What’s the Best Way to Deal with the Ku Klux Klan?

On the recommendation of my friend and colleague Mike Mitchell, I recently listened to a fascinating podcast about Daryl Davis, an award-winning musician who is best known for his role in bringing down the Maryland chapter of the Ku Klux Klan – through his friendship with Klan members.  In the podcast, Davis describes how, while playing country music in a bar in 1983, a White man approached him and expressed that he had never heard a Black man “play as well as Jerry Lee Lewis.”  The two men struck up a conversation, during which Davis discovered that his counterpart was a card-carrying member of the KKK.

Amazingly, Davis befriended the man.  Nearly a decade later, he decided that he wanted to meet more KKK members.  When experiencing overt forms of personal racism throughout his life, Davis had always wondered how people could harbor animosity towards him – without knowing him – just because of the color of his skin, and he believed that talking to members of the KKK could help him understand this phenomenon.

Davis had his secretary set up an interview with Roger Kelly, the head of the Maryland KKK at the time, and, after a tense initial encounter, Davis became friends with Kelly as well.  In the years thereafter, he developed relationships with several other high-ranking KKK members.  During each of his encounters with them, Davis listened closely to what they had to say.  He would challenge the Klansmen – when Kelly referenced the Bible during his initial interview, for example, Davis would pull out a copy of the Bible and ask Kelly to show him the relevant passages that ostensibly supported racism – but he remained polite and friendly while doing so.  Over time, as the Klansmen got to know Davis, many of their prejudiced (and factually incorrect) beliefs about Black people began to erode.  Eventually, some of the highest-ranking members in Maryland left the Klan and the organization itself dissolved.

I have deep respect and awe for what Davis did and how much he accomplished.

I would characterize Davis’s approach – politely disagreeing with Klansmen in order to break down stereotypes over time – as the “long game.”  It’s about changing people’s minds and attitudes in the long run, and, if successful, pays huge dividends.

At the same time, the long game is remarkably time-intensive.  It’s also very risky – there’s no guarantee of eventual success, and in the short run, the Klan has relatively free reign to terrify and oppress a whole lot of people.

An alternative approach – the “short game” – prioritizes protecting the oppressed over changing the mindsets of oppressors.  The short game is about checking people in power.  That often means stating, in very clear terms, that certain viewpoints are unacceptable, and that there will be consequences for people who espouse them in public.

There’s obviously some tension here between the short game and the long game, between laying down speech and policy that protect the oppressed right now and keeping the oppressors listening so they might in fact eventually change.  I generally play the short game with a few elements of the long game incorporated – I love to engage with those with racist opinions, and I am happy to listen to what they have to say, but I differ from Davis in that I won’t say “we disagree” when I’m talking about a Klan member; instead, I’ll say that the Klan member is ethically and factually wrong, and that he shouldn’t be allowed to hold his intimidation rallies (I’ve long made a similar case when it comes to LGBT issues, too).

I like to think that there is an appropriate balance to be struck between both tactics, but I struggle a lot with it.  I want Klansmen to know (and society to acknowledge) that we don’t have mere differences of opinion – the Klan is definitively wrong about race and their incorrect and unethical viewpoint harms large numbers of people.  At the same time, telling people their views are wrong and bigoted and preventing them from expressing them publicly is likely to cause them to tune out and feel more resentment, no matter how much I insist (genuinely) that I am interested in talking to them and hearing what they have to say.

There’s definitely a difference between calling a viewpoint bigoted and calling a person bigoted, but part of me thinks there’s a lot of value in tying viewpoints to identity, especially in terms of the social pressure that can bring for people to curtail open forms of oppression.  And I’m generally willing to accept some tuning out from oppressors, if it means that society will stop giving them a microphone and label racism and bigotry what it is.  I tend to think that helping a few people change is less important than making sure they don’t harm anyone, and that, absent an amplifier for oppressors’ views, reason and compassion will become much more prevalent in the next generation.

All of that said, I recognize that my White privilege allows me to advocate for this approach with little fear of repercussion, whereas Davis would very likely be labeled an Angry Black person if he were to adopt my strategy today (and if he tried it with Roger Kelly, he almost certainly would have ended up dead).  I question whether my preferred tactic for confronting racism is most appropriate in large part because it’s available to me only as part of a menu of relatively consequence-free options that may be unavailable to my Black friends.

In short, I would be very interested in hearing Davis’ and others’ thoughts on my tendencies in this space, and on whether or not there’s a better way to reconcile the tension between the pursuit of short-run protection for the oppressed and long-run change in the oppressors.

Leave a comment

Filed under Philosophy, Race

Is VAM a Sham? Depends on the Question You’re Asking.

  1. “Does data source X provide useful information?” and
  2. “Should data source X be used for purpose Y?”

are two very different questions.  Unfortunately, conflation of these questions by education researchers, writers, and advocates far too frequently results in bad policy recommendations.

This problem surfaces especially often in debates about value added modeling (VAM), a statistical method aimed at capturing a teacher’s effectiveness in the classroom.  Based on a new paper from economists Raj Chetty, John Friedman, and Jonah Rockoff, Andew Flowers writes, in response to question 1 above, that we’re pretty good at “the science of grading teachers” with VAM results.  Flowers weighs in on question 2 as well, arguing that Chetty et al.’s work means that “administrators can legitimately use value-added scores to hire, fire and otherwise evaluate teacher performance.”

In terms of question 1, the idea that VAM research indicates that we’re pretty good at “grading teachers” is itself debatable.  Flowers doesn’t conduct an extensive survey of researchers or research, but focuses on six well-known veterans of VAM debates, including several of the more outspoken defenders of the metric (Chetty and Thomas Kane specifically; Friedman, Rockoff, and Douglas Staiger are also longtime VAM supporters).  While many respected academics caution about VAM’s limitations and/or have more nuanced positions on its use, Jesse Rothstein is the only one Flowers cites.

In fact, whether VAM estimates are systematically biased (Rothstein’s argument) or not (Chetty et al.’s contention), there are legitimate questions about whether VAM results are valid (whether or not they are really capturing “teacher effectiveness” in the way that most people think about it).  VAM estimates correlate surprisingly little with other measures aimed at capturing effective teaching (like experts’ assessments of classroom instruction).  They’re also notoriously unstable, meaning that a teacher’s scores bounce around a lot depending on the year and test studied.  While other methods of evaluating teacher effectiveness have similar issues and there are certain approaches to VAM (not commonly used) that are more useful than others, it’s perfectly reasonable to argue that we’re still pretty bad at “grading teachers.”

More importantly, however, debates about bias, validity, and stability in VAM actually have much less to do with the answer to question 2 – should we use VAM to evaluate teachers in the way its proponents recommend? – than many people think.  To understand why, we need look no farther than two of the core purposes of teacher evaluation, purposes which everyone from teachers unions to education reform organizations generally agree about (at least rhetorically).

1) One core purpose of teacher evaluation is helping teachers improve. Making VAM results a defined percentage of a teacher’s evaluation is not useful for this purpose even if we assume VAM results are unbiased, valid, and stable.  Such a policy may actually undermine teacher improvement, and hence the quality of instruction that students receive.

For starters, a VAM score is opaque.  Teachers cannot match their VAM results back to specific questions on a test or use them to figure out what their students did or didn’t know.  VAM may be able to tell a teacher if her students did well or poorly on a specific test, but not why students did well or poorly.  In other words, a VAM score provides no actionable feedback. It does not indicate anything about what a teacher can do to help her students learn.

In addition, VAM results are outcomes over which a teacher has very limited control – research typically finds that teachers contribute to less than a fifth of the variation in student test scores (the rest is mostly random error and outside-of-school factors).  If a teacher’s VAM results look good, that might be because the teacher did something well, but it also might be because the teacher got lucky, or because some other factor contributed to her students’ success.  The tendency to view VAM results as indicative of whether or not a teacher did a good job – a common side effect of making VAM results a defined percentage of a teacher’s evaluation – is thus misguided (and a potential recipe for the reinforcement of unhelpful behaviors).  This concern is especially germane because VAM results are often viewed as “grades” by the teachers receiving them – even if they are only a small percentage of a teachers’ evaluation “score” – and thus threaten to overwhelm other, potentially productive elements of an evaluation conversation.

A better evaluation system would focus on actionable feedback about things over which a teacher has direct control.  Student performance should absolutely be included in the teacher evaluation process, but instead of making VAM a defined percentage of a teacher’s evaluation (part of a “grade”), evaluators should give teachers feedback on how well they use information about student performance to analyze their teaching practices and adapt their instruction accordingly.  This approach, unlike the approach favored by many VAM proponents, would help a teacher improve over time.

2) A second core purpose of teacher evaluation is to help evaluators make personnel decisions. Relative to the evaluation system described above – one that focuses on actions over which a teacher has control – making VAM results a defined percentage of teacher evaluations does not help us with this purpose, either.  Suppose a teacher gets a bad VAM result.  If that result is consistent with classroom observation data, the quality of assigned work, and various other elements of the teacher’s practice, an evaluator shouldn’t need it to conclude that the teacher is ineffective.

If there is a discrepancy between the VAM result and the other measures, on the other hand, there are a few possibilities.  The VAM results might have been unlucky.  The teaching practices the teacher employed might not be as useful as the teacher or evaluator thought they would be.  Or perhaps VAM isn’t a very good indicator of teacher quality (there’s also a possibility that the various other measures aren’t good indicators of teacher quality, but the measures suggested all have more face validity – meaning that they’re more intuitively likely to reflect relevant information – than do VAM results).  Under any of these alternative scenarios, using VAM results as a defined percentage of a teacher’s evaluation makes us more likely both to fire teachers who might actually be good at their jobs and to reward teachers who might not be.

When we evaluate schools on student outcomes, we reward (and punish) them for factors they don’t directly control. A more intelligent and fair approach would evaluate the actions schools take in pursuit of better student outcomes, not the outcomes themselves.

Relative to teacher evaluation systems that focus on things over which a teacher has direct control, using VAM results as a defined percentage of a teacher’s evaluation makes us more likely both to fire teachers who might actually be good at their jobs and to reward teachers who might not be.

To be fair, question 1 could have some relevance for this purpose of teacher evaluation; if VAM results were an excellent indicator of teaching quality (again, they aren’t, but let’s suspend disbelief for a moment), that would negate one of the concerns above and make us more confident in using VAM for reward and punishment.  Yet even in this case the defined-percentage approach would hold little if any advantage over the properly-designed evaluation system described above in helping administrators make personnel decisions, and it would be significantly more likely both to feel unfair to teachers and to result in a variety of negative consequences.

I’ve had many conversations with proponents of making VAM a defined percentage of teacher evaluations, and not a single one has been able to explain why their approach to VAM is better than an alternative approach that focuses on aspects of teaching practice – like creating a safe classroom environment, lesson planning, analyzing student data, and delivering high-quality instruction – over which teachers have more control.

So while the answer to question 1 in the case of VAM is that, despite its shortcomings, it may provide useful information, the answer to question 2 – should VAM results be used as a defined percentage of teacher evaluations? – is a resounding “no.”  And those who understand the crucial distinction between the two questions know that no amount of papers, articles, or researcher opinions, however interesting or useful for other purposes they may be, is ever going to change that fact.

Leave a comment

Filed under Education

Black Lives Matter Movement Gives Bernie Sanders’ Racial Justice Agenda the Push It Needs

Presidential candidate Bernie Sanders has unveiled a comprehensive racial justice agenda aimed at “addressing the four central types of violence waged against black and brown Americans: physical, political, legal and economic.”  The agenda includes, among other policy proposals, a call for police demilitarization, community policing, aggressive prosecution of police officers who break the law, the re-enfranchisement of those with criminal records, banning for-profit prisons, eliminating mandatory minimum sentences, automatic voter registration, making Election Day a national holiday, youth employment programs, free college, and pay equity legislation.  Sanders also has an excellent record on racial justice issues, much better than any other candidate running for president.

In the 1960s, while a young Hillary Clinton was supporting Republican presidential candidate Barry Goldwater – an outspoken opponent of civil rights legislation – in his quest for the presidency, Sanders was leading protests against police brutality and segregated schools and housing, marching in the March on Washington, and working as an officer for the Congress of Racial Equality.  His voting record while in Congress, first as a Representative (1990-2005) and then as a Senator (2006-Present), has earned him consistently excellent marks from the National Association for the Advancement of Colored People (NAACP).  The NAACP has given Sanders 100% ratings on its Legislative Report Cards for the entirety of his time in the Senate and near-100% or 100% ratings during his time in the House for, among many other things, voting in favor of strengthening the Voting Rights Act, anti-discrimination laws, and hate crimes legislation and against the death penalty, stringent sentencing guidelines for those caught up in the criminal justice system, and the welfare reform law of 1996 (the only blip on his record is gun control, an issue on which he admittedly has a mixed voting history, though his stance on the issue is much more sensible than many of his detractors contend).

A 20-year-old Bernie Sanders helps organize a protest of housing segregation in properties owned by the University of Chicago in the 1960s (via https://berniesanders.com/timeline/1960s/).

In the 1960s, a 20-year-old Bernie Sanders helps organize a protest of housing segregation in properties owned by the University of Chicago (via https://berniesanders.com/timeline/1960s/).

Because of that excellent record, a number of Sanders supporters have been upset by Black Lives Matter protests targeting Sanders.  Sanders supporters’ frustration seems to be borne out of two observations.  First, Sanders’ passion for economic justice – raising the minimum wage to $15 an hour, breaking up the big banks, making our tax system more progressive, advancing single-payer health care – is intimately connected with a passion for racial justice.  Income, wealth, and opportunity inequality in this country disproportionately affect communities of color, and a commitment to addressing them is in many ways in and of itself indicative of a view that Black Lives Matter.

Second, and relatedly, Sanders has received a disproportionate amount of attention from protesters relative to Hillary Clinton and Republican candidates, who have almost-uniformly worse records and stances (the one exception may be Clinton on gun control) on issues affecting Black Americans (in fact, Sanders has what is by far the best record of any prominent candidate on civil and human rights across the board; he has long been a strong ally on issues affecting Latinos, the LGBT community, women, and poor people around the world).  Sanders supporters wonder why Black Lives Matter is applying pressure primarily to the candidate most sympathetic to their cause.

I myself am a strong Sanders supporter and find these observations relevant, but they miss a few crucial points.  For one thing, while racial and economic justice are intimately connected, they are not the exact same thing.  As Jennifer Roesch puts it in an excellent article for Jacobin:

It is certainly true that the struggle against racism today must entail a radical program of economic demands…It is also clear that such reforms would benefit the entire working class and reduce income inequality. But such demands cannot be delinked from, or stand in the place of, explicit demands around racism…

Fighting economic inequality is insufficient — any challenge to capital has to be coupled with race-specific demands for reform. Jobs programs would have to include affirmative-action policies and a prohibition on discrimination on the basis of a criminal record; fights to expand funding for public hospitals, schools, and services would have to recognize the specific needs of black communities hollowed out by decades of deindustrialization and neglect; and housing policies would need to explicitly target practices such as redlining and predatory lending.

The crisis faced by black America is also not solely economic — it is also a social crisis. Mass incarceration, police violence, and resegregation have devastated black communities…

This fight will require forging a unity not by collapsing the fight against racism into a broader class fight for economic equality, but by highlighting the central role of racism and making it a concern of the entire working class.

Black Lives Matter protesters wanted Sanders’ campaign to stop treating racial justice as an inevitable byproduct of economic justice.  They wanted Sanders to instead promote a specific racial justice platform complementary to his economic justice agenda, and they had every right to demand that he do so.

While I also hope to see Black Lives Matter turn the pressure up on Clinton and the Republican candidates in the weeks and months to come, criticisms of their tactics thus far – targeting Sanders and “taking over” some of his speaking events – are in my view off base.  Black Lives Matter is the type of grassroots people’s movement that Sanders prides himself on representing; he was a good first target precisely because he’s a natural ally and the candidate most likely to respond to such a protest with a policy agenda addressing its legitimate concerns.  Writing about the first protest at Netroots Nation, Joe Dinkin captured it best:

Here’s one stab at a better response [Sanders] could have given [to the Black Lives Matter protesters]: “We need a democratic revolution, and you are part of it. I admire your courage in speaking up. I learned of the troubling death of a black woman in police custody, and, yes, I will say her name: Sandra Bland. I will say her name because black lives matter. I admit I don’t have all the answers. But your fight is my fight. For dignity and equality for all. I need you to fight with me and help me learn. Together we can change both politics and culture and ensure that black lives matter…”

This constituency is demanding to have the issues of structural racism and police violence taken up within the political system…They’re forcing Sanders and other candidates to respond on an issue that it seems like they would have preferred to avoid. If Sanders responds by joining in their fight, they’ve pushed the Movement for Black Lives into the presidential debate and into the mainstream of [American] progressive politics—from which they currently and justifiably feel left out.

This is fair game, and an approach that fans of Bernie Sanders should understand…For people who simply wanted to hear the candidates answer questions and present their stump speeches, there are plenty of opportunities for candidates to share positions on the issues—at least on the ones they’re not ducking…The Black Lives Matter agenda is not the only issue of moral urgency, but it most certainly is one of them. All progressives should applaud activists who took the opportunity to push it forward.

It is quite possible that, were it not for the Black Lives Matter movement, Sanders’ racial justice agenda would not yet exist.  That it contains excerpts like the following is telling:

“At the federal level we need to establish a new model police training program that reorients the way we do law enforcement in this country. With input from a broad segment of the community including activists and leaders from organizations like Black Lives Matter we will reinvent how we police America.”

So we have two groups to thank for Sanders’ ambitious racial justice platform. Sanders and his campaign staff absolutely deserve credit for unleashing it and for being allies in the movement. Black Lives Matter deserves the bulk of the credit, however, not just for pushing the conversation on this issue forward, but also for reminding us that even the best presidential candidate won’t be able to enact the change we need without a constructively critical social movement behind him.

Update (8/11/15): The original version of this post included the following paragraph as part of the block quote from Roesch’s article:

As the historical record shows, we cannot assume that reductions in the overall level of inequality will trickle down to African Americans. In the golden age of postwar American capitalism, an era to which many left-liberals yearn to return, economic inequality was much lower than it is today, but there was no corresponding decrease in racial inequality. If anything, it was even starker — in 1959, more than half of black families lived in poverty, while 15 percent of white families did.

While it is certainly true that a strong economy on its own has never come close to eliminating racial disparities in economic outcomes, the wording in this paragraph implies that outcomes for Black Americans did not improve during “the golden age of postwar American capitalism,” an implication which is incorrect (big thanks to Dean Baker for pointing out this issue).  In fact, a growing body of evidence shows that a strong economy is especially important for Black workers.

7 Comments

Filed under Poverty and the Justice System, Race, US Political System

Anti-gay Policy at the FDA and What You Can Do About It

Ireland recently became the first country to legalize gay marriage through public referendum, a major victory for the LGBT rights movement. The US Supreme Court is expected to follow in Irish voters’ footsteps soon; the court will probably rule in favor of legalized gay marriage when it issues an opinion on Obergefell v. Hodges, most likely by the end of June.

But the fight for LGBT rights is far from over – barriers to LGBT equality remain a persistent part of our culture and policies. Advocates have done an amazing job inciting change on the marriage front, and we must keep the momentum rolling by addressing outstanding forms of institutionalized discrimination.

Blood donation guidelines represent one such form of state-sanctioned prejudice. For over thirty years, the Food and Drug Administration has disqualified “men who have sex with men (MSM)” – gay and bisexual men – from giving blood. In response to calls from the public and scientific community to end the ban, the FDA recently proposed to modify its donor eligibility criteria. Yet its proposal amounts to mere window-dressing; by only allowing gay men who have been celibate for a year to donate, the FDA would preserve its policy’s core error and injustice.
 

FDA Blood Ban Proposal

The FDA’s “Draft Guidance for Industry” still recommends an effective ban on blood donation by gay and bisexual men.

 
While the FDA claims its proposed policy is intended to protect the blood supply from HIV, the science does not support the FDA’s claim. Being a man who has sex with other men is an identity characteristic, not a risk behavior for contracting HIV. Actual risk behaviors include “needle-sharing during injection drug use,” which the FDA does identify as high-risk, and certain sexual practices – like unprotected anal sex and unprotected sexual intercourse with multiple partners – that the FDA ignores when heterosexual people engage in them.

Fortunately, there’s still a way to help the FDA fix this policy error – for the next month-and-a-half, the FDA will consider comments on its proposal. My comment is at the end of this post, and you’re welcome to copy and use it if you don’t have time to write your own. Your comment in whatever form you choose can be submitted here.

Note that the FDA offers the following explanation for its decision to eschew the identification of high-risk sexual behavior and instead profile gay and bisexual men:

The individual risk-based options were not determined to be viable options for a policy change at this time for a number of reasons: pretesting would be logistically challenging, and would likely also be viewed as discriminatory by some individuals, and individual risk assessment by trained medical professionals would be very difficult to validate and implement in our current blood donor system due to resource constraints. Additionally, the available epidemiologic data in the published literature do not support the concept that MSM who report mutual monogamy with a partner or who report routine use of safe sex practices are at low risk for HIV. Specifically, the rate of partner infidelity in ostensibly monogamous heterosexual couples and same-sex male couples is estimated to be about 25%, and condom use is associated with a 1 to 2% failure rate per episode of anal intercourse (Refs. 38, 39, 40, 41). In addition, the prevalence of HIV infection is significantly higher in MSM with multiple male partners compared with individuals who have only multiple opposite sex partners (Ref. 28).

This explanation stands in stark contrast, however, to the FDA’s proposed use of its guidelines as “donor education material…so that donors can self-defer.” The recommendations appear as part of a “Donor History Questionnaire;” striking one question and adding a few in its place would not require any resources whatsoever beyond what the blood donor system can currently handle. And doing so would make the guidelines far more educational about the actual risks associated with sexual behavior – statistics about HIV prevalence, reported monogamy, and condom failure present a limited picture of an individual’s risk of HIV contraction. In fact, the FDA currently propagates misinformation about HIV risk by lumping “anal, oral, or vaginal sex, regardless of whether or not a condom or other protection is used,” into the same category, and then inaccurately suggesting that such broadly defined “sex” is high-risk when gay and bisexual men have it and low-risk when engaged in by anyone else.

The FDA’s insistence on a one-year ban for gay and bisexual men is even more absurd when considering the results of a study, called BloodDROPS, that the agency itself commissioned and that is cited in the FDA’s draft recommendations. The study found that some gay and bisexual men, correctly viewing the FDA’s policy “as discriminatory and stigmatizing,” chose to donate blood anyway. Far from wreaking havoc on the blood supply, however, these individuals actually had lower rates of HIV (0.25%) than are seen in the general population (over .35%). In other words, it appears that gay and bisexual men understand their HIV risk at least as well as the FDA does; they donate responsibly in spite of discriminatory practices and will continue to donate responsibly if and when the FDA issues accurate donor education materials.

Other countries, from Spain to Mexico to Italy, have already implemented more scientific policies that defer donors on the basis of sexual behavior instead of sexual orientation. A recent study on the Italian policy, which has been in place since 2001, concluded that the change away from profiling gay and bisexual men “did not significantly affect either the incidence or prevalence of HIV infection among blood donors.”

So without further ado, here’s the comment I have submitted to the FDA (again, please feel free to copy it, modify it, and/or to write your own comment and submit it here):

Dear FDA,

I am writing to express concern about the proposed revision to your blood donor deferral criteria for gay and bisexual men (MSM). Our knowledge of HIV transmission and the experience of other countries in adopting safe, reliable, and nondiscriminatory donor eligibility criteria indicate that a one-year deferral, while marginally better than the lifetime deferral currently in place, would continue to stigmatize gay men without improving the safety of the blood supply.

While the prevalence of HIV is higher among MSM than among the general population, an individual’s risk of contracting HIV from sexual contact depends both on the probability that a sexual partner has HIV and the probability that HIV will be transmitted through a given type of sexual contact. As a result, many individuals who engage in unprotected heterosexual intercourse with multiple partners have a greater risk of contracting HIV than gay or bisexual men who use protection, especially if those gay or bisexual men are in committed relationships.

In fact, the BloodDROPS study you commissioned found rates of HIV prevalence among MSM blood donors lower than rates of HIV prevalence seen in the general population. These results suggest that MSM who engage in riskier sexual behaviors already abstain from donation, and that they would continue to do so if provided with a more appropriately-constructed questionnaire.

I strongly urge you to strike items ix and x from your recommendations for an updated donor history questionnaire. I also urge you to strike the footnote that puts “anal, oral, or vaginal sex, regardless of whether or not a condom or other protection is used,” into the same category. Those items could be replaced with the following recommendations for deferral in the DHQ:

1. A history in the past twelve months of anal sex with multiple partners or of unprotected anal sex,

2. A history in the past twelve months of unprotected vaginal sex with multiple partners.

Making this change would not require new resources. It would preserve blood safety, end the FDA’s discrimination against gay and bisexual men, and improve the educational value of donor education material. And it would also bring the US policy in line with policies in place in Mexico, Spain, and Italy. A recent study of Italy’s policy, instituted in 2001, found that the country maintained the integrity of its blood supply after it discarded its ban on MSM in favor of unprejudiced deferral criteria.

I believe ending deferral based on sexual orientation entirely is the only way to simultaneously avoid discrimination, preserve the safety of the blood supply, and maintain the FDA’s credibility. Thank you very much in advance for considering my proposed revision.

Sincerely,
Ben Spielberg

Leave a comment

Filed under LGBT Issues

Sexual Assault Prevention Requires More than Well-Intentioned Allies

Allyson Scher, a recent graduate of Washington University in St. Louis with a B.A. in English literature and cognitive science, has studied the intersection of women’s rights, civil rights, and the influence of language on cognition.  In this post, Allyson explains why individual and institutional accountability and female agency are essential components of effective sexual assault prevention. 

Allyson Scher

Allyson Scher

Columbia University student-activist and rape survivor Emma Sulkowicz was raped by a classmate in 2012, and, after the university failed to punish her attacker, called attention to the epidemic of sexual assault on campus through a performance art piece, Mattress Performance, in which she carried her mattress around with her on campus throughout the academic year. Sulkowicz’s invitation to the President’s State of the Union Address this year as the guest of Senator Kirsten Gillibrand shows that the problem of sexual assault is increasingly gaining national attention, and it’s encouraging to see a number of prominent political figures beginning to talk about it. However, trying to address sexual assault is not sufficient to ending sexual assault; the way we address it matters, and we have a long way to go before we do so effectively.

Rape and sexual assault have received particular focus from the Obama Administration. The U.S. Department of Education is currently investigating 95 universities and colleges under Title IX sexual violence violations. The White House has also recently engaged the issue of sexual assault on campus, and in January 2014, President Obama established a White House Task Force to Protect Students from Sexual Assault, co-chaired by the Office of the Vice President and the Council on Women and Girls. In April 2014, the Task Force published its first set of action steps and recommendations regarding sexual assault on campus: the initiative “Not Alone” purports to help improve identification, prevention, and effective response to sexual assault on campuses. And in September 2014, the White House Task Force launched a PSA and report to call for bystander intervention to protect victims of sexual assault. Despite well-intentioned efforts, however, these initiatives fail to successfully address sexual assault on campus because they (1) focus on bystander intervention rather than directly addressing individual and institutional misconduct, and (2) subvert female agency.

The misaligned priorities of the initiative are apparent through the title of the Task Force: the “White House Task Force to Protect Students from Sexual Assault” suggests that it is the Task Force’s job to “protect students from sexual assault”– and not to fight to end the act of sexual assault itself. The Task Force focuses on identifying victims to the neglect of identifying perpetrators, which incorrectly suggests that the act of sexual assault is both inevitable and inherently enmeshed in our culture. The Task Force directs us to protect women, but not to identify and stop rapists. It is a welcome shift from victim-blaming, but it is misplaced to focus solely on bystander intervention (i.e., a third party protecting a “potential victim” from a “potential rapist”).

Michael Winerip noted in the New York Times last year: “The hope is that bystander programs will have the same impact on campus culture that the designated driver campaign has had in reducing drunken driving deaths (to 9,878 in 2011 from 15,827 in 1991)…Both take the same tack: Drinking to excess can’t be stopped but the collateral damage can.” In other words, Winerip identifies that bystander intervention works under the assumption that sexual assault cannot be stopped, but individual instances of victimization can.

This assumption is damaging because, in attempting to shape campus culture to emphasize the protection of women, it instead validates violence against women as an inherent and unchangeable aspect of our culture. Approaching sexual assault prevention in this way puts the onus on the bystander, and removes responsibility from the offender because “it happens.” We need to acknowledge not only the fact that rape occurs, but that we perpetuate rape culture, and consequently rape, through acceptance of its inevitability.

The White House Task Force’s PSA, despite having several commendable features, also inadvertently subverts female agency in its attempt to end sexual assault. The PSA, titled “1 is 2 Many,” features several male celebrities, including Vice President Biden, President Obama, Steve Carrell, and Seth Meyers, urging the audience to “speak up” or “do something about” sexual assault on campus. President Obama ends the message with: “It is up to all of us to put an end to sexual assault. And that starts with you.”

On first glance, there is a lot to applaud about this PSA: it displays powerful men – in politics, comedy, and entertainment, all of whom are stereotypically masculine men – speaking out against sexual assault, and declaring that “if she doesn’t consent, or she can’t consent, it’s rape, it’s assault.” That line is valid and useful to the cause of ending violence against women. Also, it is persuasive to see powerful men taking a stand against sexual assault – but that premise illustrates a significant part of the problem with this campaign.

The implication that these men, and no women, are best able to get across the message to end sexual assault is indicative of a culture in which men’s words have greater weight than women’s, a culture in which gender inequality is evident, and thus a culture in which sexual assault is tolerated as a part of our society. Because there are no women present in the PSA, when the male celebrities urge “us” to intervene to stop sexual assault, it appears that they are addressing only men. The non-presence of women here suggests that women do not have power or agency to stop sexual assault, and this further perpetuates a culture of violence in which women are “helpless” and assault is “inevitable.”

Rape and sexual assault entail the denial of women’s agency – forced or coerced sex denies a woman her right to choose what she does and does not want to do – and so, women’s agency is integral to the effort to end violence against women. It remains important to engage men as allies, but we must do this carefully so as to not take away the agency of any woman in the process. Perhaps we are able to stop specific instances of sexual assault from occurring through bystander intervention, but encouraging bystander intervention will not succeed in ending sexual assault, especially because most men who assault are “repeat rapists” – one study, for example, found that “almost two thirds of [non-incarcerated] rapists were repeat offenders who averaged close to six rapes each.” Bystander intervention programs also won’t rid society of the culture that tolerates rape.

Instead, we need to hold universities, police forces, and individuals accountable for sexual assault, and treat it in a way in which we do not resign ourselves to the expectation of its inevitability. This accountability can include pushing for a policy to expel rapists on college campuses, or even the recent NFL policy, which, although an imperfect policy, moved to banish players from the league for domestic violence offenses (this punishment is currently for second offenses, and players will receive a minimum of 6 weeks of suspension after their first offense).  Calling attention to sexual assault in a way similar to Emma Sulkowicz’s performance art piece constitutes good activism: Sulkowicz both calls attention to the rape itself (in carrying the mattress on which it occurred) and the institution which has the power to bring justice to the survivor (by carrying the mattress on Columbia University’s campus). Mattress Performance emphasizes female agency by highlighting a woman’s choice to take her assault into her own hands.

We can use the White House Task Force and its initiatives as a stepping stone to provide further attention to violence against women and the imperfect policies that address sexual violence. Nevertheless, it is important that we expand on these initiatives, and work to adjust our culture’s tolerance of sexually violent acts by empowering women while holding perpetrators and institutions accountable.

2 Comments

Filed under Gender Issues, US Political System

Money and Power Matter. Family Structure, Not So Much.

50 years ago, Assistant Secretary of Labor Daniel Patrick Moynihan wrote a report called The Negro Family: The Case For National Action. The central argument in what has come to be called the Moynihan Report was that “The Breakdown of the Negro Family Has Led to a Startling Increase in Welfare Dependency,” and that “a national effort towards the problems of Negro Americans must be directed towards the question of family structure.”

The Moynihan Report, published in March of 1965.

The Moynihan Report, published in March of 1965.

New York Times columnist Nicholas Kristof thinks “Liberals Blew It” by excoriating this report. His conclusion, however, is based on a fundamental misunderstanding of the document’s critiques. The Moynihan Report’s faults lie not with its assertion that family stability is desirable, nor with its documentation of an increase in single-parent households, but with its insistence that family structure and Black “pathology” are primary drivers of poverty and inequality. This privilege-defending and inaccurate cultural narrative, however it was intended, implies that poor people of color are to blame for the effects of institutional racism and classism and diverts attention away from the real causes of inequity.

Those who denounced the Moynihan Report for that reason didn’t “blow it;” in fact, they presciently predicted how the report would be used to justify the false claim that “lifestyle issues” are the root cause of poverty. The real mistake is made not by people who recognize that connecting all types of families to money, basic necessities, and power is the best way to help them overcome hardship, but by those who continue to lend credence to the idea that the decline of traditional families has drastic consequences.

The lone piece of evidence Kristof cites in support of his claim that single-parent households lead to poor outcomes for low-income children is “an essay by Sara McLanahan of Princeton and Christopher Jencks of Harvard” in the March issue of EducationNext. While Kristof correctly notes that McLanahan and Jencks suggest that “growing up with just one biological parent reduces the chance that a child will graduate from high school by 40 percent,” he fails to discuss the broader context that calls his thesis into question.

First, the review McLanahan and Jencks cite (a review published by McLanahan and two colleagues in 2013, though the fact that McLanahan authored it is not mentioned in her and Jencks’s essay) found smaller associations or no relationship between family structure and other outcomes for children. As McLanahan and Jencks note about the review’s other findings regarding education, for example:

The absence of one’s biological father has not been shown to affect a child’s verbal and math test scores…The evidence for other indicators of educational performance, such as high school grades, skipping school, and college aspirations, is mixed, with some studies finding that father absence lowers school attendance and aspirations and others finding no effect.

Second, McLanahan et al themselves acknowledge that the relationships they do find may not be causal; the researchers write that “family disruption is not a random event…[T]he characteristics that cause father absence are likely to affect child well-being through other pathways.” Shawn Fremstad and Melissa Boteach explain in a comprehensive report published in January that while other studies that look at this issue find similar associations, most researchers are much more wary than McLanahan and colleagues of suggesting a causal link between family structure and indicators of children’s well-being.*

In fact, Kristof’s suggestion that the rise in single-parent households is a major driver of poverty and inequality is incompatible with some key details. For instance, while poverty levels in the United States remain far too high, they have fallen significantly over the past 50 years, in large part due to the safety net. If family structure were, as Moynihan contended, “the principal source of most of the aberrant, inadequate, or antisocial behavior that did not establish, but now serves to perpetuate the cycle of poverty and deprivation” (a contention that highlights the absurdity of Kristof’s argument that “liberal denunciations of Moynihan were terribly unfair”), this reduction in poverty would not have happened, as the number of “nontraditional” families has exploded during this time period.

Third, and most significantly, little research explores more plausible causal explanations for the relationship between economic and social disadvantage and family structure. It may very well be the case that the hardships associated with poverty make traditional families less likely, or that many of the factors that contribute to poverty and inequality also disrupt family stability.

Survey data suggests that these alternate interpretations are more likely to be accurate than Kristof’s; if nontraditional households were a cause rather than an effect or merely a correlate of disadvantage, we’d expect more support for traditional family structure among more advantaged individuals. The reverse is true, however; a study of survey results in 2012 noted that, “relative to higher income respondents, low-income respondents held more traditional values toward marriage, had similar romantic standards for marriage, and experienced similar skills-based relationship problems.” That study is consistent with Fremstad and Boteach’s summary of earlier research: “If anything, working-class people seem to value the cultural and religious aspects of marriage as much or more highly than more-educated adults.”

Relatedly, as Jared Bernstein pointed out last year, “policy interventions to encourage marriage have been shown to be quite ineffective” (and costly; as Bernstein also noted, “[t]wo pilot programs introduced in the George W. Bush years cost $10,000 per couple”). Wanting children to grow up in stable households is of course a laudable goal, but the evidence indicates that achieving household stability is not about culture, preferences, or a particular type of family structure. Instead, it is about a broad social justice agenda that addresses economic and social barriers to equality.

On some level, Kristof recognizes that direct means of addressing economic and social disadvantage should be the focus of anyone interested in “helping American kids.” He correctly decries how our racially- and economically-biased system of mass incarceration has torn families apart, and he also appropriately advocates that we “support programs to boost the economic prospects for poorer families.” Criminal justice reforms, safety net programs like SNAP (food stamps), the Earned Income Tax Credit (EITC), and Medicaid, and pretax income-boosting policies like the minimum wage and elements of the full employment agenda will likely promote family stability, and, more importantly, they are a sampling of some of the best methods we have to reduce poverty and inequality directly. To the extent that Kristof is advocating for this set of ideas, he is absolutely right to do so.

But the general thrust of Kristof’s piece, like the narrative in the Moynihan Report before it, undermines the fights for racial and class equality. In the future, the report’s defenders would do better to stop castigating the activists who disagree with them and start listening to and reflecting on advocates’ legitimate concerns.

*Fremstad and Boteach also note that “McClanahan’s review and much of the existing research do not clearly distinguish between the effect of family structure per se and the effect of family instability,” a clarification consistent with Kristof’s correct observation that children raised by loving gay parents do very well.

Note: A version of this post appeared on The Huffington Post on March 20.

Leave a comment

Filed under Poverty and the Justice System, Race

How much is a (black) life worth?

I avoided writing about these issues of police brutality against black folk for a long time, because I was afraid that once I did, the chronic depression that lies latent within the black cultural consciousness would rear its ugly head — and it did. The names and “heartbreaking cases” seem endless, and posterity treats them as hashtags: #JusticeForTrayvon #MikeBrown #TamirRice, #EricGarner #ICantBreathe #Ferguson #Blacklivesmatter #Crimingwhilewhite #DariusLiddell — Because it’s only a matter of time until it happens to me or someone close to me, why should I be exempt? I take walks at night in middle-class neighborhoods — isn’t that precisely the crime Trayvon committed? I played around with toy guns when I was a kid, making shooting noises at people [1] — isn’t that what Tamir was doing?

What made Tamir and Trayvon, two unarmed human children, so unchildlike and so inhumane that a fully grown and armed police officer decided to shoot them down?

***

On the day of his death, Tamir Rice’s actions were not very remarkable or even rare: he was just another kid playing with a toy gun, whether on the lawn of his home or in the local park. According to the 911 caller, the gun was “probably fake but he’s pointing it at everybody”. Also, it was mentioned that he was “probably a juvenile”.

The dispatcher repeatedly asked (after the caller tried to evade the question) whether Tamir was black or white. Why did this matter at all? (For identification purposes perhaps, but how likely was it that the race would be needed in a case like this?). You can hear the entire call here.

The outcome of the Tamir Rice case literally leaves me speechless: Police shot him within two seconds of arriving on the scene; questions were not asked nor negotiations attempted. The abdominal wound proved fatal, and when his sister arrived at the scene to see what happened, she was tackled, handcuffed and shoved into the back of the police car. The full video is here. Tamir’s wounds were given no aid (afterwards of which it was obvious his gun was fake) and the ambulance took ~10 minutes to arrive — could this issue have been handled more poorly?

I wonder if the kid was white, would he still be alive or would anyone even have called the cops? Or what if it had been a little white girl toting a toy gun — would anyone have even blinked an eye? Some probably would have chuckled and smiled, even! But one thing is for sure, if the little innocent kid was white — because we all know Tamir Rice was innocent — there would be a lot more national outrage — about gun laws/control, about trigger-happy cops killing random people, and more generally, about America’s inevitable ascendency towards the militarization of the police.

But what about Tamir? Where is the outrage for him? His death was not an accident; no apologies were made. The City of Cleveland even went so far as to blame Rice and his family for his death.

You can’t make this stuff up. Little white girls from middle-class families are kidnapped and CNN follows them for days, aka The Missing White Woman Syndrome. Trayvon was 17, and the courts were able to convince themselves that he was on the verge of beating an armed grown man to death. Tamir was 12. How young is too young? When do boys become men?

***

The Trayvon ruling set an ugly precedent: an armed cop or “neighborhood watch guy” has a scuffle with an unarmed teen at night, kills the kid, yet is ultimately proclaimed not guilty because it was “self-defense”.

The Mike Brown ruling set an even uglier precedent: a cop can kill an unarmed teen in broad daylight with multiple (albeit conflicting) eyewitnesses present, and the case is deemed not even worthy of a trial.

Then along comes Eric Garner, who is blamed for his death because he resisted arrest for selling untaxed cigarettes. Several parties even went so far as to argue that Garner’s plethora of physical conditions (asthma, heart condition, obesity) means that he would have died anyway — in other words, if Garner didn’t have so many health problems to begin with, he would have survived the altercation. (Although the coroner’s report confirmed that Garner’s death was a homicide by “compression of neck (chokehold), compression of chest, and prone positioning during physical restraint by police.”)

***

How, really, is Garner’s case different from a public lynching? There were New Yorkers walking by as Garner died; some must have stopped to watch. Oscar Grant was shot in the back face down in a BART car. Face down.  He was no longer a threat to anyone, he was fully subdued — he could have simply been taken into custody. Why wasn’t he?

What is so frightening is that if a case like Garner’s and Grant’s can be explained away, what does it take for a police officer to be convicted for an obviously avoidable murder — and get a comparable sentence as would be accorded a civilian? (Arguably, police officers should actually get heavier sentences, to dissuade them from abusing their enormous power over civilians — power under the law and in the street — because they should be held to stricter standards than civilians, not more loose ones.) [2]

The power that is afforded police officers to kill with impunity is astonishing. Sure, even if you believe that most cops are good — even if they really are all good — the law would still allow cases like this to avoid a fair and thorough trial or have a trial wherein the officer is allowed to explain how his “split-second decisions” are totally justified in hindsight. Gail Sullivan says it best:

“But it’s not what’s on a video that matters so much under the law. Nor is it even whether the officer did or did not harbor racial prejudice. It’s what was going through the mind of the cop in the few seconds when he chose to use force that counts and whether his decision was “reasonable” under the circumstances at that time, not with the benefit of hindsight.

And “reasonable” is defined not by what the general public may think but what cops in a similar situation would think.

That’s what the U.S. Supreme Court has said. And that’s among the reasons it’s so hard to bring charges against cops when they use force — even lethal force.

All this gives police considerable leeway and if they testify before the grand jury, as Pantaleo did in this case, considerable potential sway since they have the opportunity to describe why what they did seemed necessary.”

Bottom line, if an officer happens to kill you, for whatever reason — he’ll be allowed to testify on his own behalf about exactly what his reasons were for acting in the situation that he did. He’ll be offered almost total leeway of subjectivity, simply because he is a police officer and for no other reason. [3]

***

Some say of Garner: “If he had just complied, he would not have died”.   This is a ridiculous argument because it assumes that no matter the charges police bring against you, you should never resist arrest under any circumstances. The brute facts are that cops don’t need proof of the charges when they arrest you — proof is what the verdict of the trial is supposed to ascertain. The police could have nothing more than hearsay, and you simply have to comply because they are wearing a uniform paid for by your taxes. How much power are we willing to give to a uniform?

Never resist arrest — because you might die, and even if the cops did get punished (which they probably won’t, at least not in any sense that a civilian would find commensurate for the crime), you would still be dead — so it’s not worth it in either case. Don’t sacrifice yourself for the petty pride of your conscience; subordinate yourself to the whims of the state (or whatever persons the state has designated worthy of wearing their uniform).

To make resisting arrest a crime lays the groundwork for a police state.

***

Honestly, all these suggestions about how to avoid getting killed by the cops seem eerily similar to how we advise women on how not to get raped by men. “If only you hadn’t resisted arrest (or said yes/no at the proper time with enough assurance); dressed in sagging pants with a hoodie (or in that skanky way at that frat party last night), talked with the utmost respect and deference towards the officer (or turned down his offer for just one more drink or bong hit), if only you knew how to read the minds of your police officers (and those of random power-hungry men) and could anticipate their next move at any and all times, then you wouldn’t have been raped/killed.” Sound familiar?

That’s because it’s an old story. The oppressed has to know the whims and peculiarities of the oppressor. The people and parties at the bottom or middle of the hierarchy have to learn the tastes of the ruling class in order to join it. You have to fake it ‘til you make it, essentially. For historical reasons, women have had to know men at a much deeper and more holistic level than vice versa. (Arguably, men have had to do the same but their motives were much different). I have to become acquainted with corporate culture to succeed in it, but no white person has to take black or Hispanic culture seriously in America — simply because we are not the dominant culture. To put it in crude, postmodern terms, I have to know ‘stuff white people like’ at a much subtler and deeper level than whites have to know ‘stuff black people like’. The bourgeois decides taste; there is only one real and true way to be sophisticated, according to the dominant culture, of which the first step is to articulate with proper grammar and structure (i.e. don’t talk like your black great grand-parents – you ain’t gone get no job like that). Being educated is nothing more than wearing the outer markers (dress, conversation, goals, etc) of the currently educated class.

***

But, let’s be honest, regardless of how you feel about any of these generic cases of “white cop kills black male (female cases abound — 10+ cases to get you started: here & here — but simply get way less media attention), you have to acknowledge that the outcome in all of them seems patently ABSURD when juxtaposed with the outcome of the 2012 Aurora theater shooting. Here are the highlights: James Holmes walked into a midnight screening of The Dark Knight Rises and killed 12 people and injured ~70 others. Everyone knew he was the killer. He was arrested without resisting and was taken to a detention center to undergo several psychiatric evaluations, while his lawyers continue to make “diminished capacity” pleas on his behalf.

But in the other cases we discuss, each black person was killed because they were perceived or suspected threats.  Holmes had already proved he was a threat by killing a dozen people and injuring many others… The evidence against Holmes was overwhelmingly clear, and yet his life was deliberately preserved! Excessive care was taken to ensure that Holmes was not hurt in any way, even after he had already killed a dozen people!

This is the pure, pure essence of white privilege. The treatment of Holmes versus any of our other cases cannot be justified under any circumstances.

***

In our time, it’s fashionable to disdain rage. In social dynamics, anger is perceived as a sign of weakness, a sign that you feel you’ve lost power, “lost control”. Anger is usually feared if it comes from the dominant party in the altercation, but pitied, ridiculed, or even ignored if it comes from the less powerful party. In our case, in order to deflect the great pains and horrors of any nuanced and honest racial discourse, we employ more acceptable ways to express/deflect rage, such as cynicism and irony, and transform it into laughter (and those who still become too angry are usually said to be overreacting, or in our case, “just another black person who needs to get over it”, “a race-baiter”, etc). But humor, sarcasm and cynicism are forms of coping; and as much as these methods have their place, their only true purpose is to incite change, and nothing will change as long as we use these tools to deflect our true feelings rather than empower them.

The most effective tool against racism is anger. The seemingly opposed movements of black power and nonviolent action both had the same element at the core: pure, unbridled rage.

[1] I was 5’8 at 13 just like Tamir was 5’7 at 12, so we both looked older than our age stature-wise, which would have made us both look “threatening”.

[2] It appears that it is incredibly hard to indict a police officer in cases where the civilian is severely injured or dead, because the court cannot prove that the officer did not have “objective reasonableness”. Check out the 1989 case of Graham v. Connor and a few articles (here, here, and here) detailing how the courts, the police, and the prosecutors somehow all manage to stick together when it comes down to it. (This is worth a whole blog post in itself)

[3] The black victims are always pitied in the same manner (or perps, as in every case, the cop was deemed the victim, and the still black body is always unfortunate collateral): “You know, It wasn’t supposed to be this way, I was following protocol.. I had no choice.. We make tough decisions sometimes, we didn’t want anybody to die”. It reminds me of the herd-mentality of the soldier or the employee… “I was just following orders”.

3 Comments

Filed under Race

Anti-Vaxxers: Why Medical Students Aren’t Being Trained to Weigh-in

With increasing frequency I have been asked by friends and well-wishers about how “anti-vaxxers” are being broached by my medical school professors. Simply put, we aren’t being taught anything on the matter. This is insight on how future physicians are being groomed to handle public misinformation and media outcry. Obviously we are given the molecular biology and public health angles as to how vaccinations work from the micro to macro scale, but we aren’t supplied with the tools on how to discuss these seemingly controversial topics with our patients. This could be for a few reasons.

First, the rising trend in vaccination refusals and recent measles outbreak, coupled with subsequent media hysteria, will raise awareness of the harm of not vaccinating children—and this trend will correct itself. After all, it seems affluent Millennials are seeing the greatest raise in foregoing vaccinations. They understand that chemicals are pervasive in today’s world, and while they might not buy that vaccines cause autism, they certainly don’t believe that injecting children with man-made concoctions at an early age increases their biological fitness. Therefore, when the educated anti-vaxxers see the harm they may be causing society as a whole, let alone their own kids, the trend will inevitably correct itself. One would hope.

It isn’t only the Millennials; some of the unvaccinated come from isolated religious communities, and the poorer counties within a state tend to have lower levels of vaccination rates. Each patient is unique and asks questions regarding vaccinations with different levels of background knowledge. Therefore different ways to convey the same message about the effectiveness of vaccines would need to be employed by the physician. This is a technique developed more during third and fourth year of med school (I’m still in my second year which is primarily classroom-based) so maybe it is more appropriate to have these discussions later in schooling. Sometimes a patient’s anecdotal evidence (e.g. “My friend’s sister had a normal child until they got vaccinated and then the child became autistic”) is too ingrained and no amount of sound evidence can dissuade them from their preset justification. My school might just be trying to allow its students to form their own ways of picking and choosing their battles when it comes to handling these issues with the patients.

Lastly, perhaps doctors feel that by and large they are above the entire “debate” about whether vaccinations are good or bad. Let the 24-hour news cycle run its course. Football just ended, it’s too early for 2016 elections, Russia and Ukraine’s ceasefire is mildly interesting, and by national news standards there’s not really much going on besides the latest ISIS comings and goings. By physicians engaging in a discussion about the merits of vaccinating your kids, it may lend credence to the extreme minority’s position as a legitimate conversation starter. Last year, noted scientist Bill Nye entered a debate with noted Amish-look-alike Young Earth Creationist (YEC) Ken Ham on whether creationism and a 6,000-year-old Earth is a viable model for our origin. Many people felt that Nye showing up to the debate was essentially giving YECs publicity and a form of legitimization, even though they are an extremely small and vocal minority without the backing of any evidence or scientific merit—much like the anti-vaxxers. The biggest difference being that someone believing Earth is 6,000 years old won’t necessarily raise the chance that my child gets a debilitating illness.

As far as med school teaching is concerned, we are urged to strongly recommend for vaccinations for inquiring patients, but maybe we should also be discussing issues on a larger scale and how it relates to public health. Although we have a bioethics course, which excels at giving students the facts regarding the law and why and how the law was passed, we are never given the tools for how to make more permanent change in the community. We are not instructed on how to engage in ethical discussions about whether or not something like vaccinations should be mandated by the government. In the last decade there have been failed or short-lived attempts at making HPV vaccinations mandatory throughout the U.S. The issue has been up for legislation in nearly half of the states and has failed in all but Virginia and D.C. (it was passed and later repealed in Texas). Perhaps not surprisingly, people would prefer to have the opportunity to make the wrong decision rather than having the right decision forced upon them.

I believe that people are very much products of their environment and will naturally gravitate towards the path of least resistance. Change on a macroscopic scale, like how society views public health mandates, can be unnecessarily slow to develop, except in rare cases like the polio vaccine—which was almost literally an overnight sensation. If many of the medical aspects of how we treat our bodies are dealt with in an “opt out” fashion I believe that we may see a significant increase in the quality of life across all strata of society. A great example of this is Spain’s organ donation rates. They have the highest rates of organ donation on the planet primarily due the country’s policy that each individual is automatically enrolled as an organ donor. If you want your organs to stay in your body to take them with you to heaven (or hell) after you die, you would have to fill out some paperwork. Well guess what? People generally find paperwork to be a nuisance and a tedious endeavor. You want me to fill out these forms just to be able to fill out more forms like we’re in some bureaucratic Soviet state? I’d rather just let you have my organs.

And that is the idea: create a society in which it is commonplace for people to generously donate their unneeded organs and they will eventually do so, not because it is the path of least resistance because it is the right thing to do to save other people’s lives. I envision after years or perhaps generations with a certain policy in place (like having to opt out of donating blood) that when the opt out policy is removed people still donate at the same rate because donating blood is something that people should feel compelled to do to help their fellow man. In the meantime, don’t incentivize performing a positive action, simply tack on some form of negative reinforcement to make a negative action (such as not donating blood or organs) more difficult. This way only those who have a true objection to the task will take these necessary steps.

In all likelihood there is no formal teaching for medical students on how to deal with anti-vaxxers in our pre-clinical years because it may not come up in doctors offices as much as the cable news-watching public may think. According to the CDC, vaccination rates have only had a very modest dip over the past decade and it should be far down the list of concerns doctors have for their patients. Some combination of it being a trendy topic, each patient’s situation being unique, and that it’s just beneath us as physicians to discuss, is what’s most likely being employed by our professors. There is already so much packed in our ever-expanding curriculum that we simply might not have time to really delve into the issues surrounding medical trends. Plus, by the time I actually become a doctor seeing my own patients, the medical landscape could be so vastly different that people questioning vaccinations would be a relic of a bygone era.

1 Comment

Filed under Education, Medicine

It’s Not What Employers Are Doing, But What They Can Do, That Matters

A few days ago, Buzzfeed reported that Staples, the large office supply chain, had stepped up its enforcement of a cap on hours worked for part-time employees. Despite the company’s unconvincing claim* that the policy is longstanding, it appears that Staples implemented the 25-hour-per-week cap in January of 2014 “to skirt impending rules requiring companies to provide health insurance” to employees who work at least 30 hours a week.

Staples' original memo to store managers, as published by Buzzfeed.

Staples’ original memo to store managers, as published by Buzzfeed.

Staples’ decision will undoubtedly renew arguments that the Affordable Care Act’s (ACA’s) employer mandate – the provision that requires companies with more than 50 full-time workers to insure employees who work at least 30 hours each week – has led to harmful effects on work. These arguments, like parallel narratives about minimum wage laws and paid sick leave ordinances, are largely inaccurate, and advocates of evidence-based, power-balancing policy are absolutely right to debunk them.

However, we cede too much when, as is often the case, we default to a defensive stance. “Yes, the negative incentive is there, but the data show such effects to be small or non-existent” should not be the full scope of our response.

Instead, it’s imperative that we change the nature of these conversations. As Thomas Pynchon astutely observed: “If they can get you asking the wrong questions, they don’t have to worry about answers.”

Opponents of an employer mandate, minimum wage, and paid sick leave want people to focus on what employers will do in response to each policy’s enactment. The more relevant question, however, is about what employers can do.

First, it’s important to remember that businesses can deduct employer-provided benefits from their tax bills, and that the employer contribution to health benefits is widely viewed as coming out of worker salaries. Providing employees with health coverage, decent wages, and paid sick leave costs less money than a lot of people think, though it’s certainly more expensive than offering meager wages and no benefits.

More importantly, providing such benefits is the right thing to do. And it is undeniable that a typical business, when confronted with the prospect of labor cost increases, has numerous options. The business can explore ways to improve its productivity. It can raise its prices. It can reduce the salaries of affluent executives, or maybe make a little bit less in profits.**

In the most recent quarter for which financial information is available, August through October of 2014, Staples made $216 million in after-tax profits. Their CEO, Ronald Sargeant, made over $10 million in total compensation in 2013, while other top executives raked in well over $2 million apiece. Barack Obama didn’t have those numbers when he was asked about Staples’ policy a few days ago, but his suspicion “that [Staples] could well afford to treat their workers favorably and give them some basic financial security” was clearly right on the money. The ACA didn’t make Staples cut its employees’ part-time hours; instead, Staples management consciously chose to prioritize a fifth car or third house for a few wealthy individuals over its part-time workers’ ability to put food on the table. Other large companies, from Starbucks to McDonald’s to Walmart, make similar callous choices on a range of issues all the time.

There are two ways to address this problem. The main mechanism currently at our disposal is to loudly call such decision-making what it is – greedy and unethical – and vote with our dollars for companies that treat their workers fairly. Opponents of labor standards focus on what businesses will do rather than what they can do in part because we let them avoid moral reckoning. We won’t win everyone over, but we must not underestimate the power that moral authority has to shape behavior.

The second mechanism is policy that addresses firms’ decision-making. Some recent legislative proposals, in fact, like Congressman Chris Van Hollen’s CEO-Employee Fairness Act, have the potential to begin to wade into these sorts of waters. If we’re worried that companies will choose to lay people off in response to a minimum wage increase, for example, we could raise taxes on the executives of companies that make this choice.

No matter the policy outcomes, it’s essential that we ask the right questions in these debates. It’s worthwhile and important to document the evidence that policies like the employer mandate, minimum wage, and paid sick leave have minimal consequences on work. But it’s also essential to point out that any consequences these policies do have aren’t inevitable.

*As Buzzfeed’s original coverage explained, Staples claims that their part-time hours policy has been in effect for over ten years, and that the memo Buzzfeed obtained only “reiterated the policy.” Yet the memo contained phrases like, “Beginning with the week ending 1/4/2014,” and “Staples is implementing a policy.” A Staples spokesperson did not respond to follow-up questions about the memo’s language.

**It’s possible, though I’ve never seen a study to prove it, that some businesses actually can’t afford to adequately compensate their workers, that they’re barely squeaking by as is with low executive salaries, non-existent profits, and the highest level of productivity they can possibly attain. To the extent these businesses exist – and I’m skeptical that many of them do – it’s worth asking whether a business’s right to keep its doors open should trump its workers’ right to make enough to provide for their families. I don’t believe it should.

Note: A version of this post appeared in The Huffington Post on February 16.

8 Comments

Filed under Business

Social Justice Unionism, Education On Tap Style

I recently discussed why teachers unions are important agents of social justice on “Education On Tap,” a Teach For America (TFA) podcast created by Aaron French. I really enjoyed the conversation – French goes above and beyond his promise to make the show “a little bit of fun” – and appreciated TFA’s continued (though still very young) efforts to deconstruct myths about organized labor and education reform ideas.

You can listen to the podcast here. A couple additional details on two of the topics we discussed:

1) How we refer to education stakeholders: We often use the phrase “reformer” to describe people on one “side” of the education debate. As Nick Kilstein explains, we typically think “reformers” do the following:

1. Support market forces including choice and competition as a mechanism to improve all schools. This is usually done through vouchers and charter schools.

2. Support business practices including evaluation, promotion and merit pay to motivate and attract teachers

3. Hold that teachers and schools should be accountable for student achievement, usually measured by standardized testing

4. Support alternate paths to the classroom through programs like Teach For America

5. Affiliate themselves with no-excuses charter schools

However, neither French nor I (nor Kilstein) are crazy about this term, for a few reasons. First, the group of people we call “reformers” sometimes have drastically different views on these topics. For example, opinions about the appropriateness of suspending students vary widely among people who support the rapid expansion of charter schools. Because “reformers” don’t hold monolithic views, it doesn’t make a ton of sense to lump them all into the same category.

Second, using the term “reformers” erroneously suggests that only a certain group of people support school improvements. However, teachers in unions and other critics of typical education reform efforts fight for school reforms themselves; they just have a different (and, on balance, more evidence-based and theoretically sound) perspective about which reforms we should pursue on behalf of students in low-income communities. Despite misleading claims to the contrary, very few people actually support the “status quo” in education. Though the word has become associated with negative imagery for a lot of education stakeholders, nearly everyone is a “reformer” to some extent.

Third, the use of a term like “reformers” reinforces the notion that there are two polarized “sides” in education debates, the “reformers” and their opponents. As I discussed with French, I believe the “sides” are much less in opposition than they sometimes appear to be, and that most people in education are in general agreement on the vast majority of issues. The more we can deconstruct the notion of “sides,” the better.

That said, I don’t have a great solution to either the first or third problems (for the second, I’d recommend that we use clunkier phrases more like “proponents of market-driven reforms to education” and “advocates for a comprehensive social justice approach to education policy” when we can). Categories can be useful for brevity’s sake, and as is evident below, it’s hard to construct an argument while avoiding categorization altogether. Still, I think it’s worth reflecting on our naming conventions as we endeavor to be more nuanced.

2) Why unions are power-balancing advocates for low-income kids: French explained during our discussion that many people believe the San Jose Teachers Association (SJTA, the local union for which I served as an Executive Board member from 2012 to 2014) to be an atypically progressive union. In reality (and I believe French agrees), the vast majority of unions, including national teachers unions like the National Education Association (NEA) and American Federation of Teachers (AFT), are some of the most power-balancing institutions out there.

Recent research by Martin Gilens confirms this fact: unions consistently advocate on behalf of less advantaged populations on a wide range of social justice issues. They serve as an important counterbalance to wealthy interests and exploitative policies, and have made extremely important gains for working Americans throughout their history. It’s probably not a coincidence that the steep decline in unionization over the past thirty years has coincided with a steep increase in earnings, income, and wealth inequality.

That doesn’t mean unions can’t be wrong on certain issues. We should absolutely condemn the behavior of police unions that defend racist positions, for example, and demand that they be held accountable and change. Teachers unions shouldn’t be immune from criticism, either, and it’s imperative that we confront them when we believe their positions are misguided. Not all teachers unions have realized their potential as social justice unions just yet, and while I firmly believe that a different approach from the education community would help more of them do so, organized labor must also proactively analyze and revise practices that don’t fit its mission.

Yet we must also remember that teachers unions have very strong track records on behalf of low- and moderate-income families, and more credibility as advocates for low-income kids than many of the people and organizations who malign unions. Even if you think certain teachers unions are wrong about aspects of education policy, it’s completely inaccurate to argue that their existence harms low-income kids. The empirical evidence is clear (much clearer, in general, than the evidence about education policy ideas) that teachers unions are a major net positive for low-income populations.

There’s joint responsibility to change the tone of education conversations, and union members must avoid becoming reflexively defensive when confronted with criticism. We do ourselves and our students a disservice when we react by ignoring people outright or slinging insults right back; instead, we should try to understand the legitimate elements of critiques, address them, and educate people on where they’re wrong and how to have more productive dialogue.

At the same time, union members and leaders are understandably offended when proponents of market-driven reforms (making an attempt!) imply that union opposition to these reforms is borne of laziness, selfishness, and/or incompetence. Everyone needs to remember that teachers in unions, who are directly student-facing and who will actually implement education reform ideas, typically have good ideas about what students need, and that both private and public sector unions are important advocates for low-income people in general. While there is some shared responsibility, the tone of the debate cannot change until proponents of market-driven reforms acknowledge these facts. The sooner anti-union messaging becomes a thing of education reform conversations past, the sooner we can collaboratively develop great policies for students.

A big thank you to French for having me on the show, and hope you enjoy the podcast!

1 Comment

Filed under Education, Labor