Community-Engaged Research: Another “Song and Dance” or a Balancing and Juggling Act?

jugglingimagesCA66MVB4 Seesaw Bear and seesaw images believed to be Public Domain; jugging attributed to Cliparts.com, public domain)

Check Out the Theme Song to the Webseries “Where the Bears Are”  (on ITunes at https://itunes.apple.com/us/album/where-the-bears-are-single/id556082747 ) and the Youtube Video (at https://www.youtube.com/watch?v=byJZviHNC40 ). It’s a fun song that expresses a lot about Bear culture. “Where the Bears Are,” by the way is mystery comedy series  (4 seasons and going) set in the Bear community in LA (comedy in the style of “Porky’s” or “American Pie” or “National Lampoons Vacation”–for mature audiences). Aside from intentionally or unintentionally promoting stereotypes, it’s a reflection of the community that many community members would agree fits for many members.  I think it aptly demonstrates that men in this community have embraced their larger bodies (and other men’s) and their identities are rooted in that shared appreciation, but that lots of activities in the community that reinforce those notions aren’t necessarily healthy choices for a lot of Bears–poor diet, heavy alcohol consumption, as two examples.

So, a juggler, a dancing bear, a seesaw, and a song about the Bears…let’s see how these evolve into a post on community-engaged research. I initially was thinking about dancing as the metaphor for CEnR (plus, dancing is always a part of any Bear gathering, so it seemed appropriate). I can’t dance. Not at all. However, what I overhear while other people watch “Dancing with the Stars” and what I remember from watching “Dirty Dancing,” is that dancing is about trust, sharing an understanding of choreography which tells each dancer what to do and when to do it, and determining who will lead and who will follow at different points–at least in partner dancing. That seems to fit what I know about CEnR so far. Also, I was thinking about what Tracey and Sadie were talking about in terms of partners working together to carry out project–the clear message I picked up on was that in these kinds of partnerships, it does no one any good if either (or, worse, both) partners “dance around” issues and avoid addressing them.  Juggling also entered my mind as I thought about it. For the academic researcher, at least, I think there’s the juggling of what the researcher wants to accomplish as a curious and altruistic individual or practitioner (engaging a community, helping a community, applied research with tangible value) with the expectations for an academic position (journal articles…journal articles… more journal articles…for some kinds of researchers also labs and experiments…large datasets and quantitative methodologies…large grants…objective stance conducive to a positivist orientation–and the time that is necessary to do what needs to be done in order to earn tenure and promotion–and later promotion). I’m guessing another place where there is juggling is identity–When the researcher is also an insider in the community (a researcher who happens to also be a bear…a researcher who grew up in the community…a researcher who has moved into the community…it might be any kind of community membership)–How does the researcher juggle that successfully? Sometimes one? Sometimes the other? Sometimes both? I’m thinking hard about this one for my study for certain. Then there’s balancing. In a partnership like this, I’m guessing there are lots of times when the partnership can be unbalanced, or at least teetering. How do the partners balance expectations, responsibilities, power, resources, needs, schedules, outcomes that differ? ) On this kind of teeter-totter partnership, what does each partner have to give to the partnership to make sure that both partners are staying level and one isn’t falling as the result of the other rising? And most of us who have been on a seesaw will remember the hard “slam” when we have been high in the air and a seesawing partner suddenly abandons us, jumping off and we fall quickly and painfully down.  Is this kind of work dancing, juggling, or balancing? Or all three? Guess I’ll find out.

Shared Power in Collaborative Research with Communities

tug-of-war 2

The image I really wanted to use looks like this: A tug of war in process with a group vigorously pulling on one end of the rope while a single person holds the other end. Of course, that would have been the solo researcher on the one end and the community on the other. However, I never could find a free image, so I decided to use this charming vintage picture instead.  I think they both could be fine, but slightly different representations of the idea.  What comes to mind for me is that any kind of collaboration requires some degree of “tugging” around whatever real or perceived “power” is associated with the relationship. Even in very productive collaborations, each of the sides, at least some times, needs different things, wants different things to happen, believes differently at different points–and wants to “pull the rope” their way, in their direction. Sometimes one side may really have the power to pull the rope and move it their way–regardless of the resistance the other side puts up (or because the other side gives up and doesn’t resist or their resistance has been worn down). An important issue then, is how to find where the rope can exist with tension pulling on both ends while remaining in a place that is going to allow for continued productive collaboration.  More thinking to do on this idea…

VCU CEnR Research Proposal: The Bear Trap

Bear image: "Formosan Black Bear" by Abu0804 - Own work. Licensed under CC BY-SA 3.0 via Wikimedia Commons - https://commons.wikimedia.org/wiki/File:Formosan_Black_Bear.JPG#/media/File:Formosan_Black_Bear.JPG

Bear image: “Formosan Black Bear” by Abu0804 – Own work. Licensed under CC BY-SA 3.0 via Wikimedia Commons – https://commons.wikimedia.org/wiki/File:Formosan_Black_Bear.JPG#/media/File:Formosan_Black_Bear.JPG

 

Bear Flag Image: "Bear Brotherhood flag" by Fibonacci. - Own work. Licensed under CC BY-SA 3.0 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Bear_Brotherhood_flag.svg#/media/File:Bear_Brotherhood_flag.svg

Bear Flag Image: “Bear Brotherhood flag” by Fibonacci. – Own work. Licensed under CC BY-SA 3.0 via Wikimedia Commons – http://commons.wikimedia.org/wiki/File:Bear_Brotherhood_flag.svg#/media/File:Bear_Brotherhood_flag.svg

For Americans, being overweight has become the new normal (Harvard Medical School, March 1, 2011). The obesity rate has doubled for adults since 1980 (Conniff, November 10, 2010); obesity is now a persistent epidemic (Conniff, November 10, 2010). Two-thirds of American adults are overweight if not obese (Conniff, November 10, 2010).

Obesity is dangerous health problem. Only smoking causes greater risk of cancer (Conniff, November 10, 2010) and obesity is predicted to become the number one preventable cause of death in America, exceeding smoking, the current primary cause (Harvard Medical School, March 1, 2011). Being overweight or obese is a risk factor for a legion of physical health problems (Hassan, Joshi, Madhavan, & Amonkar, 2003). Few conditions are linked to as long a list of chronic disorders known to accompany heavy weight: the chronic disorders linked with obesity, including diabetes, coronary artery disease, erectile dysfunction, congestive heart failure, hypertension, stroke, osteoarthritis, sleep apnea, depression, certain cancers, prostate tumors (Conniff, October 19, 2010), heart attack, stroke, hypertension, gallstones, osteoarthritis, fatty liver, depression, lowered testosterone, fertility impairment, and kidney stones (Harvard Medical School, March 1, 2011). Prostate health is particularly concerning for heavy men. Depending on weight a heavy man’s risk for prostate cancer can increase from 20-34% (Harvard Medical School, March 1, 2011). While each obese person’s health risks will be unique and the result of obesity’s interaction with other factors, researchers generally agree that people are significantly more at risk for serious health issues when they are obese than when they are not (Conniff, October 19, 2010).

Not only is obesity an extensive health problem, it is an expensive one. Ten percent of all American health-care costs in 2008 related to overweight or obesity illnesses, a super-sized $147 billion in costs (Conniff, November 10, 2010). Following American waistlines, costs expanded to $200 billion, or 21% of all health-care costs, in 2014. These costs are predicted to rise to some amount between $43 billion and $66 billion by 2030 (obesitycampaign.org).The problem is not only expensive at the national level but for individuals as well. Obese people may spend as much as 42% more in healthcare than people who have a healthy weight.

Obesity is not only associated with fiscal costs and negative health consequences, but also social and emotional consequences (Jia & Lubetkin, 2005). Heavy people are as likely to experience weight bias, stigma, and prejudice in addition. Weight is a source of discrimination in American society (Hassan et al., 2003) where being slim and fit is considered the ideal (Kraft, Robinson, Nordstrom, Bockting, & Rosser, 2006). Researchers have found that Americans associate obese people with a variety of unflattering and unkind terms like repulsive, unattractive, and lazy (Conniff, October 19, 2010). Overweight and obese people are often ridiculed and taunted overtly and covertly, are the butt of jokes, and are frequently targets for discrimination (Conniff, October 19, 2010).

Weight has been associated with a physical ideal for men: thin, toned, and youthful (Manley, Levitt, & Mosher, 2008). Straight and gay American men, indoctrinated with this idealized body norm, feel pressure to conform in their physical appearance; gay men, in fact, have been found to be so concerned about conforming to appearance norms that they can develop unhealthy body dissatisfaction (Morgan & Arcelus, 2009) and eating disorders (WichstrØm, 2006; Yellend & Tiggemann, 2003). Since the 1970s one subgroup of gay males, known as “Bears,” has resisted, adopting a social identity that rebels against the dominant masculine physical ideal perpetuated in straight and gay male culture (Gough & Flanders, 2009). Bears, and younger bears known as “cubs,” are typically obese—or at least stout or overweight—hairy men who embrace their weight, celebrate it, and capitalize on it socially (Gough & Flanders; Hennen, 2005). In fact, for these gay men, Bear social identity has been found to increase self-esteem (Manley et al., 2008). The Bear identity reframes a stigmatized physical trait as an attractive, desirable physical asset, allowing men who have felt marginalized based on violating appearance norms to experience social acceptance (Manley et al., 2008). Often, these men have felt unattractive and isolated from the gay community before discovering the Bear community and adopting Bear social identities (Manley et al., 2008).

Stereotypical Bear ("For Your Consideration"): "For Your Consideration" by Christopher Macsurak - For Your Consideration. Licensed under CC BY 2.0 via Wikimedia Commons - https://commons.wikimedia.org/wiki/File:For_Your_Consideration.jpg#/media/File:For_Your_Consideration.jpg

Stereotypical Bear (“For Your Consideration”): “For Your Consideration” by Christopher Macsurak – For Your Consideration. Licensed under CC BY 2.0 via Wikimedia Commons – https://commons.wikimedia.org/wiki/File:For_Your_Consideration.jpg#/media/File:For_Your_Consideration.jpg

DC Bears: "DCBearFix" by derivative work: EvilHom3r (talk)DCBear.jpg: Salesgorilla - DCBear.jpg. Licensed under CC BY-SA 3.0 via Wikimedia Commons - https://commons.wikimedia.org/wiki/File:DCBearFix.jpg#/media/File:DCBearFix.jpg

DC Bears: “DCBearFix” by derivative work: EvilHom3r (talk)DCBear.jpg: Salesgorilla – DCBear.jpg. Licensed under CC BY-SA 3.0 via Wikimedia Commons – https://commons.wikimedia.org/wiki/File:DCBearFix.jpg#/media/File:DCBearFix.jpg

Given that Bear identity embraces and celebrates weight and that within the community, weight is even a kind of social asset, weight represents a health paradox for the Bear community: a psychosocial resiliency factor that is also a significant physical health risk factor. This research project will involve partnering with Bears to explore this paradox with the researcher’s goals including better understanding Bears’ health knowledge, health needs, and identifying public health outreach strategies that Bears would receive positively, having greater impact on shaping health changes in the Bear community.

I want to pursue this research because I think this issue is important for a number of reasons: 1) For many Bears and Cubs, this bond they share around Bear identity is incredibly important to them and the Bear community that they are part of is a community that provides them a feeling of inclusion, support, connection, and belonging. And I think it’s important as a social worker to respect and appreciate this community’s identity and strengths. 2) Because Bear identity is so closely tied to weight for many Bears, it places them at risk for serious, chronic health problems–problems which often actually impair their ability to participate in their community as their health worses or through disability or early death. 3)  I think it’s important to acknowledge this identity in order to work with this community around health. My sense is that it will be important to think about how to frame weight/obesity not as another “men’s health problem,” but as the  “Bears’ health problem” because I think this identity often becomes the one that resonates most loudly for members of this community.

Conniff, R. (October 19, 2010). I hate fat people. Men’s Health. Retrieved from http://www.menshealth.com/weight-loss/i-hate-fat-people

Conniff, R. (November 15, 2010). How a fat nation can slim down. Men’s Health. Retrieved from http://www.menshealth.com/weight-loss/american-slim-down?fullpage=true

Gough, B., & Flanders, G. (2009). Celebrating “obese” bodies: Gay “Bears” talk about weight, body image, and health. International Journal of Men’s Health, 8(3), 235-253.

Hassan, M.K., Joshi, A.V., Madhavan, S.S., & Amonkar, M.M. (2003). Obesity and health-related quality of life: A cross-sectional analysis of the US population. International Journal of Obesity, 27, 1227-1232.

Harvard Medical School. (March 1, 2011). Obesity: Unhealthy and unmanly. Harvard Men’s Health Watch. Retrieved from http://www.health.harvard.edu/mens-health/obesity-unhealthy-and-unmanly

Hennen, P. (2005). Bear bodies, Bear masculinities: Recuperation, resistance, or retreat? Gender and Society, 19(1), 25-43.

Jia, H. & Lubetkin, E.I. (2005). The impact of obesity on health-related quality of life in the general adult US population. Journal of Public Health, 27(2), 156-164. doi: 10.1093/pubmed/fdi025

Kraft, C., Robinson, B.E., Nordstrom, D.L., Bockting, W.O., & Rosser, B.R.S. (2008). Obesity, body image and unsafe sex in men who have sex with men. Archives of Sexual Behavior, 35, 587-595.

Manley, E., Levitt, H., & Mosher, C. (2008). Understanding the Bear movement in gay culture. Journal of Homosexuality, 53(4), 89-112.

Morgan, J.F., & Arcelus, J. (2009). Body image in gay and straight men: A qualitative study. European Eating Disorders Review, 17(6), 435-443. doi: 10.1002/erv.955

Obesitycampaign.org. (n.d.). Obesity facts. Retrieved from http://obesitycampaign.org/

WichstrØm, L. (2006). Sexual orientation as a risk factor for Bulimic symptoms. International Journal of Eating Disorders, 39(6), 448-453. Doi: 10.1002/eat

Yellend, C., & Tiggemann, M. (2003). Muscularity and the gay ideal: Body dissatisfaction and disordered eating in homosexual men. Eating Behaviors, 4, 107-116.