MY DAUGHTER arrived home recently after completing her sophomore year at the University of Virginia.
I marvel at the emotional and intellectual growth that takes place as our children weed through the social pressures and ethical decision-making needed to successfully survive the college experience that we are financing.
She is dramatically changed. Pensive, quieter, confused and 20 pounds lighter. She runs seven miles a day, eats very carefully and comments on the number of fellow students who are having plastic surgery, suffering bulimia and anorexia, routinely binge drinking and using drugs like ecstasy to enhance their social abilities.
She is so serious, so confused, and so solemn, that I have difficulty reaching her.
She is an English major and has begun writing a book to describe the experience of college women on campus today. I glance at the first three chapters, which take me into her soul, into the cultural landscape of her dilemmas.
Her best friend from high school came home after freshman year weighing 85 pounds. She has been hospitalized twice in the past year, and has made little progress.
Another friend had breast implants, a face lift and a tummy tuck last summer. She will return this summer for "adjustments."
The health risks of sending our teen-age girls off to college are painfully real.
We discuss public health issues like violence, gun control and substance abuse. But a critical issue of equal significance, influencing all of our female children, is body image distortion influenced by constant bombardment of unrealistic media representation of feminine ideals, starting at early, vulnerable ages.
Both of my daughters have been college athletes - strong, beautiful and confident. What happened during the socialization process on campus should not be a surprise to other parents who are sending kids off for the first time.
Skinny is in, and girls meet such enormous pressure to control weight that there is an epidemic of eating disorders on campus that must be addressed. The context of the problem is the American cultural focus on youth and beauty, fed by media exploitation of feminine beauty standards.
Television and print media begin impacting young girls in middle school or earlier. It is an American cultural phenomenon that also influences young immigrant girls. To become accepted, studies have already demonstrated that many immigrant young women are starving themselves to fit into the American cultural ideal.
We have a public health issue of tremendous proportion on our hands, and it will take a grass-roots approach to make even a minor impact on the problem. Mothers who marched in Washington for sensible gun laws must also march for media standards that influence our daughters' sensitivity to unrealistic body image proportions.
In America, we are quick to criticize other cultures for what we define as human rights violations related to women. It is time we also look inward and pay attention to our own critical public health issues. If we continue to support the marketing of plastic surgery techniques in our print media and accept television media featuring skinny buxom women in tight, low-cut attire, then we all face the risk of losing our daughters along the way to diseases that remain misunderstood and often unsuccessfully treated.
The greater Washington area has more plastic surgeons per capita than any other metro area in the country. How does this influence public health in Maryland and Virginia?
Parents must be concerned about this issue. It is not going away. It will take collective, grass-roots action to make an impact on the unhealthy environmental context that we have created. Who is willing to begin the dialog?
June Miller is a registered nurse and an assistant professor of community health nursing at Johns Hopkins University School of Nursing.