Posts filed under 'Discrimination'

IMF loans linked to increased TB

The New York Times reported yesterday on a new study concluding that receipt of loans from the International Monetary Fund is associated with increased tuberculosis cases. The bottom line, from the Editors’ Summary (posted below the article):

“[T]hese results challenge the proposition that the forms of economic development promoted by the IMF necessarily improve public health”

Here is the Times article:

Rise in TB Is Linked to Loans From I.M.F.

By Nicholas Bakalar

The rapid rise in tuberculosis cases in Eastern Europe and the former Soviet Union is strongly associated with the receipt of loans from the International Monetary Fund, a new study has found.

Critics of the fund have suggested that its financial requirements lead governments to reduce spending on health care to qualify for loans. This, the authors say, helps explain the connection.

The fund strongly disputes the finding, saying the former communist countries would be much worse off without the loans.

“Tuberculosis is a disease that takes time to develop,” said William Murray, a spokesman for the fund, “so presumably the increase in mortality rates must be linked to something that happened earlier than I.M.F. funding. This is just phony science.”

The researchers studied health records in 21 countries and found that obtaining an I.M.F. loan was associated with a 13.9 percent increase in new cases of tuberculosis each year, a 13.3 percent increase in the number of people living with the disease and a 16.6 percent increase in the number of tuberculosis deaths.

The study, being published online Tuesday in the journal PLoS Medicine, statistically controlled for numerous other factors that affect tuberculosis rates, including the prevalence of AIDS, inflation rates, urbanization, unemployment rates, the age of the population and improved surveillance.

The lead author, David Stuckler, a research associate at Cambridge University, defended the study against the fund’s criticisms, noting that the researchers considered whether increased mortality might have led to more loans rather than the other way around.

Instead, they found that the increase in tuberculosis mortality followed the lending; each 1 percent increase in credit was associated with a 0.9 percent increase in mortality. And when a country left an I.M.F. loan program, mortality rates dropped by an average of 31 percent.

“When you have one correlation, you raise an eyebrow,” Mr. Stuckler said. “But when you have more than 20 correlations pointing in the same direction, you start building a strong case for causality.”

The study can be read here. Here is the Editors’ Summary for the article:

Editors’ Summary

Background.

Tuberculosis—a contagious, bacterial infection—has killed large numbers of people throughout human history. Over the last century improvements in public health began to reduce the incidence (the number of new cases in the population in a given time), prevalence (the number of infected people), and mortality rate (number of people dying each year) of tuberculosis in several countries. Many authorities thought that tuberculosis had become a disease of the past. It has become increasingly clear, however, that regions impacted by health and economic changes since the 1980s have continued to face a high and sometimes increasing burden of tuberculosis. In order to boost funding and resources for combating the global tuberculosis problem, the United Nations has set a target of halting and reversing increases in global tuberculosis incidence by 2015 as one of its Millennium Development Goals. Yet one region of the world—Eastern Europe and the former Soviet Union—is not on track to achieve this goal.

Why Was This Study Done?

To achieve these targets, the World Health Organization (WHO) and tuberculosis physicians’ groups promote the expansion of detection and treatment efforts against tuberculosis. But these efforts depend on the maintenance of good health infrastructure to fund and support health-care workers, clinics, and hospitals. In countries with significant financial limitations, the development and maintenance of these health system resources are often dependent upon international donations and financial lending. The International Monetary Fund (IMF) is a major source of capital for resource-deprived countries, but it is unclear whether its economic reform programs have positive or negative effects on health and health infrastructures in recipient countries. There are indications, for example, that recipient countries sometimes reduce their public-health spending to meet the economic targets set by the IMF as conditions for its loans. In this study, the researchers examine the relationship between participating in IMF lending programs of varying sizes and durations by 21 post-communist Central and Eastern European and former Soviet Union countries and changes in tuberculosis incidence, prevalence, and mortality in these countries during the past two decades.

What Did the Researchers Do and Find?

To examine how participation in IMF lending programs affected tuberculosis control in these countries, the researchers developed a series of statistical models that take into account other variables (for example, directly observed therapy programs, HIV rates, military conflict, and urbanization) that might have affected tuberculosis control. Participation in an IMF program, they report, was associated with increases in tuberculosis incidence, prevalence, and mortality rate of about 15%, which corresponds to hundreds of thousands of new cases and deaths in this region. Each additional year of participation increased tuberculosis mortality rates by 4.1%; increases in the size of the IMF loan also corresponded to greater tuberculosis mortality rates. Conversely, when countries left IMF programs, tuberculosis mortality rates dropped by roughly one-third. The authors’ further statistical tests indicated that IMF lending was not a positive response to worsened tuberculosis control but precipitated this adverse outcome and that lending from non-IMF sources of funding was associated with decreases in tuberculosis mortality rates. Consistent with these results, IMF (but not non-IMF) programs were associated with reductions in government expenditures, tuberculosis program coverage, and the number of doctors per capita in each country. These findings associated with mortality were also found when analyzing tuberculosis incidence and prevalence data.

What Do These Findings Mean?

These findings indicate that IMF economic programs are associated with significantly worsened tuberculosis control in post-communist Central and Eastern European and former Soviet Union countries, independent of other political, health, and economic changes in these countries. Further research is needed to discover exactly which aspects of the IMF programs were associated with the adverse effects on tuberculosis control reported here and to see whether IMF loans have similar effects on tuberculosis control in other countries or on other non–tuberculosis-related health outcomes. For now, these results challenge the proposition that the forms of economic development promoted by the IMF necessarily improve public health. In particular, they put the onus on the IMF to critically evaluate the direct and indirect effects of its economic programs on public health.

Additional Information.

Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0050143.

Add comment July 23rd, 2008

Census Bureau to dissapear gay marriages

Most researchers recognize that research is inherently affected by social beliefs, norms, and practices. But the Census Bureau is about to give us an enormous demonstration. They have decided to remove all gay marriages from their marriage data for the 2010 census, despite laws in Massachusetts and California legalizing those marriges. Perhaps next they’ll remove “Islam” from the list of reportable religions.

U.S. Census Bureau won’t count same-sex marriages

By Mike Swift
Mercury News

Tens of thousands of same-sex couples are expected to marry legally in California by 2010, if a constitutional ban on gay marriage doesn’t pass at the polls in November.

But no matter what the voters decide, the official government count of the number of married same-sex couples in California is not in doubt. It will be zero.

The U.S. Census Bureau, reacting to the federal Defense of Marriage Act and other mandates, plans to edit the 2010 census responses of same-sex couples who marry legally in California, Massachusetts or any other state. They will be reported as “unmarried partners,” rather than married spouses, in census tabulations - a policy that will likely draw the ire of gay rights groups.

The Census Bureau followed the same procedure for the 2000 census, and it does not plan to change in 2010 even though courts in Massachusetts and now California have ruled gay men and lesbians can marry lawfully.

“This has been a question we’ve been looking at for quite a long time,” said Martin O’Connell, chief of the Census Bureau’s Fertility and Family Statistics Branch. “It’s not something the bureau could arbitrarily or casually decide to change on a whim, because our data is used by virtually every federal agency.”

The Census Bureau is not falsifying people’s responses, O’Connell said, because the bureau will retain people’s original census responses.

“We’re not destroying data; we are keeping that data,” O’Connell said. “We are just showing the data published in a way that is consistent with the way every other agency publishes their data.”The Census Bureau does not ask about sexual orientation, but it does ask people to describe their relationships to others in their household. If a respondent refers to a person of the same gender as their “husband/wife” on the 2010 census form, the Census Bureau will automatically assign them to the “unmarried partner” category. Legally married same-sex couples will be indistinguishable in census data from those who chose “unmarried partner” to describe their relationship.

Researcher’s view

Critics say the census plan will mask the records of legal, same-sex, married couples and therefore degrade the quality of the government’s demographic data.

“I just think it’s bad form for the census to change a legal response to an incorrect response,” said Gary Gates of the Williams Institute, a think tank at the University of California-Los Angeles law school that studies gay-related public policy issues. “That goes against everything the census stands for.”

Gates, a prominent demographer who was consulted by Census Bureau officials about counting legally married same-sex couples, said one result is that the census will undercount marriages in states with gay marriage. And because the bureau defines a “family” as two or more people related by birth, adoption or marriage, it also will remove many same-sex married couples from being counted as families.

“It’s a systematic hiding not only of married gay couples, but gay couples as families, which I would argue is a fundamentally political decision,” Gates said.

One recently married couple called the policy “frustrating.”

“It’s just another layer of the hurdles we have to jump, as far as our relationship being recognized,” said Jim Winstead of Hollister, who recently married his partner, Rodney Naccarato-Winstead. The couple have an 18-month-old son.

Gay rights groups, learning of the policy this week, were also critical.

“To have the federal government disappear your marriage I’m sure will be painful and upsetting,” said Shannon Minter, legal director for the National Center for Lesbian Rights. “It really is something out of Orwell. It’s shameful.”

A spokeswoman for ProtectMarriage.com, campaigning in favor of the constitutional ban, declined to discuss the census issue in detail, but said it illuminates how the legalization of gay marriage potentially could dictate policy changes on government.

“One of our campaign cornerstones will be the fact that if the initiative doesn’t pass that public schools will be forced to teach the difference between gay marriage and traditional marriage,” said Jennifer Kerns.

Bureau’s reasoning

A census technical note that explains the bureau’s rationale on counting same-sex partners for the 2000 census notes that the 1996 Defense of Marriage Act “instructs all federal agencies only to recognize opposite-sex marriages for the purposes of enacting any agency programs.”

O’Connell said the Census Bureau has been unable to find any federal agency that collects data on same-sex married couples. Changing the policy before the 2010 census also would be a huge and difficult logistical issue.

“The last thing anyone wants is to use the 2010 census as a trial run,” O’Connell said.

Gates said, however, that the limitations on access to people’s original responses will make it very difficult for private researchers to analyze raw data and back out the number of same-sex spouses in California or other states.

“It’s an official closet,” Gates said, “that the government has built.”

1 comment July 12th, 2008

Conason compares Clinton to George Wallace

Ow! Joe Conason thinks Hillary Clinton  is starting “to sound like a reincarnation of the late George Wallace.” That must hurt.

Add comment May 9th, 2008

Renounce Hillary Clinton’s racism

I feel obligated to express my disgust, to put it mildly, with the racist turn in Hillary Clinton’s campaign. Not being sure of the best way to do so, I’ve decided to copy and post this entry from Talking Points Memo:

Pretty Black and White

TPM Reader AB is having a hard time reconciling Hillary’s remarks on Obama’s support among working class whites:

It seems to me that every progressive voice in this country should be outraged - jumping up and down - shouting in print and word - to repudiate Hillary Clinton’s remarks that Obama “is having trouble winning over blue collar “white” voters… “white Americans”…It is a disgraceful, shameful tactic to justify her own non-candidacy. This is a remark I would expect from a politician from Mississippi or Louisiana - not from our New York State senator… I am outraged, I am deeply embarrassed that my children have heard this reported on the news…and I regret that have I ever gave her one hard earned nickel.

All the while she touts the glass ceiling as a woman but when her chips are down, the racism springs forth fully formed.

AB is right. Maybe it’s general campaign fatigue, or the sense that the race is all but over now, but a month ago her remarks would have been a huge story, the dominant political story of the day.

The political press spent weeks trying to divine whether the Clinton camp was really attempting to cast Obama as the black candidate, a favorite son candidate of the African American community. The Clinton camp vehemently denied it then and even as recently as a few days ago Bill Clinton claimed it was the Obama camp playing the race card against him.

Race has been the subtext of much of Hillary’s argument for her own electability. But now she’s thrown it right out there in the open: Obama can’t win because he’s black. Vote for me instead.

You don’t have to believe that Hillary’s a racist (I don’t) to conclude that a combination of the rigors of the campaign trail and her own powerful ambitions have clouded her judgment and curdled her spirit. It has certainly soured what had been a historic relationship between the Clintons and the black community.

Hers is not an appeal we’d tolerate from a Republican candidate, nor should we from a Democrat, no matter how sterling her progressive credentials might otherwise be.

There’s been a lot of talk about the damage Hillary will do to the party by staying in the race this long. Perhaps she should consider the damage she’s doing to herself.

–David Kurtz

The one thing I would disagree with is the formulaic statement that David doesn’t think Hillary is racist:

You don’t have to believe that Hillary’s a racist (I don’t)…

After all, we psychologists, and any thinking person living in this society knows that, at some visceral level, we all harbor racist impulses. So, if the term “bot a racist” is to mean anything, it should mean one who fights against those impulses. Someone who chooses, for expediency, to fan these impulese, is a “racist.” After all, the same argument was made about George Wallace, that he wasn’t a “racist,” but only used racist themes for political expediency. And we know that Strom Thurmond had a complex relationship with race, with his mistress and child and all. To accept these arguments is to reduce “racism” to a personal predilection, and ignore the social and systemic aspects that make it so pernicious. Whether Hillary Clinton dislikes black people, or simply chooses to increase hatred of them for her benefit is irrelevant, except to biographers. If she chooses to unleash racism, she’s a racist.

So I would argue that anyone who deliberately appeals to racism for personal benefit, especially in a way likely to increase racial animosity, is a racist. We should not let Clinton, either one of them, off so easy. And we should should shout it from the rooftops. To do any less is to become complicit in the inexcusable.

4 comments May 8th, 2008

Mildred Loving on the meaning of Loving v Virginia

Mildred Loving died May 2 at home in Virginia. Here is her statement prepared for delivery on June 12, 2007, the 4oth anniversary of Loving v Virginia. It was not that long ago that these ordinary heroes had to fight for the right to marry a partner of a different race. Gays and lesbians today are still fighting for the right to marry whom they choose:

Loving for All

By Mildred Loving

Prepared for Delivery on June 12, 2007,
The 40th Anniversary of the Loving vs. Virginia Announcement

When my late husband, Richard, and I got married in Washington, DC in 1958, it wasn’t to make a political statement or start a fight. We were in love, and we wanted to be married.

We didn’t get married in Washington because we wanted to marry there. We did it there because the government wouldn’t allow us to marry back home in Virginia where we grew up, where we met, where we fell in love, and where we wanted to be together and build our family. You see, I am a woman of color and Richard was white, and at that time people believed it was okay to keep us from marrying because of their ideas of who should marry whom.

When Richard and I came back to our home in Virginia, happily married, we had no intention of battling over the law. We made a commitment to each other in our love and lives, and now had the legal commitment, called marriage, to match. Isn’t that what marriage is?

Not long after our wedding, we were awakened in the middle of the night in our own bedroom by deputy sheriffs and actually arrested for the “crime” of marrying the wrong kind of person. Our marriage certificate was hanging on the wall above the bed. The state prosecuted Richard and me, and after we were found guilty, the judge declared: “Almighty God created the races white, black, yellow, malay and red, and he placed them on separate continents. And but for the interference with his arrangement there would be no cause for such marriages. The fact that he separated the races shows that he did not intend for the races to mix.” He sentenced us to a year in prison, but offered to suspend the sentence if we left our home in Virginia for 25 years exile.

We left, and got a lawyer. Richard and I had to fight, but still were not fighting for a cause. We were fighting for our love.

Though it turned out we had to fight, happily Richard and I didn’t have to fight alone. Thanks to groups like the ACLU and the NAACP Legal Defense & Education Fund, and so many good people around the country willing to speak up, we took our case for the freedom to marry all the way to the U.S. Supreme Court. And on June 12, 1967, the Supreme Court ruled unanimously that, “The freedom to marry has long been recognized as one of the vital personal rights essential to the orderly pursuit of happiness by free men,” a “basic civil right.”

My generation was bitterly divided over something that should have been so clear and right. The majority believed that what the judge said, that it was God’s plan to keep people apart, and that government should discriminate against people in love. But I have lived long enough now to see big changes. The older generation’s fears and prejudices have given way, and today’s young people realize that if someone loves someone they have a right to marry.

Surrounded as I am now by wonderful children and grandchildren, not a day goes by that I don’t think of Richard and our love, our right to marry, and how much it meant to me to have that freedom to marry the person precious to me, even if others thought he was the “wrong kind of person” for me to marry. I believe all Americans, no matter their race, no matter their sex, no matter their sexual orientation, should have that same freedom to marry. Government has no business imposing some people’s religious beliefs over others. Especially if it denies people’s civil rights.

I am still not a political person, but I am proud that Richard’s and my name is on a court case that can help reinforce the love, the commitment, the fairness, and the family that so many people, black or white, young or old, gay or straight seek in life. I support the freedom to marry for all. That’s what Loving, and loving, are all about.

Add comment May 8th, 2008

PBS series on health disparities: Unatural Causes

Apropos the New York Times article I posted earlier today o increasing health disparities between rich and poor in the US, a friend has just sent this notice of a related upcoming PBS series, Unnatural Causes, which asks “is inequality making us sick?” that starts this week. Here is the series summary that she sent:

UNNATURAL CAUSES sheds light on mounting evidence that demonstrates how work, wealth, neighborhood conditions and lack of access to power and resources can actually get under the skin and disrupt human biology as surely as germs and viruses. But it’s not just the poor who are sick—so are the middle classes. At each descending rung of the socio-economic ladder, people tend to be sicker and die sooner. What’s more, at every level, many communities of color are worse off than their white counterparts. Compelling personal stories—spanning the country—demonstrate how social conditions are as vital to our health as diet, smoking and exercise.  As Harvard epidemiologist David Williams points out, investing in our schools, improving housing, integrating neighborhoods, better jobs and wages, giving people more control over their work, these are as much health strategies as smoking diet and exercise. And these are the stories that UNNATURAL CAUSES tells.

HOUR ONE: In Sickness and In Wealth (56 mins) What are the connections between healthy bodies and healthy bank accounts? In Louisville, Kentucky, the issues faced by a CEO, a lab supervisor, a janitor, and a welfare mother bring into sharp relief how socio-economic status shapes opportunities to lead healthy lives.  People of color face an additional burden. Solutions, public health officials believe, lie not in more pills but in better social policies.

HOUR TWO: When the Bough Breaks (28 mins) and Becoming American (28 min)
Why do African American infant mortality rates remain more than twice as high as white Americans? Researchers are circling in on a provocative hypothesis:  the chronic stress of racism can become embedded in African American mothers’ bodies and take a toll on their children even before they leave the womb.

In contrast, recent Mexican immigrants, though often poorer, tend to be healthier than the average American. But the longer they live here, the worse their relative health becomes. What’s protective about new immigrant communities that we can all learn from? And what erodes this shield over time?

HOUR THREE: Bad Sugar (28 min) and Place Matters (28 min) The O’odham Indians of Arizona suffer one of the highest rates of Type 2 diabetes in the world. But is this due to their genes, or is it part of the body’s response to decades of poverty, oppression and historical trauma? A new approach rooted in the community re-gaining control over its destiny offers hope where medical-only interventions have failed.

Why is your street address such a good predictor of your health? How can your surrounding built and social environment get inside your body like smog and toxic waste? As recent immigrants move into long-neglected African American urban neighborhoods, their health is beginning to deteriorate too. What can be done to create healthy communities?

HOUR FOUR:  Collateral Damage (28 min) and Not Just a Paycheck (28 min)

Globalization and the U.S. military have disrupted the lives of Marshall Islanders. Many have ended up in the unlikely place of Springdale, Arkansas where a legacy of poverty and powerlessness continues to take a toll on their bodies.

In western Michigan, a factory closure undermines the lives and health of a white, working class community. But the same company shut down their Swedish plant with hardly a ripple thanks to very different social policies.

http://www.unnaturalcauses.org/

Add comment March 23rd, 2008

Do “free markets” increase life expectancy disparities?

The New York Times today documents that the gap between rich and poor in the US involves not just income, but a growing disparity in life expectancy. Before people start complaining about Bush, not that the main data they present concerns the increase from 1980-1982, the beginning of the Reagan administration, to 1998-2000, the end of the Clinton administration. Presumably, Clinton’s free market ideology and policies contributed to the widening disparities.

Gap in Life Expectancy Widens for the Nation

by Robert Pear

New government research has found “large and growing” disparities in life expectancy for richer and poorer Americans, paralleling the growth of income inequality in the last two decades.

Life expectancy for the nation as a whole has increased, the researchers said, but affluent people have experienced greater gains, and this, in turn, has caused a widening gap.

One of the researchers, Gopal K. Singh, a demographer at the Department of Health and Human Services, said “the growing inequalities in life expectancy” mirrored trends in infant mortality and in death from heart disease and certain cancers.

The gaps have been increasing despite efforts by the federal government to reduce them. One of the top goals of “Healthy People 2010,” an official statement of national health objectives issued in 2000, is to “eliminate health disparities among different segments of the population,” including higher- and lower-income groups and people of different racial and ethnic background.

Dr. Singh said last week that federal officials had found “widening socioeconomic inequalities in life expectancy” at birth and at every age level.

He and another researcher, Mohammad Siahpush, a professor at the University of Nebraska Medical Center in Omaha, developed an index to measure social and economic conditions in every county, using census data on education, income, poverty, housing and other factors. Counties were then classified into 10 groups of equal population size.

In 1980-82, Dr. Singh said, people in the most affluent group could expect to live 2.8 years longer than people in the most deprived group (75.8 versus 73 years). By 1998-2000, the difference in life expectancy had increased to 4.5 years (79.2 versus 74.7 years), and it continues to grow, he said.

After 20 years, the lowest socioeconomic group lagged further behind the most affluent, Dr. Singh said, noting that “life expectancy was higher for the most affluent in 1980 than for the most deprived group in 2000.”

“If you look at the extremes in 2000,” Dr. Singh said, “men in the most deprived counties had 10 years’ shorter life expectancy than women in the most affluent counties (71.5 years versus 81.3 years).” The difference between poor black men and affluent white women was more than 14 years (66.9 years vs. 81.1 years).

The Democratic candidates for president, Senators Hillary Rodham Clinton of New York and Barack Obama of Illinois, have championed legislation to reduce such disparities, as have some Republicans, like Senator Thad Cochran of Mississippi.

Peter R. Orszag, director of the Congressional Budget Office, said: “We have heard a lot about growing income inequality. There has been much less attention paid to growing inequality in life expectancy, which is really quite dramatic.”

Life expectancy is the average number of years of life remaining for people who have attained a given age.

While researchers do not agree on an explanation for the widening gap, they have suggested many reasons, including these:

¶Doctors can detect and treat many forms of cancer and heart disease because of advances in medical science and technology. People who are affluent and better educated are more likely to take advantage of these discoveries.

¶Smoking has declined more rapidly among people with greater education and income.

¶Lower-income people are more likely to live in unsafe neighborhoods, to engage in risky or unhealthy behavior and to eat unhealthy food.

¶Lower-income people are less likely to have health insurance, so they are less likely to receive checkups, screenings, diagnostic tests, prescription drugs and other types of care.

Even among people who have insurance, many studies have documented racial disparities.

In a recent report, the Department of Veterans Affairs found that black patients “tend to receive less aggressive medical care than whites” at its hospitals and clinics, in part because doctors provide them with less information and see them as “less appropriate candidates” for some types of surgery.

Some health economists contend that the disparities between rich and poor inevitably widen as doctors make gains in treating the major causes of death.

Nancy Krieger, a professor at the Harvard School of Public Health, rejected that idea. Professor Krieger investigated changes in the rate of premature mortality (dying before the age of 65) and infant death from 1960 to 2002. She found that inequities shrank from 1966 to 1980, but then widened.

“The recent trend of growing disparities in health status is not inevitable,” she said. “From 1966 to 1980, socioeconomic disparities declined in tandem with a decline in mortality rates.”

The creation of Medicaid and Medicare, community health centers, the “war on poverty” and the Civil Rights Act of 1964 all probably contributed to the earlier narrowing of health disparities, Professor Krieger said.

Robert E. Moffit, director of the Center for Health Policy Studies at the conservative Heritage Foundation, said one reason for the growing disparities might be “a very significant gap in health literacy” - what people know about diet, exercise and healthy lifestyles. Middle-class and upper-income people have greater access to the huge amounts of health information on the Internet, Mr. Moffit said.

Thomas P. Miller, a health economist at the American Enterprise Institute, agreed.

“People with more education tend to have a longer time horizon,” Mr. Miller said. “They are more likely to look at the long-term consequences of their health behavior. They are more assertive in seeking out treatments and more likely to adhere to treatment advice from physicians.”

A recent study by Ellen R. Meara, a health economist at Harvard Medical School, found that in the 1980s and 1990s, “virtually all gains in life expectancy occurred among highly educated groups.”

Trends in smoking explain a large part of the widening gap, she said in an article this month in the journal Health Affairs.

Under federal law, officials must publish an annual report tracking health disparities. In the fifth annual report, issued this month, the Bush administration said, “Over all, disparities in quality and access for minority groups and poor populations have not been reduced” since the first report, in 2003.

The rate of new AIDS cases is still 10 times as high among blacks as among whites, it said, and the proportion of black children hospitalized for asthma is almost four times the rate for white children.

The Centers for Disease Control and Prevention reported last month that heart attack survivors with higher levels of education and income were much more likely to receive cardiac rehabilitation care, which lowers the risk of future heart problems. Likewise, it said, the odds of receiving tests for colon cancer increase with a person’s education and income.

1 comment March 23rd, 2008

US: The prison society

Derrick Z. Jackson reminds us of the barbarity of our society, which imprisons 6% of its black males and 1% of its adult population, far more than any other country on earth. Combine that with the fact that the US spends as much on its War Department as all other nations on earth and we see the magnitude of the institutional violence upon which our country is based:

Prisoners of sentencing politics

by Derrick Z. Jackson

WITH ODIOUS sanctimony, Secretary of State Condoleezza Rice released the annual State Department human rights report. She praised people around the world who work “to hold their leaders accountable and to achieve equal justice under the law.”

The report knocked Russia’s “selectivity in enforcement of the law,” Burma’s “abysmal” level of “indefinite detentions,” Iran’s “arbitrary arrests,” Syria’s trying of “political prisoners in criminal courts,” and China’s “20 percent increase over 2006 in convictions of citizens under China’s overly broad state security law.”

In specific numbers, the report cited China’s 1.8 million inmates and Russia’s 889,600 prisoners, the latter of whom languish in “extremely harsh” and “overcrowded” facilities where “one in 25 was HIV-positive.” Rice wrote in the report’s preface, “Leaders who are insufficiently committed to reform may revert to authoritarian habits or take disastrous detours from the rule of law.”

Missing from the State Department report was the disastrous detour of our own nation. Our inflexible reforms have for two decades turned nonviolent criminals into prisoners of politics.

The United States is the world’s leading prison state. For the first time in our history, more than one out of every 100 adults is behind bars. We have 2.3 million people in jail or prison, according to a Pew Center on the States study released last month. Our rate of imprisonment easily beats second-place Russia and is six times the rate of China, seven times the rate of Germany or France, 10 times the rate of Italy, and 12 times the rate of Japan.

State spending on prisons has grown from $12 billion in 1987 to $49 billion last year. For that, we still have overcrowded prisons where the rate of HIV/AIDS is 2.5 times that of the general population.

The reason is not crime, not when our total levels declined in the 1990s to under those of the European Union, according to the United Nations. But the impact of mandatory federal and state drug laws enacted during the crack panic of the 1980s - and never changed when the panic over drug trade violence proved unjustified - continue to devastate communities and state budgets.

The most well known of those laws are the ones that treat possession of crack cocaine much more harshly than for being caught with powdered cocaine. The Supreme Court is taking an ever-dim view of the laws and the federal US Sentencing Commission has softened them somewhat. But there is no State Department concern for black men.

One in 15 adult black men are behind bars, compared with 1 in 106 adult white men. This is despite the fact that Americans consume illegal drugs at about their racial share of the population, that crack and powder are the same pharmacologically, and that the majority of the drug trade, including crack, is nonviolent. It is wrong that crack offenders, 70 percent of them nonviolent, spend on average 3 1/2 years more in jail (10.8 years to 7.2 years) than those convicted of powder offenses.

Of the presidential candidates, Republican John McCain is likely to march to President Bush’s agenda. The Democrats are not unified in their desire to end this madness. In the 1990s, President Clinton wooed black votes, then sacrificed the black poor to his centrist politics, calling the 1994 crime bill that preserved the disparate laws the “smartest crime bill in the history of the United States.”

Fourteen years later - years which include the 2000 and 2004 presidential elections that Democrats narrowly lost as 13 percent of black men could not vote because of convictions, according to the Sentencing Project - Clinton called the laws he maintained “a cancer.” He pledged to “spend a significant portion of whatever life I’ve got left on the earth trying to fix this.”

Then again, Clinton is still sacrificing black people, almost single-handedly inciting a stampede of undecided black voters from his wife’s presidential campaign toward Barack Obama with ham-handed, racially tinged denigration of Obama.

Both Hillary Clinton and Obama say the laws are unfair. But only Obama approved of the recent decision by the bipartisan Sentencing Commission to “mitigate the unwarranted sentencing disparity” by granting mild retroactive reductions of crack sentences for mostly nonviolent offenders. Clinton’s response was, “I have problems with retroactivity.” As Condoleezza Rice rails about nations insufficiently committed to reform, we remain at high risk at home of staying on our disastrous detour.

Derrick Z. Jackson’s e-mail address is jackson@globe.com.

Add comment March 15th, 2008

Haaretz on the effects of occupation on Israelis

Haaretz has an editorial on command responsibility for abuse of Palestinians by Israeli soldiers, and what it reflects about Israeli society as their occupation of Palestinian lands grinds on:

Something bad is happening to us

by Haaretz

Three years ago, the CBS television network broadcast photos of American soldiers abusing prisoners in the Abu Ghraib prison in Iraq. The horrifying pictures led to the trials of eight soldiers, dismissals and a storm of outrage in America. At the trial of one prison guard, who was sentenced to eight years in jail, a psychologist gave his evaluation: that the man was an entirely ordinary person, without any particular violent tendencies, who served as a guard for many years in civilian life but never behaved sadistically toward American prisoners. The situation of occupier and occupied, as opposed to that of citizen versus citizen, causes ordinary people to become violent and lose restraint. At Abu Ghraib, the trial found, there was institutionalized contempt at every level. The prison guards understood that “this is the way to behave here.”

Last night, the investigative television program “Fact” broadcast pictures of our own Abu Ghraib affair. It is doubtful whether a country that has grown used to 40 years of occupation, and the stories that accompany it, will be shocked. We have become accustomed to treating the Palestinians as inferior people. Generations come and go, and new soldiers abuse the residents of occupied Hebron in almost the same manner. Stories similar to those broadcast last night were exposed by the Breaking the Silence group three years ago. The saying “occupation corrupts” has become a slogan of the left instead of a warning signal to everyone.

This time, it was regular soldiers in the Kfir Brigade. They exposed their backsides and sexual organs to Palestinians, pressed an electric heater to the face of a young boy, beat young boys senseless, recorded everything on their mobile phones and sent it to their friends. One of their “mischievous acts” was to test how long a Palestinian who was being choked could survive without breathing. When he passed out, the experiment was stopped. The soldiers described activities to “break the routine” that consisted entirely of abuse. It was enough for a boy “to look at us the wrong way” for him to be beaten.

Earlier, at the trial of First Lieutenant Yaakov Gigi, officers spoke of burnout, of “something bad happening to the brigade,” of a Wild West, of a moral crisis. The commander of the brigade, Colonel Itai Virov, said “we failed on several parameters.” His words reflect a denial of the depth of the failure. This continuing routine, far from the eyes of the commanders, must lead to a series of investigations, and perhaps to dismissals as well. It is unconscionable for the head of the Hebron Brigade, the division commander, the GOC Central Command and even the chief of staff to ignore the ongoing behavior of soldiers in the brigade responsible for routine security in the West Bank. Colonel Virov admitted that there was a conspiracy of silence in the brigade - in other words, a norm of abuse and its concealment. To change norms, one has to shock and be shocked, not be satisfied with a few imprisonments and empty words about a loss of values.

Perfectly ordinary people, as the American psychologist said of the Abu Ghraib abusers, are capable of behaving like monsters when they receive a message from the top that it is permissible to abuse, beat, choke, burn, make people miserable and generally do anything that man’s evil genius is capable of inventing to others who are under their control. Something bad is happening to us, they are saying in the Kfir Brigade. That “something” is the occupation.

Add comment February 26th, 2008

Ellen Goodman on Obama-Clinton and gender politics

Ellen Goodman in the Boston Globe has a thought-provoking perspective on the Democratic race:

The female style - modeled by a man

By Ellen Goodman

On Tuesday, I got a sarcastic e-mail from a Hillary supporter. She forwarded a crack made by Howard Wolfson, Clinton’s media man, about Obama. “Senator Clinton,” he scoffed, “is not running on the strength of her rhetoric.” To which my friend added: “Unfortunately.”

By evening, the Wisconsin blowout was serious enough that the posters in last-chance Ohio read: “We’ve Got Your Back Hillary.” Clinton’s speech sounded ominously shopworn: “One of us is ready to be commander in chief . . . One of us has faced serious Republican opposition in the past.”

These are disheartening days for Hillary supporters. Not just because of the string of losses but because of the kind of loss.

This was nothing if not a careful campaign. Neither the strategists nor the candidate had illusions about the hurdles that would face the first woman president in American history. They knew women have to prove and prove again their toughness. They knew women have to prove and prove again their experience.

They began as well by framing Clinton as the establishment candidate. But then the establishment became “the status quo” and the historic candidacy became “old politics.” She even got demerits for experience.

Something else happened along the way. If Hillary Clinton was the tough guy in the race, Barack Obama became the Oprah candidate. He was the quality circle man, the uniter-not-divider, the person who believes we can talk to anyone, even our enemies. He finely honed a language usually associated with women’s voices.

Does this transmutation resonate with women who have tried to become CEOs of lesser enterprises than America Inc.? Women of Hillary’s generation were taught to don power suits and use their shoulder pads to push open corporate doors. In the 1970s, the lessons on making it in a man’s world were essentially primers on how to behave like men. As University of Wisconsin-Milwaukee political scientist Kathleen Dolan says, “They had to figure out a way to go undercover. They could only be taken seriously if they filled the male model with XX chromosomes.”

But the next generation of advice books urged women to do it their own way. The old stereotypes that defined women as more compassionate and collaborative were given a positive spin. They were framed and praised as women’s ways of leading.

Today’s shelves are still full of titles - from “Seducing the Boys Club” to “The Girl’s Guide to Being a Boss (Without Being a Bitch)” to “Enlightened Power” - that tell us to act like a man or act like a woman. But in many ways, the transformative inspirational, collaborative, “female” style has become more attractive. Especially to a younger generation. And - here’s the rub - especially when it is modeled by a man.

Dolan sees Obama as “the embodiment of the gentle, collaborative style without threatening his masculine side.” But she adds, “He’s being more feminine than she can be. She is in a much tighter box.”

This too is a bit like what’s happened in business. Whatever advice they follow, women are still only 3 percent of the CEOs in Fortune 500 companies. Meanwhile, it’s become more acceptable for a man to take an afternoon off to watch his kids play ball than for a woman.

Ilene Lang heads Catalyst, which surveyed more than 1,200 senior executives in the United States and Europe. This research calculated the tenacity of double binds and double standards. It showed how hard it still is for a woman to be seen as both competent and likable. And it led her to the conclusion that “What defines leadership to most people is one thing. It’s male.”

As for the Obama style? “Both men and women are much more likely to accept a collaborative style of leadership from men than from women. From women it seems too soft,” she adds ruefully.

Hillary was quite right that she needed to be seen as the experienced, competent, commander in chief. Obama was quite right about the country’s desire to reach across boundaries and beyond divisiveness.

We have ended up in a lopsided era of change. After all, how many of us wanted to see male leaders transformed from cowboys to conciliators? Now we see a woman running as the fighter and a man modeling a ‘woman’s way’ of leading. We see a younger generation in particular inspired by ideas nurtured by women, as long as they are delivered in a baritone.

So, has the women’s movement made life easier? For another man?

Ellen Goodman’s e-mail address is ellengoodman@globe.com.

Add comment February 22nd, 2008

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