Antimicrobial stigmatization: Public health concerns about conventional pig farming and pig farmers' experiences with stigmatization

Fynbo, Lars; Jensen, C. E.

doi:10.1016/j.socscimed.2018.01.036

“…If these arguments hold, then new ideas about antibiotic use would remain passive unless they threaten people personally (or: we would need to combine the content with "a spark"). However, other authors have cautioned against backlashes from fear-based AMR narratives [10,36]. Problems like adverse behavioural reactions, stigma, or public resentment may be accentuated yet further in situations like ours where antibiotics cannot be easily identified and people might not actively distinguish between antibiotics and other types of pharmaceuticals [37].…”

Section: Discussionmentioning

confidence: 93%

“…Our sensitivity tests (Appendix Table 2) suggested that informal antibiotic use was consistently lower among people with "desirable" attitudes, but this reduction could be outweighed by formal antibiotic use depending on the definition of antibiotics. 10 The results therefore remained inconclusive but reinforced the possibility that more "desirable" attitudes could needlessly high antibiotic use.…”

Section: Discussionmentioning

confidence: 99%

“…Second, health communication can have adverse and unforeseen consequences [7,8], and AMR awareness raising is no exception [9]. This can be seen for example in the stigmatisation of pig farmers in Denmark, where leaflets had begun advising that, "If you work on a pig farm, you should refrain from having sex with others or seeing anybody […]" [10] (p. 4). These reasons make it questionable whether the awareness-raising agenda can live up to its expectations of changing population behaviour in the context of global antibiotic and antimicrobial resistance.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outputs, Outcomes, and Behavioural Impacts of an Antibiotic-Related Educational Activity in Lao PDR

Haenssgen¹,

Xayavong²,

Charoenboon³

et al. 2018

Preprint

3

0

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Education and awareness raising are the primary tools of global health policy to change public behaviour. Considering the limitations of awareness agenda and the lack of social research to inform alternative approaches, our objective was to generate new empirical evidence on the consequences of antibiotic-related awareness raising in a low-income country context. We implemented an educational activity in two Lao villages to share general antibiotic-related messages, but also to learn about people’s conceptions and health behaviours. Two rounds of census survey data enabled us to assess the activity’s outputs, its knowledge outcomes, and its immediate behavioural impacts in a difference-in-difference design. Our panel data covered 1,130 adults over two rounds, including 58 activity participants and 208 villagers exposed indirectly via conversations in the village. We found that activity-related communication circulated among more privileged groups, which limited its indirect effects. Among participants, the activity influenced the awareness and understanding of “drug resistance,” while effects on attitudes were minor. Evidence on behavioural impacts was sparse and mixed, but the range of possible consequences included a disproportionate uptake of antibiotics from formal healthcare providers. Our study casts doubt on the continued dominance of awareness raising as a behavioural tool to address antibiotic resistance.

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“…MRSA carrier status thus does not impose any direct costs, but it does create significant burdens when carriers need health care, starting with the simple act of having to declare carrier status when getting into contact with a new health care setting. The publicly observable effects of carrier status may also lead to stigmatisation and loss of self-worth, and these social and psychological effects may even 'infect' noncarriers in the same household (Ploug et al 2015;Fynbo and Jensen 2018).…”

Section: Introductionmentioning

confidence: 99%

A general approach to compensation for losses incurred due to public health interventions in the infectious disease context

Holm

¹

2020

Monash Bioeth. Rev.

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This paper develops a general approach to how society should compensate for losses that individuals incur due to public health interventions aimed at controlling the spread of infectious diseases. The paper falls in three parts. The first part provides an initial introduction to the issues and briefly outlines five different kinds of public health interventions that will be used as test cases. They are all directed at individuals and aimed at controlling the spread of infectious diseases (1) isolation, (2) quarantine, (3) recommended voluntary social distancing, (4) changes in health care provision for asymptomatic carriers of multi-resistant microorganisms, and (5) vaccination. The interventions will be briefly described including the various risks, burdens and harms individuals who are subject to these interventions may incur. The second part briefly surveys current compensation mechanisms as far as any exist and argue that even where they exist they are clearly insufficient and do not provide adequate compensation. The third part will then develop a general framework for compensation for losses incurred due to public health interventions in the infectious disease context. This is the major analytical and constructive part of the paper. It first analyses pragmatic and ethical arguments supporting the existence of an obligation on the part of the state to compensate for such losses, and then considers whether this obligation can be defeated by (1) resource considerations, or (2) issues relating to personal responsibility.

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“…Secondly, awareness campaigns like other development interventions can have side-effects that undermine their original purpose. For example, Fynbo and Jensen [7] (p. 4) reported how the public framing of AMR entailed the stigmatisation of pig farmers in Denmark, to the extent that leaflets began advising that, "If you work on a pig farm, you should refrain from having sex with others or seeing anybody […]." Similarly, Davis, et al [8] (p. 1163) suggested that the rhetoric of antimicrobial resistance may "spawn negative health impacts in a range of other conditions if people are taught to reduce help-seeking following initial symptoms."…”

Section: Main Text 1 Introductionmentioning

confidence: 99%

Outputs, Outcomes, and Behavioural Impacts of an Antibiotic-Related Educational Activity in Lao PDR

Haenssgen¹,

Xayavong²,

Charoenboon³

et al. 2018

Preprint

3

0

View full text Add to dashboard Cite

Education and awareness raising are the primary tools of global health policy to change public behaviour. Considering the limitations of awareness agenda and the lack of social research to inform alternative approaches, our objective was to generate new empirical evidence on the consequences of antibiotic-related awareness raising in a low-income country context. We implemented an educational activity in two Lao villages to share general antibiotic-related messages, but also to learn about people’s conceptions and health behaviours. Two rounds of census survey data enabled us to assess the activity’s outputs, its knowledge outcomes, and its immediate behavioural impacts in a difference-in-difference design. Our panel data covered 1,130 adults over two rounds, including 58 activity participants and 208 villagers exposed indirectly via conversations in the village. We found that activity-related communication circulated among more privileged groups, which limited its indirect effects. Among participants, the activity influenced the awareness and understanding of “drug resistance,” while effects on attitudes were minor. Evidence on behavioural impacts was sparse and mixed, but the range of possible consequences included a disproportionate uptake of antibiotics from formal healthcare providers. Our study casts doubt on the continued dominance of awareness raising as a behavioural tool to address antibiotic resistance.

show abstract

Antimicrobial stigmatization: Public health concerns about conventional pig farming and pig farmers' experiences with stigmatization

Cited by 24 publications

References 35 publications

Outputs, Outcomes, and Behavioural Impacts of an Antibiotic-Related Educational Activity in Lao PDR

Outputs, Outcomes, and Behavioural Impacts of an Antibiotic-Related Educational Activity in Lao PDR

A general approach to compensation for losses incurred due to public health interventions in the infectious disease context

Outputs, Outcomes, and Behavioural Impacts of an Antibiotic-Related Educational Activity in Lao PDR

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