Sutro Review 2018
SF State Journal for Undergraduate Composition
(Please click on authors and headings under Contents to navigate through the document)
We are excited to present the third annual volume of Sutro Review: SF State Journal for Undergraduate Composition, an academic journal produced by SF State students, featuring the work of some of our most promising undergraduates.
Sutro Review celebrates the diverse and talented voices among undergraduates at SF State and aims to share those voices with the broader learning community. Our third issue includes fifteen student essays, representing a variety of disciplines and academic styles, as well as showcases some of the teaching faculty who informed that writing. Essays include a range of provocative topics: from race in public school curriculum to queer sociolinguistics, environmental politics and Salvadoran migration, mass incarceration and nature in poetics... to name a few! In short, we provide a glimpse into the broad spectrum of work being produced by our talented undergraduate community at SF State.
Special thanks to English Department Chair, Sugie Goen-Salter, Director of Composition, Jennifer Trainor, and the SF State University Instructionally Related Activities Fund for making this project possible.
We hope you enjoy reading!
Sutro Review Editors
Jessop Tiedeken, "John McWhorter Is A Racist?"
Weslei Thomas, "Black History Is American History"
John Carlos Micael, "Current"
Jasmin Vargas, "The Salvadorian Perspective"
Mateo Mayorga, "Are Pharmaceutical Companies Responsible for the Opioid Crisis?"
Ruth Kopiko, "The Transcendent Aesthetic"
Najah Miller, "Mass Incarceration in America"
Robert Thompson, "The Role of the Technocrat in American Environmental Politics"
Madeline Thompson, "An Analysis of Pitch in Lesbian Identity"
Jose Francisco, "HIV Among Asian American Men Who Have Sex with Men"
Aileen Andrade, "Happy Body, Happy Kid: Preventing Type 2 Diabetes among African American Children in Low Income Neighborhoods"
Diana Alegre, "Community Assessment: The Mission"
Calder Marchman, "The Internal Ocean: Liquidity and Ambiguity in the Construction of the Self"
Leann Christopherson, "Oppression through Economic Homogeneity and Equality in The Lonely Londoners"
Jane Matchak, "O Mother, Where Art Thou: Temporality, Movement, and Grief through Poetics"
John McWhorter Is A Racist?
Jessop Tiedeken is a first-year student at SF State. Although he was born in Kansas and lived in Hawaii a short while, most of his early childhood was spent in Philadelphia, Pennsylvania. When he was ten, his family moved to Sacramento, California where he spent the rest of his child and young-adulthood, until moving to San Francisco for college. Jessop is currently a Criminal Justice major with a French minor. However, he intends to change his major to French and looks forward to studying abroad next year in Southern France.
Some of Jessop's passions include music, cars, and the outdoors. In his free time, he likes to incorporate all of these things by going for a drive on the coastal back roads, windows down, listening to good music in his 1991 BMW e30. Jessop aspires to one day work for a federal agency and/or become a diplomat.
COMMENT FROM LECTURER, NANCY DEVINE:
Jessop lit up when I announced that our final essay would be a student’s choice essay. The choice: an article from the Gale Opposing Viewpoints database online through the SFSU library, and a choice of argument types. His interests in social justice, literature, and rap and hip-hop music led him to an incendiary article he used to write an essay grounded with evidence, critical thinking, and pulsing with vigor. He dug in with my comments about anticipating counter-arguments, and understood why trimming extra details on the hip hop artists wouldn’t diminish his strong points. The result is an essay alive on the page—maybe even sizzling.
Many people think rap and hip hop cannot be educational or positive because the music can contain explicit messages, crude innuendos, or vulgar language and themes. This misconception is so widely held that even accomplished and academic people can fall victim to it. John McWhorter, a lecturer at Columbia University, asserts that “[i]t is wishful thinking to claim that hip hop and rap music have increased awareness of the problems that African Americans face and must endure.” I think McWhorter is completely wrong, and that hip hop music can be more than just a source of entertainment. In fact, I think that hip hop and rap are among the most educational genres, and have increased awareness of the problems that African Americans go through. McWhorter explains: “Hip hop is music...to expect rap to be ‘constructive’—implying that it could be…is purely illogical. The idea that hip hop...can be transmuted into changing the world is narcotic but nonsensical.” Such statements ignore facts and fail to recognize the impact that artists such as Kendrick Lamar, Beyoncé, and even 21 Savage— all artists known for their politically engaging content—have had on society. While McWhorter claims that rap and hip hop are nothing more than music genres whose purpose is to entertain, there are many examples of songs and artists that are politically charged, proving that these genres can be platforms artists use to galvanize political movements and make political statements.
Kendrick Lamar is an African American rapper from Compton, California, known as one of the roughest cities in the United States. Lamar is widely considered one of the best rappers to date and, according to Rolling Stone, he is “the greatest rapper alive” (Hiatt). He is also one of the most political rappers alive and challenges his audience to face uncomfortable truths. John Haltiwanger of Elite Daily writes that Lamar’s album To Pimp A Butterfly “is a politically-charged response to the racism, violence, and police brutality that continues to plague society.” Lamar’s song “Hood Politics,” from To Pimp A Butterfly, gives listeners an inside look into Lamar’s experience growing up in Compton. In addition to dealing with drugs, violence, and gangs, Lamar felt as if he and his community were pitted against the Los Angeles Police Department: “The LAPD gamblin', scramblin', football numbers slanderin.’” Lamar addresses the fact that the LAPD often gambles by making risky decisions and then scrambles to cover up or fix the consequences of their actions, while the football numbers in the song refer to years spent in prison. Here Lamar is shunning the LAPD and criminal justice system, pointing out that these incarcerations are defaming minority communities. At the 2015 BET (Black Entertainment Television) Hip Hop Awards, Lamar performed on stage with vandalized police cars. Although it may have been startling and uncomfortable for some, this was a provocative performance designed to trigger discussion, not simply to scare viewers. In response to the performance, Geraldo Rivera of Fox News stated, “Hip hop has done more damage to young African Americans than racism in recent years” (qtd. in Haltiwanger). Lamar, unfazed by any criticism, refused to let discussion cease. At the 2016 Grammy awards, Lamar performed in a prison uniform with chains around his wrists and ankles. His band played behind jail cell doors set up on stage. These politically motivated performances sparked conversations on race and other societal problems in the United States. Lamar’s powerful performances, coupled with his stimulating lyrics, opened discussions about mass incarceration and reform in the criminal justice system, racism in America, violence in inner-city neighborhoods, and more.
Kendrick Lamar shows how rap and hip hop can be catalysts for change. Haltiwanger comments, “When injustice permeates society, sometimes the only way to accurately convey the array of emotions it catalyzes among people is via song. Music is a potent and indispensable form of protest.” This held true in the 1960s with the help of artists like Bob Dylan and Nina Simone, and it still holds true today. Lamar’s song “Alright” is widely considered to be a modern-day protest anthem. The pre-hook goes as follows: "Ni**a, and we hate po-po / Wanna kill us dead in the street fo sho' / Ni**a, I'm at the preacher's door / My knees gettin' weak and my gun might blow / But we gon' be alright." The hook comes in, repeating the lyric, “We gon’ be alright” ("Alright"). This song details the discrimination and oppression felt by people of color in the United States, but is also an anthem of hope and inspiration. Aisha Harris writes that the song “[offers] a kind of comfort that people of color and other oppressed communities desperately need all too often: the hope—the feeling—that despite tensions in this country growing worse and worse, in the long run, we’re all gon’ be all right.” Since its release, “Alright” has been used as a rallying cry in protests all around the nation, from Lamar’s performance at the 2015 BET awards, to the city streets of Cleveland protesting police brutality.
Lamar received both applause and criticism for his performances in 2015 and 2016. That is because through these performances he made the public aware of what has been called a “racial catastrophe in the 21st century” (Brooks). Lamar highlighted injustice against Black people within the prison systems and touched on what they face in the United States. Forbes magazine reported that the 2016 Grammy’s had over 25 million viewers. Coupled with 7 million BET award show viewers, this means that over 32 million people that had heard Lamar’s message. Lamar used his influence and fame in the best way: as a platform to speak out for those who cannot speak for themselves. Between the millions of viewers at the Grammy's and BET awards, and millions of listeners who purchased his many platinum-certified albums, it is hard to argue that Kendrick Lamar is not making a political impact. Through his music, Lamar is doing exactly what McWhorter said rap could not do. He is increasing awareness of the problems that African Americans live through.
Movements and change start with leaders and their words. One problem McWhorter has with rap is that even if the message is received, what now? Just as political leaders must campaign, raise awareness, and speak about issues before they can act on them, hip hop artists are campaigning for social change and communicating a message toward action with their lyrics. For example, Beyoncé, a recognized leader in the hip hop and music world, performed for the NFL Super Bowl halftime show in 2016, putting on another politically-charged performance. She performed her song “Formation” which has since been identified as a Black power anthem, calling on Black history, culture, and women. She sings, “I like my baby heir with baby hair and afros / I like my negro nose with Jackson Five nostrils” (Knowles). Here, Beyoncé plays with African American stereotypes, telling everyone she is proud of her heritage. Beyoncé’s “Formation” is a powerful song that encompasses many issues, and Jenna Wortham of the New York Times asserts, “‘Formation’ isn’t just about police brutality — it’s about the entirety of the Black experience in America in 2016” (Caramanica et al.). Many of the issues Beyoncé presents are analogous to the ones that the Black Lives Matter movement is fighting for. At the Super Bowl, Beyoncé and her backup dancers performed in attire that paid homage to the Black political activist group known as the Black Panthers. Her aesthetic, along with her politically charged lyrics, shed a new light on what it means to be Black in America. She ignited debate concerning Black feminism, institutional racism in America, and the injustices society commits towards all people of color. The morning after the Super Bowl, the Black Panthers were trending across social media. There was also a movement to #BoycottBeyonce. Leaders of this movement were offended by her “hate speech and racism” at the Super Bowl (qtd. in Blair). However, this movement did not go unnoticed. Counter-protesters fought for Beyoncé and the issues she brought attention to. Beyoncé made America aware of societal issues plaguing Black America and motivated people to take charge of the situation, something McWhorter believes is not possible to do with rap and hip hop.
Even rap and hip hop that seems to have no educational value at all can be meaningful and important. Take, for example, Atlanta rapper 21 Savage. When asking the average person to describe today’s rap music, an artist like 21 Savage, a rapper known for vulgar lyrics, may come to mind. If you pay attention to his lyrics you may notice some common themes: sex, drugs, money, and murder. It is hard to believe that lyrics like, “Keep shootin' until somebody die, / So many shots the neighbor looked at the calendar, / Thought it was Fourth of July” have any value at all (“No Heart”). Upon further examination, it is evident that 21’s lyrics and songs have deep meaning. In Elias Leight's Rolling Stone article “21 Savage: Talking Honesty, Politics and 'Mumble Rap' With Atlanta's No-Nonsense MC” 21 is quoted as saying:
It's hard being Black, I don't think people really understand how hard it is to be Black. Especially when you coming from nothing. In the hood, there's already a lot of hate just amongst us Black people. We killin' each other and everybody else killin' us too. We poor. And the world hates us.
It becomes clear that he is not rapping about drugs and murder to show off to anyone or prove anything: he is doing it because that is what he knows, and he is sharing his personal life and experiences through his raps. 21 Savage’s lyrics are explicit, provocative, gut wrenching, and sometimes hard to listen to — but have you ever questioned why some rap and hip hop artists like 21 Savage choose to write these songs? Through his music, 21 Savage is giving society a firsthand look at the problems African Americans face — the very thing McWhorter said rap and hip hop fail to bring to light. 21 Savage recently released his debut album Issa in which he raps primarily about money, sex, and drugs. However, he also challenges and opposes controversial topics permeating society today. At one moment, you can be listening to the seemingly one-dimensional song, “Money Convo” detailing all the money and women 21 Savage has gained through fame, and at the next, you can be listening to “Nothin New,” a song that leaves the listener heartbroken and angered after being taken on a detailed journey showing them what it means to be Black today. Through artists like 21 Savage, society can become more informed about the real-life experiences and hardships African Americans face. 21 Savage is a great example of an artist within the rap community whose music contains vulgar themes and is used as a source of entertainment, but also advocates for societal change.
While it can be true that a lot of rap and hip hop is created and tailored specifically to entertain and serves no other purpose, is that not the purpose of most music in every genre? I think John McWhorter is setting a double standard by saying that rap and hip hop have no educational value. Is he saying that songs such as country singer Sam Hunt’s hit “Body Like A Back Road” — which only serves to compare a woman’s body to the curves of a backcountry road — or Calvin Harris’ pop hit “Slide” — which talks about drugs, partying, and frivolous spending — prove there is nothing educational or constructive in the entirety of those country and pop genres? No matter the genre, there will be artists who create music with no true value and no educational or constructive purpose. Likewise, no matter the genre, there will be artists who create powerful music, music that has purpose. Music that is educational, constructive, and beneficial. I think McWhorter is unfairly singling out rap and hip hop music by failing to acknowledge that other genres can be just as superficial and meaningless.
In his article, McWhorter asks his readers to fill in the blank in this sentence: “In a history book 100 years from now, we will see it written that ‘Because of hip hop raising consciousness of ghetto poverty starting in the late 1980s, _________.’” He also asks his readers to “note the difficulty” of that task. Because of artists like Beyoncé, Kendrick Lamar, and others engaging in musical protest, I think that blank is relatively easy to fill. The sentence could end with “it created the biggest revolution in American music” — at least, that is what Helen Regan for Time magazine claims hip hop has done. Better yet, a history book could read: “Without the influence of rap and hip hop music in the late 20th and early 21st century, political revolutions such as #BlackLivesMatter would have never gained as much attention or political traction.” Haltiwanger claims that, “His [Kendrick Lamar’s] album, To Pimp A Butterfly, has emerged as the unparalleled soundtrack to Black Lives Matter.” It is evident that artists like Beyoncé and Lamar are catalysts for political action that validates rap and hip hop as “constructive.”
John McWhorter claims that hip hop and rap lyrics have no value, cannot be educational, and cannot increase awareness of the problems African Americans face. He is wrong. Artists like Beyoncé and Kendrick Lamar have a prolific effect on society by bringing to notice difficult topics such as institutional racism, police brutality, suicide, feminist issues, and many more. Even artists like 21 Savage, who doesn’t have an overt political agenda, provide the public with a firsthand account of what it means to be Black in America. Every single one of these artists did this through their music — through rap and hip hop. Without a doubt, rap and hip hop can be educational, constructive, and increase awareness of the struggles Black people living in America must endure.
“Best Rapper Alive: 2016.” Genius, Genius, genius.com/discussions/267783-Best-rapper-alive-2016.
Blair, Olivia. “Beyoncé: Protest Planned in New York against Singer's Super Bowl Halftime Performance.” The Independent, Independent Digital News and Media, 10 Feb. 2016, www.independent.co.uk/news/people/beyonce-super-bowl-performance-protest-formation-a6864721.html
Brooks, Daphne A. “How #BlackLivesMatter Started a Musical Revolution.” The Observer, Guardian News and Media, 13 Mar. 2016, www.theguardian.com/us-news/2016/mar/13/black-lives-matter-beyonce-kendrick-lamar-protest.
Caramanica, Jon, et al. “Beyoncé in 'Formation': Entertainer, Activist, Both?” The New York Times, The New York Times, 6 Feb. 2016, www.nytimes.com/2016/02/07/arts/music/beyonce-formation-super-bowl-video.html.
Haltiwanger, John. “How Kendrick Lamar Is Proof Hip-Hop Can Influence Society In Big Ways.” Elite Daily, Elite Daily, 9 Oct. 2017, www.elitedaily.com/news/politics/kendrick-lamar-hip-hop-black-lives-matter/1156751.
Harris, Aisha. “Is Kendrick Lamar's ‘Alright’ the New Black National Anthem?” Slate Magazine, The Slate Group, 3 Aug. 2015, www.slate.com/articles/arts/culturebox/2015/08/black_lives_matter_protesters_chant_kendrick_lamar_s_alright_what_makes.html.
Hiatt, Brian. “Kendrick Lamar: The Best Rapper Alive on Bono, Mandela, Stardom and More.”Rolling Stone, Rolling Stone, 9 Aug. 2017, www.rollingstone.com/music/features/kendrick-lamar-on-humble-bono-taylor-swift-mandela-w496385.
Knowles, Beyonce. "Formation." Lemonade, Parkwood Entertainment, 2016, track 12. Genius, www.genius.com/Beyonce-formation-lyrics
Lamar, Kendrick. "Alright." To Pimp a Butterfly, Interscope Records, 2015, track 7. Genius, https://genius.com/Kendrick-lamar-alright-lyrics
———. "Hood Politics." To Pimp a Butterfly, Interscope Records, 2015, track 10. Genius, https://genius.com/Kendrick-lamar-hood-politics-lyrics
Leight, Elias. “21 Savage: Rising Star Talks Honesty, Politics and 'Mumble Rap'.” Rolling Stone, Rolling Stone, 26 July 2017, www.rollingstone.com/music/features/21-savage-on-honesty-politics-and-mumble-rap-w494016.
McIntyre, Hugh. “The Grammys Pulled In 25 Million Viewers.” Forbes, Forbes Magazine, 18 Feb. 2016, www.forbes.com/sites/hughmcintyre/2016/02/17/the-grammys-pulled-in-25-million-viewers/#17d30b8179a7.
McWhorter, John. "Hip-Hop and Rap Lyrics Have No Educational Value." Should Music Lyrics Be Censored?, edited by Beth Rosenthal, Greenhaven Press, 2012. At Issue. Opposing Viewpoints in Context, link.galegroup.com/apps/doc/EJ3010776203/OVIC?u=csusf&xid=0478ab27. Accessed 16 Nov. 2017. Originally published as "Where Hiphop Is 'Going' and Where It Never Was," The New Republic, 21 May 2009.
Orcutt, KC. “7 Rappers Who Think Kendrick Lamar Is One of the Best Rappers Alive - XXL.” XXL Mag, XXL Magazine, 1 May 2017, www.xxlmag.com/news/2017/05/rappers-who-think-kendrick-lamar-one-of-the-best-rappers-alive/.
Ragen, Helen. “Hip-Hop Was the Most Significant Musical Revolution in U.S. Music.” Time, Time, 7 May 2015, time.com/3849844/music-hip-hop-revolution-pop-billboard-hot-100/.
Roth, Madeline. “Why Kendrick Lamar May Be The Greatest Rapper Alive In 2017.” MTV News, MTV, 18 Aug. 2017, www.mtv.com/news/3030840/kendrick-lamar-greatest-rapper-2017/.
Weiss, Jeff. “Kendrick Lamar, the Best Rapper Alive, Is Still the Best Rapper Alive.” Noisey, Vice, 17 Apr .2017, noisey.vice.com/en_us/article/78yb49/kendrick-lamar-the-best-rapper-al ive-is-still-the-best-rapper-alive.
21 Savage. "Money Convo." Issa, Epic Records, 2017, track 11. Genius, genius.com/21-savage-money-convo-lyrics
———. "No Heart." Savage Mode, with Metro Boomin, 2016, track 2. Genius, genius.com/21-savage-and-metro-boomin-no-heart-lyrics
———. "Nothin New." Issa, Epic Records, 2017, track 8. Genius, genius.com/21-savage-nothin-new-lyrics
Black History is American History
Weslei Thomas is a freshman at SF State who comes from a two parent household with three brothers, all younger than herself, in Elk Grove, California, where she moved at the age of three. Elk Grove is a suburban town with minimal things to do. When Weslei was six years old, she began to play soccer, and at eight years old, her mother enrolled her in a performance theatre summer camp. It was then that Weslei discovered her love for theatre. Every year after that, Weslei attended the same camp and her mother enrolled her in acting classes on the weekends. Weslei had performed in school talent shows in second and third grade, but her first real theatre performance was just what she needed. From then on Weslei always enjoyed performing and her talent and love has really grown over the years. When Weslei began middle school, she no longer wanted to continue with the private theatre group, she wanted to try her luck and audition for her school’s production; although she was not cast, Weslei’s love for theatre did not allow that to rain on her parade. She forged ahead and was cast in every show thereafter. No matter the role, Weslei gave it her absolute best. As a result, she has found her love for theatre and is now majoring in Performing Arts at SF State.
COMMENT FROM LECTURER, SARA FELDER:
Weslei Thomas, in her research paper for English 114, engaged in a writing process that inspired a true re-vision of her original intent. Her first draft argued for the importance of Black History Month but after much research and writing, her final draft urges educators to integrate black history into the curriculum during the other 11 months too. Weslei’s radical shift in her thinking is mirrored by her creative approach to research. Students were asked to use a scholarly source, two other legitimate sources, a book and a non-print source; for the non-print source she eschewed TEDtalks and podcasts in favor of song lyrics. It was a revelation to see how effectively pop culture can be used in academic essays. At this moment when society is intent on destroying black lives through violence, racism and ignorance, Weslei’s clear voice and compelling evidence offers a teaching for all students and educators that not only do black lives matter, but black history matters too.
When school administrators fail to teach Black History in schools, students are not receiving a holistic picture of American History. As a result, Black History and its use in school curricula have grown to be controversial topics. The first perspective argues that Black History should be implemented into school curricula, while the other side believes it is too "exclusive" to be taught in all classrooms. From the second perspective, implementing Black History into school curriculum is seen as counterproductive to the progression of the United States. Additionally, this point of view exclaims that the curriculum being taught would have to be completely altered. These naysayers insist that since there is a Black History Month, there is no need to have Black History implemented into the overall classroom curriculum. However, Black History is a way of reminding Americans of the important efforts African Americans have made to advance developments in history. Black History also allows students to recognize the destructive mistakes in our past. When school administrators implement Black History through required courses, the youth are able to understand United States history and the sacrifices African Americans have made throughout that history. Furthermore, if schools present history from the perspectives of different communities and cultures, students of color will be able to witness positive representations of leaders who look like them, which are lacking in media and classrooms. These students will be able to learn about African Americans who were inventors, musicians, artists, scientists, writers etc. Implementing Black History into K through 12 curricula would raise awareness, as well as positively influence the self-esteem of African American students by providing adequate representation.
The African American community deserves the benefit of seeing positive representation of their lineage, which is lacking in today’s society. In the article “TV Can Boost Self-Esteem of White Boys, Study Says,” Stephanie Goldberg—a journalist for CNN—examines a case study that was released June 6, 2012 by two Indiana University professors, Kristen Harrison and Nicole Martins. This study illustrates how a lack of representation of the African American community in television ultimately leads to a negative “impact” on black boys and girls. This article highlights how the self-esteem of African American youth regressed after exposure to television shows displaying unfavorable images of African Americans. The negative imagery and lack of representation of African Americans in the media, in addition to the historic mistreatment, further emphasizes the notion that African Americans are less important. This ultimately continues the cycle of low self-esteem and reinforces the belief that society has no place for the black community. By implementing Black History into classroom curriculum, the self-esteem of the African American youth will be elevated, while acknowledging their ancestors’ contributions to American history.
Black History recognizes the mistreatment African Americans have endured throughout their history in the United States, and that history is imperative to students' intellectual development. Regina Edmondson, the Assistant Director of the Office of Student Life at Community College Aurora, states, “By reliving and remembering history, we create awareness of the struggles and challenges that African Americans overcame in this country. This proven perseverance will serve as inspiration for [all students] and the rest of America” (Edmondson 2). Edmondson explains how Black History Month is a way to acknowledge the traumas African Americans have faced while highlighting the resilience of the African American community in its entirety. In order to understand world history, there has to be an acknowledgement of the advancements of the people within history who helped to create the history in our books today. By doing this, students recognize the mistakes made by those in the past, while creating a foundation of awareness, so future generations will not repeat history. As a result, guiding future generations down a path of open mindedness.
However, opponents of this view claim there is no need to include Black History in classroom curricula because there is already a Black History Month. Some proponents of this point of view take a step further and insist since there is a Black History Month, there should also be a White History Month. In the article, “The Black History Month debate is back”, Adam Howard—web editor for The Nation and news editor of The Grio, a website that includes news and opinions—states “Some whites have pushed back with calls for a ‘Whiteness History Month’” (Howard 1). This describes how some view that if there is a Black History Month, then “White History Month” should be its complement. In other words, this position argues that African Americans should not receive special treatment or a special month. If they do, then in order to be equal, they argue, “Whites” should also have a history month.
Unfortunately, this idea that there should be a “White History Month” is deeply flawed, as every month is white history month. History has been whitewashed, and what is being taught in classrooms every month of a year is dominated by white narratives. History is written by those who have maintained power, and those who have maintained power are white. In a song titled, “Interlude: Tina Taught Me,” written by Solange Knowles, Tina Knowles describes her experience as a black woman. She highlights the misconception of Black History Month and how loving being black is negatively perceived by White Americans. Tina Knowles exclaims, “Well, all we've ever been taught is white history. So, why are you mad at that? Why does that make you angry?” (Knowles 1). Knowles emphasizes how the idea of having a “White History Month” is ridiculous. White history is the core of American history that is taught in classrooms today. Secondly, Black History Month has been assigned to the shortest month of the year. In the article, “Black History Month: Serious Truth Telling or a Triumph in Tokenism?”, John Hope Franklin—an American historian of the United States and former president of Phi Beta Kappa, the Organization of American Historians, the American Historical Association, and the Southern Historical Association—states that “comedian Dick Gregory once said, ‘Wouldn’t you know that when they got around to giving us a month, it would be the month of February with all them days missing’” (1). This means that out of all the months that could have been reserved for Black History, the government chose February, the shortest month of the year. By doing this, white Americans are able to minimize the efforts of African Americans within history. Wanting to implement Black History into classroom curriculum is not saying replace the curriculum of schools today with solely Black History. It is calling for an equal and proper representation for all communities that have been impacted by, and have impacted, American History.
Black History should be implemented into grades K through 12 curricula because American students are being provided with counterfactual information regarding the history of the United States. In order to combat misinformation, there was a month created in order to inform students about Black history, while celebrating the accomplishments made within history by African Americans during the whole month of February. The name of this is month “Black History Month” and is recognized by the government and appears on calendars. Yet, Black History Month is hardly utilized within K through 12 classrooms school. Adam Howard, an MSNBC reporter, addresses this problem in the article “The Black History Month debate is back,” explaining, “Black History Month was established nearly a century ago by historian Carter G. Woodson for the simple reason that African-Americans were systematically whitewashed out of American history” (3). Meaning, Black History has been discarded and downplayed, and in turn, school administrators continue to provide the inaccurate teaching of history. For example, in the article “How Texas Teaches History”, Ellen Bresler Rockmore— New York Times journalist—states that Texas history books described the “slave trade as bringing ‘millions of workers’ to plantations in the American South” to students (1). This statement is completely misleading, considering that words like “workers” imply that someone is being paid. Slaves were not paid; they were brutally beaten and tortured by the white people who abducted them from Africa. This history is being minimized. Through minimizations like these, it appears that the current school curriculum is concealing history, while failing to shed light on the contributions of African Americans that are crucial to the progress of this country and its history. When students are provided with information that is inaccurate and misinforming, it produces an education system that impedes the growth of students and their ability to become open minded. Not only does this decrease the number of forward thinking individuals, it also is providing an unfair, inaccurate, and improper education. This form of education will not prove to be beneficial nor can it be utilized.
In conclusion, when school administrators do not implement Black History Month into K through 12 curricula, students are cheated of their right to a thorough and proper education. As a result, these students will continue to roam aimlessly ignorant throughout their educational careers and lives, unaware that the information they are receiving in their classrooms are a watered-down account of severe moments in United States history. Moreover, this cheating cannot be corrected because students who attend college, but do not take “cultural” courses, continue to be affected negatively and remain blinded by inaccurate information they received in their educational career. The United States school curriculum further perpetuates and fosters the ignorance of its students. Typically, the average child attends school from kindergarten to 12th grade. So, what is more impactful? It would prove to be beneficial for the student to expose that student to this more transparent form of curriculum throughout their educational career. It would not only prepare them to be more open-minded individuals but, it also provides them a fair, accurate, and proper education. An education that can be utilized throughout their lives.
As I reflect on my educational career, I notice that if not for the open dialogue and encouragement to research my historical background, from my elders, I would not possess the knowledge that I have today. This black hole, pun intended, in school curriculum has shown that school administrations have failed to provide my peers, or myself, with the proper tools to make well, thought out, educated decisions for the future. This blatant disregard, as it pertains to African American history, demonstrates how the administration is failing its students. The unwillingness to fix this inaccurate curriculum demonstrated by school administrations is failing its students. The overall education system, across the nation, will continue to fail its students until a positive change in curriculum is made.
Franklin, John Hope, et al. "Black History Month: Serious Truth Telling or a Triumph in Tokenism?" The Journal of Blacks in Higher Education, no. 18, 1997, pp. 87-92. JSTOR, JSTOR, www.jstor.org/stable/2998774.
Gill, Joel Christian. "Let's Get Rid of Black History Month." The Huffington Post, TheHuffingtonPost.com, 10 Feb. 2015, www.huffingtonpost.com/joel-christian-gill/lets-get-rid-of-black-history-month_b_6655356.html.
Goldberg, Stephanie. "TV Can Boost Self-Esteem of White Boys, Study Says." CNN, Cable News Network, 1 June 2012, www.cnn.com/2012/06/01/showbiz/tv/tv-kids-self-esteem/index.html.
Howard, Adam. "The Black History Month debate is back." MSNBC, NBC Universal News Group, 22 Jan. 2016, www.msnbc.com/msnbc/the-black-history-month-debate-back.
"Interlude: Tina Taught Me." YouTube, YouTube, 29 Sept. 2016, www.youtube.com/watch?v=sE1Uu_bUO9A.
Rockmore, Ellen Bresler. "How Texas Teaches History." The New York Times, 21 Oct. 2015, www.nytimes.com/2015/10/22/opinion/how-texas-teaches-history.html.
"Why it's Important To Observe Black History Month." The Fox Call, 5 Feb. 2015, www.ccaurora.edu/blogs/fox-call/history/why-its-important-to-observe-black-history-month/.
John Carlos Micael was born in the Philippines and moved in the United States, along with his two siblings to live with their parents, a learning artist who likes to draw and write poems from time to time. Coming to SF State has influenced his artistic lens and how he sees others around him. It surprised him to learn that some people still deny the alarming warnings of climate change, as if it is not real or does not matter. These debates have a huge impact on John Carlos because in the HPillipines where he grew up, climate change means floods with every rainy season, water leaking into the house with one storm after another. It is hard to know there are people out there like Donald Trump who still deny the worldwide effects of climate change; so John Carlos wrote this poem from his strong desire to wake those people, to convince them to look and see the urgent need to protect our world.
COMMENT FROM LECTURER, DAN CURTIS-CUMMINS:
“Current” is the result of John Carlos Micael’s ‘Academic Narrative’ assignment, which served as the introduction to his year-end, ENG 105 Portfolio in Spring 2017. The prompt was “informal, but academic,” encouraging students to connect with 1-2 authors from the year and share their personal, unique academic experiences as they evolved through our course theme of ‘reading the world.’ In addition, students were encouraged to use this assignment to ‘code mesh,’ or integrate their own language alongside academic English, as well as ‘genre mesh’ to include poetry, lyricism, and other creative forms that show who they are as academic readers and writers at the end of my course.
JC took this opportunity wholeheartedly to discuss his connections with the concepts and ideas of Paolo Freire, creator of the concept of ‘reading the world.’ JC also took advantage of hte creative nature of this assignment, wrote what is in my opinion an excellent and engaging poem about the intersections of his experiences as a student, an individual, a reader and writer, and a global citizen. Moreover, JC’s poem reflected his identity as an artist, always at the forefront of his writing in my class, which I encouraged he embrace as an academic reader and writer ‘of the world.’
JC’s poem is a testament to the potential of our composition classrooms to be places that young writers can define their unique academic interests and voice. What could be a better learning outcome than that for our writing courses?
I am from the Philippines, which is known as “the most exposed country in the world to tropical storms,” as noted in the article “The Philippines is the Most Storm-Exposed Country on Earth” by Sophie Brown. Every year in the Philippines there are cyclones that have the potential to surpass the previous deadliest tropical cyclone recorded in the world, which also happens to be from the same country — my home country — the Philippines. Every year more studies show that climate change is to blame, and yet a first world country’s elected leader speaks as if no such thing exists. Just knowing that such a high-powered individual can be so ignorant and uneducated shows that there are people in the world who do not recognize that action must be taken to protect the world we are living in.
Since Freire’s work is about allowing people to speak from their own experiences in order to raise awareness of important issues, I feel it is important for me to speak about my own personal experience regarding global warming in the Philippines. Writing a poem is my way of doing this. As an artist, a student, and a seed from my home country, I think that sharing our perspectives not only unites people who have the same values, but also speaks to those who do not. Ignoring those people who are in denial of the world’s issues, which in most cases occur in third world countries, will only worsen those issues around the world.
Through the word you see
Through your world you see
That the world is messy
Full of things we try not to see
Cuz it's depressing, disturbing and just a distraction to our own designated lives,
so some of us shut our windows to the world
Trying not to see
All of us need to see
See through the darkness
not emerge within it
See that piece by piece
One of us disappears
Due to the darkness that overtakes us
So open your window
So we can all see
Before there's no more to see,
Now do you see
What I see
These writings whoever sees, see
My culture, identity and goals
Filipino I am
Just a cisgender a man I am
Make an impact to the world with the lines through my mind may I?
Earth without Art is just eh
So I remain meh
An artist doing what I do
Which make you see
Through the lines
That I draw through things you can see physically
Makes you think, switch your perspective, mehbe
Then we can both agree
That not only you can see
The me that is me
But the world that it is now
And see the light that needs to be
With us while we remain
Above the sea
The sea that will reflect upon our silents
A quite quiet current
We will be
Below the sea
The Salvadorian Perspective
Jasmin Vargas is in her second year here at SF State, majoring in Latina/o Studies, and is in the process of adding Criminal Justice as her secondary major. Jasmin is from Montebello, CA, where she attended Montebello High School. She, like many Latinx youths, comes from an immigrant family. It was her family’s hardships and sacrifices that prompted her passion for learning about Latinx history in the U.S., and she found SF State to be the perfect school to do so. Jasmin has future goals to attend graduate school and earn a Master’s Degree in Public Administration; then, possibly, a PhD in Education.
In her spare time, Jasmin enjoys attending indie/ alternative rock concerts, particularly, Bad Suns Concerts. Her favorite “activity” is binge watching her favorite TV shows: Friends, The Office, That ‘70s Show, Greys Anatomy -- just to name a few. However, she is not too sure this counts as an activity, because it mostly involves laying in bed all day. Jasmin also enjoys going to amusement parks; she is a total rollercoaster junkie. Additionally, she loves to attend baseball games, try new places to eat, and spend time with her mom, brother, and dog whenever she is back home.
COMMENT FROM LECTURER, JAY JACKL:
While Jasmin entered our English 214 community as a strong, compelling writer, she further developed her authorial identity through diligent revision and incorporation of peer and instructor feedback. In this ethnographic research essay, she thoughtfully addresses the many challenges faced by Salvadoran immigrants to the U.S. in the late twentieth century. In keeping with our course theme of social (in)justice, she critically engages an impactful sociopolitical event from recent history while performing the meta-task of offering her audience historical context for the current (and evidently divisive) issue of immigration policies in the U.S. Jasmin effectively illustrates how these policies can affect human beings who are trying to provide more stable and prosperous futures for their families by pursuing the ideals of the “American dream.”
Salvadorans began migrating to the U.S. in the 1980s during a most unfortunate time. During the cold war, communist sympathies were rising in El Salvador, which prompted the U.S. government to interfere with El Salvador’s military, to prevent El Salvador from becoming a communist country. As a result, El Salvador became a war zone; children were regularly kidnapped and killed, and families were being broken apart. Everyone feared for their lives. Many joined the guerrilla movement in El Salvador, which worked toward defeating the military but also cost the lives of countless boys and men. During this time, despite its direct contribution to the thousands of deaths in El Salvador, the Reagan administration militarized border enforcement, making it difficult for Salvadorans to obtain political asylum in the U.S. Thus, Salvadoran migrants were met with additional barriers during their pursuit to freedom and safety in the U.S. “[The] Illegal Immigration Reform and Immigrant Responsibility Act . . . made it more difficult for immigrants to obtain legal permanent residence . . . and also made legal permanent residents deportable” (Abrego 8). Consequently, Salvadorans seeking political asylum had no viable option but to enter the U.S. illegally. The “U.S. production of illegality had denied most migrants the opportunity to travel safely—even though they were fleeing political and economic conditions created directly and indirectly by U.S. enforced policies” (Abrego 55). Both men and women were subjected to physical and mental abuse traveling through multiple borders to reach the U.S.-Mexico border. Poor Salvadoran parents were the most common victims of this abuse because they were unable to afford safe methods of transportation.
Poor Salvadoran mothers and fathers were more inclined than middle-class parents to leave their families and migrate to the U.S., hoping for better job opportunities and American citizenship. During this time, it was especially difficult for working-class Salvadoran families to find work or keep a job. They were highly targeted by guerrilla fighters to join the movement, causing employers to fear for their safety. Thus, many poor Salvadoran parents were fired, which resulted in their choice to migrate. Once completely settled in the U.S. with stable income and decent housing situations, the end goal was to save the rest of their family from El Salvador and bring them to the U.S. However, this process was not always successful, and in too many cases, it took years before Salvadoran immigrants reunited with their family. Due to their low financial status, many men and women were forced to entrust a coyote—an immigrant smuggler—to get them across the U.S.-Mexico border. This method resulted in enormous debt and prolonged the life-threatening experience for Salvadoran immigrants traveling across multiple borders to reach the U.S. More women and young children were raped, robbed, beaten, and killed at the Mexican border than at any other border. To make matters worse, they had to pay coyotes thousands of dollars without any assurance that they would make it to their destination. Abrego states, “By 2013, the financial costs for an unauthorized trip . . . [was] upwards of $8,000 and even $10,000 per traveler” (50). Salvadoran immigrants were already accumulating debt before being bombarded with legal costs in the U.S., all before knowing whether they could even find a job that would cover all their expenses and leave enough to send remittances, or money sent by mail, to their families in El Salvador.
Illegality shaped the settlement process in the U.S. for Salvadorans and greatly affected the way employers treated them. Fortunately, some could obtain Temporary Protected Status (TPS), which is “a form of administrative relief that allows otherwise undocumented immigrants to legally reside and work in the United States for eighteen months at a time” (Abrego 14-15). But, like most U.S. policies, TPS had its flaws. Most TPS recipients were middle-class Salvadoran parents, leaving poor undocumented Salvadorans with scarce resources and exposed to labor exploitation. Undocumented Salvadorans did not have government support to oppose dangerous working conditions or low wages, and if they did, their employers met them with ICE threats. This coincides with the difference in financial and living situations between poor and middle-class Salvadorans in the U.S. Unlike poor Salvadorans, middle-class Salvadorans were able to earn higher wages, workers compensation, and support from the government. Most even became eligible to “become Legal Permanent Residents (LPRs) only when they [were] given permission to reside (and work) in the United States permanently;” and would eventually become a “…naturalized citizen…who after a period of time with LPR status…gains full legal citizenship rights” (Abrego 70). It was rare for poor undocumented Salvadorans to gain the same rights as middle-class Salvadorans, which is why they lacked any financial stability, were unable to send remittances, and often failed to reunite with their families in El Salvador. Thus, the extended separation between poor Salvadoran migrant mothers and fathers forced them to renegotiate their notions of parenthood.
The effects of this division of class between Salvadorans, in terms of illegality, can also be seen in the lives of children in El Salvador who have migrant parents in the U.S. Abrego argues, “[Children] of undocumented immigrants experienced illegality through limited remittances and terrible living conditions[;] these families were also likely to be completely distraught about family separation” (83). In the parent’s defense, their children had not yet been to the U.S. to witness how difficult it had been for them to settle in American society. Many children in El Salvador began to lose hope in their parent’s success when, after several years of separation, they still had not made progress towards joining them in the U.S. Unfortunately, when undocumented Salvadoran parents in the U.S. were failing to provide substantial remittances, they became embarrassed and ashamed. Over time, they became distant with their children so that they could refrain from facing the guilt of failing them. “On the other hand, when parents were able to remit large and consistent sums of money, their children experienced improved living conditions, greater access to education, and, sometimes, notable upward mobility in socioeconomic status” (Abrego 83). This also gave middle-class parents the opportunity to reunite with their children and establish a new life for their family in the U.S., uncommon events for undocumented parents, who were more likely to be deported. According to a study in 2014 of identified cases of deportee murders, forty-five Salvadorans were killed during the deportation process (Kennedy). Furthermore, legal status not only regulated the number of remittances Salvadoran migrant parents were able to send; it also determined the likelihood of family reunification.
Illegality continues to play a key role in the lives of many Latin Americans in the U.S. However, no other Latino community has faced the discriminatory and unjust effects of U.S. immigration policy the way Salvadorans did during the 1980s and 1990s. Ronald Reagan’s administration made it especially difficult for Salvadorans to gain protection and American citizenship during the end stages of the Cold War, in an effort protect American citizens from Communists. In Lillian Guerra’s article “Late-Twentieth-Century Immigration and U.S. Foreign Policy: Forging Latino Identity in the Minefields of Political Memory,” an interviewee states, “People didn’t know too much about the war in Central America—all they knew were ‘communists’” (128). However, had it not been for the sacrifices of Salvadoran immigrants, El Salvador would have faced even greater negative effects of U.S. foreign policy. Without their sacrifices and contributions to American society, Salvadorans would not have later gained recognition in the U.S. In the early 2000s, “[the] U.S. Federal Government [recognized]…the trauma [it inflicted] on families and communities… [by] funding clinics meant to treat torture victims [and commissioning symbolic monuments] of so many refugees’ own perilous journey” (Guerra 143). Though these acts of recognition do not directly relieve the issue of illegality, they succeed at recognizing Salvadorans as victims of U.S. policy in Central America.
Abrego, Leisy J. Sacrificing Families: Navigating Laws, Labor, and Love Across Borders. Stanford Univ. Press, 2014.
Guerra, Lillian. "Late Twentieth Century Immigration and U.S. Foreign Policy: Forging Latino Identity in the Minefields of Political Memory" In American Latinos and the Making of the United States: a Theme Study. Washington, D.C.: National Park Service, 2013.
Kennedy, Elizabeth G. "In the Press/ En La Presensa." Elizabeth G. Kennedy. 2 March 2016, https://elizabethgkennedy.com/in-the-press/
Are Pharmaceutical Companies Responsible for the Opioid Crisis?
Mateo Mayorga is a second year student at SF State pursuing a degree in Psychology with hopes of obtaining a Master’s Degree in Clinical Psychology. His experiences since early adolescence growing up in Sacramento, his ever expansive family, and his travels around Central America have fueled his passion for writing as a medium of expression. Mateo has written a handful of short stories, some delving into simple family struggles, others factious stories of San Francisco. Impassioned by drug illiteracy and mental health issues in America, he has become an advocate for change to the status quo regarding drug use and the demonization of drug users. He wants more empathic addiction treatments and hopes writing about it can strike at the hearts of readers to help influence that change.
COMMENT FROM LECTURER, SARAH ANN COX:
This essay contains an extremely careful and meticulous construction of an argument: pharmaceutical companies played a massive role in the opioid crisis. The amount of evidence and the thoroughness of Mateo Mayorga's investigation is relentless and quite frankly, brilliant. Mayorga shows how shifting medical attitudes, false claims about addiction, pharmaceutical lobbyists, and the DEA all combined to create the opioid crisis facing America today.
Substance abuse has been around for millennia, ever since the advent of intoxicants. According to a CNN article by Sonia Moghe titled “Opioid History: From ‘Wonder Drug’ to Abuse Epidemic,” the prominence of opioids in United States history has been an ongoing phenomenon since the 1860s. Moghe states that in 1898 Bayer Co. produced a new opium-based medication that they called heroin. Bayer Co. considered heroin to be a “wonder drug” and a cure-all, and it was utilized regularly as a cough suppressant. Intravenous heroin use grew rapidly among those previously addicted to morphine due to the intense high that heroin provided. However, though the opioid wild west of the late 1800s and early 1900s was profitable, in 1914, the government passed the Harrison Narcotics Tax Act, which imposed tariffs and taxes on importers, producers, and sellers of opioids and put economic pressure on heroin and morphine. The Harrison Narcotics Tax Act set into motion a new precedent: by the 1920s, physicians actively avoided prescribing opioids due to their addictive nature.
By the 1970s, a clear shift occurred in the medical community’s attitude towards opioids. Although two new drugs, Percocet and Vicodin, hit the market during the 1970s, physicians were initially wary of prescribing opioids for patients. However, Moghe points out that in January 1980, the New England Journal of Medicine published a research study promoting opioid prescription by downplaying the effects of addiction. The two researchers, Dr. Hershel Jick and Jane Porter, said in their study that “[t]he development of addiction is rare in medical patients [receiving opioids] with no history of addiction” (qtd. in Moghe). The study by Jick and Porter looked at 11,882 patients who had undergone some form of opioid treatment. Moghe quotes Jick’s own words when he says, “Less than 1% of patients died from these drugs.” This obviously falsified data set the foundation for more and more opioids being prescribed for non-cancer patients. Combating pain became a key factor in hospital care and was enforced by many hospitals around the country. The backing of the New England Journal of Medicine allowed the company Purdue Pharma to fabricate further studies to coincide with their study. These circumstances provided a perfect justification for opening the floodgates on opioid prescriptions. Considering the historical development from cautious opioid prescription to the exploding opioid crisis, it is clear that a third variable in this equation led to the attitude shift towards opioids. This third variable is comprised of the pharmaceutical companies that purposefully misconstrue the addictive potential of their opioid-based drugs.
It has become apparent that pharmaceutical companies are directly accountable for the opioid epidemic across the United States. These companies do not care for the livelihoods of millions of American lives, as they flood communities full of highly addictive opioids without any repercussions from federal agencies like the Drug Enforcement Administration (DEA). Furthermore, pharmaceutical companies have infiltrated the United State Congress through aggressive lobbying techniques. Lobbyists are essentially bribing representatives and senators to push pro-pharmaceutical legislation. Not only have they influenced our legislators, put in power to serve the interest of the people; they have also bought out ex-DEA agents to further preclude any possibility of legal repercussions from the DEA. From their lies about non-addictive opioids to their pervasive, predatory lobbying and “front company” tactics that place profits over the lives of millions of Americans, it is apparent that pharmaceutical companies are responsible for the worst drug crisis in American. Yet their schemes reach further still by utilizing ex-DEA attorneys to avoid judicial repercussions and foist blame on innocent victims affected by over-prescription of these addictive drugs. One of the most divisive tactics utilized by the drug industry is the overwhelming deceitful use of faulty medical studies and drug-industry-sponsored research to influence increased prescriptions of opioids.
Purdue Pharma’s Destructive Falsehoods
Purdue Pharma released OxyContin in 1996 with the idea that this drug would be the ultimate opioid-based pain medication, yet they had to convince the medical community of its benefits. Purdue Pharma’s OxyContin campaign, according to Patrick Raddan Keefe of The New Yorker in his article “The Family that Built an Empire on Pain,” was the largest pharmaceutical marketing campaign in United States history. So how did this drug become the such a market success? According to Raddan Keefe, Purdue Pharma spent millions of dollars funding research and paying doctors to sell the idea that opioid addiction was an overblown concern. One doctor, named Russell Portenoy, former pain specialist at the Memorial Sloan Kettering Cancer Center in New York, was paid by Purdue Pharma to say that OxyContin was a “Gift of Nature” and to tell doctors to get over their “opiophobia” since addiction to OxyContin was a “medical myth.” It is abundantly clear that Purdue’s agenda allowed for publicly dissuading thousands of medical officials without any regard for human life. Examples of Purdue Pharma outright lying are they did not conduct clinical studies of the addictive prosperities or possible potential to abuse OxyContin. Worst of all, according to an article in The Atlantic called “Are Pharmaceutical Companies to Blame for the Opioid Epidemic” by Alana Semuels, Purdue told physicians that OxyContin lasted 12 hours even though the drugs active effects only worked for less than the allotted time. This led to withdrawal symptoms of patients told to take OxyContin twice a day. These withdrawal symptoms were the precursor to the opioid crisis, and no one expected to see it explode. The withdraw symptoms caused by the prescribed misuse of OxyContin lead to addiction, and once the patient is weaned off their medication, there is nowhere else to go to alleviate their symptoms. An article in The New York Times by Nicolas Kristof, titled “Drug Dealers in Lab Coats,” discusses some of the illicit actions undertaken by Purdue Pharma, such as funding $11 million dollars to medical journals in 2011 to expand the acceptance of opioids for use with chronic pain and back pain even though there is no scientific evidence that opioid use helps with chronic pain. Kristof goes on to point out is how the drug industry used addiction to sell more medication. For example, “[Purdue Pharma] argued that signs of addiction were a reason to prescribe more opioids.” Using addiction to prescribe more opioid medication shows how blatantly careless these companies are. As Purdue flooded communities with millions of pills, OxyContin’s falsified benefits were only ever to be utilized to make money, even if it meant that millions of lives were ruined by addiction and death. The research shows that OxyContin’s success was built upon a bed of lies with the help of the U.S. Congress. So, how did they get the legal justification and support that we see today? Pervasive lobbying and the use of puppet public interest companies are to blame.
Legal Bribery and the Betrayal of the DEA
Pharmaceutical companies’ gargantuan lobbying machine, with its pharma-sponsored public interest groups, is one of the most effective tools that help push pro-pharma legislation as well as evade responsibility for the opioid crisis. An article published by The Guardian, titled “How Big Pharma’s money, and Its Politicians, Feed the Opioid Crisis,” by Chris McGreal, breaks down the extent to which our politicians are influenced by the pharmaceutical company lobbyists. McGreal states that drug companies invested over $2.5 billion in lobbying campaigns in the past decade. McGreal also points out that this $2.5 billion went to nine out of ten members in the House of Representatives and all but three of the 100 United States senators. There are on average two lobbyists employed by pharmaceutical companies per member of Congress, according to McGreal. Almost all our representatives and senators have received money from pharmaceutical campaign contributions that ultimately ensure influence on how pro-pharma legislation is created, even in the face of this epidemic. The amount of power pharmaceutical companies wield from lobbying allows them to sell cheap opioids, of various types, with little competition from generic providers or any fear of repercussion from federal agencies like the DEA. In some cases, lobbying is more dangerous than just lying to medical professionals since it gives the legal precedent to continue to drown communities with millions of opioids with the applause of the U.S. Congress. The power held by these pharmaceutical companies allows them to defend themselves against any attempt at regulation.
McGreal points a case in which two representatives, Mary Bono and Hal Rogers, who were part of the Caucus on Prescription Abuse attempted to pass the Ryan Creed Act, which would have required doctors to be trained on the dangers of opioids. This very reasonable piece of legislation would have ultimately helped reduce opioid prescription and educate physicians, but it was seen by the American Medical Association as a “burden on physicians” as well as a “blatant attempt at depriving millions of Americans, with chronic pain, legitimate treatment,” according to McGreal. More lobbying organizations, such as the Pain Forum, spent millions of dollars to shoot down any legislation from the Caucus of Prescription Abuse. It is very apparent that these lobbying companies, their coffers kept full by big pharmaceutical companies, maintain the status quo of drug legislation. These companies are willing to spend billions of dollars just so they can continue to waterboard the American people with unnecessary opioids. This is the reason why the opioid crisis has grown so destructive: these companies keep the status quo while spreading propaganda on the benefits of over-prescription. The result is a positive feedback loop of prescription and addiction. These destructive lobbying tactics have also directly caused the dismantling of the DEA, through the divisive persuasion of former DEA agents and attorneys.
The Drug Enforcement Administration is responsible of overseeing all opioid transports throughout the United States, yet Congress, with the funding of billions of dollars in pharmaceutical money, has actively been dismantling them, which in turn allows millions of pills to flood communities and fuel the opioid crisis. In an explosive 60 Minutes interview, Bill Whitaker dives into a controversial bill enacted in 2016 with the help of Ex-DEA attorneys. Titled “Ensuring Patient Affairs and Effective Drug Enforcement Act,” the bill ultimately stripped the DEA of its enforcement powers. According to Whitaker’s investigation, pharmaceutical companies grew tired of DEA fines, which totaled around $341 million annually. Companies were fined for not inspecting suspicious shipments of opioids, as required under the Controlled Substances Act. These fines set a legal, and financial, need to halt further DEA encroachment into the opioid industry. Given the size of the federal government, how did these companies decide to combat the DEA’s vast and effective legislative arm? These companies utilized their most powerful asset: money. Around 2011, according to Whitaker, parades of DEA attorneys began to take up high-paying positions defending pharmaceutical companies against DEA fines. Around 46 lawyers, detectives, and high-ranking supervisors from the DEA, as well as 32 special attorneys from the division that is responsible for regulating the drug industry, made this transition from the public to the private sector. These ex-DEA agents and lawyers are dangerous for the state of the United States since their insider knowledge could ultimately lead to the destruction of the DEA. The best ex-DEA attorneys were well-versed in the weaker legal tactics used by the DEA and this knowledge allowed them to halt further fines while pharmaceutical companies, with the help of ex-DEA agents, lobbied Congress to pass a new bill. The Ensuring Patient Affairs and Effective Drug Enforcement Act passed swiftly through the House of Representatives and the president’s desk. The act ensured that the DEA could not utilize diversion tactics to freeze suspicious shipments of opioids around the nation. Enforcement by the DEA is impossible under this bill, meaning that millions of opioids can be shipped out to communities. The stripping of the DEA’s enforcement powers will allow opioids to remain a profitable business for pharmaceutical companies. Pharmaceutical companies are responsible for the opioid crisis, as they legally saturate communities with these drugs with impunity, and it is almost impossible to halt the opioid pill floodgates now that they are open. Those individuals who are affected by the opioid crisis are ultimately used as pawns to further pharmaceutical companies’ agenda.
Blaming the People for Addiction
Attempts to combat the opioid crisis on an individual level have been problematic. Doing so creates a justification for pharmaceutical companies to shift the blame onto those addicted to opioids, in turn making combating them impossible. When faced with criticism, pharmaceutical shift blame to those most affected by over-prescription, claiming that the addicted are responsible for their own actions. In McGreal’s article in The Guardian, he illustrates how drug companies shift the blame: “The pharmaceutical industry poured resources into attempting to place blame for the crisis on millions who have been addicted instead of on the mass prescribing of powerful opioids.” Diverting attention to those addicted allows for these companies to avoid responsibility and demonize those people who are suffering from opioid dependency.
There have been cases in which individuals try to sue pharmaceutical companies for maltreatment, only for the court to throw the case out, arguing that the plaintiff was addicted to opioid medication. The defense all pharmaceutical companies employ when faced with lawsuits from individual people is to point out that those who are addicted or have died from opioid dependence are misusing their drugs and obtaining them illegally. Individual patients’ lawsuits are considered to be void of legal defense since it is the responsibility of doctors to monitor these individuals. The counterargument that it is the people who are at fault is problematic since it plays into the idea that “addicts” are inherently irresponsible abusers of prescription medication. In actuality, these people are average people who fell into the trap of opioid dependency. Given this information, how can one fight back against the pharmaceutical companies who have caused this crisis?
Combating Pharmaceutical Companies: Is It Even Feasible?
According to the CDC, around 200,000 people in the US have died from opioid-based prescription medication since 2000. It is very apparent that the opioid crisis has affected the lives of millions of American while pharmaceutical companies profit from the pain of these individuals. So how do we, as a nation, combat these multibillion-dollar pharmaceutical companies? On an individual level, the easiest action is to become educated on this subject and have a dialogue with people about how pharmaceutical companies are to blame for this crisis. Dialogue and discussion are the first step in sparking resistance within people, providing the necessary seed that allows for change to occur. Individuals must also understand the proper use of opioids when prescribed to them for surgery or chronic pain because they are dangerously addictive. A cautious and educated approach is needed for people to understand the seriousness of these powerful drugs. Besides drug education and discussion, people need to consider the contributions our representatives receive and ask the hard questions when they support suspicious legislation like the Ensuring Patient Affairs and Effective Drug Enforcement Act. Our representatives should represent the voice of the people, not the voice of the pharmaceutical company. Though these companies are leviathans of influence, it is possible to make our voices heard. We can use our voting powers to elect officials who care for the lives of their constituents. The muffled voices of those suffering under the pain of opioid addiction are just starting to be heard, and it is our duty to amplify them.
Frances, M.D. Allen. "Pharma Corruption Started the Opioid Epidemic." The Huffington Post, TheHuffingtonPost.com, 4 Oct. 2017, www.huffingtonpost.com/entry/pharma-corruption-started-the-opioid-epidemic_us_59d4f8c7e4b0da85e7f5ed58.
Higham, Scott, and Lenny Bernstein. "How Congress Allied with Drug Company Lobbyists to Derail the DEA's War on Opioids." The Washington Post, WP Company, 15 Oct. 2017, www.washingtonpost.com/graphics/2017/investigations/dea-drug-industry-congress/.
Johnson, Steven R. "Modern Healthcare." The Opioid Abuse Epidemic: How Healthcare Helped Create a Crisis, 13 Feb. 2016, www.modernhealthcare.com/article/20160213/MAGAZINE/302139966.
Keefe, Patrick Radden. "The Family That Built an Empire of Pain." The New Yorker, The New Yorker, 4 Dec. 2017, www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain.
Kristof, Nicholas. "'Drug Dealers in Lab Coats.'" The New York Times, The New York Times, 18 Oct. 2017, www.nytimes.com/2017/10/18/opinion/opioid-pharmaceutical-addiction-pain.html.
McGreal, Chris. "How Big Pharma's Money - and Its Politicians - Feed the US Opioid Crisis." The Guardian, Guardian News and Media, 19 Oct. 2017, www.theguardian.com/us-news/2017/oct/19/big-pharma-money-lobbying-us-opioid-crisis.
Moghe, Sonia. "Opioids: From 'Wonder Drug' to Abuse Epidemic." CNN, Cable News Network, 14 Oct. 2016, www.cnn.com/2016/05/12/health/opioid-addiction-history/index.html.
Semuels, Alana. "Are Pharmaceutical Companies to Blame for the Opioid Epidemic?" The Atlantic, Atlantic Media Company, 2 June 2017, www.theatlantic.com/business/archive/2017/06/lawsuit-pharmaceutical-companies-opioids/529020/.
Whitaker, Bill. "Ex-DEA Agent: Opioid Crisis Fueled by Drug Industry and Congress." CBS News, CBS Interactive, 17 Oct. 2017, www.cbsnews.com/news/ex-dea-agent-opioid-crisis-fueled-by-drug-industry-and-congress/.
The Transcendent Aesthetic
Ruth Kopiko is a Bay Area native, who moved to San Francisco from a suburb in the East Bay Area. She is an English Education and Linguistics major. She understands that language and culture influence each other, and she is enthusiastic to apply her knowledge about language in a manner that reconciles cultural divides. She is curious to learn about foreign customs and traditions in order to grow more compassionate toward others.
Traveling has contributed to much of her development. She enjoys venturing out to explore different areas of San Francisco that she has not been to before. However, her frequented visits to the beach have made it her favorite place to go to relax. She says that the best part about going to the beach is sitting along the shoreline and gazing out to where the ocean and sky connect.
While taking science general education courses during her first semester at SF State, Ruth experienced many moments of being awestruck and amazed by the intricacy of human biology and the infiniteness of the stars and planets in the universe. These observations solidified her beliefs of humanity's humble relationship to nature. She seeks to find the everyday beauty that surrounds her.
COMMENT FROM PROFESSOR MARY SOLIDAY:
Ruth Kopiko is an English Ed major with a concentration in linguistics, and I met her in my 480-GWAR class. This class was themed around how we represent the natural world, and I like how Ruth analyzes the representation of nature in print and visual texts produced in different times and places.
Transcendence can only be appreciated once the observer takes a step back from systematic analysis and focuses on essence rather than quantifiable attributes. Walt Whitman addresses the distinct connection between man and nature in his poem “When I Heard the Learn’d Astronomer.” After escaping from a highly intellectual science presentation, the speaker says: “When I sitting heard the learned astronomer where he lectured / with much applause in the lecture room, / How soon unaccountable I became tired and sick, / Till rising and gliding out I wander’d off by myself” (5-8). This excerpt depicts the speaker’s distaste for the structured format of the learn’d astronomer’s approach to astronomy. Later, the speaker shows a reverent attitude towards celestial objects. The speaker says: “In the mystical moist night-air, and from time to time, / Look’d up in perfect silence at the stars” (9-10). Here, the speaker seems to be in awe of nature; they are intrigued by the night sky. They are content with simply gazing at the stars and accepting their own observations, as opposed to filling their mind with textbook knowledge from the learn’d astronomer. These lines leave the reader with an open-ended thought, concluding with the pensiveness of the speaker. There is no detailed description of what the speaker sees; nature is explained as “perfect silence,” so the reader must close this gap in their own interpretation.
Curiosity is able to organically guide any individual to observe the beautiful qualities of nature. When thinking about the mysterious attributes of nature, an individual’s intrigue heightens and this might eventually lead to a transcendent moment. William Wordsworth focuses on this in his poem “I Wandered Lonely as a Cloud,” in which the speaker says: “I gazed—and gazed—but little thought / What wealth the show to me had brought” (17-18). There is a sudden attraction towards nature from the speaker. Here, the “wealth” referred to is the abundant beauty of nature. The speaker’s surrounding environment increases their fascination, making them fixated on observing it thoroughly. Earlier in the poem, the introduction of daffodils sparked this delight: “When all at once I saw a crowd, / A host of golden daffodils” (3-4). Similar to Whitman’s poem, the speaker is awestruck by nature. The daffodils act as surprise visitors to the previously lonely speaker. This accompaniment directly connects the speaker to nature, the flowers, and it sparks the transcendence of this particular circumstance.
The speakers in both poems are asserting their relationship to nature when they make these observations. Wordsworth refers to the vast presence of nature when he mentions the night sky: “Continuous as the stars that shine / And twinkle on the milky way” (7-8). A faraway presence limits the speakers from being able to truly relate to nature. This estranged existence causes the individual to wrestle with their understanding of nature. However, the incredible vastness of nature, such as the starry night sky, intrigues the speakers as they continue to observe in wonder. Their curiosity drives their interest and fascination. This perspective lessens the speaker’s view of themselves, placing them into a diminutive state which leads to the individual decreasing their dependence on facts but rather on their emotional sensations. A novel approach like this, which reaches past ordinary limitations, provides the reader with the conclusion that there is a transcendental theme found in these poems.
Another transcendent moment occurs in a film clip of James Cameron’s Avatar. There is a scene when the protagonist Jake Sully flies with the mountain banshees, which are visually appealing creatures. This is an important scene in the film because it signifies Jake’s capability of connecting to the foreign creatures since he is a human disguised as one of them. These blue and purple-hued flying creatures are only able to be mastered by one individual; their unique connection is made from a special neural link. The clip shows Jake successfully making the link with the mountain banshee, and they complete their first ride together. Here, Jake is depicted as content and relieved; he seems to be sincerely enjoying himself while flying on the creature. The background music for this scene also heightens the significance of their newly established relationship. Dramatic crescendos highlight the moments when Jake and the banshee seem to bond the most. Jake takes in the beauty of nature from the vantage point of riding his mountain banshee. The neural link connection between Jake and the mountain banshee creature later leads to his experience and appreciation of nature.
Similarly, David Lean’s film Doctor Zhivago incorporates transcendentalism. A film clip where Doctor Zhivago and his family are stuck indoors, because of the snowy weather, depicts the protagonist peering out of a frosted window to look at the barren wintry trees outside. In Doctor Zhivago’s mind, the stripped trees transition into another season in which he imagines sunny spring weather. He is shown in a warmer landscape, specifically in a field of daffodils. This depicts his admiration of nature. Throughout the duration of the scene, the music grows louder and this implies the significance of the moment. Doctor Zhivago’s connection to nature stems from his desire to another woman he is attracted to. This person offers him fulfillment, similar to how warm weather breathes life into hibernating plants. This scene portrays Doctor Zhivago reminiscing about a positive connection he had experienced with nature, which fostered his blissful admiration.
The poetry of Whitman and Wordsworth depict an individual connecting with their surrounding environment, as do the films clips from Avatar and Doctor Zhivago. The transcendence found in these examples display how an individual must go beyond their head-knowledge to find a remarkable connection to nature. These art forms highlight how the beauty of nature has the power to influence individuals. Whitman’s poem explores transcendentalism by having the speaker go beyond science and math, the literal, and instead pursue a different approach to learning. The speaker’s departure from the traditional perspective of dense analysis broadens their perception of nature’s beauty, particularly with the nighttime sky. Likewise, Wordsworth’s poem addresses transcendence by focusing on the human curiosity of nature’s vastness. While Whitman mentions the continuity of stars in the sky, Wordsworth writes about the overwhelming presence of nature’s beauty, which surrounds the speaker. The film clips both include transcendent motifs when showing the protagonists enjoying their time surrounded by nature. Being outside in the wild provides Jake Sully in Avatar a connection with a wild beast, and it presents Doctor Zhivago with the freedom to daydream.
Delight and gratification are the culminating factors for individuals reaching transcendence. This is due to the visual effect that captures an individual’s mind, allowing them to personally connect and emotionally relate to their environment. After a unique bond with nature, the speakers allude to a greater power as they observe nature in admiration. The vastness of this transcendence sparks the curiosity in individuals and motivates them to be in wonder and awe. It is this transcendent power that is worth noting, as it shows readers that they are also capable of experiencing similar moments to marvel at the aesthetic qualities of nature.
"Avatar Flight with the Mountain Banshees." YouTube, uploaded by RoundxSeal, 3 Oct. 2015. https://www.youtube.com/watch?v=KYk0zVOAOgQ.
"daffodils." YouTube, uploaded by hotmonger, 1 Feb. 2011. https://www.youtube.com/watch?v=GGjpsvIYECM.
"transcendental, adj. and n." OED Online, Oxford University Press. January 2018. www.oed.com/view/Entry/204610. Accessed 27 Nov. 2017.
Whitman, Walt. "When I Heard the Learn'd Astronomer." 1865.
Wordsworth, William. "I Wandered Lonely as a Cloud." 1798.
Mass Incarceration in America
Najah Miller was born and raised in Oakland, CA and is currently twenty-one years old. She recently transferred from Berkeley City College, and is now a junior at SF State studying Communications. Najah is first and foremost a dancer, having trained for five years at Oakland School for the Arts. She teaches dance to kids ages seven to fifteen, and absolutely loves it. She hopes she can continue to be a role model, especially to African American youth. Najah has always loved to write, and has found it to be a great release and a way to express herself about issues that concern her.
COMMENT FROM LECTURER, JAY JACKL:
Najah’s writerly voice shines in this essay on the racial biases that engender mass incarceration in America. She synthesizes her rigorous research with her own critical perspective on the problem to create a dialogue with prominent voices from the field, while productively anticipating and addressing counterarguments. As discussed and practiced in our English 214 community, she enters the academic conversation on the consequences of this markedly pressing issue to craft an effective, persuasive argument on a self-chosen social (in)justice topic of personal interest. Her compelling, conversational style combines with appropriately situated engagement with evidential sources to present a strong, thought-provoking argument. Perhaps most impressive is that, within the page length boundaries of the assignment, she offers concise and relevant historical context for her audience to consider the severity of this important (and topical) social problem.
In the New York University Law Review, James Forman Jr. argues against the Jim Crow “analogy” being used for mass incarceration. Forman Jr. states, “analogizing mass incarceration to Jim Crow tends to suggest that something similar is at work today” (Forman, 12). That is exactly what myself and Michelle Alexander in her book The New Jim Crow (as well as many others) are arguing about mass incarceration. Mass incarceration is similar to Jim Crow because it specifically targets people of color, mainly men, and it has ruined opportunities for newly released prisoners, such as the right to vote, access to government services, and access to decent jobs and housing. Therefore, the analogy is perfect. Forman Jr. also argues that the Jim Crow analogy overlooks how mass incarceration also targets White people. The goal of speaking about the mass incarceration of Black men is not to discredit any other races and say that they are not of importance. There is a significantly large difference between the rate of incarceration of Black people over White people in this society, especially when it comes to drug crimes. So, no, the mass incarceration of White men is not going to be brought up in my argument or Michelle Alexander’s. As an African American woman, I am going to focus on getting the word about my community out to my community, and anyone else that will listen.
Where do I even start? Well, first, what is Jim Crow? The Jim Crow Laws were racist laws put in place to discriminate against Black people. These laws kept Black people separate from White people, and affected their daily lives. Black people had to use different facilities, live in different neighborhoods, attend completely different schools, and much more. Jim Crow laws did not make it easy for Black people to live their lives comfortably — it only made living life difficult, stressful, and almost unbearable. These laws extended to schools, churches, housing, restrooms, jobs, hospitals, and more (Alexander, 35). Today, mass incarceration of African American men is considered the new Jim Crow because of the laws that keep a felon separate from the rest of society, just like how Black people were kept separate under the Jim Crow Laws. As a felon, one is stripped of their natural born rights; they are legally denied the right to vote, denied access to obtain employment, housing, and public benefits. Sounds familiar, right?
American society has worked to destroy and tear down Black people since they brought Africans to America and made them slaves. Michelle Alexander explains how we have come to this mass incarceration of Black men. The United States has the highest rate of incarceration in the world, and imprisons a larger percent of its Black population than South Africa did during apartheid (Alexander, 6). The birth of mass incarceration in America began with the rhetoric of “law and order” during the 1950s (40). This law and order rhetoric was used by White officials in opposition to the Civil Rights Movement. Civil rights protests were mostly depicted as criminal rather than political, and federal courts were accused of “lenience” toward lawlessness, which contributed to the spread of crime. There is not one specific reason why crime began to spread, but while civil rights were being labeled a threat to law and order, crime shot up. Throughout the 1960s riots broke out in urban communities, street crime rose, and homicides doubled (41). Black people during this time experienced extremely difficult times economically, and they lost a key figure to the Civil Rights Movement with the assassination of Dr. Martin Luther King. Black people were being harassed and abused by police, and still had to abide by Jim Crow Laws; the anger and pressure in Black communities was high. White conservatives and officials used this time to really crack down on Black communities, and did not distinguish between direct action tactics of civil rights activists, violence in inner cities, and traditional crimes (43).
Fast forward to Ronald Reagan’s War on Drugs campaign, which “had little to do with public concern about drugs and much to do with public concern about race” (49). When the drug war began, inner-city communities were suffering from an economic collapse. The factory jobs that were available for African Americans during the ‘50s and ‘60s vanished. Technological changes within the workplace affected the less educated and less skilled workers, which included mainly to African American men, leaving jobs for only the highly educated workers (50). This decline in employment increased the incentive to sell drugs, mostly crack cocaine. Crack hit the streets in 1985, leading to an increase in violence resulting from the anger and frustration of jobless individuals (51). Black men were selling crack to help their families, as well as using crack to escape harsh realities, which resulted in dangerous and hostile actions such as fighting, shooting, stealing, and even killing. In September 1986, the Anti-Drug Abuse Act was signed, placing harsh penalties such as mandatory minimum sentences and more severe punishments for distribution of crack cocaine (53).
It is no secret that African American men were targets. Black men are specifically seen as a threat to this society and the systematic oppressions that I have discussed so far proves that. Is it that Black men are too strong? Are they too intelligent? Do they have too much potential? The answer is yes, and I believe that truth scares society. I honestly do not know if there is a specific answer to why Black men have continued to endure the amount of oppression, harassment, and profiling that they have, but I believe fear has a lot to do with it. The fear of what Black men can and will become makes this society only want to tear them down more. Black people having rights and prospering in this society is not wanted. White people, government officials, the prison system, and American society are continuously attempting to destroy Black people and their communities, but there’s one man’s story that defied all odds, and fought against the system.
Kalief Browder was born a “crack baby,” meaning that his mother was a crack addict, and he was separated from his biological mother immediately and put into the foster care system. In the documentary, Time: The Kalief Browder Story, Michelle Alexander explains that how instead of Kalief’s mother receiving the proper help, like rehab or a treatment facility, she was labeled a “felon,” and put in prison with no help or treatment. As another example of what the “War on Drugs” did to the Black community, the story of Kalief Browder is both shocking and inspiring. Kalief Browder was sixteen when he was arrested for allegedly stealing a backpack in New York. He spent almost three years in Rikers Island, more than half of which was spent in solitary confinement. He was a sophomore in high school, simply on his way home from a party when he was stopped by the police, and that is not even the worst of it. The documentary shows the horrible mistreatment Kalief endured while at Rikers Island. He was beaten by correction officers and other inmates, as well as starved in solitary confinement for an excessive amount of time. During the three years Kalief was at Rikers nearly thirty of his court dates were rescheduled, for many different excuses. The courts could not bring forward a witness for his case, but he still served time for a crime that he ALLEGEDLY committed. What is extraordinary about Kalief’s story is that every time he went to court, hoping he would be able to go home, the judge would ask him to plead guilty — but he refused every time. He refused to be labeled a felon, he refused to give in to a system wanting him to fail, he refused to give up, and he refused to further the stereotype.
Kalief’s charges could have been dropped any one of those times he went to court, but that did not happen. They kept him locked up and away from his life, and he did not deserve that. Sadly, after being released with all charges dropped, Kalief took his own life. He explains in the documentary how he felt “demons” were constantly with him — not from what he had done, but from what he saw and experienced at Rikers. It affected him negatively in every way possible, and he took his life because of it. I believe Kalief’s story is important and an example of how our “justice” system fails Black men. His story is an example of how Black men are profiled, how Black men can be wrongfully arrested, and serve time for a crime they did not commit; this is not new. Kalief just endured the worst of it.
Despite this evidence, Stephanos Bibas, a University of Pennsylvania law and criminology professor and former prosecutor, argues in his article “The Truth about Mass Incarceration,” that: “There is no racist conspiracy, nor are we locking everyone up and throwing away the key. Most prisoners are guilty of violent or property crimes that no orderly society can excuse” (Bibas, National Review). Here Bibas is including everyone in the conversation, which is fine, but this is not an “All Lives Matter” type of issue. He is correct that we are not “locking everyone up and throwing away the key,” but we are doing that to many African American men. Kalief Browder’s story can be used as an example of someone that we gave up on and simply just locked up without turning back — and he is not the only story either.
The mass incarceration of Black men in this country is a serious matter for our society. It has become a way to legally repeat history and it has got to stop. Fathers, uncles, and brothers are taken away from their families every day, and given much longer sentences than our White counterparts. Once Black men are labeled as felons, their lives change dramatically. Imagine not being able to vote anymore, not being able to get a decent job, or have access to government services when you need it the most. These men and boys that are placed in prison for unnecessary amounts of time lose out on so much. I believe once these men are released there should be a program in place to get them back on their feet. They should not be released into the world with nothing to look forward to — they should be released and be inspired to change and do better for themselves.
Alexander, Michelle. "The Rebirth of Caste." New Jim Crow: Mass Incarceration in the Age of Colorblindness, New Press. 2016.
Bibas, Stephanos. "The Truth about Mass Incarceration." National Review. 16 Sept. 2015. www.nationalreview.com/article/424059/mass-incarceration-prison-reform
Forman, James Jr. RACIAL CRITIQUES OF MASS INCARCERATION: BEYOND THE NEW JIM CROW. Westlaw, Apr, 2012. www.naacpldf.org/files/case_issue/Racial%20Critiques%20of%20Mass%20Incarceration.%20Beyond%20the%20New%20Jim%20Crow%20(00033884).PDF.
Furst, Jenner. Director. Time: The Kalief Browder Story. Netflix. www.netflix.com/watch/80187140?trackId=14170068&tctx=0%2C0%2C04476eb3-2160-438b-879c-91485d7096ad-160210923.
The Role of the Technocrat in American Environmental Politics
Robert is a junior at SF State majoring in Environmental Studies with a concentration in sustainability and social justice. His academic interests are narrowly focused on the impacts of climate change on forest ecology. His personal interests are broad but can be defined as an interest in the intersection of politics, science, society and identity. From 2014-2017 he freelanced as a photojournalist and has published numerous photo essays and stories with publications such as the New York Times, The Intercept and The Guardian US. Upon graduation, Robert plans to pursue a PhD in Environmental Systems and forest ecology in California's Sierra Nevada mountain range.
ROBERT’S HONORS ESSAY WAS WRITTEN FOR DR. LOU SCHUBERT AT CITY COLLEGE OF SAN FRANCISCO
Environmental policy in the United States can be traced to technocrats who lead agencies within the government. Technocrats are scientists who have been appointed to lead executive agencies because of their technical expertise. Because they are appointed to their roles rather than elected, technocrats operate in a world between politics and science. Technocrats' power lies in their capacity to navigate the world of policy from an evidence-based perspective. In this paper, I analyze the influence of technocrats on modern American environmental politics. Looking at the trajectory of some key environmental policies, regulations, and achievements over the past 100 years, this paper illustrates the ways in which technocrats have come to influence American environmental policy. In a time of mounting environmental challenges, understanding the forces at play that determine the United States’ response to these challenges is imperative.
Keywords: Technocrats, environmental politics, policy, regulations
Max Weber outlines the organization of a bureaucracy in his book The Theory of Social and Economic Organization (2012). Weber describes several types of authority and the roles of government officials, elaborates on the process by which authoritative figures are selected, and illustrates the relationship between authoritative figures. Weber’s text is a significant source on which this paper is based since it provides the framework I use to analyze the role of technocrats in the United States government.
In "Beyond the Technocrat? The Professional Expert in Development Practice" (2016), Gordon Wilson analyzes the role of the technocrat via depoliticization of development. Though Wilson’s article focuses on the development practices in the Third World, it serves to help in the quest to understand, define, and discover technocrats in modern American environmental politics.
The role of the technocrat encompasses the regulation of the natural environment on which human life relies. Francis Fukuyama writes about the organization and initial goals of the United States Forest Service (USFS) in his paper “America in Decay: The Sources of Political Dysfunction” (2016). Fukuyama describes the process used to hire each member of the USFS, in which their technical merit formed the basis of their qualification for the position. Rather than hold an election in which citizens of the United States decide who should run the Forest Service, this agency has been staffed with the highest echelon of technical experts, a process which continues today (Fukuyama 2016).
What is a Technocrat?
The myriad executive agencies that are part of the United States government are staffed, controlled and influenced by technical experts, referred to as “technocrats.” The United States operates in a system of bureaucratic organization in which decisions are not made solely by elected representatives but in tandem with executive agencies whose members, hereby referred to as technocrats, are appointed based on their experience and technical expertise. A technocrat is defined as someone with a highly technical background and extensive experience in a field who occupies a position within a government as an appointed official at the top of their field (Weber 2012). When a technocrat’s appointment to an executive agency is being decided, their level of education and experience in the field are weighed against the goals of that agency. This method of selection remains relatively uniform within the administrative staff of a bureaucracy (Weber 2012). In politics, the technocrat serves as a state official with their level of authority determined by technical knowledge and experience.
Why the Technocrat?
Elected officials are chosen based on the consent of voters, whereas appointed officials are chosen based on their technical abilities, accomplishments, and experience. A single ‘head of state’ exercises control over every appointment, a system which Weber (2012) refers to as monocratic. In contrast, the legislative branch makes decisions collectively. However, a defining aspect of the legislative branch within the United States government is the complicated decision-making process that takes place.
In Congress, a body comprised of representatives who are supposed to reflect the sentiments of the people they represent, clashes of ideologies often occur (Weber 2012). This becomes problematic when critical decisions must be made, and this has become increasingly common in modern times (Mann 2008). Decision-making is expedited in the case of the technocrat as the sole decision-maker for a regulatory agency like the Environmental Protection Agency or National Oceanic and Atmospheric Administration. Regulations like those on deep-water oil drilling, fisheries, US Forest Reserves, endangered species or major industries such as oil, gas and coal would be difficult to implement within the necessary timeframe if left up to Congress.
The monocratic system, however, is capable of a high degree of efficiency since the head of state maintains the ability to make final decisions and operate with a sense of autonomy, further enhancing their capabilities of efficient rule (Weber 2012). The benefits of this system lie in the role of knowledge of the appointed technical experts. The appointed official with the technical understanding of a given issue can establish a pattern of technically plausible solutions, and while the elected official may have some power over the law establishing body, the official with technical knowledge and ability to solve the issues at hand will be better suited to set effective policy.
Weber (2012) discusses how the technical expert, being appointed rather than elected, retains more power than the elected official. Because elected officials often operate based on the feelings of the people they represent, the power of government is limited. This is helpful to democracy but harmful to effective policy-making. Technocrats, on the other hand, have been appointed to their position by the president based on their ability to perform in a technically proficient manner. The ability of a technocrat to gather evidence and prove their theories serves to reinforce their power (Weber 2012).
In the United States, the government agency responsible for environmental matters is the Environmental Protection Agency (EPA). When Congress fails to pass or even introduce legislation to protect the environment, the EPA can set regulations to do so. When a new chemical is produced and threatens to destroy the environment, the EPA can act to classify and regulate that chemical. Technocrats have demonstrated that their expertise in environmental science is the best chance we have in addressing environmental degradation. That expertise explains why presidents listen to their Science Advisor and why Congress requests scientists to testify on the floors of the House and Senate to help them comprehend problems faced by the American people. Nuanced facts in science—such as that when analyzing global climate change, long-term trends show temperatures rising overall, while short-term trends show temperatures fluctuating from high to low—demonstrate the need to have these technical experts decide the best possible course of action (Hansen 2010).
A History of Technocrats in American Environmental Politics
Beginning in the late nineteenth century, pioneers of conservation promoted the role of the technical expert in government to solve humankind’s most difficult problems. The establishment of the US Forest Service (USFS) weighed the technical knowledge of its employees when determining their eligibility. The first Chief of the Forest Service, Gifford Pinchot, championed this method to demand autonomy from the complications of Congress (Fukuyama 2014).
Pinchot, a graduate of Yale University who went on to study forestry in France, was hired by the National Academy of Science to research forest areas for possible reserves. His years of education and experience in the field led to his being appointed by President Theodore Roosevelt as first Chief of the Division of Forestry. When the management of the forest was moved to the Department of Agriculture and the United States Forest Service was established, Pinchot was named chief (Forest History).
Under Pinchot, the number of National Forests grew from 60 to 150 within five years, from 56 million acres to 172 million acres (Forest History). Pinchot’s commitment to conservation and protecting the environment set the tone for the USFS. However, in January of 1907, controversy erupted over the recently declared forest reserves in Washington. After Roosevelt repealed his decision, a bill was drafted to remove the president’s power to declare any future reserves in the Pacific Northwest. However, the night before the bill was signed into law, Pinchot and the president worked to establish 16 million more acres of reserves in this region, ensuring the indefinite protection of these fragile ecosystems. Roosevelt believed firmly in the role of experts in the conservation of natural resources. In 1908, he established a National Conservation Commission to “inquire into and advise him as to the condition of our natural resources.” This commission’s report was used by the President in his efforts to conserve our natural resources (Williams 2005). The legacy provided by Pinchot’s achievements set the stage for technocrats playing a key role in politics and policymaking.
Hugh Hammond Bennett, who held a bachelor's degree in chemistry and geology and worked as a surveyor for the USDA Bureau of Soils, set another important precedent for technocrats working in government. Witnessing the devastating effects of soil erosion on rural farming communities, Bennett published his seminal work, Soil Erosion: A National Menace, in 1928 to mobilize the federal government into action. In 1928, Bennett persuaded Congress to create the first federal erosion experiment stations and, in 1932, President Roosevelt championed the rhetoric of protecting the country from the threat of soil erosion. The National Industrial Recovery Act was passed in June of 1933 which formed the Soil Erosion Service and allocated funds to fight soil erosion. Bennett was appointed the head of the SES and spearheaded new projects in eroded regions that showed landowners the benefits involved in conservation (NRCS Staff). Bennet went on to influence Congress’s passing of the Soil Conservation Act of 1935 and often found himself testifying before Congress to pass soil conservation legislature. In 1935, the Soil Conservation Act was passed, establishing the Soil Conservation Service and Bennett was appointed chief (NRCS).
In 1952, President Truman appointed physicist Lee A. Dubridge as chairman of his Science Advisory Committee (Bronk 1974). In 1969, after retiring from his position at the California Institute of Technology (CalTech), Dubridge went on to become President Nixon’s Science Advisor, a role that lasted 18 months (Greenstein 1997). In 1969, Nixon established by executive order the Environmental Quality Council, led by Dubridge. This was a “cabinet level advisory group,” as Nixon called them, whose main goal was to advise the executive branch on methods to protect the environment (Nixon 1969).
The National Environmental Protection Act was signed into law by President Nixon in 1969. This act required that all governmental agencies complete Environmental Impact Statements (EIS) for any activity that could impact the human environment. A critical component of this act was to create the Council on Environmental Quality (CEQ) within the executive branch. Although Nixon had previously created a similar council, the formality of the CEQ’s construction reflected the influence and role of the technocrat in protecting the environment. When the Environmental Protection Agency (EPA) was established, Nixon listed “[t]he conduct of research on the adverse effects of pollution and on methods and equipment for controlling it, the gathering of information on pollution, and the use of this information in strengthening environmental protection programs and recommending policy changes” as one of their principal roles (Nixon 1970). In broad terms, the EPA is mandated with setting and enforcing pollution control standards and is required to base its decisions and policies on science.
Rather than advise on policy, as many other executive agencies are tasked with doing, the EPA creates its own policies through regulations that are binding and must be followed by every American. For example, an important accomplishment of the EPA is its ban on lead-based interior paint (EPA Press Release 1995). For decades, Americans used lead-based paint in their homes, which led to thousands of reported illnesses. The agency’s ability to use science to detect lead-based paint poisoning was paramount in their efforts to stop its use in consumer products.
When the pesticide DDT entered the spotlight in 1962, many Americans became concerned with the environmental damage it caused. A decade later, in 1972, the EPA issued a cancellation order based on “its adverse environmental effects.” To this day DDT is banned for every use except the control of malaria in the United States (DDT). The EPA’s control of hazardous waste is also important. The agency’s existing hazardous waste regulatory program influenced Congress’s crafting and passing of the Hazardous and Solid Waste Amendments of 1984. After Congress passed the Resource Conservation and Recovery Act of 1976, the EPA was charged with setting standards for generators and transporters of hazardous waste. Many of the amendments reflected already established actions of the EPA and only helped to strengthen their necessity (EPA Press Release 1984).
In 1976, Congress passed the National Scientific Policy, Organization and Priorities Act. The act established the Office of Science and Technology Policy (OSTP) within the Office of the President whose primary function is to provide advice on the scientific aspects of issues that require the attention of the highest levels of government. The OSTP, or the director of the OSTP, serves as a source of scientific analysis on governmental policies and programs. Up until this point, presidents would form and disband their science and technology advisory councils, thus leaving a path of inconsistency and impermanence. Once the OSTP was made part of legislation, it imbued a lasting importance by ensuring the presence of sound, scientific analysis in all future administrations (Sargent 2016).
President George H. W. Bush signed The Global Change Research Act of 1990, which mandated the establishment of the U.S. Global Change Research Program (USGCRP). The primary function of the USGCRP is to “develop and coordinate a comprehensive and integrated United States Research Program which will assist the nation and the world to understand, assess, predict, and respond to human-induced and natural processes of global change.” Furthermore, Section 102 of the Global Change Act establishes a Committee on Earth and Environmental Sciences whose role is to consider problems and developments in the field of science and recommend policies (Legal Mandate). This committee consists of representatives from a variety of scientific agencies, such as the EPA and Department of Energy. The requirement to join this Committee is that each member must be a high-ranking official of their department or agency; they must be technocrats by definition (USGCRP).
In the description of Reorganization Plan No. 4, which was established in 1978, the National Oceanic and Atmospheric Administration (NOAA) was formed, and they launched into years of research into the climate and the effect human civilization was having on the climate. The 1978 National Climate Program Act allowed NOAA to formulate a National Climate Program Plan (Shea 2006). After the appointment of Dr. Jane Lubchenco as head of the administration, NOAA made several significant strides, among them their response to the Deepwater Horizon Spill in 2010, after which they immediately launched research programs to understand the disaster more fully (Samenow 2012). The results of research conducted by NOAA on the use of dispersants helped the administration define the risks and trade-offs of using chemical dispersants in response to oil spills (Helton 2015). While their scientists already suspected that some of the trade-offs of using chemical dispersants include spreading the oil deep into the water column, where it could potentially harm other marine life, their research made it clear that there were serious trade-offs and that each situation had to be approached carefully (Helton 2015). Because of this research, the United States gained the ability to better respond to future spills and to set internal regulations on how to respond, as well as directly regulating the industry responsible for the spill.
Dr. Lubchenco’s ability to combine political goals—such as setting the Scientific Integrity Policy, the nation’s first National Ocean Policy, reforming the international fishery management organizations to be more in line with current science and establishing grants for coastal conservation—with scientific goals like endangered species conservation, improved weather-forecasting capabilities, and the promotion of climate, weather and ecosystem science was a major step forward in environmental protection and policy. Using the research gathered by NOAA, the Department of the Interior established an aggressive regime of regulations to restrict the possibility of a similar event taking place. These regulations include the addition of heightened well-design standards and the requirement for operators to prove access to blowout safety and control equipment prior to approval for deepwater operations (Department of Interior). These regulations were a direct result of the level of technical expertise that allowed NOAA to conduct high-quality, scientific research in the wake of the Deepwater Horizon Oil Spill.
Over the past 100 years, the United States government has increasingly relied on the expertise of technocrats for setting environmental policy. The United States has lawyers in Congress who set and challenge environmental laws, but frequently these laws are influenced by the research and regulations put forth by technocrats who are better equipped to assess the impacts of policy. Society has become increasingly complicated over the roughly 200-year history of the United States. Industrialization has fueled decades of economic growth, but it has also resulted in the prolonged squandering and use of our natural resources. These shortfalls, combined with the results provided by the few technocrats spread across the government, demonstrate the need for more technical approaches to our problems and how significant an impact these approaches can have on our environment.
The role of science and scientists in government can be complicated. On one hand, the threat of politicizing science has the potential to create a climate of doubt around the accuracies of science and disbelief of sound science. It becomes increasingly easy for political opponents to dismiss science in the political realm as an extension of a specific administration’s agenda. On the other hand, the accomplishments of science in government have been especially important in leading to sound environmental policy, independent of the political affiliations of the administration under which these technocrats serve.
The technocrat is alive and well in American environmental politics and has been for well over a century. Many of the United States’ environmental regulations have been influenced by appointed officials with the technical expertise to understand the importance of protecting our environment and how to do it. This makes clear the fact that modern environmental politics in America would not exist without the technocrats.
Bronk, Detlev W. "Science Advice in the White House." Science, vol. 186, no. 4159, 1974, pp. 116-121. JSTOR, JSTOR, www.jstor.org/stable/1738135.
Chasek, Pamela S., Downie, David L., Brown, Janet Welsh. Global Environmental Politics. 6th Ed. Boulder: Westview Press, 2014. Print.
Council on Environmental Quality, The: "CEQ 25th Anniversary Report." https://clinton4.nara.gov/media/pdf/front_1.pdf
DDT - A Brief History and Status EPA. https://www.epa.gov/ingredients-used-pesticide-products/ddt-brief-history-and-status Department of Interior, "Reforms Since the Deepwater Horizon Tragedy." https://www.doi.gov/sites/doi.gov/files/uploads/5%20YR%20DWH%20fact%20sheet-%20DOI%20April%202016%20BSEE%20update.pdf
EnerKnol Research, "New Offshore Oil Regulations Respond to Key Failures of Deepwater Horizon Spill." 27 April 2015. http://breakingenergy.com/2015/04/27/new-offshore-oil-regulations-respond-to-key-failures-of-deepwater-horizon-spill/
EPA Press Release. "A Look at EPA Accomplishments: 25 Years of Protecting Public Healthand the Environment." EPA. 1 December 1995. https://archive.epa.gov/epa/aboutepa/look-epa-accomplishments-25-years-protecting-public-health-and-environment.html
Etnoyer, P., Wickes, J., Silva, L., Dubick, N., Balthis, M., Salgado, D., & MacDonald, L. (2016). Decline in condition of gorgonian octocorals on mesophotic reefs in the northern Gulf of Mexico: Before and after the Deepwater Horizon oil spill. Coral Reefs, 35(1), 77-90.
Executive Office of the President, "The President's Climate Action Plan," June 2013. https://www.whitehouse.gov/sites/default/files/image/president27sclimateactionplan.pdf
Fukuyama, Francis. "America in Decay." Foreign Affairs. 26 Oct. 2016. Web. 26 Oct. 2016. https://www.foreignaffairs.com/articles/united-states/2014-08-18/america-decay
Greenstein, Jesse L.: "Lee Alvin DuBridge 1901-1994." National Academies Press. 1997. http://www.nasonline.org/publications/biographical-memoirs/memoir-pdfs/dubridge-la.pdf
"Guardian, The: Origins of the EPA." 1992. https://archive.epa.gov/epa/aboutepa/guardian-origins-epa.html
Hansen, J. "Global Surface Temperature Change." 14 December 2010. http://onlinelibrary.wiley.com/doi/10.1029/2010RG000345/full
Helton, Doug. "What Have We Learned About Using Dispersants During the Next Big Oil Spill?" http://response.restoration.noaa.gov/about/media/what-have-we-learned-about -using-dispersants-during-next-big-oil-spill.html
Henry, Charlie "Recalling the Early Hours - and Challenges - of the Deepwater Horizon Oil Spill." http://response.restoration.noaa.gov/about/media/recalling-early-hours-and-challenges-deepwater -horizon-oil-spill.html
Holdren, John P. "Statement: Intergovernmental Panel on Climate Change Approves Physical Science Report" 27 September 2013. https://www.whitehouse.gov/blog/2013/09/27/statement-intergovernmental-panel-climate-change-approves physical-science-report
Incardona, J., Gardner, L., Linbo, T., Brown, T., Esbaugh, A., Mager, E., . . . Scholz, N. (2014). Deepwater Horizon crude oil impacts the developing hearts of large predatory pelagic fish. Proceedings of the National Academy of Sciences of the United States of America, 111(15), E1510-8.
Inman, Mason. The Oracle of Oil. New York: W. W. Norton, Inc. 2016. Print.
Klein, Roberta. Pielke, Roger Jr. "The Rise and Fall of the Science Advisor to the President of the United States" Springer Science and Business Media. 2009 http://sciencepolicy.colorado.edu/admin/publication_files/resource-2719-2009.05.pdf
Legal Mandate, U.S. Global Change Research Program "Sec. 102 Committee on Earth and Environmental Sciences" http://www.globalchange.gov/about/legal-mandate
Luther, Linda: "The National Environmental Policy Act: Background and Implementation." Congressional Research Service Library of Congress. 16 November 2005.http://nationalaglawcenter.org/wp-content/uploads/assets/crs/RL33152.pdf
Mann, Thomas, and Norman J Ornstein. The broken branch how Congress is failing Americaand how to get it back on track. Oxford University Press, 2008.
Neal F. Lane, Kirstin R.W. Matthews, "The President's Scientist." Cell, Volume 139, Issue 5, 25 November 2009 (http://www.sciencedirect.com/science/article/pii/S0092867409014366)
Nixon, Richard: "Special Message to the Congress About Reorganization Plans to Establish the Environmental Protection Agency and the National Oceanic and Atmospheric Administration," July 9, 1970. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ws/?pid=2575.
Nixon, Richard: "Statement Announcing the Creation of the Environmental Quality Council and the Citizens' Advisory Committee on Environmental Quality," May 29, 1969. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ws/?pid=2077.
NOAA Administrative Order 202-735D: Scientific Integrity http://www.corporateservices.noaa.gov/ames/administrative_orders/chapter_202/202-735-D.html
NRCS, "Biography of Hugh Hammond Bennett." http://www.nrcs.usda.gov/wps/portal/nrcs/detail/national/about/history/?cid=nrcs143_021410
NRCS Staff "80 Years Helping People Help the Land: A Brief History of NRS." http://www.nrcs.usda.gov/wps/portal/nrcs/detail/national/about/history/?cid=nrcs143_021392
Office of Response and Restoration "Deepwater Horizon Oil Spill Tied to Further Impacts in Shallower Water Corals, New Study Reports." 26 October 2015http://response.restoration.noaa.gov/oil-and-chemical-spills/significant-incidents/deepwater-horizon-oil- spill/deepwater-horizon-oil-spil
OSTP Initiatives, "Combating Climate Change." https://www.whitehouse.gov/administration/eop/ostp/initiatives#Climate
Pinchot, Gifford. "Breaking New Ground." Island Press. 1998.
President's Advisory Council on Executive Organization. "Memorandum for the President SUBJECT: Federal Organization for Environmental Protection." 29 April 1970. https://archive.epa.gov/epa/aboutepa/ash-council-memo.html
Samenow, Jason. "NOAA Administrator Jane Lubchenco Stepping Down in February." The Washington Post. 12 December 2012. https://www.washingtonpost.com/blogs/capital-weather-gang/post/noaa-administrator-jane-lubchenco-stepping-down-in-february/2012/12/12/b9edb47c-4477-11e2-9648-a2c323a991d6_blog.html#pagebreak
Sargent, John F. Jr. Shea, Dana A. "Office of Science and Technology Policy (OSTP): History and Overview." Congressional Research Service. 22 June 2016. https://www.fas.org/sgp/crs/misc/R43935.pdf
Scott, Howard. "History and Purpose of Technocracy." 1965 https://archive.org/stream/HistoryAndPurposeOfTechnocracy.howardScott/HistoryAndPurposeOfTechnocracy.howardScott.pd-2_djvu.txt
Shea, Eileen L. "A History of NOAA" National Oceanic and Atmospheric Administration, NOAA Central Library. 8 June 2006 http://www.history.noaa.gov/legacy/noaahistory_1.html
Weber, Max The Theory of Social and Economic Organization. Mansfield Centre: Martino Publishing. 2012. Print.
Williams, Gerald W., Ph.D. "The USDA Forest Service - The First Century." 2005. http://www.fs.fed.us/sites/default/files/media/2015/06/The_USDA_Forest_Service_TheFirstCentury.pdf
Wilson, G. (2006), Beyond the Technocrat? The Professional Expert in Development Practice, Development and Change, 37: 501-523. doi:10.1111/j.0012-155X.2006.00488.x
An Analysis of Pitch in Lesbian Identity
Madeline Thompson is a senior in English Linguistics at SF State from Sacramento, California. She is graduating in May of 2018 and plans to pursue an MA in Linguistics in the following fall semester.
The author has taken courses in phonology, morphology, syntax, and, most notably for her interests, sociolinguistics. The last of these resonated the most with Madeline, specifically the sections surrounding queer linguistics. As a gay woman, she has a special interest in further understanding the intricacies of language use in the gay community. Research such as this allows her to explore her interests in depth while also helping her to contribute her voice and research to the relatively small community of queer linguistics. Madeline’s goal is to bring more awareness to this community and by doing so hopefully increase others’ understanding and acceptance of it as well.
COMMENT FROM PROFESSOR TERESA PRATT:
Madeline's research paper explores the use of pitch variation among two lesbian-identified YouTube personalities, using data from their popular lifestyle vlogs. She demonstrates that these two YouTubers utilize different pitch patterns in the construction of two distinct lesbian identities -- femme and butch. Further, the two speakers exhibit different pitch range patterns across different speech contexts -- when introducing themselves and the particular vlog installment, as opposed to a stretch of speech that is particularly emotionally charged. In highlighting the within-group variation among lesbian speakers, this work contributes an important and understudied perspective to sociolinguistic scholarship.
The study of lesbian speech occupies a relatively small part of the already young field of sociolinguistics. Researchers in this area have frequently studied linguistic variation on the basis of gender, class, region, and other factors. More recently, sexual identity entered into this mix as well. However, those that have researched lesbian speech have largely only used it as a comparison to gay men’s and heterosexual women’s speech; few studies have focused on the differentiation that occurs within the community itself. Lesbian women typically fall onto a masculine-feminine spectrum with more masculine women being known as “butches” and more feminine women as “femmes.” This paper aims to contribute to the study of sociolinguistics by exploring some of the speech contours and intricacies used by butches and femmes. In doing so, I hope to shed light on this topic because it allows us to see how linguistic variables differ in a relatively understudied community. It also gives us an insight into the agency that these people undertake to align themselves more with one characteristic over another.
In order to study crosslinguistic variation in the lesbian community, I have chosen to focus on the use of pitch by two popular YouTube vloggers: Ingrid and Sarah. Specifically, I am studying how my speakers’ pitch changes based on the topic of conversation, namely introductory or emotional. An analysis of these YouTubers’ pitch reveals that the woman who identifies as butch, Sarah, utilizes a wider range in an emotional setting than when she introduces herself in a video. The opposite is true for Ingrid, my femme speaker; she maintains a bigger range in her introduction and a smaller one when telling an emotional story.
In this paper, I will first present research conducted by sociolinguists that explains why I have conducted my case study. In this section, I will discuss previous studies that demonstrate a gap in knowledge, which my paper will help fill. I will then present my methods, analysis, and interpretation, explaining in detail what the numbers I have collected regarding my speakers’ pitch means for how they index their identities as masculine or feminine. Finally, I will conclude with a discussion on possible avenues for further research on lesbian speech, as well as sexuality-based speech in general. While my study uses pre-recorded data from YouTube rather than organic speech, it remains useful to study because it provides insight into these speakers’ perhaps unconscious attempts at communicating identity.
For my project, I am focusing on how butch and femme lesbians index their masculinity or femininity through their suprasegmental speech patterns, such as pitch. In order to do this, I have first looked up resources to define what exactly the differences are in speech perceived as masculine versus feminine. One study by Brown shows that the variable /s/ is perceived as more feminine if it has a high center of gravity (2015, p. 135). Another paper by Linneman looks at the occurrences of up-talk in male and female speakers, and this study finds that women are more prone to using uptalk, especially if they are young and white (2013, p. 1). Studies such as these show that there are clear differences between stereotypically masculine and feminine speech. This information sets a background for variables that typically index a more masculine or feminine identity. These variables can be seen in two ways: performing and perceiving. As the above studies show, people associate certain speech patterns with certain gender identities. A person who uses many high frequency /s/ variables may be perceived as being feminine. They may also choose to utilize other more feminine variables, such as uptalk, to index a feminine persona, for example. This is the performative nature of language. Overall, these studies reveal that a higher pitch is associated with femininity, including pitch excursions that rise dramatically.
Given these stereotypes surrounding gender-differentiated speech, one may wonder how this intersects with lesbian speech specifically. One study in particular by Kulick reveals several linguistic stereotypes that lesbians engage in, including their use of cursing, “hypercorrect grammar,” and flat intonation (2000, p. 26). It is important to note that Kulick does not specify whether the lesbians that she studied identified as more masculine or feminine; she instead discusses a general stereotype of lesbian speech. Kulick also cites a fascinating study by Moonwomon-Baird, which found that “one of the primary ways in which lesbians may index themselves (and are thus able to identify one another) is through the decidedly marked combination of a number of linguistic styles” (p. 20). Again, stereotypes surrounding lesbian speech patterns surface. Judging by these sources as well as my own personal experience, the lesbian archetype is a woman who is on the masculine side of the butch-femme spectrum; her swearing and relatively flat intonation typically do not align with the standard female speech that I discussed earlier. Queen reveals that this stereotyped lesbian typically “[has] narrower pitch ranges than straight women” (2014, p. 7). This research demonstrates that looking at this community as a whole, instead of in a more detailed way, can reinforce traditional stereotypes. Therefore, while these studies do focus specifically on lesbian speech styles, they are still very broad, and so I have endeavored to also find sources that look inside the lesbian community itself.
Of the papers that study variation in lesbian speech, few focus on the differences within the lesbian community. Gibson and Meem offer one perspective, explaining that society “[assigns] us to qualities that link butch and femme with stereotypes of men and women” (1996, p. 15). This study draws attention to the connections between butch and femme identities and male or female linguistic variables. I believe it’s necessary to note that there is a connection there in the first place; even the names butch and femme demonstrate this association. Additionally, Inness and Lloyd point out that within the lesbian community, “[b]utch was seen as male-identified, and femme was seen as selling out to the traditional feminine stereotypes of women” (1995, p. 3). For the purposes of my analysis, this point is useful because it shows that femmes tend to adopt linguistic styles associated with straight (and feminine) women, while butches do the opposite.”
As I have pointed out, there is a surprising lack of research on specific linguistic variables regarding butch and femme lesbians. Therefore, I am focusing on how lesbians who identify as more masculine or feminine index and perform these identities through their use of pitch. We know some of the differences between stereotypical straight and lesbian women, as well as between masculine and feminine styles, but there is a surprising lack of sociolinguistic research within the lesbian community. My research regarding how femme and butch speakers perform their identities sheds light into the bricolage each speaker uses; modifying their clothing, hairstyles, speech, and other factors allows lesbian speakers to perform their identities.
In order to conduct my study on lesbian speech, I first researched possible candidates that self-identified as butch or femme. I chose YouTube as my specific platform because many, many vloggers use it to share their stories. The two YouTubers that I chose are Ingrid Nilsen and Sarah Croce, both popular lifestyle vloggers. Ingrid is a 28-year-old femme lesbian from Orange County, CA. Sarah is 33-year-old a butch lesbian who is originally from Providence, RI but now resides in California. Both of my speakers are Caucasian and of western European descent.
For my study, I chose one video per speaker to analyze. To maintain consistency, each video that I picked covered the same topics: shopping, fashion, and clothing. Ingrid and Sarah’s videos also follow the same format. First, there is an introduction, where they introduce themselves and the topic of their video. Next, the YouTubers tell their stories in the body of the video, which is split up into sections as indicated by the creator’s editing. Finally, they conclude by requesting that viewers subscribe and “like” their video. For my purposes, I analyzed 10 intonational phrases (IPs) in the introduction section as well as in the body of each video, specifically where the speaker told an emotional story. I therefore had 20 phrases for each YouTuber.
Using the data that I had transcribed using Elan, I conducted a pitch analysis using the Praat pitch finder. I adjusted for mechanical error only on the IPs that showed dramatic pitch excursions that the speaker clearly did not take. As I analyzed each IP, I compiled in an Excel spreadsheet the absolute minimum, maximum, and range pitches for each speaker as well as averages of all these measurements. Using this data, I created bar charts as well as Praat Picture diagrams to display and analyze my results.
My analysis of my data collected through Elan and Praat demonstrates that Ingrid and Sarah each employ pitch in a different way depending on what they are discussing. When they are greeting their respective audiences, Ingrid consistently maintains a higher pitch and wider range when she speaks. On the other hand, Sarah’s pitch is lower overall and her intonation flatter. This pattern can be seen in Figure 1 below. All numbers denote F0 frequencies in Hz.
Figure 2 details this shift.
In addition to these tables, there are also four Praat Pictures contained in Appendix A. There are two pictures per speaker, and of these two, one is an example of introductory speech while the other shows emotional speech. Sarah’s examples, Figures 3 and 4, demonstrate the shift in pitch range discussed in the earlier tables. In Figure 3, Sarah is beginning to introduce herself and the topic of her video; this example shows that her pitch is relatively flat throughout the IP. Figure 4, on the other hand, occurs in the middle of Sarah’s emotional story where she recalls her discomfort of being the only woman trying on men’s clothes in a store dressing room. This picture contains a much more dramatic pitch range than in Figure 3, showing a contrast between normal introductory and emotional speech.
After Sarah’s Praat Pictures, Ingrid’s examples are contained in Figures 5 and 6. The first of these, Figure 5, is taken from the beginning of Ingrid’s video as she introduces herself and her dog, Tayto. This picture shows that Ingrid uses dramatic pitch in an introductory setting. This pattern reverses once Ingrid begins to tell her emotional story later in the video. In this part, she describes the recent volatility of her emotions as well as how she has been coping. Her speech range in Figure 6 is markedly smaller than in Figure 5. Like in Figure 2, Ingrid’s range shrinks when she moves to an emotional topic.
The dramatic contrast between Ingrid’s and Sarah’s pitch ranges is especially interesting in light of previous research surrounding lesbian identity and gender. Recall first that Kulick and Queen both established that a flat intonation pattern and lower pitch is typically indexical of masculinity as well as a stereotypical butch lesbian. In the introduction section, Sarah aligns more with this standard than Ingrid. The former uses a smaller pitch range and lower pitch overall when compared with the latter, which is demonstrated by Figures 1, 3, and 5. Sarah’s use of pitch in her introduction suggests that, when attempting to make a first impression on her audience, she appeals to the masculine side of her identity as a butch lesbian. Other aspects of her speech in Figure 3 suggest this as well, such as her use of swearing, which Kulick maintains also denotes a more masculine identity. On the other hand, Ingrid employs a broad pitch range and higher overall pitch when she introduces herself than Sarah does. Her contrasting style, along with her almost complete lack of swearing throughout the video, seems to indicate that she wishes to convey a more feminine appearance to her viewers. In this respect, Sarah and Ingrid’s identities as butch and femme respectively are reinforced by their introductory use of pitch.
The emotional story segments of these YouTubers’ videos seem to contradict their identities. Sarah, who previously used a lower, narrower pitch range, now takes on Ingrid’s previous higher, wider range. The latter’s pitch range shrinks, which essentially marks a total swap, as indicated by Figure 2. The question stands, then: does this switch in pitch range also correspond to a switch in roles that each YouTuber is attempting to index? I argue that no, this data does not suggest a complete overhaul of Sarah’s and Ingrid’s identities as butch and femme. Sarah’s use of a higher pitch range may correspond with more traditionally-held views of feminine speech as detailed by Linneman and Kulick, but she still maintains her swearing, which hails back to her masculine identity. Moreover, Ingrid’s introductory pitch already aligns strongly with feminine standards. Although her emotional pitch shrinks in range, Ingrid uses other feminine variables, such as up-talk, to continue indexing her femininity.
Overall, I believe that my data shows that identity is multifaceted and complex. Sarah, for example, self-identifies as butch but utilizes stereotypically feminine speech. This does not, however, automatically undermine her identity. Instead, it reveals an interesting method of conveying emotion: Sarah appears to tap into feminine speech standards when she is discussing negative emotions like vulnerability and discomfort. Her confident, masculine persona that she uses in her introduction is thus set aside in order to convey these emotions through her speech. In short, instead of feminine variables challenging Sarah’s identity, they enrich it and offer an additional insight into her way of thinking.
In conclusion, the lack of research into linguistic variation in the lesbian community has left a gap in sociolinguists’ understanding of this speech group. Previous research has demonstrated similarities between stereotyped lesbian and men’s speech, for example. My paper offers a look into this understudied area by connecting previous studies like this with new research into the ways that lesbians utilize pitch to index their identities. My femme lesbian speaker, Ingrid, used introductory pitch to index her femininity through her use of high pitch, wide range, and up-talk. Sarah, my butch speaker, indexed her masculinity by utilizing swearing and lower pitch ranges. In the emotional setting, however, these trends virtually reversed. Therefore, my data suggests that lesbian speech is not, despite its stereotypes, a black-and-white affair. Ingrid and Sarah each employ both feminine and masculine speech variables in order to index their identities.
This study in no way answers all of the questions brought forth by the gap in our knowledge of the lesbian community. Future studies may focus on how ethnicity, masculinity, and sexuality integrate as well as how speakers who index some part of these identities use pitch to demonstrate their community membership. Other research may go beyond pitch as well to discover what, if any, lexical features define lesbian speech, for example. There are many opportunities for future research in the lesbian community, and I believe that each step we take will help us improve our understanding of one another.
 The introductory period refers to the first 10 phrases of the video, in which the YouTuber introduces herself to the audience. The “emotional story” occurs later in the videos where the YouTuber describes their personal feelings and experiences; it is a story characterized by vulnerability and self-exploration.
 “Absolute” here is intended to show the absolute highest or lowest a pitch goes in an intonational phrase. It denotes the extremes in an intonational phrase.
Brown, L. (2015). Phonetic Cues and the Perception of Gender and Sexual Orientation (Order No. 3709048). Available from ProQuest Dissertations & Theses Global: The Humanities and Social Sciences Collection. (1699059882). Retrieved from https://search.proquest.com/docview/1699059882?accountid=1380.
Bucholtz, M., & Hall, K. (2005). Identity and interaction: A sociocultural linguistic approach. Discourse Studies, 7(4/5), 585-614. Retrieved from http://www.jstor.org/stable/24048525.
Eckert, P. (2008). Variation and the Indexical Field. Journal of Sociolinguistics, 12(4), 453-476. https://doi.org/10.1111/j.1467-9841.2008.00374.x.
Gibson, M., & Meem, D. (1996). Teaching, Typecasting, and Butch-Femme Identity. Feminist Teacher,10(1), 12-16. Retrieved from http://www.jstor.org/stable/40545740.
HIV Among Asian American Men Who Have Sex With Men
Jose Francisco is a graduating senior at San Francisco State University where he is earning his B.S. in Health Education with an emphasis is Community-Based Public Health. He grew up in both the Bay Area and the islands of the Philippines, and it was at San Francisco State where he discovered his passion for social justice and health equity. Currently, he is the Campus Health Initiatives Intern at Health Promotion & Wellness in San Francisco State University and the president for his academic department's student association, where he continuously grounds his work in supporting the health and well-being of his campus community. Further, he is also a current intern at the San Francisco Department of Public Health. This is his second publication with the Sutro Review, as is very excited to be able to continue to voice issues on health disparities and health and social inequities among marginalized populations through his writings. This summer, he will be a participant in the Centers for Disease Control and Prevention Undergraduate Public Health Scholars Program in Atlanta, Georgia. He ultimately aspires a career in government in order to give representation and voice to communities that are marginalized and disenfranchised in the political process.
COMMENT FROM PROFESSOR RUBY TURALBA:
In this upper division Health Education course, students analyze and unpack the role of structural oppression on the health of marginalized communities. Extensive data and research are collected and explored within a political economy framework to develop sound recommendations and strategies addressing root causes of health inequities.
Jose’s piece presents a thoughtful and critical analysis of HIV/AIDS among Asian American Men Who Have Sex With Men, particularly in their exploration of the intersections of Asian cultural norms which stigmatize same sex relationships, discriminatory laws and practices in the United States, and immigration status. They provide viable community-based solutions to build resilience and improve the health knowledge and behaviors within this population, as well as policy recommendations to implement school-based sexual education programs and curriculum that incorporate the experiences of cultural and sexual minorities.
This essay has been abridged for publication purposes. For the full version, please inquire at firstname.lastname@example.org
Cultural beliefs that influence social norms significantly shape the sexual ideologies and behaviors of AAMSM which may attribute to the increasing rate of HIV among this population. Sexuality in many Asian cultures remains a subject of taboo, where conservative values such as modesty, decency and an appropriation of sexuality solely within the context of marriage between man and woman are accepted (Lee et al., 2015; Okozaki, 2010). Further adhering to these conservative ideologies, homosexuality has been depicted in many Asian cultures as shameful and stemming from moral weakness (Carrier, Nguyen, & Su, 1992; Chan, 1989; Yoshioka & Schustack, 2001; Aoki, Ngin, Mo, & Ja, 1989). Various Asian cultures share the view of a collective orientation within the family unit, meaning that an individual’s behavior casts a reflection on the entire family; therefore, homosexuality within this unit imparts a sense of collective shame to the family name (Chin & Kroesen, 1999). Adherence by AAMSM to Asian values and homophobic cultural ideologies has been linked to internalized homophobia and the concealment of one’s sexual orientation, both factors that increase the likelihood of AAMSM to engage in high-risk sexual behaviors (Szymanski & Sung, 2013; Choi et al., 1999; Han, 2007). In contrast, Choi et al. (1999) identified that less adherence by AAMSM to these traditional Asian values have been associated with a greater likelihood of accessing HIV-related health care services and utilizing safe sex practices such as condom usage during sexual intercourse.
Furthermore, although Asian Americans are depicted in U.S. society as the “model minorities,” having better socioeconomic characteristics and a higher income and educational attainment compared to other ethnic minority groups—attributes that decrease the likelihood of contracting HIV according to studies by Ogunmola et al. (2014) and Ransome et al. (2016)—Asian Americans, especially AAMSM, are still as likely to participate in high-risk sexual behaviors. A study found that among different ethnic groups, Asian Americans reported lower condom use (48.9%) compared to Latinos (55.2%), African Americans (65.7) and Whites (58.6%) (Lee & Rotheram-Borus, 2009). Thus, since financial mobility and educational success do not improve the health outcomes of HIV among Asian Americans, facets of Asian culture may be a contributing factor in the rise of HIV cases among AAMSM, particularly with the negative cultural acceptance towards sexual minorities.
Among Asian cultures, the “outness” or disclosure of sexual identity among AAMSM to their families may lead to disownment; therefore, AAMSM are likely to conceal this part of their identity which can negatively influence positive sexual health decision-making (Szymanski & Sung, 2013). Although Asian Americans maintain a higher income and are more likely to have insurance compared to the national average, AAMSM may be avoiding HIV-related health care services for fear of their sexual orientation being “outed”. Overall, Asian Americans receive less parental-initiated sexual education and have less knowledge of HIV risk which may further decrease the likelihood of AAMSM in getting tested or treated (Szymanski & Sung, 2013; Wong et al., 2012). In addition, Asian Americans, especially AAMSM, have a low perceived risk of HIV infection even if they are engaging in high-risk sexual behaviors (Do et al., 2005). Due to the burden in concealing aspects of their identity, AAMSM may feel a lack of social support from their family, which increases the likelihood of AAMSM engaging in unprotected anal sex (Poon & Ho, 2002). Although some of the cultural barriers described may be self-imposed, they are still rooted in one’s cultural beliefs (Yoshioka & Schustack, 2001).
Although Asian culture may appear to be the root of homophobia among this population, Western imperialism and colonialism may have influenced the reinforcement of heteronormative identity, sexuality, and orientation. Ideologies can be used to control others; and although ideologies in society are constructed, they are controlled by those in power (Eagleton, 1991). Religious scholars attribute the Asian community’s refusal to accept homosexuality to religious doctrines, particularly Confucianism and Christianity (Kulig, 1992; Heyes, Porter, & Tombs, 2016). Ironically, throughout various Asian countries, “same-sex sexualities and queer genders existed acceptably before Western imperialism mandated strict moral codes that restricted native customs and people” (Sueyoshi, 2016). While culture has a significant impact on the sexual ideologies and behaviors of AAMSM, to their ability and willingness to access health care services, institutional policies and laws have further influenced society’s overall acceptance of sexual minorities.
Laws and institutional policies in the United States have reinforced the maltreatment of sexual minorities in our society, and although reform towards increasing the civil liberties of sexual minorities continues to be fought for, the remnants of discrimination and prejudice against sexual minorities is still perpetuated, whether explicitly or implicitly, particularly in the medical system. Laws throughout U.S. history have ruled that those who do not conform to a heteronormative identity, sexuality and orientation receive unequal protection under the law. In the U.S., for example, sodomy laws have been used to justify the firing or the denial of jobs for gay people, a form of outright discrimination that has since been abolished (American Civil Liberties Union [ACLU], 2017). Until 1973, homosexuality was a disorder listed in the Diagnostic and Statistical Manual of Mental Disorders. The former characterization of homosexuality as a mental disorder may further strengthen the Asian cultural belief that homosexuality is abnormal (Carrier, Nguyen, & Su, 1992). Although this classification has since been revoked, clinicians continue to have homophobic attitudes: 18% of clinicians reported feeling uncomfortable treating gay patients (Smith & Matthews, 2007). Studies of MSM of color suggest hesitance in disclosing their sexual orientation in a medical setting, despite the importance of such information for their care. These hesitations were also linked to both the fear of their sexuality being revealed and internalized homophobia, much like in AAMSM, along with additional factors such as past experiences of bias and mistrust among health care providers (Eliason, 2001; Santos et al., 2013; Wolitski & Fenton, 2011; Blair et al., 2011; Burgess et al., 2010). If AAMSM are not disclosing their sexuality due to their multiple layers of oppressions faced within Asian cultures—as well as the structural laws that have harmed sexual minorities and have influenced their maltreatment in society—health care providers are not able to assess HIV-related risks among this population (CDC, 2017e). The historical context of the exclusion of sexual minorities’ civil liberties becomes a critical point of analysis as systematic oppression continues to persist in the medical system, which may further deter AAMSM from accessing HIV-related care, leading to the increasing HIV diagnosis rate among this population.
Although there is limited research about immigrant AAMSM populations, the fact that Asian Americans are the fastest growing immigrant group in the U.S. means an individual’s proficiency in English due to immigration may also contribute to the lack of use of health care services. Studies have suggested that language barriers in health care settings may compromise the care a patient attains (e.g. poor symptom recognition), and may lead to decreased access to primary and preventative care (Wilson et al., 2005; Ngo-Metzger et al., 2003; Chin et al., 2006). Thus, language may present a barrier for AAMSM in navigating a foreign health care system, which may contribute to why Asian Americans are experiencing low HIV-testing rates overall (U.S. Census Bureau, 2016b; Anderson et al., 2003). In addition, like the cultural and structural factors that influence the concealment of sexual identity among AAMSM, according to Durso & Meyer (2013), immigration status has also influenced disclosure of sexual orientation, especially among those who are undocumented, due to language barrier and fear of having their legal status questioned.
The resilience and continuous fight for equality by sexual minorities who have been marginalized and disenfranchised—particularly among lesbian, gay, bisexual, transgender and queer (LGBTQ) peoples—has brought about social transformations and shifts in attitudes towards this community. Through forceful demonstrations by LGBTQ people during the Stonewall riots, which became a catalyst for the rise of the gay liberation movement, to community organizing that led to the legalization of same-sex marriage—the movement for social equality for LGBTQ people has influenced the development of laws and policies to establish rights, benefits, and protection. Laws at the national level include the Equal Employment Opportunity Commission's ruling that Title VII of the Civil Rights Act of 1964 does not allow discrimination based on sexual orientation or gender identity, and the Supreme Court’s 2015 ruling of Obergefell v. Hodges which outlawed state-level bans on same-sex marriage under the Constitution (U.S. Equal Employment Opportunity Commission, 2017; Supreme Court of the U.S., 2015).
Although LGBTQ Asian Americans have long felt marginalized within the LGBTQ rights movements due to their ethnicity, activism among LGBTQ Asian Americans has been rising (Hogan & Hudson 1998). San Francisco has been a leading city to address the junction between sexuality, ethnicity, and health with social programs such as Asian Pacific Islander (API) Equality that target LGBTQ APIs, and health care programs such as API Wellness that provide culturally specific HIV-related care (API Equality, 2017; API Wellness, 2017). The prevalence of community and health care programs in San Francisco that targets LGBTQ Asian Americans signify the necessity of such culturally specific interventions.
Various studies have supported the importance of having culturally specific HIV-related interventions among AAMSM, particularly with the programs Brief Group Counseling in San Francisco and Bridges Project in New York City. Choi et al. (1996) evaluated Brief Group Counseling, an intervention aimed to reduce HIV-risk among homosexual Asians and Pacific Islanders (API) men in San Francisco. The intervention was comprised of four elements: “the development of positive self-identity and social support; safer sex education; eroticizing safer sex; and negotiating safer sex.” Participants were placed in a three-hour group counseling session with roughly eight men and were evaluated three months after attending. The intervention had several highlights that address previously discussed Asian cultural barriers that may attribute to the rise of HIV among AAMSM. Participants were presented HIV-related health facts and safe sex practices, which may address the lack of positive parental-initiated sexual education during adolescence (Szymanski & Sung, 2013). Further, participants were encouraged to engage in group dialogue relating to experiences of being API and homosexual, providing a space for participants to safely discuss aspects of their identity that is often concealed among their family (Han, 2007). In addition, participants were encouraged to build support around their self-image, in a space where self-acceptance may be developed and reshaped from previously being conditioned to internalized homophobia due to a cultural push (Choi et al., 1999).
Results of the intervention include a reduction of unprotected anal intercourse by more than half of participants, and fewer sexual partners by 46%. This intervention may have benefited participants even further if the sessions had continued beyond just one meeting. Since lack of family support among AAMSM correlates with high-risk sexual behaviors, increasing the frequency of meeting in the same group to more than one session may foster community building and thus increase social support which may lead to positive sexual health decision-making (Poon & Ho, 2002).
Chin et al. (2006) evaluated the Bridges Project, an intervention aimed to target HIV-positive API in New York City and the disparities in accessing HIV/AIDS-related care within this population. This intervention helped to alleviate language and cultural barriers that exist in HIV-related health care by hiring part-time peer-advocates and full-time management staff that assisted in language interpretation, client escort and comprehensive case management. Participants were evaluated after the program, which ran from 1996 through 2001. Highlights of the intervention include the selection of hospitals and community clinics within communities that had a large API population, and the peer-advocate staff that had the capacity to speak 12 different API languages and dialects. The cultural familiarity provided by the staff was an important source of comfort for participants, especially for individuals that were undocumented or had limited English proficiency.
Significant outcomes include the improvement in service utilization of HIV-related treatment for participants that were undocumented and had limited English proficiency, factors that may hinder such use of medical services among AAMSM (Wilson et al., 2005; Ngo-Metzger et al., 2003). The intervention may have benefited from having the part-time peer-advocate staff hired as full-time staff, since they are the primary bridge of participants to HIV-related care. This would have increased the retention rate and motivation among the peer-advocate staff; however, due to the high cost of having a diverse variety of staff that accommodates participants with differing Asian languages and dialects, such implementation was not possible.
Drawing from the success of both community level interventions of the Brief Group Counseling in San Francisco and Bridges Project in New York City, being culturally tailored towards Asian Americans is of high significance. Both interventions address the various cultural and social barriers that Asian Americans face in addressing HIV-related issues. Brief Group Counseling draws success in the intervention’s HIV-related educational component and aspects of empowerment through self-reflection (Choi et al., 1996). Since Asian Americans generally lack such discussion concerning sexual health from Asian parents due to the stigma around sexuality and the emphasis on traditional marriage, a community-level recommendation would be to create a culturally specific sexual education program that targets adolescent Asian Americans in predominantly Asian communities (Lee et al., 2015; Okozaki, 2010). Moreover, since AAMSM are likely to conceal their sexual identity due to traditions of collective shame and fear of family disownment, to empower AAMSM, especially those that identify as gay or bisexual, sexual minority centered community events for AAMSM should be organized (e.g. movie nights, yoga classes, hiking) to foster community building among individuals with similar experiences (Yoshioka & Schustack, 2001).
Further on a community level, sexual health care subprograms that are tailored to address both cultural and sexual minority identities among AAMSM should be created within existing sexual health care and HIV-related programs in local hospitals and community clinics. Drawing from the Bridges Project, these subprograms should implement a full-time staff of peer-navigators who are culturally and linguistically certified to address the needs of AAMSM to help improve and sustain this population’s ability to navigate and utilize already existing services, since Asian Americans tend to underutilize HIV-related care in both the preventive and post end (Chin et al., 2006). This would be greatly beneficial for immigrant and undocumented AAMSM, considering that Asian Americans are the largest growing immigrant population in the U.S, and for AAMSM with limited English proficiency, since Asian Americans are less likely to speak English “very well” compared to the national average (U.S. Census Bureau, 2016b).
Current providers and staff of sexual health and HIV-related programs should be better trained to address sexual minorities from ethnic minority communities overall. With an aim to increase social acceptance among this marginalized population, workshops that target providers and staff in the clinical setting can develop greater understanding of how to better address AAMSM in relation to HIV-related care, since aspects of care among this population may still be compromised due to provider and staff bias in the clinical setting that have been enforced in laws that have enabled discrimination among sexual minorities in the past (ACLU, 2017; Eliason, 2001; Santos et al., 2013). Further, current educational material on LGBTQ-related health information should be translated into various Asian languages and dialects. In addition, more representation of the diversity of Asian subcultures needs to be present in LGBTQ-related, HIV-related and sexual health related advertisement through language and imagery presented (e.g. Filipino, Lao, Thai, etc. MSM represented in ad campaigns).
Ultimately, although HIV incidence rates among AAMSM may be lower compared to other MSM populations, the alarmingly high rise of HIV diagnosis among AAMSM is troubling. Compared to all other MSM ethnic groups, AAMSM experienced the highest rate of HIV diagnosis from 2005 to 2014 (101%) (CDC, 2016b). Although Asian Americans are perceived as “model minorities,” due to their higher socioeconomic status, Asian Americans, especially AAMSM, are as likely to participate in high-risk sexual behaviors such as unprotected sexual intercourse, the leading cause of HIV transmission (Lee & Rotheram-Borus, 2009). Although HIV-related individual risk behaviors such as having multiple sexual partners and substance abuse may further increase the chances of contracting HIV, social and structural factors also drive HIV transmission (CDC, 2017c).
AAMSM experience multiple layers of oppression due to their cultural and sexual identity, which may significantly shape their ideologies and behaviors that contribute to poor health behavior and attribute to the rise of HIV among this population. Cultural beliefs such as sexuality being stigmatized and homosexuality being viewed as shameful has been shown to pressured AAMSM to conceal their sexual identity; both a strong adherence to Asian culture and concealment of sexual identity to family have been shown to increase the likelihood of AAMSM to participate in high-risk sexual behaviors such as unprotected anal sex (Lee et al., 2015; Okozaki, 2010; Choi et al., 1999; Han, 2007; Wong et al., 2012).
Further, social beliefs that have been enforced through the discrimination of sexual minorities under past laws and in medical practice continue to negatively influence providers giving care and, inadvertently, in patients receiving the care: 18% of clinicians felt uncomfortable treating gay patients. MSM of color also continue to face hesitance in disclosing sexual orientation due to past experiences of bias and mistrust from providers. Both factors can hinder AAMSM from receiving adequate care (Smith & Matthews, 2007; Eliason, 2001). The enforcement of culturally-tailored interventions that address the intersections of Asian culture and sexual minority identity is significant in targeting HIV among AAMSM (Choi et al., 1996; Chin et al., 2006). The dismantling of cultural factors that have promoted homophobia as well as structural factors that have encouraged discrimination based on ethnic identity, sexual orientation, and immigration status can begin at the community level. This includes incorporating better youth sexual education among Asian Americans overall, the promotion of community building and empowerment within AAMSM, and programs in hospital settings that can assist AAMSM in navigating sexual health and HIV-related care, and help diminish bias towards sexual minorities among health care providers and staff.
Adih, W. K., Campsmith, M., Williams, C. L., Hardnett, F. P., & Hughes, D. (2011). Epidemiology of HIV among Asians and Pacific Islanders in the United States, 2001-2008. Journal of the International Association of Physicians AIDS Care, 10(3): 150-159. Retrieved at: https://www.ncbi.nlm.nih.gov/pubmed/21508298
American Civil Liberties Union (ACLU). (2017). Update on the status of sodomy laws. Retrieved at: https://www.aclu.org/other/update-status-sodomy-laws
Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., Normand, J., & the Task Force on Community Preventive Services. (2003). Culturally competent healthcare systems: A systematic review. American Journal of Preventive Medicine, 24(3): 68-76. Retrieved at: http://www.umiamibgs.com/dli-1/wp-content/uploads/2015/03/gh_m5_culture_and_health_care_system.pdf
Aoki, B., Ngin, C. P. N., Mo, B., & Ja, D. Y. (1989). AIDS prevention models in the Asian American communities. Primary Prevention of AIDS, Psychological Approaches. New Jersey: Sage.
Asian Pacific Islander (API) Equality. (2017). Mission, vision, & values. Retrieved at: https://www.apiequalitync.org/aboutus/mission-and-vision-statement/
Asian Pacific Islander (API) Wellness. (2017). Our mission. Retrieved at: http://apiwellness.org/about/
Blair, I. V., Steiner, J. F., & Havranek, E. P. (2011). Unconscious (Implicit) bias and health disparities: Where do we go from here? The Permanente Journal, 15(2): 71-78. Retrieved at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140753/#i1552-5775-15-2-71-b44.
Burgess, D. J., Warren, J., Phelan, S., Dovidio, J., & van Ryn, M. (2010). Stereotype threat and health disparities: What medical educators and future physicians need to know. Journal of General Internal Medicine, 25(Suppl 2): 169-177. Retrieved at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2847106/.
Carrier, J., Nguyen, B., & Su, S. (1992). Vietnamese American sexual behaviors & HIV infection. The Journal of Sex Research, 547-560. Retrieved at: http://www.tandfonline.com/doi/abs/10.1080/00224499209551666
Centers for Disease Control and Prevention (CDC). (2016b). CDC fact sheet: Trends in U.S. HIV diagnoses, 2005-2014. Retrieved from: https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/hiv-data-trends-fact-sheet-508.pdf
Centers for Disease Control and Prevention (CDC). (2017c). HIV transmission. Retrieved at: https://www.cdc.gov/hiv/basics/transmission.html
Centers for Disease Control and Prevention (CDC). (2017d). HIV among gay and bisexual men. Retrieved at: https://www.cdc.gov/hiv/group/msm/index.html
Centers for Disease Control and Prevention (CDC). (2017e). HIV Among Asians in the United States. Retrieved at: https://www.cdc.gov/hiv/group/racialethnic/asians/index.html
Centers for Disease Control and Prevention (CDC). (2017f). Statistics overview. Retrieved at: https://www.cdc.gov/hiv/statistics/overview/index.html
Centers for Disease Control and Prevention (CDC). (2017g). HIV among African Americans. Retrieved at: https://www.cdc.gov/hiv/group/racialethnic/africanamericans/index.html
Chan, C. S. (1989). Issues of identity development among Asian-American lesbians and gay men. Journal of Counseling & Development, 68(1): 16-20. Retrieved at: http://psycnet.apa.org/record/1990-04422-001
Chin, D. & Kroesen, K. W. (1999). Disclosure of HIV infection among Asian/Pacific Islander American women: Cultural stigma and support. Cultural Diversity and Ethnic Minority Psychology, 5: 222-235. Retrieved at: http://psycnet.apa.org/record/1999-03274-004
Chin, J. J., Kang, E., Kim, J. H., Martinez, J., & Eckholdt, H. (2006). Serving Asians and Pacific Islanders with HIV/AIDS: Challenges and lessons learned. Journal of Health Care for the Poor and Underserved, 17: 910-927.
Choi, K., Kumekawa, E., Dang, Q., Kegeles, S. M., Hays, R. B., & Stall, R. (1999). Risk and protective factors affecting sexual behavior among young Asian and Pacific Islander men who have sex with men: Implications for HIV prevention. Journal of Sex Education and Therapy, 24: 47-55. Retrieved at: http://www.tandfonline.com/doi/abs/10.1080/01614576.1999.11074282
Choi, K. H., Lew, S., Vittinghoff, E., Catania, J., Barrett, D. C., & Coates, T. J. (1996). The efficacy of brief group counseling in HIV risk reduction among homosexual Asian and Pacific Islander men. AIDS, 10(1): 81-7.
Do, T. D., Chen, S., McFarland, W., Secura, G. M., Behel, S.K., MacKellar, D. A., Valleroy, L. A., & Cho, K. H. (2005). HIV testing patterns and unrecognized HIV infection among young Asian and Pacific Islander men who have sex with men in San Francisco. AIDS Education and Prevention, 17: 540-554. Retrieved at: https://www.ncbi.nlm.nih.gov/pubmed/16398576
Durso, L. E. & Meyer, I. H. (2013). Patterns and predictors of disclosure of sexual orientation to healthcare providers among lesbians, gay men, and bisexuals. Sexuality Research & Social Policy, 10(1): 35-42. Retrieved at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3582401/
Eagleton, T. (1991). Ideology: An introduction. Research School of Social Sciences. London: Verso.
Eliason M. J. (2001). Does "Don't ask don't tell" apply to health care? Lesbian, gay, and bisexual people's disclosure to health care providers. Journal of the Gay and Lesbian Medical Association, 5(4): 125-34. Retrieved at: https://link.springer.com/article/10.1023/A:1014257910462
Han, C. (2007). They don't want to cruise your type: Gay men of color and the racial politics of exclusion. Journal for the Study of Race, Nation and Culture, 13(1). Retrieved at: http://www.tandfonline.com/doi/abs/10.1080/13504630601163379
Hayes, M. A., Porter, W. J.m & Tombs, D. (2016). Religion and sexuality. London: Bloomsbury academic.
Hogan, S. & Hudson, L. (1998). Completely queer: the gay and lesbian encyclopedia. New York: Henry Holt.
Kulig, J. (1992). Sexuality beliefs among Cambodians: Implications for health care professionals. Health Care for Women International, 15: 69-76.
Lee, S. J., & Rotheram-Borus, M. (2009). Beyond the "model minority" stereotype: Trends in health risk behaviors among Asian/Pacific Islander high school students. Journal of School Health, 279(8): 347-354. Retrieved at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818149/
Lee, Y. M., Florez, E., Tariman, J. D., McCarter, S. P., & Riesche, L. (2015). Factors related to sexual behaviors and sexual education programs for Asian-American adolescents. Applied Nursing Research, 28: 222-228. Retrieved at: https://pdfs.semanticscholar.org/0790/5a4846dfc15a6a5863634dadd95e16d4b7a7.pdf
Ngo-Metzger, Q. Massagli, M. P., Clarridge B. R., Manocchia, M., Davis R. B., Iezzoni, L. I. & Phillips, R. S. (2003). Linguistic and cultural barriers to care. Journal of General Internal Medicine, 18(1): 44-52. Retrieved at: http://onlinelibrary.wiley.com/doi/10.1046/j.1525-1497.2003.20205.x/full
Ogunmola, O. J., Oladosu, Y. O., & Olamoyegun, M. A. (2014). Relationship between socioeconomic status and HIV infection in a rural tertiary health center. HIV/AIDS (Auckland, N.Z.), 6: 61-67. Retrieved at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003148/
Okozaki, S. (2010). Influence of culture on Asian Americans' sexuality. The Journal of Sex Research. 39(1): 34-41. Retrieved at: http://www.tandfonline.com/doi/abs/10.1080/00224490209552117
Poon, M. K. L. & Ho, P. T. T. (2002). A qualitative analysis of cultural and social vulnerabilities to HIV infection among gay, lesbian, and bisexual Asian youth. Journal of Gay & Lesbian Social Services, 14(3): 43-79. Retrieved at: http://www.tandfonline.com/doi/abs/10.1300/J041v14n03_03.
Ransome, Y., Kawachi, I., Braunstein, S., & Nash, D. (2016). Structural inequalities drive late HIV diagnosis: The role of black racial concentration, income inequality, socioeconomic deprivation, and HIV testing. Health & Place, 42: 148-158. Retrieved at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584790/
Santos, G. M., Beck, J., & Wilson, P.A. (2013). Homophobia as a barrier to HIV prevention service access for young men who have sex with men. J Acquir Immune Defic Syndr., 63(5): 167-70. Retrieved at: https://www.ncbi.nlm.nih.gov/pubmed/24135782
Smith, D. M., & Mathews, W. C. (2007). Physicians' attitudes toward homosexuality and HIV: survey of a California medical Society. J Homosex, (52): 1-9. Retrieved at: https://www.ncbi.nlm.nih.gov/pubmed/17594969
Sueyoshi, A. (2016). Queer Asian American Historiography. In The Oxford Handbook of Asian American History: Oxford University Press. Retrieved from: https://faculty.sfsu.edu/sites/default/files/faculty_files/52/publications/QueerAsAmHist_Sueyoshi.pdf Supreme Court of the U.S. (2015). Obergefell v. Hodges. Retrieved at: https://www.supremecourt.gov/opinions/14pdf/14-556_3204.pdf
Szymanski, D. M. & Sung, M. R. (2013). Asian cultural values, internalized heterosexism, and sexual orientation disclosure among Asian American sexual minority persons. Journal of LGBT Issues in Counseling, 7(3): 257-273. Retrieved at: http://www.tandfonline.com/doi/full/10.1080/15538605.2013.812930?scroll=top&needAccess=true
U.S. Census Bureau. (2016b). 2016 American community survey 1-year estimates. Retrieved at: https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk
U.S. Equal Employment Opportunity Commission. (2017). What you should know about the EEOC and the enforcement protections for LGBT workers. Retrieved at: https://www.eeoc.gov/eeoc/newsroom/wysk/enforcement_protections_lgbt_workers.cfm
Wilson, E., Chen, A. H., Grumbach, K., Wang, F., & Fernandez, A. (2005). Effects of limited English proficiency and physician language on health care comprehension. Journal of General Internal Medicine, 20(9): 800-806. Retrieved at: http://onlinelibrary.wiley.com/doi/10.1111/j.1525-1497.2005.0174.x/full
Wolitski, R.J. & Fenton, K.A. (2011). Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States. AIDS and Behavior, 15(Suppl 1), S9-17. Retrieved at: https://www.ncbi.nlm.nih.gov/pubmed/21331797
Wong, F. Y., Nehl, E. J., Han, J. J., Huang, Z. J., Wu, Y., Young, D., and The MATH Study Consortium. (2012). HIV testing and management: Findings from a national sample of Asian/Pacific Islander men who have sex with men. Public Health Reports, 127(2): 186-194. Retrieved at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268803/
Yoshioka, M. R. & Schustack, A. (2001). Disclosure of HIV status: Cultural issues of Asian patients. AIDS Patient Care & Studies, 15(2): 77-82. Retrieved at: https://www.ncbi.nlm.nih.gov/pubmed/11224933
Zaidi, I. F., Crepaz, N., Song, R., Wan, C. K., Lin, L. S., Hu, D. J., & Sy, F. S. (2005). Epidemiology of HIV/AIDS among Asians and Pacific Islanders in the United States. AIDS Education & Prevention, 17(5): 405-417. Retrieved at: https://www.ncbi.nlm.nih.gov/pubmed/16255637
Happy Body, Happy Kid:
Preventing Type 2 Diabetes among African American Children in Low Income Neighborhoods
Aileen is a Senior majoring in Health Education with an emphasis in community-based public health and minoring in Women's Health Issues. She currently works in the San Francisco Unified School District as a school nurse, assisting children who suffer from developmental, neurological, and metabolic diseases. Aileen has extended her medical outreach globally in two medical relief trips, one to Panama and one to Peru. Assisting and advocating for the underserved communities in those countries, along with her work with school children, has sparked her passion and pursuit of a career in global health, specifically epidemiology. Her hope is that through her research she can influence changes needed to address the inequities in health care rampant in marginalized communities. During her free time, Aileen enjoys reading, watching critically acclaimed films, and striking up conversations with complete strangers as way of getting to know various cultures and communities.
COMMENT FROM PROFESSOR MARTY MARTINSON:
Aileen Andrade’s thoughtful paper on the disproportionate rates of type 2 diabetes among African American children in low income neighborhoods reflects a comprehensive understanding of the social and structural influences on community health. She describes how unhealthy food systems produce unhealthy foods that are marketed directly to low income children, how neighborhood and school conditions in low income communities of color often prevent adequate access to healthy foods and physical activity, and how public policies can play an important role in creating healthier food and neighborhood environments. She then focuses on the elementary school environment to increase physical activity opportunities among students as an institutional change in the prevention of type 2 diabetes.
According to the CDC (2015a), diabetes is identified as a disease in which blood glucose (sugar) levels are found to be outside of the normal range (70-120 mg/dl) due to insufficient insulin production. Insulin, a hormone produced by the beta cells of the pancreas, is responsible for transporting sugar found in the blood system into the cell, where it is stored to be used as a future energy source needed for basic bodily functions. The cause of insufficient levels of insulin production in an individual can vary from being auto-immune related (Insulin-dependent type 1), pregnancy induced (gestational), or the body’s improper use of insulin (Insulin-resistant type 2) (American Diabetes Association [ADA], 2016). Insulin resistant type 2 is the most prevalent form of diabetes in the United States and is seeing a steady increase within the African American children (under the age of 14 years) population of low socioeconomic neighborhoods (CDC, 2015b).
Prevalence and Incidence Rates
As of 2012, type 2 diabetes has seen an exponential increase in diagnoses among American youth, accounting for 20-50% of incidences that year (Dabelea et al., 2014). This indicates that type 2 diabetes is a growing epidemic for the children population, where it had previously been known to only affect adults. Of these new-onset diabetic cases, minority groups are seen to be the most affected. According to the CDC (2014), in 2009 the prevalence of type 2 diabetes among African American children (ages 10-14 years) was 1.06 per 1000, compared to the 0.79 per 1000 among Hispanic children and 0.17 per 1000 among Caucasian youth. This demonstrates a significant health disparity among African American children compared to other minority and Caucasian pediatric patients.
Furthermore, ethnic minority children living in lower socioeconomic neighborhoods were twice as likely to develop type 2 diabetes compared to Caucasian children, with 58% of those incidences affecting African American children (Lieb, Snow, & DeBoer, 2009).
Type 2 diabetes can lead to series of short and long-term complications, and can ultimately result in death. If a diabetic person is hypoglycemic (blood glucose level less than 70 mg/dl) and is left untreated, these low blood sugar levels can lead to seizures or unconsciousness, and emergency interventions are necessary (ADA, 2015). If blood levels are higher than the normal range (typically higher than 150 mg/dl for pediatric patients), a diabetic is considered hyperglycemic. Immediate complications of hyperglycemia can result in ketoacidosis. Ketoacidosis occurs when there are low levels of intracellular glucose, causing the body to metabolize proteins as a backup energy source. This metabolization of proteins creates by-products known as ketones, which create an acidic pH in the body. This acidity interferes with the body’s homeostasis and can lead to the interruption of normal bodily functions (ADA, 2014). Long-term effects of type 2 diabetes include blindness, poor wound healing (especially for limbs), hypertension, nerve damage, poor digestion and bowel movement, renal failure, and, in severe cases, death (United States Department of Health and Human Services [USDHHS], 2017).
On an interpersonal level, families (particularly parent/guardians) of affected children face the challenge of not only maintaining the child’s optimal glycemic levels, but of also ensuring that their children are living a ‘normal’ childhood. Living a ‘normal’ childhood involves a child feeling safe and included within school activities and being able to eat meals that other children enjoy, without being blatantly aware of the restrictions that come with being a diabetic. This can be directly influential to not only the child’s mental health, but also their family’s, who have to constantly monitor the child’s well-being. A child under any type of physical or mental stress can lead to inconsistent, or fickle, blood levels, requiring parents to have to set aside time, which can include missing work, to tend to their diabetic child (Hirose, Beverly, & Weinger, 2012). Children living in a single-parent low-income household are found to have worse metabolic control and glycemic levels due to the challenges their parents face of raising a child with a difficult chronic disease (Thompson, Auslander, & White, 2001). This can then become an ongoing loop of stressors and unstable readings.
Emerging cases of type 2 diabetes among the African American pediatric population living within under-resourced lower socioeconomic communities, will (in the long run) lead to a higher prevalence of diabetic-related complications, such as heart disease and/or deaths.
Level of Prevention
The growing rate of type 2 diabetics among African American children who live in lower socioeconomic U.S. neighborhoods as well as the association of type 2 diabetes with extenuating social factors call for interventions at the primary level. Primary level care emphasizes preventive interventions to avert the onset of disease affecting a population, which in this case is type 2 diabetes.
Literature Review, Findings
Individual Level: Type 2 diabetes is a unique chronic disease that is the result of many contributing factors. On an individual level, there are many biological influences, including genetic predispositions, that contribute to the development of this disease. Dissecting type 2 diabetes through the pathophysiological aspect, an individual must initially possess an insulin-resistant genetic defect which inhibits the take-up of glucose from the blood system and into the muscle cell, where it is used as an energy source (Fletcher, Gulanick, & Lamendola, 2002). Additionally, an individual may also have an accumulation of glucose in the blood system, resulting in impaired glucose tolerance (IGT), as a result of their failed beta cell compensation (Nolan, Damm, & Prentki, 2011). IGT is indicative of a higher than normal risk of progression to type 2 diabetes, and its presence classifies an individual as prediabetic. Prediabetic individuals have a range of 2.3-11% (per year) chance of having IGT progress to type 2 diabetes; this is especially so among non-white racial and ethnic groups, such as African Americans (Nolan, Damm, & Prentki, 2011).
With new technological developments, the physical activity level of children level has seen a steady decline, resulting in a sedentary lifestyle. Children are opting for hours in front of a television or computer screen, rather than partaking in physically stimulating activities. In a study conducted by Boulos, Vikre, Oppenheimer, Chang, & Kanarek (2012) which looked at the risk factors for type 2 diabetes in children, elementary-aged children who spent more than 120 minutes per day watching television were less active during recreational hours and were found to possess a higher body mass index, placing these children at a higher risk for developing the disease. A strong correlation has also been observed with inactivity from television-viewing and higher HbA1c readings (used to detect the average blood glucose reading of the previous three months) in both obese and non-obese individuals, which indicates that a sedentary lifestyle can cause a disruption of blood glucose regulation (Power, Snehal et al., 2014). Physiologically, poor lipoprotein lipase (a protein produced during muscle stimulation) function is a result of general inactivity, which causes a predisposition to the development of metabolic disease and/or type 2 diabetes (Hamilton, Hamilton, & Zderic, 2007).
Interpersonal Level: Relationships within a child’s immediate social circle play a vital role in the prevalence of type 2 diabetes. A child’s relationship with a parent or guardian can assist or inhibit a child’s health outcome. Lack of family functionality, specifically parent-child relations within lower socioeconomic households, was found to directly impact poor metabolic control in the children within these homes, with stress a primary influence (Lewin & Heidgerken et al., 2005). Single-parent families were also found to have a higher mean difference in HbA1c compared to two-parent families (Lewin & Heidgerken et al., 2005). As a protective factor, establishing good parent-child relationships has been effective in introducing healthier dietary patterns into the child’s life, which is particularly significant since the lack of such patterns has been directly correlated as a primary contributing factor in the development of type 2 Diabetes. A study found that the simple act of eating family dinner together shapes a child’s ability to choose healthier eating habits/decisions (Gilman et al., 2000).
Besides from parent-child relationships, a school-aged child heavily bases decisions upon the influence and acceptance of their peers. Choosing healthier habits is particularly difficult in young children who do not have the proper social support to shape their decisions. Children often allow factors such as embarrassment, the need to be socially accepted, the need to be “normal,” and their natural inclination towards competing interests, influence how they construct their day-to-day routines (Shelagh, Mudasiru, & Schlundt, 2008). This was especially common among ethnic minority children living in urban communities whose parents often must work “more than average hours” to earn a living, which led to a strong reliance on peers for decisions regarding dietary choices and physical activities (Patil, 2004).
Community Level: Accessibility to healthier food options within lower socioeconomic neighborhoods that have many ethnic minority residents is uncommon. This is seen as a deficit that can influence the development of type 2 Diabetes. Processed foods, genetically altered livestock, and corn-based foods have been categorized as staples of the Western diet (Cordain et al., 2005). In comparison to the naturally cultivated organic foods of the East, Westernized diets have typically consisted largely of simple carbohydrates and saturated fats, which have been linked to metabolic syndrome and type 2 diabetes (Zimmet, Alberti, & Shaw, 2001). While healthier food options have been made available in efforts to shift these components of a Western diet, healthier options are still not accessible in ethnic minority communities who often have fewer supermarkets and a higher prevalence of fast food chain restaurants. The availability of healthy products within supermarkets resulted in reports of healthier diets in the individuals residing in the store’s immediate vicinity (Glanz & Yaroch, 2004). An observational study further supports the food inaccessibility factor for ethnic minority communities, finding that African Americans consume the same number of calories as their Caucasian counterparts but that their intake consisted of a greater percentage of calories from fat and that they consumed higher quantities of sugary drinks (Alberti et al., 2004).
Protective factors on a community level that promote healthier children are seen in after-school programs. Establishments such as the YMCA host programs that provide educational workshops on healthy eating and the benefits of increased physical activity to both the children and parents of underserved communities. EPIC Kids (a branch of the YMCA programs) uses technology to teach healthier behavioral choices to parents and provides recreational areas for after-school activities for children (Hingle et al., 2015). Other programming interventions such as physical activity through the art of dance, in conjunction with lifestyle education, are proven to reduce the risk of type 2 diabetes (Hogg et al., 2012).
Institutional Level: School systems, especially those located in lower socioeconomic neighborhoods, have a direct impact on the health of children. A study that looked at the high level of inactivity in school-aged children found that schools were not providing adequate recess or recreational breaks to allow sufficient physical activity needed for school-aged children (Carrel, Sledge, Ventura, Eickhoff, & Allen, 2014). The study also recognized that having transportation available for students meant fewer students were walking and/or biking to school, further promoting physical inactivity.
In addition, fast food corporations are spending an average of $870 million in food advertisements to children (Boulus et al., 2012). This is significant due to the fact that children have heightened short-term preferences that are easily influenced by marketing. These children display characteristics of the “nagging effect,” and they guilt their parents into taking them to the stores or restaurants they saw in an advertisement (Borzekowski & Robinson, 2001). Behavioral studies have found that the more food advertisements an individual is exposed to, the more primed they are to seek out those businesses; this is especially significant among younger viewers (Burton, 2007).
Another institutional influence on the type 2 diabetes epidemic among African American children is their housing conditions. Overcrowding and the poor structure of affordable housing units has been associated with a higher prevalence of type 2 diabetes among its residents (Burton, 2007). The socioeconomic status of an individual’s home can contribute to their behavioral patterns (such as physical activity and diet), which subsequently influences the development of type 2 diabetes (Grant, 2004).
Public Policy: In 1990, Congress passed a law that regulated children-targeted commercials by fast food corporations. It limited the amount of air time to “10.5 minutes per hour on weekends and no more than 12 minutes per hour on weekdays” (Borzekowski & Robinson, 2001, p. 44-45). In 2006, the Council of Better Business Bureaus (BBB), worked closely with major fast food corporations such as McDonald’s USA, Burger King, Kraft Foods, the Coca-Cola Company, and others to launch an initiative that encourages healthier dietary choices and lifestyles. Furthermore, food marketed in these advertisements had to contain no more than one gram of saturated fat, zero grams of trans fat, less than 13 grams of sugar, and less than 140 grams of sodium (Boulus & Vikre et al., 2012). This, in some parts, is a controversial factor regarding type 2 Diabetes. Fast food corporations may lure customers in with their healthier food options, but upon visiting their establishments, individuals are then exposed to their many unhealthy food options, leaving the responsibility of making healthier choices solely on the overwhelmed individual.
Other protective factors on the public policy level include services such as the Women, Infants, and Children (WIC) nutritional program, which provides food coupons/stamps to families that fall into the lower socioeconomic bracket. These food coupons/stamps are widely accepted, even in some farmer’s markets which may offer fresh and healthier food options. Additionally, policies that provide incentives to child care centers for providing and implementing healthier food and nutrition policies within their institutions resulted in significant differences in their children’s physical well-being (Glanz & Yaroch, 2004).
Public policy and its influences in zoning and the built environment can also influence a child’s level of activity and health. Neighborhoods with zoned areas that encourage physical activity (such as outdoor green spaces), along with a healthy food intake, resulted in a 38% lower incidence rate of type 2 diabetes in its residents. Zoning in residential areas can also lead to safer sidewalks and more expansive bike paths, which can encourage residents to opt for modes of transportation that are more physically engaging (Auchincloss et al., 2009). Children that lived in fractured-grid type of neighborhoods were found to have more sedentary lifestyles, as opposed to heavily zoned grid-pattern type neighborhoods (Raine, Muhajarine, Spence, Neary, & Nykiforuk, 2012). This can be further explained by understanding that fractured-grid neighborhoods consist of cul-de-sacs that lack proper crosswalks, narrow sidewalks, and main streets that allow for fast-travelling traffic, all of which discourage a pedestrian from travelling by foot. Grid-type neighborhoods have an abundance of wider, strategically placed crosswalks, and are designed to slow down traffic (Rowden, 1993).
Based on the information found through this literature review, many social factors contribute to the growing prevalence rates of type 2 diabetes among African American children who live in lower socioeconomic neighborhoods. From the research collected, contributing factors at an individual level were not well addressed. Besides genetic predispositions, it is vital to dissect individual behavior in order to have a better understanding of the outside influences on children’s behavior (conceding that school-aged children do not have the cognitive development to demonstrate logical decision-making). Behavior in this age group is typically mimicked and therefore attributed to the interpersonal level and above. Physical inactivity and food accessibility as contributing factors for type 2 Diabetes in this population were further elaborated upon in the interpersonal, community, institutional, and public policy levels.
Within the research gathered, the level of physical inactivity in ethnic minority children (including African American children) living in lower socioeconomic neighborhoods was influenced by the poor zone planning typical to lower socioeconomic neighborhoods, which fail to include areas for recreational purposes and/or sidewalks or bike paths that encourage physical activity. The school system’s failure to allot sufficient time for children to perform physical activities also contributes to physical inactivity in ethnic minority children. All of these factors result in an increase in the number of hours a child spends in front a television set or computer screen.
The hours spent in front of a screen then exposes impressionable children to fast food advertisements, that subsequently influence their dietary preferences. Interpersonal relationships between parents, peers, and children also play a part in molding dietary habits, and a lack of positive relationships results in negative dietary choices. This, in conjunction with inaccessibility to healthier food options, can cause a child to be susceptible to develop type 2 diabetes.
Protective factors such as after school programs that provide health education and promote physical activity to children, public policy that regulates food industries and their marketing to minors, and incentives for healthier institutional programs all positively influence and counteract the type 2 epidemic among the African American children population.
While conducting the research for this literature review, some limitations and gaps were encountered. This included insufficient evidence to support the link between housing and the built environment of lower socioeconomic neighborhoods and higher prevalence rates of type 2 diabetes among its child residents. Many studies also looked at ethnic minorities as a whole and did not differentiate between the African American children population and other ethnic minorities. Furthermore, more epidemiological research studying type 2 diabetes in children is needed because it is the new chronic disease for this age group.
Primary Contributing Factors: This literature review suggests that certain contributing factors can be recognized as a significant influence in terms of primary level of intervention. These notable influences can be categorized under three centralizing contributing factors. The first contributing factor to acknowledge is the interpersonal relationships between parent and child, as well as the relationship between children and their peers. This factor highlights the magnitude of how a child’s social circle can influence day-to-day routines and establish lifelong habits. The second contributing factor is the lack of a healthy diet, which is then influenced by food accessibility, marketing by food industries, regulations on these companies, and the abundance of fast food chains within lower socioeconomic neighborhoods. Finally, the third principal contributing factor is physical inactivity attributed to the built environment and institutional influences.
Theory-based interventions, Theoretical frameworks
Community-based health theories assist in developing effective interventions to address the health disparities caused by various contributing factors at multiple levels of the ecological model. These theories influence changes in individual, social, and institutional behaviors and can be efficiently applied in the development of health programs that strive to improve health outcomes within populations. Among these theories are the Transtheoretical Method (also referred to as Stages of Change) and the Diffusion of Innovations theory, whose constructs provide an implicit method of addressing the primary contributing factors that lead to the development of type 2 diabetes among African American children of lower socioeconomic neighborhoods.
Transtheoretical Method: The Transtheoretical method conceptualizes the process by which an individual intentionally seeks to change a problem behavior. The key constructs of this theory include recognizing the phases (or stages) that are indicative of an individual’s level of readiness to change. Once the level of readiness is identified, interventions are then individually adjusted to ensure the adoption of new behaviors. Among the key phases are the precontemplation, contemplation, preparation, action, maintenance, relapse, and termination stages.
The precontemplation stage is the phase at which an individual has not yet begun to consider potential to change. These individuals may have reservations that can be attributed to being un/misinformed on the repercussions of their problem behavior. Raising an individual’s critical consciousness of these repercussions can motivate a person into the next phase, which is contemplation. The contemplation stage sees the individual with an intention to modify their behavior, but the process to change has not been initiated. During this phase, the cons may outweigh the benefits to the individual and inhibits the potential for change. However, emphasizing the benefits and positive outcomes that result from this change can shift the individual’s perspective and influence their level of readiness. With their new perspectives, individuals will then begin to seek out resources as initial steps in behavioral improvements, thus entering the preparation phase. In this phase, individuals have made a significant commitment to modifying their behavior but have not taken action. Identifying potential barriers that may arise will facilitate any final adjustments needed before beginning the process of change. Once preparation is complete, the individual enters the action phase, where individuals engage in the actual process of modifying behaviors. A health education program may be introduced during this stage which can potentially be conducive in achieving the target behavior. Action requires continuous commitment and the most investment. It also requires the most energy and can typically take, on average, up to six months for recognizable results. After this period of time individuals enter the maintenance stage and are now modeling new behaviors, but are still susceptible to regression. It becomes crucial to conduct follow-ups and offer continued support in order to sustain the new changes long-term.
Unfortunately, even with the most effective maintenance interventions, some may return to old behaviors or relapse. It is important to acknowledge that relapsing is a natural component of human behavior. Relapse itself is not the primary issue in this situation; rather, the issue is when an individual is unable to bounce back from this vulnerable state. Identifying and establishing effective methods to deal with the barriers that led to the relapse will restore confidence and increase self-efficacy. This will enable the individual to continue practicing new behaviors. The goal, for this theory, is to reach the termination stage in which the temptation to relapse is no longer an issue and the new behavior now becomes the standard behavior for the individual (Rimer & Glanz, 2005).
Diffusion of Innovation: The Diffusion of Innovations theory provides an analysis on how social systems adopt new ideas, products, and/or practices over time. When applied to a public health setting, this theory can facilitate the utilization of resourceful tools in order to counteract negative health outcomes among communities. The constructs of this theory include: relative advantage, compatibility, simplicity, reversibility, observability, the ‘S’-curve, and change agents.
In order to effectively implement a new “innovation” into a given population, a health educator has to entice communities by appealing to their shared values and addressing their concerns or hesitations. The construct of relative advantage uses repeated education to create an understanding of how adopting new innovations is a viable alternative to current customs. This may present a challenge when the desired changes are not a significant variation from current behavior, in which case the relative advantage is to highlight the synergistic benefits that lead to positive health outcomes. The Compatibility construct is a direct appeal to the common values and shared beliefs of a target population. These values may be attributed to cultural, religious, or societal influences that often impact the decisions of individuals. To bridge the gap between the innovation and the core values of the target community, thorough research should be done to establish their commonalities. This, in tandem with the practice of cultural humility, provides an effective method in addressing the compatibility factor.
In certain instances, the community of interest may have reservations about adopting an innovation. In such cases, it is vital to highlight the simplicity of an innovation by avoiding complex methods of implementation or by using unnecessary jargon. Demonstrating to the community what little effort is needed to adopt new practices can assist in the increased likelihood of adoptability. In addition to an innovation’s simplicity, the construct of reversibility states that the perceived risk of adoption can affect rates of adoption. This means that the more permanent or irreversible an innovation may be, the less likely it will be adopted into communities. Providing a trial period for the innovation can allow community members to experience the benefits of the new practice, with the comfort of knowing that there is no finalizing commitment. Utilizing this technique can facilitate a community’s collective decisions to incorporate new practices, behaviors, or ideas into their social structure, rather than forcefully implementing it. Furthermore, this theory states that populations have a higher probability to adopt an innovation if allowed to physically witness the differences in other similar communities. Known as the observability construct, this aspect of the theory provides a social reference that motivates community members to want to adopt a change.
Finally, the “S”-curve provides an understanding of the rate at which an innovation is spread throughout a community. It accounts for speed as well as sequence, and details which community members are adopting the innovation. In regards to public health programs, the curve itself can be used as an evaluative tool to determine how efficiently the program has been adopted by the target community. It can also assist in pointing out what approaches or initiatives should be adjusted to ensure outreach to all members of the community. The facilitators who coordinate health programs or who introduce new innovations into communities are known as the “change agents.” These change agents can be outsiders or emerge from within the community itself. Regardless of their origin, these individuals catalyze positive changes within populations (Rimer & Glanz, 2005).
After thorough analysis of the contributing factors leading to type 2 diabetes among African American children living in lower socioeconomic neighborhoods, an intervention geared at the primary level would be the most effective in preventing the onset of this disease. Physical inactivity has been identified as one of the primary contributing factors that can lead to development of type 2 diabetes among African American children, and can be attributed to influences at all levels of the ecological model, including the relationships between peers and parents with the child, the built environment, and institutional influences (such as the schools these children attend). Using the Transtheoretical method and the Diffusion of Innovations theoretical frameworks, a health program targeted at elementary school-aged children, particularly of the second, third, or fourth grade level, will be implemented in an attempt to increase physical activity and counteract the growing incidence rates of type 2 diabetes.
Happy Body, Happy Kid: Over the last couple of decades, elementary schools have integrated modern technology, such as computers and tablets, as valuable tools to aid in their educational objectives (Kulik, 2003). Embracing technology in the classroom in this manner converts it from being a contributing factor of childhood physical inactivity, to an asset that can improve teaching programs. It also provides a platform for educators to connect with students through devices that are popular among many age groups.
Titled “Happy Body, Happy Kid,” this two-part program-based intervention will be implemented for a pilot academic year into the school curriculum for children in the 2nd to 4th grades, and will incorporate the use of a computer software application to increase levels of physical activity among students. The first portion of this program will utilize the pre-established system of instruction used in elementary schools, who organize their weeks of instruction by centralizing themes. A week centered on promoting physical activity will be carried out in the first half of the academic year. During this week, lessons plans will be aimed at identifying the benefits of physical activity. At the beginning of the week, the class will be asked to partake in an individual writing activity where they describe the type of physical activity they do (if any), when and where they do it, and other forms of activity they would like to try. Through this activity, the teacher will evaluate which stages of the transtheoretical model students are in. Those students in the precontemplative stage can be influenced into the next stage by highlighting how their bodies were “designed to move” and that they become “happier” the more they do so. In consideration of this impressionable age group, instructors should be mindful to not focus on the implications of reduced physical engagement, and instead raise consciousness of the body’s need to move. Additionally, emphasizing the benefits of physical activity, such as a more alert brain or an improvement in race times, will appeal to those students that are in the contemplative stage. As for those students in the preparation stage, the instructor will aid in identifying different ways to engage in physical activity and will account for those who may not have access to outdoor spaces (which is typical for those living in lower socioeconomic neighborhoods).
The second portion of the program will involve the use of an application (or app) which will be used for the remainder of the school year and target students at the action phase. The app will be programmed into the school’s tablets and can be downloaded onto smartphone devices using school login information. The app is designed to track physical activity through an action game as its guise. In order for children to unlock different levels to the game, they will have to log a minimum of 30 minutes of activity daily (school days only), which will incentivize students to maintain their physical activity levels. A parent/guardian or teacher must sign off on a student’s recorded physical activity in order to ensure records are accurate. An administrator’s version of the app will be run by the instructor, where students’ progress and hours can be monitored. The app will require daily input of physical activity and will provide an option for days when no physical activity is completed. If selected, the app will then ask the child to select a reason for the inactivity. The child can choose between “I was not feeling well,” “I ran out of time,” or “other” with a comment area to add feedback. Whenever one of these choices is selected, the app will prompt a response that will state, “We understand, things happen. Make sure to come back tomorrow to log in more minutes and unlock more levels!” Three consecutive days of inactivity logged in the app will prompt an alert on the administrator’s app, notifying them of a student who is in possible relapse. Teachers will then follow up with their students and identify the barriers that prevented them from participating in physical activity. Using the app for most of the academic school year will further assist in ensuring that physical activity is a consistent and normal behavior for students, leading them into the termination stage.
In “Happy Body, Happy Kid,” the Diffusion of Innovations theory and the Transtheoretical method are used in the implementation of the app in classrooms. The relative advantage of using the app for students is that it will play into their competitive nature (typical of their age group) which is catalyzed by their peer-to-peer influences, and will motivate them to get further ahead in the action game. The compatibility and simplicity of the app is that it will appeal to their shared love of games and their smart devices. In the event that students do not possess a smart device, an online version will be available for students, which can be accessed at a home or school desktop. The app will only be used for an academic year as a pilot, assuring a level of reversibility for students. If successful, the program will continue and be adjusted for other grade levels. The teachers, or change agents, can create a space where students can observe the notable physical differences among their peers. This can be done in a multitude of ways, such as timing a 100-meter dash before using the app and again at the end of the school year. By tracking student’s progress through the administrator’s app, teachers will construct an “s”-curve to evaluate how efficiently the innovation (the app) is diffused into the student’s lives.
“Happy Body, Happy Kid” will be an intervention that addresses the factors, found through the data collected in the literature review, that contribute to type 2 diabetes among African American children who live in lower socioeconomic neighborhoods. It will place an emphasis on physical inactivity and will reshape negative influences at all levels of the ecological model into positive influences. On the individual level, technology, which was found to have resulted in sedentary lifestyles, will be repurposed to promote physical activity by enticing students to unlock more levels of the action game within the app. This, in turn, will result in improved blood glucose regulation among children. Requiring parents/guardians to sign off on student’s recorded activity in the app will promote positive interpersonal relationships between parent and child, which will counteract the poor metabolic control found in African American children of lower socioeconomic households. It will also account for the competitive nature of school-aged children and how much they construct their day-to-day routines based upon the influences and acceptance of their peers. Furthermore, school systems, especially those located in lower socioeconomic neighborhoods, were found to have a direct impact on health outcomes on children. For this reason, schools were used as the central location to implement this health program. By doing so, it forces schools to promote more physical activity during recreational breaks and can provide a safe space for students to be active in, where their built environments might not otherwise allow. “Happy Body, Happy Kid” transforms key contributing factors into protective factors and provides an effective method in counteracting the development of type 2 diabetes among African American children (under the age of 14) of lower socioeconomic neighborhoods.
American Diabetes Association [ADA]. (2014). Hyperglycemia (high blood glucose).Retrieved from http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html
ADA. (2015). Hypoglycemia (low blood glucose). Retrieved from http://www.diabetes.org/living-with- diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html
ADA. (2016). Diagnosing Diabetes and Learning About Prediabetes.Retrieved from http://www.diabetes.org/diabetes-basics/diagnosis/
Alberti, G., Zimmet, P., Shaw, J., Bloomgarden, Z., Kaufman, F., & Silink, M. (2004). Type 2 diabetes in the young: the evolving epidemic. Diabetes Care, 27(7), 1798-1811.
Auchincloss, A. H., Roux, A. V. D., Mujahid, M. S., Shen, M., Bertoni, A. G., & Carnethon, M. R. (2009). Neighborhood resources for physical activity and healthy foods and incidence of type 2 diabetes mellitus: The Multi-Ethnic study of Atherosclerosis. Archives of Internal Medicine, 169(18), 1698-1704.
Borzekowski, D.L. & Robinson, T.N. (2001). The 30-second effect: An experiment revealing the impact of television commercials on food preferences of preschoolers. Journal of the American Dietetic Association, 101(1), 42-46.
Boulos, R., Vikre, E. K., Oppenheimer, S., Chang, H., & Kanarek, R. B. (2012). ObesiTV: How television is influencing the obesity epidemic. Physiology & Behavior, 107(1), 146-153.
Burton, A. (2007). Built Environment: Does Poor Housing Raise Diabetes Risk?. Environmental Health Perspectives, 115(11), A534-A537.
Carrel, A. L., Sledge, J. S., Ventura, S. J., Eickhoff, J. C., & Allen, D. B. (2014). GPS suggests low physical activity in urban Hispanic school children: A proof of concept study. International Journal of Pediatric Endocrinology, 2014(1), 25. Center for Disease Control and Prevention (CDC). (2015a). Basics about diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.html
CDC. (2015b). National Diabetes Statistics Report [Brochure]. Retrieved from https://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf (page 3)
Cordain, L., Eaton, S. B., Sebastian, A., Mann, N., Lindeberg, S., Watkins, B. A., ... & Brand-Miller, J. (2005). Origins and evolution of the Western diet: health implications for the 21st century. The American Journal of Clinical Nutrition, 81(2), 341-354.
Dabelea, D., Mayer-Davis, E. J., Saydah, S., Imperatore, G., Linder, B., Divers, J., ... & Liese, A. D. (2014). Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA, 311(17), 1778-1786.
Fletcher, B. Gulanick, M. & Lamendola, C. (2002). Risk factors for type 2 diabetes mellitus. Journal of Cardiovascular Nursing, 16(2), 17-23.
French, S. A., & Wechsler, H. (2004). School-based research and initiatives: Fruit and vegetable environment, policy, and pricing workshop. Preventive Medicine, 39, 101-107.
Gillman, M. W., Rifas-Shiman, S. L., Frazier, A. L., Rockett, H. R., Camargo Jr, C. A., Field, A. E., ... & Colditz, G. A. (2000). Family dinner and diet quality among older children and adolescents. Archives of Family Medicine, 9(3), 235.
Glanz, K. & Yaroch, A.L. (2004). Strategies for increasing fruit and vegetable intake in grocery stores and communities: Policy, pricing, and environmental change. Preventive Medicine, 39, 75-80.
Grant, R.W. (2007). Invited commentary: Untangling the web of diabetes causality in African Americans. American Journal of Epidemiology, 166(4), 388-390.
Hamilton, M.T., Hamilton, D.G., & Zderic, T.W. (2007). Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes, 56(11), 2655-2667.
Hingle, M. D., Turner, T., Kutob, R., Merchant, N., Roe, D. J., Stump, C., & Going, S. B. (2015). The EPIC Kids Study: A randomized family-focused YMCA-based intervention to prevent type 2 diabetes in at-risk youth. BMC Public Health, 15(1), 1253.
Hirose, M., Beverly, E. A., & Weinger, K. (2012). Quality of life and technology: Impact on children and families with diabetes. Current Diabetes Reports, 12(6), 711-720.
Hogg, J., Diaz, A., Cid, M. D., Mueller, C., Lipman, E. G., Cheruvu, S., ... & Nimkarn, S. (2012). An after-school dance and lifestyle education program reduces risk factors for heart disease and diabetes in elementary school children. Journal of Pediatric Endocrinology and Metabolism, 25(5-6), 509-516.
Kulik, J. A. (2003). Effects of using instructional technology in elementary and secondary schools: What controlled evaluation studies say. Arlington, VA: sri International.
Lewin, A. B., Heidgerken, A. D., Geffken, G. R., Williams, L. B., Storch, E. A., Gelfand, K. M., & Silverstein, J. H. (2005). The relation between family factors and metabolic control: The role of diabetes adherence. Journal of Pediatric Psychology, 31(2), 174-183.
Lieb, D. C., Snow, R. E., & DeBoer, M. D. (2009). Socioeconomic factors in the development of childhood obesity and diabetes. Clinics in Sports Medicine, 28(3), 349-378.
Ludwig, J., Sanbonmatsu, L., Gennetian, L., Adam, E., Duncan, G. J., Katz, L. F., ... & McDade, T. W. (2011). Neighborhoods, obesity, and diabetes-a randomized social experiment. New England Journal of Medicine, 365(16), 1509-1519.
Nolan, C.J., Damm, P., & Prentki, M. (2011). Type 2 diabetes across generations: From pathophysiology to prevention and management. The Lancet, 378(9786), 169-181.
Patil, RR. (2014). Urbanization as a determinant of health: A socioepidemiological perspective. Social Work in Public Health, 29(4), 335-341.
Power, C., Pereira, S.M.P., Law, C. & Ki, M. (2014). Obesity and risk factors for cardiovascular disease and type 2 diabetes: Investigating the role of physical activity and sedentary behaviour in mid-life in the 1958 British cohort. Atherosclerosis, 233(2), 363-369.
Raine, K. D., Muhajarine, N., Spence, J. C., Neary, N. E., & Nykiforuk, C. I. (2012). Coming to consensus on policy to create supportive built environments and community design. Can J Public Health, 103(Suppl 3), S5-S8.
Rimer, B. K. & Glanz, K. (2005). Theory at a glance: A guide for health promotion practice (2nd Edition). Bethesda, MD: National Institutes of Health [NIH], National Cancer Institute, NIH Publication No. 05-3896. Accessible at: http://www.cancer.gov/PDF/481fd53-63df-41bc-bfaf-5aa48ee1da4d/TAAG3.pdf
Rothman, R. L., Mulvaney, S., Elasy, T. A., VanderWoude, A., Gebretsadik, T., Shintani, A., ... & Schlundt, D. (2008). Self-management behaviors, racial disparities, and glycemic control among adolescents with type 2 diabetes. Pediatrics, 121(4), e912-e919.
Rowden, W. C. (1993, September). Neo-traditional neighborhood design. In 4th National Conference on Transportation Planning Methods Applications, Volumes I and II. A Compendium of Papers.
Thompson SJ, Auslander WF, White NH. (2001). Comparison of single-mother and two-parent families on metabolic control of children with diabetes. Diabetes Care 24:234-8.
United States Department of Health and Human Services [USDHHS]. (2016). Long-term complications of diabetes. Retrieved from https://medlineplus.gov/ency/patientinstructions/000327.htm
Zimmet, P., Alberti, K.G.M.M., & Shaw, J. (2001). Global and societal implications of the diabetes epidemic. Nature, 414(6865), 782-787.
Community Assessment: The Mission
Diana Alegre is a senior at San Francisco State University, where she studies Health Education with an emphasis on Community-Based Public Health and has two minors in Dance and Women’s Health Issues. Born in Manila, Philippines, Diana moved to San Francisco at eight years old and grew up in the Mission District. In this diverse community, Diana found her passions for community service in non-profit organizations across the city as a youth-leader organizer empowering youth to become leaders to advocate for social-political issues through community outreach and education. Diana discovered her advocacy passions in healthcare from exposure to clinical and non-clinical duties in leadership and professional development programs at UCSF Medical Center and St. Luke’s Hospital.
Currently, she works at the Health Promotion and Wellness (HPW) program at San Francisco State as a Mental Health Intern and president of student-led organization, Active Minds, to promote mental health awareness and wellness by de-stigmatizing conversations surrounding mental health issues. Diana’s interests lay in social justice, health equity, and education to better serve the underserved communities in society. As Vice President of Health Education Student Association, she works with her Cabinet to raise awareness about physical, mental, personal, social, and political health issues that affect our marginalized communities. After her undergrad, she plans to pursue a career in clinical leadership, policy, research, and education.
COMMENT FROM PROFESSOR RUBY TURALBA:
In the first of four sequenced and scaffolded Health Education courses, students research and develop a comprehensive community profile of a specific San Francisco neighborhood. Extensive data spanning the history, demographics, health disparities, assets and deficits in the built environment, and crime reports are collected and thoroughly analyzed to develop sound recommendations and strategies addressing root causes of health inequities.
Diana’s piece presents a thoughtful and critical analysis of the social conditions in the Mission, particularly in their exploration of diabetes, socio-economic status, access to healthy foods and health care services, and the impact of acculturation in this predominantly Latinx community. They provide viable solutions that integrate policy level recommendations to expand health care services for low-income residents, as well as culturally relevant health education and outreach fostering community organizing and mobilizing for change.
This essay has been abridged for publication purposes. For the full version, please inquire at email@example.com
Bounded by 13th Street to the north, Potrero Avenue to the east, 26th Street to the south, and 19th Street to the west, the Mission District houses a community of culture, art, and history. The Mission’s zip codes are 94103 and 94110, represented by District 9, which is supervised by Supervisor Hillary Ronen. Some geographic landmarks of the neighborhood include the Mission Turn Hall, the Women’s Building, and Dolores Park (San Francisco Planning Department, 2017).
The Mission District, locally known as “The Mission,” is a deeply diverse community in San Francisco. The neighborhood was formerly called “the Mission Lands” due to the Spanish settlement missions, or religious community stations, created during the 1760s and 1830s to spread Christianity to Native Americans. These missions eventually established California. Misión San Francisco de Asis, the oldest surviving building in San Francisco, was created as a steady home of worship for the residents in the Mission. In 1848, the Gold Rush attracted immigrants from Eastern Europe, Ireland, Sweden, Germany, and China, who sought gold in San Francisco. The infamous 1906 earthquake that hit San Francisco spared a majority of the Mission, which led to an influx of homeless refugees from San Francisco’s business district. In 1910, Mexican immigrants fled Mexico’s repression during the Mexican Revolution. Throughout the 1930’s and 1970’s, a surge of immigrants from all over the world moved in the Mission. Irish immigrants fled Ireland from the Potato Famine, Latino immigrants fled World War II repression, Asian immigrants sought for better lives, and Nicaraguan immigrants escaped economic and political instability.
The last wave of immigrants were Hispanic immigrants from Mexico and Central/South America fleeing their countries’ domestic-political conflicts. The Hispanic cultural contributions in the Mission are easily found in the neighborhood’s murals on street walls, cuisine, and music. The Mission has become widely known as a working-class immigrant neighborhood, as well as a space of expressing heritage and protest through public art (Carlsson, n.d.). Throughout the 1990s and today, young white entrepreneurs continue to move into the Mission and gentrify the neighborhood, raising the cost of living and making rent and housing prices more unaffordable for the families who have lived in the neighborhood for decades (Northern California Coalition on Immigrant Rights, n.d.).
General Population Characteristics and Demographics
The Mission’s diverse community has 75,180 residents of the 881,893 total residents of San Francisco’s entire population (Conduent Community Health Solutions (CCHS), 2017d). In San Francisco as a whole, 7.8 families per 10,000 live below the poverty line, while the Mission has a slightly higher rate at 8.3 per 10,000 of the population (CCHS, 2017c). The median income per household in the Mission is $95,196, while San Francisco’s median income per household is $81,294. The Hispanic/Latino group makes up 35.70% of the Mission population, compared to 15.46% of San Francisco’s entire population. The non-Hispanic/non-Latino group makes up 65.30% of the Mission’s population, compared to 84.54% of San Francisco’s entire population. Whites have the highest population by race, making up 60.44% of the Mission’s population, compared to 47.08% of San Francisco’s entire population. Native Hawaiian/Pacific Islanders have the lowest population by race making up only 0.32% of the Mission’s population, compared to 0.42% of San Francisco’s entire population. The highest rate in educational attainment among professionals 25 years or older is bachelor’s degrees, with 19,151 residents, which makes up 32.02% of the Mission’s population. The lowest education level attainment is less than 9th grade, with 5,113 residents, or 8.55% of the population. The highest education level attained is a doctorate degree with 1,261 residents, or 2.11% of the population (CCHS, 2017d).
Predominant Health Issues
Cancer, diabetes, and heart failure are among the top three predominant health issues within the Mission neighborhood. According to the San Francisco Health Improvement Partnership (SFHIP), 2017 data presents that cancer has caused 133.1 deaths per 100,000 of the population, diabetes has contributed to 14.8 ER visits per 10,000 for people aged 18 years or older, and heart failure causes 6.4 ER visits per 10,000 for people aged 18 years or older (CCHS, 2017e). Compared to the Mission district, there is no recorded data for cancer rates in the population; while there are 23.9 ER visits per 10,000 aged 18 years or older due to diabetes, and 7.0 ER visits per 10,000 aged 18 years or older due to heart failure (CCHS, 2017f). Regional data demonstrates that the Mission neighborhood suffers from a disproportionately high rate of diabetes.
Between 2011 and 2014, the rate of diabetes did not have any drastic changes for better health outcomes of the community. From 2011-2012, diabetes was at 5.3% to 5.6% in 2013-2014 data (CCHS, 2017a). Data is not available to illustrate the prevalence of diabetes before 2011, but within three years, the community has suffered steadily with the 5.6% of diabetes, which could increase in the next couple of years if left unaddressed. Further analysis of the Mission’s demographics will help in understanding its current diabetes condition and create ideas to promote healthier outcomes within the community.
U.S. Census Bureau Data
The census tracts (CT) within the Mission are 017700, 020100, 020800, 020900, 021000, 021500, 022801, 022803, 022901, 022902, 022903, 025100, 025200, and 025300 (U.S. Census Bureau, 2017). CT 020800 (CT 208) was the focus of this analysis because it disproportionately represented the lowest median household income at $67,295 compared to other census tracts in this district with median household incomes ranging from $96,081-$110,000+. CT 208 also has the highest total population at 6,302 residents compared to the other tracts that range from 4,000-5,300 residents (U.S. Census Bureau, 2011-2015a).
Demographic Data: Race/Ethnicity
The race and ethnic group distribution in the Mission are at diverse proportions. Data collected from the U.S. Census Bureau compared the Hispanic/Latino population within both CT 208 and San Francisco as a whole. The biggest trends in the comparison of CT 208 and San Francisco’s race/ethnic distribution lie with Hispanic/Latino and Asian groups. In CT 208, the Hispanic/Latino population at 47.1% is triple as much as that of San Francisco’s Hispanic/Latino population at only 15.3%. In CT 208, the Asian population in San Francisco’s entirety at 33.5% is twice as much in comparison to CT 208’s Asian population at only 12.8%. In CT 208, 32.5% are white, with 41.2% reported in San Francisco. (U.S. Census Bureau, 2011-2015b).
The educational attainment levels in both CT 208 and San Francisco’s (SF) entire population for individuals aged 25 years or older were collected by the United States Census Bureau through 2011-2015. Data shows that the highest rate of educational attainment level for both CT 208 and San Francisco’s entire populations is a bachelor’s degree with 32.6% (SF) and 31% (CT 208), indicating a slight difference. The lowest educational attainment level is less than 9th grade, with San Francisco at 8.1% and CT 208 with almost three times SF’s rate at 21.4%. For some college, no degree, CT 208 is at 8.2%, while San Francisco is almost twice as high at 14.9%. The highest educational attainment level is a graduate or professional degree, which sets a 5.5% discrepancy between San Francisco at 21.2% and CT 208 at 15.7%.
The household income levels reported by the United States Census Bureau (2011-2015 data) in both CT 208 and San Francisco’s entire population are in diverse proportions. The lowest income level is less than $10,000 with CT 208 at 5.1% and San Francisco at 6.5%. The median income at CT 208 is at $67,295, while San Francisco as a whole is at $81,294. The mean income for CT 208 is $107,806, while San Francisco as a whole is at $119,406. The highest income level is $200,000+ with CT 208 at 14.2% with only a 2.2% discrepancy from San Francisco at 16.4%.
The United States Census Bureau collected data on poverty status in the past 12 months between CT 208 and San Francisco’s population as a whole. Below poverty line, CT 208 is at 13.9% and San Francisco as a whole at 13.5%. At or above poverty level, CT 208 is at 86.1% and San Francisco as a whole at 86.5% (US Census Bureau, 2015). Both CT 208 and San Francisco data on poverty status in the past 12 months are similar.
The employment statuses within the population of 16 years old and over between CT 208 and San Francisco as a whole were collected by the United States Census Bureau in 2011-2015. In San Francisco as a whole, 69.5% of the population is in the labor force. In this labor force, 69.4% is employed within civilian labor force, which means that these workers are employed with any government or military institutions, while 4.7% is unemployed. In CT 208, 79.3% of the population is in the labor force, in which 73.6% is employed within civilian forces, and 5.7% unemployed. San Francisco as a whole has 0.1% of its population employed in the armed forces, while it is 0.0% at CT 208.
The nativity status within populations between CT 208 and San Francisco overall were collected by the United States Census Bureau in 2000. In San Francisco, there were 491,192 native individuals of the 776,733 residents, which made up 63.2% of the population. Foreign-born individuals living in San Francisco counted 275,541, which made up 36.8% of the population. In CT 208, 3,440 individuals were native to the district, which made up 46.7% of the population. Foreign born individuals living in CT 208 counted 3,931, which made up 53.3% of the population.
An observational tour was conducted by Diana Alegre, Millie Boonkokua, Karina Leiderman, and Celeste Robleto on April 7th, 2017 from 9:30am to 11:30am, that involved one hour of a driving tour and another hour of walking surveys to assess the Mission District's assets and deficits. The driving route was the beginning of the tour, as it began at 26th Street, the western boundary of the Mission, and continued all around the boundaries of the Mission District through the southern boundary at Cesar Chavez Street, Potrero Avenue at the eastern boundary, and 14th Street at the northern boundary.
Figure 7. Walking Survey and Driving Route of Observational Tour
-Outer A-B route: Driving tour
-Inner A-B route: Walking survey
- Community Centers - Throughout the Mission District, there were many community centers that provide many services to its community. Community centers like the Women’s Building, Galeria de la Raza, La Raza Community Resource Center, Mission Recreation Center, and the Mission Corps Community Center are nonprofit organizations that provide resources on job search assistance, legal aid, community-based cultural hubs that promote cultural studies, housing opportunities, and immigration services. In these centers, the community members learn about history and the current events of the neighborhood. These centers are platforms of organized spaces for interaction where people can also discuss and act on community challenges. There seemed to be a protection and conservation of traditions, customs, and resources throughout the Mission.
- Grocery Stores - In the Mission, plenty of grocery stores were accessible to the neighborhood. The Duc Loi Supermarket is an Asian family-run grocery store that offers a broad range of traditional Asian grocery items and Vietnamese deli fare. Casa Lucas Market is a small humble supermarket of fruits, vegetables, dairy items, and basic groceries, and Latino products. Casa Guadalupe is a simple market that offers locals with traditional Mexican grocery items and fresh produce. Mi Ranchito Produce is another produce market. There are also a few markets that offer organic products such as Whole Foods, Rainbow Grocery, and Bi-Rite Market. These grocery stores are beneficial for the community as they provide healthy whole cultural foods for different ethnic groups living in the Mission.
- Parks/Green Space - There were plenty of parks and open spaces throughout the Mission. The historical Mission Dolores Park located at Dolores Street and 19th Street, adjacent to the Mission has a large playground for children and a green space for families to hold picnics and for any events to be held at the park. There are plenty of children’s playground all over the neighborhood like Garfield Square at Harrison Street and 26th Street, James Rolph Jr. Playground at Cesar Chavez Street and Potrero Avenue, Boys & Girls Club of San Francisco at 450 Guerrero Street, San Francisco Parks Alliance at Mission Street, and others. These parks/green spaces allow the community to appreciate nature, as well as participate in outdoor physical activity. Children and adults can participate in daily exercise around the parks or sit on benches to relax.
- Monastery - The Mission District has a couple of monasteries that include the San Francisco Buddhist Center and Hua-Zang Si. During the walking survey, group members Diana Alegre, Millie Boonkokua, Karina Leiderman, and Celeste Robleto visited the Buddhist temple, Hua-Zang Si. Hua-Zang Si is a Chinese Buddhist Temple with welcoming monks who greeted the group. The group followed a monk to the ceremony room in which the monk explained the history of the temple as well as discipline and practices. The group gathered that this temple is a safe place for contemplation and meditation through the Buddhist teachings.
- Cultural Arts - Throughout the tour, there were plenty of cultural arts centers observed. Mission Cultural Centers for Latino Arts is a venue that presents Latin American arts in a gallery and events consisting of ancient to contemporary pieces of work.
- Health Centers - In this neighborhood, there was a health center, the Mission Neighborhood Health Center (MNHC), which provides community-based health care to Mission’s low-income families. There is also Mission Dental Health along Mission Street. These health centers are beneficial for the community’s health needs and assessment resources for promoting positive lifestyles.
- Liquor Stores - On every block throughout the Mission, there were various liquor stores. On 16th Street, there were Stagi Sixteenth Street Liquor and Randa’s Market, Tony’s Market & Liquor at 24th Street, Mike’s Groceries & Liquors at Mission Street, That’s It at Mission Street, Local Cellar at 22nd Street, Fred’s Liquor & Delicatessen at Valencia Street, Bartlett Market & Liquors at 24th Street, and many more (Boonkokua, M., et. al., 2017). These liquor stores are readily accessible food outlets for the neighborhood’s residents, but they do not provide healthy options for families to eat every day. These liquor stores become the normalized food sources for the community, which creates social norms for eating non-nutritional foods between families.
- Housing/Gentrification - On 18th Street and Valencia, there were several tents across the blocks where many individuals took shelter. These tents may indicate homeless campsites. As the Mission also faces gentrification and a rise in rent and housing demand that pushes out the neighborhood’s families who cannot afford these new prices, these tents may also indicate a need for accessible and affordable housing.
Crime data reported on a 0.25-mile radius of the Mission Turn Hall, or the Women’s Building, in the Mission District listed a total of 725 crime incidents within a 90-day period from January 1st, 2017 to March 31st, 2017. The three most reported crime incidents are disturbing the peace (202 reports), assault (96 reports), and vehicle break-in/theft (86 reports). Data shows that most reports of disturbing the peace and assault occurred on Saturday and Sunday, while highest reported vehicle break-in/theft incidents occurred on Sunday, Monday, and Wednesday. The three lowest rates of reported crime incidents are motor vehicle theft (28 reports), weapons (20 reports), and DUI (6 reports). The highest motor vehicle theft and weapons incident reports occurred on Monday and Saturday, while DUI incident reports occurred Saturday.
Figure 8. Crime Data CT 208 1/4-mile radius from Mission Women’s Building:
In the Mission District, the three most major health issues involve adults with diabetes, heart disease and stroke, and respiratory diseases. Diabetes is a major concern for the community as it presents the highest rates for adults in the neighborhood. There are 23.9 ER visits related to diabetes per 10,000 population of individuals aged 18 years or older in the Mission (Conduent Community Health Solutions (CCHS), 2017a). Compared to California’s overall data at 25.7 ER visits related to diabetes per 10,000 population of individuals aged 18 years or older, the Mission has a slightly lower value (CCHS, 2017a). This 1.8% discrepancy rate of diabetes between California, a state with over 39 million residents, and the Mission, a neighborhood with 75,180 residents, illustrates the alarmingly high rates of diabetes in a small urban neighborhood in San Francisco when compared to an entire state population’s diabetes rates. In the Mission, there is a lack of ready access to medical centers and healthy foods for families to buy. From the conducted walking survey and driving tour, it was determined that a controversial asset that also serves as a deficit of the neighborhood is the single health center that exists in the district—the Mission Neighborhood Health Center (MNHC) (Boonkokua, M., Leiderman, K., & Robleto, C., 2017). There are 75,180 residents in the Mission, while MNHC is the only existing health center in the neighborhood with limited services. This small community clinic does not provide all the quality medical care and resources to Mission’s residents.
Limited access to health care and education contributes to the high rates of diabetes within low-income families living in the Mission. A study conducted on racial/ethnic disparities in diabetes quality of care and the role of health care access and socioeconomic status among African-Americans, Hispanics, and Asians in the United States found that lack of insurance coverage and education correlated to the racial/ethnic disparities observed in diabetes quality of care (Canedo, JR., et. al., 2017). With 43.1% of the Mission’s residents having a high school diploma or less compared to the 74.2% of San Francisco residents who received a higher education, there is a large educational attainment gap that points to the lack of information that residents of color in the Mission can access to make healthier dietary options. This also points to the need of improving education about diabetes care.
The high rates of diabetes in the Mission can also be attributed to acculturation—the process through which immigrants adapt to living in the United States and which has played a major role in immigrants’ mental and physical health. The 46.7% that makes up the number of natives to the Mission from the Spanish settlement era combined with the 53.3% foreign-born residents in CT 208 show the high rates of families that have brought their culture to the neighborhood (USCB, 2000). The cultural differences in diet that immigrants deal with every day affect their plans to maintain American-defined healthy lifestyles. A qualitative study conducted on 24 low-income Hispanic/Latino adults diagnosed with type-2 diabetes mellitus living in the United States demonstrated a correlation between greater degrees of acculturation and less positive lifestyles. The patients indicated that their high degrees of acculturation corresponded to “less favorable [behavior] in diabetes control, fiber density, leisure-time physical activity, and more physical disability” (Plasencia, J., et. al., 2017). Due to drastic cultural changes that assimilating immigrant families face, these families’ traditional diets prove difficult to break with new values and structures as families work hard to preserve their culture.
A dynamic community change for decreasing the high rates of diabetes within low-income minority families in the Mission can start with community education. The several community centers found in this neighborhood and defined as some of its assets can create programs to educate families about different ways to gain access to more medical services in the Mission. These centers can also create nutritional classes to involve families in their own health, while families can learn how to maintain their cultural cuisine while integrating healthy options. These efforts will involve community leaders in outreach to the families they serve. The studies discussed in this paper focused on factors like the environment, social circles, and self-care behaviors that influenced a person’s ability to achieve their desired nutritional and physical health—and community organizations can attribute to positive change.
On a policy level, the City and Council of San Francisco must fund for an expansion of Mission Neighborhood Health Center to provide more medical services to its families. An even more widespread change would be to implement a citywide policy to fund for a minimum of two health centers within San Francisco’s different districts. In this way, the Mission will gain more medical services for families to access for both short-term and long-term quality care.
Throughout its long history, diabetes has plagued many low-income American immigrants. Until now, there has only been a focus on short-term interventions to assist struggling families in need, but these interventions fail to address long-term health complications. The Mission houses a community of minority groups who face food insecurity, limited access to health care, and the negative impacts associated with assimilating to the American lifestyle. Hundreds of community leaders throughout the Mission who continue to fight against these health and resource disparities will bring positive changes to create steady healthy lifestyles for its families in need. The continual efforts of a collective community to influence policies to improve the living conditions of the families it protects will revolutionize the present and future health conditions of the Mission.
Alperin, J. (n.d.). Public Housing. Historical Essay. Retrieved March 30, 2017. http://www.foundsf.org/index.php?title=PUBLIC_HOUSING
Boonkokua, M., Leiderman, C., & Robleto, C. (2017). Personal observation. Google Maps.Walking-Driving Surveys Map. Retrieved 13 April 2017 from https://www.google.com/maps/d/edit?mid=1pB-r3d5tWrvkYHYkg9sC17HBMVU&11=37.75681464761727%2C-122.41438000000005&z=15
Canedo, JR., Miller, ST., Schlundt, D., Fadden, MK., & Sanderson, M. (2017). Racial/Ethnic Disparities in Diabetes Quality of Care: the Role of Health care Access and Socioeeconomic Status. J Racial Ethnic Health Disparities. Retrieved 4 May 2017 from https://www.ncbi.nlm.nih.gov/pubmed/28078660
Carlsson, C. (n.d.) Mission. Retrieved April 1, 2017 from http://www.foundsf.org/index.php?title=Category:Mission Conduent Community Health Solutions (CCHS). (2017a). Age-Adjusted ER Rate due to Diabetes. San Francisco Health Improvement Partnership (SFHIP). Retrieved 30 March 2017 from http://www.sfhip.org/index.php?module=indicators&controller=index&action=view&indicatorId=133&localeId=131337
CCHS. (2017b). Families Living Below Poverty Level. Neighborhood: Mission, Bernal Heights (94110). San Francisco Health Improvement Partnership (SFHIP). Retrieved 30 March 2017 from http://www.sfhip.org/index.php?module=indicators&controller=index&action=view&indicatorId=240localeId=131337
CCHS. (2017c). Families living Below Poverty Level. County: San Francisco. San Francisco Health IMprovement Partnership (SFHIP). Retrieved 30 March 2017 from http://www.sfhip.org/index.php?module=indicators&controller=index&action=view&indicatorId= 240&localeId=275
CCHS. (2017d). Summary Data for Neighborhood: Mission, Bernal Heights (94110).Retrieved March 30, 2017 from http://www.sfhip.org/index.php?module=demographicdata&controller=index&action=index&id=131337§ionId=0
CCHS. (2017e). All San Francisco Health Data. Retrieved March 30, 2017 from http://www.sfhip.org/index.php?module=indicators&controller=index&action=dashboard&alias=alldata
CCHS. (2017f). All San Francisco Health Data. Mission, Bernal Heights (94110). Retrieved March 30, 2017 from http://www.sfhip.org/index.php?module=indicators&controller=index&action=dashboard&id=83017301341974213&card=0&localeId=131337
Northern California Coalition on Immigrant Rights. (n.d.). The People. Historical Essay.Retrieved March 30, 2017 from http://www.foundsf.org/index.php?title=The_People
Plasencia, J., Hoerr, S., Carolan, M., & Weatherspoon, L. (2017). Acculturation and Self- Management Perceptions Among Mexican American Adults with Type 2 Diabetes.Department of Food Science and Human Nutrition, Michigan State University. Family & Health Community. Wolters Kluwer Health, Inc. Retrieved 30 April 2017.
San Francisco Planning Department. (2010). SF Find Census Tracts. Retrieved 6 April 2017 from http://propertymap.sfplanning.org/?name=sffind
San Francisco Planning Department. (2017). San Francisco Historic Landmarks Map.Retrieved March 30, 2017 from http://sf-planning.org/San-Francisco-landmarks-map
TriTech Software Systems. (2016). Crime Incidents at the Women's Building Retrieved 6 April 2017 from https://www.crimemapping.com/map/location/the%20womens%20building?id=#
United States Census Bureau (USCB). (2011-2015a). American Community Survey 5-Year Estimates. Income in the Past 12 Months (2015 Inflation-Adjusted Dollars). Retrieved 6 April 2017 from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_15_5_YR_S1901&prodType=table
USCB. (2011-2015b). ACS Demographic and Housing Estimates 2011-2015 American Community Survey 5-Year Estimates. Retrieved 6 April 2017 from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_15_5_YR_DP05&prodType=table
USCB. (2011-2015c). Employment Status. American Community Survey 5-Year Estimate.Retrieved 8 April 2017 from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_15_5_YR_S2301&prodType=table
USCB. (2011-2015d). Educational Attainment. American Community Survey 5-Year Estimates. Retrieved 8 April 2017 from https://factfinder.census.goc/faces/tablesrvices//jsf/pages/productview.xhtml?pid=ACS_15_5YR_S150&prodType=table
USCB. (2000). Nativity, Citizenship, Year of Entry, and Region of Birth: 2000. Census 2000 Summary File 4 (SF 4) - Sample Data. Retrieved 8 April 2017 from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=DEC_00_SF4_QTP14&prodType=table
Walker, R., Williams, Strom., & Le, E. (2016). Influence of Race, Ethnicity and SocialDeterminants of Health on Diabetes Outcomes. Department of Medicine, Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina. Retrieved 30 April 2017 from https://www.ncbi.nlm.nih.gov/pubmed/27079342
Wieners, B. (1997). Gentrifying Valencia. Historical Essay. Retrieved April 1, 2017. From http://www.foundsf.org/index.php?title=Gentrifying_Valencia
The Internal Ocean: Liquidity and Ambiguity in the Construction of the Self
Calder Marchman is a senior English Literature major at San Francisco State University. An Oakland native, he has served as the Poetry Editor for Enizagam literary magazine, as well as for The Northridge Review. His creative work has been published in Generations Literary Journal and COG Zine. His analytic lenses are post-structural, Marxist, and feminist critical theory. When he is not reading or writing, his interests include playing bass guitar, guerrilla gardening, and restoring and riding vintage mopeds with his gang, Blk Blk. After completing his undergraduate degree, he hopes to continue his studies in law school, where he can apply his efforts to causes of social justice and equity in the Bay Area and internationally.
COMMENT FROM PROFESSOR MEG SCHOERKE:
In English 526, “Age of the American Renaissance,” I ask students to adopt the 19th century practice of keeping commonplace books: writing down, by hand, in a journal passages from their course reading that strike them as memorable, or as challenging enough to be worth rereading and rethinking. For their final essay, I require students to read through their commonplace books, choose three of the most interesting passages (one from an essay, one from a story, and one from a poem) and consider what connects them, especially how and why they exemplify particular currents of 19th century American thought. In his beautifully crafted essay, Calder Marchman navigates those currents by charting the ways in which Ralph Waldo Emerson, Frederick Douglass, Nathaniel Hawthorne, and Walt Whitman tap liquid metaphors to envision the self as fluid.
This essay has been abridged for publication purposes. For the full version, please inquire at firstname.lastname@example.org
Conceptions of the self from other places and times provide useful counterpoints to the account of subjectivity developed in nineteenth-century American literature. Klaus Theweleit, in his theoretical work on the formation of the fascist self in Weimar Germany, noted the conflict between liquid and solid in the diction Freikorps soldiers used to describe their orientation in the world:
“All over the country the groundwaters rose up, expelled by the forces of Hell. Above this murky flood, only the German cities still towered, isolated, threatened, slowly sinking” (Bronnen). “Around the periphery of the German sphere of influence…the Polish flood surged with mixed success” (Lieutenant General von Hülsen). Troops as a “rock amidst the raging sea,” against the enticement of the prostitutes of Lüttich (von Heydebreck). Whether it is the man himself, a city, a rock, or a periphery: the aspect of towering up is decisive in warding off the flood. (245)
In other words, the proto-fascist ego being constructed by these German authors was fixed, a bastion of solidity and firmness in the face of the oceanic torrent of their communist collective enemy, and in many respects, all the external world.
This, the metaphor of the self in operation as the “last bulwark against the flood of the masses,” finds its corollary inversion in the work of Emerson (246). In Self-Reliance, Emerson bemoans the tendency for American artists and intellectuals to “[go] abroad to beg a cup of water from the urns of men” when they have at their disposal the ability “to put [themselves] in communication with the internal ocean” (246). In the American conception, the self is liquid, as vast and uncontainable as an “ocean,” and it is the external world which is solid, an “urn” which threatens to reduce the ocean into a meager “cup.” Worse yet, the inflexibility of the external transmutes the object’s relation with this fluid self: the internal ocean is capable of being “communicated” with, whereas the cup is a commodity and can only be “begged” from another. Still, the subtext of the quote is telling—Emerson states the danger of containment will arise if “we are a mob” (246). The insular effect of the outside world is engendered by the refusal of the individual to acknowledge their self. A close reading reveals that, apart from this dynamic, Emerson dreams of an America in which the internal ocean of each person may freely intermingle with each other, rather than being artificially segregated by the fixed norms of civil society. Emerson, therefore, has constructed an American self far more adaptive than the German self Theweleit constructs. The self is not an island, definite and rigid; instead, the conceptual power of Emerson’s self stems from his alignment of the individual with the indefinite mixture of all the possibilities conceivable in the formation of personal identity.
In the Narrative of the Life of Frederick Douglass, Douglass appears to have adapted the Emersonian argument while also problematizing the concept of the fluid self. Douglass describes his treatment at the hands of Mr. Covey as follows: “I was made to drink the bitterest dregs of slavery” (1199). The line clearly evokes Emerson’s fear of an oceanic self being reduced to a consumable, but Douglass expands upon the metaphor as he coopts it. By introducing the idea that the identity he is being forced to consume contains “dregs,” Douglass plays upon the definition of the term. Literally, he is referring to “the sediment of liquors: the more solid particles which settle at the bottom of solutions or other liquid” (OED Online), often associated with “[f]æces, excrement, refuse, rubbish; corrupt or defiling matters” (OED Online), leading the reader to the conclusion that slavery is inherently connected with sinfulness and squalor. However, in a clever use of foreshadowing, Douglass evokes a second meaning: “The last remains, small remnant, residue” (OED Online), realized when, in his narrative, he frames his confrontation with Covey as the end of his mental slavery. In the metaphor of the liquid self, slavery has polluted Douglass’s individuality with particulates of solidity, the certainty of his existence as a slave. By draining these last dregs, Douglass both showcases the impurity of slavery as an institution, and sets up as a social good his freedom to access his internal ocean of the self. This reading is reinforced by Douglass’s concerns with the effects of his treatment as a slave: “I was broken in body, soul, and spirit. My natural elasticity was crushed” (1199). Douglass then, is portraying the inflexibility of slavery as one of the great evils of the system. By taking this rhetorical route, Douglass can both elicit sympathy from the Emersonian tradition and play to the fears of a white audience by connecting slavery with an affront to the constructed American self.
Hawthorne, too, seems to have been preoccupied with the trauma attendant to confining or reducing the self. In all of his stories, the characters become isolated, unable to achieve the fluid possibilities promised by the self, but in The Minister’s Black Veil, Hawthorne explores the conflict between the Emersonian ideal and the reality of American culture. Mr. Hooper, instead of being liberated by his embrace of ambiguity, symbolized by the obscuring and “glimmering” effects of the black veil, becomes more and more hindered by his refusal to elaborate on, and therefore confine, his identity (370). While insisting the black veil to be deeply personal—“Know then that this veil is a type and symbol, and I am bound to wear it ever”—Hawthorne does not hesitate to problematize Hooper’s condition as, “a man apart from men” (373, 375). However, Hooper too seems uneasy in his newly constructed and unconfined self, and the metaphor of liquid and solid once again returns. In the act of marrying a young couple, “Mr. Hooper raised a glass of wine to his lips,” paralleling both Douglass and Emerson in the portrayal of the self (372). Then, “catching a glimpse of his figure in the looking glass, the black veil involved his own spirit in the horror with which it had overwhelmed all others” (372). The repetition of the word “glass” connects the two disparate objects, unifying the vessel containing the liquid with the outward appearance of Hooper’s physical form. Yet the physical properties of the two glasses differ: one is transparent, containing all the baggage Emerson implied when he used the term to describe his idealized self, and the other is reflective, allowing no light to enter, and not containing any of the fluidity it falsely appears to have. Hooper’s reaction to this contradictory set of images is obviously not meant to evoke the confidence of self-identity instilled by Emerson: “he spilt the untasted wine upon the carpet, and rushed forth into the darkness. For the Earth, too, had on her black veil” (372). Removed from Douglass’s dregs polluting his envisioned self, Hawthorne questions whether a liquid self is even possible. Yes, the veil is described as “fluttering” and can be associated with imagery of water, but it remains a solid affect, worn by “Earth” (370). Hawthorne’s language here upsets the liquid/solid duality under which Emerson first advanced his argument. If the certainty of being trapped by the walls of an urn was reductive and harmful for Emerson, Hawthorne asserts here that the uncertainty of a fluid analogy could be deeply unsettling, precisely because the liquid possesses the possibility of solidity.
While Hawthorne’s provides a critical response to the Emersonian self, Whitman’s is conciliatory. Fluidity streams from nearly every word of Whitman’s poetry, and he would much rather revel in all possible meanings of a word than employ a context which would fix meaning. While there is a psychosexual case to be made for the ambiguous function of liquid being employed in Whitman’s young men being indiscriminant with “whom they souse with their spray,” in the context of this essay Whitman’s poetry will be examined from the perspective of forming a self (1319). From this view, it becomes obvious that although the twenty-eight young men are just that—twenty-eight individuals—their placement and actions, “bath[ing] by the shore,” represent a blurring effect of grouping (1319). While in theory their individuation remains intact, the speaker describes “beards of the young men…their long hair…their white bellies” as if these features were universally applicable to all of their bodies (1319). For the observer inside the narrative, too, difference inside the grouping is collapsed: “Which of the young men does she like best? / Ah the homeliest of them is beautiful to her” (1319). The young men then, while each occupying their individual spot of ocean, can be fluidly interchanged with one another, reflecting Emerson’s implicit argument against containment of the internal ocean of self.
So, if these men are the realization of Emerson’s ideal, what can be said about the restriction upon the woman observing this spectacle? A clear proto-feminist argument is advanced throughout the poem. The nameless woman is restrained by the repressions of femininity under patriarchy; she is set in “the fine house by the rise of the bank” and is characterized as, “handsome and richly drest aft the blinds of the window” (1319). Clearly she has received the material benefits of participating in patriarchal society, but her desire leads her to “splash in the water, yet…stay stock still in [her] room” (1319). She is contained by the solid constructs of her material conditions, so how then is she able to become “the twenty-ninth bather” (1319)? The answer is that, despite the attitudes of the time, she contains her own internal ocean, expressed through her fantasy life. Whitman takes special care to not disavow the realness of the woman’s fantasy of self; she is “not see[n]” by the young men, rather than not actually being present (1319). Furthermore, her position is supported by the narrator, when they profess to her that they “see [her] there” (1319). The result is that the woman is able to enjoy her liquid self, alongside the men. Though described as an “unseen hand”, she is given the agency to “seize fast to them,” ultimately transforming the power relations between the observer and actor, and revealing that the woman’s oceanic self transcends material containment (1319).
Emerson’s metaphor of the self as liquid occupies a central place in the American imagination. Artists return again and again to his metaphor, realizing the dangers of attempting to fix the self to any certainty even if they differ on the feasibility of this course. Perhaps this is a deficit in language, their shared medium. To define signs solidly would negate some aspect of their power, and literature would become certainty, unable to revel in all the possibilities provided by ambiguity. This clarity of definition would ironically result in the destruction of meaning in the larger sense, and readers would be unable to interact with these truly dead texts. The fascist self Theweleit observed being constructed suffered from this intrinsic instability—the self was perceived as whole and steady against the dangers presented by ambiguity and intermingling. But this self was ultimately unsustainable, driven to destruction by paranoia about the mythical other, isolationism, and bureaucracy. That the interstitial and fluid self remains as a construction today, while the solid self rose and collapsed, is a testament to its integrity.
"dreg, n." OED Online. Oxford University Press, June 2017. Web. 9 December 2017.
The Norton Anthology of American Literature. New York: W. W. Norton & Company. 2012. Print.
Theweleit, Klaus. Male Fantasies Volume 1: Women, Floods, Bodies, History. Minneapolis: University of Minnesota Press. 1987. Print.
Oppression through Economic Homogeneity and Equality
in The Lonely Londoners
Leann Christopherson is an English Literature Major at San Francisco State University. Her work engages literature that examines (post)colonialism, queer-ness, trauma communications, and feminism for their ability to express resistance and persistence as well as undermine transnational forms of heteropatriarchal power structures. Her current projects examine the way western women (including western feminists) co-opt colonial ideology to establish dominance within gendered-racial hierarchies as a mode of perpetuating oppressive power structures in (post)colonial states. She critiques various forms of texts including novella, short stories, films, pictures, and music and believes in the inclusivity of human expressions as "literature."
COMMENT FROM PROFESSOR KATHLEEN DE GUZMAN: Leann’s essay for Global Cities persuasively analyzes Sam Selvon’s novel The Lonely Londoners using the influential ideas of sociologist Georg Simmel. At the same time, Leann goes beyond merely applying sociology to literature and shows how the issues of capitalism and color/race have been entwined for centuries. Leann’s essay models the kind of illuminating interdisciplinary thinking and writing that I tried to foster in the new Global Cities course.
In The Lonely Londoners, Selvon portrays a variety of characters that move to the city to pursue social and economic wealth. Their intentions for this pursuit vary: familial migration, personal wealth, physical vices, or the intent to send back monetary aid to those they left behind in the West Indies. The contrast between an immigrant’s desires and their reality is clearly explained during the opening scene of the novel, as Moses waits at a London train station for a new immigrant named Tolroy. When Tolroy asks about his work upon his arrival, Moses is curt about his feelings towards the struggles of employment and wealth: “That is a question to limit, that is what everybody trying to figure out. They can’t get work… We can’t get no place to live, and we only getting the worse jobs” (Selvon 28-29). Moses is then interrupted by Tolroy’s abrupt exit, consequently making his description of the struggles of West Indians in London a vain attempt to warn other immigrants of the realities they will face in London. Having just arrived in the city, Tolroy has not yet had to confront the economic imbalance and disadvantages that immigrants face, while Moses has experienced immense poverty and hunger. The stark contrast between the realities of the two characters highlights how the city transforms the bodies of those who inhabit its walls, and displays a misguided view of those who can only view the city at its exterior. Simmel explains the unforgiving attitude that Moses and the other inhabitants have adapted to and says,
Money is concerned only with what is common to all, i.e., with the exchange of value which reduces all quality and individuality to a purely quantitative level… It is in this very manner that the inhabitant of the metropolis reckons with his merchant, his customer, and his servant, and frequently with the persons with whom he is thrown into obligatory association. (326-327)
In this case, we see that the equal treatment of the West Indians puts them at a disadvantage compared to the white Londoners because of the immigrants’ lack of education, familiar vernacular, and familial inheritance due to the enslavement of their ancestors. The dismissal of their economic disadvantages as descendants of former Caribbean slaves perfectly illustrates not only the unforgiving quality of money in the 20th century, a time in which the West Indian’s bodies were used solely as commodities by the colonizer, but also the disproportional advantage that those who are ethnically British or European experience under non-discriminatory economic opportunity. Simmel’s personified version of money is associated with the English or European elite, who realistically control the flow of wealth, jobs, and living conditions due to their ancestors’ pillage-and-plunder attitudes. The West Indians immigrated under faux-philanthropic allowances by the British government; despite their option to receive employment and maintain living quarters in London via the British Nationality Act of 1948, they were still disadvantaged, as the intention of the legislature was to fill gaps that were forming in labor intensive, low-wage jobs post WWII. Because they had equal rights, and were therefore measured by the same set of standards as white British citizens, an equality that does not account for their upbringing, income, and familiarity with social codes, they are not truly equal to the white Londoners vying for the same positions.
The callous attitude of the money economy puts West Indians at not only an economic disadvantage because of their history of oppression, but also at an appearance-based ethnic disadvantage. “Money, with its colorlessness and its indifferent quality, can become a common denominator of all values[.] [I]t becomes the frightful leveler- it hollows out the core of things, their peculiarities, their specific values and their uniqueness...” (Simmel 330). While discussing the unfeeling operation of the money economy, Simmel points out the physical qualities of paper money: it is rough and colorless. This money acts both a reminder and representation of those who retain so much of Europe’s wealth: the older, white elite. As the object of their desires, the money causes the West Indians to reassess their own “uniqueness” and “core,” that differentiates them from the wealthy, displaying the way that money, or rather what it represents, has no sympathy for their individuality. This causes an assimilation of culture: a forced abandonment of cultural practices and languages, which in turn divides and isolates the immigrants by placing them in between their West Indian lineage and their aspiration to be a part of British culture. Whether the abandonment is inadvertently forced due to the amount of physical time and energy they must spend working to enable their survival, or if it is due to a conscious plan to rid themselves of their own cultural practices, the West Indians are isolated from each other and their culture, causing their bodies to occupy a space between two identities that furthers their loneliness in the city, and eventually forces them into an unsympathetic individualism.
The gradient-based scrutiny of skin color is displayed in the character Bart, a lighter West Indian: “if a fella too black, Bart not companying him much… he always have an embarrass air when he with them in public, he does look around as much as to say: ‘I here with these boys, but I not one of them, look at the colour of my skin’” (Selvon 63). Bart’s avoidance of association with the other West Indians is not only a racial issue, as Selvon’s narrator points out, but is also evident of an individualistic attitude that the city has nurtured. He argues that this is the shift to the intellectual attitude that a city-dweller must adapt to survive and not be emotionally affected by the myriad of people they encounter daily. The city turns an emotional person into an intellectual who, in the interest of self-preservation, is cold and unforgiving: “Money and the domination of the intellect stand in the closest relationship with one another. They have in common a purely matter-of-fact attitude in the treatment of persons and things in which a formal justice is often combined with an unrelenting hardness” (Simmel 326). The “formal justice” that Bart believes he is fairly exacting on the people around him is based on his own judgements as to who will benefit him, and who will impede his ability to climb the socio-economic ladder. The “unrelenting hardness” that naturally follows this line of body-as-commodity logic is the abandonment of Bart’s association with any person of color, as he has clearly recognized that they are unable to benefit his personal wealth and appearance. This emphasis on the “intellectual” in Bart’s character is one that the city has enforced on him in the interest of preservation, and which in turn makes him abandon other West Indians, as well as his own ethnic identity, for an association with the wealthier European class. This cause-and-effect relationship of the money economy, and its quiet support of Imperialized racism, appears throughout the novel. However, Selvon continually reminds the reader that this is not due to the faults of the West Indians, since colonial control put them at a disadvantage that only a lighter skin color can solve.
The guise of equality that allows cities to have the appeal of homogeneity that attracts ethnically and economically disadvantaged groups is the same one that simultaneously abuses and oppresses them, forcing them into industry jobs that the privileged and the economic elite do not want to occupy. This inequality through equality that the city maintains furthers the imperialist and colonial structure that impoverished the West Indians in the first place, and yet proves to attract them to London throughout the novel. The wealth disparity continues their legacy of inferiority, and displays an unintentional compliance in the system that will continually leave them in a state of wanting.
Selvon, Samuel. The Lonely Londoners. Hodder Education, 2015.
Simmel, Georg. Metropolis and Mental Life. Syllabus Division, University of Chicago Press, 1961.
O Mother, Where Art Thou: Temporality, Movement, and Grief Through Poetics
Jane Matchak is a senior at SF State, with a double major in English Literature and Comparative & World Literature, graduating Spring 2018. Initially raised along the foot of the Santa Cruz Mountains, then moving to San Francisco for school, Jane has a native devotion to the Bay Area, and experiences anxiety with the increasing saturation of tech-based labor and modernity in general. Interested in the poetics of queer female experience, she looks to explore nuanced performances and privileges evolving from intellectual and creative femalehood. For this fall, Jane has accepted an offer to pursue an MA in Contemporary Literature, Culture, & Theory at King's College London, where she hopes to research working-class feminist writing.
PROMPT FROM PROFESSOR KHANMOHAMADI:
This essay will compare at least one poem written in one language (English is fine) and another written in another language.
Gabriela Mistral situates “La Fuga” in the temporal: straddling the present and past, first existing alongside her mother, then speaking to the latter’s absence after her death. Mistral opens the poem by speaking to her mother as the two inhabit the role of women in exile from the patriarchy; Mistral is left following, speaking perpetually in the “vagamente” (vague) (5) direction of her mother. In this “sueño” (dream) space, “un monte negro” (a black mountain) (3) twists into an eternal journey, never reaching complete satisfaction: “pero siempre hay otro monte redondo / que circundar, para pagar el paso / al monte de tu gozo” (but there always is another round mountain / to encompass, to pay the passage / to the mountain of your pleasure) (Translated by Giachetti) (Mistral 6-8). Mistral’s mother remains at a distance from the speaker, unreachable through physicality, but exists in the continuity of the natural world. Without physical connection, Mistral and her mother are left “sitiéndonos, sabiéndonos” (sensing each other, knowing each other), suggesting an internal connection after her mother’s death (11).
Contemporary poet Taije Silverman opens her piece “Blackout” similarly—in motion, side by side with her mother. In adherence to the poem’s title, the speaker immediately confronts darkness: “We walk home from dinner to find the street dark/ and we try to remember streetlights. Anything is possible” (Silverman 1-2). The speaker’s reaction to the lack of light is curious; with no light as guidance, the reality in front of her and her mother becomes unpredictable. With an ailing mother, the small prickling hope for a deus ex machina of sorts is not lost on Silverman’s speaker. Resolving to candlelight, “[t]he house looks/ familiar again, like the right dream,” and the speaker enters a surreal, temporal space––a space that has arguably been visited by Gabriela Mistral in exile (4-5).
As Mistral writes from the first quarter of the twentieth-century, her experimental style embodies very modern ideas of sexuality, writing transgressive bodies and interchanging gender and age between subjects. Writing as the daughter of a married heterosexual couple, Silverman conveys more traditional gendered roles within “Blackout” as well as throughout the larger collection, Houses Are Fields, from which it comes. In contrast, Mistral scholar Licia Fiol-Matta explores Mistral’s writing through the poet’s suppressed identity as a queer woman. In the essay “A Queer Mother for the Nation Redux,” Fiol-Matta describes Mistral’s “queer figurations” of the mother as “dependent on her strange manipulation of the feminine in modernity” (46). Throughout Tala, the collection containing “La Fuga,” Mistral employs poetic tropes that include women in movement and migration, as well as women’s encounters with “madness and the feminine” (46). In “La Fuga,” Mistral details the loneliness experienced due to lack of access to communication with her mother. It is this disconnection from the maternal figure that leads Mistral to characterize herself and her mother “cual la Eurídice y el Orfeo solos” (like Eurydice and Orpheus alone) (14). Mistral renders the speaker as the masculine Orpheus, following Eurydice––Mistral’s mother––through Hell, though never able to reach her. In choosing to allegorize this legend, Mistral conveys the hellish purgatory she finds herself and her mother’s spirit in exile to once they can no longer be together.
In contrast, Silverman’s speaker finds herself wandering in the dark of the unknown while confined to her home, where her mother exists in retrospect. Mistral remains at a distance from the physical world, whereas Silverman’s speaker anchors herself in reality. She utilizes touch, sound, and sight to keep the memory of her mother close and sustained. Later, however, Silverman cannot help but deny reality, as she regresses through a physical connection to a memory: “I have pressed my face down to the floor / of the bathroom where my mother fell one year ago . . . we never / say it” (16, 18-19). Placing her face where her mother’s body once experienced a moment of weakness is indicative of a daughter attempting to reconcile her mother’s uncontrolled ailment through physical senses such as touch: “I held her . . . For how long did I hold her? / Someone answer. For how long did I hold her” (21-22). The severance between physical connection and time is fostered by anxiety over how much time is left for the speaker to “hold” her mother. Silverman first questions the length of time her and her mother held each other in this memory, unable to recall exactly how long they remained in an embrace. As she continues, this question becomes a declarative statement, asserting their embrace as endless, unquantifiable in memory. Silverman focuses on this memory of the fall not to share a moment of her mother’s weakness with the audience, but rather to call for assistance by reviving a memory in which the speaker and her mother held each other in all their vulnerability, fused together as one.
Mistral turns towards a similar moment, in which she and her mother are connected beyond gendered physicality. The frustration Mistral expresses from her mother’s constant distance from her becomes internalized:
Pero a veces no vas al lado mío:
Te llevo en mí, en un peso angustioso
y amoroso a la vez, como pobre hijo
Galeoto a su padre galeoto (17-20)
(But at times, you are not at my side:
I carry you inside of me, an anguished
and loving weight, and at the same time;
I am like a child galley slave
with his father galley slave)
Mistral’s description of the unconditional yet complicated love that she maintains for her mother takes on a heaviness within her. This weight, “angustico y amoroso a la vez,” juxtaposes two conflicting emotions generated by her mother’s absence, each weighing on Mistral’s physical and mental self. Previously Orpheus, Mistral now inhabits her speaker’s portrayal of a male galley slave rowing in a prescribed direction. This time, Mistral’s mother inhabits the paternal, the “padre galeoto,” suggesting that the paternal figure may be responsible for the child galley slave’s inescapable mistreatment. Mistral, herself born into poverty with a father who left the family soon after her birth, speaks of the temptation to blame her mother for a childhood that lacked financial and paternal stability (Fior-Matta 35). This helps to make sense of the anguish Mistral experiences as a product of her mother’s poverty and her father’s abandonment. Yet without either parental burdens, she would not have formulated the identity that attracted her to poetic and queer feminist expression.
Both “La Fuga” and “Blackout” take a critical emotional turn, each piece building to a climax that expresses frustration with the irresolvable distance between the poet and her mother because of the mother’s gradual death. In generating the climax, both poems maintain uniquely similar internal structural form, or “its dynamic shape, which derives from the curve traced by the emotions of the poem as they change over its duration” (Vendler 119). The emotional tenor of “Blackout” fluctuates as “[w]alls shake with light” and pulse along with intermingled images of pain and love (Silverman 4). Mistral’s “La Fuga” shapes a mountainous physical and emotional structure, moving between high and low emotional points in her reflection of her mother’s death, culminating as an arduous journey through emotional consciousness. Typically, “fault lines” along the internal structure can help navigate the different “parts” of the poem (Vendler 120). Mistral’s inventive exploration of queer experience manipulates boundaries of conventional space, making it difficult to track or divide definitive poetic states: “Y me das una voces de sarcasmo / desde tres puntos, y en dolor me rompo, / porque mi cuerpo es uno, el que me diste” (You respond to me with a sarcastic voice, / from three points, and in pain, I am shattered, / because my body is one, that which you gave me) (29-31). This passage appears in the longest stanza of the poem, as the exasperated center that lacks a period for nine lines. Mistral connects the speaker’s body to the mother then immediately transforms the image of the body altogether: “tú eres un agua de cine ojos” (you[, mother] are water with a hundred eyes) (32). Mistral’s ability to blend present with past, to defy death with life, allows her to succeed in the ultimate transgression of the human body. The madness of grief and love pointedly disturbs the ability to clearly track the poem’s formal movements, as Mistral consistently (and beautifully) shifts the emotional tone and imagined space.
The internal structure of “Blackout” pulses between moments of strength and weakness, as the speaker’s frustration disrupts formal poetic diction and punctuation. Silverman’s use of irony demonstrates this: “I forget the dream where her voice / is her old voice and where / when she hugs me goodnight, all of her is there” (12-14). Here, the poem shifts into an unclear moment in the speaker’s consciousness, where a memory becomes an unrecallable dream which she continues to describe. Perhaps it feels impossible to return to a time when “all of her is there,” and the speaker’s mother was not yet experiencing pain or illness. Similar to Mistral, Silverman utilizes the dreamscape setting to project a self-conscious narration that wishes to remember things as they were––only to have pain, then an inevitable death, disarm her from conveying memory with a realistic sharpness. The climatic turn of “Blackout” comes with a breakdown of punctuation and emotional maturity:
Mommy? [Father] asks, and I start to sob.
Shh, he says, so she won’t hear me. Shhh.
and I say why is this happening to us.
Why is this happening is what you ask
but you keep walking through rooms to relight candles.
If you can see something, you think,
you can see enough. (25-31)
The stanzas above break from the rest of the poem’s two-line stanzas, the majority of which follow the formal punctuation of declarative period use for statements. These two stanzas grow slightly longer (three lines, then four) in comparison to preceding stanzas as well as those that follow. The use of childlike diction–– the father’s plea of “Mommy” while the speaker regresses to sobbing––signifies a breakdown triggered by lack of control over the mother’s state. “[W]hy is this happening to us” takes on the form of a declarative statement, as the speaker cannot remove herself from the situation in order to question it from a distance. Silverman interweaves the memory of the fall with the present state of the power outage, where there is not much control to exercise over the situation, leaving the speaker “walking through rooms to relight the candles.” Silverman prioritizes sight to anchor objects in a reality she can place herself in, thereby reminding herself that this is not another “dream.” In the surreal, Silverman romanticizes the space indeterminable by darkness: “the corners look larger. You can’t see / where things end. There must be more space / that you’d ever expected” (35-37). Silverman returns to a desire for more time, more space, that she can utilize for her mother before losing her. Silverman’s ability to maximize then minimize space proves to be effective as an expression of the fluctuating quality of grief that entraps the speaker within the dim house.
While Silverman closes her poem with a sense of the speaker left alone to consider space after losing her mother from present space, Mistral addresses her mother directly at the end of “La Fuga.” Yet Mistral also remains aware of mortality, her mother’s and her own: “Y nunca estamos, nunca nos quedamos / como dicen que quedan los gloriosos” (And we never are, we never remain / as they say the glorious ones remain) (37-38). Returning to the trope of women in exile, Mistral marks herself and her mother as outcasts from Catholicism, as two spiritual “anillos de luz” (rings of light) joined together after life (40). Nevertheless, Mistral’s emotional connection to her mother can never fully resolve the grief she experiences from her physical absence. The speaker’s use of conscious, second-person narration reinforces the one-sidedness of Mistral’s address to her mother––eternally calling to her from an imagined space where no response can be solicited. As her mother dispatches to the afterlife, Mistral finds herself cast off to a space equally alienated from communication.
To the casual observer, the intersectional identities of Gabriela Mistral (a queer Chilean feminist in exile during the early twentieth century) and Taije Silverman (a white contemporary feminist scholar teaching at University of Pennsylvania) may seem to lack a connection through experience. However, through the strength of maternal influence on their style and structure as poets, Mistral and Silverman exist in a shared moment of grief over the loss of their mothers. The boundaries of earthly space and mortal time threaten the closeness of each poet to her mother; the immortality and strength of feminist poetry offer refuge as room for grief and redemption.
My mother is two words.
Is the sky and the life, the daily world.
––Taije Silverman “Listen, No One, They’re Sleeping”
- - -, Agosín, Marjorie and Giachetti, Maria. A Gabriela Mistral Reader. White Pine Press, Fredonia, N.Y, 1993.pp.113-114. Fiol-Matta, Licia. "A Queer Mother for the Nation Redux Gabriela Mistral in the Twenty-FirstCentury." Radical History Review, no. 120, 2014. pp. 35-51.
Mistral, Gabriela, and Doris Dana. Selected Poems of Gabriela Mistral. Baltimore, Published for the Library of Congress by the Johns Hopkins Press, 1971. pp. 128-129.
Silverman, Taije. Houses Are Fields: Poems. Baton Rouge, Louisiana State University Press, 2009. pp. 3, 6-7.
Vendler, Helen. "Describing Poems." Poems, Poets, Poetry. Boston: Bedford, 2002. pp. 107-135.
Sutro Review thanks the following teaching faculty for their comments: Professors: Mary Soliday, Teresa Pratt, Ruby Turalba, Marty Martinson, Meg Schoerke, and Kathleen De Guzman; and Lecturers: Nancy Devine, Sara Felder, Dan Curtis-Cummins, Jay Jackl, and Sarah Ann Cox.
In addition, we’d like to thank English Department staff Erin Macke, Tyler Sciacqua, Kitty Quinn-Friel, and Jace Allen for their invaluable time and support; and again, English Department Chair, Sugie Goen-Salter and Director of Composition, Jennifer Trainor for making this project possible.