Thanks to the work of activists, legislatures, and constituents alike, Alabama’s laws have been updated so that they no longer criminalize LGBTQ+ individuals within the states schools’ sex education curriculum. Yet, the work is not over, and schools are still able to refuse to educate students on safe sex practices for non-heteronormative relationships, as long as parents of students consent to the curriculum proposed by staff. This continuation of the lack of medical sex education in our school systems is still leaving children vulnerable to ignorance, and exacerbating the current health issues which are prevalent amongst marginalized groups, especially within the South. Certain organizations, such as the Alabama Campaign for Adolescent Sexual Health and Advocates for Youth Sex Education, are currently advocating for proper sex education. If you are interested in getting involved, sign up to be an advocate for proper seed education through AMAZE, or with WISE (Working to Institutionalize Sex Education), to help aid in the fight for proper sexual education for our youth. Furthermore, if you would like to learn more about the rights of LGBTQ+ individuals and current issues within the LGBTQ+ community, then click this link.
The United States is one of three countries in the world, and the only first world country, that does not provide paid time off upon the welcoming of a new child into the home. Today, eighty-two percent of U.S. voters, across party lines, support implementation of a national paid family and medical leave policy. However, only thirteen percent of American workers have access to such privileges. Much of the debate surrounding the topic involves who will pay for such policies, and who exactly should be eligible to receive the benefits. Whether you have personally been put at a disadvantage by this situation or have the privilege of merely learning about it from media outlets, such as Senator Bernie Sander’s audacious Instagram posts, it is quite difficult to ignore the prevalent issue of the lack of paid parental leave in America.
Paid Parental Leave as a Human Right
The scarcity of paid parental leave is a violation of various aspects of the Universal Declaration of Human Rights.Article 23 of the UDHR states that everyone has the right to “just and favorable conditions of work” and “remuneration ensuring for himself and his family an existence worthy of human dignity and supplemented, if necessary, by other means of social protection.” The definitions of adequate work conditions and social protections can and will obviously be interpreted by society in different ways over time; however, Article 25 goes on to state:
“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including…medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
Motherhood and childhood are entitled to particular care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.”
Regardless of not being stated specifically, it is a common belief that paid parental leave exists within the realms of the above stated rights and is an ethical standard to which society should be held. Pushing personal opinions aside, a recent article from The Guardian says “The American College of Obstetricians and Gynecologists (ACOG) recommends women take at least six weeks off work following childbirth. But with no federally mandated paid family leave, for many women maternity leave is an unaffordable luxury.”
The Reality of a Working Mother without Parental Leave
As the participation of women in the workforce has steadily increased since post-World War II, the modern era expects women to work full-time as if they are not raising children, yet also expects women to raise children as if they are not working full-time jobs. This concept is evident in many American women’s lives who push off having a career until their children are grown or wait to have children until they are settled in their career. With the knowledge that many women do not have access to parental leave, another question is evoked: what happens to working women when a child is born? Those who are lucky enough to have a planned pregnancy may opt to save as many sick days as possible before their delivery date to be used during their recovery. But unfortunately, in many cases women can be forced to leave their jobs because of choosing to give birth.
Not all Families are Impacted the Same
In addition to women being disproportionately affected on a large scale, there are various other societal groups which are put at a greater disadvantage. According to a June 2021 article on BBC, “workers in blue-collar jobs are less likely to get paid parental leave than those with corporate jobs.” This not only affects the lower-income spectrum of the working class, but therefore largely affects BIPOC women and families at a higher rate than their white counterparts. Specifically in the post-war years, resistance formed through the idea that granting universal leave to all workers would encourage the “wrong” families to have the ability to produce. The UDHR lays out in Article 2 that all persons should have access to such human rights without any distinction regarding not only sex and gender, but race and social status as well.
What does the fight towards ensured parental leave in America look like today?
The fight for paid parental leave is not new to the agenda of human rights crises. In November of 1919, The International Labor Organization was quoted by the International Congress for Working Women in stating 12 weeks of paid parental leave is a “medical necessity and social right.”
Today, lawmakers across America’s political spectrum voice their support for paid parental leave. Regarding the public, advocating for paid parental leave should be accompanied by voting for politicians at a federal and state level that will bring action to further implementing this agenda into legislation. There are also various activist organizations nationwide that can be further magnified by volunteers or monetary donations, including the PL+US and the National Partnership for Women and Families.
The homeless population in America tends to be neglected by the society they live in. They are among the most vulnerable, belonging to already marginalized communities that struggle to meet their day to day needs. As a result, the unhoused have little to no power or influence on social norms and affairs. As someone who has experienced homelessness both in India and in America, I have come to distinguish some of the common misconceptions society holds about the unhoused population. There are a lot of stereotypes and social stigma that surrounds the discussions around homelessness, which often blames the victims of systemic issues, instead of restructuring the conversation around how we as society can best help these marginalized groups realize their basic human rights to shelter. In order to do so, we must first understand what it really means to be homeless in America.
History of Homelessness in America
Homelessness is not an issue unique to the United States, as it can be found in countries all over the world. While homelessness in America can be found as early as the colonial times, modern homelessness rose as a response to the Great Depression, where people experienced high levels of unemployment and poverty. Especially interesting is the relationship between the growth of urban cities and the rise in homelessness. Coupled with low-wages and higher costs of living, people found it more expensive to find places to live in urban centers, such as New York and California. The aftermath of the Great Depression put a lot of people in desperate need of employment, and as the economy took to the service industry, more and more undereducated, impoverished people had no other choice but to turn to these low-income jobs. The country’s shift to a service economy meant that laborers were now being paid lower wages, leaving service industry employees unable to afford the rising costs of housing. Coupled with higher housing costs and lower wages, when people turned to social welfare programs, they found these programs to be lacking in funds as well.
Additionally, there was a campaign to “Deinstitutionalize” people held in mental asylums. While the campaign itself was well-intended, its applications were lacking in structure, and instead of providing patients with proper access to mental health resources, people with mental disabilities were released to fend for themselves. The neglect of these institutions led to the increasing numbers of mental health patients facing housing insecurity. To make matters worse, gentrification policies (made to bring in wealthy real-estate investors and high-income residents to underdeveloped parts of the city) led to the displacement of many low-income families, putting them out of their homes. These policies disproportionately affect people of color, something that has forced many marginalized communities to fall prey to an endless cycle of poverty and degradation.
Unfortunately, one of the most concerning additions to the homeless population is the disproportionate number of youths that identify as being part of the LGBTQ+ community. According to a recent study conducted by Chapin Hall at the University of Chicago, LGBTQ+ youth had a 120% higher risk of experiencing homelessness. These members who already belong to an ostracized community can become more vulnerable to harassment, violence and hate crimes.
Additionally, unable to find jobs after returning home from military service, many veterans end up homeless with nowhere else to go. Although places do exist to support veterans who experience homelessness, many are either unaware of the resources at hand, or too ashamed to use these resources. As a result of the social stigma surrounding the topic, people experiencing homelessness often become withdrawn from society.
Society’s Attitudes Toward the Homeless
Homelessness is received with wildly different attitudes among different cultures. America is a very diverse country, with people that share hundreds of different cultures and traditions, and these cultural attitudes can carry over in the way they respond to contemporary social issues. Different cultures share a varying definition of what a “home” means, and even more distinctions in their approach toward people experiencing homelessness. What the dominant White culture might consider to be a home, (an individual unit of space for nuclear families), might not be what someone who belongs to the Indigenous population believes. They might argue that a home is where you can interact with your community, a place to feel safe and share with friends and family. Even the attitudes toward helping people who are unhoused have strict cultural implications. As described in Islam, it is part of the every-day religious ritual of a Muslim to give alms and help the poor in their community. In Hinduism, while helping the poor with food and shelter is allowed, certain castes are not allowed to eat alongside with or sit beside people of lower castes. People experiencing homelessness have their own unique culture, where certain skills or strategies for survival on the streets are shared amongst each other.
Along with all these complexities, the unhoused also undergo various types of stigmas, including social stigma, and cultural stigma. Social stigma can be discrimination and harassment directed toward the homeless population by the institutions, systems and people that make up society. Cultural stigma can refer to the stigma expressed by friends and family members or other religious or cultural institutions that may shame and blame the victims for being homeless.
Unhoused people also have a hard time finding employment. This is partly due to the fact that the job application requires a home address for the application process to be completed. As a result, people who are dispossessed also experience difficulties when finding housing. The applications for apartments include a proof of income/employment section and applying for government housing takes months to be processed and reviewed. Many states have long and complicated application processes, and even then, it is not a guaranteed housing option. Nevertheless, applicants can be denied, and they would still need a place to stay while awaiting their application to be approved.
Adding to these difficulties, people in the homeless community are constantly harassed with wild stares or abuse, (both verbal and physical), from members of society. The law enforcement agency, an institution designed to serve and protect people of the community, may make matters worse by deteriorating the situation further. Without proper training, police approach the homeless defensively, ready to attack at the slightest “abnormal” reactions. What they haven’t been trained to realize is that many people experiencing homelessness are also at high-risk of developing mental health issues due to the stress and realities of being homeless. These altercations can turn deadly, and unfortunately, many people of the homeless community have either been locked up or even killed by officers of the law. Many of these instances were even caught on camera, yet these officers faced little to no accountability or legal punishment.
People experiencing homelessness are also easy targets to getting their possessions robbed, and many times, police will raid their camps and confiscate what few belongings they might acquire, including sleeping tents and toiletries. Society also treats the homeless population as a burden and blames them for being “lazy” or “druggies” or “criminals/suspicious,” without any provocation from the homeless community. It can be especially insulting for the people experiencing homelessness to be judged for their situation while society simultaneously fails to criticize the state’s inability to protect peoples’ fundamental human rights to food, shelter, and other basic needs.
The Legal Response to Homelessness in America
The legal response to the homelessness crisis in America has not been a heartwarming one either. Urban cities all over the United States have put in place anti-homelessness measures, otherwise known as hostile architecture. These include slanted benches, benches divided by armrests, spiked and rocky pavements to prevent people from sleeping there, and even boulders under bridges. Not only are these measures inhumane, they also cost the tax-payers a lot of money. These atrocious tactics are put in place to discourage homelessness, attempting to connect rising numbers of homelessness to increased crime rates. As recently as July of this year, Los Angeles even went so far as to make homelessness downright illegal, restricting homeless encampments in majority of the city. The city has even prohibited the homeless from sitting, sleeping, or laying in public. Due to the fact that homelessness overwhelmingly affects people who belong to already marginalized communities, a rights-based approach is necessary, one that addresses the existing systemic issues which need to be fixed first.
Covid-19 and How it Continues to Impact the Homeless Population
The Covid-19 pandemic continues to impact many different communities in a variety of ways. The pandemic hit especially hard among the homeless population, where access to hygienic products are often slim, if not non-existent. People experiencing homelessness may not have the ability to continuously wash and sanitize their hands, with limited access to clean water and soap products. They also been experience complications with social distancing measures, forced to be in crowded spaces like homeless shelters, which has only increased their risks of getting infected. Furthermore, even when infected, or exposed to the disease, the homeless population has very limited ability to quarantine, further allowing the spread of the disease to others in close proximity. The unhoused population has limited access to healthcare and medicinal treatments, and many are already immunocompromised or have pre-existing conditions, which increases their vulnerability of catching the disease. Stereotypes geared toward the homeless population labeling them as “junkies” or “druggies” has influenced the care they receive, leading to many cases of misdiagnoses or mistreatment as a result of biases held by healthcare professionals and others in the health care industry. Due to the rise in unemployment numbers during the economic shutdown as a response to the pandemic, millions of people who did not qualify for unemployment benefits, and could not make ends meet, also became homeless as a result.
Some Successful Approaches to Ending Homelessness
There have been some successful attempts at ending homelessness in America as well as in other nations. Utah attempted to decrease its rates of homelessness back in 2015, which successfully reduced its homelessness by 91%. They executed a policy known as “Housing First,” which gave their chronically homeless populations free housing, a decision that cost the state less money than alternative anti-homelessness measures. This program unfortunately has not been a complete success, as people experiencing homelessness in other states have been migrating to Utah, making it too expensive for Utah alone to pay for the country’s increasing homelessness crisis. A national policy, on the other hand, that could implement the Housing First approach taken by Utah, may be the easiest, and essentially cheapest option to ending the homelessness crisis in America. This is essentially what Finland did. In 2019, Finland approached the homelessness issue with the most obvious of answers, by providing housing for all those who are unhoused. Like Utah, they applied the “Housing First” policy, (which came with no strings attached), recognizing that housing is an essential human right that should be protected and promoted. They also understand that in the long run, providing the homeless population with housing is the cheaper option to society. Also, as examined earlier, if applied in America, this Housing First policy will inevitably save more lives, with fewer interactions between the homeless and the police.
While homelessness is not something people are normally born into, the unhoused face discrimination, stigmatization, and marginalization from society just as much as any other group. Although people’s socioeconomic status is a major factor in determining who is most vulnerable to experiencing homelessness, as we’ve seen in the case of the LGBTQ+ youth, and older veterans as well, homelessness can impact people of any and all races, at various age levels, and at any given time. The pandemic itself has expanded the homeless population as people are unable to pay their backed-up rent or mortgage payments. While alternative approaches can assist to eradicate levels of homelessness in our society as implemented in Finland and Utah, it is crucial that we also continue to destigmatize being homeless in American society and take a rights-based approach to finding long-term solutions to end their suffering.
On Wednesday, September 29, the Institute for Human Rights at UAB welcomed Katie White, UAB Masters of Public Health student, to the Social Justice Café. Katie facilitated a discussion on gun violence and human rights.
Katie began by sharing that her research on gun violence in Birmingham emphasizes the intersections with public health and public health responsiveness. Katie shared statistical data on national rates of gun violence as well as in the state of Alabama. In the United States, there are an estimated 393 million guns — more guns than humans. Gun violence accounted for 961 deaths in the state of Alabama in 2020. The state of Alabama has the 5th highest death rate nationally, and there was a 15% increase in gun related homicides from 2010 to 2019.
Katie also discussed how the city of Birmingham is addressing the growing trend of gun related homicides. Birmingham has invested in various forms of technology such as; ShotSpotter, Predictive Policing, and a state-of-the-art real time crime center. The implementation of new technology is a step in the right direction, according to Katie; however, technology can be flawed and subject to bias and discrimination, especially against People of Color and people living in underserved communities. Additionally, the merger of traditional police work with new technology is inherently reactionary, creating a strong response whether than creating a strong deterrent.
Social Justice Café participants asked questions and shared their personal opinions. One participant asked Katie if she had any suggestions on how to minimize gun related homicides in the Birmingham. Based on her research, Katie suggests a three-point plan beginning with the implementation of economic development within disadvantaged communities that have historically lacked social mobility and access to opportunities. Next, Katie suggested the implementation of “Hospital Based Gun Violence Intervention (HBCVI).” HBCVI is initiated when a gunshot victim is admitted into a medical facility. Katie shared that “people who are most likely to commit gun violence are often likely to become victims of gun violence.” HBCVI is a proactive policy used to break the cyclical nature of gun violence. The victim will be offered social assistance in the form of social workers and a police officer. It will be the responsibility of the police officer to gather obtain information to locate the perpetrator of violence. It will be the responsibility of the social worker to administer much needed support to the victim as they journey down the road to physical and mental recovery. The implementation of HBGVI could solve a plethora of social injustices. The neglect experienced in underserved communities tends to manifest in the form of violence and mental health deterioration. HBGVI can address violence within underserved communities, as well as administer much needed mental health support during moments of extreme stress. Finally, Katie suggests the City of Birmingham create conflict resolution courses to be taught within communities as well as in the classroom. Arming citizens with healthy conflict resolution skills, instead of firearms, will better prepare citizens to avoid conflict.
After a robust discussion, varying in topics ranging from public health initiatives to community building, Katie offered a final sentiment: “Gun violence is a complex issue and requires a complex solution.” It is the responsibility of everyone to prioritize institutional response to the escalating threat of gun violence.
This 2021 Spring Semester, UAB’s Institute for Human Rights had the privilege of partnering with Clínica Verde in Nicaragua to dive into the human rights issues that women in the country face, especially regarding health care. The internship, directed by Dr. Tine Reuter and Dr. Stacy Moak, has opened doors to important conversations about the importance of voicing and advocating for people who need support. Although the semester just started, those involved with the internship have already been exposed to several educated and experienced scholars that are making a mark on the country and are looking to equip and inspire others to do the same. In just one month, students have learned about the life of women and children have struggled to find economic stability, and access to basic resources. The purpose of this partnership with Clínica Verde is dive deeper into the ways that UAB (University of Alabama at Birmingham) students can serve others even during a global pandemic. Through the development of the course students will develop programs and educational presentations that aim to advocate the same values and goal displayed by the staff at Clínica Verde to reach out to more people in the clinic’s surrounding community but also to those in more rural areas.
Feed My Starving Children (FMSC)
Yolanda Paredes-Gaitan was the first speaker invited to speak to the students. She lived in Nicaragua for twelve years but is now currently living in California and working for the U.S. government. While in Nicaragua, she worked alongside Clínica Verde helping find ways to advocate for human rights issues, now she does that in partnership with the U.S. Valuable information shared through her presentation revealed that 65% of people in Nicaragua live in rural areas that are usually only accessed by walking or horses. Although the country of Nicaragua is rich in resources such as coffee, chocolate, and honey, however the country has been deemed the second poorest country, after Haiti. So why does this matter? It matters because it affects everything, including the quality of life in the country. Every community in the country has what is known as a health post. Each health post is usually the primary place for individuals to go to for basic health care needs, especially since few people have access to a nearby hospital. However, the problem is that most of the posts are rundown and in need of repairs. With the help of Clinica Verde, one post which had a structure that was falling apart, had holes in the roof, had no running water was transformed into a new and improved post that is now a green building that has natural ventilation, lighting and has access to water and the resources needed to provide the community with quality services. The goal of Clínica Verde is not to keep all the knowledge to themselves but instead to spread it with those in the country. Another thing that the clinic has been able to do is to provide posts with the knowledge necessary to run an intensity garden. The reason the clinic does this is because they are not looking to provide the women and children with short term solutions to their problems. They want to equip people with the knowledge to improve their lives long term, so they are more educated on how to live a more healthy and sustainable life.
Who visits the clinic?
People from all around the country visit the country. One lady traveled by bus and walked two hours up a hill just to get back home, but she did it because she loved the care provided by Clínica Verde. However, unlike the traditional view that when patients need care, they must go to the clinic, Clínica Verde travels to rural communities three times a week. Their mission goes beyond what the four walls of their building. They make it a priority to reach those who would otherwise not have time to visit the clinic. Another important thing to note is that the clinic also Nicaragua had no education in optometry until one donor came to the country and changed that. Now the team at Clínica Verde also has a program that helps provide people in the community with free glasses which is centered around the students but also anyone in the student’s lives that may also need glasses. This optometry program has also allowed senior citizens to have surgeries that have saved them from going blind.
Since the middle of November, COVID-19 cases have hit record-highs for the pandemic across the world. Countries around the world are pushing to get healthcare workers and the general population vaccinated to ease the burden of increased cases on health systems, economies, and citizens. The logistics of obtaining and delivering the vaccine have proved a slow, arduous task in many countries across the world.
However, Israel has reported success in rapidly vaccinating health care workers and the general population. At the end of December and early January, Israel reported that it had administered vaccines to around 17% of the population. According to the Jerusalem Post, Israel has secured enough vaccines to have all Israeli citizens vaccinated by March 16th of this year. Israeli Prime Minister Netanyahu has declared, “We will be the first country to emerge from the coronavirus. We will vaccinate all relevant populations and anyone who wants to can be vaccinated.” He went on to say that Israel will be a “model-nation” for how to exit the coronavirus.
A significant portion of Israel’s borders is made up of 5 million Palestinians who live in the West Bank, Gaza Strip, and East Jerusalem. Israelis within the defined borders of the state number at 8 million, making Palestineans comprise 39% of the population. Israel occupies the West Bank, meaning most of the territory is under the control of the Israeli government. Gaza Strip has been blockaded, and the Israeli government controls all resources entering and exiting the area. However, Israel has no plans to vaccinate any Palestinians even though they are inoculating residents living in Jewish settlements in occupied territory. They sight the Oslo Peace Accords from the 1990s, saying that Palestine is responsible for their own healthcare. So far, the only Palestinians that have received any vaccines are those living in East Jerusalem, since they have Israeli residency and access to Israeli healthcare.
Within Israeli territory, Palestinians have carried the higher burden of COVID-19 cases and deaths per capita. Of the people who get COVID-19 in Palestine, 1.1% will die from the disease. In Israel, this number is 0.7% due to better access to higher quality healthcare. Israel has begun to give vaccines to medics, nurses, and doctors working in the 6 Palestinian hospitals, but they were not available until the past few weeks. Vaccines are still unavailable to Palestinians with high-risk health conditions and those over 65, even though all Israelis over 40 are now eligible.
The human rights body of the United Nations has released a statement saying that it is Israel’s responsibility as an occupying power to provide equitable access to Covid-19 vaccines for Palestinians in Gaza and the West Bank. There has been a huge inequality in vaccine distribution between Israel and Palestine, and the people of Palestine need vaccinations like those in the occupying power of Palestine.
UPDATE (March 29, 2021): According to BBC News, in early March, Israel decided to start offering the vaccine to the some 130,000 Palestinians living in occupied East Jerusalem or coming to work in Israel or in Israeli settlements in the West Bank. In other parts of the West Bank and in Gaza, the situation continues to be very bleak – infections are rising, new restrictions are being imposed, and vaccination efforts have been much slower to start. The Palestinian authorities have begun administering vaccines supplied under the international Covax vaccine-sharing scheme, which is intended to help poorer countries access supplies, and the UAE has donated 20,000 doses of the Russian-made vaccine to residents of Gaza. There is some argument over who is responsible for vaccinating Palestinians, with Israel pointing to the specification in the Oslo Accords stating that “Powers and responsibilities in the sphere of Health in the West bank and Gaza Strip will be transferred to the Palestinian side, including the health insurance system.” On the other hand, the United Nations issued a statement saying that according to the Fourth Geneva Convention, Israel (the occupying power) is “responsible for providing equitable access to Covid-19 vaccines for Palestinians in Gaza and the West Bank.” In any case, now that the vaccine is in greater supply, Israel has begun including Palestinians with work permits in the vaccine rollout.
Social work is a field in which professionals are intended to do their best to help connect members of vulnerable populations with the resources necessary to allow them to live with their rights and general well-being safe. However, on October 12 of this year, during a meeting between the Texas Behavioral Health Executive Council and the Texas Board of Social Work Examiners, a section of the social workers’ code of conduct was altered. A section which previously stated, “A social worker shall not refuse to perform any act or service for which the person is licensed solely on the basis of a client’s age; gender; race; color; religion; national origin; disability; sexual orientation; gender identity and expression; or political affiliation.” During the meeting, the words “disability; sexual orientation; gender identity and expression” were taken out. They instead replaced that phrase with the word sex, making the social workers’ code match the Texas Occupations Code.
This is concerning for a few reasons, the most glaring one being that it leaves members of the LGBTQ+ community and people with disabilities in Texas, two populations that are already seriously vulnerable, even more vulnerable than before, as social workers can now turn away potential clients from those communities.
This led to an uproar among advocates for the LGBTQ+ community and people with disabilities, as at puts their ability to access important resources that are related to their basic human rights directly at risk. There is an increasingly serious concern that members of these populations will face even more obstacles in accessing the things they need than they already do.
The Human Rights Connection
It’s important to recognize that is an issue of human rights, even outside of the clear issue of discrimination against these groups that is involved. Consider some of the jobs of social workers. They include therapists, case workers, workers for Child Protective Services, and much more. In addition to working with people with disabilities and members of the LGBTQ+ community in general, many social workers specialize in work with children and older adults, two groups which overlap with the former. Then these vulnerable populations are unable to get the support they need in order to access the tools, programs, and resources that exist specifically to help them live life and access their basic needs, they are by extension often kept from being able to access their basic human rights.
One clear example of this is when people with disabilities require financial aid to support themselves do to an inability to be a part of the general workforce. Social workers are an important part of the process of connect the people affected by this issue with the resources and government programs they need. Without the aid of social workers, they might have significant difficulty accessing their “right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control,” as recognized in Article 25 of the United Nations’ Universal Declaration of Human Rights.
The fact that this allows social workers to discriminate certain groups in accepting clients is human rights issue in itself, as according to Article 7 of the UDHR, all are entitled to equal protection under the law and,“All are entitled to equal protection against any discrimination in violation of this Declaration and against any incitement to such discrimination.”
The Purpose of Social Work: Helping Vulnerable Populations
Another reason this change in the Texas social workers’ code of conduct is problematic is that the field of social work is inherently meant to involve professionals helping vulnerable populations (such as the LGBTQ+ community and people with disabilities). According to the National Association of Social Workers’ (NASW) Code of Ethics,“The primary mission of the social work profession is to enhance human well–being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty.” A vulnerable population is a group or community “at a higher risk for poor health as a result of the barriers they experience to social, economic, political and environmental resources, as well as limitations due to illness or disability.”
Social work is also built a set of core values: service, social justice, dignity and worth of the person, importance of human relationships, integrity, competence. It is the job of a social worker to do what they can to uphold those values by helping vulnerable populations access the resources they need. Therefore, social workers’ turning away members of the LGBTQ+ community and people with disabilities, particularly vulnerable groups, goes against the social work code of ethics.
The ethical principles of social work also bar social workers from participating in acts of discrimination on the “basis of race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical ability.”
There is a meeting set for October 27, 2020 so that the Texas Behavioral Health Executive Council can discuss the issue of discrimination as it applies to the changes that were made to the Texas social workers’ code of conduct. It is vital that we do not underestimate the significance of this situation and the serious harm that it can cause.
The illicit pharmaceutical industry is bigger than one might think. In an age where coverage for prescription drugs may be limited and an opioid crisis is rampant, more and more people are turning to this illicit market. Because not everyone that purchases pharmaceutical drugs is aware they are doing so, this industry has been difficult for law enforcement to track. Thus, it has grown internationally and there are few places that are not affected by it.
The illicit pharmaceutical drug industry is a far reaching one. One reason for this is because counterfeit drugs can be made relatively cheap. A recent 60 Minutes segment illustrates how easy it is for companies to produce counterfeit pharmaceutical drugs; small rooms with relatively primitive equipment are used to make multiple drugs including blood pressure medicine, Viagra, painkillers, and seizure medication. One-way people are able to get these drugs is through illicit dealers posing as legitimate online pharmacies. So, even if an individual is not intentionally seeking out alternatives to legally prescribed medication, they may be tricked into it none the less. Other dealers have been much less reserved in how they market their products. As with the “Silk Road” site that operated on the dark web from 2011 to 2013, which included 4,000 dealers and around 100,000 buyers, it made no attempt to hide their illegality. This site acted as a huge distributor of numerous illicit substances including prescription drugs. While the “Silk Road” has been shut down for years, there are still many other sites on the dark web facilitating illicit pharmaceuticals. Additionally, when costumers buy illicit drugs online from sites posing as legal businesses, or even from sites like the “Silk Road,” they are often shipped to buyers through the postal service. This makes drugs difficult to stop, especially when they are shipped in small amounts. All in all, this makes it easy to deal in counterfeit drugs and allows the industry to spread across the globe.
But what are the negative implications? Is it only the pharmaceutical industry’s profit margins that suffer from this illicit industry? The answer is, sadly, no. There have been numerous negative consequences for public health that have resulted from it. Especially in the wake of the opioid pandemic–which hit the country largely due to doctors over prescribing highly addictive opioid painkillers–this industry has caused a large amount of irrevocable damage. As one source states, it is hard to know for sure how much the illicit drug industry has impacted people’s health. That said, it is predicted to have contributed significantly to the 42,249 deaths that resulted from opioid related causes in 2016 alone. Additionally, counterfeit pharmaceuticals are entering hospitals and pharmacies around the country. Even if the drug itself was manufactured licitly, counterfeit materials can make their way into the ingredients, or the ingredients may be safe but the wrong dose is recommended, thus making it counterfeit. These counterfeit ingredients can be anything from chalk to flour. While chalk and flour are fairly harmless, when those ingredients are used in life-saving medications, the results can be catastrophic. In one instance, counterfeit materials found their way into the blood thinner, Heparin, which resulted in the deaths of 80 people. While most pharmaceutical drugs that people receive are not counterfeit, the illicit pharmaceutical industry is continuing to grow and deceive people.
So, what can be done? As previously stated, most of these illicit pharmaceutical drugs are shipped through the mail and they have proven difficult to stop. Even so, there is still hope. There are new procedures being put in place including implementing new technology in international mail carrier facilities that allows those working there to scan packages and detect even minuscule amounts of opioids, and dark web sites are increasingly being monitored by government analysts. As of now, counterfeit drugs account for less than 1% of all pharmaceutical drugs sold in the United States. While counterfeit drugs are still a major problem in developing countries, it seems like likely that countries across the globe will eventually pick up similar measures to the U.S. and other countries that have reduced the problem significantly, so that this trade can be further snuffed out.
In essence, there are many outlets to the illicit pharmaceutical industry. These range from seemingly legal sites on the internet, the dark web, and even pharmacies and hospitals. These outlets have knowingly, and sometimes unknowingly, helped distribute sometimes dangerous counterfeit drugs to citizens across the globe. This has resulted in the deaths of many people and also helped perpetuate the opioid epidemic. Thankfully, the U.S. has amped up regulation in recent years leading to very little illicit pharmaceuticals ending up in the homes of people across the nation. In the future, it seems hopeful that the regulations that have been implemented in countries like the U.S. will soon be commonly used in other countries as well in order to stop this industry for good.
The Memphis Sanitation Strike started the environmental justice movement in February of 1968 when sanitation workers in Memphis, TN organized a strike to protest unfair treatment and the effects on their health. The workers had been receiving less pay than their white coworkers, while also doing the more dangerous work. Before the beginning of the strike, two black men had been killed by the trash compactor during work. The movement eventually lead to a recognized union and higher pay. This was not the first instance of environmental racism. However, it was one of the first time that head way was made when it comes to equality and equity.
The most famous example of a fight for environmental justice, Love Canal, seems to have few people of color as part of the story as many of the vocal people involved were white women. After heavy rain fall in 1978, residents of Love Canal, NY, noticed that there was a bad smell in the air, children were returning home after playing outside with burns on their skin, and babies were being born with birth defects at a very high rate. They didn’t know that toxic chemicals had seeped from the chemical waste dump they had built their homes and school on.
However, there was a federal housing project in the area as well that housed mainly people of color, and their voices were overshadowed by people like Lois Gibbs. The movement to move people out of the hazardous area did not extend to moving the people living in the federally funded housing to a safer area even though they were affected by the hazardous waste just as significantly. Luckily, both groups were able to relocate and receive compensation for the health effects.
While the Memphis Sanitation Strike and Love Canal both happened over 40 years ago, the environmental injustice experienced during those times has not completely gone away. Today people of color and low-income individuals are still more likely to live and work in hazardous areas. Most Superfund sites, which are areas that have been deemed severely environmentally contaminated, are within one mile of federally funded housing. Even more disturbing, a disproportionate amount of these families are people of color.
The disproportionate placing of federally funded housing, and therefore low-income communities of color, into environmentally hazardous areas stems from systematic racism, or more specifically, a Not In My Backyard (NIMBY) mentality held by higher-income white communities. No one wants to live near a hazardous waste site, a factory that releases toxic fumes, or a stinky landfill. However, the people with the power to say no get their way while the people who are already more likely to have health risks are placed in dangerous situations.
A larger problem is that low-income communities and communities of color have been not listened to. In northern Birmingham, AL a recent study showed that a coke mill on a Superfund site has been releasing carcinogenic chemicals in the air for years. Many residents have severe respiratory problems, such as asthma, and now can’t survive without many medications. However, the EPA didn’t catch the extremely high levels of rarer toxins in the air because they don’t typically test for those. It took a study from a nongovernmental organization to expose the harm that the coke mill was doing to this community.
No one wants to live somewhere that is going to make themselves or their family sick, and they shouldn’t have to. While the United States has made progress towards environmental justice over the past 40 years, there is still a long way to go. Superfund sites were created in 1980, but most of the current public housing was created before then. New federally funded housing should not be put near hazardous areas like Superfund sites, and we should work on solutions to clean up Superfund sites near federally funded housing or moving that housing . By reducing the number of housing projects near hazardous waste and taking note when a whole community gets sick, we will begin to move towards racial and income equity when it comes to the environment we live and work in.
In the Appalachian region of the United States, there have long been overarching socioeconomic problems that have prevented the region from seeing the same levels of growth as other parts of the country, and even been part of its decline in other domains. Much of Appalachia’s population of twenty-five million people remains remote, isolated from urban growth centers and beneficial resources that exist in cities. The rural towns and counties in which many Appalachian people live have not had the ability to maintain the public infrastructure, furnish the business opportunities, or provide the medical services that are necessary to sustain populations.
There are three regions of Appalachia: the southern region, which covers parts of Georgia, Alabama, Mississippi, the Carolinas, and Tennessee; the central region, which covers parts of Kentucky, southern West Virginia, southern and southeastern Ohio, Virginia, and Tennessee; and the northern region, which includes parts of New York, Pennsylvania, northern West Virginia, Maryland, and northern and northeastern Ohio. While the entire Appalachian region struggles with higher levels of poverty, unemployment, and lack of services and infrastructure, some sub-regions suffer worse than others, and in different ways (Tickamyer & Duncan).
Even when compared to other rural areas, Appalachia struggles on measures of educational attainment, household income, population growth, and labor force participation. Rates of disability and poverty are significantly higher in rural Appalachia than they are in other rural areas of America. In 2018, the number of Appalachian residents living below the poverty line was higher than the national average in every age group except those 65 and older. The largest disparity was among young adults (18-24), where the Appalachian population was more than 3% higher than elsewhere. From 2009 to 2018, median household income in Appalachia went up by 5%, not far behind the national average of 5.3%. However, the median household income in Appalachia remains more than $10,000 lower than the national median.
One area where disparities between Appalachia and elsewhere in the country are particularly noticeable is in healthcare. The Appalachian Regional Commission released in 2017 “Health Disparities in Appalachia”, which reviews forty-one population and public health indicators in a comprehensive overview of the health of the twenty-five million people living in Appalachia. The study found that Appalachia has higher mortality rates than the rest of the nation in seven of the nation’s leading causes of death: heart disease, cancer, COPD, injury, stroke, diabetes, and suicide. In addition, diseases of despair are much more prevalent in Appalachia than the rest of the country. Rates of drug overdose deaths are dramatically higher in the Appalachian region than the rest of the country, especially in the region’s more rural and economically distressed areas. Research indicates that diseases of despair will increase under COVID-19, as well. This will be especially true for women, who experience death from diseases of despair at a rate 45% higher than the national average in Appalachia. The ARC found that, while deaths as a result of diseases of despair were more numerous in metropolitan counties of Appalachia, rates of suicide and liver disease were higher in rural counties.
These issues are exacerbated by the fact that there is a much lower supply of health care professionals per capita, including primary care physicians, mental health providers, specialists, and dentists in Appalachia. The supply of speciality physicians is sixty-five percent lower in the central sub-region of Appalachia than the rest of the nation as a whole. Other factors negatively impact health in Appalachia, as well. Nearly twenty-five percent of adults in Appalachia are smokers, compared to just over sixteen percent of all American adults, and obesity and physical inactivity are extremely prevalent. However, it is worth noting that in some areas of public health interest, such as the occurrence of STIs/STDs and HIV, Appalachia does better than the rest of the country. Healthcare disparities are an increasingly dramatic phenomenon. From 1989-1995, the cancer mortality rate in Appalachia was only 1% higher than the rest of the US, but by 2008-2014, it had risen to be 10% higher. In the same time frames, the infant mortality rate was 4% higher versus 16% higher, respectively. And, in 1995, the household poverty rate in Appalachia was 0.6% higher than the national average, but by 2014 was 1.6% higher. We like to think of these problems as things of the past, but the gaps are still very much relevant. Fortunately, people living in Appalachian communities are more likely to have health insurance coverage than other Americans. 8.8% of the population in Appalachia do not have health insurance versus the national average of 9.4%.
This year, in the midst of the coronavirus pandemic, some factors of the Appalachian population have put people living there at greater risk of COVID-19. 18.4% of people living in Appalachia are over age sixty-five, which is more than two percent higher than the national average. In more than half of Appalachian counties, over 20% of people are older than 65. This, combined with high rates of obesity and smoking, put many people in the “high-risk” category. COVID-19 has affected Appalachian communities in ways that don’t result in death but make surviving even more difficult. Food insecurity, for instance, is an increasingly severe problem. At one soup kitchen, “…we were serving about 200 people a day, and our numbers have nearly tripled since COVID started,” social worker Brooke Parker, from Charleston, West Virginia, said.
However, perhaps due to the isolated nature of many Appalachian communities, mortality rates from COVID-19 have not been markedly higher than the national averages.
With schools moving to online learning, problems with access to internet in Appalachia become more relevant and pressing. Around 84% of Appalachian households have a computer, which is five percentage points below the national average. 75% have access to reliable internet, which is also five percent lower than average. There is no easy solution to this lack of access to education. Even in non-Appalachian counties, students are being severely impacted by the disruption to their normal education activities.
Human rights organizations ought to keep a close eye on Appalachia as we see the results of COVID-19 on an already vulnerable and at-risk population. The ultimate consequences of the pandemic will likely be more severe here than elsewhere in the country. People living in Appalachia deserve the same assistance being offered to and resources being put towards urban centers in other parts of America. Too often have they seemingly been forgotten.
1. “Health Disparities in Appalachia”. Marshall, J.,Thomas, L., Lane, N., Holmes, G., Arcury, T., Randolph, R., Silberman, P., Holding, W., Villamil, L., Thomas, S., Lane, M., Latus, J., Rodgers, J., and Ivey, K. August 23, 2017. https://www.arc.gov/wp-content/uploads/2020/06/Health_Disparities_in_Appalachia_August_2017.pdf. Retrieved December 3, 2020.
2. Population Reference Bureau. https://www.prb.org/appalachias-current-strengths-and-vulnerabilities/. Retrieved December 9, 2020.
3. Tickamyer, A., Duncan, C. (1990). Poverty and Opportunity Structure in Rural America. Annual Review of Sociology. 16:67-86.
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