The pad project

This is the English version of the homesite of the research project Emergent Un/Sustainabilities of Care: The Global Political Economy of the Adult Incontinence Pad.

The project is based at Global Health and Development, Faculty of Social Sciences in Tampere University, and funded by the Academy of Finland (grant #321972) and Kone Foundation.

The destigmatising power of knowledge

It has been estimated that up to 400 million people in the world live with urinary incontinence, and up to 6 % of those under 40 suffer from faecal incontinence. Altogether, one in ten people living in the community may suffer from both urinary and faecal leakages.

Often, these conditions cannot be completely cured – or information on cure is not readily available – which makes continence management products such as the adult incontinence pad a widely used mundane commodity.

Despite its wide prevalence, adult incontinence remains as one of the most stigmatising health problems. Due to the stigma, we know very little about the world of incontinence pads. Yet, exactly due to the stigma, adding lay knowledge about the world of incontinence is important.

Knowledge makes matters of incontinence less of a myth, easier to talk about and, consequently, gradually less stigmatising. It may also make care, cure and information on options of managing incontinence more accessible.

Namely, the stigma has an impact on health services too. Even though incontinence is common, matters of incontinence remain marginalised in the training of different health professionals. Consequently, they might not always have the knowledge to provide adequate continence advise on treatments – or management products alternative to the pads. (See e.g. a comprehensive portal to choosing the right product here .)

Such lack of knowledge within health professions can normalise pad usage, even in situations where treatments or more suitable products are available.

In addition to the social and medical aspects of the stigmatised condition, there are also other reasons why we should know more about the world of the adult incontinence pads.

A rapidly growing global industry

The world of adult incontinence is not just about stigma. It is also about a range of alternative, or mutually complementary, solutions to treat and manage the condition – from physiotherapeutic to surgical interventions to drugs. All solutions aim to help people live good lives with incontinence.

The incontinence pad (i.e. “diaper”, as in the sometimes infantilising speech, or “absorbent material”, as in technological jargon) is perhaps the best known and most widely used product for continence management. And its usage is growing, globally.

In both mature and emerging markets, the transnational pad industry grows rapidly and constantly. The worldwide sales of adult incontinence pads are estimated to grow from 9.2 billion USD in 2015 to 14.7 billion in 2021. The growth has to do with the ageing of populations across the world, but also with innovation, new product families, accessible pricing, reduction of stigma and so on.

The rapid growth of the global pad markets means many things. It means that more and more people will have access to this hygiene product, which helps them manage their condition better.

The growth in the value of the sales also means that there is a wider variety of products and pad technologies available – some more expensive and higher tech than others – which may allow for a more sophisticated and effective continence care. The increase in variety also means that people may more easily find the products that suit to their particular body form and leakages.

On the downside, the growth in pad usage may also be an implication that alternative means of cure and care are not adequately considered.

Simultaneously, the growth in the worldwide pad sales means that more and more money in the world is used for buying pads – and also that more and more money is made through pad sales. This in turn means that, on aggregate, the households living with issues of incontinence are likely to spend more money on pads than before. Similarly, public spending on pads tends to increase in states where incontinence products are publicly subsidised.

Elsewhere, someone profits, and capital accumulates. Some of the profits are invested back to research and development, as well as to charity, and more or less taxes are paid too. Yet, the worldwide pad sales impacts the accumulation of capital in complex ways – not only through the pad companies, but also through financialised actors involved in the distribution of the pads, such as for-profit care providing companies and the insurance sector.

Isn’t it interesting – to see how the global circulation of the pads entangles with the complex webs of finance and global circulation of money!

That 400 million people in the world live with adult incontinence, and many use pads to manage the condition has, in other words, a massive impact on the global political economy. And we need to know more about this impact, so that it becomes possible to intervene in ways that the impact is more just and sustainable – socially, economically, as well as ecologically.

The ecological burden

The growth of the worldwide pad sales inavoidably adds to the burden of waste that the humankind accumulates on the planet everyday. While there are washable pads also for adults, the growth in pad sales refers particularly to disposable products, that do not compost.

And each disposable pad produced, sold, and used adds to the mountain of waste that is challenging and still often impossible to get rid of in ecologically sustainable ways.

In the era of climate and environmental crisis, it is here that the need to know the world of the pads is most urgent – and the concern should be shared by different interest groups, despite their sometimes conflicting interests.

The need for co-produced knowledges

In collaboration with different actors in society, the large pad companies are already involved in a range of projects that address the difficult questions of pad usage – from stigma to ecological sustainability and the question of pad waste.

Solutions are sought from circular economy, for instance, which addresses the whole life cycle of the pad, from production to usage to disposal and, importantly, recycling.

The pad companies’ efforts to create a more sustainable future for incontinence care is not to be ridiculed, or underestimated.

They are powerful actors, with a great potential to contribute to better and more sustainable continence care. Indeed, their contribution to these aims is crucially important, and in this project we hope to collaborate with the big companies, too.

However, large stock listed companies as they are, they arguably operate on commercial interests that are tied to pad sales. Hence, the search for a more sustainable future cannot be left for the pad companies alone.

Imagining a more sustainable future for incontinence care necessitates the involvement of all kinds of interest groups, even if there may be tensions between their interests.

Aware of the tensions

The search for a more sustainable future needs to account for the views and practices of a whole variety of stakeholders: from the pad users to carers and different health professionals regardless of professional hierachies; from public and private institutional care providers to those responsible for the public infrastructure of waste managament; from the big pad companies to the start up world.

Such actors – and more – all participate in the day-to-day reality, where the present global political economy of the pad is made. If we want to make that global reality more sustainable, all these actors need to be accounted for.

This is not an easy task, since the world of incontinence care is full of tensions and conflicting interests, many of which return to the questions of stigma, unequal distribution of resources and profit-making, and environmental concerns.

These tensions need to be accepted for what they are: conflicts. Conflict, however, is not a negative thing, but an integral part of human life as well as a site that necessitates negotiation over and across opposing views.

In this project, we are aware of tensions and conflicting interests that have to do with our research – and indeed each of us holds views of our own. Yet, the very aim of our research is to understand the tensions more thoroughly and from several perspectives. Only after that it maybe possible to disentangle the tensions, for the joint interests of sustainable future.

That said, even if you would not agree with all that is said on this website, but are interested in our goal of sustainable continence care across the world, do get in touch. We appreciate your views, and want to count them in. This is important.