't it always too late?
In my sixth summer ...
I dreamt, looking back over my father's shoulder
At our living room in flames.
In my seventh summer ...
I awoke, looking back over my father's shoulder
At our living room in flames.
I've spent my whole life dissecting that sequence
Trying not to believe in things I've dreamed.
Host Amber Smith: This has been Upstate's "HealthLink on Air," brought to you each week by Upstate Medical University in Syracuse, New York.
Next week on "HealthLink on Air" -- adult vaccine recommendations for fall.
If you missed any of today's show, or for more information on a variety of health, science and medical topics, visit our website at healthlinkonair.org.
Upstate's "HealthLink on Air" is produced by Jim Howe, with sound engineering by Bill Broeckel.
This is your host, Amber Smith, thanking you for listening.