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Be Prepared for End-of-Life: Have Conversations During the ‘Good’ Times By Glenn Ellis

June 30, 2019

Be Prepared for End-of-Life: Have Conversations During the ‘Good’ Times
By Glenn Ellis

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(TriceEdneyWire.com) - The entire lifespan of most African-Americans is consumed by efforts to stay alive: overcoming obstacles associated with societal injustice and inequality, and in many cases, institutional racism. Perhaps, this is one of the main reasons that, traditionally, African-Americans tend to be less prepared for the inevitability of death.

In 2013, The Pew Foundation did a study and found that while 73 percent of all Americans have given “some thought” to end-of-life, only 37 percent of African-Americans have done the same. This means that when doctors and others on the care team of a terminally-ill patient may decide to discontinue providing care and treatment; when you may feel that your loved one has had enough, and should be allowed to die in peace, with dignity.

For the disproportionate number of us, death is accompanied by the dilemmas around how we choose to die. Hospice; Palliative Care; Advance Directives; and Competency become terms that we, or our loved ones, are all of sudden faced with and expected to deal with.

What we know is that African-Americans are less likely than any other group to be prepared for end-of-life, and not surprisingly, are less likely to have a prepared Advance directive. The Pew study also found that African-Americans tend to die more often “hooked up” to machinery in hospitals and facilities, away from home, suffering and in pain. This doesn’t have to be our fate.

First, let’s talk about Advanced Directives. This is the document that should be prepared to outline, in detail, what type of care (if any) we desire as our lives come to an end, and we are not able to make decisions for ourselves.

An Advanced Directive includes things that typically are not even thought about during times when life is good.

Generally, it will include things such as such as a living will or do-not-resuscitate order, or an identification of a health care surrogate. Regrettably, it’s not until we are in a hospital ICU; a hospice Center; or even on home hospice that we (or our loved ones) are confronted with having to make difficult decisions, while dealing with imminent death.

In spite of the fact that studies show that 80 percent of Americans would prefer to die at home, the reality is that 60 percent of us will die in a hospital; 20 percent of us will die in a nursing home; and only 20 percent will end up in a situation where we will be able to make our transition in the comfort and peace of our own home.

If you are not competent or capable of making medical decisions and you do not have an advance directive, or it is unavailable when needed, decisions will nevertheless have to be made.

In the absence of an advance directive, this could become a point of contention, and the patient is caught in the middle. Or, it could be the other way around, you may feel that there is still hope for a recovery, and the doctors feel that there isn’t. Again, the patient lies there in limbo, and often suffering unnecessarily. For African-Americans, it’s worse. One study found that only 13 percent of all African-Americans have an advanced directive in place.

It can be a difficult and often an uncomfortable conversation. But collectively, we must begin having conversations during the “good” times in life with our families and loved ones about what we would do and don’t want should we ever find ourselves in a position where we are unable to make medical decisions for ourselves.

Think about how often we attend funerals, and families are still reeling over how things came to an end with conflict and contention between families of a patient who died, and the medical staff at the hospital. Think about how different it would be if we made our wishes known, before something happened unexpectedly.

Another critically underutilized resource for many terminally ill African-Americans and their families is hospice. Many African-Americans are either unaware of hospice care or lack a clear understanding of what hospice is.

Most importantly, let your loved ones know what you have in your advanced directive. People only like surprises for their birthday. Don’t wait for them to find out at an emotionally difficult time when they are grappling with the inevitability of your death. Contrary to most widely-held beliefs, hospice in and of itself is not a “death sentence”.

The goal of home hospice is comfort and pain management when cure is no longer medically possible. Curative, life-prolonging treatments such as surgeries and chemotherapy are stopped. And the focus shifts to quality of life. Hospice care focuses on the patient’s physical, emotional, social, and spiritual needs.

Too many people, particularly African-Americans, suffer in anguish, robbing themselves of an end-of-life absent of dignity and a deserving quality of life.

You don’t need a lawyer to create your advanced directive. But you do need to make sure you understand the laws of the state you live in regarding advanced directives. Some states have restrictions that you need to be aware of that may prohibit your wishes.

And finally, keep in mind that no one get’s out alive; make sure you’ve properly prepared for your exit.

Remember, I’m not a doctor. I just sound like one. Take good care of yourself and live the best life possible! The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice.

Glenn Ellis, is Research Bioethics Fellow at Harvard Medical School and author of Which Doctor?, and Information is the Best Medicine. For more good health information listen to Glenn, on radio in Philadelphia; Boston; Chicago; Shreveport; Los Angeles; and Birmingham., or visit: www.glennellis.com

 

Will White House Advisory Council Act to End America's Affordable Housing Crisis? by Charlene Crowell

June 30, 2019

 

Will White House Advisory Council Act to End America's Affordable Housing Crisis?

By Charlene Crowell

 

NEWS ANALYSIS

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Ta-Nehisi Coates

 

kelly-miller-mathematician and sociologist

Kelly Miller

 

(TriceEdneyWire.com) - Nearly 90 years ago, Kelly Miller  (1863-1939), a Black sociologist and mathematician, said, “The Negro is up against the white man’s standard, without the white man’s opportunity.”  As the first Black man to enroll as a graduate student at Johns Hopkins University in 1908, Miller also authored a book entitled Race Adjustment, published in 1908.

 

Ironically, despite the passage of time, Miller’s words express the same sentiment held today by many Black Americans. As a people and across succeeding generations, we have held fast to our hopes for a better life. Yet it is painfully true that many opportunities enjoyed by other Americans have been elusive for people of color.

 

Noted author and journalist Ta-Nehisi Coates expressed a similar view during his June 19 Capitol Hill testimony on reparations.

 

“Enslavement reigned for 250 years on these shores,” noted Coates. “When it ended, this country could have extended its hallowed principles—life, liberty, and the pursuit of happiness—to all, regardless of color. But America had other principles in mind. And so for a century after the Civil War, black people were subjected to a relentless campaign of terror, a campaign that extended well into the lifetime of Majority Leader McConnell.”

 

While economists, public policy think tanks and other entities may sing a chorus of how well the American economy is performing and expanding, people of color – especially Blacks and Browns – have yet to see or feel economic vibrancy in our own lives – particularly when it comes to housing and homeownership.

 

On June 25, Harvard University’s Joint Center for Housing Studies (JCHS) released its annual report, The State of the Nation’s Housing. One of the housing industry’s most broadly anticipated and cited reports, it once again chronicles recent trends and issues.

 

“The limited supply of smaller, more affordable homes in the face of rising demand suggests that the rising land costs and the difficult development environment make it unprofitable to build for the middle market,” said Chris Herbert, JCHS’s managing director.

 

Among this year’s key findings:

 

  • Since 2018, the monthly housing payment on a median-priced home has been $1,775;

 

  • In 2019, the cost of a median-priced home rose by 4% to $261,600 when a comparable home in 2011 was priced far lower at $177,400.

 

  • This rise in home prices is also the seventh straight year that median household incomes have failed to keep pace in 85 of the nation’s largest 100 markets.

 

  • Nearly $52,000 would be required to make a 20% down payment on a median priced home. Even if buyers opted for an FHA 3.5 percent down payment mortgage, more than $9,000 would be needed to pay it, closing costs, and related fees;

 

  • In rental housing, four million units of housing priced at $800 or less were lost between 2011 and 2019. Also, since 2010, renters now include consumers earning $75,000 or more.

 

Families who already own their own homes, these findings signal that their investments are appreciating, growing in equity and wealth.

 

But for those trying to make that important transition from renting to owning, it’s a very different outlook. As rental prices continue to soar and moderately priced apartments disappear from the marketplace, both prospective homeowners and current renters face a shrinking supply of affordable housing.

 

When homeownership is possible, housing costs can be better contained with fixed-interest rate mortgages, tax credits, and eventual equity. Even so, the Harvard report finds that only 36 percent of all consumers could afford to buy their own home in 2018. With higher priced homes in 2019, the affordability challenge worsens.

 

“It is equally noteworthy that once again this key report shares how consumers of color continue to face challenges in becoming homeowners, noted Nikitra Bailey, an EVP with the Center for Responsible Lending. “According to the report, only 43 percent of Blacks and 47% of Latinx own their own home, while white homeownership remains at 73 percent.

 

“This 30% disparity deserves further examination and proportional remedies,” continued Bailey. “Greater access to safe and affordable credit, better fair housing enforcement, preservation of anti-discrimination laws – including disparate impact – can play a role in eliminating homeownership gaps. Further, as the future of Fannie Mae and Freddie Mac are publicly debated, a renewed commitment to serve all creditworthy borrowers must be embraced.”

 

Calvin Schermerhorn, a professor of history in Arizona State University's School of Historical, Philosophical and Religious Studies and author of The Business of Slavery and the Rise of American Capitalism, 1815-1860, holds similar views to those expressed by Bailey. In a recent Washington Post op ed column, Schermerhorn addressed the historic disparities that Black America continues to suffer.

 

“One-fifth of African American families have a net worth of $0 or below; 75 percent have less than $10,000 for retirement,” wrote Schermerhorn. “The enduring barriers to black economic equality are structural rather than individual…. “Escalators into the middle class have slowed and stalled, and the rung of the economic ladder one starts on is most likely where one will end up.”

On the same day as the Harvard report’s release, President Donald Trump signed an executive order that establishes a new advisory body that will be led by HUD Secretary Ben Carson. A total of eight federal agencies will work with state and local government officials to remove “burdensome governmental regulations” affecting affordable housing.

 

“Increasing the supply of housing by removing overly burdensome rules and regulations will reduce housing costs, boost economic growth, and provide more Americans with opportunities for economic mobility,” stated Secretary Carson.

 

If Secretary Carson means that local zoning rules favor single family homes over multi-family developments is a fundamental public policy flaw, he may be on to something. However this focus misses the crux of the affordable housing crisis: Wages are not rising in line with increasing housing costs. And now, after the housing industry continues to cater to more affluent consumers, while many older adults choose to age in place, the market has very little to offer those who want their own American Dream, including some who are anxiously awaiting the chance to form their own households.

 

Builders have historically, not just of late, complained about the time it takes to secure permits or the series of inspections that must be approved during construction and before properties can be listed for sale.  What is missing from this new initiative is a solution to the financial challenges that average people face.

 

It was scant regulation and regulatory voids that enabled risky mortgage products with questionable terms that took our national economy to the brink of financial collapse with worldwide effects. Taxpayer dollars to rescue financiers while many unnecessary foreclosures stripped away home equity and wealth from working families.

 

Time will tell whether new advisors and proposals remember the lessons from the Great Recession.

 

Charlene Crowell is the communications deputy director with the Center for Responsible Lending. She can be reached atThis email address is being protected from spambots. You need JavaScript enabled to view it..

Trump Did the Right Thing by Jesse Jackson

June 25, 2019

Trump Did the Right Thing
By Jesse Jackson

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(TriceEdneyWire.com) - In the last week, President Donald Trump suddenly reversed two major decisions. He announced he would not begin mass deportations of those who are living in the country illegally, which he previously threatened to do, and he pulled the plug on a bombing attack on Iran, even as the military jets were on the runway.

The reversals stunned aides and allies alike. In both cases, Trump disappointed hawkish advisers and zealous supporters who had urged him to act. In both cases, Trump did the right thing. It’s easy to be skeptical or dismissive about Trump’s flip-flops. In both cases, he defused crises of his own making. In both, he avoided what would have been a humanitarian horror. In both, the impulsiveness of the threatened action was matched by the suddenness of the reversal. In both, the reversals may only be a temporary attack of sanity.

Critics argue that Trump’s reversals undermine his credibility and sap American authority. Cynics discount the decisions, saying even a broken clock gets the time right twice a day. All that may be true, but it is worth thanking Trump when he makes the right choice.

On Iran, he is surrounded by advisers — like National Security Adviser John Bolton — eager to ratchet up the crisis. Even his former secretary of defense, James “Mad Dog” Mattis, was an advocate of taking on Iran. The so-called “adults in the room” — the folks said to be reining in an impulsive and uninformed president — would have pushed us into another war.

Attacking Iran would have violated Trump’s campaign promise to get us out of “stupid wars.” As president, he repeatedly says that “great powers don’t fight wars without end,” and boasts he’s getting the troops out. In fact, however, the war in Afghanistan goes on, the troops are still in Syria and Iraq, Trump vetoed the congressional effort to end our role in the Saudi attack on Yemen, and he’s been ratcheting up pressure and sanctions on Iran from the beginning of his administration.

When the Iranians shot down a U.S. drone, the hawks had exactly the provocation they wanted to begin bombing. Trump initially agreed, but then reversed himself, allegedly because he thought a bombing strike that might kill hundreds of Iranians was “disproportionate.” Hopefully, it was also because he remembered his campaign promise, and his sensible instinct that beginning another war in the Middle East would be catastrophic.

Trump has targeted immigrants from the beginning of his campaign, libeling those seeking asylum, implementing truly grotesque policies that rip children from their parents and cage them in unspeakable conditions. He vetoed the bipartisan immigration reform that Congress passed. Now he is ratcheting up the rhetoric for election purposes. When White House advisers like Stephen Miller reportedly pushed for mass deportations, the president suddenly announced they would begin, and then just as suddenly agreed to postpone them. He may have postponed them simply because the bureaucracy wasn’t ready to act. In any case, the decision was the right one.

The face-off with Iran continues. The White House announced it has launched a cyber-attack, will continue to punish Iranians with economic sanctions and is considering various covert ways to strike Iran. The conflict will escalate unless Trump follows the decision not to bomb with a clear plan of action that deescalates the tension and finds a way back to the negotiating table. On the border, Trump only postponed the threat of mass deportations. He clearly wants to make immigrants a target once more in his re-election campaign.

What would make sense is to convene the governments of our neighbors to the south and create a multilateral plan for humanitarian relief and economic development that would alleviate the desperation that forces families to leave their villages and come north. Without comprehensive immigration reform, Trump’s sudden act of common sense will soon be forgotten. In both cases, Trump’s policies are likely to make things worse rather than better. But at least, in this instance, he chose not to follow the ruinous advice of his aides and supporters. At least that is encouraging.

Census Citizenship Question Appears Blocked - for Now By Marc H. Morial

June 28, 2019
To Be Equal 
Census Citizenship Question Appears Blocked, for Now
By Marc H. Morial
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(TriceEdneyWire.com) - “Altogether, the evidence tells a story that does not match the explanation the Secretary gave for his decision. We cannot ignore the disconnect between the decision made and the explanation given.  Our review is deferential, but we are ‘not required to exhibit a naiveté from which ordinary citizens are free.’  Accepting contrived reasons would defeat the purpose of the enterprise.  If judicial review is to be more than an empty ritual, it must demand something better than the explanation offered for the action taken in this case.” -- Chief Justice John G. Roberts Jr., United States Department of Commerce v. New York

Civil rights groups and advocates for a fair census breathed a sigh of relief this week when the U.S. Supreme Court rejected the Trump administration’s “contrived” justification for adding a citizenship question to the 2020 census.

However, the court did not categorically rule out the addition of a question, should the administration eventually provide sufficient justification.

We must not let down our guard.

We have known from the beginning that the addition of a citizenship question was a blatant ploy to reduce minority participation and rob communities of their political power, and that Secretary Wilbur Ross’ explanation that the question is “critical” to enforcement of the Voting Rights Act was laughable.  That’s why we joined other civil rights group in filing a “friend of the court” brief opposing the citizenship question.

As we argued in our brief, “There is no factual or legal basis—none—to support the position that collecting citizenship data from the decennial census is needed for VRA enforcement. In fact, modifying the short-form census to ask for the citizenship status of everyone in the country, as Secretary Ross has proposed, would undermine VRA enforcement.

And we – grassroots, advocacy, labor, legal services, education, and faith-based organizations who came together to file the brief – would know. “[We] have been among the most experienced guardians of the VRA and the values it reflects for the past 54 years. In that time, existing citizenship data drawn from sample surveys or the long-form census sent only to small subsets of American housing units have been more than sufficient for robust, effective enforcement of the VRA.”

There has never been a Voting Rights Act enforcement case in history that turned on the unavailability of citizenship data from the decennial census.

We’re relieved the Supreme Court saw through the administration’s flimsy argument, especially since the real motivation behind the citizenship question emerged just days after the case was argued before the justices.

Computer files revealed that a political consultant who played a crucial role in the decision to add the question had authored a study concluding that adding the question would allow the drafting of extremely gerrymandered Congressional maps to drain even more influence away from urban communities and communities of color.

The citizenship question was one of several potential problems that could produce a significant undercount of Black Americans, including underfunding, understaffing and the practice of prison-based gerrymandering. Under current policy, incarcerated persons are counted in jurisdictions where they are imprisoned rather than in the communities where they live. This represents a massive transfer of political power and federal funding for programs like Head Start, Medicare, Lunch programs and transportation infrastructure, from urban districts of color to rural, prison hosting, predominantly white districts.

In the face of this week’s ruling, the National Urban League and the Urban League Movement is recommitted to working for a fair census and urging participation among Black communities.

An inaccurate census will deprive communities of accurate data for most federally produced statistics, and critical social, demographic and economic research. It would deprive communities of more than $675 billion in federal funding, and the just enforcement of civil rights laws and constitutional protections like fair housing and voting rights.

Most importantly, an inaccurate census will deprive communities of fair political representation in the U.S. Congress, the Electoral College and state and local legislatures.

Blocking the citizenship question is just one step among many in safeguarding a fair, accurate Census.

America’s Challenge: Moving Toward Racial Healing and Transformation by Gail. C. Christopher

June 24, 2019

America’s Challenge: Moving Toward Racial Healing and Transformation

 By Gail. C. Christopher

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 Dr. Gail Christopher

(TriceEdneyWire.com) - Months after Virginia Gov. Ralph Northam came under fire for the racist images on his yearbook page from Eastern Virginia Medical School in 1984, he remains in office, a battered and chastised, public figure.  But maybe this isn’t a bad thing. 

A quick resignation would have elicited rhetorical condemnations, a symbolic “washing of hands,” and sent the wrong message that everything has been resolved.  It most certainly has not been, and in late May an investigation by the medical school couldn’t conclusively determine whether it’s the governor in the photo.  But the Commonwealth of Virginia, and our nation, have an even weightier problem: they must address the root cause of racism 35 years ago, and today - the belief in a hierarchy of human value that poisons our society.

Through centuries, America has failed to do the required work of uprooting and finally eliminating the idea and belief in a hierarchy of humanity – the empowering of one human being over another because of skin color or religion or ethnicity.  It was stunning that when USA Today examined 900 yearbooks from the same era, they found more than 200 examples of racist materials, demonstrating the depth of racial bias in our society.

The heart of the problem is the hierarchy of human value. This core belief is the myth that built America. Human value hierarchy fueled unfettered land confiscation from Native Americans and unprecedented human decimation and enslavement of Africans; all of which fueled a young country’s rapid economic growth and emergence as a world power.

As long as the foundational myth of unequal human value is allowed to fester consciously and unconsciously, the idea can, will and indeed IS being manipulated for political gain and potentially authoritarian power.

Hitler perfected this art of fearmongering and emotional manipulation using the idea of a hierarchy of human worth and value. His Nuremberg laws became the basis of Nazi Germany and the Holocaust. These laws were modeled after racist laws and practices here in the United States. The 2017 book, Hitler’s American Model by Yale Legal scholar James Whitman, documents how America’s racial oppression helped inspire the Nazis’ anti-Jewish legislation.

Clearly, if America only “washes our hands” after every incident of racism, we fail to enact any meaningful change. The action that is long overdue in Virginia and the whole of America is a truth and racial healing process.

To heal is to make whole, to set right. A broken bone must be re-set in order to heal without deformity. Setting the United States right requires humanely and sincerely facing and unpacking the truths of our past; and finally burying the myth of a hierarchy of human value; replacing it with awareness and appreciation of the sacred interconnected reality of humanity. We must all realize that we are truly one human family, ultimately tracing our genomic ancestry to common ancestors on the continent of Africa.

Only at this point can we begin to envision a healed and shared future together as one America - not simply as red or blue - but with a shared vision of a truly reconstructed America that values all equally. No more susceptibility to manipulation through “dog whistle politics” and social media tricksters. No more deeply held racial resentments ripe for the picking by domestic and foreign enemies.

Together, we can then create a new, more complete narrative. We can construct a new story of America for our children, one honoring and embracing all of them. We can heal our perceived divides; share authentic memories and listen to one another, forging relationships of mutual understanding, trust and respect.

We can leverage these new bonds to meld division and separation into the “Beloved Community” envisioned by Dr. Martin Luther King. Working together, communities are capable of creating affordable housing, employing equitably, educating and caring for all. Laws and policies need to redress inequities created by centuries of adhering to a human hierarchy.

A compassionate, united and thoughtful people can create an authentic and expansive form of democracy that is poised to generate a far more fair and equitable economy; rather than continuing to increase wealth and income divides.

This change in our core belief and perception, in our way of seeing and willingness to relate to and with one another is America’s unfinished business. The persistence of blackface, Klansmen (with and without hoods), racial, anti-Semitic, gender and xenophobic violence are symptoms of the deeper pathology of having embraced human hierarchy as a way of life.

Let us take this moment to begin the true journey of healing that our future demands. 

Dr. Gail Christopher is the former Senior Advisor and Vice President of the W. K. Kellogg Foundation and architect of the Truth, Racial Healing and Transformation (TRHT) framework and process that is being implemented in cities, colleges, universities and organizations across America.

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