{"id":46351,"date":"2020-01-03T09:00:29","date_gmt":"2020-01-03T08:00:29","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=46351"},"modified":"2020-01-14T12:24:16","modified_gmt":"2020-01-14T11:24:16","slug":"katie-knight-when-stock-photography-fails-to-get-the-picture","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/01\/03\/katie-knight-when-stock-photography-fails-to-get-the-picture\/","title":{"rendered":"Katie Knight: When stock photography fails to get the picture"},"content":{"rendered":"<p class=\"standfirst\"><span style=\"font-weight: 400\">The lack of variety of medical stock photography images helps to perpetuate stereotypes and negate the existence of other experiences<\/span><\/p>\n<p><!--more--><\/p>\n<p><span style=\"font-weight: 400\">When BBC Health <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/health-50215011\"><span style=\"font-weight: 400\">published an article about asthma inhalers<\/span><\/a><span style=\"font-weight: 400\"> alongside a picture of a child <\/span><i><span style=\"font-weight: 400\">not<\/span><\/i><span style=\"font-weight: 400\"> using a spacer device with their inhaler, the paediatric community was quick to call out the problem of normalising incorrect (and potentially dangerous) inhaler technique. A few retweets by disgruntled paediatricians got some attention, and the <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/health-50215011\"><span style=\"font-weight: 400\">image was swiftly replaced<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Unfortunately, the &#8220;inhaler without spacer&#8221; drama has played out several times in recent memory, and there is a frustratingly obvious reason why.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Browsing stock photography websites brings up several thousand results for \u201casthma.\u201d In the top few pages, none of the images show a child with a spacer and inhaler. (For non paediatricians: children can\u2019t coordinate their breathing &#8220;in&#8221; with the puff of the inhaler, so without a spacer the medication will just spray into the mouth where it has no effect, rather than reach the lungs). The lack of a pictured spacer may seem a trivial observation until you consider that deaths from asthma in the UK are among the highest in Europe, <\/span><a href=\"https:\/\/www.rcplondon.ac.uk\/projects\/outputs\/why-asthma-still-kills\"><span style=\"font-weight: 400\">two in three of which could have been prevented with the right care<\/span><\/a><span style=\"font-weight: 400\"> or are related to poor understanding of treatment.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Ubiquitous stock photography creates shared mental images that are powerful, stereotyped versions of an idea\u2014without the nuance of individual experience or the subtlety of professional expertise. And where health is concerned, images that enter the public\u2019s mind (and our professional subconsciousness) have the potential to cause harm.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Let\u2019s take a look at some concerning finds.<\/span><\/p>\n<p><span style=\"font-weight: 400\">SEARCH: &#8220;depression.&#8221; Hundreds of images of a person sitting alone on a bed, holding their head in their hands appears. This erases the reality of the thousands of people who experience depression while still holding down full time jobs, raising families, supporting their friends, volunteering, engaging in activism. Does this stereotyped image make it harder for a person to talk to their family, their friends, or employer about their mental health when they <\/span><a href=\"https:\/\/www.time-to-change.org.uk\/media-centre\/responsible-reporting\/using-images\/get-picture-campaign\"><span style=\"font-weight: 400\">don\u2019t seem to fit the picture<\/span><\/a><span style=\"font-weight: 400\">?<\/span><\/p>\n<p><span style=\"font-weight: 400\">SEARCH: &#8220;childbirth,&#8221; and it brings up a gallery of white women with white partners surrounded by white medical professionals. You have to search multiple pages deep into search results until there is a woman from a black or ethnic minority and her baby. Black women in the USA and the UK report having their <\/span><a href=\"https:\/\/www.propublica.org\/article\/nothing-protects-black-women-from-dying-in-pregnancy-and-childbirth\"><span style=\"font-weight: 400\">concerns dismissed or ignored in pregnancy<\/span><\/a><span style=\"font-weight: 400\">. The chance of death is 1 in 2500 for black women during pregnancy and childbirth according to the<\/span><a href=\"https:\/\/www.npeu.ox.ac.uk\/downloads\/files\/mbrrace-uk\/reports\/MBRRACE-UK%20Maternal%20Report%202018%20-%20Web%20Version.pdf\"> <span style=\"font-weight: 400\">UK Confidential Enquiry into Maternal Deaths<\/span><\/a><span style=\"font-weight: 400\">; the rate was five times smaller for white women. Does the lack of visual representation reflect racial bias in healthcare?<\/span><\/p>\n<p><span style=\"font-weight: 400\">SEARCH: &#8220;heart attack.&#8221; A familiar visual trope appears\u2014the image of a middle aged man clutching at their chest. Not all heart attacks cause chest pain; <\/span><a href=\"https:\/\/ahajournals.org\/doi\/full\/10.1161\/circulationaha.117.031650\"><span style=\"font-weight: 400\">women especially can present with abdominal pain, nausea, or dizziness<\/span><\/a><span style=\"font-weight: 400\">. The lack of public (and professional) awareness of the gender differences here has led women to be diagnosed late\u2014or not at all\u2014with sometimes fatal consequences.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In our current cultural climate, broadening the narrative and representing alternative viewpoints is essential. If a picture really paints a thousand words, the lack of variety of medical stock photography images helps to perpetuate stereotypes and negate the existence of other experiences. We deserve better stock photography and must demand it.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/KKpic.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-44858\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/KKpic-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/KKpic-150x150.jpg 150w, https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/KKpic.jpg 442w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a><em><strong>Katie\u00a0<span class=\"il\">Knight, <\/span><\/strong><span style=\"font-size: medium\">Paediatric Emergency Medicine Consultant, <\/span><span style=\"font-size: medium\">London, and <\/span><span style=\"font-size: medium\">2018-19 National Medical Director&#8217;s Clinical Fellow.<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Competing interests<\/strong>: Katie Knight is one of the co-founders of <a href=\"http:\/\/www.wsih.co.uk\">Women Speakers in Healthcare<\/a>.\u00a0<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The lack of variety of medical stock photography images helps to perpetuate stereotypes and negate the existence of other experiences [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/01\/03\/katie-knight-when-stock-photography-fails-to-get-the-picture\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":46363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-46351","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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