Sept. 15, 2013

CBC-ALC Meeting This Week: ‘It Starts With You’
By Zenitha Prince

A. Shaunise Washington, president, CBCF

Rep. Chaka Fattah, (D-Pa.), chairman, CBCF
 

Special to the Trice Edney News Wire from the Afro American Newspaper

Sept. 15, 2013

Article X of 11-part series on race in America - past and present.

America's Prison Dilemma
By Glenn C. Loury

Even if every convict were rightly sentenced, America's vast, racially skewed incarceration system would still be morally indefensible.

(TriceEdneyWire.com) - Over the past four decades, the United States has become a vastly punitive nation, without historical precedent or international parallel. With roughly 5 percent of the world's population, the U.S. currently confines about one-quarter of the world's prison inmates. In 2008, one in a hundred American adults was behind bars. Just what manner of people does our prison policy reveal us to be?

America, with great armies deployed abroad under a banner of freedom, nevertheless harbors the largest infrastructure for the mass deprivation of liberty on the planet. We imprison nearly as great a fraction of our population to a lifetime in jail (around 70 people for every 100,000 residents) than Sweden, Denmark, and Norway imprison for any duration whatsoever.

That America's prisoners are mainly minorities, particularly African-Americans, who come from the most disadvantaged corners of our unequal society, cannot be ignored. In 2006, one in nine Black men between the ages of 20 and 34 was serving time. The role of race in this drama is subtle and important, and the racial breakdown is not incidental: prisons both reflect and exacerbate existing racial and class inequalities.

Why are there so many African-Americans in prison? It is my belief that such racial disparity is not mainly due to overt discriminatory practices by the courts or the police. But that hardly exhausts the moral discussion. To begin with, let's remember the fact that the very definition of crime is socially constructed: as graphically illustrated by the so-called "war on drugs," much of what is criminal today was not criminal in the past and may not be tomorrow.

Let us also frankly admit that a massive, malign indifference to people of color is at work. I suspect strongly, though it is impossible to prove to the econometrician's satisfaction, that our criminal and penal policies would never have been allowed to expand to the extent that they have if most of the Americans being executed or locked away were White.

We must also frankly ask why so many African-American men are committing crimes. Many of the "root causes" have long been acknowledged. Disorganized childhoods, inadequate educations, child abuse, limited employability, and delinquent peers are just a few of the factors involved. In America, criminal justice has become a second line of defense, if you will, against individuals whose development has been neglected or undermined by other societal institutions like welfare, education, employment and job training, mental health programs, and other social initiatives. As a result, it is an arena in which social stratification, social stigmas, and uniquely American social and racial dramas are reinforced.

We should also remember that "punishment" and "inequality" are intimately linked-that causality runs in both directions. Disparities in punishment reflect socioeconomic inequalities, but they also help produce and reinforce them.

Is it not true, for example, that prisons create criminals? As the Rutgers criminologist Todd Clear concluded after a review of evidence, the ubiquity of the prison experience in some poor urban neighborhoods has had the effect of eliminating the stigma of serving time. On any given day, as many as one in five adult men in these neighborhoods is behind bars, and as Clear has written, "[T]he cycling of these young men through the prison system has become a central factor determining the social ecology of poor neighborhoods, where there is hardly a family without a son, an uncle or a father who has done time in prison."

For people who go to prison, time behind bars almost always also diminishes their odds of living crime-free lives when they get out, by lowering employability, severing ties to healthy communal supports, and hardening their own attitudes. When such individuals return to their communities, they join many others with the same harsh life experience, often forming or joining gangs. This, in turn, further diminishes the opportunities that law-abiding residents in those same neighborhoods have to escape poverty or preserve the often meager value of their property.

Huge racial disparities in the incidence of incarceration should therefore come as no surprise. The subordinate status of Black ghetto-dwellers-their social deprivation and spatial isolation in America's cities-puts them at greater risk of embracing dysfunctional behaviors that lead to incarceration, and then incarceration itself leads to more dysfunction.

Put it all together and look at what we have wrought. We have established what looks to the entire world like a racial caste system that leaves millions stigmatized as pariahs, either living behind bars or in conditions of concentrated crime and poverty that breed still more criminality. Why are we doing this?

The present American regime of hyper-incarceration is said to be necessary in order to secure public safety. But this is not a compelling argument. It is easy to overestimate how much crime is prevented by locking away a large fraction of the population. Often those who are incarcerated, particularly for selling drugs, are simply replaced by others. There is no shortage of people vying to enter illicit trades, particularly given how few legal paths to upward mobility exist for most young Black males.

The key empirical conclusion of the academic literature is that increasing the severity of punishment has little, if any, effect in deterring crime. But there is strong evidence that increasing the certainty of punishment has a large deterrent effect. One policy-relevant inference is that lengthy prison sentences, particularly in the form of mandatory minimum-type statutes such as California's Three Strikes Law, are difficult to justify.

The ideological justification for the present American prison system also ignores the fact that the broader society is implicated in the existence of these damaged, neglected, feared, and despised communities. People who live in these places are aware that outsiders view them with suspicion and contempt. (I know whereof I speak in this regard, because I am myself a child of the Black ghetto, connected intimately to ghetto-dwellers by the bond of social and psychic affiliation. While in general I am not much given to advertising this fact, it seems appropriate to do so here.)

The plain historical truth of the matter is that neighborhoods like North Philadelphia, the West Side of Chicago, the East Side of Detroit, and South Central Los Angeles did not come into being by an accident of nature. As the sociologist Loïc Wacquant has argued, these ghettos are man-made, coming into existence and then persisting because the concentration of their residents in such urban enclaves serves the interests of others. As such, the desperate and vile behaviors of some ghetto-dwellers reflect not merely their personal moral deviance, but also the shortcomings of our society as a whole. "Justice" operates at multiple levels, both individual and social.

Defenders of the current regime put the onus on law-breakers: "If they didn't do the crimes, they wouldn't have to do the time." Yet a pure ethic of personal responsibility does not and could never justify the current situation. Missing from such an argument is any acknowledgment of social responsibility even for the wrongful acts freely chosen by individual persons.

This is not to imply that a criminal has no agency in his behavior. Rather, the larger society is implicated in a criminal's choices because we have acquiesced to social arrangements that work to our benefit and to his detriment-that shape his consciousness and his sense of identity in a way that the choices he makes (and that we must condemn) are nevertheless compelling to him.

Put simply, the structure of our cities with their massive ghettos is a causal factor in the deviancy among those living there. Recognition of this fact has far-reaching implications for the conduct of public policy. What goals are our prisons trying to achieve, and how should we weigh the enormous costs they impose on our fellow, innocent citizens?

In short, we must think of justice as a complex feedback loop. The way in which we distribute justice-putting people in prison-has consequences, which raise more questions of justice, like how to deal with convicts' families and communities, who are also punished, though they themselves have done nothing wrong. Even if every sentence handed out to every prisoner were itself perfectly fair (an eminently dubious proposition), our system would still be amoral, because it punishes innocents.

Those who claim on principled arguments that "a man deserves his punishment" are missing the larger picture. A million criminal cases, each rightly decided-each distributing justice to a man who deserves his sentence-still add up to a great and historic wrong.

Glenn C. Loury is the Merton P. Stoltz Professor of the Social Sciences and Professor of Economics at Brown University. He is the author of, among other works, "Race, Incarceration, and American Values: The Tanner Lectures." This article, the 10th of an 11-part series on race, is sponsored by the W. K. Kellogg Foundation and was originally published by the Washington Monthly Magazine.

Sept. 15, 2013

What the Affordable Care Act Means to You
By Edna Kane-Williams

(TriceEdneyWire.com) - We’ve heard about it in bits and pieces over the past three years – the Affordable Care Act (ACA) and how it will benefit all Americans. But, the specific details can be confusing, even overwhelming. At AARP, we are here to untangle the jargon and empower you with the answers and information you are seeking for yourself and for your family.

Beginning Jan. 1, 2014, the ACA will provide 6.8 million uninsured African-Americans an opportunity to get affordable health insurance coverage. The bottom line is if you are not insured, low cost or free plans will soon be available. If you already have insurance, you may be able to find an even more affordable plan.

Here is what has already happened through the ACA:

• 3.1 million young adults have gained coverage through their parents’ health insurance plans. This includes more than 500,000 young African-American adults between ages 19 and 25, according to the U. S. Department of Health and Human Services (HHS).
• 6.3 million seniors are paying less for prescription drugs. And if you have Medicare Part D, and you reach the coverage gap or “doughnut hole” in 2013, you will get more than a 50 percent discount on brand name prescription drugs and more than a 20 percent discount on generic drugs while in the coverage gap. The discounts will continue until 2020 when the gap will end.
• 105 million Americans are paying less for preventative care and no longer face limits on lifetime coverage, according to HHS. The 4.5 million elderly and disabled African-Americans who receive health coverage from Medicare also have access to many preventive services with no cost-sharing, including annual wellness visits with personalized prevention plans, diabetes and colorectal cancer screening, bone mass measurement and mammograms, according to HHS.
• 17 million children with pre-existing conditions are no longer denied coverage or charged extra. The issue of pre-existing conditions has been a consistent barrier to obtaining insurance. Under the ACA, beginning in 2014, insurance companies can no longer deny you coverage, even if you have a pre-existing condition like asthma, diabetes, high-blood pressure or even cancer. And if you or a family member gets sick or injured, insurance companies can’t cut off your coverage or cancel your plan.
• Because African-Americans suffer from diseases such as obesity, heart disease, and diabetes at higher levels than America’s general population, the ACA will not only provide greater access to affordable quality health care, but will also “invest in prevention and wellness, and give individuals and families more control over their care,” according to HHS.

The obvious question is how do you get started with the benefits? On October 1, 2013, a recently created website, HeathCare.gov, will present what is called the Health Insurance Marketplace. The website will present competing insurance agencies and help guide health care seekers – individuals, families and small businesses - to the best decisions on which plan to choose or switch over to.

For more information about the Affordable Care Act and how the law applies to you, visit AARP's HealthLawAnswers.org. Our goal is to make it plain.

Edna Kane-Williams is vice-president of Multicultural Engagement at AARP.

Sept. 15, 2013

'Baby-Friendly' Hospitals Bypass Black Communities
By Rita Henley Jensen

Baby in a hospital
PHOTO: Crystal Marie Lopez/LaBellaVida on Flickr, under Creative Commons

Special to the Trice Edney News Wire from Women's eNews.

(TriceEdneyWire.com)-Very few of the maternity wards that have won a seal of approval for providing breastfeeding support are located in communities with a significant population of African-Americans, a Women's eNews analysis finds.

Breast milk is the most local of all foods and one that can have an outsized impact on the health of mothers and infants.

However, for many African-American parents, finding a maternity ward that supports the process immediately after birth can be extremely difficult.

That's the finding of Women's eNews' review of the U.S. locations of so-called Baby-Friendly hospitals, maternity hospitals that have passed a set of stringent standards established by the World Health Organization to assist brand-new parents to begin breastfeeding.

A Women's eNews analysis finds that 45 percent of U.S. Baby-Friendly hospitals are in cities and towns that have African-American populations of 3 percent or less.

A full 83 percent of U.S. Baby-Friendly hospitals are in communities where the African-American portion of the population is 13 percent or less.

This geographic segregation of breastfeeding care and support may play a significant role in the lower breastfeeding rates among African-American mothers, which in turn means the mothers and the infants do not enjoy the health benefits of breastfeeding.

Moreover, despite their potential role in improving the nation's health, the "Baby- Friendly" designation is not widely understood, even in the highest public health circles, anecdotal evidence suggests.

At a recent conference on medical issues surrounding breastfeeding, one questioner asked Dr. Ana Pujol McGee, chief medical officer and executive vice president of the Joint Commission, the agency that sets standards for hospitals nationwide, about the lack of support for Baby-Friendly hospitals at the highest levels of the health system.

"Why is there no leadership from the commission on Baby-Friendly hospitals?" McGee was asked.

"What's a Baby-Friendly hospital?" McGee replied.

The attendees moaned in response. Later, in the hallway outside the meeting, Trish MacEnroe, executive director of Baby-Friendly USA, gave McGee a quick briefing.

Local Champions

The location of Baby-Friendly hospitals depend on what many call "champions," someone within a hospital who has the leadership skills, time and determination to lead the change. Hospitals must volunteer to change their breastfeeding support practices and pass inspection by Baby-Friendly USA in order earn the Baby-Friendly status.

This dependence on local leadership has led to a haphazard distribution of breastfeeding support throughout the United States, affecting all parents. However, given that Black mothers are the least likely to breastfeed, the lack of assistance during the crucial hours after birth seems at least a major missed opportunity as well as a reflection of the cost of racial segregation that persists throughout most of the United States.

One of the key Baby-Friendly rules-designed to limit the influence of infant formula makers-requires the hospital buy its own infant formula and not provide free formula to departing parents, including the free diaper bags provided at no cost by formula companies with a handy six-pack of formula inside.

Few Baby-Friendly hospitals can be found in big urban centers with large African-American communities and other low-income residents.

New York City, for example, home to more than 2 million African-Americans-9 percent of all African- Americans nationwide-- has only two Baby-Friendly hospitals, but none in the areas outside Manhattan where most African Americans live.

Detroit, now seeking to avoid its pension obligations in bankruptcy court, has a population of 700,000 that is 83 percent African American and has no certified Baby-Friendly hospitals. A suburb does though; the affluent Grosse Point, with a community that is 3 percent African American.

Kiddada Green lives in Detroit and is founding director of the Black Mothers' Breastfeeding Association, a national organization that aims to eradicate the racial disparity in breastfeeding rates among African American women. Green is among the leaders of grassroots advocacy and service organizations declaring the week of Aug. 25 Black Breastfeeding Week.

Demographic Disparities

The geography of Baby-Friendly hospitals concerns Green.

"In order to increase the number of black babies who are breastfed, we must look specifically at the regional and racial demographics of the locations of Baby-Friendly hospitals and identify ways to increase the number of Baby-Friendly hospitals in areas that are highly populated with African American families," she said.

The cities other than New York and Detroit with the largest African American populations are, in order, Chicago, Philadelphia and Houston. None of these cities has a Baby-Friendly hospital and yet, combined, 1-in-8 African-Americans live in these five cities.

Based on births in 2009, the Atlanta-based Centers for Disease Control and Prevention (CDC) reported two years ago that, overall, Baby-Friendly hospitals were relatively scarce across the country.

Nebraska had the highest percentage of infants born in Baby-Friendly hospitals, with more than 20 percent. Nine states, mostly in the South and Midwest, had none.

For Nearly 1-in-5 Black Americans No 'Baby-Friendly' Hospital In-State

Less than 5 percent of the 166 U.S. hospitals meeting criteria for the WHO'S Baby-Friendly Hospital Initiative are in the nine states plus District of Columbia with the highest concentrations of black Americans; areas home to one-third of the country's black population. Nationwide, almost one-fifth of Black Americans live in states without a single hospital meeting the WHO's 22 year-old standard of care.

Support for breastfeeding in all communities has increased dramatically during the administration of President Barack Obama.

Through a concerted effort of the former surgeon general, Regina M. Benjamin, and many others in the health community, U.S. breastfeeding rates have continued to rise. Between 2000 and 2010, the percentage of mothers who said they breastfed their babies in the early postpartum period increased to nearly 77 percent from 71 percent, according to an August report from the CDC.

The CDC also reported in August that black mothers nationwide lag behind other racial and ethnic groups when it comes to breastfeeding. In a recent CDC study, 54 percent of black mothers initiated breastfeeding compared with 74 percent of white mothers and 80 percent of Hispanic mothers. The CDC reports this gap persists regardless of income and educational attainment.

Rise in Baby-Friendly Hospitals

Meanwhile, the number of Baby-Friendly hospitals certified by Baby-Friendly USA has increased by 12 this year, for a total of 166. Of the 12, however, only two are located in a community with a large African American population: St. Mary's Hospital in Decatur, Ill., where the African American population is 23 percent, and Georgetown. S.C., with a 57 percent African-American population.

The CDC has addressed the geography issue, said MacEnroe of Baby-Friendly USA, the organization that works with hospitals seeking the certification.

An initiative launched by the CDC, called Best Fed Beginnings, is working with 89 additional hospitals serving low-income patients that are willing to work toward becoming officially Baby-Friendly. Of those, two are in Houston, two are in Philadelphia and one is in Chicago. None are in New York City or Detroit, with a total of more than 3 million African-American residents.

The CDC also reported this month an unprecedented decline in U.S. obesity rates, attributed in part to increased breastfeeding. The obesity rate for school-age, low-income children in the United States dropped by as much as 1 percent, in what the CDC hopes might be a trend. At the current time, 1-in-5 Black children and 1-in-6 Hispanic children are obese, leading to lifetimes of poor health.

Increasing breastfeeding is seen as a major strategy on the national level for improving the health of African-American mothers and their children. For women, breastfeeding reduces the risks for breast and ovarian cancer, as well as obesity, diabetes and heart disease.

For infants, the health benefits are also significant. Babies who are breastfed have lower risks of ear and gastrointestinal infections, diabetes and obesity. Breast milk also contains antibodies that help babies fight off viruses, bacteria, allergies and asthma.

"This persistent gap in breastfeeding rates between black women and women of other races and ethnicities might indicate that black women are more likely to encounter unsupportive cultural norms: perceptions that breastfeeding is inferior to formula feeding, lack of partner support and an unsupportive work environment," said a 2002 report published by the Journal of the Black Nurses Association.

Green, the breastfeeding activist in Detroit, said she also wants a closer look at the impact of Baby-Friendly hospitals on these breastfeeding rates. She said, "It is my wish that there is an examination of how this initiative is positively impacting the breastfeeding disparity gap for black babies."

Rita Henley Jensen, a prize-winning investigative reporter, is founder and editor in chief of Women's eNews.