sakai.unc.edu Web viewShe mentioned that the WHO Commission on social determinants of health uses...

EPID799, spring 2015, Student posts in Sakai forum as of 3/18/2015 5pm

Zach -4Dolly – 4Jasmin Hainey - 4Jennifer – 4Kevin - 4Lorenzo – 1Ndang - 1Raven - 4Vanessa - 4

New! Social Programs that Work: Op-Ed by Ron Haskins in the New York TimesJennifer Richmond (jenni404) (Jan 20, 2015 3:53 PM) - Read by: 4

In this opinion-editorial, Ron Haskins writes about some little known evidence-based social programs that the Obama administration has funded and supported for many years. Unfortunately, many studies find that approximately 75 percent of programs to improve school and work outcomes do not work very well. For example, D.A.R.E has been widely supported in schools throughout the country to prevent substance abuse, but evaluations typically show disappointing results. Therefore, the author uses this op-ed to argue that congress must be able to identify which programs work and continue funding many of the Obama administration’s evidence-based social programs.

As part of the article, the author also shares a few examples of model social programs that appear to work. For instance, the Wyman’s Teen Outreach program in Florida aims to teach ninth graders “healthy behaviors, life skills, and a sense of purpose,” and evidence suggests that it reduces teen pregnancy and school suspension rates. As another example, the Nurse-Family Partnership in Pennsylvania funds nurses to visit low-income first-time mothers starting before birth and lasting until the child is two years old. Evaluation results show that children continue benefitting from the program until they are at least fifteen years old. Mothers participating in the program are more likely to have a job and are less likely to abuse their children while their children are healthier and more prepared for school.

The article ends by noting why rigorous evaluations are often unpopular among all political parties; we would likely find that many popular, widespread, and expensive programs are ineffective if we evaluated them. Therefore, the author argues that successful programs must continue receiving money. After all, “social policy is too important to be left to guesswork.”

Relevance: This opinion-editorial discusses an important issue for individuals interested in reducing health disparities starting with some of the root causes: social programs and policies. It also reminds us that although a program may be targeting a social problem known to be associated with health disparities (e.g., poverty), this does not mean that the program itself is effective. This article is also a reminder of how our social policies (both good and bad) can influence the health and overall well-being of individuals.

Source: Haskins, R. (2014, December 31). Social programs that work. The New York Times.

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Retrieved from http://www.nytimes.com/2015/01/01/opinion/social-programs-that-work.html?ref=us&_r=0

New! Re: Social Programs that Work: Op-Ed by Ron Haskins in the New York TimesJennifer Richmond (jenni404) (Jan 20, 2015 3:54 PM) - Read by: 4

After class today, I reflected more about this op-ed and how it applies to our class discussion. As someone training to be a researcher, many of the points about evidence-based interventions rang true. However, it also made me think about community-based participatory research (CBPR). When we look to implement effective social programs, very few of them likely include true CBPR methods. Although there are techniques for tailoring an intervention to different cultures and communities, this is quite different from giving the community the true power to define the problem and approach to solving it. If we start with a problem and turn to the literature to find an evidence-based intervention, we will likely arrive in the community with a prepackaged solution. Although there may be some flexibility in the intervention, it makes me wonder how we can best balance the need to use our limited resources on evidence-based interventions with our goals of CBPR. What if the community wants to go in a direction that is not evidence-based?

Additionally, I thought this piece also tied to many of our discussions about the influence of politics in public health. Often effective and successful programs are cut due to funding constraints while others (which may or may not be working) continue receiving funds. This issue made me reflect on our discussion about the agendas and goals of individuals who have the power to make decisions or to influence decision-makers.

New! Precis: Summary of the Major Findings of the Evans County Cardiovascular Study by John Cassel MD, MPHDolly Penn (pennd) (Jan 30, 2015 12:18 PM) - Read by: 4

"Summary of the Major Findings of the Evans County Cardiovascular Study" by John Cassel MD, MPH, highlights knowledge gained as a result of a collaboration between Dr. Cassel (an academic epidemiologist) and Dr. Hames (a primary care physician in Evans County, Ga). The idea began when Dr. Hames observed in his clinic and community that (1) he rarely saw "black patients, particularly black men, with any manifestaton of coronary hear disease (CHD) despite the fact that levels of blood pressure in many of their patients were markedly elevated" and (2) coronary disease was a very common manifestation in his white patients."

They designed a prevalence study in which every community member over 40 years old and a smaller sample of individuals 15-39 years old had medical examinations and laboratory tests completed. The participation rate was 92% (3,102 people). The study showed:

(1) "all manifestations of [CHD] occurred very rarely in black men"

(2) among white men men in higher social class had higher rates than men in lower social class

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http://www.nytimes.com/2015/01/01/opinion/social-programs-that-work.html?ref=us&_r=0

http://www.nytimes.com/2015/01/01/opinion/social-programs-that-work.html?ref=us&_r=0


(3) white men in lower social class and black men had similar rates.

Interestingly, while none of these differences could be explained by other measured risk factors variations in how physically demanding the mens occupations were seemed to be partly responsible for differences between white men of higher social class and the other men studied.

The prevalence study was followed by an incidence study to determine outcomes (stroke and CHD) for those who did not have CHD in the original study. They obtained follow up information for 98.8% of the original participants. Findings showed;

(1) lower class white men had rates closer to higher class white men than previously observed

(2) black men continued to have lower rates even though they responded to risk factors the same way white men did

(3) when black and white men were both sharecroppers, white men had similarly low rates

Again, the differences were not explained by risk factors.

Provocatively, Cassel explains why measures of statistical signficance were not calculated or necessary and provides data for the "interested reader [to] compute these tests himself."

Relevance:

(1) Collaborative work between public health and clinical medicine allows us to identify a situation affecting a populations health and study it to answer the question "Why?"

(2) Good rapport between investigators and the community members builds relationships and creates a greater willingness to participate

(3) Clinical significance and statistical significance are not synonymous!

New! Institutional Racism in the Gardener's TaleLorenzo Hopper (hlorenzo) (Feb 2, 2015 5:10 PM) - Read by: 4

Hello all,

I wanted to take the opportunity to write briefly about Dr. Jones and her gardener's tale allegory that we briefly discussed in class on Thursday. The most interesting part of the article/story to me is the question of who is the gardener? The article states that in the United States, the gardener is our government, but I would venture to state that the gardener is anyone who knowingly or unknowingly perpetuates systematic racism in our society, including us! Last semester I was introduced to this concept of "gatekeeping" by the Racial Equity Institute. I believe that as young researchers we are trained to identify and populations that need health

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interventions and learn the methods to conduct research that is considered evidence based. After our training is complete many of us will go on to work on improving health and reducing health disparities, but under the wing of a larger organization and restricted by funding and other external factors. This was just a quick thought, but the more I hear the story the more I think about who exactly is the gardener in the story today and where do we start when it comes to working towards health equity.

LH

New! Precis: Out in the Rural: A health center in MississippiDolly Penn (pennd) (Feb 9, 2015 6:49 PM) - Read by: 2

Last Edited By Dolly Penn (pennd) on Feb 9, 2015 7:00 PM

In Out in the Rural: A health center in Mississippi the story of the Tufts-Delta Health Center in North Bolivar County in Mississippi is shared. In the documentary Jack Geiger, Helen B. Barnes, LC Dorsey along with residents and other involved people talk about the comprehensive health center and all of its programs.

There were 14,000 black people living the 500 square mile area of North Bolivar County. The median family income was $900 per year. Most people were functionally illiterate with an average of 4 years of schooling. The median age was 15 years and the median age of the male heads of household was 57 years. 50% of the people had no onsite water and 65-70% of housing in the area would be considered un-inhabitable for humans. According to the documentary, "women are the hardest hit because the men just leave." Unsurprisingly, given the aforementioned social descriptors, this county had a high infant mortality rate (70 deaths/1000 births).

In this setting, Dr. Geiger developed a comprehensive community health center which included a physician, laboratory, pharmacy and home health visits because he recognized the need for social change and the role health services could play in being a "route of entry" for social change. He introduced a concept called community health action in which the "concept of health is to make social change, to build institutions that can make social change, and keep it going."

In addition to the health center, the community members were organized into a health council and health association to assess the needs of the community and act in the interest of the "overall community not just health." Members of the community were trained to make necessary environmental changes (ie sanitation and housing). The community members also started a farm cooperative for internal consumption and for export for revenue.

Other community programs included: transportation system, supplemental food, legal assistance, low cost housing, head start, youth career guidance, in service training for health center staff, college preparatory courses and a county bookstore and cultural center focusing on black

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history.

Relevance: Sustainable disease prevention and healing results from integration of traditional medicine to address health concerns and community leadership to facilitate social change since in many cases, disease is a manifestation of social ills.

New! Precis: Interview of Jack Geiger, L.C. Dorsey, John Hatch Tape 1Dolly Penn (pennd) (Feb 18, 2015 10:22 AM) - Read by:Last Edited By Dolly Penn (pennd) on Feb 18, 2015 10:23 AM

Tape 1 of the interview of Jack Geiger, L.C. Dorsey, and John Hatch focused on their reflections on what worked to transform the community in Mound Bayou, Mississippi and how they saw the community change over time.

Regarding what worked, Jack Geiger said; "There is not one thing that worked." Each time period has a set of problems and solutions for those problems. Even if the problems are the same over time, the solutions change based on the community. However, solutions that transcend time are "educating and training" the community because these investments benefit the entire community. "Institution building" is another investment that empowers the local community. The focus of community building is not only the current generation but the effects for future generations.

Hatchet opined many of the improvements of the past are not respected by the present generation. He said the younger generation seems lost and have "no dream or hope of betterment." This difference in attitude and motivation compared to past generations is manifested in an unwillingness to work hard and study for improvement. The black church, in his opinion, must take the lead in "changing the activities of the youth and the communities."

The sense of community as was seen in the past no longer exists. An important reason for this shift is lack of employment opportunities in the area since 1965 caused by decrease in the labor economy and increased opportunities for employment in other states. This migration of labor produced broken families (without fathers in the home for long periods of time), a more segregated community, and wealth "stratification within the black community." Interestingly, Hatchet mentioned he "traveled to Europe and found the level of living for the lower third abroad" was better "than citizens in Durham. NC." L.C. Dorsey said, "the real problem in the US is economic but people are seeing it as a people problem."

Despite the current state, there was still belief that the problems can be overcome with investment in the community and empowerment through education and skills training so that the community is self-sustainable.

Relevance: Community empowerment for positive change must start within the community and focus on investing in people and institutions to improve current conditions and prepare for the future. In Geiger's words; we must "build institutions, invest in the people, and

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continually define the problem in current terms so that you get a response from the community."

New! Precis: Using a Population Health Approach to Eliminate Health DisparitiesDolly Penn (pennd) (Mar 1, 2015 9:36 PM) - Read by: 2

At the annual Preventive Medicine conference, I attended a session focused on health disparities where one of the speakers, Dr. Linda Rae Murray had a dynamic presentation that made many of the audience members uncomfortable and made me smile because I have heard Dr. Jenkins say many of the things she mentioned, most notably, that “race does not exist.” She also talked about wealth and community health.

Dr. Murray talked about how people do not like to talk about racism. She described disparities as “observed differences” and inequities as “ethical judgments about differences.” According to her, we cannot discuss inequities without discussing values. She mentioned that the WHO Commission on social determinants of health uses the word “discrimination” where it should use “racism” because people are afraid to talk about racism. She said “if we cannot talk about racism and discrimination, we will continue to have problems.” In her opinion, the “white” race exists only in the united states of America and is a direct result of individuals wanting to be something different than those they thought less of (ie African Americans and Indian Americans).

From the global perspective, she talked about how the Institute of Medicine’s US Health in International Perspective showed rich white Americans are sicker than rich Europeans. She then opined “if white people continue to be brainwashed that white is a race, they will continue to do poorly compared to their peers.” Next, she talked about wealth in a way that enlightened me.

Dr. Murray showed a graph which displayed the differences in wealth by “race” (white >$100,000, black $6,000, Hispanic $8000). Interestingly, when home equity was removed from the equation wealth was noticeably reduced (white <$35,000, black $2,000, Hispanic $4,000). She used the change in wealth die to home equity to make the point that there is a misconception of wealth in the US. “Everyone thinks they are a part of the middle class, which is epidemiologically impossible.” In reality, we are ALL poor!

Finally, she addressed the importance of community oriented health services. Like Geiger, Dorsey and Hatch, she believes “care to address health cannot just be within the exam room.” We have to go into the community.

Relevance: There are a few scholars talking about health disparities, racism, wealth, and community oriented health care from a perspective that is not widely accepted. WE must be the scholars to continue this conversation with our generation and to teach it to the next generation so that the conversation continues and so that we are moved to action which precipitates change.

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New! Precis: Solo Interview with Jack Geiger - Tape 1Zachary Lampron (zlampron) (Mar 13, 2015 3:44 PM) - Read by: 1

The first tape of this solo interview with Jack Geiger cover’s his early life, education, and early career. This interview charts Dr. Geiger’s path from his childhood in New York City to the community health center in Mount Bayou, Mississippi.

The interview, much like our first EPID 799 class, focuses on the importance of a person’s background and how that influences their perspective and their work. Dr. Geiger grew up in New York City, the son of a doctor and a microbiologist. He graduated from high school at age 14 and, with his parents’ blessing, moved in with the actor and activist Canada Lee after meeting him at a theatre adaptation of “Native Son”. Jack lived in Harlem for a year before heading to the University of Wisconsin where he got involved in civil rights; while working for the school newspaper he discovered that the University had a list of “approved off campus housing” that was not open to people of color. They tackled the issue of segregated University housing. He and some colleagues then started the second branch of CORE in Madison.

Jack also enlisted in the Merchant Marine. He chose this branch over others because it wasn’t segregated. When he would return to NY he would hang out with Canada Lee and other intellectual leaders of the black community. At the University, an older group of black students informally taught Jack how to organize people. He was involved in the first threatened march on Washington which was aimed at desegregating defense industry jobs. A lot of his subsequent experience in the Merchant Marine and as a pre-med student at the University of Chicago had an activist bent – he and others would put on their dress blues and take an integrated group to buy train tickets at the “whites only” ticket counter, document hospital discrimination, and pressured the University to accept Black medical students.

By 1954 he was getting bored with journalism and went to medical school. While there, he “discovered” social medicine only to learn that it had been invented about 100 years prior. He saw a lot of social medicine in the British literature but the American literature was “fuzzy, liberal, tender loving care” and talked about social medicine as an attitude rather than a thing that you did. He then tells a great story about how he ended up in South Africa that I cannot do justice to by summarizing.

In South Africa at that time, there was a lack of activism to change the political scene – doctors mostly provided “palliative” care that didn’t address social structures. He came back to the U.S. and then ended up in Mound Bayou, Mississippi – I assume he discusses his work there in more detail on the second tape.

Relevance: Jack Geiger is a seminal figure in the history of social medicine in the United States. The process by which he came to see this need, and develop a community approach to a solution, in the United States is fascinating. We have talked a lot in this class about the importance of understanding how your own history, and the history of others, shapes individual perspectives; this interview is a comprehensive overview of Dr. Geiger’s history and how it led to his work in Mound Bayou. He is also a good storyteller and I found that listening to him speak was

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enjoyable.

New! Precis: Applying the TM Technique to Address Autism-Spectrum Disorders, ADHD, and Other Neuropsychological Disorders of Adolescence and Young AdulthoodZachary Lampron (zlampron) (Mar 13, 2015 5:25 PM) - Read by: 1

This webinar features two speakers: Dr. Fred Travis from the Maharishi University of Management and Dr. William Stixrud from the George Washington University School of Medicine. During his portion of the webinar, Dr. Travis presents research (much of it his own) that provides evidence that Transcendental Meditation produces significant neurological effects in the brain. He displays slides featuring EEGs and other brain scans that illustrate neurological markers that support these findings.

The webinar then presents a video produced by David Lynch (an advocate for TM) that shows a case study of a young man with a diagnosis of Asperger’s who experienced social and academic improvements after learning TM.

Dr. Stixrud speaks about the prevalence of stress in society and its effects on the developing brain. He states that reducing stress can improve outcomes for children with ADHD and references Dr. Travis’ data that suggests that TM is effective at improving school behavior, reducing anxiety, improving mood, sleep, and emotion regulation, among other things. Dr. Stixrud states that children with autism often experience high levels of stress and anxiety that may be reduced by engaging in TM. Dr. Stixrud also presents some information on the Quiet Time program which is being implemented in some schools and that includes two fifteen minute periods of TM per day (more information is available at www.davidlynchfoundation.org).

Relevance: Dr. Travis provides a brief overview of some research on TM and Dr. Stixrud provides some anecdotes about the efficacy of TM in practice. This webinar provides some more information about the use of TM and may be a useful resource for those who wish to learn more about the practice. One note: much of the information presented in this webinar is anecdotal and/or does not establish a causal link between TM and the myriad health outcomes that are mentioned.

New! Precis: When Affirmative Action Was White - An Untold History of Racial Inequality in Twentieth-Century AmericaZachary Lampron (zlampron) (Mar 14, 2015 2:27 PM) - Read by: 1

We often talk about affirmative action in the United States as method for increasing opportunities for African Americans; those who oppose affirmative action frequently argue that these types of programs is no longer necessary because Blacks are no longer at a relative disadvantage – racism is largely a non-issue. What we never talk about is that the plethora of opportunities and programs that have benefited European Americans for centuries are essentially a historical program of affirmative action for whites that continue to contribute to inequality in

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this country.

In his book, When Affirmative Action Was White, Ira Katznelson provides a detailed description of the litany of public policies that were enacted throughout the 20th century that deliberately benefited White Americans at the expense of African Americans. He describes how the post-civil war southern states had inordinate sway over the New Deal because they flooded the Senate not just with conservative Republicans, but also with conservative Democrats that undermined the numerical Democratic majorities in Congress by uniting with southern Republicans to form a “Conservative Coalition”. In order to pass his New Deal policies, FDR was forced to make concessions in the legislation for this group. As a result, “farmworkers and domestics” were left out of the New Deal; the vast majority of these workers were African American.

Dr. Katznelson then explains how Black veterans were largely unable to enjoy the benefits of the GI bill since there were fewer colleges that would accept them. He describes how the process of redlining dramatically restricted African-American access to affordable home loans and prevented Black families from moving into neighborhoods with rising home values, thus limiting their ability to accumulate wealth. Throughout, Dr. Katznelson exposes the inherent racism in Federal policies and highlights how this bias was exacerbated through the state-level implementation of laws, particularly in the south.

Relevance: Anyone with an interest in how our government has systematically maintained economic, educational, occupational, health, and overall quality of life disparities across color lines could learn a great deal from this book. Dr. Katznelson provides a compelling historical framework for the creation and maintenance of these inequities and makes clear the lengths that we have gone to hide their source and to ignore them.

New! Precis: Youth Justice, Youth of Color, and Health Policy ImplicationsZachary Lampron (zlampron) (Mar 15, 2015 3:30 PM) - Read by: 1

This webinar was presented by James Bell J.D., the Founder and Executive Director of the W. Haywood Burns Institute in Oakland California and was presented by the National Partnership for Action to End Health Disparities as part of their “Equity in All Policies” webinar series. (The webinar is available here.)

Mr. Bell presents a number of studies that suggest that Black young people are treated very differently than White young people in our justice, mental health, school, and child welfare systems. He is careful to state that these systems are performing their intended function, but that in doing so they produce different outcomes for children of color than for White children. Some of the data presented by Mr. Bell suggest that the justice system is disproportionately used to manage the behavior of children of color (rather than to punish violent crimes), that police officers tend to perceive Black youth as four to six years older than they actually are, and that when experiencing a mental health disorder, White youth are often referred to treatment while Black youth are more likely to be referred to a correctional placement.

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The thrust of Mr. Bell’s talk is that the justice, mental health, school, and child welfare systems, need to fully understand how critically interconnected they are – there is opportunity for data sharing and collaboration that could allow these systems to better serve youth, particularly youth of color who are disproportionately impacted by each of them. The justice system is designed primarily to protect public safety – perhaps this system is not the one that should be handling the misbehavior of children because we know that detention is not an effective behavior change method; the youth justice system is “transactional, not transformational”, it is processing young people, not helping them.

Relevance: Mr. Bell’s succinct and data-driven presentation provides compelling evidence for how institutions, through a lack of coordination or despite it, contribute to disproportionate negative outcomes across the life course for people of color compared to European Americans. If one seeks to create change, one must have an understanding of how the system is structured and how it functions.

New! Precis #1-Wharton Study Shows the Shocking Result When Women and Minorities Email Their Professors

Raven Harris (harav) (Mar 21, 2015 7:19 PM) - Read by: 2 Reply

Last Edited By Raven Harris (harav) on Mar 21, 2015 9:42 PM

Wharton Study Shows the Shocking Result When Women and Minorities Email Their Professors

New research finds that women and minorities have difficulty in finding mentors in a university setting. Professors tend to favor white male students when it comes to assistance and mentorship. This research was led by Wharton School's Katherine Milkman through an email study. 6,5000 professors from 89 disciplines at the top 259 schools were contacted through email by people posing as students with racial and gender obvious names, such as "Brad Anderson", "LaToya Brown", and "Deepak Patel". As expected, white males were the type of students who received the most responses from professors. Researchers measured how often professors wrote back agreeing to meet with students and found very large disparities. Women and minorities were less likely to receive any response, especially one that was positive and supporting.

Faculty at private universities and in more lucrative fields were more likely to be discriminatory in whom they chose to respond. Contrary to stereotypical ideal of “Asians as a model minority group”, racial bias was most evident towards students with names of Asian descent. This data exhibited how Asians are a silent minority whose mythic “model minority” status often obscures their real, lived discrimination in America. Largely, this study further illustrates how white men continue to experience academic privilege despite the misbelief that federal amendments such as Title IX and executive orders such as affirmative action created a “post-racial” America. The U.S. Department of Education reports that there remains a substantial achievement gap between whites and racial minorities for primary and secondary education, which continues to be seen in college. Though black men tend to be most engaged in tutoring programs, white men are six time more likely to graduate in three years with a degree. This

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https://sakai.unc.edu/portal/tool/e78eb1b0-359e-4047-ae02-cfef2608d420/discussionForum/message/dfFlatView





large divide in academic achievement in college is often attributed to minorities entering college with “weaker academic skills,” which scholars suggest can be countered by “building strong personal connection on the campus”. Unfortunately, minorities don’t often receive this institutional support.

Relevance: (Highly Relevant to this course and all academia)

One of the various reasons there’s an educational gap in America between whites and minorities is because minorities often don’t receive support early on in elementary and high school. Unfortunately, this cycle continues in college and adversely impacts education, health, and wealth outcomes for minorities. With no equity in access to education and academic support, educational gaps will continue to widen.

New! Precis #2-Fearing abortion and lesbians, Conservative Christians boycott Girl Scout cookies

Raven Harris (harav) (Mar 21, 2015 9:43 PM) - Read by: 2

Last Edited By Raven Harris (harav) on Mar 21, 2015 9:44 PM

Precis #2: Fearing abortion and lesbians, Conservative Christians boycott Girl Scout cookies

Conservative Christians are raising a fuss about Girl Scouts again. Some Christians have chosen to boycott Girl Scout cookies because they believe the organization promotes abortion and lesbianism. This initiative and call-to-action is called “Cookiecott 2015”. According to these organizers, because Girl Scouts honors people such as Nancy Pelosi, Sheila Jackson Lee, and Barbara Lee who are supporters of free choice, Girl Scouts supports abortion. In addition, supporters of “Cookiecott 2015”, disapprove of the partnership Girl Scouts has with Planned Parenthood. Anna Saladin, a conservative Christian and founder of My Girl Scout Council argues, “The Girl Scout curriculum series promotes many women and organizations that publicly advocate for abortion rights, without a similar inclusion of women and organizations that publicly advocate against abortion.” Fox News pundit Todd Starnes also calls for a boycott of the cookies because he believes that Girl Scouts money that funds Planned Parenthood further propels a “very liberal pro-abortion agenda”. Many other criticisms of Girl Scouts include promotion of promiscuity, encourager of lesbianism, and developer of radicals.

In reality, Girl Scouts is an organization that accepts all members. The Girl Scouts are 2.8 million leaders worldwide that offer young women enriching experience. They denounce discrimination and are accepting of lesbian and bisexual members. They were founded and operate on the mission of making the world a better place. Through camaraderie and team work, Girl Scouts seeks to build courage, confidence, and character through self-empowerment. Selling cookies is simply one of the vehicles the organization uses to allow young girls to gain self-

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confidence by interacting directly with customers to develop skill sets in decision making, goal setting, and business.

Relevance:

This article represents how a group of people can misconstrue a message due to their own belief system. Whether one is Christian or not, the impact that Girl Scouts has had in terms of empowerment and confidence is unarguable. The social justice misfortune lies in boycotting a group of young girls due to their support of an organization that happens to partake in abortion. Planned Parenthood is an informative resource for sexual and reproductive health. Their sole purpose or mission is not abortion. Hence, this disdain of one of the services of Planned Parenthood shouldn’t negatively impact the entire organization nor should Girl Scouts be punished for the service of one its many partners.

New! Re: Precis #2-Fearing abortion and lesbians, Conservative Christians boycott Girl Scout cookies

Vanessa Miller (vmiller) (Mar 21, 2015 10:18 PM) - Read by: 1

wow. this is just astounding. girl scouts promoting abortion and lesbianism?!? I have never even thought of the girl scouts as a progressive group before--I thought they had an emphasis on producing well-mannered 'ladies' with badges for cooking and cleaning. However, as a result of reading your post, I went to the website http://forgirls.girlscouts.org/home/badgeexplorer/ and was pleased to see there are plenty of innovation focused girl scout badges and even a science and technology badge section.

Thanks for posting!

New! Precis 1: Demography of Inequality in the United States


The Demography of Inequality in the United States (November 2014)

20 page report

45 minute webinar

Available online at: http://www.prb.org/Publications/Reports/2014/united-states-inequality.aspx

Summary:

The Population Reference Bureau is a US organization with the mission statement to “informs people around the world about population, health, and the environment, and empowers them to use that information to advance the well-being of current and future generations”. They publish

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http://www.prb.org/Publications/Reports/2014/united-states-inequality.aspx


the Population Bulletin twice a year and this particular issue is related to the demography of inequality in the US.

A good portion of the publication explains the difference between poverty and income inequality. Before reading The Demography of Inequality in the US, I was not familiar with the Gini index, but the reading provides a background and explains the usefulness of the Gini index as compared with the poverty index. The Gini index is a measure of income across households. In contrast to the poverty levels that has increased and decreased numerous times since 1967 the Gini index has been steadily increasing. This means that inequality has been increasing as the Gini index is a number between 0 and 1 where 0 represents all households have equal income while a value of 1 represents one household has all of the income. Recently the population has grown quickly in areas with high inequality but low poverty. North Dakota is a good example of this trend where the oil industry has fostered population growth as well as inequality when there are several extremely wealthy landowners and at the other extreme many blue-collar workers. The blue-collar employment prevents this area from having high rates of poverty but the inequality creates a vast divide between lower and higher income families.

Relevance:

The trends of inequality presented in this publication are very interesting and the online resources such as the “what-if” scenario showing how changes in poverty and wealth distribution could impact groups of people (children especially are impacted by changes in poverty and wealth distribution) and the interactive graphics allow the user to explore state by state data and allow the user to seek out trends of inequality. I would recommend this resource to anyone interested in poverty, inequality, and the demographics of the US.

New! Precis #3: “It’s Time to Revolutionize Race Relations”


Precis #3: “It’s Time to Revolutionize Race Relations”

Bernard J. Tyson, Chairman and CEO of Kaiser Permanente, shares his thoughts on the current state of race relations in America. Tyson expresses that many would think that as a top executive of $55 billion organization his experience as a black man would be different from a black man who works in retail or food service to make a living. However, he believes that the two share a commonality of being a black male that trumps economic status or job title.

Tyson believes that in order for America to move forward in race relations and to experience positive outcomes from demonstrations for change such as the Ferguson protests, negative imagery of black men must cease. White police officers are notoriously known for describing black men as “hulking and demonic”. These are adjectives that portray black men in a dehumanizing light and reference the days of slavery.

As a black man, Tyson speaks from real and lived experiences rather than a theoretical

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standpoint and he shares personal recent personal experiences of racism. He recounts times when he was “followed” throughout retail stores, had food servers explain to him how to tip once he was seated, and been singled out in stores to provide identification when using a credit card. Tyson also reflects on lessons taught to him by his father on how to act when confronted by a policer. The irony he faced when learning how to protect himself against the people who were supposed to protect him continues to resonate with him.

Tyson concludes on how he thinks we as country should move forward in combatting poor race relations. He endorses police body cameras, continued community activism, and more support of school and church leaders that seek to engage in positive dialogue about creating safer neighborhoods.

Relevance:

Bernard Tyson is one of the few healthcare CEOs that maintains a strong social media presence. He is a person of color who is visible in the social justice and public health community. Though he has become exceptionally successful in his vocational pursuits, he still recognizes the challenges faced by a black man. By sharing his experiences, he reminds people nationwide that education and money aren’t equalizers in America. Disdain for skin color continues to be a weapon for oppression.

New! Precis #4: Being Poor in the United States has rarely meant anything so simple as having too little money.


Precis #4: Being Poor in the United States has rarely meant anything so simple as having too little money.

In the summer of 2013, Fox News aired a segment featuring a 29-year-old surfer in La Jolla, California named Jason Greenslate. Greenslate received $200 per month in food stamps and used some of these funds to purchase sushi and lobster. Greenslate drove a Cadillac truck and called his shellfish “free food”. Republicans were furious, claiming that social welfare was allowing people like Greenslate to enjoy a lavish lifestyle and gourmet diet using the money of taxpayers. A month after the segment aired, House Republicans voted to cut national food assistance by $40 billion, and a GOP member referenced the Greenslate segment from Fox News. Contrary to the picture painted by the GOP of a “vulgar, cocky,” and well-to-do person who was carelessly using financial assistance, ninety percent of food stamp recipients live in a household with a child, are a senior citizen, or have a disability. (In fact, Greenslate, later revealed to reporters that he agreed to be apart of the Fox News segment in hopes of gaining publicity for his band.)

In America, there’s a distinction between those who deserve public or private assistance and those who don’t. The deserving poor are often widows and children. The working power,

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however, seem to be unworthy of charity and support. There was a time when the term poor had a different connotation in America. Prior to the twentieth century, there was a more of a community responsibility to assist those in need. The Industrial Revolution, however, changed this perspective for many. With more economic growth, financial shortfalls were viewed more as “individual failings”. Today, Republicans bash food assistance programs by speaking of the very few instances of fraud and abuse in government assistance and increasing number of food stamp recipients without acknowledging that possibly these circumstances are the result of increasingly challenging economic times people are experiencing.

Relevance:

This article speaks to a variety of American’s ongoing issue, including “unemployment, persistent wage stagnation, and increasing inequality”. Disadvantaged groups are often unable to rise out of poverty because some people in America feel that they are unworthy of assistance. This American structure we live in is designed for some people, depending on race, social status, educational background, etc. to succeed while other people are considered “lesser than” and deserving of poverty because of their assumed insufficient work ethic.

New! Precis: Completion of TM Survey

Jennifer Richmond (jenni404) (Mar 25, 2015 10:34 AM) - Read by: 2

Per Vic's email on 3/21, I am posting in this forum to note that I completed the TM survey to count for one of the Precis.

New! Re: Precis: Completion of TM Survey


Me too!

New! Precis: The Case for Reparations

Jasmin Hainey (hainey) (Mar 27, 2015 2:42 PM) - Read by: 2

In his "Case for Reparations", Ta-Nehisi Coates documents the various methods used by the U.S. government to deny Black Americans access to privileges and opportunities, and prevent them from accumulating wealth and passing it down to the next generation. Through the use of interactive redlining maps, article screenshots, photographs, videos, and accounts of the terrorization of Black Americans, he asserts that after 250 years of slavery, 90 years of Jim Crow, 60 years of "separate but equal", and 35 years of racist housing policies, America will "never be whole until we reckon with our compounding moral debt."

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Coates frames his essay with the life experiences of individuals who have experienced the racism and forced segregation throughout their lives. One of these individuals is Clyde Ross, an African American man born in Mississippi in 1923. During Ross' childhood, Mississippi authorities seized his father's land and property. This common practice, which Coates refers to as "elevated armed robbery" reduced many families to sharecropping and subsequent poverty. Years later, Ross was drafted into the Army, and after fighting in World War II, decided to take his chances in Chicago in 1947. Like the millions of other African-American migrating to the North, he was seeking better opportunities and protection of the law. In 1961, Ross and his wife attempted to purchase a home, but were told that there was no financing available except through exploitive contracts. Years later, Ross helped to found the Contract Buyers League, a coalition of homeowners who fought back against the racist housing practices.

Coates highlights Chicago in particular as one of the most segregated cities in the country, a place in which white supremacy was upheld at every level in discreet ways. At one time, the city had the heaviest use of restrictive covenants, a clause in the deed forbidding the sale of the property to anyone other than whites, in the country. Other methods included deliberate site selection for public housing in all-black neighborhoods, the formation of block associations to enforce segregation, and mobs using violence to force Black people to move out of white neighborhoods. When these tactics no longer worked, white homeowners engaged in "white flight", leaving neighborhoods that began to have Black residents. In Chicago, as in other cities, American piracy was a “fact of nature", and Black people were “viewed as contagion.”

As the essay draws to a close, Coates discusses racially evasive politics and the more recent actions taken against reforms developed to improve access to opportunity for Black Americans, such as affirmative action, Aid to Families with Dependent Children, and the Voting Rights Act. Even the Affordable Care Act was considered to be reparations of sorts (by Rush Limbaugh, of course), even though it makes no mention of race in its text. Over the years, scholars have offered ideas for reparations ranging from taking the Black-white difference in per capita income to program for job training and public works. In this work, however, the idea of reparations is defined as "the full acceptance of our collective biography and its consequences.”

Relevance: Coates' insightful and well-crafted essay incorporates several of the topics mentioned in class as well as themes from the keynote lecture for the 36th Annual Minority Health Conference. The essay highlights Jim Crow laws, stolen land and resources, the Great Migration, racist housing policies, and racist social engineering practices that continue to have an effect on the overall health status and quality of life for Black families. The huge wealth gap and restricted choices of neighborhood are no accident, and taking a historical perspective on these issues allows us to understand how these social inequities were created, and how we can address these issues today. This essay also makes it clear that we must get to the root of our problems, and not just address the symptoms through interventions and initiatives. The suppression and punishing of Black success has been implemented at local and federal levels, and improving not only health, but the quality of life for Black Americans will require a shift in the mindset of the American people. We can no longer collectively ignore the fact that this country was built upon notions of white supremacy, and we must face racism head-on at every level.

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New! Precis: 14 Striking Findings from 2014


This collection of data analysis from the Pew Research Center presents 14 interesting findings gleaned from over 150 reports covering topics including demographic change, religious affiliation, politics, and public opinion.

Politics: According to their data, which is based on a scale of 10 political values questions, Republicans are more divided along ideological lines that at any point in the past two decades. This is no surprise, given the tension between President Obama and Republican leaders. Divisions are greatest among individuals who are more engaged and active in the political process, but it seems that the majority of American do not have uniformly conservative or liberal views, and believe that both parties should come together to resolve issues instead of remaining in their “ideological silos”.

Demographics: The world’s aging population continues to be a cause for concern, especially for the global economy and policy decisions affecting social programs. It is projected that by 2050, the median age in the U.S. will be 41, compared with 53 in Japan and South Korea. As the growth of the unauthorized immigrant population has slowed in the U.S., the median length of residence has grown from 7.4 years in 1995 to 12.7 years in 2013.

Media/Communication: Americans are more attached to internet access and cellphones than to their televisions or landline phones, and 39% of all Americans feel that they “absolutely need to have internet access.” In terms of news sources, 47% of consistent conservatives report Fox News as their main source, while consistent liberals named sources such as CNN, NPR, MSNBC.

Economics: The earnings gap between young adults with and without a bachelor’s degree reached its widest in 2013, even with high levels of student debt and youth unemployment. Millennials with only a high school diploma earns just 62% of what someone with a bachelor’s degree or higher makes. Additionally, wealth inequality has widened along ethnic lines, especially since the Great Recession. The median wealth of white households was 13 times the wealth of black households and 10 times that of Hispanic households in 2013.

Religious Affiliation: About 72% of the general public believes that the influence of religion on American life in waning, and most of these people believe this to be a bad thing. In fact, a growing number of people believe that religion should play an increasing role in politics.

Relevance: These demographic and political shifts in our society will likely have direct or indirect influence on the health status and health outcomes in the U.S. Trends in media usage may suggest changes in the way that interventions are designed and conducted, and demonstrate the need for an improvement in the way that health information and other new is delivered to the general public. The policies developed and enforced by different political parties (who may be influenced by religious beliefs) can potentially threaten our collective well-being, and it is imperative that we move past ideological differences in order to do what is in the best interests of

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everyone in this country, not just certain groups. The increasing wealth gap will continue to be relevant to discussions of health disparities, especially given the ways in which wealth is accumulated and distributed amongst individuals, and the fact that wealth accumulation is not always a protective factor in health status for minority populations.

New! Precis: Meditation Nurtures Social Activism


This article discusses the oft-asked question asked to those that practice meditation: Are you not afraid to become too aloof and distanced from the real world?’ This question is based on the misconception that the idea that meditation eventually leads to a complete withdrawal from society as the meditator finds personal well-being and develops a numbness to the plight of others around them. However, research has shown that practicing Transcendental Meditation leads to “more engaged, compassionate, and empathic position towards other beings”, and gives individuals the strength to take on social responsibilities. Those who meditate also seem to decreasingly view others as competitors for resources, which tends to be a source of political and economic issues.

To illustrate the effects of TM on activism, the author employs the life stories of Alice Leahy and Aziza Hussein, two social activists who have been practicing TM for decades. Alice Leahy, a co-founder of a voluntary organization, describes how TM has prevented her from becoming “worn out and jaded”, and allows her to keep on going at 70 years old. Aziza Hussein, a civil rights activist working in Egypt, relies on her practice of TM to help to continue to work into her early 90s and “keep her bearings” within a complex political situation.

Relevance: In thinking about the fight for social justice, it seems contradictory that bringing oneself into a more relaxed and harmonious state of being can actually help one’s commitment to social activism. Without a certain anger, frustration, and/or passion, how can one lead and sustain a movement against injustice? Can individuals, especially members of marginalized groups, actually maintain this state of mind in the face of the powers that be? While I’m not completely sold on TM as a method to develop better human beings and eliminate the ills of society, I can understand the ways in which being at peace within oneself could possibly lead to greater understanding of how current issues affect society as a whole and an increased desire to become involved.

New! Precis: The UNC Minority Experience


The UNC Minority Experience is a 9-minute YouTube video that details the experience of being a Black student at UNC-Chapel Hill. The video opens with a Black male student delivering a speech that serves to undermine (word choice) the notion that Chapel Hill and UNC are a "Southern Slice of Heaven", as that has not been the collective experience of Blacks students on campus. The general consensus seems to

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be that the Black students are only on campus because of Affirmative Action, even though only 98 of the 3,948 first-year students in 2013 were Black males. The administration claims to value diversity, but only seems to value minority students when they're athletes and generating revenue for the school. The student also noted that while UNC has increased spending for athletic programs by about 30%, the school has also made cuts to the budget for student life by 12%, demonstrating what the administration truly values. Other topics briefly mentioned were the conflation of race and class, the educational inequalities that leave some Black students ill prepared for college studies, and the recent scandals surrounding African American studies.

The video then focuses on the different experiences of four Black students. Such experiences include being the only person in a class that looks like them, having to walk past buildings named after known racists and klansmen, potentially falling into stereotypes such as the “angry Black woman”, and feeling obligated to educate others and debunk negative stereotypes. The students agreed that the experience that they were promised when during the application process did not turn out to be the case once they arrived on campus. The video ends with a student saying that the group’s mission was to change the perception of minorities on campus, through the fulfillment of goals such as increasing the presence of minority faculty and staff, changing the names of campus buildings and statues, and developing initiatives to create a more inclusive community at UNC-Chapel Hill.

Relevance: The students in the video discussed several points that resonate with our class discussions and have implications for the health inequities that we are attempting to eliminate. Obtaining higher education is a way of improving one's social status and opportunity, yet these experiences speak to the point of the potential psychological damage associated with trying to become more upwardly mobile. Feelings of being different and inadequate, and dealing with stereotype threat and various micro-aggressions, can have a negative effect on stress levels and one's overall health status. Experiences like these illustrate why college-educated Black women have higher rates of infant mortality than white women with only a high school education.

In light of the recent incident involving the SAE fraternity at the University of Oklahoma, videos like this highlight the way in which the racism concentrated on college campuses across the U.S., and the manner in which it is dealt with, serves to perpetuate and uphold white supremacy. The case in Oklahoma seems like an outlier, as there are rarely consequences for racism and bigotry in predominately white fraternities and similar student groups further than a short suspension, a slap on the wrist, and some events for “dialogue”. There seems to be this notion that once the older generations die off, then we can finally move toward a more just society. However, these privileged, racist college kids are indicative of the ideologies currently present in our generation, and likely to be present if there is no intervention. These same people will become the politicians and lawmakers and people of influence in our society who will create the laws that we live by, passing their beliefs down the next group, and upholding the ideas, structures, and belief systems of the dominant culture. This certainly has important implications for tackling social justice issues from a policy perspective, and we have to willing to call out and address bigotry, not just letting it go unchecked, and stop this cycle from continuing to happen.

New! Precis: ‘Bowling Alone’ Author Tackles the American Dream

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Kevin White (whitek) (Apr 6, 2015 12:21 PM) - Read by: 2 Reply

This piece is an NPR interview with Robert Putnam, political scientist and author of “Bowling Alone”. It follows the release of his book, Our Kids: The American Dream in Crisis. In the interview, he tells of the town in Ohio where he grew up and how the majority of those who graduated high school with him went on to achieve a higher educational and economic status that their parents, a phenomenon that would seem to support the American dream, that hard work will earn opportunities for upward mobility. Whatever family background you come from, you have the opportunity to be successful in life. On a return visit to his hometown, things were markedly different. It was not apparent that the same opportunities he had as a child were available to all children in the town, and the difference between the “haves” and the “have nots” were largely based on parental educational attainment. The rich kids, he says, are simply those who have come from college-educated homes, while the poor kids come from homes with nothing further than a high school diploma.

One of the key differences he points out between rich kids and poor kids is the stability of family dynamics. Between 60 and 70 percent of poor kids of all racial identities live in a single parent household. By comparison, only six or seven percent of rich kids live in single parent households. For poor kids, this means fewer family dinners, fewer family activities, and greater stress in the home, and fewer adults to act as mentors.

The internet, he argues, only mirrors the disparity that already exists because while poor and rich kids have similar access, they use the internet for different purposes.

Changing this trend isn’t easy. He says this will require a culture change. When he was growing up, his parents would talk about doing things for “our kids,” meaning all the kids in town, not just their biological offspring. Over the past 3 - 5 decades, the scope of who we consider “our kids” has narrowed. If we begin to think of all children as “our kids”, as part of our future, this disparity could change.

This article is relevant for social justice because social isolation is counter-productive in mitigating social injustice. Calling attention to broad cultural phenomena that exacerbate disparity is worthwhile, though this in itself is not enough. Culture has a lot of inertia. For change to occur, there must be sufficient stimulus to upset the inertia.

New! Precis: Commentary- Considerations for Use of Racial/Ethnic Classification in Etiologic Research

Kevin White (whitek) (Apr 6, 2015 5:45 PM) - Read by: 2 Reply

This article argues that although the use of “race” in epidemiology lacks uniformity, there are appropriate uses of it in biomedical research. The authors set out to create guidelines for appropriate use of racial/ethnic information in this body of research. They assert that documenting “race” is meaningful in that it captures environmental variations that arise from social stratification and that these reflect meaningful differences in disease risk. Establishing clear and uniform guidelines for collecting and using racial/ethnic data is useful for research regarding racism and health disparities.

In the biomedical literature, race is broadly understood as biological heritage; by contrast, the predominant understanding of ethnicity is an individual’s cultural heritage. In theory, these are distinct attributes, but they are often collapsed in research literature because the data is most often self-reported and many respondents understand race and ethnicity as synonymous.

Self-report of race/ethnicity is considered the “gold standard” assessment. Investigators searching for a more objective method of measurement have proposed using genomic markers. Although there are genetic markers correlated with ancestry, there is only an abundance of minor genetic variations as opposed to a single definitive marker (consider the X/Y chromosomal variations between men and women).

The authors cite logical, conceptual, and practical problems associated with using this data. Racial/ethnic information may be valid and useful in surveillance of disparities, which has implications for public policy (surveillance of disease burden, funding allocation for public health programs, health care, housing programs, education, etc.). One critique of this use is that it simply reinforces race as a biomedical quantity rather than a reflection of social constructs. Racial/ethnic data may be valid when race is a reflection of an etiologic process that is external to the individual. The authors argue that racial/ethnic data as a variable of interest when the effects of race/ethnicity are hypothesized to be internal to the individual study participant.

This article is very relevant to this course in that the authors attempt to improve the tools for assessing and analyzing racial/ethnic information. This information is an important metric for surveilling health disparities and progress towards social justice.

New! Precis: Invited Commentary- “Race,” Racism, and the Practice of Epidemiology

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Kevin White (whitek) (Apr 7, 2015 10:37 AM) - Read by: 2 Reply

In this article, Dr. Camara Jones responds to Dr. Kaufman’s and Dr. Cooper’s paper entitled “Considerations for Use of Racial/Ethnic Classification in Etiologic Research”. She argues that Kaufman and Cooper’s guidelines for using racial/ethnic information in biomedical research is limited in several important ways.

First, although Kaufman and Cooper assert that “race” is a social construct and not a biological phenomenon, their guidelines for using racial data frame race as a self-reported attribute of the individual, similar to ethnicity. Second, the original paper offers several examples of research in which use of racial data may be highly valid. Jones counters that some of these examples may in fact make it more difficult to understand racism and racial disparities. She argues that “race” is a contextual variable, not an attribute of the individual. Jones asserts that “race” is socially assigned, and would vary across countries. The same person (with the same genetic makeup) would be assigned different races in the United States, South Africa, and Brazil.

According to Jones, investigators use “race” in their research predominantly because they understand it to represent some combination of social class, genetics, and culture. While Black people are overrepresented in poverty, they comprise a minority of impoverished Americans, and not all Black people are poor. Culture is extraordinarily heterogeneous, arguably varying more by geographic origin (e.g. American south, New England, urban, rural) than by skin color. Furthermore, as Kaufman and Cooper wrote in the original paper, there is no single definitive genomic marker for “race”. Thus, Jones argues that “race” makes a poor proxy for social class, genetics, and culture.

Race-associated differences in health outcomes are largely neglected because epidemiologists (who are mostly White) are not personally invested in such a research agenda and because these race-associated differences no longer surprise us or pique professional research interest.

This article is relevant for this course in that it adds to the discussion of using racial/ethnic information in biomedical research. Surveillance of racial/ethnic health disparities requires measurement and incorporation of this data into statistical analysis. This paper pushes forward the agenda of addressing racism in the US by calling into question common statistical and methodological practices among the scientific community.New! Precis: “Is there anything you would not do for a million dollars”

Vanessa Miller (vmiller) (Apr 15, 2015 11:42 PM) - Read by: 1 Reply

Last Edited By Vanessa Miller (vmiller) on Apr 15, 2015 11:46 PM

"Is there anything you would not do for a million dollars"

WUNC radio

http://wunc.org/post/there-anything-you-would-not-do-million-dollars

This is an interesting 11 minute interview with Stephen Vaisey, who is a sociologist at Duke who is research morality. The interview talks about his novel approach which is studying the development of morality over time by enrolling teenagers as young as 13 and following them into adulthood (late 20s) to answer some very important questions. Those questions include things like “why does someone become a conservative” and “why do some people care about social justice” but unfortunately, at the time of this interview in 2014, Vaisey doesn’t have the answers to these big questions.

What he does have to offer is his findings that have conflicted with previous findings about conservative versus liberal values and some ideas about the importance individuals place on being part of a group, which is where liberals and conservatives seem to have a clear divide with conservatives are interested in preserving traditions, being proud of their country, and liberals are more concerned with the welfare of people as a whole as opposed to conservatives who are more concerned with ‘taking care of the people around them’.

Relevance: This interview has some relevance to this course in that we have asked some of these

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same questions about why people care about some issues while other people do not buy in to social change or become invested in social equality. There are no easy answers to these questions. It is also important to note that people probably answer questions about what they would do much differently from how they actually choose to behave in their day-to-day lives. It is important to understand morality, but in this interview there isn’t the depth from defining the terms like ‘morality’ and ‘liberal’ that would make this information more coherent.

New! Precis: “Is there anything you would not do for a million dollars”Vanessa Miller (vmiller) (Apr 15, 2015 11:42 PM) - Read by: 1

Last Edited By Vanessa Miller (vmiller) on Apr 15, 2015 11:46 PM

"Is there anything you would not do for a million dollars"

WUNC radio

http://wunc.org/post/there-anything-you-would-not-do-million-dollars

This is an interesting 11 minute interview with Stephen Vaisey, who is a sociologist at Duke who is research[ing] morality. The interview talks about his novel approach which is studying the development of morality over time by enrolling teenagers as young as 13 and following them into adulthood (late 20s) to answer some very important questions. Those questions include things like “why does someone become a conservative” and “why do some people care about social justice” but unfortunately, at the time of this interview in 2014, Vaisey doesn’t have the answers to these big questions.

What he does have to offer is his findings that have conflicted with previous findings about conservative versus liberal values and some ideas about the importance individuals place on being part of a group, which is where liberals and conservatives seem to have a clear divide with conservatives are interested in preserving traditions, being proud of their country, and liberals are more concerned with the welfare of people as a whole as opposed to conservatives who are more concerned with ‘taking care of the people around them’.

Relevance: This interview has some relevance to this course in that we have asked some of these same questions about why people care about some issues while other people do not buy in to social change or become invested in social equality. There are no easy answers to these questions. It is also important to note that people probably answer questions about what they would do much differently from how they actually choose to behave in their day-to-day lives. It is important to understand morality, but in this interview there isn’t the depth from defining the terms like ‘morality’ and ‘liberal’ that would make this information more coherent.

New! Precis: WUNC The State of Things - “The Social Science of Diversity”

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Kevin White (whitek) (Apr 17, 2015 2:52 PM) - Read by: 2

Last Edited By Kevin White (whitek) on Apr 17, 2015 2:52 PM

Host Frank Stasio interviews Dr. Rupert Nacoste after the release of his recent book, Taking on Diversity. Dr. Nacoste tells of his experiences in the U.S. Navy during the race riots in the U.S. military of the 1970s. His commanding officers chose him to be a “Racial Awareness Group Facilitator,” leading conversations among fellow sailors about diversity.

“Our anxiety over addressing racial disparities is stunting our ability to accept people who look or act differently.” He seeks to move from anxiety to respect, asserting that the fear of being perceived as “racist” stifles conversation on the issue. This was not as important several decades ago when people were not as afraid of being labeled a racist.

Prejudice is not bigotry is not racism. Everybody has prejudices. These may be conscious or perhaps unconscious until there is a particular stimulus. Bigotry is the outward behavioral manifestations of prejudices. Racism, he argues, is institutional and organizational; it “authorizes and supports bigotry” through both implicit and explicit policies. Dr. Nacoste refuses to talk about white privilege in his classroom because it “puts white kids on the defensive.” Because everyone carries around prejudice, “there are no innocent… There are no innocent in America.”

One important lesson he learned from his students is how important “inter-group” interactions are among college students. In asking his students to reflect on their most intense inter-group interaction, he found that interactions between people of differing races, religions, sexual orientations, or classes greatly influence their life experiences.

Dr. Nacoste speaks of the minimal group paradigm, in which people subconsciously sort things into categories. Some of these are adaptive (e.g. sorting poisonous berries from safe ones), but some are maladaptive (“us” vs. “them”). The danger comes when this tendency comes at the expense of other groups, when “we’re trying to interact with a person who we’re only looking at in one way.”

Quoting the opening line of the Declaration of Independence, he argues that diversity is supposed to be central to America’s identity. The heterogeneity in America precludes cookie-cutter solutions in addressing racism, but creating a safe environment for conversations about diversity is very important for promoting a change from anxiety to respect on a national level.

New! Precis: Voting Law Changes Hurt DemocracyNdang Azang-njaah (ndang) (Apr 18, 2015 3:19 PM) - Read by: 2

In her April 2014 opinion piece in the News and Observer, Ellie Kinnaird, Mayor of Carrboro and a former N.C. State Senator, describes in detail the regressive changes associated with the Voter Identification Verification Act (VIVA) passed by the North Carolina State Senate in 2013. She highlights several important consequences of the bill all of which introduce restrictions to the ability of North Carolinians to participate in the voting process.

Mayor Kinnaird succinctly explains the consequences associated with this new legislation. VIVA repealed the ability of 16 and 17 year old students to pre-register to vote, which she describes as a lost opportunity to introduce high school students to the importance of citizenship and the democratic process. Early voting was shortened by one week, which

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introduces additional obstacles to for all North Carolinians, mostly African Americans for whom early voting was the most popular method of voting. Same-day registration and voting was repealed, which marginalizes college students and other members of society who may be too busy to register 25 days prior to Election Day. Repeal of the straight party ticket, introduces additional obstacles for voters, particularly choosing candidates running for lesser-known political seats. Moreover, following the passing of the VIVA, photo identification will be required for all voters and will be restricted to an unexpired N.C. driver’s license or special ID issued by the DMV; unexpired passport; or enrollment card from a government recognized Native American Tribe.

Mayor Kinnaird goes as far to mention that although legislators were presented with statistical charts as to how black voters would be disproportionately affected, little concern was shown for the potential effects this law would have on this community. She questions the underlying motives of the conservative legislators, as the majority of those who have been or will be affected by VIVA vote heavily Democratic. She closes her piece by contextualizing the actions of the N.C Senate within the larger movement of the U.S. Supreme Court releasing all states from measures of the 1965 Voting Rights Act that had required the Justice Department to review changes to voting laws, highlighting her concern for North Carolina’s most restrictive voting laws in the country.

Relevance to the course: This opinion piece by Mayor Kinnaird acknowledges the consequences associated with differential access to knowledge, resources, and power, within the context of who is able to vote and whose vote counts in a democratic society. The restrictions to voter freedom in North Carolina disproportionately affects minority communities and youth, who tend to vote to democratic lawmakers, and liberal ideals. Such restrictions curtail the democratic process and have major implications for social justice, inequality, and health disparities, when particular communities, particularly those that have been previously marginalized are kept out of the process of voting for elected officials.

New! Precis: How do schools promote equity among students? Video Interview with Pedro NogueraJennifer Richmond (jenni404) (Apr 19, 2015 12:57 PM) - Read by: 1

In this video the executive director of the Metropolitan Center for Urban Education, Pedro Noguera, discusses how schools can promote equity among students. He notes that in education, equity means more than just opportunity (e.g., access to education); it also means equity in student outcomes. In theory, all children, no matter where they live, will experience equitable education. However, we know that is not the case, especially for children living in poor areas.

Interestingly, Dr. Noguera notes that schools promote inequity because they deliberately assign the best teachers to educate the already highest performing students. On the other hand, the least experienced teachers often teach students with high needs. This process often happens for political reasons; the parents of high performing students often have more resources and possibly power in demanding that their students receive the best education. Additionally, teachers with seniority often demand that they teach high performing students. Importantly, Dr. Noguera does

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not blame parents or anyone else for wanting the best for their children, but the practice means that some children do not get equitable education because of their circumstances.

To make education more equitable, Dr. Noguera discusses the need for leaders to make a true commitment toward excellence for all students and not just the gifted ones. Commonly, we build certain classes and educational enrichment opportunities that are reserved for gifted students, but by doing so we build inequity into education.

To conclude, Dr. Noguera explains that we should aim for all children to learn skills they can apply to their specific situation. As an example, he tells the story of an environmental science teacher who wanted to connect with her students and their lives. She spent time in the community and realized that if residents used the soil in their community to garden, they would expose their families to toxins. After teaching the children how to test soil for toxins, the children organized and approached the County Health Commissioner to warn the families about the problem and to devise solutions for safe gardening. Dr. Noguera argues that these children will always remember their lesson on soil toxins because they were able to apply what they learned to their community.

Relevance: This video discusses one of the key social determinants of health—education—and how we frequently promote inequality in the current education system. It reminds us that by focusing our resources on the highest performing students, we are promoting inequality for the other students who may have a higher need. If all students were to receive equitable education, it would mark a critical move forward in our efforts to eliminate health inequity as well.

Source: http://player.vimeo.com/video/3780975?portrait=0

New! Precis: Maharishi’s Keynote Address at the Annual Convention of the American Association of Higher EducationJennifer Richmond (jenni404) (Apr 20, 2015 2:03 PM) - Read by: 1

In March 1973, Maharishi gave the keynote address at the Annual Convention of the American Association of Higher Education. In this speech, he discussed the relationship between higher education and quality of life for individuals. To understand this connection, Maharishi explains that the current education system ignores that knowledge of the knower (i.e., the knowledge that a student already possesses) and instead focuses on teaching subjects (e.g., physics). In teaching this way, a student can never master all subjects.

When the knower is ignorant of himself, Maharishi notes that the structure of education is baseless. Without a base, knowledge is unfulfilling, and this unfulfilling knowledge does not motivate students to continue embracing or pursing higher education. Unsurprisingly, Maharishi describes that all over the world, students are choosing not to pursue higher education. Although this decision could be attributed to multiple reasons, boredom and issues within the education system can be factors.

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Maharishi continues to explain that the knowledge of the knower can be gained through the process of Transcendental Meditation (TM), which brings awareness to the field of consciousness that is the home of all knowledge. By increasing awareness, the knower gains access to this knowledge. Without the awareness, the knower remains ignorant to his or her own knowledge. As part of this solution, Maharishi argues that TM should be taught and practiced in schools. In doing so, Maharishi notes that quality of life would improve because one’s mind becomes unbounded and full potential can be reached.

Relevance: This keynote address describes how education and quality of life are linked. As education is associated with many key public health outcomes, Maharishi’s address describes how one potential solution (TM) can make students more aware of the knowledge they already possess and experience better overall education. As there is evidence to suggest that TM may improve some student outcomes (e.g., test scores and ADHD symptoms) Maharishi’s address describes a tool that may contribute to the reduction of health disparities. [i]

[i] The Quiet Time program: Improving academic performance and reducing stress and violence. (n.d.). Retrieved April 20, 2015, from http://www.davidlynchfoundation.org/schools.html

New! Black Lives Matter - A Challenge to the Medical and Public Health Communities

Lorenzo Hopper (hlorenzo) (Apr 20, 2015 10:33 PM) - Read by: 2 Reply

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Last Edited By Lorenzo Hopper (hlorenzo) on Apr 23, 2015 11:03 AM

Last Edited By Lorenzo Hopper (hlorenzo) on Apr 21, 2015 11:28 AM

In light of the very public and racially charged recent events, many Americans have been left wondering where do we go from here and how do we as a collective come together to end racism? Mary T Bassett, Health Commissioner of NYC, writes an article in the New England Journal of Medicine that resulted after a group of medical students approached her after the Staten Island Grand Jury decided not to indict the police officers involved in the murder of Eric Garner. Dr. Bassett poses the question, "Should health professionals be accountable not only for caring for individual black patients but also for fighting the racism -- both institutional and interpersonal -- that contributes to poor health in the first place? Should we work harder to ensure that black lives matter?" The article describes how lives are cut short and not only by violence, but also by dramatic disparities in many health outcomes (e.g. cardiovascular disease, cancer, and HIV).

The article shifts to focus on how physicians, nurses, and public health

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professionals witness these inequities every day yet many are reluctant to address the role of racism in these inequity gaps. This topic relates directly to our semester long discussion on racism and how it contributes to persistent health inequities. Dr. Bassett highlights how over 300 articles have been published in the Journal over the past decade, and only 14 have contained the word “racism” half of which were book reviews. Dr. Bassett then challenges black US physicians and allies to acknowledge the legacy of injustice in medical experimentation and other historical trauma that communities have faced and stop sitting on the sidelines.

Black Lives Matter NEJM 02.2015.pdf

New! America is a Horror Show

Phenesse Dunlap (pmdunlap) (Apr 21, 2015 12:06 AM) - Read by: 2 Reply


Bill Moyers, a journalist and political commentator, interviews former journalist and writer/producer David Simon during a segment of his personal show. Simon is best known for two critically acclaimed TV dramas The Wire and Treme, which depict the everyday lives of Americans who were never meant to achieve the “American Dream”. Rather, the lives of these marginalized individuals are much closer to a nightmare, as these individuals must fight for relevance even as society actively works to degrade their existence. Simon positions his characters as being players in the economic and political plight of the United States. The result is what he calls a “horror show”, and he mainly blames the current economic system for the harsh outcomes experienced by many communities.

David Simon’s overall view juxtaposes President Obama’s 2014 State of the Union address, where the president optimistically speaks social progress in the coming years. While maintaining a level of respect for the president, Simon expresses doubt that much will change due to having a “rigged game”. American society has come to a point where the measure for progress is only money. With this capitalistic mindset, there are populations that will always be at a disadvantage. The free market approach that seeks to constantly reduce costs and increase profit margins resulted in the closing of many domestic factories. This meant that many Americans lost their livelihood, and they were often unable to find substantial work. For many, the only viable option was to enter into the illicit drug trade. The government, in turn, harshly penalizes these individuals by heavily enforcing laws that disproportionately affect the most vulnerable. Simon emphasizes that what makes this situation even more terrifying is that society has even found a way to profit even further from these downtrodden individuals through populating the prison systems. The “war of drugs” is actually a disguise for a war on the poor. Overall, Simon believes that the poor have lost, and that America has largely shifted from the democratic struggle of balancing both sides in order to reach a middle-point that is best for society.

This interview candidly explores social determinants that shape the lives of many

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marginalized communities. While specific health outcomes are not discussed, it is not difficult to imagine how the distribution of health outcomes are affected by larger socio-economic forces at play. Without doubt, it is within these populations that we see some of the starkest health disparities in the United States. Although smaller-scaled interventions might alleviate some of the affects that the present American economic system has, it is inconceivable that health equity can be achieved without pursuing social justice. Simon offer two potential solutions that might address the issue of equity for those who are systematically disadvantage due to economic forces. The first is to pay people if their services are not currently needed in an economic system. This is commonly thought of as welfare in the United States, but Simon presents it in a way that is digestible and de-stigmatizing. The second solution is to train people in areas where they can be productive and actively participate in the economy. Both of these solutions require spending money, and they would be beneficial to the entire society. However, the nation’s growing libertarianism strongly opposes putting forth resources so that all communities can thrive. I believe that it is necessary to push back against free market practices and its accompanying philosophies in the pursuit of health equity.New! Precis: Dear Chancellor Folt

Ndang Azang-njaah (ndang) (Apr 21, 2015 9:24 AM) - Read by: 2 Reply


Dear Chancellor Folt is a 8 minute and 47 second video created in 2014 that is the culmination of a shared experience of American Indian students at the University of North Carolina at Chapel Hill. The video clip opens with an all too familiar scene of the Halloween celebration on Franklin Street. Several students are seen donning stereotypical Native American costumes, walking through the streets, posing for pictures, and even conversing with the producer of the film. Within the close of the first minute the cameraman focuses in on one male student, who appears in red face, dressed as a Washington "Redskin". When questioned on his choice of costume, the student replies, “It’s Halloween…if there’s no controversy there’s no Halloween.” Seconds later an African American female student also dressed as a native american notes that she felt that she saw someone dressed in blackface, screaming out, “that’s racist”, apparently unaware of the racial undertones of her own costume choice.

The video then transitions to a group of students within the American Indian center who openly share their experiences of at UNC. One student shares an experience of how her non-native peer appropriated aspects of native culture through a tribal themed party and openly laughed about it; two other students note that many other peers have questioned the authenticity of their American Indian heritage; another student expresses the shock she felt when she was mistaken for housekeeping upon entry into a basketball game at the Dean Dome.

As the video continues with additional experiences of the American Indian students on UNC’s campus several statistics are intertwined to highlight the dearth of an American Indian presence on campus. For instance, the film highlights low rates of admissions for native students (30 admitted/year) compared to their white counterparts (2800 admitted per year). The native students express their disappointment in UNC, which they expected to have a higher standard,

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with more excellence and greater awareness, regarding the diversity of different cultural groups. Instead they acknowledge an environment where it is acceptable for others to appropriate native culture, to treat native students as the other, and to question the essence of native culture. Some students express a sense of feeling unwelcomed and a need to justify themselves by educating their non-native peers as a way to validate their experience at Carolina.

The students acknowledge the presence of the American Indian Center, which has provided a safe space for native students on campus, allowing students to be themselves, not having to put on a façade or change their views, as compared to their experiences within the wider culture at UNC. They express their thanks for the staff at the center, who help to validate their student experience and remind them that they belong at UNC. The students provide several suggestions to Chancellor Folt throughout the film on how their experience at Carolina could be improved. They request for Chancellor Folt to encourage more discipline and cultural competency training for students; to facilitate making the native voice on campus stronger; to increase the representation of diversity on campus; and to recruit native students at a higher intensity.

Relevance to the Course:

This film highlights several instances, which in aggregate show that there appears to be a relative lack of support and representation for Native American students at the University. Several of the students acknowledge feelings of inadequacy and a trauma associated with the lack of respect for their identities and legitimacy to be a part of the community at UNC. The solutions provided by the students also acknowledge the importance of understanding culture and creating a diverse community. Through improved representation and deeper appreciation for other cultures, supportive environments can be created for underrepresented students. Such an environment can help to address distressful situations that can be detrimental to one’s health and wellbeing.New! Precis: The Time Coca-Cola Got White Elites in Atlanta to Honor Martin Luther King, Jr.

Ndang Azang-njaah (ndang) (Apr 21, 2015 1:53 PM) - Read by: 1 Reply


This NPR code switch article written by Jim Burress recounts the historical roles that large corporations have had in intervening within larger social movements. The article begins by discussing the aftermath of Arkansas and Indiana’s “religious freedom” laws. Large corporations including Wal-Mart, Apple, and even NASCAR voiced their opposition on the basis on the potential for discrimination against gays and lesbians, coupled to the potential of the legislation to be bad for business. The article then revisits the history of Coca-Cola intervening in Atlanta at a time were the social conservative elite initially refused to honor Dr. Martin Luther King, Jr. for receiving the Nobel Peace Prize in 1964.

The article notes that when event invitations went out to Atlanta’s elite to attend a dinner honoring Dr. King for his Nobel Price, almost no one initially responded. Subsequently, the

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mayor of Atlanta appealed to the former CEO of Coca-Cola, Robert Woodruff, who was opened-minded and forward thinking enough to recognize that shunning of Dr. King by Coca-Cola and Atlanta, both of which had aspirations for international recognition, would be bad for business and for the image of the city. Mr. Woodruff who was at the time one of the most powerful individuals in the city was receptive to the Mayor’s concern asked the current CEO, J. Paul Austin, to intervene.

Accounts of Mr. Austin’s perspectives, as recounted by former U.N. ambassador Andrew Young, note that Mr. Austin, who had previously seen the economic impact of apartheid on South Africa, would not let Atlanta succumb to “pettiness and racism” manifested in the social conservatives resistance to attending Dr. King’s event. The article concludes indicating that in response to Coca-Cola’s strong stance, more than 1,600 people were in attendance of the dinner for Dr. King and that the event proceeded without issue.

Relevance for the course: This is another example of how the activity of corporations can shape the local environment. Corporations almost always act within their self-interest, which may contribute to advancement of social justice, as seen within the actions of the aforementioned corporations or contribute to health inequities. These historical events suggest that the best way for the public health community to convince corporations of the importance of social justice in advancing health equity would be to provide a business case to establish the legitimacy of he importance of social justice and equality.Precis: The Supreme Awakening (TM book)

Vanessa Miller (vmiller) (Apr 22, 2015 10:02 PM) - Read by: 2 Reply


Precis: The Supreme Awakening: Experiences of Enlightenment Throughout Time—And How You Can Cultivate Them

By Craig Person

Summary:

This is a book about transcendent meditation from ‘historical’ perspective. The back cover describes the book as bringing “… a remarkable collection of transcendent experiences reported by people through the ages and shows that they are experiences of advanced stages of human development…” I’ll talk about this aspect of the book only briefly first and then summarize the section about research on meditation, which was the part that appealed to me most in the book.

The book relies on quotes from everyone from St. Augustine to Buddha to Jesus to William James and interprets them as historical accounts of transcendental consciousness. I find this problematic because none of these people are relating their experiences about TM. Interpreting

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someone’s words to a practice that that person has not reported engaging in seems disingenuous and manipulative.

Chapter 9 is called “Meditation in the Laboratory” and reviews some of the research that has been conducted with regard to TM. It has a few interesting figures including a few seconds of an EEG that shows how TM brain activity is different than just resting brain activity. However, I don’t know enough about interpreting EEGs to actually know what this means other than it’s different.

Relevance:

I cannot say this book has relevance for a course on social justice. I would not recommend this book unless someone is into TM and wants to read a book about it. The intention is not an objective appraisal of TM, but a book promoting the power of TM.

Re: Precis: The Supreme Awakening (TM book)

Victor Schoenbach (vschoenb) (Apr 23, 2015 10:46 AM) - Read by: 1 Reply


Vanessa, perhaps I made a mistake in having your read that book rather than another one. I believe that Craig Pearson's point is that the experience of transcendental consciousness is a natural phenomenon that quite a few people have experienced in history, including a number of historically important figures. Indeed, it has been suggested that the founders of all great religions have been inspired by the experience of transcendental consciousness. He is wanting to document that transcendental consciousness is a universally available experience, not something that Maharishi invented or that is entirely a function of TM. The human nervous system has the inherent ability to function in a way that gives that experience.

However, the descriptions of the experience of transcendental consciousness are not generally accompanied by a straightforward procedure for having the experience, and before Maharishi there was not a widely available simple, systematic procedure. TM is a systematic procedure through which the mind can experience transcendental consciousness and eventually develop the ability to experience that state of consciousness permanently, along with other states of consciousness (waking, dreaming, sleeping). So I don't think that Craig Pearson is interpreting the quotations he cites as being connected to the practice of TM but rather suggesting that the question at issue is not whether transcendental consciousness exists but whether TM can in fact enable people to experience it. I suspect that most people in public health do not yet appreciate that transcendental consciousness exists, so in that regard alone Craig Pearson's book may make a real contribution.

Do you think that I am misinterpreting?

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New! Precis: Irwin Schatz, 83, Rare Critic of Tuskegee Syphilis Study, Is Dead

Ndang Azang-njaah (ndang) (Apr 23, 2015 8:50 AM) - Read by: 1 Reply


This New York Times article highlights the actions of the late physician Irwin Schatz, who was one of the earliest critics of the Tuskegee Study of Untreated Syphilis in the Negro Male. The article recounts that when Dr. Schatz first read of the news of the study in a 1964 Archives of Internal Medicine journal, he was “appalled” that physician researchers were withholding treatment from the “poor, uneducated, black sharecroppers” that were in listed in the study. Although it was early within his professional career as a physician, he wrote a letter in 1965, protesting the ethics and morality of those involved in conducting the study.

The article continues on to note that while Dr. Schatz did not receive a reply from his letter of protest, receipt of his letter was documented as the first received and that the research investigators had no intentions of answering his letter. It would take another 7 years before the study would be revealed in The Washington Star by Peter Buxtun, a former health service interviewer. Dr. Schatz’s letter was later found by the Wall Street Journal as a result of a Freedom of Information Act request. The article closes by paying tribute to additional aspects of Dr. Schatz’s professionalism.

Relevance to the Course: This brief article provides additional insight to the early opposition that existed in response to the unethical aspects of the Study of Untreated Syphilis in the Negro Male. This relates to portions of the course where we have discussed the importance of understanding our own personal values and identity in the event that we may be faced with a critical and compromising decisions to make in the future. Though Dr. Schatz was not involved in the study, he made an effort to voice his concerns regarding the ethics of the Tuskegee Study, which were being disregarded. He serves as a strong example of the importance of valuing the ethical principles in public health, within the efforts of advancing health equity and social justice.

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