Opportunity Radio Episode 7: Health Equity (Part II)

Part II of our podcast with Rinku Sen of Color Lines Magazine and the Applied Research Center.  You can subscribe to Opportunity Radio on iTunes or Feedburner

If you have suggestions for future podcast topics and guests, leave a comment below.

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Opportunity Radio Episode 7: Health Equity

Our latest podcast is up.  You can subscribe to it via iTunes or Feedburner, or listen to it via the embedded player below.  You can find it here on our website.

In this episode, our Research Director and Co-Founder Dr. Brian Smedley talks to Rinku Sen, Executive Director of the Applied Research Center, about race and health care.

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Health Equity in Central Brooklyn

We've got a new video up on our YouTube Channel.  Check it out:

Go After The System, Not The Individuals

So I read about the Immigration and Customs Enforcement (ICE) raids conducted at six meat plants in six states. (NYT, LATimes, WaPo) The idea of an immigrant round-up is disturbing in itself, but I was struck by the justification for these raids: workers at these plants had allegedly stolen identities of US citizens in order to work there, and thus they need to be deported. Really?? ICE is on a witch hunt for identity thieves in immigrants' clothing?

Going after workers themselves hardly seems like the way to change a system that basically promotes ID Theft. Many of the workers at the plants were suspected to be undocumented, and using falsified documents to work here in the States. I think it is wrong to pretend to be someone else. It is also wrong for companies to hire these workers in the first place. Companies across the country know that only the weakest of efforts are required to stay off the hook for hiring undocumented workers. A program called Basic Pilot verifies documents presented by a potential employee. And then it's over for the employer--they did not knowingly hire an undocumented immigrant once the program gives a green light. The fact is that the program shields employers by not . They can hire cheap labor and exploit workers, then when the feds come-a-knockin' the company shows that they used Basic Pilot. That makes the company free and clear...to go and replenish the labor force with new undocumented workers. Let's note that the company that owns the plants has not been charged. I guess that means it's looking to hire, if anyone is interested.

Deporting these individuals will probably have little effect on the future hiring of undocumented workers. Maybe the people who are actually stealing and selling other people's Social Security numbers should be targeted. Maybe the corporations so desperate to increase quarterly profits they prey on immigrants to cut labor costs should be targeted. Not only do the raids seem futile in terms of preventing future undocumented workers from being hired, it's also separating families and destabilizing communities. I think ICE was way off target with this one. There are better ways to prevent Identity Theft, and they don't include thinly veiled attacks on immigrants.

Many of us are looking for a way to reform the system by which new Americans can arrive and succeed here. There was a real outcry for progress last spring and summer. Yes, we want to keep offering the American Dream. Well, we're not really offering the Dream if we criminalize the very desire to achieve it. Rather than making systematic changes in labor and immigration policy, our federal government chose to turn a dear ear to our outcry, and go after individuals. In the near future, I hope to celebrate positive immigration reform. And I hope we realize that the path to citizenship cannot be paved with ICE raids.

Mixed Messages from the Supreme Court

Many of us who attended Monday’s Supreme Court arguments in a pair of school integration cases are still reeling with a mix of emotions—pride, dejection, hope, and, at times, outrage. 

In these cases, the Court will decide whether modest, voluntary efforts by Louisville, Kentucky and Seattle, Washington to keep their schools diverse and inclusive somehow violate the Constitution.  It seems amazing that this question is even before the Court, but Monday’s argument made clear that even these meager, uncontroversial efforts are very much in jeopardy.

As we waited on line outside the Court, it was inspiring to see a huge crowd of students, parents, and other everyday folks marching in the cold to support integration. 

As the arguments proceeded, it was heartening to see Seattle and, especially, the formerly-segregated city of Louisville, vocally defending their right to protect inclusion and the promise of Brown vs. Board of Education. 

And it was stirring to hear Justice Breyer’s eloquent explanation of why careful efforts to promote integration fulfill the core purpose of the 14th Amendment and are clearly constitutional.

The Court’s other three moderate members—Justices Stevens, Souter, and Ginsberg—appear to agree with Justice Breyer that these communities’ efforts are not just constitutional, but vital to the future of our increasingly diverse and interconnected society.

All eyes, however, were on Justice Anthony Kennedy who, with the departure of Sandra Day O’Connor, is now the ideological center of the Court and the key swing vote in cases like these.  Justice Kennedy began his questioning (in the Seattle case, which was argued first) in measured tones that seemed to reflect an effort to balance competing interests.  But as the two hours wore on, the tone and content of his questions were often troubling. 

Perhaps most distressing, Justice Kennedy seemed actively resistant to the reality that promoting inclusive and integrated education—which he appears to support as a compelling governmental interest—necessarily requires an intentional consideration of the demographics of the students who attend the schools. 

Kennedy repeatedly asked about school siting decisions (i.e., locating new schools in places calculated to draw an integrated student body), magnet schools, and other strategies that he presumed to be less focused on student’s individual characteristics.   But, as the lawyers for Seattle and Louisville pointed out, those communities had tested and considered a range of efforts, and found them to be ineffective.  And, as we’ve seen in voting rights cases, the drawing of attendance zones (like electoral districts) still requires a consideration of individual demographics. 

More hopefully, Justice Kennedy seemed impressed with Louisville’s successful transition from a community with enforced segregation to one in which residents and their elected officials are actively choosing integration.

Ultimately, it seems the key to how these cases are decided, will be whether Justice Kennedy accepts the reality of what’s required to achieve integration in any meaningful way.

The argument also offered plenty to be angry about.  First, there was the Court’s rejection of the NAACP Legal Defense Fund’s request, as a litigating “friend of the court” in these cases, to share the school districts’ argument time—a request that the schools supported.  The absence of a voice for communities of color or civil rights—and the presence of the Bush Administration, which is opposing the integration plans—created a stunning scenario: Two city school districts (one of them segregated as late as 2000) arguing with dissenting white parents and an anti-civil rights Bush Administration about the future of integration in America.  That there was no racial or gender diversity among the lawyers arguing the case made the scene all the more stunning.

Also striking was the fact that the Seattle and Louisville lawyers—though able and committed—were not constitutional or civil rights experts, nor were they experienced Supreme Court litigators.  The eloquence and expertise of Ted Shaw, Director-Counsel of the NAACP Legal Defense Fund, was especially missed at the argument.

Another source of outrage was the hostile and at times offensive commentary of Justice Antonin Scalia.  No one was surprised that Justice Scalia believes these plans to be unconstitutional.  He has never voted to uphold a program designed to promote diversity or integration in education.  But the tenor and content of his comments in Monday’s case were, at times, breathtaking.  Most striking was his implication that only a white-controlled school board could be assumed to have benevolent motives in adopting an integration plan, while the same action by a majority-black school board would be inherently suspect.  The following exchange—between Justice Stevens, Justice Scalia, and Solicitor General Paul Clement (who presented the Bush Administration’s position) reflects a bit of Justice Scalia’s position:

GENERAL CLEMENT: Absolutely. And it also has some real world consequences when we decide we're not going to apply the normal scrutiny we would to racial classifications just because we've made some -- I don't know based on what judgment that in this case, it is benign, so we can trust the local school officials.

JUSTICE STEVENS: Well, it isn't that we've made a judgment, the local school board has made a judgment which has a lot of experience under both systems.

GENERAL CLEMENT: There's a lot of experience in Brown, too, and those were local school boards, too. And I think the lesson is --

JUSTICE SCALIA: Do we know the race of the school board here? I mean, that was not -- how do we know these are benign school boards? Is it stipulated that they are benign school boards?

GENERAL CLEMENT: I missed that in the joint stipulation, Justice Scalia.

You can hear the full oral argument of the Louisville case by clicking here, and the Seattle case by clicking here.

The other remarkable theme that we heard from Justice Scalia, the Solicitor General, and Chief Justice Roberts was that considering students’ race to promote integration and inclusion is the constitutional and moral equivalent of considering race to promote segregation and exclusion.  This is just the kind of twisted analysis, detached from our country’s past, present, and future, that many Americans feared when they opposed Roberts’ elevation to the position of Chief Justice.

Justice Alito, for his part, was more nuanced in his questions, focusing on the details of the two plans.  But his questions also seemed strongly to indicate that he believes these plans to be unconstitutional, at least in their specifics.

So how should we think and talk about these cases in the months before the Court announces its decision?  We think it’s important to:

  • Point out the flawed logic and constitutional theory that underlay many of the Justices’         questions—as well as the Bush Administration’s position;
  • Hold up the enlightened comments of Justice Breyer and his moderate colleagues on the Court; and
  • Communicate our hope that Justice Kennedy will come to grips with the real life implications of this case and its importance to the future of our nation.

Looking forward, it will be important to encourage communities to promote integration to the full extent allowed by the Court’s decision, once it’s announced.  And, beginning next year, it will be crucial to demand of the new leadership of the Senate Judiciary Committee that they refuse to confirm judicial nominees who do not show an understanding of our nation’s history and current reality, or of the proper role of the Equal Protection Clause.

Bringing Human Rights Home

Alan's latest piece is now up at TomPaine.com.  Go give it a read, and listen to what New Yorkers think about human rights in our video on the left.

What if the world’s governments came together and agreed on the fundamental rights that every human being must have in order to enjoy basic dignity, opportunity, and
a meaningful life? What if their agreement was profoundly progressive,
recognizing civil and political rights like free speech, due process,
and non-discrimination, as well as economic and social rights like the
right to health care and housing, to organize, and to receive a living
wage for a hard day’s work? And what if they memorialized those rights
in a seminal document, from which more specific commitments and
enforcement could and did flow?

Most Americans would be surprised to learn that such a document exists. It’s called the Universal Declaration of Human Rights and it turns 58 years old this December 10—International Human Rights DayRead More>>

More School Cases Links

You can listen to audio of today's hearing via C-Span online, or read a transcript (pdf).

For the hardcore lawyer types, ACS Blog has the goods on Amicus Briefs and legal history of the issue, as well as a round-up of some interesting interviews you can stream online.  To their great round-up, I'd also add this radio program from The Mainstream Media Project.

In the print media, the Washington Post and the New York Times both feature articles covering demonstrations at the court today, while the Op-Ed page of the Times endorses the decision of the lower courts, which upheld the school districts right to create more diverse classrooms.  The Op-Ed frames the issue as a matter of states/local rights.

Don’t Call it Health Care Reform: Shifting the Responsibility to the Individual

Efforts to make Americans responsible for their own health care are popping up everywhere. My problem with these “individual responsibility” approaches to health care reform is that they neglect very real and high-impact circumstances beyond a person’s power. Lack of transportation, lack of health insurance, lack of dependable child care, and inflexible job schedules are just a few of those circumstances. Making a person solely accountable for their health lets too many people (ahem, government) off the hook for providing the necessary tools to make healthy decisions. The damage that this “do it alone” attitude can do is exemplified in two recent news stories.

Last week the Kaiser Family Foundation released a survey of people in “consumer-directed health plans” and found that the benefits of being a savvy health care consumer are overshadowed by the drawbacks. These new plans have very low premiums but very high deductibles. Instead of traditional plans where you might pay a small co-payment for a doctor’s visit or prescription medications while paying a larger monthly premium, these plans often require the consumer to pay out-of-pocket for these services until the coverage kicks in. The study found that half of the enrollees would switch out of the plan if given the choice. Additionally, the enrollees were twice as likely as those in traditional plans to report that they went without care due to cost.

The surveyed enrollees tended to be wealthier, better educated, and healthier than the average American. If traditional plans lose healthy and wealthy enrollees to the new plans, I can’t help but think that we all will experience some very negative effects of this division. A story in The Washington Post had a quote from Gail Shearer of the Consumers Union that really put the situation in perspective:

Instead of our health system moving towards one where we're all in this together, this type of option is leading to more splitting the population into different segments and, to me, that's an unhealthy thing," Shearer said. She added that poorer, sicker consumers could get left behind.

Another effort to make people “individually responsible” for their health comes from West Virginia by way of The New York Times. The state has reorganized the way it offers Medicaid by making enrollees pledge to be personally responsible for their well-being by doing things like getting regular check-ups, taking prescribed medications, and being on time to appointments.

“Those signing and abiding by the agreement (or their children, who account for a majority of Medicaid patients here) will receive “enhanced benefits” including mental health counseling, long-term diabetes management and cardiac rehabilitation, and prescription drugs and home health visits as needed, as well as antismoking and antiobesity classes. Those who do not sign will get federally required basic services but be limited to four prescriptions a month, for example, and will not receive the other enhanced benefits.”

I’m not a doctor, but wouldn’t those “enhanced benefits” be useful for all Medicaid patients? And wouldn’t those services go a long way for improving a person’s health—more so than a promise to be on time to appointments?

So why not offer the best possible care for all Medicaid patients, and start by putting community health centers in each community that that needs one. Keeping a clinic open late could do a lot to ensure that working parents can see a doctor after their kids get out of school and after traditional business hours. Making sure that physicians and staff speak the same language that their patients do could make the care accessible and more effective for people with limited English proficiency. Offering transportation to and from the doctor’s office would guarantee that those without a car could make it to their appointments without having to rely on (less dependable) mass transit. Those are just a few ideas that could go a long way towards helping people to make healthy decisions. Perhaps empowering people with these resources is scarier than just punishing people for lacking them, but let’s get over that fear and truly commit to promoting healthy behaviors.

Affirming School Diversity

This is a guest post by Robert Anthony Watts.

The (Seattle) plan does not segregate the races; to the contrary, it seeks to promote integration ... There is no competition between the races, and no race is given a preference over another ... The program does use race as a criterion, but only to ensure that the population of each public school roughly reflects the city’s racial composition.

--Judge Alex Kozinski, Ninth U.S. Circuit Court of Appeals
Appointed in 1985 by President Ronald Reagan

School officials and community leaders in Louisville, Kentucky (Jefferson County) have to be shaking their heads.

In 1975, Louisville was the scene of tumultuous, bitter civic strife as court-ordered busing was initiated to integrate the local schools. White parents rose up in furious opposition.  Buses carrying children were pelted by eggs and rocks. Police officers in helmets and riot gear worked overtime to protect buses and school children. The Ku Klux Klan held meetings and prominently took a role in opposing busing.

A funny thing happened in Louisville: the protests died down, tensions eased, and the idea of racially integrated schools gained wide support among blacks and among whites.  Over time Louisville school officials adjusted their plan to give parents much more choice and freedom in where their children attend schools.

In the history of school desegregation, the experience of the Jefferson County school district (the county and city merged its school districts in the early 1970’s) is one of the successes.  Indeed largely because of Jefferson County, Kentucky has the most integrated schools in the nation, according to the Harvard Civil Rights Project (pdf).

In 2000, the Jefferson County school district was released from federal court supervision after a judge concluded that it had removed “all vestiges” of segregation. Jefferson County could have returned to a “neighborhood” school plan. But given the prevailing pattern of housing segregation in Jefferson County (and in the nation), this option would have meant the end of integrated schools for 30,000 to 50,000 of the district’s 97,000 students.

What’s more, the community had come to desire integrated classes.  Parents wanted their children in classes with members of other groups.  Acting on its own, the Jefferson County school district decided to maintain its policy of creating integrated schools.

Today, the U.S. Supreme Court will hear oral arguments in a challenge to the Jefferson County diversity efforts and to similar efforts in Seattle, Washington.  Plaintiffs in each case have sued their school system alleging discrimination on the basis of race.

Fifty years ago in Brown v. Board of Education, the Supreme Court concluded that the 14th Amendment was intended to reject segregation and to bring the country together.  In the years since Brown, although de jure segregation has been largely eliminated, de facto segregation remains a barrier to creating opportunity for all Americans. In the last two decades, African American and Latino students have become more segregated from white students, according to a recent study by the Harvard Civil Rights Project (pdf).

No one knows the exact number of school districts and programs that could be affected by the ruling.  But dozens of school systems have programs and policies—often “magnet” programs—to create diverse schools and diverse classes.

What’s important is that most of these recent efforts have been implemented by local officials responding to the desire of parents to send their children to integrated schools.  In Seattle and in Louisville parents, students and community leaders strongly endorse diversity.   Also important is that plans like those in Louisville and Seattle are highly flexible plans in which race is one factor among several for how students are assigned to school.

These cases also allow Americans a chance to reflect on the importance of diverse schools in breaking down barriers and creating a society that allows everyone an opportunity to fulfill his potential.  As the United States becomes more and more multiracial, and as school officials ponder new efforts to create integrated classes, they can draw upon a broad body of research that reveals the many benefits of an integrated classroom.

A key finding—cited by Louisville and Seattle in their court briefs—is that integration produces educational benefits as well as societal benefits of increased racial and ethnic understanding.  Research also shows that racially diverse classes improve critical thinking skills for all students, and that learning in a diverse setting improves problem solving and communication skills for all students.

Other research findings conclude that:

  • Increased interaction among different groups is associated with lower levels of prejudice
  • Students who have attended integrated schools (including Jefferson County and Seattle) say integrated classes better prepared them for work and for public life.
  • Experiences in diverse classrooms allow people to work more productively with members of other groups.
  • White students in integrated schools display greater tolerance and less fear than white students in segregated schools.
  • Minority students who graduate from integrated schools are more likely to have access to social and professional networks that have traditionally been available only to white students.Diverse schools can be structured to make positive outcomes more likely.
  • Diversity efforts have resulted in modest improvements in reading and English for minority students.

Now that the United States has moved beyond the rancor and turmoil associated with court-ordered school integration, it would be sadly ironic if the Supreme Court places the breaks on voluntary programs like those in Louisville and Seattle.

Americans have made major progress in race relations since Brown.  Diverse schools have been part of that effort.  Americans have come to embrace diversity in great numbers.

The Supreme Court needs to affirm the importance of integrated classes.

Images of Opportunity

The Doors of Opportunity IIHere are The Opportunity Agenda, we are fortunate to have a strong partnership with the New School University in New York, where we teach a class on media and social justice, and work with some great professors who use our organization as a case study in their classes.  Most recently,
Professor Kit Laybourne used our organization as the "client" in his media production class.

Students in the class were tasked with producing an image that was representative of:

  1. an issue area in which The Opportunity Agenda was active; and/or

Redemption is in our Nature

one of the 6 Core Opportunity Values that we use as the basis of our framing. 

Students tasked with producing two images.  One of which contained text and could function as an iconic image on our blog or website when we cover a particular issue or message around a particular core value.  The second image was designed specifically for use by others.  It was to contain no text, and was meant to be a "blank canvass" that other nonprofit organizations or social justice activists could use to remix and reuse the images for their own work.  To that end, all images were to be original photos taken by the students, original graphic illustrations, or images found under a suitable creative commons license

Community Graphic

The results are in, and we're really please with the results.  I've created a Flickr set of the images and tagged the photos with a number of common tags - non profit, creative commons, etc.

I'd invite you take a look at the work the students produced, pass the
photos around, and use them in your own work.  If anyone has questions
about our process, usage rights, or recommendations on how we might take this to the
next level, please let me know.

All the images can be viewed here, on our Flickr page.

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