Handbook on Gender and Health

This post was contributed by Dr Jasmine Gideon, senior lecturer in Development Studies at Birkbeck’s Department of Geography, Environment and Development Studies. Here, Dr Gideon offers an insight into her new book: The Handbook on Gender and Health

My monograph ‘Gender, Globalization and Health in a Latin American Context’ develops the idea of a gendered political economy of health and uses this framework to consider health reform in Chile. Compiling the Handbook on Gender and Health offered me an opportunity to develop my ideas further through directly engaging with a wide range of

Dr Gideon's book cover features an piece by Gambian artist Suelle Nachif titled 'Faj' ('heal')

Dr Gideon’s book cover features a piece by Gambian artist Suelle Nachif titled ‘Faj’ (‘heal’)

academics and policy makers working in this area.

The Handbook offered an opportunity to highlight empirical examples from across the globe and draw attention to case study analysis of specific issues that I was not able to include in my own book. Working on the Handbook was also a chance to think about what my ‘dream team’ of authors would look like and bring together a wide range of writers working on a variety of health-related issues, ranging from the historical development of health systems and how women and men are located within this to more ‘contemporary’ debates around migration, climate change and low paid labour which all have critical implications for health, particularly when viewed through a gender lens.

The Handbook brings together a wide range of disciplinary perspectives to consider four overarching themes, all constituting distinct but over-lapping elements of a broader gendered political economy of health. These are:

Gender equity vs gender equality

The first theme is the tension between ideas of gender equity and gender equality and how these translate in practice when applied to the health sector. Chapters explore the difference between ‘reductionist’ approaches where categories of women and men are not sufficiently explored, for example by failing to address how other axes of inequality (e.g. race/age/ class) can affect people’s ability to engage with health systems. In contrast a gender equality approach seeks to promote gender justice.

According to UN Women (2010), this entails ending the inequalities between women and men that are produced and reproduced in the family, the community, the market and the state. However, at the same time it requires that mainstream institutions are more accountable and transparent and points to the second theme discussed in the book.

Dr Jasmine Gideon

Dr Jasmine Gideon

The gendered nature of health systems

Several of the chapters reflect on the need to uncover the gendered nature of the health system itself and shed light on the diverse ways in which women’s interests are frequently marginalised or health policies work to reinforce women’s gendered roles and responsibilities.

Including marginalised voices

The third theme that is examined is the importance of incorporating the voices of excluded groups in policy processes as several chapters highlight the health costs of failing to engage with marginalised sectors of society.

Challenging ‘one size fits all’

Finally the fourth theme that emerges from a number of the chapters is the importance of appropriate policy responses and a move away from the ‘one size fits all’ approach, often espoused by international donors and global health discourses.

Within the Handbook authors from the Global North and South highlight how many of these challenges have wider relevance to all of our lives and that ‘gender’ remains central to any analysis of health, regardless of the level of development within the health system or wider economy.

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Birkbeck’s Published Alumni Series: Elizabeth Fremantle

This post was contributed by Valeria Melchioretto. This summer the Birkbeck Creative Writing department launched its new website The Mechanics’ Institute Review Online. This year marks a huge success for the Creative Writing MA as ten alumni have novels coming out this year.

To celebrate these achievements we are profiling a selection of the authors and extracts from their upcoming novels will appear on MIROnline. Here, Valeria speaks with alumnus Elizabeth Fremantle, about her novel, The Girl in the Glass Tower (Penguin, June 2016)

Read an extract of the book at MIROnline

VM: Congratulations on your latest novel The Girl In The Glass Towerwhich is due out in June and thanks very much for taking the time to answer a few questions. All your novels are set in the Tudor era and focus on remarkable women who actually lived at that time. What made you write about these heroines in the first place?

TheGirlInGlassTowerEF: I became interested in early modern women when I was studying for my BA in English at Birkbeck. A course that explored women’s writing from the renaissance period opened my eyes to some of the first English women to publish their own original work. This helped me to understand the ways in which women were able to find their voices in a wholly misogynistic culture that expected female silence and obedience.

Katherine Parr, the protagonist of my first Tudor novel, was one of these women and I wanted to bust the notion of her as the dull nursemaid of popular Protestant myth and show her as the intelligent, courageous and dynamic woman she really was. All the women I write about lived remarkable lives that have been altered, or overlooked by a history that privileges male narratives and it has been my aim to, at least in some small way, redress that balance by reimagining their stories.

You must be a very prolific writer as this is your fourth published novel within just over two years. How did this extraordinary magnum opus come about? Did you approach an agent with all four novels ready to go or did you have one novel and wrote the other three as part of a publishing deal?

It’s misleading really, as it makes it seem as if I write two books a year. This is not actually the case. Queen’s Gambit was already finished when I signed my first three-book deal with Michael Joseph/Penguin in 2012 and by the time that was published a year later I had finished work on the next. My pattern is to write a book a year and The Girl in the Glass Tower is the first of a new four-book deal with the same publishers.

I already had an agent when I decided to work on the historical novels and had been, unsuccessfully, writing contemporary fiction. The change of focus helped me finally find my voice and I benefitted from a good deal of support and encouragement from my agent.

There is a huge demand on novels about the great and the good of the Tudor era, from the works of Sansom to Gregory and of course Mantel. Why do you think readers seem so keen to engross themselves into the lives of a well known elite from so long ago, or to put it differently, do you ever feel the pressure of having to fulfil readers’ expectations?

Why the Tudors continue to fascinate is a question people ask all the time and there is no single answer. The period marked the beginning of our modern world; it was a time of great upheaval, the Reformation forced people to reconsider beliefs that had gone unquestioned for hundreds of years and it marked a fundamental societal change. It was a time of great cultural flourishing in poetry and drama, which still resonates to this day, and also saw the first explorations to the New World.

As someone who is preoccupied with women’s stories I have found great inspiration from being able to listen in to authentic women’s voices from the first writings by women I mentioned above. For a writer it is a world in which the stakes are stratospherically high which creates a constant tension in any narrative.

There are of course the constraints of accuracy as the narrative arch is fixed by history itself. How do you manage to reclaim these characters and make them your own?

Elizabeth Fremantle

Elizabeth Fremantle

I don’t really think about that when I set out to write. I do a great deal of research and then set it all aside so I can build my characters from the inside out. Character is, after all, formed from inaccessible inner worlds. I may know some of the actions of the real life counterparts of my characters and the way they responded to others’ actions, or I may have read a line in a letter that sparks something in my mind, which in turn transforms into a trait that can be built on. But these people derive as much from my imagination as the historical record. I aim for accuracy in the overarching narrative but for me the historical facts are a framework on which to hang my characters.

How do you get so much writing done? Do you set yourself a daily word target or is it about having an ideal working environment? What’s your secret?

My secret is a very dull one: it’s nothing more mysterious than discipline. I work all the time and rarely take time off. There is nothing I’d rather be doing. I do find that a daily word count helps with my tight writing schedule. My absolute minimum is 1,000 words but if I haven’t written 1,500 in a day I’m not happy. I edit as I go along, reviewing the previous days’ work on the following morning and absolutely must be at my own desk, surrounded by all my reference books.

In which way do you think the MA has prepared you for your career as a writer?

I think one of the key things I derived from the MA was an understanding of the difficulty of the path I had chosen but also to take myself seriously as a writer. The truth is though, that it was only the beginning. The only way to develop ones craft is to practice it ceaselessly and that I did, for some time before I finally found my voice.

What has been the most challenging step on your way towards publication?

The decade of perpetual rejection, when I was writing but couldn’t find a home for my work. In hindsight I realize this period was an important part of my development as a writer but I could have done with it being less prolonged.

Your list of forthcoming events seems very busy at the moment. What is it like to come face to face with your readers?

It’s always a pleasure to meet the people who have read your work, though I get very nervous about public speaking.

Can you tell us about your forthcoming writing project(s)?

I’m working on a Jacobean thriller at the moment called The Poison Bed. It is set around the circumstances of a notorious murder in the Tower of London, which scandalized England and remains, to this day, something of a legal mystery. It will be my first crime novel. It is a new process for me as the structure and pace, as much as character, are key to making it work. Usually character is the cornerstone of my work, so this is different, though it has many of the characteristics of my other novels. I’m very excited about it and am thoroughly enjoying exploring a new genre and stretching myself creatively.

Also by Elizabeth Fremantle ‘Watch the Lady’, ‘Sisters of Treason’ and ‘Queen’s Gambit’ all published by Penguin.

Elizabeth Fremantle is the author of four novels all published by Penguin. She has a BA in English and an MA in creative writing from Birkbeck, University of London and has contributed to various publications including The Sunday Times, Vogue, Vanity Fair, The Financial Times and the Wall Street Journal. She also reviews fiction for The Sunday Express. She lives in London.

Valeria Melchioretto

Valeria Melchioretto

Valeria Melchioretto is the author of Podding Peas and The End of Limbo. She received a bursary from the Arts Council. In 2012 she represented Switzerland at the Poetry Olympics at the South Bank and won the ‘New Writing Ventures’. She holds an MA in Creative Writing from Birkbeck and a MA in Fine Art.

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The Myth of the Optimism Bias?

This article was originally posted by ‘Neuroskeptic’ on DiscoverMagazine.com on 3 June 2016. The article discusses research on optimism bias, as carried out by a team of psychological researchers including Birkbeck’s Professor Ulrike Hahn.

OptimismAre humans natural, irrational optimists? According to many psychologists, humans show a fundamental optimism bias, a tendency to underestimate our chances of suffering negative events. It’s said that when thinking about harmful events, such as contracting cancer, most people believe that their risk is lower than that of ‘the average person’. So, on average, people rate themselves as safer than the average. Moreover, people are also said to show biased belief updating. Faced with evidence that the risk of a negative outcome is higher than they believed, people don’t increase their personal risk estimates properly.

But now a group of researchers, led by first author Punit Shah of London, hascriticized the theory of biased belief updating and, by extension, the whole optimism bias model. Shah et al. say that optimism bias may be a mere statistical artifact, a product of the psychological test paradigms used to assess it. They argue that even perfectly rational, unbiased individuals would seem ‘optimistic’ in these tests. Specifically, the authors say that the apparent optimism is driven by the fact that negative events tend to be uncommon.

The new work builds on a 2011 paper by Adam J. L. Harris and Ulrike Hahn, also authors of the present paper. The 2011 article criticized the claim that people show an optimism bias by rating themselves as safer than the average. The new paper takes aim at biased belief updating. Here’s how Shah et al. describe their argument:

New studies have now claimed that unrealistic optimism emerges as a result of biased belief updating with distinctive neural correlates in the brain. On a behavioral level, these studies suggest that, for negative events, desirable information is incorporated into personal risk estimates to a greater degree than undesirable information (resulting in a more optimistic outlook).

 

However, using task analyses, simulations and experiments we demonstrate that this pattern of results is a statistical artifact. In contrast with previous work, we examined participants’ use of new information with reference to the normative, Bayesian standard.

 

Simulations reveal the fundamental difficulties that would need to be overcome by any robust test of optimistic updating. No such test presently exists, so that the best one can presently do is perform analyses with a number of techniques, all of which have important weaknesses. Applying these analyses to five experiments shows no evidence of optimistic updating. These results clarify the difficulties involved in studying human ‘bias’ and cast additional doubt over the status of optimism as a fundamental characteristic of healthy cognition.

I asked Shah and his colleagues to explain the case against the optimism bias in belief updating in a nutshell. They said

All risk estimates have to fit into a scale between 0% and 100%; you can’t have a chance of getting a heart attack at some point in your life of less than 0% or greater than 100%. The problems for the update method arise from the fact that the same ‘movement’ in percentage terms means different things in different parts of the scale.

 

Someone whose risk decreases from 45% to 30% has seen their risk cut by 1/3, whereas someone whose risk increases from 15% to 30% has seen their risk double -much bigger change. So the same 15% difference means something quite different if you have to revise your beliefs about your individual risk downwards (good news!) or upwards (bad news!) toward the same percentage value. The moment people’s risk estimates are influenced by individual risk factors (a family history of heart attack increases your personal risk by a factor of about 1.6), people should change their beliefs to different amounts, depending on the direction of the change. The update method falsely equates the 15% in both cases.

 

If the difference in belief change simply reflects these mathematical properties of risk estimates then one should see systematic differences between those increasing and those decreasing their risk estimates regardless of whether they happen to be estimating a negative or a positive event. But in the first case, this will look like ‘optimism’, in the second case it will look like ‘pessimism’. This is the pattern our experiments find…

 

The evidence base thus seems far less stable than previously considered. There is, using various paradigms, plenty of evidence for optimism in various real-world settings such as sports fans predictions and political predictions, but these just show that certain people might be optimistic in certain situations, not that there is a general optimistic tendency across situations that would be required to say people are optimistically biased. It is also important to note that because this belief updating paradigm has been used in so many neuroscience studies, it means those neuroscience data are also uninterpretable.

Read the original article on DiscoverMagazine.com

Read the original article on DiscoverMagazine.com

In my view, Shah et al. make a strong case that the evidence for optimism bias needs to be reexamined. Their argument makes a crucial prediction: that people should show a ‘pessimistic’ bias (the counterpart of the optimism bias) when asked to rate their chance of experiencing rare, positive events. In the new paper, the authors report finding such a pessimistic bias in a series of experiments. But perhaps they should team up with proponents of the optimism bias and run an adversarial collaboration to convince the believers.

  • Punit Shah, Adam J. L. Harris, Geoffrey Bird, Caroline Catmur, & Ulrike Hahn (2016). A Pessimistic View of Optimistic Belief Updating Cognitive Psychology
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Birkbeck’s Published Alumni Series: Karin Salvalaggio

This post was contributed by Melanie Jones of The Mechanics’ Institute Review. This month the Birkbeck Creative Writing department launched its new website The Mechanics’ Institute Review Online. This year marks a huge success for the Creative Writing MA as ten alumni have novels coming out this year.

To celebrate these achievements we are profiling a selection of the authors and extracts from their upcoming novels will appear on MIROnline. Here, Melanie Jones speaks with alumnus Karin Salvalaggio, about her latest novel, Walleye Junction (Minotaur, May 2016)

Read an extract of the book at MIROnline

Walleye Junction by Karin SalvalaggioMJ: Walleye Junction came out in May this year and is the third novel in the Macy Greeley Mysteries series. Can you give us a brief introduction to the novel?

KS: Walleye Junction is the third book in a series of crime novels set in northern Montana. The stories follow a special investigator named Macy Greeley, a single mother struggling to balance career and home life. She’s often on the road and when the book opens she’s in Walleye Junction, a rural community that lacks the necessary infrastructure to deal with a major crime. Members of one of Montana’s private militias are suspected of kidnapping and murdering a controversial radio talk show host named Philip Long. When two of the kidnappers turn up dead of a massive heroin overdose the local authorities believe the case is solved, but Macy has doubts. A cryptic email message points the investigation toward the murky world of prescription painkiller abuse and Philip Long’s estranged daughter is beginning to think there’s a link between her father’s murder and a school friend’s death 12 years earlier.

Did you always intend to write a series of novels or did this come about organically?

The series came about organically. I started writing the opening novel, Bone Dust White during my first year at Birkbeck where I was working toward an MA in Creative Writing. I never intended to write a ‘crime novel’ and saw this first book as a standalone, but life has a way of throwing up unexpected opportunities. Early versions of Bone Dust White were far more ‘experimental’ and infinitely less publishable. Looking back I’m relieved most of it ended up on the cutting room floor. The result is far more accomplished. Bone Dust White is a taut thriller with a strong sense of place and a cast of characters that feel authentic. I’m very proud of how far I stretched the genre in a debut novel. I’m now writing the fourth book in the series and it’s probable there will be more in the future. I don’t get bored because each book has its own personality and unique set of challenges. The only constant is Macy but she too is slowly evolving. It is the locations, characters and plotlines that change radically with each new publication.

What do you enjoy most about writing crime fiction?

I suppose I should now hold my hand up high and admit that I have an unhealthy fascination with the darker side of human nature. I read crime fiction but am often turned off by the gratuitous violence and the unending parade of serial killers stalking young girls. I prefer a good psychological thriller with authentic characters, a believable storyline and zero time spent in the morgue. I try to base my books on issues that are prevalent to small town America. Burnt River features returning war veterans who are suffering from PTSD and Walleye Junction touches on the prescription painkiller and heroin epidemic that is presently crippling America. Gun crime, drug abuse, sex trafficking, right wing militias, traumatised war veterans, unemployment and general disillusionment are all elements that feed into my novels. I like to create a point of tension that can no longer be sustained and drop an inciting incident into the middle of it. Throw in a bit of small town politics and a population that is barely hanging on and you’ll find the plenty of stories in the reckoning that follows.

The short story, Walleye Junction, was published in The Mechanics’ Institute Review in 2011. Are the novel and short story connected?

The short story, Walleye Junction, is actually connected to the whole series, as its setting and tone provided much of the original inspiration. I didn’t attempt a direct adaption until the third novel because I needed some distance from the source material. Redrafting it into a longer format would require making a lot of changes to a short story that meant a great deal to me. There was little room for sentimentality. A lot of ‘darlings’ died while writing this book.

The short story follows a young woman who is returning home to a rural community after years of estrangement. She has to cope with both her father’s death and the many unresolved issues she’s left behind. Much of the storyline is left to the reader’s imagination. We don’t know the cause of her father’s death or why she was forced to leave town in the first place. We only know that she’s been unfairly blamed for the death of a friend who died of a drug overdose sixteen years earlier. The novel puts these mysteries to rest.

In the beginning I tried to stay true to the short story’s plotline but I ended up making some major changes. Try as I might, I couldn’t make the original ending work. It was too sentimental. The young woman had changed too much over the course of the novel. She refused to bend to the ending I’d originally set up for her. I tried writing it a dozen different ways but to no avail. I ended up changing it radically. It is now much more subtle.

Can you tell us a little bit about your writing process?

Karin Salvalaggio

Karin Salvalaggio

Anyone who writes seriously spends a great deal of time sitting in a desk chair in front of a computer. If you’re not writing, you’re doing research. If you’re not doing research, you’re doing admin. There’s no garret in Paris and I’ve not smoked a Gitane in years. It’s actually a lot like running a small business. If you’re going to stay on top of ancillary writing commitments, social media, your finances (such as they are) and your relationships within the industry it pays to be highly organised.

I’ve written 4 books in 5 years. I’m not one to skimp on quality so that means I work long, hard hours. Though I have an idea of how I’d like things to go I never plot out my novels ahead of time. I create a place, a cast of characters and an inciting incident. After that anything goes. I try not to think too much about outcome when I’m working as I feel it’s better to be a little lost on the page. When I’m writing freely I tend to find the most surprising and interesting storylines. This strategy has its setbacks. There is a lot of waste. Thousands and thousands of words get thrown out. I’m far more brutal than I was when I started. Instead of saving it in a file, I simply hit delete. It’s strangely liberating.

I get up as early as 4 in the morning if I’m on a roll, but usually the alarm goes off at 7. I make a vat of black coffee, eat some breakfast and sit down to work. I’m lucky to have a beautiful home so I rarely feel the need to write anywhere else. In summer there’s a little house at the end of the garden. In the winter I’m in my office, at the kitchen table or on the window seat in the front room. I’m a bit of a social media junky so I have to be sure to shut down everything if I want to get the word count up. If I need to clear my head I take my dog for a walk. I’m pretty sure people think I’m going crazy as I sometimes talk to myself when I’m trying to work out an issue I’m having with a book. Thankfully, the dog doesn’t seem to notice. Generally speaking, I work on new stuff in the morning and edit it in the afternoon. Interjected within these hours are bouts on social media and something I like to call my ‘real life’.

How did the Creative Writing MA at Birkbeck affect you as a writer and do you have any advice for current students of creative writing?

I owe a great deal to the Creative Writing course at Birkbeck. I went in with zero confidence and I came out believing it was just a matter of hard work and time and I would be published.

I found the ‘work-shopping’ modules to be invaluable. It was how I learned to look at my work and the work of others more critically. It was also my first chance to see how readers really viewed my writing. Most of the students were incredibly generous with their time and feedback and I tried hard to reciprocate. Much of the course’s success depends on student participation. I’m not sure it’s the norm but I’d say I was in a particularly good year group. The cooperative approach to learning created an atmosphere that was surprisingly intimate. I made some very close friends during my studies at Birkbeck.

My advice to current students is that you’ll only learn if you listen. If everyone is telling you it’s not working, it’s probably time to put your ego aside and stop resisting. Some students would argue against every criticism that was thrown their way. I always wanted to ask them why they were on the course if they had no interest in improving their work.

Can you tell us about your current writing? What’s next?

I’m pretty much finished with the fourth novel in the series. It is tentatively entitled Silent Rain and will be out in May 2017. The storyline was originally inspired by Joyce Carol Oates’ novella Beasts but I’ve made so many changes that the source is barely recognizable. It’s an ambitious project. I’ve been a huge fan of Oates for years so have even more reason to get things right.

My next novel will be a standalone, which I’m hoping to work on between my other writing commitments. Though it’s a thriller, it will be set in London and Suffolk so will have a completely different feel. If I want to get a solid first draft done in a timely manner it will mean writing two books in one year. It sounds like a pretty insane thing to do but I’m determined to try. I need to get my head out of Montana for a while. I want to write about the city I live in and the characters I meet everyday.

Karin Salvalaggio was born in West Virginia in the 1960s. Her father was career military and her mother was a homemaker. Karin has fond memories of her nomadic childhood – the hours spent on the road, the anticipation of a new life, the unpacking of the old one. She’s lived in places as climatically diverse as Alaska and Florida and as culturally distinct as California and Iran. Karin attended the University of California Santa Cruz, graduating in 1989, but aside from two years in Italy, she has lived in London, England since 1994.

She has an MA in Creative Writing from Birkbeck, University of London. Her short story “Walleye Junction” was published in the Mechanics Institute Review in 2011. Bone Dust White was her first full-length novel.
 Her second novel Burnt River was published in 2015. Walleye Junction will be available on May 10th.

Melanie Jones

Melanie Jones

Melanie Jones graduated from the Birkbeck Creative Writing MA in 2015. She is the Managing Editor of MIROnline and a member of the MIRLive Team. She was a member of the editorial team for The Mechanics’ Institute Review, Issue 12.

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