Category Archives: class

Medicine and Sustainability

Two important stories that will make sense to all of you, but specifically to those “I wanna be a doctor” folks among us. As you’ll learn in the California story, doctors get paid by the task — office visit, exam, surgery, etc. This is not sustainable given where health care may be headed; it’s certainly not beneficial to the consumer. Also as you’ll hear, given the cost of medical school and the loans MD’s have to pay back after graduation, specialization in the system drives doctors away from where they are indeed needed — primary care.

In California, Facing Down a Family Physician Shortage

In another story that shows us how wonderful we are, this is concerns Global Health. In fact, this link will take you to several stories concerning Global Health — cholera perhaps spreading to the DR and Miami, organ trafficking, and a global food crisis.

As you ponder your last “mini” essays, think about some of these challenges.

Robert Moses and Majora Carter – Terrible Infrastructure and Environmental Justice

I had an interesting discussion with my architecture professor, James Butler, who introduced me to the source of New York’s horrible infrastructure in low income areas. Robert Moses, who is seen as a savior to residents of Westchester County, Rockland County and Long Island, pushed for the construction of major freeways throughout NYC. One of his projects, the Cross-Bronx Expressway, abruptly cut through the South Bronx, demolishing countless apartments and displacing over 600,000 working class people on a month’s notice. Since Moses was well-connected with the upper-class and was also backed up by Master’s from Oxford and a fancy PH.D from Columbia, he neglected the voice of the neighborhoods he destroyed and just let business dominate. My professor states “Moses was so politically powerful, that all he needed was to find the most talented architectures, and manipulate them to fullfil his projects.”

Another point about Moses is that his environmental projects, i.e Riverside Park, East River Park and Central Park were reserved for areas where mostly the upper-class lived. Although willing to destroy and increase car pollution in countless neighborhoods for highways, he never decided to place a pool or a park in Hunts Point or Bed-Stuy.

Also,

I also found an interesting interview with Majora Carter. Addressing the same tensions, Carter states the reasons why environmental concerns in low income areas are inevitable. Her point express how corps can still profit by engaging in projects that equalize environmental sustainability in all neighborhoods.

Check it out. It was intriguing to listen to, and they typed-up the interview if you just want to read through the ideas.

Edit 11/16/10 : Her interview basically reiterates the points in Cooper’s essay which we read today. Thanks Cooper for introducing us to Majora Carter’s ideas.

For those of you driving back home for Thanksgiving, think about the cities/towns you pass by. Is it evident that infrastructure has cut through low income areas near you? Please share.

http://www.democracynow.org/2010/7/22/neither_the_destruction_of_the_9th – link to Carter interview.

http://en.wikipedia.org/wiki/Robert_Moses

http://gothamist.com/2007/01/25/caro_gets_snubb.php

Pic of the Cross Manhattan Expressway Moses designed.

“There is nothing more frightful than ignorance in action.” – Johann Wolfgang

Best,

Frederic

Who Will Stand Up to the Superrich?

Frank Rich wrote an interesting article, today, in The New York Times, Who Will Stand Up to the Superrich?

Rich tells us that Americans don’t hate the rich; in some cases even admire the rich. The wealthy who lost elections, he goes on, also provided jobs for people. Rich, though, tells us that we should worry about another kind of rich American, the unseen:

The wealthy Americans we should worry about instead are the ones who implicitly won the election — those who take far more from America than they give back. They were not on the ballot, and most of them are not household names. Unlike Whitman and the other defeated self-financing candidates, they are all but certain to cash in on the Nov. 2 results. There’s no one in Washington in either party with the fortitude to try to stop them from grabbing anything that’s not nailed down.

This is serious because a democracy requires an informed citizenry; however, if this citizenry can’t see, we therefore aren’t ever sure where ideas and their motivations come from, thus trust suffers a serious blow.

As Rich suggests, “The bigger issue is whether the country can afford the systemic damage being done by the ever-growing income inequality between the wealthiest Americans and everyone else, whether poor, middle class or even rich.” Are we prepared to live in a country where the evidence — physical and otherwise — will uncover an abyss between the superrich and rich and the working class, and by working class I mean, as is evident in Rich’s column, people earning less than $200,000 and below? (Believe me, this isn’t a lot of money)

What happens in this world, this “new normal,” as we like to say, is that we lose our narrative, we can’t trust it; we also begin to sense that perhaps it’s never exited. Rich says, “That burden is inflicted not just on the debt but on the very idea of America — our Horatio Alger faith in social mobility over plutocracy, our belief that our brand of can-do capitalism brings about innovation and growth, and our fundamental sense of fairness. Incredibly, the top 1 percent of Americans now have tax rates a third lower than the same top percentile had in 1970.” The entire American concept is Romantic — it’s a romantic story that grows out of Enlightenment thinking. The trick, actually, is to reach for the Romantic sense of authenticity that shuns aristocratic values for real experience but never quite really getting there; this keeps us going or moving towards a vision of what’s real, what’s truthful. In my mind, this is what Rich is pointing to — the erosion of this Romance with the real, the lived experience, the authentic self and the journey towards that self.

I read Rich’s editorial as an explanation of the law of unintended consequences — that is, as the rich, those unseen ones especially, continue to garner more of our resources to sustain their lives, we, the workers of America, begin to realize that we’re in fact working to sustain that small percentage of citizens that reap the rewards of our labors. Thus, a percentage, an increasingly larger percentage of our value — our worth — is determined, according to Rich, by people we don’t know and people who are pulling at strings we don’t see.

How do we work through this? What do we have to do to better understand our roles in the world of labor (yet to come for you)? How does Rich make you feel? What is the relationship between Rich’s editorial and McKibben’s Eaarth?

Understanding Social Determinants of Health

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Understanding the Social Determinants of Health: Breaking the Link between Poverty and Health

Brown graduates working with Project Health (program where college students work in local health clinics) based in Providence, Rhode Island. Samantha Murder (Program Manager) and Hanna Nichols (National Talent and Technology Coordinator)

Cycle of Poverty

MONEY is needed for healthy food, healthy housing, childcare (so you can go to work), education and school, clothing (job interviews), health care, utilities, medicine
in order to get money you need a JOB
in order to have a job, you need EDUCATION

Need education and a good job for money, but need money for education and chance for a job! Not a linear path and a difficult cycle to enter.

Project Health works to provide resources and knowledge.

Social Determinants of Health- “economic and social conditions under which people live which determine their health”

The Big Five: Food, housing, energy, education, and employment/insufficient income.
Shaped by the distribution of money, power, and resources (influenced by policy choices)
Social determinants are mostly responsible for health inequities

What do we mean by Poor?

Mentioned that the federal poverty line has been used a lot throughout the symposium as a measure of poverty. They stressed that people are struggling for money well above the federal poverty line. The federal poverty line for a family of 4 is $22,050, but, in suburban Illinois for instance, a family needs at least $58,000 for necessities (study done by NCCP -see budget calculator)

FOOD

Food insecurity greatly increases likelihood for poor health (ex. low birth weight for mothers)

Compared nationally, Vermont is doing well, subsidized lunches and breakfasts at school are critical (50% of kids in Essex county use this) Essex also has high levels of low birth weight.

What’s out there? Resources to combat food insecurity

food stamps
WIC (for women and infants/children under 5, counseling on nutrition)
Free/reduced school meals
Pantries/meal sites

ENERGY

Heat or eat?

Energy insecure households- 22% increased chance of being hospitalized since birth

What’s out there?

LIHEAP (covers a large amount of monthly winter heating bill, if you can’t meet cutoff your utilities will be shut off- difficult to pay back. Grants are getting smaller)
local neighborhood funds
Special protections for disabilities
Payment plans (utilites prefer some money)

HOUSING

Related to health. Household mold (makes you 2.2 times more likely to experience asthma!), cockroaches, cold, lead poisoning, unsafe housing conditions, stress from not being able to pay rent contribute to asthma and low nutrition, hospitalizations, poor health

Housing is considered not affordable when it costs more than 30% of income.

Housing in context- Vermont. Top 10 occupations in Vermont include retail salespeople, cashiers, janitors and cleaners- none of whom have a salary high enough to pay for housing. Not a livable salary! Poverty is “not just about getting a job”

What’s out there

public subsidized housing (projects)
private subsidized housing (contracted out)
housing choice voucher Program (Section 8)- pay up to 30% of income and government pays rest- HARD TO GET, 5 to 8 year wait for voucher in Rhode Island
shelters
transitional housing
rental assistance
legal action- something unsafe in house- legal pressure on landlord (less expensive than moving)

EDUCATION

They highly suggested the film “Waiting for Superman”! (check out the trailer)

What’s out there

GED classes
ESOL classes (English is 2^nd language)
Adult basic education
Computer literacy
Child enrichment
Head start and early head start (includes literacy classes for parents, checkup for kids, losing seats right now)

INSUFFICIENT INCOME/ EMPLOYMENT

Related to obesity and other health issues. Not knowing what will happen raises stress and sickness- lack of locus of control.

People below the poverty line live an average of 9.6 health adjusted years less than Americans above the poverty line!

What’s out there

Child care subsidies
Food stamps

PROJECT HEALTH

Founder noticed underlying health problems involved with evictions

Doctors could do nothing for patients suffering from unemployment, poor housing.

Student in project health connect families to resources/volunteers. For example, they often connect families to food pantries or call utilities to arrange payment plans.

HOW THEY WORK

guided referrals
resource knowledge
identification of barriers
creative solutions
education
advocacy
connections

Conversations about food security and housing are important to both doctors and patients, but those conversations weren’t happening. Health services often don’t have the time or the knowledge to refer people, which is where Project Health steps in. Project Health also works to collect data that can be used in advocacy movements and campaigns.

Located in 6 cities, with 600 volunteers, and has helped over 5,000 families.

If you’re interested, check them out here!

The Corrosion of America

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Bob Herbert writes, in The Corrosion of America, that, “Aging and corroded pipes are bursting somewhere every couple of minutes. Dilapidated sewer systems are contaminating waterways and drinking water. Many local systems are so old and inadequate — in some cases, so utterly rotten — that they are overwhelmed by heavy rain.”

This is creating a very dangerous situation throughout the US. And if you look at this “corrosion” and couple it to Fred’s post, below, about poverty, then

If this were a first-class society we would rebuild our water systems to the point where they would be the envy of the world, and that would bolster the economy in the bargain. But that would take maturity and vision and effort and sacrifice, all of which are in dismayingly short supply right now.

We can’t even build a railroad tunnel beneath the Hudson River from New Jersey to New York.

Improving water systems — and infrastructure generally, if properly done — would go a long way toward improving the nation’s dismal economic outlook. According to the U.S. Conference of Mayors, every dollar invested in water and sewer improvements has the potential to increase the long-term gross domestic product by more than six dollars. Hundreds of thousands of jobs would be created if the nation were serious about repairing and upgrading water mains, crumbling pipes, water treatment plants, dams, levees and so on.

Millions of jobs would be created if we could bring ourselves to stop fighting mindless wars and use some of those squandered billions to bring the nation’s infrastructure in the broadest sense up to 21st-century standards.

What Democracy?

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Following our discussion on Thursday, defining terms — Democracy, Socialism, Communism, Capitalism and The Yankees — several parallel stories have appeared that suggest the struggle and the tension we discovered in our exercise, in our discussion.

Please examine these, carefully, and again per group (each group, except one, still is behind and has to do the Scott Page post), determine HOW these stories define Democracy/Capitalims/Us and HOW these stories parallel Empire of Illusion.

The first story is from Terry Gross’s Fresh Air, ” ‘Citizens United’ Ruling Opened Floodgates on Groups’ Ad Spending.”

The next 2 are not stories, but rather, commentaries. First, Bob Herbert, writing for the New York Times, in Policy at its Worst, tells us that, “We can’t put the population to work, or get the kids through college, or raise the living standards of the middle class and the poor. We can’t rebuild the infrastructure or curb our destructive overreliance on fossil fuels.”

The next opinion, also from the Times, is by Charles M. Blow, High Cost of Crime. Here, Blow informs us that, “Our approach to this crime problem for more than two decades has been the mass incarceration of millions of Americans and the industrializing of our criminal justice system. Over the last 25 years, the prison population has quadrupled. This is a race to the bottom and a waste of human capital. A prosperous country cannot remain so by following this path.” Take a look at how much a single murder costs — then ask yourself: why do we incarcerate more people than anyone else in the industrial world?

The last story, which parallels Hedges’ chapter, “The Illusion of Wisdom,” and written by the indefatigable Camille Paglia, was sent to me by Izzy Ocampo. In “Revalorizing the Trades,” Paglia asks, “what if a student wants a different, less remunerative or status-oriented but more personally fulfilling career?” She responds to her question, saying that, “There is little flexibility in American higher education to allow for alternative career tracks.”

In a moment, Paglia sounds a lot like Hedges:

Jobs, and the preparation of students for them, should be front and center in the thinking of educators. The idea that college is a contemplative realm of humanistic inquiry, removed from vulgar material needs, is nonsense. The humanities have been gutted by four decades of pretentious postmodernist theory and insular identity politics. They bear little relationship to the liberal arts of broad perspective and profound erudition that I was lucky enough to experience in college in the 1960s.

Examine each of the stories and the editorials, then discuss, online, how all this fits our notion of the struggle for democracy, our struggle for the truth?

A Conversation with Noam Chomsky

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It’s rare that Noam Chomsky is asked to appear on mainstream media. That fact that he’s not asked to appear should say plenty about our media establishment, particularly about the owners.

In a rare moment, Chomsky gave an interview, Tuesday, on On Point Radio, NPR, with Tom Ashbrook.

Listen here. He’s speaking on U.S. rage and ruin.

The New Biopolitics of Race and Health

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“The New Biopolitics of Race and Health” by Dorothy Roberts of Northwestern University School of Law

Disparity and Health Inequities- Introduction

In Chicago

1/3 of blacks would not have died if rates of black and white deaths were equal
black women are 2X more likely to die of breast cancer than white women (even though whites are more likely to get it)
black women are not more susceptible, white women just had more access to new technologies from 1996-2004

Globally

50% of black woman wouldn’t have died of breast cancer if rates were equal
Rates of child mortality (before the age of 5) is 6/1000 in high-income countries, 88/1000 in developing countries, 120/1000 in poor countries
In the U.S, there were 83,570 excess black deaths (the number of deaths that could be prevented in the U.S if the black-white mortality gap were eliminated)

New Biopolitics of Race

Different approaches to the WHY behind health inequalities
One explanation is to treat race as a biological category, which attributes disparate health outcomes to racial differences
Roberts says this approach is denying the impact of race on society and reinforces racial inequality
Human Genome Project showed no evidence of racial divisions (Bill Clinton, Francis Collins, Craig Ventor all noted this at the conclusion of the project)
For some reason, the results of the Human Genome Project are now being geared towards research involving the differences of race (on a genetic level) and health. Nicholas Wade of the New York Times said researchers are now being “forced to confront a treacherous issue: the genetic differences between human races”. Roberts says this is ridiculous, and that none of the results of the project suggest this line of research.
Somehow, she says, the reasoning is that the 0.1% genetic difference in people’s genomes accounts for race which accounts for unequal health outcomes. Roberts says this argument is ridiculous.

Research

Flawed studies about genetic differences, race, and health have gained lots of media attention

Study done that supposedly proved that genetics were the cause of blacks having more preterm babies. The researchers said the experiment was independent of social constraints, but they only controlled a few things. Without proof, or any scientific backing, they leapt to the conclusion and created a theory that genetics were the cause of the difference in the number of preterm babies between black and whites. This highly flawed study made it to a New York Times headline.

Millions of dollars are being invested into genetics and race research (especially from the U.S and U.K). Roberts mentioned this article

Drugs

If genes are the cause of health inequities, there are 3 ways to address this

nothing we can do, blame nature
gene therapy
drugs

This last option has gained a lot of attention. Roberts described the history of BiDil, which is a heart disease prevention drug that is specifically made for blacks. The drug is actually just two generic drugs put together, and was originally patented for anyone. The FDA only patented the drug once it was specifically marketed for blacks. The FDA said this was a “step towards personalized medicine”. The original goal of the Human Genome Project was to provide personalized medicine, but the FDA is now using race as a proxy for genetic difference, while waiting for legitimate drug treatment differences based on people’s individualized genotypes. Dr. Steve Nissen, of the FDA, said himself, “We’re using self-identified race as a surrogate for genetic markers”. Roberts says this is unfounded and inappropriate. Obviously, the FDA is using race and health concerns for it’s own commercial advantage.

New Race Based Genomics – where is this new ideology being implemented (already mentioned drugs and research)

race as a category in biomedical and human gentic varation research
race specific pharmaceuticals
genetic ancestry testing
DNA forensic and biobanks
reproduction-assisting technologies (eggs and sperm grouped by race)

What “They’re” Saying

This new theory says that racial differences are real at the molecular level, but constructed at the social level. Treating race as an ideology, rather than a scientific truth, is what causes social tensions (the example of political correctness). People are starting to believe that social justice is actually working against improving health through genetics!

What Dorothy Roberts is Saying

Why would we ever divide cell lines by race? The idea that we should divide people by race as a biological category is engrained. But we are seperated by society, not by genetics. “Race is a political category, not a biological one”.
Inequity is a product of the social and political situation, and is not a “natural” difference. Inequity is unjust and calls for social change, not solutions involving individual choice (like race-based drugs).
Social justice is a way of achieving better health, and genetics and social justice should not be pitted against each other.
“A More just World would be a Healthier One”

Corporate Captilism vs. Intrinsic Nature of Race

What is causing this change in thinking? Roberts’ says it is a combination of both corporate capitilism (whatever sells, example of BiDil) and the perputuating defintion of racial order. Ever since race was invented, the idea that some people are naturally inferior has persisted. The very function of race was to create political division. The evidence of natural divisions is now manifesting in genetics. This sort of manifestation has been happening for years (ex. Tuskiki experiments in the 1970’s) and just because it’s said to be based in science doesn’t mean it is unbiased or justified. The two components are working together to spread this ideology, one has “a hand in the pharmaceutical industry” and one is based on “the usefulness of race in America”.

Zoe and Dorrie

Communicating Health Lisa Russell:”A Filmmaker’s Perspective: Utilizing Media and the Arts for Global Health Advocacy”

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Before Lisa Russell became an Emmy-award winning filmmaker she was interested in medicine. She describes hearing Jonathan Mann, former head of the World Health Organization’s global AIDS program, speaking about AIDS as a social issue, from a gender, race, and economic perspective, as the day she changed her views. With a masters in Public Health, she set off on a career as a documentary filmmaker showcasing health issues in countries like the Congo, Niger, Ethiopia, Lebanon and many more.

During the talk she spoke about Not Yet Rain, a film she made in 2008 with Ipas about unsafe abortions in Ethiopia. Although Ethiopia decriminalized abortions in 2006, which the government believed would allow women access to safe abortions, many women still resort to unsafe abortions. The documentary follows two young women who are denied abortions because they are too far along in their terms. Russell describes her film as “putting a human face” to a human rights issue. She got a lot of feedback from people, even on Face Book, where a 19 year old girl from Dubai, sought help from Russell to get her to Ethiopia for an abortion. This shows the magnitude of power of media, that people from all over the world were made aware of this issue.

Another project Lisa Russell works with is Urban Word NYC. The program works with teenagers on areas such as creative writing, journalism, etc. It is based on the principle that “teenagers can and must speak for themselves.” This I thought was especially powerful because it gives young people an outlet to express themselves, and to raise awareness about certain issues.

This leads into her Emmy-award winning piece. Her close ties to NYC and the overall flexibility in her film topics are displayed in the next video she presents. She informs us of her close work with young students in the Bronx, New York on issues regarding race, gender and economics. She brings to life in her film, the inspiring poem of a young 13-year-old girl from New York, which she calls ”Biracial Hair”. The poem commences with light and humorous approach of a young girl fussing over her hair, but then both the poem beautifully creates a parallel between the pride holds for both her hair type and how she views herself in society.

Russell is heavily involved in promoting UN MDG Summit #5, one of the few goals the United Nations have prepared, in which the nations engaged plan to decrease and hopefully eliminate maternal mortality. She administers a site, www.MDGfive.com that provides a network and trafficking of situations, ideas, and news that will stimulate awareness and engagement on the said issue. Although the site is relatively new, we found it very well organized and took light into one very cool feature, which would be the clip remixer. In which there are tons of powerful quotes, photos and clips, which you can assemble together for your own custom slide show.

We decided to make one for Class and the Environment: (Please comment) (Fred picked the song)

http://mdgfive.realitydigital.net/Media.aspx?key=DDAC5AFF450B7832

Lisa Russell described her projects as more spontaneous than pre-decided, and we think this illustrates her unique and well-organized way in developing them more than anything. She is meticulous in almost every step of her project and makes sure that she is not offending the people that she films. She also analyzes every position of the issue; by making sure even the “bad guys” that are performing the abortions get their voice. At times she stated she feels in a paradox in terms of films being documented about Africa due to the overall negativity a the films, and she explained that she makes sure her films shed light to the positives, so that there is no inferiority.

Overall her presentation was insightful, informative, and an endearing pleasure to be a part of.

Fred and Sonam

The End of Nature, FEMA Trailers, and Bed Bugs