Political Women: A Double Standard

jill biden
Dr. Jill Biden. Source: Center for American Progress. Creative Commons.

On December 11th, a Wall Street Journal article was released critiquing the future First Lady’s, Jill Biden, use of the label “Dr.” The author stated that the “Dr.” in front of Dr. Biden’s name is fraudulent because it represents her doctorate in education instead of representing Dr. Biden as a medical doctor. The author also states that the title of a PhD might have once held prestige due to the rigor of past PhD programs, but no longer could be considered prestigious. As a daughter of four proud PhD holders, two of which who have PhDs in education, I found this article incredibly ignorant and insulting. However, I was most struck by the blatant encouragement of the double standards placed on women, especially women in politics.

In 2020, only 23.6% of the United States Congress is composed of women. That is 126 women out of the total 535 Congressional members, with 105 of the women represented by the Democratic Party and 21 represented by the Republican Party. To further break this down, 25% (or 25 members) of the Senate are women and 23.2% (or 101 members) of the U.S. House of Representatives are women. The lack of women representation in United States politics is shocking, especially considering the amount of women’s health and rights legislation is debated upon in the government each year. It is evident that there is a significant lack of women in the political field and those few women who have managed to succeed in such a male dominated sphere face intense scrutiny and misogyny from insiders and outsiders alike.

Hillary Clinton at at rally
Hillary Clinton. Source: Lorie Shaull. Creative Commons.

This fact is highlighted by many women in politics, but especially the experience of Hillary Clinton in the 2016 presidential election and then Elizabeth Warren in the 2019 democratic party runoff. In 2016, Clinton made history by becoming the first woman to win a major party’s nomination. The reactions to her nomination were blatantly sexist. While there were many objections to the policies proposed by Clinton, a primary objection to her presidential bid was her “lack of likeability.” Her supporters were described as “disconnected” and “unlikable.” She was often compared to Massachusetts senator Elizabeth Warren, a woman who, in 2016, was considered a much more likeable alternative to Clinton. Two years later, during Warren’s presidential bid, many of the characteristics applied to Clinton in 2016 were applied to Warren.

Former First Lady Michelle Obama was the subject of media and political scrutiny during and after her husband’s presidential terms. While Obama headed many interesting initiatives during her time as first lady, much of the criticism was focused on her looks and likeability. Even worse, the criticism appeared to be levied towards her identity as a woman of color. Obama has been called by prominent politicians and media outlets alike an “ape in heels,” a “gorilla face,” and a “poor gorilla.” She was said to not have the “look” of a first lady and thought to weigh too much to care about the health of the country, in direct response to her campaign to help the United States exercise more and eat healthier. In a similar fashion, she was criticized for eating too much and not supporting dessert. One person even stated that she had no business, as First Lady, being involved in such things as the health of Americans.

Michelle Obama at a rally
First Lady Michelle Obama. Source: Tim Pierce. Creative Commons.

The criticism of women in politics is not just levied toward Democratic politicians. In October 2020, tapes of a secret 2018 recording of Melania Trump were released. In these tapes, Trump expressed frustration in the double standard placed on women in the White House. At the time the recordings were made, Trump was expected to work on the White House Christmas decorations, decorations that were later mercilessly mocked on social media platforms and media outlets. However, she was also being criticized for President Trump’s policy regarding the separation of families. Trump’s frustration is over the expectation placed on her, and other First Ladies, to prepare and organize the Christmas decorations for the White House, an arguably trivial thing to the general public.

Kamala Harris at a rally
Vice President Kamala Harris. Source: Gage Skidmore. Creative Commons.

The political field has proven to provide some of the most difficult boundaries for women. As of 2020, the United States has continued to fail in electing a woman president. The media has continued to be more interested in the fashion habits and likeability factor of prominent female politicians instead of their support or lack thereof of pieces of legislation. There have been great strides for women despite the many challenges. Yesterday, Kamala Harris became the first woman vice president in United States history. She is also the first person of color in the position as well. Today, we celebrate VP Harris and the women on whose shoulders she stands. While we recognize these achievements, we continue to call out the sexist tendencies that persist in media and in the political sphere, and we continue to work towards the day when women are represented equally in these spaces.

The Illicit Pharmaceutical Industry and its Impact on Public Health

by Sadie-Anne Jones, guest blogger

Image of a packet of pills
Source: Creative Commons

The illicit pharmaceutical industry is bigger than one might think. In an age where coverage for prescription drugs may be limited and an opioid crisis is rampant, more and more people are turning to this illicit market. Because not everyone that purchases pharmaceutical drugs is aware they are doing so, this industry has been difficult for law enforcement to track. Thus, it has grown internationally and there are few places that are not affected by it.

The illicit pharmaceutical drug industry is a far reaching one. One reason for this is because counterfeit drugs can be made relatively cheap. A recent 60 Minutes segment illustrates how easy it is for companies to produce counterfeit pharmaceutical drugs; small rooms with relatively primitive equipment are used to make multiple drugs including blood pressure medicine, Viagra, painkillers, and seizure medication. One-way people are able to get these drugs is through illicit dealers posing as legitimate online pharmacies. So, even if an individual is not intentionally seeking out alternatives to legally prescribed medication, they may be tricked into it none the less. Other dealers have been much less reserved in how they market their products. As with the “Silk Road” site that operated on the dark web from 2011 to 2013, which included 4,000 dealers and around 100,000 buyers, it made no attempt to hide their illegality. This site acted as a huge distributor of numerous illicit substances including prescription drugs. While the “Silk Road” has been shut down for years, there are still many other sites on the dark web facilitating illicit pharmaceuticals. Additionally, when costumers buy illicit drugs online from sites posing as legal businesses, or even from sites like the “Silk Road,” they are often shipped to buyers through the postal service. This makes drugs difficult to stop, especially when they are shipped in small amounts. All in all, this makes it easy to deal in counterfeit drugs and allows the industry to spread across the globe.

But what are the negative implications? Is it only the pharmaceutical industry’s profit margins that suffer from this illicit industry? The answer is, sadly, no. There have been numerous negative consequences for public health that have resulted from it. Especially in the wake of the opioid pandemic–which hit the country largely due to doctors over prescribing highly addictive opioid painkillers–this industry has caused a large amount of irrevocable damage. As one source states, it is hard to know for sure how much the illicit drug industry has impacted people’s health. That said, it is predicted to have contributed significantly to the 42,249 deaths that resulted from opioid related causes in 2016 alone. Additionally, counterfeit pharmaceuticals are entering hospitals and pharmacies around the country. Even if the drug itself was manufactured licitly, counterfeit materials can make their way into the ingredients, or the ingredients may be safe but the wrong dose is recommended, thus making it counterfeit. These counterfeit ingredients can be anything from chalk to flour. While chalk and flour are fairly harmless, when those ingredients are used in life-saving medications, the results can be catastrophic. In one instance, counterfeit materials found their way into the blood thinner, Heparin, which resulted in the deaths of 80 people. While most pharmaceutical drugs that people receive are not counterfeit, the illicit pharmaceutical industry is continuing to grow and deceive people.

Image of a medicine bottle with a caution label encouraging users to ensure what they are taking is correct
Source: Creative Commons

So, what can be done? As previously stated, most of these illicit pharmaceutical drugs are shipped through the mail and they have proven difficult to stop. Even so, there is still hope. There are new procedures being put in place including implementing new technology in international mail carrier facilities that allows those working there to scan packages and detect even minuscule amounts of opioids, and dark web sites are increasingly being monitored by government analysts. As of now, counterfeit drugs account for less than 1% of all pharmaceutical drugs sold in the United States. While counterfeit drugs are still a major problem in developing countries, it seems like likely that countries across the globe will eventually pick up similar measures to the U.S. and other countries that have reduced the problem significantly, so that this trade can be further snuffed out.

In essence, there are many outlets to the illicit pharmaceutical industry. These range from seemingly legal sites on the internet, the dark web, and even pharmacies and hospitals. These outlets have knowingly, and sometimes unknowingly, helped distribute sometimes dangerous counterfeit drugs to citizens across the globe. This has resulted in the deaths of many people and also helped perpetuate the opioid epidemic. Thankfully, the U.S. has amped up regulation in recent years leading to very little illicit pharmaceuticals ending up in the homes of people across the nation. In the future, it seems hopeful that the regulations that have been implemented in countries like the U.S. will soon be commonly used in other countries as well in order to stop this industry for good.

People of Color Live Disproportionately Close to Superfund Sites

dirt field with a dumpster and a sign that reads "EPA Quanta Resources Superfund Site. Warning: Hazardous substances present in the soil. No trespassing.
Quanta Resources Superfund Site. Source: Anthony Albright, Creative Commons.

As a Public Health major, I am often looking at disparities and inequities in the distribution of poor health. Environmental justice, which can be defined as “the fair treatment and meaningful involvement of all people with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies” is one topic I’ve learned about in many classes because of the significant impact the environment has on health. Unfortunately, the color of one’s skin plays a large role in their likelihood to live and work in an area that has an unhealthy environment, and the history of people of color unknowingly living and working in areas that are hazardous is long.

The Memphis Sanitation Strike started the environmental justice movement in February of 1968 when sanitation workers in Memphis, TN organized a strike to protest unfair treatment and the effects on their health. The workers had been receiving less pay than their white coworkers, while also doing the more dangerous work. Before the beginning of the strike, two black men had been killed by the trash compactor during work. The movement eventually lead to a recognized union and higher pay. This was not the first instance of environmental racism. However, it was one of the first time that head way was made when it comes to equality and equity.

The most famous example of a fight for environmental justice, Love Canal, seems to have few people of color as part of the story as many of the vocal people involved were white women. After heavy rain fall in 1978, residents of Love Canal, NY, noticed that there was a bad smell in the air, children were returning home after playing outside with burns on their skin, and babies were being born with birth defects at a very high rate. They didn’t know that toxic chemicals had seeped from the chemical waste dump they had built their homes and school on.

However, there was a federal housing project in the area as well that housed mainly people of color, and their voices were overshadowed by people like Lois Gibbs. The movement to move people out of the hazardous area did not extend to moving the people living in the federally funded housing to a safer area even though they were affected by the hazardous waste just as significantly. Luckily, both groups were able to relocate and receive compensation for the health effects.

While the Memphis Sanitation Strike and Love Canal both happened over 40 years ago, the environmental injustice experienced during those times has not completely gone away. Today people of color and low-income individuals are still more likely to live and work in hazardous areas. Most Superfund sites, which are areas that have been deemed severely environmentally contaminated, are within one mile of federally funded housing. Even more disturbing, a disproportionate amount of these families are people of color.

The disproportionate placing of federally funded housing, and therefore low-income communities of color, into environmentally hazardous areas stems from systematic racism, or more specifically, a Not In My Backyard (NIMBY) mentality held by higher-income white communities. No one wants to live near a hazardous waste site, a factory that releases toxic fumes, or a stinky landfill. However, the people with the power to say no get their way while the people who are already more likely to have health risks are placed in dangerous situations.

A larger problem is that low-income communities and communities of color have been not listened to. In northern Birmingham, AL a recent study showed that a coke mill on a Superfund site has been releasing carcinogenic chemicals in the air for years. Many residents have severe respiratory problems, such as asthma, and now can’t survive without many medications. However, the EPA didn’t catch the extremely high levels of rarer toxins in the air because they don’t typically test for those. It took a study from a nongovernmental organization to expose the harm that the coke mill was doing to this community.

No one wants to live somewhere that is going to make themselves or their family sick, and they shouldn’t have to. While the United States has made progress towards environmental justice over the past 40 years, there is still a long way to go. Superfund sites were created in 1980, but most of the current public housing was created before then. New federally funded housing should not be put near hazardous areas like Superfund sites, and we should work on solutions to clean up Superfund sites near federally funded housing or moving that housing . By reducing the number of housing projects near hazardous waste and taking note when a whole community gets sick, we will begin to move towards racial and income equity when it comes to the environment we live and work in.

The Syrian Refugee Crisis Rages On

by Mariana Orozco, UAB student

In March 2016, The European Union and Turkey made an agreement stating Turkey would keep all asylum seekers who arrived on the Greece border in return for billions of dollars. This deal has put many asylum seekers at risk due to the dangerous environment in Turkey. However, this continues to be accepted and there are no signs of change in the future due to Greece’s incomplete assessment of Turkey as a safe third country. In February 2020, Turkey retracted their statement, saying they would not stop refugees going into Europe. Turkey is the country with the most refugees – 3.6 million Syrian refugees. Since the Syrian government started bombarding their citizens with air strikes, no other European country has tried to host Syrian citizens. When Turkey finally opened its borders into other European countries, the asylum seekers were met by armed Greek border guards, tear gas, rubber bullets, and razor wires. Turkey opened its borders to force the European nations to stop ignoring the crisis in Syria. If the international community does not step in more unarmed civilians will continue to face violence in Syria, and the situation in Turkey will worsen.

Photo of makeshift tent at refugee campsite in Turkey
“Syrian refugees’ camp in Cappadocia, Turkey” by Fabio Sola Penna; Source: Creative Commons

What is the status in Turkey?

Turkey has been home to over 3.7 million refugees, providing them with free public services, health care, and gainful employment; there are many obstacles Syrian refugees have to go through to get these. For example, Turkey adopted a work permit in 2016, but they must be requested by employers, who are often unwilling to cover the costs and face the administrative hurdles of hiring a refugee. As a result, most refugees work in low-paying jobs, such as jobs in small textile workshops and construction.

Furthermore, Turkey does not sign off on international refugee law. Therefore, they do not allow many refugees to obtain legal status. Many Turkish authorities also force the refugees to go back to Syria, leading them to want to flee to a safer place regardless of the conditions, such as Greece. 

Greece’s Response to Turkey Opening Borders

Greece has broken European Union and international law. The government is suspending the registration of any asylum claims and deporting anyone for any reason something that goes against Geneva’s Convention on Refugees. The core principle states that a “refugee should not be returned to a country where they face serious threats to their life or freedom.”  Close to 40,0000 migrants are being held in camps with short food supply, poor sanitation, and tensions with locals. Although the United Nations Refugee Agency did urge Greece to address its overcrowding and precarious conditions, not much has improved. Once refugees arrive, they are not allowed to leave until their asylum requests are processed, leading to the 90,000 cases backlog.

Image of a refugee camp in turkey; dozens of makeshifts tents on a field
“Syrian refugees’ camp in Cappadocia, Turkey” by Fabio Sola Penna; Source: Creative Commons

What about the rest of the European Union?

Turkish President Recep Tayyip Erdogan warned NATO allies and European allies that if they “do not share the burned with us, we will open the gates” . President of the European Commission described Greece as Europe’s shield in migrant crisis. They also proposed financial and material support to prevent people from entering Greece, because once they do they will continue to spread in Europe.

What should Happen next?

Europe should take a new approach to safeguarding the human rights of refugees and start sharing the responsibility for allowing them to live in dignity and peace. Many of the people leaving their countries do it out of desperation, and European governments need to ensure asylum seekers have fair procedures. Also, they must control border control and unlawful acts by authorities. Instead of hoping that the problem goes away by having migrants go to different places, the European Union needs to address the reasons why people are fleeing Syria.

The Gender Pay Gap in Alabama in the Context of COVID-19

by Lauren Lockhart, UAB student

Two dollars bills reading "Equal Work" and "Equal Pay!"
Equal Pay for Equal Work. Source: Mirk, Creative Commons.

I will never forget the time in my 12th-grade year that a boy told me the gender wage gap didn’t exist. Even after being presented with evidence and facts, he still swore that there is no pay gap based on gender, and if there were, it was obviously for a reason. Although this wasn’t the first time I had heard a statement like this regarding human rights and equality, I still cannot believe the pay inequality that exists based on gender, and how this gap continues to grow for individuals with compounding intersectional identities. 

The Pay Gap During COVID-19

According to the U.S. Census, between 2018 and 2019, no progress has been made on closing the overall gender pay gap, with the average full-time working woman earning only 82 cents for every dollar earned by men. During COVID-19, this pay gap has continued to grow as women face more hardships and barriers as they try to support themselves and their families. 

At the beginning of 2020, women’s labor force participation in the U.S. stood at 58%, but by October, it had dropped two percentage points because of COVID. Not only is this due to the fields that have been shut down were majority women, such as restaurants, tourism, and office space maintenance, but women have also had to shoulder the responsibility of childcare. Not only was this already a problem contributing to the pay gap before COVID, but it has since grown into a greater responsibility with the shutdown of daycare centers, schools, and after-school programs. This has led to many mothers having to reduce their hours or leave their jobs entirely to take care of their children. Among parents working at home during the crisis, fathers’ childcare has increased by 4.7 hours per day, while mothers’ hours of childcare has increased by 6.1 hours. 

This reduction of hours for childcare has also increased the worry among women in the long-term evaluation for promotions and raises. Not being considered for raises and promotions puts working women during COVID at an even greater disadvantage due to the pay cuts they experienced at the beginning of the pandemic. A recent survey of 984 professionals showed that while men and women have experienced pandemic pay cuts at nearly equal rates, men (52%) were more likely than women (44%) to say their pay has been restored. So, these women are not only facing long-term consequences for their reduction in hours, but they are also facing issues presently with pay cuts and restoration. 

Image of protest sign that reads: I'm so sick of running as fast as I can wondering if I'd get there quicker if I was a man.
Sabrina Groschke. Source: Selbstbestimmung, CreativeCommons.

On top of childcare and the fear of demotion, women who contract COVID face even greater obstacles. Experts and health professionals have started to call women that face COVID “long-haulers” because of the continued work and hardships that women face returning to the workforce after having the virus. After getting COVID, many women still wrestle with lingering symptoms, in addition to trying to balance home life and work. This creates numerous barriers for women amidst this strange time we are living in, with no long-term guarantees. 

Women’s Well-Being in Alabama

The Women’s Fund of Greater Birmingham recently released its annual report, Status of Women, and although Alabama already treks behind many states in terms of gender equality, conditions for women have worsened amidst COVID-19. One of the key findings included in this report is that the wage gap in Alabama is wider than most other states and the national average, with women earning 73 cents for every dollar a man makes, compared to 82 cents for U.S. women overall. For women in Alabama who have children, the annual cost for an infant (under 12 months old) is nearly 17% of the mother’s median annual earnings, totaling approximately $5,858. However, add in that women have accounted for 57.3% of the total unemployment claims in Alabama since the beginning of COVID, and it seems that all of these factors can make it virtually impossible for women to sufficiently support themselves and their family.

Photo of a protest with woman holding sign that reads "Equal Pay"
Equal Pay. Source: Penner, Yahoo Images.

Universal Fight for Gender Equality

Even though it may not be taking place in Alabama, six mayors around the world have joined forces with the organizers of City Hub and Network for Gender Equity (CHANGE) to fight the increased gender inequality during COVID-19. The network aims to continue to spread these projects among other city mayors in hopes of attracting more attention and progress. Los Angeles mayor, Eric Garcetti is requiring that every city department must have a gender action plan and measure to show progress on tackling gender equality. These measures can range from closing the gender pay gap, appointing women to boards and top positions, and ensuring more girls use public spaces, like sports fields. While these may not be large steps towards gender equality, there is an effort, nonetheless.  

The Causes and Consequences of California’s Wildfires

by Mariana Orozco, guest blogger

If you went to California’s oldest state park right now, you would probably find many trucks logging trees and trees that have been chopped down. This is the result of one of the many wildfires that have happened in parts of Washington, Oregon and California this year. Although the wildfires were sometimes started by lightning or by humans on accident, climate change is deepening the effect of the fires. The fires are larger, more intense, and harder than usual to put out, causing many Californians to evacuate their homes.

The Role of Climate Change
It is important to point out that wildfires are not unusual to Californians. They usually occur annually during the summer and fall. Due to rising temperatures from climate change, more moisture evaporates from the ground, dries the soil, making the vegetation more flammable. Not only are the fires worse due to climate change, but the fires themselves worsen climate change by increasing CO2 emissions. Also, the forest pest infestations are also creating more tree deaths.

Graph showing that the additional acres burned with climate change has almost doubled since 1985
Source: Union of Concerned Scientists

Due to climate change, weather patterns are shifting and the seasonal Fall rains are delayed. This year, it led to a very dry Summer and a windy Fall, making the fires more intense. The wind brings more oxygen to the fire, causing flames to spread over larger areas. With less precipitation in this arid climate and less snow due to rising temperatures, the soil and vegetation are becoming even more dry. There has also been an increase in extreme weather conditions, such as heat waves and lighting storms.

Social, environmental, and economic costs of the wildfires
People who had never been affected by the fires are now being forced to evacuate. To fight the wildfires, large financial assistance is required. Also, once communities are affected, more money is needed to rebuild them. Just to fight them, the federal government is spending an average of 2.4 billion dollars, which has more than doubled in the last 20 years. Not only are the number of wildfires increasing, but the effect on land is expanding as well. The number of acres burned is growing exponentially, with 100 more wildfires each year than the year before since 2015. With the continuous effect of wildfires, more wildlife is being destroyed, animals are being forced to relocate, and ecosystems are being damaged.

Graph showing the number of acres burned per year since 1985
Source: Union of Concerned Scientists

Impact on Native Americans
Many Native American people in California have been forced from their lands due to the fires. With them, they take their knowledge of taking care of the overgrown forests. In Karim territory, one of the largest indigenous tribes in California, people are taught to keep the area around their houses burned off. Char Miller, director of environmental analysis at Pomona College, states that removing millennia of knowledge from the land has resulted in the current wildfires. One of the ways Native Americans would keep the land healthy was through lighting fires on purpose to keep extra dry fuel from building up. California state and federal agencies are starting to collaborate with each other to prevent wildfires.

What can you do?
Society needs to cut carbon emissions to stop rising temperatures. We need to agree on a shift towards renewable energy and cut our reliance on fossil fuels. In order for this to happen, you can start by voting and advocating for candidates who have strong climate change policies. In Washington, Oregon, and California, there have to be better building codes so that construction takes places away from fire prone areas. There needs to be a proactive approach by removing dead trees and planting new native species, in an effort to not harm the ecosystem. You can engage in more direct actions to reduce the effects of global warming. Things as simple as reducing your water waste, buying better light bulbs, eating less meat and throwing less food away, unplugging any electronics if they are not being used, and keeping your tires inflated can help stop global warming and reduce the effect of the wildfires in the future.

Human Rights in Appalachia: Socioeconomic and health disparities in Appalachia

The previous blog posts in this series are located here:
Human Rights in the Appalachian Region of the United States of America: an introduction
Human Rights in Appalachia: The Battle of Blair Mountain and Workers’ Rights as Human Rights

In the Appalachian region of the United States, there have long been overarching socioeconomic problems that have prevented the region from seeing the same levels of growth as other parts of the country, and even been part of its decline in other domains. Much of Appalachia’s population of twenty-five million people remains remote, isolated from urban growth centers and beneficial resources that exist in cities. The rural towns and counties in which many Appalachian people live have not had the ability to maintain the public infrastructure, furnish the business opportunities, or provide the medical services that are necessary to sustain populations.

There are three regions of Appalachia: the southern region, which covers parts of Georgia, Alabama, Mississippi, the Carolinas, and Tennessee; the central region, which covers parts of Kentucky, southern West Virginia, southern and southeastern Ohio, Virginia, and Tennessee; and the northern region, which includes parts of New York, Pennsylvania, northern West Virginia, Maryland, and northern and northeastern Ohio. While the entire Appalachian region struggles with higher levels of poverty, unemployment, and lack of services and infrastructure, some sub-regions suffer worse than others, and in different ways (Tickamyer & Duncan).

graph of people in poverty by age group
Percent of persons in poverty in rural Appalachia by age group: 2014-2018

Even when compared to other rural areas, Appalachia struggles on measures of educational attainment, household income, population growth, and labor force participation. Rates of disability and poverty are significantly higher in rural Appalachia than they are in other rural areas of America. In 2018, the number of Appalachian residents living below the poverty line was higher than the national average in every age group except those 65 and older. The largest disparity was among young adults (18-24), where the Appalachian population was more than 3% higher than elsewhere. From 2009 to 2018, median household income in Appalachia went up by 5%, not far behind the national average of 5.3%. However, the median household income in Appalachia remains more than $10,000 lower than the national median.

 

map of population age in appalachia
Map of population age in Appalachia

One area where disparities between Appalachia and elsewhere in the country are particularly noticeable is in healthcare. The Appalachian Regional Commission released in 2017 “Health Disparities in Appalachia”, which reviews forty-one population and public health indicators in a comprehensive overview of the health of the twenty-five million people living in Appalachia. The study found that Appalachia has higher mortality rates than the rest of the nation in seven of the nation’s leading causes of death: heart disease, cancer, COPD, injury, stroke, diabetes, and suicide. In addition, diseases of despair are much more prevalent in Appalachia than the rest of the country. Rates of drug overdose deaths are dramatically higher in the Appalachian region than the rest of the country, especially in the region’s more rural and economically distressed areas. Research indicates that diseases of despair will increase under COVID-19, as well. This will be especially true for women, who experience death from diseases of despair at a rate 45% higher than the national average in Appalachia. The ARC found that, while deaths as a result of diseases of despair were more numerous in metropolitan counties of Appalachia, rates of suicide and liver disease were higher in rural counties.

These issues are exacerbated by the fact that there is a much lower supply of health care professionals per capita, including primary care physicians, mental health providers, specialists, and dentists in Appalachia. The supply of speciality physicians is sixty-five percent lower in the central sub-region of Appalachia than the rest of the nation as a whole. Other factors negatively impact health in Appalachia, as well. Nearly twenty-five percent of adults in Appalachia are smokers, compared to just over sixteen percent of all American adults, and obesity and physical inactivity are extremely prevalent. However, it is worth noting that in some areas of public health interest, such as the occurrence of STIs/STDs and HIV, Appalachia does better than the rest of the country. 

Healthcare disparities are an increasingly dramatic phenomenon. From 1989-1995, the cancer mortality rate in Appalachia was only 1% higher than the rest of the US, but by 2008-2014, it had risen to be 10% higher. In the same time frames, the infant mortality rate was 4% higher versus 16% higher, respectively. And, in 1995, the household poverty rate in Appalachia was 0.6% higher than the national average, but by 2014 was 1.6% higher. We like to think of these problems as things of the past, but the gaps are still very much relevant. Fortunately, people living in Appalachian communities are more likely to have health insurance coverage than other Americans. 8.8% of the population in Appalachia do not have health insurance versus the national average of 9.4%.

This year, in the midst of the coronavirus pandemic, some factors of the Appalachian population have put people living there at greater risk of COVID-19. 18.4% of people living in Appalachia are over age sixty-five, which is more than two percent higher than the national average. In more than half of Appalachian counties, over 20% of people are older than 65. This, combined with high rates of obesity and smoking, put many people in the “high-risk” category. COVID-19 has affected Appalachian communities in ways that don’t result in death but make surviving even more difficult. Food insecurity, for instance, is an increasingly severe problem. At one soup kitchen, “…we were serving about 200 people a day, and our numbers have nearly tripled since COVID started,” social worker Brooke Parker, from Charleston, West Virginia, said.
However, perhaps due to the isolated nature of many Appalachian communities, mortality rates from COVID-19 have not been markedly higher than the national averages.

With schools moving to online learning, problems with access to internet in Appalachia become more relevant and pressing. Around 84% of Appalachian households have a computer, which is five percentage points below the national average. 75% have access to reliable internet, which is also five percent lower than average. There is no easy solution to this lack of access to education. Even in non-Appalachian counties, students are being severely impacted by the disruption to their normal education activities.

Human rights organizations ought to keep a close eye on Appalachia as we see the results of COVID-19 on an already vulnerable and at-risk population. The ultimate consequences of the pandemic will likely be more severe here than elsewhere in the country. People living in Appalachia deserve the same assistance being offered to and resources being put towards urban centers in other parts of America. Too often have they seemingly been forgotten.

Additional References:
1. “Health Disparities in Appalachia”. Marshall, J.,Thomas, L., Lane, N., Holmes, G., Arcury, T., Randolph, R., Silberman, P., Holding, W., Villamil, L., Thomas, S., Lane, M., Latus, J., Rodgers, J., and Ivey, K. August 23, 2017. https://www.arc.gov/wp-content/uploads/2020/06/Health_Disparities_in_Appalachia_August_2017.pdf. Retrieved December 3, 2020.
2. Population Reference Bureau. https://www.prb.org/appalachias-current-strengths-and-vulnerabilities/. Retrieved December 9, 2020.
3. Tickamyer, A., Duncan, C. (1990). Poverty and Opportunity Structure in Rural America. Annual Review of Sociology. 16:67-86.

Offender Alumni Association: Protecting and Empowering Previously Incarcerated People

by Mariana Orozco, UAB student

During the Fall 2019 Semester at UAB, Dena Dickerson, the program Director at the Offender Alumni Association, and one of her mentees visited Beth Shelburne’s honors seminar. During their visit, they shared testimonials with students, talked about an organization that they are part of, and closed the session with the man singing to the students. This was a a very emotional class, leaving many students with tears. Furthermore, many of these students were also moved to advocate for those who are in prison or who have been released. Dena, being the program director, has contacted students who have volunteered with the Offender Alumni Association (OAA) and spread the word about it on campus. A couple of students sold Pura Vida bracelets to their peers and were able to raise $150. 

Photo of Dena Dickerson and students in class
Dena Dickerson speaks to students at UAB. Source: the author.

Background

OAA is an organization that helps those who have been previously incarcerated. Since its founding date, in 2014, they have impacted over 500 former offenders and their family members. They have been officially named a 501(c)3 nonprofit and launched several support forums in some of Alabama’s and Georgia’s major prisons. The main goals of this organization are to reduce recidivism rates, develop healthy relationships within communities, and provide opportunities for social, economic, and civic empowerment for people coming out of prison.  

The Effect of OAA for People

Similarly to the commonly known Alcoholics Anonymous program, OAA offers peer to peer support to help those who are seeking encouragement and support once they are released from prison. An organization like OAA is significant in providing help to people who have been in the same situation as those seeking it. OAA allows a place of honesty without any judgement. Not only are formerly incarcerated people benefiting from this, but OAA is also a place for their families to get resources and network with others who understand their situation. Many times, the focus of the people affected by the prison system is only on those who are incarcerated. However, there are many cases where the most affected is the family. OAA provides a space for these conversations and relationships to occur. 

The Effect of OAA in the Community 

Mass incarceration is everybody’s issue. Tax payers have to pay and communities have to suffer. As 2020 has brought attention to many people, there are many problems within the prison system. Alabama prisons are overpopulated, understaffed, and underfunded. The 2019 Department of Justice report described Alabama Prisons for Men as unconstitutional because of the guards’ abuse of the people in prison. OAA’s goal is to help reduce the number of people in prison through reducing recidivism rates. Through education and mentorship, they work towards reducing recidivism rates.  Although this does not necessarily mean the environment inside prisons will suddenly be good, it would create more living space and reduce the number of people being negatively affected by the system. OAA bridges the gap between “them” and “us” to help bring everyone together and treat people as human beings. 

An image of two young boys getting haircuts in a barber shop
OAA takes students from “Heroes in the Hood” to get haircuts. Source: the author

Future Programs

In efforts to further decrease the number of people in prison, OAA is opening a Youth Program. “Heroes in the Hood” took off in the middle of this pandemic. Currently, there are eight students, ages 14 to 18, who are mentored about work ethic and community pride. Dr. Stacy Moak, a Social Work professor at  UAB endorsed this program, saying that-“mentoring programs have shown promise in improving the opportunities for these youths to see new possibilities, complete high school, become job ready, and become productive members of society.” This Youth Program hopes to help good students who have been in jail because they do not have resources to help them be successful. 

How You Can Help 

In order for the new Youth Program to be successful, OAA is working on raising money. This money will be used to provide the students with computers and other school supplies. There are also plans on having engaging events with the student’s mentors to build trust with each other. They are selling OAA colors Pura Vida bracelets for $6. Any other donations can be done through their website. You can also help by educating those around you, sharing this article, or volunteering with this organization. 

Photo of Pura Vida bracelets
Green, white, and yellow PuraVida bracelets for the Offender Alumni Association. Source: OAA

COVID-19 in ICE Detention Facilities

Children advocating for
Children ask for their parents’ safety while they are in ICE facilities during COVID-19. Source: Yahoo Images

On a visit to a private United States Immigration and Customs Enforcement (ICE) facility in Texas, a reporter met with Philip, an immigrant from the Democratic Republic of Congo, to speak about the conditions of ICE facilities amid the coronavirus pandemic. Philip recalled his experience, telling the reporter that ICE does not “pay attention to the rules,” and “agents do not wear masks and do not respect quarantine.” Furthermore, he shared that the agents claim “health isn’t ICE’s responsibility.”

How severe is the risk of COVID-19 in the ICE facilities?

After hearing about the first warnings of COVID-19, Chris Beyrer, MD, Desmond M. Tutu Professor of Public Health and Human Rights, highlighted the potential for catastrophic outbreaks of the virus in America’s jails, prisons, and immigration detention centers. His background in epidemiology and research on infectious diseases in prisons gave him the credibility he needed to make such a grave claim. Additionally, in Wutan, China, where one of the first big outbreaks of COVID-19 was, prisons and jails had all the red flags that worsened the spread of COVID – indoor facilities, crowded populations, and hygiene challenges. This was more alarming to Breyer since he was aware of America’s densely populated facilities and their lack of preparedness in handling a pandemic.

Breyer was approached by a group of lawyers working with five older Latina women in the El Paso ICE facility; the women, in addition to their age, had at least one preexisting condition, such as diabetes and hypertension, putting them at a greater risk of becoming severally ill if they were to contract COVID. The lawyers sent Breyer detailed plans of the facility and housing arrangements, and Breyer’s team concluded that ICE could not protect the five women; they would be at high risk if they were exposed. The case reached a federal court where the judge ordered the release of all five women, who fortunately had family in the U.S., so they could go home. The judge’s ruling cited the irrefutable scientific evidence and explicitly said that ICE had failed to prove that they could protect the women from exposure. This precedent itself sets the standard for any other case that emerges during COVID in relation to ICE and the safety of a detention facility amid a pandemic.

Police in ICE facilities ignore COVID-19 guidelines. Source: Yahoo Images.

What else has ICE been doing amid a pandemic?

The sad part is that this unsanitary environment was present prior to the pandemic. In a 2019 inspection of ICE facilities by the Department of Homeland Security (DHS), the report says the DHS found “egregious violations”: moldy bathrooms, food safety issues, lack of hygiene items, and inadequate medical care. If these problems existed pre-pandemic, there is no guarantee that ICE has improved their filthy detentions’ environments. Though the ICE website has posted that it is abiding by CDC guidelines, there is no solid proof of such changes. Instead, ICE’s ongoing deportation flights have not ceased. Since January, over 450 deportation flights to fifteen countries in Latin America and the Caribbean have taken place. Eleven of these fifteen countries have confirmed that deportees returned with COVID-19. Since March, ICE has arranged 180 flights from detention centers in hotspot states – Texas, Arizona, California, and Florida – to the Northern Triangle and Mexico. Cases across the region in March jumped from few to thousands, which has been worsened by the deportations of COVID-positive immigrants.

A Call to Action

Amy Zeidan, an assistant professor of Emergency Medicine at Emory University, called for ICE to comply with mandatory CDC guidelines and release as many people as possible from immigrant detention. It has also been suggested to do three things in the meantime to fix the underlying structural issues that have worsened the spread of COVID in detention facilities: “increase COVID-19 screening and mass testing; improve access to medical care outside of ICE facilities for COVID-19 positive detainees; [and] implement systematic investigation into ICE facilities in violation of other guidelines.”

Homeland security is something that everyone cares about. But if America needs to cage immigrants in unsanitary, filthy conditions where they are at a greater risk of dying, then the DHS and ICE need to rethink their stance and their treatment of people who have immigrated to the United States. This pandemic affects everyone, but it can be mitigated with the correct precautions. People like Philip who witness such malnourishment within ICE facilities do not deserve to be treated with such cruelty.

people
One perspective into an ICE detention facility. Source: Yahoo Images.

Let’s #BreakTheChains

Break the Chains
Source: Human Rights Watch.

“I used to be chained around the waist and one ankle. My waist used to hurt because the chain was so heavy. My leg used to hurt, I would scratch it and cry. I felt relieved when the chain was removed.”

–Rose, Kenya

An estimated 792 million people globally – that is 1 in 10 people, including 1 in 5 children – have a mental health condition. Despite this irrefutable fact, governments spend less than two percent of their health budgets on mental health. The absence of proper mental health support and knowledge of how to cope with a mental health condition has lead to thousands of people being shackled in inhumane conditions.

“People in the neighborhood say that I’m mad [maluca or n’lhanyi]. I was taken to a traditional healing center where they cut my wrists to introduce medicine and another one where a witch doctor made me take baths with chicken blood.”
—Fiera, 42, woman with a psychosocial disability, Maputo, Mozambique, November 2019

This brutal practice is an open secret in many communities, according to Kriti Sharma, the senior disability rights researcher at the Human Rights Watch. Sharma and her team compiled a 56-page report titled “Living in Chains: Shackling People with Psychological Disabilities Worldwide,” shedding light on the conditions in which people with mental disabilities are bound by families in their own homes or in overcrowded and unsanitary institutions against their will. This is due to the widespread stigma and taboo of mental health issues within governments and health institutions in several countries. In state-run, private, traditional, and religious institutional “healing centers,” people with mental health conditions are often forced to fast, take medications or herbal concoctions, and face physical and sexual violence.

Afghan
“A mentally ill patient is chained in a cell at Mia Ali Saeb Shrine in Samar Khel, Afghanistan on Nov 12, 2008. Patients, usually brought here by family members, are only given daily rations of bread, black pepper and water, and are kept in their cells for 40 days. With mental illness widely misunderstood, many Afghans believe God will cure the patients with such treatment.” Source: Yahoo Images.

The Human Rights Watch’s study of 110 countries unveiled evidence of shackling people with mental health conditions across age groups, ethnicities, religions, socioeconomic levels, and urban and rural areas in about 60 countries. Countries that indulge in these types of practices include Afghanistan, Burkina Faso, Cambodia, China, Ghana, Indonesia, Kenya, Liberia, Mexico, Mozambique, Nigeria, Palestine, Yemen, and several more.

Though a number of countries have started to acknowledge mental health as a real problem, the inhumane act of shackling remains largely out of sight. There is no data or coordinated effort at either international or regional level to eradicate the binding of people who are mentally ill. The act of shackling impacts both the mental and physical health of someone who is already ill. Some effects include post-traumatic stress, malnutrition, infections, nerve damage, and cardiovascular problems, not to mention the loss of dignity. The #BreakTheChains Movement is an organization devoted to bringing awareness of shackling to nations and increasing access and awareness of mental health services in countries where shackling is a common problem. The movement has been successful in Indonesia where its country-wide interviews and advocacy led the government of Indonesia to deepen its commitment to #BreakTheChains. Over 48 million households in Indonesia now have access to community-based mental health services.

Laymen can also assist the movement by following two easy steps: sign the pledge, and share the movement on social media to promote awareness. It is time to acknowledge that mental health is a real issue that affects millions of people, and shackling and ignoring the issue will not resolve any issues, nor will it reduce the stigma associated with mental health. If we, as global citizens, have learned anything from this pandemic, it is how deathly and dangerous the invisibility of a disease is. Mental health is invisible like COVID-19, but there are always symptoms. Make an effort to educate yourself, and take the opportunity to check in on people by simply asking how someone has been. It really is that simple.

Brief Video about the Chained