Rachel's Democracy & Health News #875
Thursday, October 5, 2006
From: Rachel's Democracy & Health News #875 ..........[This story printer-friendly]
Octover 5, 2006
HOW CAN HEALTH BE IMPROVED IN THE U.S.?
[Rachel's introduction: As we saw last week, the health of U.S. citizens is poor, compared to that of other wealthy, industrialized societies. In Part 2 of this important essay, Dennis Raphael shows that U.S. public health policies largely ignore the primary determinants of health: early life, education, employment and working conditions, food security, housing, income and its distribution, social safety net, social exclusion, and unemployment and employment security.]
By Dennis Raphael
[Editors' introduction: Dr. Dennis Raphael is a professor in the School of Health Policy and Management, York University, Toronto. In recent years he has edited two volumes on the social determinants of health -- Staying Alive: Critical Perspectives on Health, Illness, and Health Care (2006), and The Social Determinants of Health: Canadian Perspectives (2004). He is the author of Inequality is Bad for Our Hearts; Why Low Income and Social Exclusion are Major Sources of Heart Disease in Canada (2001). If you have a high-speed internet connection, you can see and hear Dr. Raphael delivering an interesting lecture. If you are not familiar with the concept of "social determinants of health," you might read this short article in Wikipedia. In manuscript, this article was originally titled, "Public Policies Drive the Deteriorating Population Health Profile in the USA."]
The USA Public Health Scene
Numerous writers have considered how the USA population health and public policy profiles are linked (9, 35, 36, 65, 75). Certainly, the evidence urges the raising of these issues and seeking their policy solutions through public health action. It is therefore, fascinating to interrogate contemporary public health documents such as the Institute of Medicine's The Future of the Public's Health (22), Healthy People 2010 (23), and documents from the American Public Health Association (APHA) (76, 77) for their attention to these issues. The dominant model is organized around themes of:
a) racial and ethnic disparities with little concern for how broader determinants of health cause these disparities;
b) access to health care rather than issues of income and other resource distribution, and
c) a wide gap between knowledge concerning the broader determinants of health and action to address these determinants in the policy sphere (4).
National Policy Documents and Reports
Like other USA documents, Healthy People 2010 contains a chapter on the broader determinants of health and its health model is consistent with a broader health perspective. It has a prominent emphasis on issues of access to health care which is not surprising given that 17% or 45 million Americans are without health insurance coverage.
However, closer inspection of the document reveals that the role played by broader determinants of health is undeveloped. The Leading Health Indicators "[R]eflect the major health concerns in the United States at the beginning of the 21st century." These objectives -- physical activity, overweight and obesity, tobacco use, substance abuse, responsible sexual behavior, mental health, injury and violence, environmental quality, immunization, and access to health care -- are firmly planted in the biomedical and behavioural public health model.
Explicit indicators of poverty or income levels, unemployment or job security, or any other obvious indicator of broader determinants of health are absent. Any and all examples of influencing policy are limited to legislative changes designed to promoting healthy behaviors or access to health care. There is little recognition of early life, education, employment and working conditions, food security, housing, income and its distribution, social safety net, social exclusion, and unemployment and employment security as primary determinants of health.
The Institute of Medicine's The Future of the Public's Health has similar shortcomings (Institute of Medicine, 2002). It has a chapter on developments in population health, yet these concepts do not diffuse to the rest of the volume. Virtually all issues to be addressed are health care-related or behaviorally-focused around diet, tobacco use, or physical activity. Policy is conceived narrowly as legislation related to risk behaviors and health protection.
APHA policy statements and numerous "Fact Sheets" reveal an emphasis on access to health care, the situating of health differences in terms of racial and ethnic disparities, and attention to modifying behavioral risk factors for disease and illness (76, 77). They describe differences in health status among White, African-American, Hispanics and Latinos, American Indian and Alaskan natives, and Asian Americans and Pacific Islanders, but highlight findings of unequal access to, and quality of, health care treatment.
Broadening the Scope
Some public health agencies address broader influence upon health. The report America's Health: State Health Rankings provides data and rankings for states on four sets of indicators of which two have a broad scope (78). Community Environment (violent crime, lack of health insurance, infectious disease, children in poverty, and occupational fatalities), and Health Policies (percent of health dollars for public health, per capita public health spending, and adequacy of prenatal care) focus on broader health determinants.
A commentary accompanying the report points out that the infant mortality rate in the USA showed the first increase in 40 years, ranking the USA 28th internationally. Yet, like many other USA analyses, the emphasis for action is primarily health care-related with a consistent, though undeveloped call to address persistent disparities, particularly among racial/ethnic groups.
A few innovative local public health initiatives address broader determinants of health. Many of these are state-level initiatives occurring under the auspices of a Robert Wood Johnson Foundation program (25). The predominant activity of these is the creation of data bases and community networks to meet basic public health functions. Only Minnesota has highlighted broader determinants of health and the role they play in health inequalities. A Call To Action: Advancing Health for All Through Social and Economic Change calls for public policy action to influence the broader determinants of health (24). However, a new governor has modified the health department mandate threatening this unique emphasis. A noteworthy exercise taking place in New York City is the Agenda for a Healthy New York where an alliance is educating the public with the goal influencing a range of broader determinants of health (79).
In summary, public health activity in the USA is characterized by a) a focus on providing access to health care access to its citizens; b) ethnic and racial disparities in health rather than a range of health determinants; c) a reluctance to consider the role structural aspects of society such as the distribution of economic and social resources play in influencing health; and d) a blind-spot as to the broad public policy antecedents of these determinants.
The Role of Public Health in Linking Population Health and Public Policy
Clearly, structural analyses of population health have had little penetration into public health discourse. The increasingly conservative public policy environment in the USA associated with reduced assistance payments, reduction of entitlements to the poor, and growing income and wealth inequalities combines with Americans' generally negative attitudes towards the roles of governments to make an activist public health agenda problematic (3, 9, 80).
The focus on racial and ethnic health differences represents a carryover from the civil rights activities of the 1960s as well as the intellectual and political barriers to addressing issues of income and social class (81). The effects of this is remove increasing income and wealth gap among Americans and issues important to the majority of Americans such as wages, employment security and working conditions, as public health issues. The focus on health care represents a reasoned response to an egregious situation whereby over 45 million citizens are not insured for health care costs. But again, the effect of this focus is to divert attention from a variety of health determinants whose quality is rooted in the public policy processes.
There are no shortage of suggestions on how public health researchers and workers could begin to address the structural issues that shape the presence of health inequalities and the USA population health profile (37, 42, 82). It is not my intention to repeat these here. What is obvious is that for the most part these suggestions have not been taken up to any discernible degree by the public health community in the USA. Why might this be the case?
In a series of interviews with prominent health researchers and policy advocates across the USA, I investigated the reasons for public health neglect of these broader issues. No surprises emerged from these analyses. The rise of neo-liberal and neo-conservative forces -- reflecting both a breakdown of the post-war consensus among government, business, and labor and the legacies of the Reagan Revolution -- have served to actively suppress virtually all public health activity related to addressing broader determinants of health. This is especially the case for issues related to income and as noted by Navarro,(56) social class as an object of inquiry and analyses has always been the subject of derision by academic researchers, policymakers, and elected officials.
Difficulties in addressing broader determinants of health and their public policy antecedents is not a problem of evidence, it is a problem of political will on the parts of public health researchers and workers and their governmental masters. This analysis suggests three key roles public health workers and researchers could play in raising these issues: education, motivation, and activation in support of the social determinants of health. These activities would help build the political supports by which public policy in support of the social determinants of health could be implemented. Each is considered in turn.
Educate
In the USA the general public health community and the American public -- remain woefully uninformed about, and stubbornly resistant to the concept and implications of the social determinants of health. At a minimum public health researchers and workers could carry out -- and publicize the findings from -- critical analysis of the social determinants of health and their role in influencing health. There is no shortage of areas in which these activities could take place: social determinants of health such as poverty, housing and food insecurity, and social exclusion appear to be the primary antecedents of just about every affliction known to humankind. My short list of such afflictions includes coronary heart disease, type II diabetes, arthritis, stroke, many forms of cancer, respiratory disease, HIV/AIDS, Alzheimers, asthma, injuries, death from injuries, mental illness, suicide, emergency room visits, school drop-out, delinquency and crime, unemployment, alienation, distress, and depression. Examples of such analyses and critiques of the dominant paradigms are available (83, 84).
Motivate
Public health researchers and workers can shift public, professional, and policymakers' focus on the dominant biomedical and lifestyle health paradigms to a social determinants of health perspective by collecting and presenting stories about the impact social determinants of health have on people's lives. Ethnographic and qualitative approaches to individual and community health produce vivid illustrations of the importance of these issues for people's health and well-being (85). There is some indication that policymakers -- and certainly the media -- may be responsive to such forms of evidence (86). In addition, community-based activities allow community members to provide their own critical reflections on society, power and inequality (87-89). These approaches allow the voices of those most influenced by the social determinants of health to be heard and hold out the possibility of their concern being translated into community and political activity on their part and policy action on the part of health and government officials.
Activate
The final role is the role that is the most important but potentially the most difficult: supporting political action in support of health. There is increasing evidence that the quality of any number of social determinants of health within a jurisdiction is shaped by the political ideology of governing parties (35). Nations with a larger left-cabinet share from 1946 to the 1990s had the lowest child poverty rates and highest social expenditures; nations with less left-share had the highest poverty rates and lowest social expenditures (36). Poverty rates and government action in support of health -- the extent of government transfers -- is higher when popular vote is more directly translated into political representation through proportional representation (38).
The USA has never had members of a left political party in federal government. The USA does not have a viable left party (90, 91) and some argue the Democratic Party does not qualify as a center party applying international baselines. Similarly, the strength of the labor movement is a strong determinant of both public policy and population health (92). The USA has the lowest union membership density (13%) and lowest collective agreement coverage (14%) of any wealthy industrialized nation (93). Strengthening workers' rights to organize and improve wages, benefits, and employment security is clearly a public health issue that requires action in the political sphere (94, 95). The implications are clear: population health will be improved by support of political parties, governments, and policymakers that propose public policies in favor of health. Public health in the USA would be well-served by diverting at least a small portion of current focus and activities towards these broader issues. Some beginnings have been made in this direction in the USA (24, 79, 96-98) and certainly numerous examples from outside the USA are available (28, 52, 99-101).
Conclusion
A political approach to addressing health inequalities and promoting population health recognizes the public policy conditions necessary for health. These conditions include equitable distribution of wealth and progressive tax policies that create a large middle class, strong programs that support children, families, and women, and economies that support full employment. While the USA has become an outlier among wealthy industrialized nations in its public policy approaches in favor of health, American history shows that there have been periods of progressive activity and legislative action in support of its citizens (102). There is also increasing recognition that the USA model of public policy is inappropriate for meeting the challenges of a post-industrial economy (103). Political reversals are possible in democracies. The United Kingdom emerged from two decades of neo- liberal conservative rule to elect a labor government in 1997 committed to reducing health inequalities. New Zealand took a similar neo-liberal course during the 1990s, but has now reversed direction. Ideologies are malleable and national social policies can be changed.
The best means of promoting population health and reducing health inequalities through a social determinants of health perspective involves citizens being informed about the political and economic forces that shape the health of a society. Once so empowered, they can consider political and other means of influencing these forces. This is not a role that public health researchers and workers have considered their own. It appears rather a daunting task, but one that hold the best hope of promoting the health of citizens in the USA. Is this possible?
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From: Dallas (Tex.) Morning News ..........................[This story printer-friendly]
July 22, 2006
CRITICS SAY EPA STANDARDS LEAVE KIDS IN HARM'S WAY
Rules on cancer-causing chemicals add margin of safety, agency says
[Rachel's introduction: The new EPA cancer guidelines are "not protective of children," says Philip Landrigan, professor of pediatrics and community and preventive medicine at Mount Sinai School of Medicine in New York City. "It's an example of the administration failing the most vulnerable members of our society."]
By Sue Goetinck Ambrose
For years, scientists have warned that government safety standards leave children too exposed to cancer-causing chemicals.
Last year, the Bush administration took action. But many experts say the new guidelines may offer only one-tenth the protection that children need from the chemicals most dangerous to them.
The U.S. Environmental Protection Agency, which issued the guidelines, says they add an extra margin of safety to already stringent standards. But some public health specialists note that while some chemicals are 100 times more toxic to children than adults, the EPA's new guidelines assume the worst chemical is only 10 times as bad.
The new guidelines are "not protective of children," said Philip Landrigan, professor of pediatrics and community and preventive medicine at Mount Sinai School of Medicine in New York City. "It's an example of the administration failing the most vulnerable members of our society."
The need for special protection for children was widely recognized more than a decade ago, after a 1993 report from the National Academy of Sciences concluded that pesticides probably posed greater risks to children than adults. But it wasn't until March 2005 that the EPA issued the guidelines, officially known as the Supplemental Guidance for Assessing Susceptibility From Early-Life Exposure to Carcinogens.
The guidelines are used primarily by the EPA to set standards for acceptable chemical exposure levels in various settings, such as in air or drinking water or at waste cleanup sites.
Until the early 1990s, many scientists say, the idea that children may have an extra sensitivity to some chemicals was not widely appreciated, Dr. Landrigan said.
"I don't think there was deliberate inaction," he said. "The consciousness of children's susceptibility just wasn't there."
Children are not miniature adults when it comes to chemical exposures. They have their own behaviors -- playing close to the ground, putting dirty hands to their mouths -- that distinguish them from adults. Children also eat, breathe and drink more per pound of body weight than adults and differ in how they metabolize foreign chemicals that enter the body.
And in recent years, scientists have become aware of a deeper difference between children and grown-ups: The rapid development of children both before and after birth can make them more susceptible to harm from chemicals.
Scientists suspect that a child's swift growth can leave less time to repair chemical damage to cells or genes, creating populations of cells with dormant, tumor-causing alterations that can erupt into a cancer later in life. Indeed, studies in lab animals have shown that exposure to certain chemicals before birth or early in life can cause cancer in adulthood.
Each year, about 700 new chemicals enter the market, according to a 2005 government report. Not all of those will be directly tested for their potential health effects. And when a chemical is tested for its ability to cause cancer, the research generally is conducted on adult lab animals, not juveniles.
"Virtually all the data that are now used for cancer risk projection are based on these studies that exclude the period of greatest vulnerability," said Dale Hattis, a geneticist and toxicologist at Clark University in Worcester, Mass.
To create the new guidelines, the EPA examined the few published studies that do exist -- some dating to the 1960s -- on cancer-causing chemicals given to juvenile animals. Of 50 chemicals identified by the EPA as causing cancer after early-life exposure, adequate comparisons between juvenile and adult exposure existed for only 18. And of those, the EPA focused its efforts on 12 chemicals that appear to cause cancer by creating mutations in genes.
The EPA calculated how potent each of the 12 chemicals was in its ability to create tumors in juveniles vs. adults. Some chemicals were almost 10 times more potent in adults. But the EPA found that others were more than 100 times more potent in juveniles.
Studies limited
Few of the known cancer-causing chemicals -- the government lists more than 230 known or probable cancer-causing substances -- have been compared in studies on younger and older animals. So the EPA took, in essence, a one-size-fits-all approach to devise its new policy for all untested chemicals. To account for the wide range of potencies, the agency chose to use a value known as the geometric mean, which is similar to an average.
For the potencies of the 12 chemicals, the geometric mean was 10 -- and the EPA used that number in its guidelines. For children under age 2, for example, the EPA said acceptable carcinogen levels for any untested chemicals should be set 10 times lower than they would have been before the guidelines were issued. For children between 2 and 16, the acceptable levels should be three times lower.
"What it's telling you is that, on average, children are more susceptible and that tenfold is the average," said Dr. Lynn Goldman, professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore and a former assistant administrator at the EPA under the Clinton administration. "But by applying this factor, they may not be sufficiently protective."
It's likely, she said, that many carcinogens -- if they were specifically tested -- would be more than 10 times as potent in juveniles, just like the chemicals in the EPA analysis found to be more than 100 times as potent in young animals.
"You don't want to stop here and say 10 is right," she said. "That should be the starting point to make sure we aren't underprotecting kids from a whole series of chemicals."
The chemical industry has its own perspective on the EPA guidelines - at least one industry group said it thinks the EPA's guidelines are based on faulty science.
"There are fundamental problems with the dataset," said Rick Becker, a toxicologist with the American Chemistry Council. "There's very limited data across the board to show that there's increased susceptibility" in children.
He argues that the EPA should be responsible for testing whether chemicals actually are worse for juveniles.
"You shouldn't base decisions on science that isn't supported by the data," he said.
Dr. Landrigan dismissed Dr. Becker's reasoning.
"They're ignoring the vast body of literature that children are more susceptible than adults," he said.
The EPA says it will incorporate new information on chemicals' effects on juveniles, should it become available.
"We didn't choose the chemicals that were tested," said Martha Sandy, a toxicologist at California's state EPA. "We're depending on what's out there in the literature. We don't know about other chemicals that we're exposed to that haven't been tested."
As a result, Dr. Sandy said, the guidelines essentially are an educated guess for any chemicals that haven't been tested. If some of the studies analyzed by the EPA simply hadn't been done, Dr. Sandy said, the default factor could have come out lower or higher.
Another shortcoming is that the studies weren't originally designed to measure the relative potencies for juveniles vs. adults, scientists said. So even choosing the best calculation to capture the broad range of potencies is a matter of scientific debate.
Environmental officials from California and Connecticut, for example, have said that for their states' own guidelines, they are likely to use calculations that end up offering more protection than the EPA's federal guidelines.
In theory, the EPA could have proposed a higher adjustment factor for children, one that would account for the higher potencies seen in the animal studies. This would cover more chemicals that are the worst for juveniles but overprotect for chemicals that don't seem to pose any increased risk.
Bill Farland, a top official in the EPA's office of research and development, predicted that there would not be many chemicals that would need more stringent regulation to protect children.
Further, he said of the new guidelines, "We're adjusting something that was already... protective."
Prenatal exposure
But other scientists said it's unfortunate that the EPA guidelines don't address prenatal exposure to potentially harmful chemicals. Studies have shown that exposure to chemicals in utero can influence adult health. For example, women whose mothers took the anti- miscarriage drug DES were more likely to develop vaginal cancer in their 30s.
"The policy that the EPA put in place does not address prenatal exposure but clearly... that's an important time and needs to be thought about," said Tracey Woodruff, an EPA scientist who participated in the study that led to the new guidelines. She made her comments in a lecture at the National Academy of Sciences this year.
And the EPA's guidelines only cover chemicals thought to cause cancer via genetic mutations.
"We don't quite have enough information to look at any [other] group of chemicals as a whole," Dr. Woodruff said.
Others disagree. Dr. Henry Anderson, a medical officer at the Wisconsin Division of Public Health, led the advisory committee assigned to evaluate the guidelines while they were still in draft form. He said the EPA could have addressed chemicals that trigger cancer in ways other than via mutations.
"The EPA said... for the other carcinogens that don't work through that [mutation] mechanism, we aren't going to change anything," Dr. Anderson said in an interview. "We came at it the other way."
In fact, scientists are beginning to understand that while genetic mutations definitely contribute to cancerous growth, other kinds of changes to the genetic blueprint can be just as harmful.
One type of such change reprograms genes without actually causing a mutation. Just like mutations, these so-called epigenetic changes can encourage the rampant growth that's the hallmark of cancer cells. One new theory even holds that epigenetic changes -- not mutations -- are the first missteps on the long road from healthy tissue to cancer.
The debate over the guidelines raises another, broader issue, said Clark University's Dr. Hattis -- a cost-benefit analysis of what risks are acceptable, given the conveniences that chemicals offer and the costs associated with avoiding any potential harm from them.
"You might want to impose more burden on the responsible parties to achieve confidence that you should be more protective," he said. "But all that is a discussion... that has not been really engaged in by risk managers or the public."
E-mail sgoetinck@dallasnews.com
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From: OpEdNews.com ........................................[This story printer-friendly]
October 2, 2006
OP-ED: HOUSE DEMOCRAPS HELPED PASS A TERRIBLE BILL
[Rachel's introduction: On Sept. 29 the House approved a bill that can only be described as a direct attack on local community land control. The bill was heavily promoted by the many corporate interests that make up the sprawl industry, particularly home builders, land speculators and sprawl developers.]
By Joel S. Hirschhorn
An amazing 37 House Democraps voted in favor of HR 4772 Private Property Rights Implementation Act of 2006 that passed on September 29. Considering the many other toxic political events, this little gem of our MISrepresentatives serving corporate interests received little attention. In a nutshell, the legislation serves corporate interests with significant financial resources who are unhappy with unfavorable local zoning decisions. The bill allows them to strong-arm local governments that cannot afford to litigate every zoning decision in federal courts.
By the way, 27 Republicrooks voted against the bill. And the bill would have passed anyway without the support of the Democraps. There simply is no logical explanation for voting for the bill other than to please corporate interests.
Jerry Howard, executive vice president and chief executive officer of the National Association of Home Builders said: "We commend House Majority Leader John Boehner (R-Ohio) for bringing this bill to a vote and Chairman Jim Sensenbrenner (R-Wis.) for bringing it out of the House Judiciary Committee. I want to thank Representatives Steve Chabot (R-Ohio) and Bart Gordon (D-Tenn.) for introducing the measure and helping to bring strong bipartisan support."
The bill is a direct attack on local community land control. It was desired by many corporate interests that make up the sprawl industry, particularly home builders, land speculators and sprawl developers. The bill is aimed at making it difficult for municipalities and zoning boards to control large developments or enforce their environmental or safety regulations.
The Congressional Budget Office said that it would likely impose additional costs on the federal government by increasing both the number of cases heard by federal courts and the number of claims brought against the United States.
Corporate interests have been hurt by the national smart growth movement and the attack on uncontrolled suburban sprawl. They want federal courts to rule. Whatever happened to minimizing the role of the federal government among Republicrooks? The bill would prohibit a federal district court from refusing to hear claims of takings by states and localities until a final decision has been rendered by a state court. The bill also would make other changes to existing law applicable to takings claims, such as defining "final decision" for the claims, thereby relaxing the standards by which such claims are found ripe for adjudication in federal district courts or in the U.S. Court of Federal Claims. This is legalese for saying that corporate interests could bypass local and state authorities.
Word is that the Senate will not consider the bill this term. But who knows what tricks the Senate Republicrooks might pull. House Democrap Jerrold Nadler said: ""Nobody's going to be able to go to their local zoning board and complain. They'll have to go to the Supreme Court, which won't have time for them."
The Sacramento Bee editorialized: "Courts no longer would be able to look at the 100-acre parcel as a whole, but would have to look at each lot. So, local government would have to pay developers not to build on every inch in the 100-acre parcel. Taxpayers would pick up the tab for this extortion. If developers didn't get what they wanted from local zoning boards, they'd be able to bypass state courts and go to federal court. Judge Frank Easterbrook, a Reagan appointee in the 7th U.S. Circuit Court of Appeals, dismissed such special pleading in a 1994 case. 'Federal courts are not boards of zoning appeals,' he wrote. Those who 'neglect or disdain' their state remedies should be thrown out of court, period."
So if you care about sprawl and local government authority -- and corporate corruption of our government -- pay attention to this corporate attempt to screw we the people. Even if the Senate does not consider it this term, watch out for what happens in the next congress.
Author's Website: www.delusionaldemocracy.com
Authors Bio: Joel S. Hirschhorn is the author of Delusional Democracy - Fixing the Republic Without Overthrowing the Government. His current political writings have been greatly influenced by working as a senior staffer for the U.S. Congress and for the National Governors Association. He advocates a Second American Revolution.
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From: New York Times (pg. A23) ...........................[This story printer-friendly]
September 28, 2006
A PLATFORM OF BIGOTRY
[Rachel's introduction: Race is central to political power in the U.S. The Republicans' "southern strategy," developed decades ago, was fundamentally a racist strategy and it has served them well from 1964 to today. Anyone who wants to build political power -- for chemical policy reform or any other worthwhile reform -- probably can't succeed if they ignore race.]
By Bob Herbert
George Allen, the clownish, Confederate-flag-loving senator from Virginia, has apparently been scurrying around for many years, spreading his racially offensive garbage like a dog that should be curbed. With harsh new allegations emerging daily, it's fair to ask:
Where are the voices of reason in the Republican Party -- the nonbigoted voices? Why haven't we heard from them on this matter?
Mr. Allen has long been touted as one of the leading candidates for the Republican presidential nomination in 2008. But this is a man who has displayed the quintessential symbol of American bigotry, the Confederate battle flag, on the wall of his living room; who put up a hangman's noose as a decoration in his law office; who used an ethnic slur -- macaca -- in an attempt to publicly embarrass a 20-year-old American student of Indian descent; and who, according to the recollections of a number of his acquaintances, frequently referred to blacks as niggers.
The senator has denied the last allegation. But his accusers are low- keyed, straight-arrow professionals who have no obvious ax to grind. They, frankly, seem believable.
Dr. R. Kendall Shelton, a North Carolina radiologist who played football with Mr. Allen at the University of Virginia in the 1970's, recalled a number of incidents, including one in which Mr. Allen said that blacks in Virginia knew their place. Dr. Shelton said in a television interview that he believed then, and still believes, that Mr. Allen was a racist.
Beyond the obvious problems with the senator's comments and his behavior is the fact that he so neatly fits into the pattern of racial bigotry, insensitivity and exploitation that has characterized the G.O.P. since it adopted its Southern strategy some decades ago. Once it was the Democrats who provided a comfortable home for public officials with attitudes and policies that were hostile to blacks and other minorities. Now the deed to that safe house has been signed over to the G.O.P.
Ronald Reagan may be revered by Republicans, but I can never forget that he opposed both the Civil Rights Act and the Voting Rights Act of the mid-1960's, and that as a presidential candidate he kicked off his 1980 general election campaign in Philadelphia, Miss., which just happened to be where three civil rights workers -- Andrew Goodman, Michael Schwerner and James Chaney -- were savagely murdered in 1964.
During his appearance in Philadelphia, Reagan told a cheering crowd, "I believe in states' rights."
The lynching of Goodman, Schwerner and Chaney (try to imagine the terror they felt throughout their ordeal) is the kind of activity symbolized by the noose that Senator Allen felt compelled to put up in his office.
One of the senator's Republican colleagues, Conrad Burns, is up for re-election in Montana. He's got an ugly racial history, too. Several years ago, while campaigning for a second term, Mr. Burns was approached by a rancher who wanted to know what life was like in Washington. The rancher said, "Conrad, how can you live back there with all those niggers?"
Senator Burns said he told the rancher it was "a hell of a challenge."
The senator later apologized. But he has bounced from one racially insensitive moment to another over the years, including one occasion when he referred to Arabs as "ragheads."
You don't hear President Bush or the Senate majority leader, Bill Frist, or any other prominent Republicans blowing the whistle on the likes of George Allen and Conrad Burns because Republicans across the board, so-called moderates as well as conservatives, have benefited tremendously from the party's bigotry. Allen and Burns may have been more blatant and buffoonish than is acceptable, but they have all been singing from the same racially offensive hymnal.
From the Willie Horton campaign to the intimidation of black voters in Florida and elsewhere to the use of every racially charged symbol and code word imaginable -- it's all of a piece.
The late Lee Atwater, in a 1981 interview, explained the evolution of the Southern strategy:
"You start out in 1954 by saying, 'Nigger, nigger, nigger! By 1968 you can't say 'nigger' -- that hurts you. Backfires. So you say stuff like forced busing, states' rights and all that stuff. You're getting so abstract now [that] you're talking about cutting taxes, and all these things you're talking about are totally economic things and a byproduct of them is [that] blacks get hurt worse than whites."
It's been working beautifully for the G.O.P. for decades. Why would the president or anyone else curtail a winning strategy now?
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From: Yes! Magazine .......................................[This story printer-friendly]
October 15, 2006
BETTER HEALTH THROUGH FAIRER WEALTH
[Rachel's introduction: Research now tells us that lower socio- economic status may be more harmful to health than risky personal habits...]
By Brydie Ragan
[DHN editors' introduction: We have added some links within this story to make it more informative for our readers.]
I recently saw a billboard for an employment service that said, "If you think cigarette smoking is bad for your health, try a dead-end job." This warning may not just be an advertising quip: public health research now tells us that lower socio-economic status may be more harmful to health than risky personal habits, such as smoking or eating junk food.
In 1967, British epidemiologist Michael Marmot began to study the relationship between poverty and health. He showed that each step up or down the socio-economic ladder correlates with increasing or decreasing health.
Over time, research linking health and wealth became more nuanced. It turns out that "what matters in determining mortality and health in a society is less the overall wealth of that society and more how evenly wealth is distributed. The more equally wealth is distributed, the better the health of that society," according to the editors of the April 20, 1996 issue of the British Medical Journal. In that issue, American epidemiologist George Kaplan and his colleagues showed that the disparity of income in each of the individual U.S. states, rather than the average income per state, predicted the death rate.
"The People's Epidemiologists," an article in the March/April 2006 issue of Harvard Magazine, takes the analysis a step further. Fundamental social forces such as "poverty, discrimination, stressful jobs, marketing-driven global food companies, substandard housing, dangerous neighborhoods and so on" actually cause individuals to become ill, according to the studies cited in the article. Nancy Krieger, the epidemiologist featured in the article, has shown that poverty and other social determinants are as formidable as hostile microbes or personal habits when it comes to making us sick. This may seem obvious, but it is a revolutionary idea: the public generally believes that poor lifestyle choices, faulty genes, infectious agents, and poisons are the major factors that give rise to illness.
Krieger is one of many prominent researchers making connections between health and inequality. Michael Marmot recently explained in his book, The Status Syndrome, that the experience of inequality impacts health, making the perception of our place in the social hierarchy an important factor. According to Harvard's Ichiro Kawachi, the distribution of wealth in the United States has become an "important public health problem." The claims of Kawachi and his colleagues move public health firmly into the political arena, where some people don't think it belongs. But the links between socio- economic status and health are so compelling that public health researchers are beginning to suggest economic and political remedies.
Richard Wilkinson, an epidemiologist at the University of Nottingham, points out that we are not fated to live in stressful dominance hierarchies that make us sick -- we can choose to create more egalitarian societies. In his book, The Impact of Inequality, Wilkinson suggests that employee ownership may provide a path toward greater equality and consequently better health. The University of Washington's Stephen Bezruchka, another leading researcher on status and health, also reminds us that we can choose. He encourages us to participate in our democracy to effect change. In a 2003 lecture he said that "working together and organizing is our hope."
It is always true that we have choices, but some conditions embolden us to create the future while others invite powerlessness. When it comes to health care these days, Americans are reluctant to act because we are full of fear. We are afraid: afraid because we have no health care insurance, afraid of losing our health care insurance if we have it, or afraid that the insurance we have will not cover our health care expenses. But in the shadow of those fears is an even greater fear -- the fear of poverty -- which can either cause or be caused by illness.
In the United States we have all the resources we need to create a new picture: an abundance of talent, ideas, intelligence, and material wealth. We can decide to create a society that not only includes guaranteed health care but also replaces our crushing climate of fear with a creative culture of care. As Wilkinson and Bezruchka suggest, we can choose to work for better health by working for greater equality.
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Brydie Ragan is an indefatigable advocate for guaranteed health care. She travels nationwide to present "Share the Health," a program that inspires Americans to envision health care for everyone.
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Rachel's Democracy & Health News (formerly Rachel's Environment & Health News) highlights the connections between issues that are often considered separately or not at all.
The natural world is deteriorating and human health is declining because those who make the important decisions aren't the ones who bear the brunt. Our purpose is to connect the dots between human health, the destruction of nature, the decline of community, the rise of economic insecurity and inequalities, growing stress among workers and families, and the crippling legacies of patriarchy, intolerance, and racial injustice that allow us to be divided and therefore ruled by the few.
In a democracy, there are no more fundamental questions than, "Who gets to decide?" And, "How DO the few control the many, and what might be done about it?"
Rachel's Democracy and Health News is published as often as necessary to provide readers with up-to-date coverage of the subject.
Editors:
Peter Montague - peter@rachel.org
Tim Montague - tim@rachel.org
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