The First Step Act: A Step Towards Criminal Justice Reform

A slightly open jail cell door.
Untitled. Source: Neil Conway, Creative Commons

On December 21 of 2018, Donald Trump signed the First Step Act into law.  This piece of legislation has been marked by some as a massive breakthrough in criminal justice reform.  The bill is intended to “ensure people are prepared to come home from prison job-ready and have major incentives to pursue the life-changing classes that will help them succeed on the outside and includes changes that will potentially lower the cost of upkeep for correctional facilities. 

Improving Experiences of Time in Prison and Their Outcomes 

Many of the aspects of the First Step Act are geared towards decreasing recidivism (people returning to criminal behavior after being released from prison) through opportunities and resources that help prepare people for their lives after incarceration.  For example, the bill creates strong incentives to encourage prisoners to participate in preparative programs that are available to them.  For every 30 days of “successful participation,” individuals can receive 10 days of prerelease custody, where they are transferred to halfway houses or home confinement.  Incentives can also include increased phone and visitation privileges, access to email, increased commissary spending, and other requested incentives. 

The bill also designates $250 million to be used over five years by the Federal Bureau of Prisons (BOP) to expand and develop skill-building classes and vocational training opportunities.  It also allows the BOP to work with outside organizations that can provide such classes.  According to the First Step Act, prisoners who are at a medium or high risk of recidivism are to be prioritized for receiving these opportunities, as well as counseling and treatment.  Before leaving federal prison, all are to receive their ID, allowing people to re-enter society more quickly and avoid “collateral consequences of incarceration.” 

In order to make it less difficult for families to visit, the bill states that people should not be placed in prisons that are more than “500 driving miles” away from their families.  This improves their ability to maintain ties with their relatives, which can improve their quality of life while incarcerated and make the process of reintegration into society easier afterwards. With the help of a strong support system and the tools needed to find work, released prisoners have a better chance of finding their place in their communities and not being reincarcerated later. 

Decreasing the Population Actually in Prison 

There are some aspects of the First Step Act that help to decrease the population of people in prison.  Increases the number of days of good time credit, which is earned through good behavior, from 47 to 54 days per year.  This change also applies to everyone in federal prisons who has already earned good time credit.  It is estimated that this change will save $40 million in the first year.  Additionally, the bill required the BOP to transfer prisoners that are considered low/minimum risk to prerelease custody and expanded compassion release.  Eligibility for the elderly offender program of compassion release now starts at age 60 instead of 65, the minimum portion of one’s sentence that must be served has been decreased from 75% to 66.7%, and the program is now available in all prisons. 

Views of the Purpose of Prison 

One’s understanding of the importance of legislation like the First Step Act can be significantly impacted by their perspective on the purposes of prisons.  Some people believe that prisons should be used to achieve retributive justice, where the main purpose is to punish criminals for their wrong-doings and to have them suffer for their action.  For someone who believes in retributive justice, the changes made by the First Step Act may not seem so important.   

Alternatively, other people believe that the incarceration system should be used to rehabilitate prisoners and prepare them to re-enter society as individuals who can make more positive contributions to their community and avoid taking actions that would lead them back to imprisonment.  When you look at the First Step Act from this point of view, it is easy to see why the bill’s intended impacts are so significant.  It gives people a chance to learn from their mistakes and helps them become more productive members of society. 

Three prison windows.
p1000578.jpg. Source: David Johnson, Creative Commons

Why It Matters 

As of 2016, there were 2.2 million people incarcerated in the United States.  That year, $57.7 billion were spent in state expenses for the upkeep of correctional facilities.   

According to the American Civil Liberties Union (ACLU), “Chronic illnesses go untreated, emergencies are ignored, and patients with serious mental illness fail to receive necessary care,” which, in some cases, has led to the deaths of incarcerated individuals.  This violates Article 25 of the United Nations’ Universal Declaration of Human Rights (UDHR), which states that everyone has the right to a living standard that is sufficient to support their health and well-being and specifically includes things like medical care and vital social services.  Prison authorities are legally responsible for providing prisoners with their medical needs, based on the Supreme Court’s ruling in the case of Estelle v. Gamble.  The ruling recognizes the potential of ignoring these needs to “amount to cruel and unusual punishment” due to the pain and suffering they can cause.  However, overcrowding in prisons and a lack in resources makes giving prisoners the care they need a challenge. 

The intended outcomes of the First Step Act can improve the access to human rights of people who have been incarcerated.  As it is said in the UN’s Basic Principles for the Treatment of Prisoners, prisoners are entitled to all the rights that are declared in the UDHR and other human rights documents and should have access to resources that can aid their ability to successfully rejoin society.  Decreasing rates of recidivism, as the actions of the First Step Act hopefully will, helps to lower the number of people in prison overall.  This allows for a change in the allocation of funds to take better care of people living in prisons, giving them greater access to their human rights.  People living in prisons are human beings just like everyone else and should not be treated as anything less. 

Climate Change and Refugees

Climate Change Refugees. Source: Flickr, Creative Commons

Climate Refugees

The ongoing debate about climate change never seems to become resolved because there are certain people who believe in it and others who refuse to believe it. However, both sides often forget about climate refugees, a fairly new term that has no formal definition or protection under international law. As of 2008, millions of people lose their homes to weather disasters. Other aspects such as desert expansion and sea levels rising also affect people in terms of where and how they live. Scientists say the three most endangered regions are sub-Saharan Africa, South Asia, and Latin America while a World Bank report estimates that by 2050, those three endangered regions will consist of 143 million people who are displaced.

Climate Change and its effects

According to scientists, climate refugees consist of “people who must leave their homes and communities because of the effects of climate change and global warming.” Climate change pertains to the change of a climate in a region, while global warming is how the average temperature of the Earth is rising. As a result, global warming is leading to climate change. Rising temperatures due to global warming can cause glaciers to melt which can lead to flooding and the rising of sea levels. Furthermore, it can lead to droughts and desertification. These results of global warming can make the land people live on uninhabitable and make it difficult for people to survive.

In Bangladesh, thousands of people are affected by flooding each year, especially in Dhaka. In West Africa, Lake Chad is almost completely gone due to desertification. These problems are not just limited to the developing world. In the United States, approximately 2,300 Puerto Rican families who were displaced due to Hurricane Maria are looking for permanent housing. Additionally, small coastal communities in areas like Alaska and Louisiana are fading into oblivion due to rising sea levels.

In regard to droughts and desertification, individuals are not able to grow crops where they live. Thus, with no food, they are forced to move elsewhere. In China, the Gobi Desert is expanding more than 1,390 square miles every year. Farmers and merchants who live near the Gobi Desert migrate to more urban areas because the grasslands are turning into deserts. Droughts and desertification are a global problem. Also, in Morocco, Tunisia, and Libya more than 386 square miles of productive land are lost to desertification.

Desertification. Source: Wikimedia, Creative Commons

 

Climate Change and its ambiguity

In Europe, a journal estimated that if global temperature trends continue, applications for asylum to the European Union would increase by 28% by the year 2100. Additionally, many climate refugees live in rural or coastal communities and are forced to migrate to urban areas. Their skills, such as farming, are not beneficial in urban areas. Thus, finding a job can be difficult. Climate refugees who leave their country can face struggles when adjusting to new laws, languages, or cultures.

According to the development expert at the Center for Strategic and International Studies, Yayboke, the biggest problem that arises is there are millions of people who are considered a climate refugee, but there is no consensus as to what we can do about them. There are currently no international laws that protect climate refugees and they can be sent back to their homelands or forced into refugee camps. The reason that the term climate change is ambiguous is due to “the effectiveness of rights and legal certainty”. Since it is not covered by the law, there are no guaranteed international protections. Another source of ambiguity arises when you need to determine why those individuals were displaced. Was it actually due to climate change or was it because of another reason? For example, say there is a drought and a farmer moves to another area in order to find other work. Did the farmer move due to climate change or because the economy has no alternatives for employment? The term “climate refugee” tends to be associated with a variety of factors and not simply just climate change. Thus, an absolute definition is hard to define.

In 2016, the UN General assembly introduced the New York Declaration for Refugees and Migrants. In this declaration, it discussed the development of two global compacts: In 2018, climate refugees became recognized in the Global Compact on Safe, Orderly, and Regular Migration. The purpose of this compact is to protect the rights of those who displaced and to determine the economic, environmental, and social factors that individuals who are forced to leave their homes face. Unfortunately, the compact does not focus on trying to control the man-made forces behind global mass migration.

Another major problem is how climate refugees are not covered by the 1951 Convention in regard to the Global Compact of Refugees. Their definition of refugees has nothing to do with individuals who are displaced due to environmental factors. Thus, the term ‘climate refugee’ does not fall under the score of the 1951 Refugee Convention and their protocol. Therefore, individuals who are displaced cannot be classified as refugees and cannot appeal for resettlement and are “trapped in worsening environmental conditions”. However, a counterargument is that those who are displaced due to the environment could rely on the protection of their national government, whereas the traditional refugee cannot rely on the national government because they tend to be the source of persecution.

Hope for the future

In 2009, the EU decided to place a greater focus on climate change as a cause of migratory flows, in terms of security. From 2011-2013, a strategy paper was created for a European Commission project whose goal included working with developing countries in regard to migration and asylum. Additionally, the paper states focusing on climate change and migration. In 2013, the Commission published a paper on internal displacement. In 2015, Jean-Claude Juncker, the European Commission President stated “Climate change is one of the root causes of a new migration phenomenon. Climate refugees will become a new challenge – if we do not act swiftly”. However, EU Member States still have not created a category for climate refugees.

Climate refugees is a vague term that is hard to define. However, the economic, social, and political consequences are apparent and need to be addressed. Based on the global compact on migration and the international climate, one of the most salient ways to address this burgeoning human rights issue is for there to be numerous regional agreements that influence the creation of international law for climate refugees.

Addressing Menstruation and Birth Control, Improving Women’s Lives

by Pam Zuber

Nyaya Health: A chant and a dance on the practice of Chhaupadi by the CHWLs and FCHVs
Nyaya Health: A chant and a dance on the practice of Chhaupadi by the CHWLs and FCHVs. Source: Possible: Creative Commons.

Menstruation and birth control.

Discussing these topics sometimes makes people uncomfortable. Why? Society sometimes says that we’re not supposed to talk about what happens down there, that they’re just not proper topics for everyday conversation. Could this discomfort be due to the fact that men have often traditionally served as political leaders, media gatekeepers, and educational instructors? Women’s power, voices, and advancement opportunities have been limited. So have their concerns, even if they’re everyday issues that women have faced since the dawn of time.

Such concerns are extremely important to the survival of our species. Menstruation and birth control are crucial parts of life. Without menstruation and everything that accompanies it, we wouldn’t be here. Depending if people have access to it, birth control is also a factor that can greatly improve or hinder a woman’s quality of life. But, these topics are often taboo. People don’t want to talk about them. People often can’t talk about them or do anything about them. Or, if people talk or act on these topics, they may face stigmas and punishments. Living normally during menstruation and controlling one’s reproductive destiny should be vital human rights everywhere. They’re often not, which has created inconveniences, obstacles, and even tragedy. Luckily, individuals and groups are shedding light on menstruation and birth control and how they impact women and the greater culture.

Menstruation discrimination

Although banned by law, menstruation huts are still a reality in some rural areas of Nepal. They’re part of traditions stating that menstruating women or women who have just given birth are impure or the bearers of bad luck. These beliefs have led people to banish menstruating women to live in huts or cattle sheds, prevent them from touching farm animals, and forbid them from eating certain foods.

Known as chhaupadi, this practice of separating women from the general population puts women at risk. Many of the huts lack heat or bathroom facilities or are far removed from the rest of society. In 2019, a woman and her two children died after they inhaled smoke from a fire inside of this type of hut. A teenager died in 2017 from a snakebite she received while staying in a hut. People who live in such huts may have to travel miles to use toilets, wash, and gather supplies. They cannot attend school and their employment opportunities may be limited.

Under chhaupadi, disadvantaged women face even more obstacles that prevent them from overcoming their disadvantages and improving their lives. They do not have the full measure of human rights that males enjoy, simply because they are menstruating. Similar fears about female impurity have long banned women of menstruating age from the Hindu Sabarimala temple complex in India. As part of a number of protests, two women defied this ban and entered the temple in 2019. Their actions sparked further protests for and against women’s rights in the region and ignited international debate.

Positive period news

In a positive period-related development, access to feminine hygiene products is increasing for many. The states of Illinois, California, and New York provide free sanitary products for their public school students. Educational institutions such as the University of Washington also offer such products and other schools are considering it. These efforts are global. The government of Scotland provides free sanitary products to students who attend schools, colleges, and universities as well as to people who visit leisure centers and libraries. Several states in the United States have also removed the sales tax for such products (the tampon tax) or are considering doing so.

Period. End of Sentence is an Academy Award-winning short documentary that also testifies to the power of proper period care. Directed by Rayka Zehtabchi and produced by Melissa Berton, the film depicts efforts in India to provide sanitary products, end stigma about menstruation, and improve the lives of women and girls. “I can’t believe a film about menstruation just won an Oscar!” said Zehtabchi. The filmmakers acknowledged that Indian initiatives can help girls pursue schooling. “A period should end a sentence, not a girl’s education,” said Berton. Girls in India missed school 20 percent of the time because of menstruation, according to a report by the United States Agency for International Development (USAID). Females who lack sanitary products might use hay, old fabric, rags, or other products during menstruation, which can lead to unsanitary conditions and infections. It could make menstruation more visible and thus subject to scrutiny and stigma, eroding girls’ self-esteem and confidence in their abilities.

Others question whether menstruation really causes girls to leave school but acknowledge that taboos surrounding menstruation do indeed exist. Supporting girls and women is vital. “Providing girls with a product can only get you so far if you don’t have the enabling environment in the school, supportive teachers, and information about what’s happening to your body,” said Columbia University professor Marni Sommer on a National Public Radio interview. Proper period care “is a human right,” noted Sommer. “We shouldn’t have to justify that girls are deserving of an environment where they can just meet their basic bodily needs.”

Destigmatizing menstruation and providing access to menstruation products may create more equality. If women and girls face discrimination and lack essential hygiene products, they may stay home from work, school, civic engagements, and social events. They cannot fully participate in their lives and the lives of others. People who lack sanitary products live lives similar to women who live under the practice of chhaupadi. Just because they menstruate, women and girls affected by both cannot fully engage with the outside world. People are working to highlight and change this.

the movie poster for Period. End of Sentence.
Source: Creative Commons

The cost of unintended pregnancies

Access to birth control is also an important driver of human rights. Like sanitary products, effective and accessible birth control products provide physical and mental health benefits. Both can be valuable tools for improving and sustaining human rights. Physically, birth control helps women prevent pregnancies. This sounds obvious, but it means so much. Pregnancy and labor take tremendous physical tolls on women. Even after childbirth, breastfeeding mothers’ bodies are not entirely their own, and mothers face the physical and mental strain of raising children and running households.

Mental strain can be considerable for mothers. They are charged with taking care of themselves and their children and completing other tasks, such as working various jobs, helping their families, and fulfilling other responsibilities, not to mention trying to find time to pursue various interests. It can be difficult enough to do those things when they’re deliberate choices when women plan the size of their families. Not having access to birth control makes this precarious juggling act even more difficult. Becoming pregnant unintentionally may impact women’s health since they’re gaining weight, dealing with hormone fluctuations, and experiencing other intense physical changes related to pregnancy. Mentally, they may be facing the stress, anxiety, and depression of unwanted pregnancies and the profound life changes they may create.

Unintentional pregnancies can also burden women and their families financially. Women may take unpaid maternity leaves, turn down promotions or specific positions, or quit their jobs to raise children. They may have to allocate a considerable part of their incomes to pay for childcare. Mothers who re-enter the workplace may not earn the same incomes, have access to the same opportunities, or achieve the same advancements as colleagues who never left the paid workforce. Health and financial issues, unintended pregnancies, and other types of stress can strain women’s relationships with their partners. It could cause women to feel unfulfilled with their lives and feel that they’re not doing all that they want to do because they must fulfill the various responsibilities in their lives.

The worth of birth control

Birth control may shift this balance, helping women do what they want to do instead of what they feel they must do. Access to birth control gives women agency. There are mixed messages about this agency. Just as some higher education institutions are providing sanitary products, some are providing birth control access to their students. Arguably, they’re not providing full access. For example, institutions such as the University of Oregon operate health centers that employ pharmacists who prescribe birth control pills and other forms of contraception. They do so without appointments and charge $15.00 per visit. Not requiring appointments may make it easier for students to visit in spite of busy schedules. Charging $15.00 might make it easier for students for affording such visits. On the other hand, the university isn’t paying for birth control itself. Students must use health insurance or pay out-of-pocket to cover the costs of birth control. This means that people may go without much-needed birth control because they can’t afford it. They may not be able to pay for the $15.00 pharmacist visitation fee or other costs as well.

Sanitary napkins, tampons, birth control pills, and other forms of contraception often aren’t expensive, but the lack of them are. Women who don’t have them may face much more expensive financial, emotional, and physical costs in the future. Providing assistance and access to such items can change an individual woman’s life and transform society as a whole.

About the author: Pamela Zuber is a writer and editor who has written about human rights, health and wellness, business, and gender.

International Women’s Day: Continuing the Fight while Celebrating the Victories

a picture of Peruvian women in front of a mountain range
Peru. Women in the Colca valley. Source: Pedro Szekely, Creative Commons

Today is International Women’s Day. This year’s theme is “Think Equal, Build Smart, Innovate for Change.” In her context statement about the theme, UN Women Executive Director Phumzile Mlambo-Ngcuka states that the changing world continues to shape the lives of people and “we have to be intentional about its use to positively impact the lives of women and girls. [The theme] puts innovation at the centre of efforts to reflect the needs and viewpoints of women and girls and to resolve barriers to public services and opportunities.” Innovation highlights the game-changers and activists willing to “accelerate progress for gender equality, encourage investment in gender-responsive social systems, and build services and infrastructure that meet the needs of women and girls.” The goal of today is to celebrate the incredible achievements of women and girls who seek to overcome their marginalized status in their communities, level the representation across various academic disciplines and professional fields and undo the cycles of intersectional injustices to bring about a more equitable world.

History

What started as a response to a women’s labor strike in New York 1909 became an international movement to honor the rights of women and to garner support for universal women’s suffrage. In 1913-14, International Women’s Day was a tactic to protest World War I as a part of the peace movement. The UN adopted 8 March as the official date in 1975 during the International Year of Women. Gender equality and the empowerment of all women and girls is Sustainable Development Goal #5 in 2015.

Celebrating some game-changers and activists

The list below is not extensive. Its purpose is to assist you in your search to discover and know what women are doing and have done around the world.

Kiara Nirghin: Won Google Science Fair for creating an orange and avocado peel mixture to fight against drought conditions around the world. She will join Secretary-General António Guterres.

Elizabeth Hausler: Founder of BuildChange.org, an organization that trains builders, homeowners, and governments to build disaster-resistant homes in nations often affected by earthquakes and typhoons.

Jaha Dujureh: Founder of SafeHandsforGirls.org, an organization fighting to end child marriage and female genital mutilation (FGM).

BlackGirlsCode.com: A San Francisco based organization seeking to increase the number of girls from marginalized communities in STEM fields by 2040.

Shakhodat Teshebayeva: When the water crisis threatened her livelihood, she organized and mobilized a women’s group to advocate for a place for women at the discussion table regarding equal access to water.

Mila Rodriguez: Cultivates safe spaces for young people to use music to promote peace in Colombia.

Wangari Maathai: late Nobel Peace Prize Laureate from Kenya who initiated the GreenBeltMovement.org by planting trees for the cultivation of sustainable development and peace.

Next Einstein Forum: Continental STEM forum in Africa

Una Mulale: the only pediatric critical care doctor in Botswana who works to combine medicine and art to bring healing to the body and the soul.

The Ladypad Project

This coming week, Dr. Tina Kempin Reuter and Dr. Stacy Moak will take 12 UAB students to the Maasai Mara in Kenya. The team, in collaboration with the I See Maasai Development Initiative, will fund education on women’s health rights and provide 1500 girls with materials, including underwear and reusable pads, for menstrual hygiene management. The project was awarded a grant through Birmingham’s Independent Presbyterian Church Foundation.

Continuing the Fight

International Women’s Day is not only about celebrating the accomplishments of women and girls, but it is also about shining a light on the continuing injustices faced by more than half of the world’s population. From femicide and early marriage to FGM and sexual violence and exclusion from peace talks, gender inequity discounts the contribution of women and girls to the overall value of humanity. Kofi Annan, the late UN Secretary-General, posited that the empowerment of women proves more effective than any other tool for development. Noeleen Heyzer concludes that although there are women’s issues and rights still to be raised and respected, including those outlined in the Convention on the Elimination of All Forms of Discrimination Against Women, there are many that we must continue to protect. March is Women’s History Month and our contributors will write about issues that continue to impact the lives of women and girls around the world.

 

Health Care Is a Human Right

by Pam Zuber

a photo that reads "Save the ACA."
“Save the ACA”. Source: Creative Commons.

Being sick or struggling with a chronic medical condition can harm health, emotions, and finances. Sickness can hurt various aspects of a person’s life and impact society as well. It causes people to miss days of work. It creates financial costs if people have to cover medical expenses for uninsured people. Isn’t it better to help treat and prevent illness in the first place? One would think so, although some people don’t believe that health care is a fundamental right. But, restoring and maintaining health improves the quality of life and so much more. Ensuring proper health care can produce a healthier, happier, and more productive society.

What are some federal government attitudes about health care?

Attitudes about health care are different in different areas. There are many diverse opinions and proposed solutions regarding health care in just the United States alone. The Patient Protection and Affordable Care Act (also known as the Affordable Care Act, the ACA, and Obamacare) represents a microcosm of this diversity. Although it became law in 2010, the Affordable Care Act has garnered considerable controversy before its creation and continues to generate controversy after its passage. Much of this controversy has coalesced around party affiliations. Some members of the Republican Party have decried the ACA a form of socialism because it’s a federal government program that works with state government programs. In this view, the ACA is un-American because other countries sponsor their own state-funded health care programs.

While not a socialist state, Canada is one such country. According to a Canadian federal government website, “Canada’s publicly funded health care system is best described as an interlocking set of ten provincial and three territorial health systems. Known to Canadians as ‘medicare,’ the system provides access to a broad range of health services.” Canada’s federal government funds, administers and sets policies for this system under legislation known as the Canada Health Act (CHA). The goal of the CHA is “to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers,” according to the Government of Canada. The CHA thus features complex interactions between federal and provincial governments and the Canadian health care system. This is reminiscent of how the U.S. federal government administers and funds government programs in U.S. states as part of the Affordable Care Act.

How is New York approaching health care?

Federal governments aren’t the only government bodies that feel strongly about health care. In January 2019, the administration of New York, New York mayor Bill de Blasio announced that the city would offer health care for uninsured residents. City residents would pay for health services on a sliding scale. Known as NYC Care, the initiative would provide mental health care and substance abuse care. “We recognized that obviously health care is not just in theory a right,” de Blasio said. “We have to make it in practice a right.” “Health care is a right, not a privilege reserved for those who can afford it,” stated the mayor. “While the federal government works to gut health care for millions of Americans, New York City is leading the way by guaranteeing that every New Yorker has access to quality, comprehensive access to care, regardless of immigration status or their ability to pay.”

Stories about the de Blasio proposal highlighted that this health care would be available to all New Yorkers, even undocumented immigrants. This proposal occurred at a time when immigration was a hotly contested topic. In fact, immigration was so contested that the topic helped spark a partial shutdown of the U.S. federal government in December 2018 and January 2019 because of debate over funding for a wall between the United States and Mexico to prevent illegal immigration. The de Blasio administration’s decision to fund health care for undocumented immigrants reflected the view that health care should be universally accessible to all, regardless of financial cost or political repercussions. In this view, health care is a human right and the right thing to do.

Why is healthcare a right?

Health care is a human right in part because health – or more accurately, bad health – can permeate every area of a person’s life. It can even have repercussions far beyond a single individual. Say a person is struggling with depression. Depression is a mental illness. It’s also physical one since depression can cause pain, other physical symptoms, or conditions such as substance abuse. (Pain and other conditions can cause depression as well, which underscores the importance of treating mental and physical illnesses so they don’t influence each other.) Depression is more than mental and physical pain. It can wreak havoc on other areas of people’s lives. For example, conditions such as depression may prevent people from going to work. If people take frequent absences, their coworkers may have to perform work extra work to compensate for their absent coworkers. Or, taking frequent absences could lead depressed people to lose their jobs. Losing their livelihoods means people may have trouble paying for food and shelter. People without jobs may not be able to support their families. People who are depressed may lack the physical and mental energy to attend parent-teacher organization meetings, to vote, to run for office, to manage their lives, or to contribute to the lives of others. They can’t fully exercise their human rights because they’re struggling to meet their basic needs. Basic access to mental health care could prevent these struggles and ensure basic rights.

What is the status of current health care initiatives?

It’s clear that spending a little money early may prevent future health problems (and possibly save money) in the long run. But, it appears that some entities don’t want to spend money on such purposes. Others have reluctantly, grudgingly accepted health care initiatives. In 2017, the U.S. Congress passed the American Health Care Act (AHCA). This legislation would have prevented Medicare expansion and other aspects of Medicare funding and would have reduced taxes for some insurers and higher income people. The legislation never took effect, so the ACA remained intact. Commentators have noted that despite efforts to reverse the Affordable Care Act, the ACA is “gaining in popularity – despite the repeal-and-replace rhetoric Trump and fellow Republicans have voiced for years.” The commentators note that politicians realize this and are using the increasing acceptance of the program to bolster their own political fortunes. They recognize that gutting a popular program could hurt their own popularity. The administration of U.S. president Donald Trump issued rules regarding the implementation of health care programs in U.S. states in 2018, for example. This acknowledged that the programs exist, serve many people, and are well-liked and well-used by voters who could determine the political future of the administration and its members. The administration’s rules vividly illustrated the old adage, “If you can’t beat ‘em, join ‘em.”

What is the future of health care?

The future of universal health care is uncertain. On one hand, the Affordable Care Act continues. Conservative administrations and everyday voters have acknowledged the ACA and support it to various degrees. There is still considerable pushback to the ACA and similar initiatives, however. Not surprisingly, some of this pushback is from entities that could be affected by universal health care plans or other health care reforms. Private insurance companies often oppose universal health care reforms because they could affect their profits. The companies and other free-market supporters say that universal health care and other reforms are a direct rebuke to capitalism and the practice of small government. The Partnership for America’s Health Care Future is one such opponent. This organization includes a number of private insurance companies and health-related entities. Interestingly, though, it also includes a number of politicians from the Democratic Party and people affiliated with the party, such as workers from the presidential administrations of Bill Clinton and Barack Obama.

On the other hand, this organization is operating at a time when other Democrats are criticizing their fellow party members for not being progressive enough. A number of Democratic candidates running for the U.S. Congress in 2018 supported a single-payer health care system known popularly as Medicare for All to replace private health insurance. A Reuters poll in that same year reported that growing numbers of voters affiliated with both the Democratic and Republican parties also favored Medicare for All-type policies. A growing number of people and some politicians support universal health care. Other politicians and private corporations don’t. Given the increasingly divided political climate, it’s uncertain whether we’ll reach workable decisions about health care any time soon. But, given the far-reaching impact that good health can provide, aren’t they worth a try?

 

Pamela Zuber is a writer and an editor who has written about human rights, health and wellness, business, and gender.

 

Health & the Black Body

A black woman expresses surprise
Pop Art Explanation Explain by JanBaby, Creative Commons

Introduction

The field of medical anthropology is charged with exploring how cultures determine health outcomes and how health determines culture within a given population.  Culture is here defined here as the continuous process by which humans create and communicate shared values, customs, and knowledge within a society; health is here defined as the state and process by which an individual promotes well-being and quality of life.  Medical anthropology is especially interested in marginalized populations, exploring how these groups both suffer from health disparities and overcome these disparities through culturally-particular sources of resilience and strength.  At the core of medical anthropology’s exploration is the concept of our three ‘bodies’: (1) our physical body, i.e. the body of lived experiences; (2) our social body, i.e. how culture symbolizes and represents our personhood; and finally (3) our body politic, i.e. how our bodies are regulated, surveilled, and controlled over our lifetime (Scheper-Hughes & Lock, 1987). Individuals suffering from any form of violence (direct, indirect, and / or structural) typically suffer worse health outcomes, unless other protective factors (e.g. resilience, medical intervention) can transform this violence.

Of particular importance within the American ‘health culture’ is that of black bodies – how Americans of African descent suffer from higher rates of diseases, illnesses, and sicknesses than their counterparts from European descent.  This health-based intersection of nationality, ethnicity, and violence is not only a concern of medical anthropologists – many other academic disciplines are working hard to predict, control, and prevent health disparities within Americans of African descent.  For example, I currently manage a health and clinical psychology laboratory at UAB under the direction of UAB Psychology professor Dr. Bulent Turan.  Our lab explores the biopsychosocial burden of stigma on health outcomes in African American populations.  The question of how culture enacts stress, trauma, and negative health outcomes in minority populations, and how to prevent this from happening in the future, is a huge task – first undertaken by medical anthropology, now including diverse fields such as health psychology, public health, neuroscience, peace and conflict studies, and medical sociology.  In honor of Black History Month, this blog post explores how cultural prejudice and hate quietly kills Americans of African descent.

The Allostatic Model of Stress
The Allostatic Model of Stress, Author’s Collection

Allostasis and Structural Violence

One of the most prominent and empirically-validated theories to explore the relation between culture and health is that of allostasis, first proposed by Drs. Peter Sterling (a neuro-biologist) and Joseph Eyer (an epidemiologist) in 1988.  These scientists and their research team sought to explain how stressful life events impact an individual’s health, first drawing on Walter B. Cannon’s famous dictum of homeostasis– the idea that our bodies attempt to ‘correct’ itself in response a changing environment. Homeostasis explains why, when you step outside on a cold day, that your body begins to sweat to cool you down. However, Sterling and Eyer ran into an obstacle with homeostasis.  Individuals react widely differently to physiological stress, and Cannon was unable to explain why this might be the case.  Sterling and Eyer proposed that stress over the lifetime creates ‘wear and tear’ within our bodies – higher amounts of stress (for example, chronic stress resulting from racial discrimination) create a higher allostatic load(AL). High allostatic load, according to Sterling and Eyer’s research, results in symptoms including:

  1. High blood pressure / hypertension
  2. High levels of fatty deposits in our blood stream
  3. Blood clotting
  4. Atherosclerosis (hardening and narrowing of arteries)
  5. Suppression of our immune response system
  6. High demands of oxygen by our heart
  7. Having a stroke
  8. Congestive heart failure / heart attack

Allostatic theory (and subsequent empirical support) is quick to add that not all stress is damaging to an individual – eustressoccurs when challenging life events actually make us stronger (for example, the stress your body endures during a challenging workout at the gym).  However, chronic and unpredictable stressors are embodied and produce the aforementioned health concerns (this kind of stress is called distress).  Therefore, it may be assumed that individuals at a high risk of distress over the lifetime are placed at high risk for negative health outcomes, ranging from momentary physiological arousal to premature death.

A primary driver of chronic, unpredictable distress is structural violence, defined by Galtung (1969) as cultural inequalities (especially lack of access to power) preventing individuals from reaching their full potential. Structural violence is often difficult to pinpoint because there is no one culprit – no one person is responsible for unequal access to healthcare for Americans of African descent; our social system itself is configured to place minorities at a greater risk for distress and lower health outcomes.  Farmer (2004) correctly locates several insidious causes for structural violence across cultures, citing historical factors, political forces, latent racism and other forms of unconscious bias, and economic orders as a few examples.

To summarize, here are the takeaways of the complex relation between allostatic theory and structural violence:

  • Vulnerable populations have unequal access to power within a society.
  • These populations experience distress due to this unequal access.
  • Chronic distress manifests in the physical bodies of these populations, leading to high allostatic load.
  • High allostatic load results in health disparities.
  • These health disparities go unaddressed due to unequal access.

While indeed tautological, this feedback loop illuminates the vicious cycle many Americans of African descent embody – bodies unjustly assailed and structures unfairly positioned.

A conceptual map, noting five impacts on human health: individual behavior, social circumstances, genetics and biology, medical care, and physical environment
Social Determinants of Health Map by Jsonin, Creative Commons

Black Bodies & Intervention

As previously mentioned, many medical anthropologists conceive of three ‘bodies’ of health: physical, social, and political. The relative health of these bodies acts on one another; it is therefore paramount to address health promotion in a holistic fashion – not only ‘curing the disease’ but also disarming cultural forces that predisposed disease in the first place.  Below, I organize threats to and interventions for health in Americans of African descent, according to their physical, social, and political bodies.

Physical

Physical bodies are the stuff of muscles, of skin, of blood.  For Americans of African descent, population-level physical health and wellbeing is simply incomparable to Americans of European descent in major ways, including: higher rates of diabetes; of hypertension; of coronary heart disease; of cardiovascular disease; of prostate, lung, and breast cancer; and of asthma-related death.  Furthermore, American adolescents of African descent suffer disproportionally from sexually transmitted infections.  The infant mortality rate of these Americans is approximately three times higher than infants born to American mothers of European descent.  Geronimus, Hicken, Keene, and Bound (2006) demonstrated Americans of African descent experience higher allostatic load than other Americans, controlling for demographic variables, such as education and poverty levels.

According to a systematic review by Crook et al. (2009), there are a few promising avenues for intervention to address physical health in Americans of African descent.  These include placing health centers within communities of marginalized populations, using trained volunteer community health workers, and hiring nurses from within the communities of these populations.  Additionally, ‘traditional’ healthcare settings (i.e. hospitals) are not necessary to delivery physical health interventions; these interventions can be administered in community centers.  Of critical importance here is self-representation – members of marginalized communities empathize with and deliver quality care to members of other marginalized communities.

Social

Our social bodies are reflective of cultural norms, symbols, and values.  This body may be conceived of as psychosocial experiences. Our social body is maintained by the attitudes other people have about us.  In the case of Americans from African descent, bias, prejudice, and discrimination oftentimes characterize their social body.  Clinical-community psychologist Dr. Lyubansky of the University of Illinois at Urbana-Champaign, is quick to assert that this phenomena looks like “racism not always by racists”.  In line with allostatic theory, chronic and unpredictable experiences with bias and discrimination induces stress; which, again, causes stress and disease.

Dr. Janice Gassam, applied organizational psychologist, draws on scientific and popular literature relating to social stigma and discrimination and recently published a short guide to disarming unconscious bias.  First, we must be aware of our biases; one way to do this is by taking Harvard’s Implicit Association Test.  Next, members of majority or privileged populations must make a long-term commitment to reducing bias; this phenomenon will not happen overnight.  Next, specific behaviors related to bias must be neutralized; this includes unfair hiring practices and medical maltreatment.  Finally, Dr. Gassam asserts that teamwork with members of minority populations can fundamentally disarm cultural bias – evidenced by Edward B. Tichener’s and others’ research on the Mere Exposure Effect.

Political

Finally, the body politic refers to the relation of an individual and her or his political milieu, specifically how the human body is a political tool.  The relation is bidirectional as it relates to health and medicine: bodies are both governed by political decisions while also exerting power over the political process. Some bodies (and their corresponding health or otherwise) are prioritized within a political system; other bodies are ignored or violated.  A striking example of the violation of political bodies in American culture is voter suppression; we may look to the recent Georgia gubernatorial election and the myriad audacious tactics to keep Americans of African descent out of the voting booth.  If individuals cannot vote for policies that may benefit their physical and social health, these individuals do not have political health.

Within the context of the United States of America, voting behavior is the primary way disenfranchised individuals exert political control; it is therefore paramount to empower minority voters so these individuals may elect leaders dedicated to championing causes related to health promotion within marginalized communities.  The think-tank Center for American Progress offers five ways to protect the votes of Americans of African descent: (1) eliminate strict voter ID laws; (2) prevent unnecessary poll closures; (3) prohibit harmful voter purges; (4) prioritize African American voters in political outreach; and especially (5) recruit African American candidates for political office.  Marginalized Americans must be able to vote for policies and representatives that can break the health disparity cycle.

Conclusion

Observing, predicting, preventing, and controlling health disparities within marginalized populations is an immensely complex issue. As stated in the beginning of this post, medical anthropologists take a cultural standpoint to examine these issues; one prominent theory in this discipline is the systematic examination of ‘bodies’ – how these bodies are affected by health and disease alike. Other fields, such as health psychology, take a more empirical approach – locating specific points of intervention within an individual’s biopsychosocial health processes.  This post combines these approaches, explaining how health deficits arise within the communities of Americans of African descent, utilizing allostatic theory and structural violence.  To reduce these health disparities, chronic stressors and structural barriers plaguing these communities must be transformed.  This transformation begins by accepting a simple fact about black health: the stress from hate can kill you.

References

Crook, E. D., Bryan, N. B., Hanks, R., Slagle, M. L., Morris, C. G., Ross, M. C., Torres, H. M., Williams, R. C., Voelkel, C., Walker, S. & Arrieta, M. I. (2009). A review of interventions to reduce disparities in cardiovascular disease in African Americans. Ethnicity & Disease, 19(2), 204-208.

Farmer, P. (2004). An anthropology of structural violence. Current Anthropology, 45(3), 305-325.

Galtung, H. (1969). Violence, peace, and peace research. Journal of Peace Research, 6(3), 167-191.

Geronimus, A. T., Hicken, M., Keene, D. & Bound, J. (2006). “Weathering” and age patterns of allostatic load scores among black and whites in the United States.American Journal of Public Health, 96(5), 826-833.

Scheper-Hughes, N. & Lock, M. M. (1987). The mindful body: A prolegomenon to future work in medical anthropology. Medical Anthropology Quarterly, 1(1), 6-41.

Sterling, P. & Eyer, J. (1988). “Allostasis: A new paradigm to explain arousal pathology” in S. Fisher and J. Reason (Eds.) Handbook of Life Stress, Cognition and Health. Hoboken, NJ: John Wiley & Sons.

Policing Our Imagination

a Black Lives Matter sign
Ferguson Solidarity Washington Ethical Society. Source: Johnny Silvercloud, Creative Commons

On Thanksgiving evening, while many of us were still enjoying or recovering from a day of family and feasting, Emantic Bradford Senior – who is currently battling cancer – was waiting for his son EJ to come help him with his chemo medicine. “He was my best friend,” Senior says, “and my nurse. He treated me like I was his kid.” As EJ got ready to leave his father’s house that night, Senior, as he always did, asked his son if he needed any money. EJ was on his way to join eager Black Friday shoppers at the Galleria in Hoover. Late that night, Senior’s stepson woke him up. “You talked to EJ?” he asked. “Not since he left the house,” Senior responded, rousing himself. He showed Senior his phone, opened to a video posted on Facebook depicting a chaotic scene at the Galleria, shoppers running and screaming in panic. At this point, the Hoover Police Department had released a statement that there had been an altercation at the shopping mall around 10:00 PM and that police had shot and killed the instigator as he fled the scene. We’re “very, very proud” of the response of our officers, the statement said, for “engaging the subject and taking out the threat.” It was 12:30 AM. Emantic Bradford Junior – EJ – had been dead for two and a half hours at this point, but this would not be confirmed to the family until the next morning. Seeing the social media reports, Senior immediately called the Hoover PD to ask if the police had killed his son. “We’ll call you back in 10 minutes,” they told him. Ten minutes went by, no phone call. Senior called back. Again, “Someone will have to call you back.” This went on for a while until Senior finally demanded to know if that was his son – lying lifeless and uncovered on the cold, white floor – in the photos on Facebook. “I’m sorry, sir, I can’t give you any information at this time. You’ll have to call the county.” In frustration and terror, Senior calls the county police – he is put on hold, transferred, put on hold again, until finally a man gets on the line and confirms that yes, EJ is dead. Several hours go by, and the Hoover PD releases another statement: we got the wrong guy. 

EJ had been shot and killed by a police officer who wrongfully assumed that he was the person instigating violence at the mall that night. In the precious hours between the police department applauding the officer’s “heroic” actions for stopping a violent crime and admitting that EJ “very likely wasn’t the shooter,” EJ’s image was misconstrued and misrepresented in the news and on social media – at first, to fit the profile of a killer, and later, as someone who made some bad choices that resulted in his untimely death. There was a desperation to prove that this situation was different, that it was an isolated incident, and that it did not serve as an example of police brutality against people of color. A narrative about EJ’s life and the circumstances of his death was planted, one that justified the officer’s actions and placed the blame on EJ himself. And this is where we end up:

EJ had a gun.

Right…and Trayvon Martin was wearing a hoodie. Eric Garner was hustling cigarettes. How could we know that Tamir Rice was holding a plastic toy and not a real gun? And maybe the most egregious justification of all: Michael Brown “looked like a demon.” There is always some way to extract the wrongful killing of a black man by police officers from the systemic problem of police brutality. There is always something we can point to and say well, this had nothing to do with skin color and everything to do with…fill-in-the-blank. 

But let’s be clear: EJ wasn’t shot because he was carrying a gun (which he was licensed to own and trained to use). EJ was not perceived as a “good guy with a gun.” EJ didn’t brandish a weapon in the sense of acting threateningly with it. He didn’t have to – he was the weapon. And the words of Claudia Rankine ring in our ears:

“Because white men can’t

Police their imagination

Black men are dying”

The unnamed officer didn’t regard EJ as a person in that moment but as a black man with a gun, which in his imagination and under Alabama law, justified three shots to the back, ending EJ’s life. But we can’t help but wonder – to appropriate Matthew McConaughey’s powerful line in A Time to Kill – what would have happened if EJ were white. Even mass shooters – who are nearly always white – are often apprehended by police officers without being harmed. When they do die, it’s usually because they take their own lives. For example, after he opened fire on unsuspecting worshipers at the Emanuel AME Church in Charleston, police chased Dylan Roof through two states before they caught him and took him to Burger King to get something to eat. Travis Reinking had a history of mental illness, had threatened violence multiple times, his many firearms had been confiscated – and then returned – before he walked into a Waffle House and shot four people. “He just didn’t seem like a violent person,” one coworker said of Reinking, joining with others who insisted that he was “intelligent and polite.” Reinking fled the scene, and officers chased him into the woods before he was apprehended unharmed. At a movie theater in Aurora, police mistook James Eagen Holmes for a fellow officer because of “the tactical clothing he was wearing.” In other words, he looked like them. But one look at EJ Bradford, and that was it. A black man holding a gun, standing near the victim…bang, bang, bang.  

I imagine that police officer didn’t walk into that shopping mall that night intending to kill a black man. The nature of the situation forced him to make a snap judgement, and according to the official report, it took about three seconds to assess the situation, identify EJ as the target, and take him out. And it wasn’t until his family started demanding answers that they even questioned whether or not they had gotten the right guy. Ultimately, it was concluded that the officer “reasonably exercised his official powers, duties, or functions” when he fired those shots. And in a legal sense, it’s hard to argue with that. But we need some context here – there is a larger problem that must be addressed.

a cardboard sign that reads "We're not anti-police, we're anti-police brutality"
We’re Not Anti-Police, We’re Anti-Police Brutality. Source: Jagz Mario, Creative Commons

The lives of black people in the United States have been and continue to be conditioned and defined by violence – structural, institutionalized, everyday violence and brutal retaliation by the state and other groups against their demands to be seen and heard and regarded as human. Black bodies are weaponized in the popular imagination, associated with crime and danger, and the full participation of black people in society is subjugated by a collective consciousness that centralizes whiteness and systematically excludes people of color. The truth is that compared to white people, people of color are disproportionately killed by police officers in the United States. This is not because all white police officers are explicitly racist but because of where we hold space for black bodies in our broader cultural ethos. What gives police brutality its life force is the same thing that makes it harder for black people to buy houses, get into college and acquire health insurance. This refined yet insidious form of racism resides deep in our collective consciousness, and it engenders the unspoken but deeply felt sentiment that non-whites are threatening and dangerous, that we need the state to protect us from them. 

And where does this come from? When slavery ended, the South (and eventually the rest of the country) adopted slightly more palatable systems of subjugation and discrimination against the newly freed citizenship. The preservation of the white male patriarchy depended on one thing – fear. As long as white people continued to be terrified of black people, white supremacy reigned unimpeded. Over time, laws ensuring civil rights and protections for people of color were slowly updated and selectively enforced. To be sure, these were victories. Progress, however, is not a zero-sum game. As overt ideals and expressions of racism were put asunder on paper, they didn’t go away. Instead, they burrowed down deep inside of our subconscious. On the surface, we developed new ways of explaining the unequal distribution of resources and power and opportunity without ever outwardly implicating skin pigmentation. We relegated black people to conditions of poverty, denied all but a few access to the middle class, and then blamed those left behind for bringing about their own woes. We associated violence in black communities not with poverty and lack of access but with blackness itself. We moved black bodies from the plantation to the prison system, once again denying them their freedom, but this time blaming them for it. Not all of them, of course, but enough to sustain the image and the fear.

Shop owners at the Galleria will tell you that there is a “black” side and a “white” side of the mall. Where do you think the police presence was concentrated that night? When it comes to spaces occupied by black bodies, the police force tends to emphasize the “force” over the policing. And yet…“You just don’t bring guns into a crowded mall,” the Hoover mayor admonished in his statement about the wrongful killing. How ironic. Okay, Mr. Mayor, tell that to the NRA. Better yet, if that’s such an obvious unspoken rule, try to make it a law in Alabama and see how far you get. At the very least, say what you mean: if you’re black, don’t carry a gun into a shopping mall. Because for people of color, certain constitutional rights must be qualified.

This is refined racism: when white people hear of the wrongful killing of a black man by police officers, we latch on to some element of the story that distracts us from the color of the victim’s skin and emphasizes some other factor that explains the officers’ actions. Rather than trying to understand what it means to be a black person in this country, to confront our own implicit biases and to acknowledge our complicity in upholding a racist social order, we look for something, anything, to assure ourselves that this was an isolated and unavoidable incident (at least on the part of the officer). In doing so, we sustain the devaluation of black bodies and black minds and justify the power of the state to marginalize people of color, to treat them as an inconvenience and to perceive them as a threat that needs to be neutralized by whatever means necessary. In situations like this, that is where our minds naturally go. We make our excuses, we qualify our apologies, we blame the victim. The story gets whitewashed. And just like that, Trayvon’s death, Philando Castille’s death, EJ’s death are their own faults.

So how do we change this reality? It is going to take more than providing courses to police officers on racial sensitivity and limiting the use of force. If we truly want to live in a world where the state treats people of all skin tones equally, white people must police their imaginations. We must actively work to decentralize whiteness, aggressively refute the narrative that people of color pose a threat to our society, and unequivocally demand that they be protected rather than forcibly policed. The political justice system won’t change until our collective consciousness changes, until we break ourselves of false equivalencies and false associations around blackness, until we recognize what the enduring legacy of slavery and centuries of subjugation and oppression have done to individuals and families and communities, until we give the black man a chance to be the good guy. We are all stakeholders in this process; if we’re going to move forward as a society, we have to do it together.

The Galleria reopened at six o’clock the next morning, as scheduled, because consumer capitalism can’t be bothered by the death of a black man. The Christmas shopping season went ahead full stride, while Emantic Bradford Senior was left to mourn the death of his son, to contend with his disease alone, to wallow in the pain of never again getting to hear his son call him ‘daddy.’ After two months of investigation, the Attorney General of Alabama ruled that the nameless officer who shot and killed EJ was “justified” in doing so. Under Alabama law, no crime was committed. But EJ’s mama, April Pipkins, leaves us with an important question: “If this happened to your child, would you still call it justice?”

The answer is no, you would call it murder. 

Disability Rights, Health, and Medicine

Disability Symbols. Wikipedia, Creative Commons.

What is a disability?

“A disability is a condition of the body or mind that makes it more difficult for the individual to do certain activities and interact with the world around them.”

Approximately one in five adults in the United States has some type of disability. There are numerous types of disabilities that impact people’s daily lives through sight, movement, learning, or communication, although there are many others. Furthermore, even if two people have the same disability that doesn’t mean they are impacted the same way. Thus, individuals who have a disability do not consist of one general population, but instead a diverse population with various needs. Now the focus is more on how the word disability refers to the three components mentioned in the next paragraph and how there are numerous factors that go into having a disability.

The World Health Organization created the International Classification of Functioning, Disability, and Health (ICF). The ICF introduces the word disability into three main categories that are impairment, activity limitation, and participation restrictions. The term disability and impairment do not mean the same thing. Before the 1970s, the common view was that a disability is measured by whether or not an individual has an impairment or a health condition. In the 1970s there was the disability rights movement, which geared people away from this medical view. However, many people still focus on the more traditional, medical model of disability.

Disability and Health

Those with disabilities tend to face health care disparities such as less access to adequate care, both in terms of promoting health and preventing diseases. Some people even go as far as labeling those with disabilities as a medically underserved population. There has been some research on how people with disabilities usually have a lower quality of health and are more likely to experience secondary conditions. Some examples of the health disparities include not having interpreters during medical examinations, adults with developmental disabilities being at risk for secondary conditions such as obesity, seizures, and cardiovascular disease, and women who have disabilities are less likely to get Pap tests and mammograms. Furthermore, some other issues include misconceptions and stigmas surrounding the word disability, shortage of suitable training, lack of proper medical equipment and facilities, lack of accessibility, and little to no individualized accommodations.

Disability Rights. Flickr: Féin, Creative Commons.

The Stigma

While there are medical advances over the years in regards to individuals with disabilities, there is a stigma surrounding people with disabilities. They tend to be seen as individuals incapable of making decisions or helpless. There are implicit or even unconscious biases against individuals who have a disability. Furthermore, there are several articles on how the medical community treats those with disabilities as having less value than non-disabled people. The medical interpretation of a disability is viewed as a pathological disorder and so this perspective focuses on how one can treat or cure it, rather than a social problem. In contrast to the medical model, there is the social model of disability, which focuses on how disability is formed from a social situation or construct, rather than a person’s characteristics. This viewpoint focuses on dividing impairment from disability, rather than recognizing that one is a component of the other.

The National Council on Disability says, “people with disabilities comprise the largest and most important health care consumer group in the United States, yet the Institute of Medicine and others have warned that Federal agencies, policymakers, and health care systems have not yet responded to the broad-ranging implications, for individuals, and for society, of the demographic increase in disability as the population ages.”

Health Insurance

Another barrier is that people with disabilities tend to lack health insurance or adequate coverage for healthcare. The National Council on Disability conducted research and found that few health care training programs address disability issues in their curriculum and most federally funded health disparities research do not look at people with a disability as a disparity population. Furthermore, while Medicaid and Medicare cover some people with disabilities, these programs do not cover those who have private insurance. Private group plan insurances are usually given through employers; however, not all employers offer health insurance and not all people who have disabilities are working. Those who have private group plans through their employer are required to cover basic care for the average working population. Medical equipment such as wheelchairs, ventilators, and crutches are limited in terms of annual payments.

Individual plans charge higher premiums to individuals with disabilities. Persons with emotional disabilities consist of those most uninsured, closely followed by persons with visual or hearing disabilities.

The three key elements of health care insurance are availability, affordability, and coverage for critical benefits. Important benefits can include long-term care, mental health, and medications. There have been national surveys that found people with disabilities have a hard time figuring out the insurance system, visiting specialists, and obtaining medical equipment that is durable. Additionally, numerous essential health care services can be out of their budget, meaning that they go without certain things because they simply cannot afford it.

According to the Journal of Disability Policy Studies, “estimates suggest that these factors obstruct or delay care for as many as 30 – 50 percent of adults with disabilities.”

The Henry J Kaiser Family Foundation conducted a national survey that found, “health insurance is inadequate for more than one in three people with disabilities who reported delaying care, skipping medication, or going without needed equipment because of cost.”

Accessibility

Accessibility can be broken down into many different components. The two main sections to focus on are communication and physical access.

Physical barriers are objects that are either natural or manmade that hinder or block mobility or access. These barriers can include inadequate transportation, accessibility to the facility and offices, and lack of accessible exams. Something as simple as getting a mammogram exam can provide numerous difficulties because the mammogram machine cannot adjust for height or health professionals are not adequately trained for lifting assistance. Thus, some health professionals conduct exams while patients are in their wheelchairs, which can yield inaccurate results. Other physical barriers include parking at the medical facility, entering the building, and the bathroom facilities, making it more difficult for someone with a disability to receive proper care.

Proper communication and education are required to make a change. Individuals with disabilities should feel they can discuss their challenges without fearing discrimination, while, those in the healthcare field should appropriately discuss, support, and address the challenges people with disabilities face. Research shows there is a lack of awareness and inadequate instruction among health care providers. For example in Connecticut, “91% of primary care physicians said they had no training in intellectual and developmental disabilities.” Without proper training, people tend to make assumptions about people with disabilities and often times they are incorrect. Some stereotypes include thinking that those with developmental disabilities cannot feel pain so they do not need anesthesia, people who are deaf have problems with their cognitive functioning because they are not fluent in standard English, or women who have disabilities do not need reproductive care because they are assumed to be sexually inactive. Making assumptions is not only harmful to the health of the patient but also it undermines who they are as a person. This can lead to damaging the patient-provider trust and provoke people with disabilities to not even bother to seek care. Ultimately, having access to appropriate health care can prevent new health conditions and could possibly stop current health conditions to worsen. In order to be effective and efficient, health care must be inclusive and accessible.

 

Keep up with the latest announcements related to the upcoming Symposium on Disability Rights by following the IHR on Facebook, Twitter, and Instagram.

 

Interconnection Among Dance and Human Rights

Two things, seemingly unrelated, have the ability to impact and reshape people’s lives.

Toni Shapiro-Phim worked at a refugee camp in Indonesia and Thailand, where a lot of people came from Vietnam and Cambodia. In Vietnam, many went through a horrific journey to arrive in Indonesia, while in Cambodia they were fleeing genocide. Something that connects these two countries is the ability to enlist in the arts as a way of survival and endurance. Many were drawing, painting, creating poetry, and dancing. You may ask yourself, what do the arts have to do with social justice? In regards to Cambodians, dance has to do with the “spirits of the land”; it is a way to connect to the “earth of Cambodia”. Dance is able to coexist during hardships and violence. They chose to find something beautiful amidst the chaos. Dance is a way to connect individuals with their community, create conversations, provide resources, and, most of all, create a sanctuary.

“When people are ground down by the inhumanity, danger and chaos around them, they choose to participate in a certain form of expressive culture because it is, at that moment, something they can’t live without.”

 

Three Female Dancers. Source: Pixabay, Creative Commons

In Chile, there was a dictator by the name of Pinochet who managed to make people who were “enemies of the state” disappear. Women would go into the streets and dance the cueca sola, the country’s national dance as determined by Pinochet. The dance is traditionally known as a couple’s dance. However, the women altered the meaning of this dance by dancing alone. On their clothes, they had pictures of their loved ones that had disappeared. This bold statement led way to the end of the Pinochet regime. Dance has the ability to make a change and speak in a way where words are not needed.

In some countries, dancing is believed to be too influential and as a result, has been banned. Some of these countries include Japan, Sweden, and Germany. Many people are surprised to hear that Sweden has a dancing ban. You are not allowed to spontaneously dance. Bars and pubs have to get a license in order for people to dance. Japan had a similar ban which forbade dancing unless the venue had a license up until midnight. However, the ban was recently repealed. Dancing on Good Friday is forbidden in 13 of the 16 states in Germany. The dancing ban is called “Tanzverbot”. Although, in the three states where it is not illegal, there is still a ban until 9 pm on Good Friday. People found dancing will be fined. Specifically, in Baden-Württemberg, dancing is banned from Maundy Thursday to Easter Monday at 3 am. Dancing is also banned from Christmas Eve to Boxing Day at 3 am.

As Macaulay, a chief critic of the New York Times, said, “think globally, dance locally.”

BBOY. Source: Flickr, Creative Commons

FLEXN Evolution is an improvised dance performance that addresses racial equality and social justice. Their production, called “bone breaking”, focuses on being broken physically or emotionally and rebuilding yourself. Not only do these dancers use dance to express their pain, but they also use dialogue and photography. Before every performance, they have an event with a panel consisting of Common Justice (an organization that works with racial equality and crime survivors),  scholars, and community leaders to hold conversations on the issue they are trying to advocate. In addition to the performance, there is a photo series of portraits of all the dancers. The purpose of these photos is to show people what it feels like to be in America – the good and the bad.

A topic that often comes up in the news is climate change. Here are three choreographers and their inspiring story on how they integrated dance with climate change.

Davalois Fearon choreographed a piece on water scarcity. Something that set her apart from other choreographers was how she used dance as a way to interact with the audience. Two dancers hand out cups randomly to some audience members, while a third dancer pours water in some of the cups. Fearon’s goal is to give the audience members an idea of what it feels like to be “denied a resource, overlooked and ignored.” The message doesn’t stop with the performance but continues on with a discussion. The discussion is meant to create a safe environment where people can talk about the issue and try to understand it.

The next artist, Jill Sigman, created a piece on disposability called the Hut Project. Her project focuses on creating hut that is made out of scavenged materials. She wants to go against societal norms of prizing things that are new and shiny and tossing out things that are old. By creating huts from materials deemed as old and useless, she shows people that there is beauty in things that we deem as disposable. She tells you to not be so quick to throw out things simply because they are old and goes on to reveal how things we discard have a story and are complex. Additionally, she hosts a conversation after the performance to talk more about the issue.

The third choreographer, Rulan Tangen, also uses dance as a platform to raise awareness about disposability. She creates discourse on how climate change is a symptom of injustice and people not respecting all forms of life. Currently, she is creating a piece on renewable energy from different perspectives such as cultural and practical. She even goes on to discuss the sustainability for the design of her dance production.

 

Climate Change. Source: Wikimedia Commons, Creative Commons

In Los Angeles, street dance activism is on the rise. In 2014, Ezell Ford, a black man with mental illness was shot by the police. Activist, Shamell Bell, camped out by the police department for days to request that the officers involved in the shooting be fired. She invited her friend Dashawn Blanks, a noted street dancer, to instruct social dances that were generated in black communities. Protestors, while there for an important cause, were also able to be cheerful while dancing because they were dancing for a cause but also for themselves. Another example is in 2012 when Trayvon Martin’s killer was found not guilty where people headed to Leimert Park to express themselves through dance. Eventually, the L.A. chapter of Black Lives Matter was produced and, in the following years, there have been numerous fatal shootings so Bell would orchestrate dance as a way to show a different way to protest. She also went on to form a group, called the Balance Collective, of both dancers and artists who fight “racism, police brutality, sexism, and homophobia”. “I teach because it’s not about me. I wish I could fade into the background,” Bell says. “This work is about us using art as a platform to save ourselves so we can save others.”

Dance is where people can use movement to portray inequities. Different social justice issues ranging from the environment to racial inequality can be addressed through dance. Never underestimate how powerful dance can be.

 

 

Ending Violence Against Women

by Pam Zuber

November 25 is UN International Day to End Violence against Women. Source: Creative Commons
November 25 is UN International Day to End Violence against Women. Source: Creative Commons

“But the details about that night that bring me here today are ones I will never forget. They have been seared into my memory and have haunted me episodically as an adult.” – Christine Blasey Ford, 2018

Christine Blasey Ford spoke these words during her opening statement during a September 2018 hearing before the United States Senate Judiciary Committee. The purpose of the hearing was to determine if nominee Brett Kavanaugh was fit to serve on the United States Supreme Court. Blasey Ford said that when she and Kavanaugh were both teenagers, an extremely drunk Kavanaugh sexually assaulted her by groping her and trying to remove her clothes. When she tried to scream, he covered her mouth, and Blasey Ford said she was afraid that this action would suffocate her.

This testimony illustrates how many women have experienced physical and sexual violence. This testimony joins the many heartrending stories we’ve heard as part of the #MeToo and Time’s Up campaigns. The repercussions of this violence can linger long after the violence has ended. They can affect women for the rest of their lives and affect their loved ones and acquaintances. Violence thus creates a ripple effect that touches all parts of society, not just the women directly harmed by the acts of violence.

To address this violence, the United Nations (UN) sponsors the International Day for the Elimination of Violence against Women every year. In 2018, this day occurs on November 25, 2018. This day is part of the United Nations Secretary-General’s UNiTE Campaign’s 16 Days of Activism to End Violence Against Women.

What is violence against women?

Sadly, there are many types of violence against women. Violence can be physical, sexual, verbal, emotional, or a combination of these. It can be the threat of violence, such as threatening violence against women if they do or don’t do certain things. Violence can be against ciswomen (people who were born biologically female and identify as female). It can be against trans people or nonbinary individuals and sometimes occur because of their trans or nonbinary statuses. Women, nonbinary people, and trans individuals of color also might also encounter violence. This article refers to all women, nonbinary people, and trans individuals unless otherwise specified.

Violence can occur in public or it can occur in homes, schools, or workplaces. It can occur among strangers or among family members, coworkers, classmates, or teachers and students. Some people and groups use violence against women as a weapon of war, raping women and girls because they think the violence will serve as a sign of dominance and power. In this perspective, any pregnancies that result are an added bonus because the pregnancies perpetuate the dominant/violent lineage instead of the groups they’ve vanquished.

Some people commit violence against women simply because they feel that they can. They feel that they can get away with such behavior without suffering any negative repercussions. In this view, their feelings and physical needs are more important than the feelings of the women in their lives, even though, as we’ve seen, such actions can create lifelong consequences for the women and the people who know them. Such feelings of entitlement might partially explain the Kavanaugh/Blasey Ford incident. After all, when examining cultural problems, it helps to examine the cultures that created them.

How does culture contribute to violence?

Violence against women – or any violence – does not exist in a vacuum. Cultural forces often help to create and perpetuate violence against women. Even today, we hear the excuse “boys will be boys” in discussions of sexually aggressive behavior by men and boys. People still question whether women are inviting sexual aggression by their choice of clothes, their behavior, their decision to go places alone, and their drinking habits. While such attitudes exist in the United States, they are sometimes even more pronounced in other countries. Honor killings are a sadly common occurrences in some parts of the world. There were about 1,100 such murders in Pakistan alone in 2015.

In honor killings, people kill their female relatives because they believe that the females’ actions have shamed their families. In this view, shameful actions include dancing, working outside of the home, appearing on social media, dating, not marrying the families’ choices of suitors, or even being raped (even though rape is obviously not a person’s fault). People also worry that women will falsely accuse their sons of rape, even though their daughters are far more likely to experience sexual violence. And this is only for reported incidents of violence. The U.S. Bureau of Justice Statistics estimates that people report 35 percent of sexual assaults to the police. This means that people do not report almost two-thirds of all sexual assaults.

Why? One only has to observe what happened to Christine Blasey Ford. Because she recounted her experiences, she

  • Received death threats.
  • Moved with her family from their home because she feared for their safety.
  • Faced intense scrutiny from politicians, the media, and the U.S. public.

“I have had to relive my trauma in front of the entire world, and have seen my life picked apart by people in television, in the media, and in this body who have never met me or spoken with me,” Christine Blasey Ford admitted. Meanwhile, the man she accused, Brett Kavanaugh, still became a justice of the U.S. Supreme Court.

Is it any wonder why women and trans and nonbinary people are often reluctant to report violence against them? Even if they speak out, do people really listen? Are people really willing to take actions to deal with such violence or prevent such violence in the first place?

a protest for violence against women
End Violence against Women. Source: Creative Commons

How does violence affect women and society at large?

If people don’t listen to women’s stories of violence, take action to remedy them, or try to prevent violence, there are repercussions. Violence harms women, the people around them, and society at large. Ending the culture of violence against is the responsibility of societies and the governments that represent them. On a political level, such efforts protect and encourage half of the population, a population that votes and can support governments that support them (or withhold their support for unsupportive politicians and governments).

More importantly, such efforts are imperative on a human rights level. Ending a culture of violence against women ensures that all of a society’s citizens are respected and can fully experience society. It allows people to advance instead of holding people down. Violence causes immediate physical and emotional harm. It also can also create long-lasting consequences. For example, women who have been raped might

  • Contract a sexually transmitted disease such as HIV/AIDS.
  • Face unwanted pregnancies.
  • Struggle with post-traumatic stress disorder (PTSD) or other mental health conditions.
  • Develop a drug addiction or a dependence on alcohol because they are using substances to try to forget the attack.
  • Encounter problems at school or work because the attack led to absences or made it difficult to concentrate.
  • Experience shame and stigmatization from people who believe that they were responsible for the rape.
  • Find it difficult to begin new relationships or manage existing ones.
  • Deal with fear, anger, and other emotions.

These consequences are complex and require extensive professional help. Help is also necessary to address other aspects of violence. That’s because violent attacks hurt more than just women. They hurt their families because the families see how much the women in their lives are struggling. The women may also be unable to engage with others because of such attacks.

Violent attacks prevent women from contributing to their homes and workplaces. But, more importantly, they stifle women and violate their human rights. They could make women fearful of doing things that they might feel trigger such attacks, although violence is not their fault, but the fault of perpetrators. They might be afraid to do anything because of such attacks. This fear could paralyze them, prevent them from living full lives, and deprive society of their contributions.

25 November is United Nations Day to End Violence Against Women – the SL SAY NO campaign has been set up to support the campaign in Second Life. Source: Bea Serendipity, Creative Commons.

How can people prevent such violence?

It’s imperative, then, to prevent violence against women. Governments, people, and organizations are working to do just that. UN Women, part of the United Nations, has discussed the commitments and efforts of several countries around the world who have pledged to end violence against women. Such efforts include general commitments to investigate violence and work with groups to end and prevent it. UN Women also discussed specific actions, such as the country of Senegal’s creation of a hotline to help women and the country of Australia’s creation of a public campaign promoting respectful relationships and a project to promote workplace safety for women.

The annual United Nations-backed International Day for the Elimination of Violence against Women and the 16 Days of Activism to End Violence Against Women are examples of such efforts. The Center for Women’s Global Leadership’s Global Leadership Institute originated the 16 Days of Activism in 1991.

From the start, the organization and its work were inclusive. According to a website for the 16 Days of Activism campaign, the first participants in 1991 came from different countries in all of the world’s regions and were drawn from a variety of fields – lawyers, policymakers, teachers, health care workers, researchers, journalists, and activists. These women were local civil society leaders with at least two years of experience in women’s organizing who were also interested in building the global women’s human rights movement.

While this antiviolence campaign has always been global, it is interesting that it began at a time of great debate about violence against women in the United States. That’s because 1991 was also the year that law professor Anita Hill testified that Clarence Thomas had sexually harassed her. Clarence Thomas, like Brett Kavanaugh, was a nominee for the U.S. Supreme Court. Thomas, like Kavanaugh, became a justice of the court despite the accusations against him.

Is it any wonder why organizations continue to sponsor efforts to end violence and harassment against women? For example, the International Day for the Elimination of Violence against Women, November 25, 2018, inaugurates these 16 Days of Activism to End Violence Against Women. International Human Rights Day, December 10, 2018, ends these 16 Days of Activism.

The timing of these days illustrates how the United Nations and other organizations consider violence not just a women’s problem, but a human rights issue. It sends the message that violence against women is a blight on humanity that concerns us all, not just the people immediately affected. Orange Is the World: #HearMeToo is the theme for 2018’s 16 Days of Activism campaign. This campaign builds on the momentum of movements such as #MeToo and Time’s Up. The UN Women and the Secretary-General’s UNiTE Campaign says that the color orange is intended to “symbolize a brighter future without violence. For us, the ‘orange’ comes from the fire ignited by the many women’s groups dedicated to combating violence against women around the world.”

To combat this violence, #HearMeToo has championed inclusiveness. It has encouraged people to share their stories of violence and created spaces for people to share them. It has shared their stories through digital and print media. It has sponsored listening events that included voices from all sectors, aiming to “create opportunities for dialogue between activists and policy makers, private sector organizations and the public.”

Other organizations are speaking out about violence. The NoVo Foundation founded the Move to End program to end violence against women and girls. The Move to End program’s On the Move blog contains several stories about efforts to end violence and encourages people to contribute as guest bloggers. Several other sites also feature blogs that encourage contributors, such as Ms. magazineThese blogs provide information. They provide a forum for people to share this information so they can speak and others can listen. Listening may sound simple, but it’s a vital step. Violence uses power to silence victims. Letting voices be heard helps dispel fear, secrecy, and uncertainty.

Pam Zuber is a writer and editor who has written about a wide variety of topics, including politics, addiction, and gender.