About Me

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Policy provokes me to think and write. I currently work in ivory towers inspiring people to engage in their world. I am a student of the human condition and my classroom is the world. I don't need credentials to have an opinion but I've got paper to prove I know a few things about public health, social welfare and economics. I'm coming out of the tower and taking the words to the people and hope you will send some words back at me.

Tuesday, December 17, 2013

A Simple Argument for A (Barely) Living Wage

I couldn't say this any better so I will repost it.

It's Not OK That Your Employees Can't Afford To Eat
by Peter Cappelli
Professor of Management at the Wharton School
Harvard Business Review Blogs Facebook Page
December 16, 2013


Thursday, November 28, 2013

A Feminist's Thanks Giving

Today is a day when I want to give thanks for some human rights I deserve and some things I am lucky to have as a woman.

I am grateful that my parents were happy I was born a girl.
I am happy that my parents valued my education, and for all the education I have achieved and that I can use my education to take any job I choose.
For tampons and feminine sanitation, I feel lucky.
For contraception and the right to abortion, I thank the women who came before me.
For being free to marry who they choose when they choose, I am happy for my sisters who thinks this the right choice for them.
I wish my 17 year old daughter would appreciate her good fortune at having the right to drive.
I am thankful for a job that allows me to buy as much or as little clothes that I can wear as I please.
I am grateful for laws that protect me from rape and violence (the effectiveness of such are left for another day)
It is liberating to be able to have sex outside of marriage.
I am happy to not need a male escort to appear in public.
Without wanting to practice any religion, I am happy that I can change my mind at any time.
Lastly I am grateful for being able to write this piece without impunity or censorship.

Wednesday, November 20, 2013

Good Intentions and Questionable Outcomes: The 'Voluntourist'

To be clear, I honor the good intentions of people who take trips around the southern (and sometimes Eastern) part of our world trying to alleviate the pain and suffering that can be found there. However, good intentions is not enough and sometimes it gets in the way of doing good and being useful.

As someone who made 5 trips to Belize with (mostly) white girls in tow to spend 2 weeks (for college credit) doing sustainable service in collaboration with local non-profits, I have spent a lot of time questioning my intentions and challenging the intentions of my students. I still find it hard to reconcile some of the racial, economic and geopolitical implications of the work that I did there, and also on another project on which I worked in Uganda.

So for those considering taking a trip abroad to do service, perhaps you may find these two pieces relevant. Perhaps you may question the implications of your good intentions. Perhaps you may find ways to make your trip more useful or perhaps you may find that there are other ways to contribute. These pieces are here for you to ask questions of yourself; questions for which you may not find answers, at least not easy ones.

A repost of a Guardian piece titled, 'Beware the 'voluntourist' doing good", written by Ossub Mohamud, published on February 20, 2013 in Guardian Africa Network.

Since first posting this post in November, I found another blogpost which is germane to this topic. It's called, "The Problem with Little White Girls (and boys). Why I stopped being a voluntourist"

Wednesday, November 6, 2013

'Partnership' in the Context of Global Health

The word 'partnership' is trending in global health and has been for quite some time. Foundations, NGO's, and universities in the global north and south  'partner' with local communities in Asia and Africa to implement research or programs that will move forward knowledge about what works and what doesn't.

But what does 'partnership' mean in the context of huge power imbalances that come with differences in human, knowledge, institutional and fiscal resources? How do hierarchal institutions that assign power based on title, rank, alma mater, publications, departments etc share power with people who, if they had any, would preferably not be 'partnering' with people they do not know, who do not know them and who view them as in need of assistance?

With good intentions, professors, doctors, nurses, social workers and various sundry 'helping' professions write proposals that say they will listen to the local folks and link with the existing power structures although most do not integrate with public heath providers on the ground but choose to provide parallel services because of distrust of local systems.

But evidence-based practice is also trending in global health which means that helpers must implement what has been shown to work, regardless of the fact that the effective program was proven such in another country in another language or with another ethnic group. So what does partnership mean if one already arrives in-country with plans and cash? How many organizations involve communities in the writing of proposals for programs that will impact their lives?

And what of the products of these partnerships? The grants, the accolades, the publications, the promotions? How do local people get their share.

Granted, there are increased efforts to bring local voices to the mostly useless meetings where unenforceable documents get written and unachievable goals get set. And this is a good thing when the practice has been to sit on stage and tell the story of that mother, that child, that grandmother that foreign expert met in whatever country that moved them, changed their life or is evidence of the need for their program. Those stories get old when told 'on behalf of' instead of in-person. And after a while, one wonders why we need such stories at all. Is it not enough that said community is resource poor? Would we not expect sad stories of non-existent health services that caused death, injury or disability?

So what does partnership mean?

Partnership means equality in the relationship, and given the lack of respect for local knowledge and local intellectual resources, and the mismatch of status and money, partnership has a hollow sound when said in the context of global health. Partnership requires humility. It requires transfer of power. It requires acknowledgment of the legitimacy of existing structures.

Partnership requires that we (those who go to help) accept and acknowledge that we are pretty clueless about if it will work and with who and how. We all can't go around the world doing randomized controlled trials in each community to 'prove' what will work. But starting out by asking for permission, for guidance, for leadership with the communities we hope to change, is a start.

After reading this post, Dr. Joerg Maas, head of DSW in Germany (who is a friend) said the following, "Not sure I agree fully with the article - equality is not a prerequisite for partnership - isn't it more complimentarity and playing roles organizations can play best given their experience which matters?"

In response to his question, I believe that equality is about power and not necessarily about having the same skill set. Complimentarity is ideal but one partner is receiving and one is giving and that is often the key fact that drives this notion. And because the roles are somewhat determined by who is picking the partner, the same roles tend to get played by the same players.

One thing to note is that partnerships are often based on serendipity with regard to people connecting with each other, but also quite often academics and NGOs choose their locations and thus choose their partners by going south. It is rare that communities from the south come seeking a particular partner.

As the phrase goes... he who pays the piper calls the tune.

Wednesday, September 25, 2013

Exploring the poverty line and poverty guidelines: definitions, impact, history

How do we define poverty?
Who is poor?
What does poor mean when you live in New York City or Birmingham, Alabama?
Survive or thrive or well-being?.

For a measure on which so many of our social safety net depends, we calculate it in such an anachronistic way and our floor is so low that although more than 40 million Americans are considered poor, so many more millions are caught in-between destitution (below the poverty line) and borderline survival, that the measure clearly needs updating so that people can get the help they need.

Click on the links below to explore how the poverty line was created, how it is evolving, the impact it has on the lives of poor people, and what the future is.

NPR discusses the relevance/impact of the poverty line

How the Census measures poverty

The nomenclature of poverty

The development of the Orshansky Poverty Thresholds and their subsequent history as the official U.S. poverty measure

2012 Health and Human Services Poverty Guidelines

Fight for a higher floor for poverty. Write your congressman and say you want poverty guidelines and a poverty line that reflects the world of 2013 when housing is our biggest cost, not food.

Thursday, August 8, 2013

Opting in or Opting Out. Social Policies and the Childbearing and Childrearing Choices of Smart Women

In the last two days, there have been two highly controversial and widely read articles that have explored the choices that women are forced to make about having a career and having children.

In an article in the Guardian by Sadhbh Walshe titled, "Should we care that smart women aren't having kids", women who have achieved academically and in their careers are having low birthrates. Duh!

This is based on some new research that is rather controversial. According to Satoshi Kanazawa, a psychologist from London School of Economics "maternal urges drop by 25% with every extra 15 IQ points". He discusses his findings in his new book, The Intelligence Paradox. I am not sure why Kanazawa thinks it is a paradox because the social policies in place for women with children do not provide an incentive for making this choice.

On the other hand, the New York Times' Judith Warner wrote an article titled, "The Opt-Out generation wants back in" in which she details the trials and successes of women who chose to have children and decided to leave successful careers and stay home to raise them. Mostly there are trials and very few successes. It turns out that women who are choosing not to have children are making a decision which current social policy supports through its neglect of families.

So what are the social policy requirements that may change women's decisions to have children and when they have children, have the freedom to stay home and return to careers??
  1. Fully covered maternity care so that co-pays and lack of insurance does not present a cost barrier to giving birth. Being in debt from having a baby just when you need the money is not conducive to choosing to give birth.
  2. Paid maternity leave. As one of the last countries on earth that does not provide a federally mandated paid leave after pregnancy, (California and New Jersey excepted), the USA provides a hostile environment for women who want to have children and return to work. It also provides a hostile environment for children who are often weaned because many workplaces are not conducive to pumping. All Vault 100 law firms and Fortune 100 companies have paid maternity (and often paternity) leave because they know it's good for recruiting and retaining the best talent, which makes their companies competitive and saves them money.
  3. Child benefit that is paid to the parent who is not in the workforce. This would provide a source of income support that is not directly tied to the breadwinner and would reduce the impact that income dependency has on a relationship.
  4. Subsidized high-quality childcare for everyone. For many poor women, staying home is the better economic choice and for middle class women, the economic incentive to work is so small that they are often doing it for reasons of identity, accomplishment and a more egalitarian relationship with their spouse. 
  5. A school day that lines up with the workday so that after-school programs are not required (they are very costly and inconvenient) and students could learn more in a longer school day.
  6. Social security benefits that give women credit for staying home to care for children. If it costs a woman to have someone else care for their children then their work as a mother clearly has economic value. How we calculate that value is another issue but women should not be fiscally penalized in their old age for raising their children.
  7. Lastly, what cannot be legislated are the antiquated and deeply ingrained value systems that infiltrate even the most evolved relationships once a 'traditional' relationship is created based on woman out of the paid workforce and husband the only breadwinner. The challenge is that once a woman knows the power and freedom of earning her own way, it is hard to depend on her spouse for money. And once that woman is unemployed, men's expectations of her change.

Saturday, July 27, 2013

The Charitable-Industrial Complex - A review

This opinion piece by Warren Buffet's son Peter Buffet is a game-changer in the world of philanthropy not because of what is said but for who is saying it and where and what the implications are for his foundation and others.

It's good to see the wealthy, powerful, and charitable own up to their shortcomings, their savior complexes and their ignorance. Of particular significance if the 'conscience laundering' (his term) and the inappropriate use of certain business principles in the growing industry that is philanthropy.

For those of us who are part of the implementation of these philanthropic endeavors who have struggled with the challenges of changing priorities, trendy strategies and what often seems like the whims and fancies of well-meaning (and guilty-feeling) wealthy donors, this op/ed (his first, hopefully of more) makes us feel heard. That finally, someone gets what we have been saying, writing and even whining about all these years; that just because you have money and hired some bright and eager, Harvard-minted consultant does not mean you have THE answer to the world's problems.

As Mr. Buffet admits, people are solving problems with their right hands that others (and in my view sometimes themselves) help create with their left. The same tax laws that benefits the wealthy and encourage the creation of foundations are the same tax laws which reduce the amount of money that the federal government has to spend on the same social problems that these philanthropist want to address.

I am not against wealth. I am not against capitalism. But there is something perverse about how wealth is created and preserved in the USA. Even Peter Buffet's own launch into philanthropy (his dad Warren Buffet set up foundations for his children) reflects the self-serving gifting of the wealthy who obviously think they can do a better job than government or anyone else. Each non-profit being based on a great idea competing with other non-profits for funding of the next attempt to solving 'the problems of poverty' often maintained (through union-busting, foreign outsourcing etc) by the same corporations which fund these foundations.

So it really is a relief, surprise and a bit of a validation to read this piece by Peter Buffet.

Thank you Peter Buffet for saying what needed to be said by someone with the money and power to make a difference in how philanthropy operates in the USA and the world. You have opened the door to new ways of thinking by saying you are willing to listen.

The Charitable-Industrial Complex by Peter Buffet, New York Times, July 25, 2013, p. A19

Friday, July 26, 2013

Dear Barack Obama, What About the Poor?

I could write a long list of statistics about poor people in the USA but at the end of it all, you will know what you already know: being poor in America is a hard row to hoe. What with the cutbacks in food stamps, subsidized childcare and a stubborn unemployment rate, being poor means to do without and to struggle to get what you have and fight to get what help is offered.

And yet.... it is not the poor that President Obama is worried about as he does his stump(?) speech on his economic plan for America. It's the middle class. It's the people who may have to tighten their belts but their kids will go to college. They have health insurance (or soon will be forced to under Obamacare) and tend to live in the suburbs unless they are flush enough to live the more expensive life of the urbanite. It seems the poor have nothing to contribute to economic growth. Our Gini index could put us on par close to Jamaica and Cameroon and behind Uganda in terms of income inequality, which data in several social sciences link to quality of life.

So as a social worker, public health professional, professor and mental health activist, I would like to ask our president, "What about the poor?" What do they get from Congress? Where do they fit in your economic plan for America's future?

Mr President, it was the middle class who 'occupied' America fighting against the inequality that keeps growing because it seems that most politicians in this country do not care about the poor, even when they are not running for election.... like you.

Mr President, you have already admitted that Congress is going to fight you on whatever economic strategies you put forth to help the middle class so since they are already middle class and it is the poor that is being left behind, why not just go for it and fight for the poor the way some Republicans fight for wealthy taxpayers or the unborn.

Go for it, Mr President, be THAT guy. Be the President remembered for using his last 3 years to fight for those who are being left behind. Those with whom you worked as a community organizer in Chicago. As my Dad would say, these are the people for whom the first meal is a surprise and the second a wonder. The people for whom the roof is a sky and a pillow a rock. The ones with kids who have decaying teeth despite having insurance (but have low health literacy). The ones in crappy schools and unsafe/crowded housing. The ones eating one meal a day and sometimes it's the one their kid brought home from a free lunch program... of course that's if they still qualify.

I get it. Middle class people vote more than poor people. And maybe that's because noone is representing the interests of the poor. They get nothing from their vote but to give some guy another chance to screw them over.

So dear Mr President, I ask you..... "What about the poor?"

If you get this far, click on the following link: contact the white house  and write to the president and ask him what he is doing for poor people.                                                                                       

Wednesday, July 17, 2013

Global Citizen v Global Subject: A critical discussion of study/service abroad

Full disclosure: I have developed and led service-learning abroad programs in Central America for 5 years. It is my experience as leader and as traveler that have led me to question the methodology and intent of such programs with regard to their implications for the communities outside the USA in which they are implemented.

As globalization penetrates the towers of ivory, there is a push for the development of graduates who can participate in the world beyond their own localities and their own national borders. This corps of 'global citizens' are supposed to have an identity that transcends geography and borders with an identification with the common humanity that bounds us all.

To create this cadre of new world graduates, institutes of higher learning are pushing the study/service abroad agenda. With colleges and universities setting targets for how many of their students get to go abroad before they graduate. Of course, this trend is also growing among the high school crowd who seek to gain an edge on college admissions or to improve their language skills.

The primary goals of study abroad are usually to build intercultural skills and often to build language fluency that help develop such skills. There is also an emphasis on experiential learning of global problems. The places students go include local language schools, foreign-based branches of American or UK institutions, international schools or a home-stay and attendance at a local educational institution.According to Sachau and Braser (2010), more than 250,000 American students study abroad.

Service learning abroad includes the goals of study abroad but these are achieved through direct service in local communities abroad. Reflection is an integral part of this process as students grapple with the issues that come with integrating service into their learning.

So I am not going to argue that there is anything wrong with the intention of service/study abroad programs. Human beings need to engage with each other across borders in order to understand each other, both culturally and linguistically.

However, I will argue that the one-directional structure of most programs create global subjects that are studied or serviced in the development of global citizens. The class bias of the latter is obvious as most middle class or poor students cannot afford the cost of study abroad tuition and travel and the opportunity costs of lost wages from their jobs that support their educational pursuits. This class bias that already exists in higher education relegates most study/service abroad programs to the reach of wealthier students who then gain further advantage for graduate and hiring programs who give an edge to such 'global citizens'.

But how much global citizenry do these students develop? On a recent trip to Greece, I ran into a group of students who were obviously American students doing study abroad. (As a leader of such trips I have acquired a sense of who these students are when I see them). These students were mostly white, mostly girls and were exploring the Ancient Agora on their day trip from their Semester at Sea. I spoke to a few of them about their engagement with local populations as they traversed the oceans and were taught on board by an international faculty. They admitted that the trip was what each person made it but that most people hung out with their friends and did not make friends where they visited. This tends to be the trend among most students who don't do a home-stay version of these programs. Language programs that are full immersion are much better than ones where groups of American students go off to Florence or Paris and spend a lot of time visiting sites and partying as much as they spend learning the language, which they often don't speak because they have each other with whom to speak English. Having local communities learn about American life through these programs is not usually an objective. There is hardly an 'exchange' but more of a "Thank you for letting me learn about you" attitude. And if you're an Italian in Florence, you don't learn more than a bad stereotype of the worse of what American college life can be.

As for service-learning projects, these also tend to be one-dimensional. Students fly from the USA to countries near and far in the East and South (mostly) to donate their time and develop their skills, in contexts that challenge them in many ways. This is great for the American student but the short-term and often non-sustainable aspects of this service is questionable in value for the local communities. I am sure there are programs for foreigners to do service in the USA but I have yet to read of them. Foreigners may come on their own but America is not seen a place that needs 'service' but is a source of 'service'. The socio-cultural and economic implications of this belief reinforce neo-imperialistic ideas of who Americans are and what their place is in the world.

After reviewing hundreds of articles on these programs, there were only a few that bothered to evaluate the impact on communities because the focus is on the education of the students. Most of the time, the communities that students serve are not the ones requesting such service but are the ones that are chosen for students to serve. These sites are chosen for many reasons that often have to do with the connections of the instructor to those communities or historical ties of an institution to a community.

So how do we make these programs more of an exchange and not an exercise in which students in one country gain skills through their contact or engagement with people of another culture? How do these programs go beyond 'educational tourism' or 'volun-tourism' to be a cultural engagement that involves meeting and greeting and engaging with local people? I will keep the list short.

1. Make them truly an exchange. Students of each country should engage with each other in learning about each other and learning language skills from each other. If possible, there should be an exchange of students across borders; not a visit of one to the other.

2. Let reception communities drive the service/learning that occurs. What are their needs? How can they be met in a sustainable way? Projects should include products like grant proposals, educational curricula, training, buildings etc

3. Evaluate the impact of these programs on local communities. People of the South and East do not exist to be the cultural experiences of American students that change their lives. They too have educational needs that includes cultural engagement.

4. Engage with educational institutions in the locality where studies/service takes place. Including local teachers as the cultural guides and paying them for their services makes these trips more valuable to local communities.

5. Engage before and after the trips take place so that the experience can be meaningful to participants on both sides of borders. Technology makes this extremely easy and engaging this way in the classroom may be a temporal and technological challenge but well worth the equality of experience for both cultures.

6. Use locally owned services and purchase locally made goods as much as possible. No point in going abroad to enrich the pockets of American service providers.

This post is based on a presentation I gave at The Learner Conference held in Rhodes, Greece, July 11-13, 2013.

Wednesday, April 17, 2013

Background checks, guns and deterrence

In the USA, there are millions and millions of guns in circulation.

Today, Congress failed to pass a bill that would expand background checks to purchase a gun legitimately. The problem is that guns are so easy to come by that those who want to find a gun need not submit themselves to a background check. They can simply find a stolen gun on the street that probably cannot be traced in order for them to do whatever evil desires their twisted minds conjure.

Background checks are a way to put a tiny little barrier between the bad guy and his bad deeds. Anti-drug laws stop lawful people from buying drugs but anyone who wants to buy anything from heroin to oxycontin wont find it difficult to do so despite all the barriers in place. Even the limits on cough syrup dont much hinder meth production.

The background check is a distraction from the main issue that guns are still going to be for sale and the secondary sale of guns makes getting a gun fairly easily if one desires. A guy who wants to shoot up a school or a theater need not go through the hassle of a background check because guns are easily available in this society. THAT is the issue. Not many felons are going to go to a legitimate outlet to buy a gun,

Not to say that background checks are not evidence of due diligence on behalf of the state but its a lame attempt to act on a much more significant problem: reducing the number of guns in the USA. And no.... a background check wont stop a felon from getting a gun to rob a bank. It wont stop a gangbanger from finding the firepower to kill territorial intruders. It wont stop a psychopath, a sociopath or a man on the hunt for the target of his twisted love obsession.

It will somehow make us feel like we're doing 'something' even if that 'something' makes no difference in the kinds of events we want to stop. Doing 'something' is pointless if it changes nothing.

The ownership of guns has become part of the American identity for many and so any challenges to the 'American way of life' will meet with strong resistance.

Perhaps my bar is too high or I am just a cynic but until there are significant measures to reduce the manufacture and sale of guns (reducing outlets is one such measure), all other actions simply create laws that are more administrative hassle than crime stopper.

Friday, February 1, 2013

28th Amendment (Amendment XXVIII)

A Proposal for the 28th Amendment (Amendment XXVIII)

The Congress makes the following findings:
1. Firearms injure and kill people.
2. There is common agreement that the right to bear arms articulated in 2nd Amendment (Amendment II) of the Bill of Rights was given to the people of the United States for their safety and protection and the US Supreme Court ruled in 2010 (District of Columbia v Heller), that this right was not linked with service in a militia.
3. There are almost enough firearms for every woman, child and man in the country (1, 2) and, 47% of households (3) in the United States possess a firearm.
4. Firearms are a danger to the health and welfare of the citizenry based on their role in the morbidity and mortality of people, especially vulnerable populations such as children, women with violent partners, and people who live in poor, urban settings
5. Therefore, in light of this demonstration of the crisis in our nation, it is the sense of the Congress that prevention of injury and death is a very important government interest and the policy stated in section 6 below is intended to address this crisis.
6. As of February 1, 2013, there will be a moratorium on the sales of ALL firearms in the United States. This moratorium DOES NOT infringe the right of the people to keep and bear arms as granted them by Amendment II in the Bill of Rights in the Constitution of the United States and supported by the US Supreme Court.

(1) The Congressional Research Service, estimates there are 310 million firearms in the USA (Gun Control Legislation, William J. Krouse, Nov 12, 2012, p. 8)
(2) The US Census  estimates that there are 314 million people in the United States (2012 estimate).
(3) Gallup poll on October 26, 2011