The State of Opportunity

Court Upholds LAPD's Policy of Not Asking Immigration Status

Last Thursday, June 26^th a California Superior court upheld the LAPD’s 29-year-old policy of neither arresting people based on immigration status nor asking about immigration status during interviews. This policy, described by Police Chief William Bratton as “an essential crime-fighting tool for us,” is meant to avoid discouraging the undocumented population in many LA communities from communicating with police officers and reporting crimes. Proponents of the policy’s abandonment, who filed suit in April 2007, argue that it conflicts with federal and state law. While under the policy officers do alert immigration officials in the case of a suspect who has either previously been deported or is arrested for a felony/multiple misdemeanors, plaintiffs argue that illegal immigrants are repeatedly arrested rather than appropriately deported.

The judge’s decision affirms that immigration law is to be applied on the federal, and not the local level. Local law enforcement officials cannot and will not be asked to act as federal immigration agents. The defendants argued, and the court agreed, that this conflation of positions is not warranted on legal grounds and is detrimental to the goals of local law enforcement.

The overturning of this lawsuit averts several troubling implications that elimination the disputed policy would have had. The role of a local police officer and that of an federal immigration agent have vastly different objectives; while the former exists “to protect and serve” residents, the latter aims to “effectively enforce our immigration and customs laws… by targeting illegal immigrants.” In an area with a significant undocumented population, these roles are often at odds with each other. To ask that police officers assume the duties of immigration agents is to cast them into a confused role that ineffectively pursues conflicting goals. Furthermore, incorporating these duties into local law enforcement greatly increases the risk of racial profiling in pursuit of undocumented residents.

The court’s decision to uphold the LAPD’s longstanding policy marks a victory for security in these communities. As one of its six core values, the Opportunity Agenda holds security to be vital to our human dignity. Without safe and healthy living conditions, it becomes overwhelmingly difficult for residents to access any of the other opportunity that society has to offer. To put local police officers in a position that undermines their ability to serve their communities as a whole would be to betray a fundamental commitment to equality, security, and community. With its policy on immigrants intact, the LAPD can go forth in its goal to “build safer communities throughout the City of Los Angeles.”

Local Progress in Tackling Health Disparities

Earlier this month the Atlas Project at the Dartmouth Institute for Health Policy and Clinical Practice released a report documenting the state of health inequalities in the United States.  The report (which was previously mentioned in a post on The State of Opportunity blog) titled “Disparities in Health and Health Care among Medicare Beneficiaries” can be accessed here. 

The report calls attention to the fact that health care reform is not only about expanding insurance coverage and improving efficiency standards for health spending – it is also about addressing the unequal access to and the quality of health care in the U.S.  As the Dartmouth report articulates, health disparities are widespread and extensive.  There are higher rates of obesity and smoking among African Americans than there are among whites; this leads to blacks experiencing higher rates of diabetes and cardiovascular disease than whites do.  Blacks have poorer access to primary and specialty care, and this limits their ability to manage any chronic illnesses they might have.  Blacks also have poorer access to advanced surgical solutions, and are more likely to face unfavorable, last resort treatments like leg amputation for diabetes.

Monday Health Blog Roundup

•    This past week there have been a number of news articles on HIV and the racial disparities among those who are infected.  The Washington Post reported that the number of young homosexual men diagnosed with HIV has risen 12%.  The largest increase of 15% was among young African American men (compared to a 9% increase among young white men):

Previous studies have found that gay black men on average have fewer sex partners, are less likely to use drugs and are no more likely to have unprotected intercourse than gay white men. Consequently, their higher rate of infection does not appear to arise from riskier behavior.

Instead, it reflects the higher prevalence of HIV -- as well as syphilis and gonorrhea, which increase a person's susceptibility to HIV -- in the black population.

Despite this negative news of increasing health disparities between whites and African Americans, there was also a positive step in the battle against HIV.  According to the New York Times, the New York City Health Department has announced a three year plan to give an HIV test to everyone living in the Bronx:

While Manhattan has long been the epicenter of the AIDS epidemic in New York, with the highest incidence of both AIDS and H.I.V., the virus that causes it, the Bronx, with its poorer population, has far more deaths from the disease. Public health officials attribute this to people not getting tested until it is too late to treat the virus effectively, thus turning a disease that can now be managed with medication into a death sentence.

Though the story does not mention the demographic population of the Bronx, 35.6% of Bronx residents are African American, a much larger percentage than the percentage of African American Manhattanites (who make up only 17.4% of the borough’s population).  Expanding HIV testing in the Bronx is an important part of combating the racial disparities among those with HIV and helping end the upward trend of HIV rates among young African Americans. 

•    The Kaiser Health Disparities Report has a story on a House bill to reduce allowable lead levels in paint.  The bill, which just unanimously passed the House Financial Services Committee, aims to lower the number of children exposed to lead-based paint (many of whom are poor, minority children who live in older homes):

According to bill sponsor Rep. Keith Ellison (D-Minn.) and other lawmakers, despite a 1992 law that restricted the use of lead-based paint in houses, hundreds of thousands of children are exposed to excessive levels of lead, which can cause brain damage and other serious health problems.

•    The HealthBeat blog has a posting on how progressives should incorporate cost control into their discussion of health care reform.  Without cost control on the agenda of health care reform, it will be difficult to bring Americans who are most concerned with rising costs of health care on board:

That is why I believe that progressives must begin talking about the high cost of care, and how we need to wring the waste out of the system to make truly effective, high quality care affordable for everyone. Don’t let the conservatives dominate the debate about spending. If they do, they’ll take the conversation in the wrong direction.

The Opportunity Agenda believes that addressing the issue of cost is crucial to a fruitful, productive discussion on health care reform. For example, 52% of American workers do not enroll in employer insurance plans because they are too costly.  Premiums for family coverage have increased by 59% since 2000.  Decreasing these costs, in addition to addressing the problems of unequal access and unequal quality, is absolutely necessary in order to reform the health care system in the U.S.  To learn more, take a look at The Opportunity Agenda fact sheet, Health Care and Opportunity.

•    For a touch of humor, check out a recent posting on Disease Management Care Blog.  Along with a YouTube video of Canned Heat’s “Let’s Work Together” there are new lyrics encouraging all to work together to reform health care in the U.S.:

Together we'll stand
Divided we'll fall
we need more data
the… cash flows will stall
let’s work together
Come on, come on
let’s work together
Now now people….
Because together we will stand
Every doc, all the vendors and Plans!...

Thursday Immigration Blog Roundup

•    Last week, The Opportunity Agenda's Immigration Blog Roundup linked to an Of América posting about the Guantanamo-like treatment of individuals held at ICE detention facilities.  The latest Breakthrough video titled “Death by Detention” documents individuals’ stories of their horrific experiences at these facilities.  The video has been posted on numerous pro-migrant blogs, including Standing FIRM.

•    Immigration News Daily has posted an editorial titled “No Getting Around the Wall.”  The editorial, which originally appeared in La Opinión, condemns the Supreme Court for refusing to hear a challenge to the Department of Homeland Security decision to build a wall along the U.S.-Mexico border.  Numerous Arizona environmental organizations have claimed that the DHS ignored 36 environmental protection laws in deciding to construct the wall:

Once again, as in the case of the "mismatch letters" and other similar actions, the Bush Administration is trying to improvise an immigration policy without taking into account the consequences triggered, the rights violated, or the injustices committed.

Building a wall along the border is bad policy. As long as it continues, the courts have the responsibility to stop the abuse of authority that stems from its implementation.

•    Wednesday’s Immigration Equality Blog posting calls attention to a USA Today story describing how U.S. citizens are suing the DHS after they were detained and interrogated by ICE workers.  The plaintiffs in the suit claim that they were subject to racial profiling and that ICE officials violated workers rights in the process of detaining people.  One immigrant worker, Jesus Garcia, was thrown in jail because of the ICE agents’ “mistake”:

ICE agents went to Jesus Garcia's home on April 16 in conjunction with a raid on a nearby Pilgrim's Pride poultry processing plant, where he worked marinating chicken meat. Garcia, from Mexico, has been a legal permanent resident for a year and a half. When about 10 ICE agents and local sheriff's deputies knocked on his door, they told him he was using the wrong Social Security number, says his wife, Olivia Garcia, a U.S. citizen.

Though Garcia showed the agents his green card, they handcuffed him and jailed him. He was released a day and a half later after agents told him he wasn't the person they wanted, he says. He had spent the night in jail. "He said it was pretty bad," Olivia says. "People were crying and screaming."

•    A story that appeared in Medical News Today and was initially reported by the Ventura County Star examines California Governor Arnold Schwarzenegger’s decision to save $87 million in the state’s Medicaid program (“Medi-Cal”) by cutting funding for health care services to approximately 91,000 immigrants each month:

Immigration advocates say the cuts would prevent patients from obtaining preventive care, thus increasing emergency department visits and costs. State Assembly and Senate budget committees have voted against the proposals and other Medi-Cal changes, but state officials say they will continue to push for the cuts.

Owning Up To Racial Bias

A Washington Post/ABC News poll released this week includes some interesting findings, as Americans contemplate the possibility of the nation's first African-American president.  The survey finds, for example, that 3 in 10 Americans admit to having at least some feelings of racial prejudice.  There was little difference between whites, blacks, and "others," in their response to the question.  While social science research shows that virtually all of us carry around subconscious or implicit biases, it is surprising to see so many Americans consciously owning up to their prejudices and confessing them in a telephone survey.

As in other surveys, African Americans were more likely than whites to believe that discrimination persists as a problem, but the numbers were closer than in other recent polls.  When asked "Do you think blacks who live in your community experience racial discrimination, or not?" 54% of blacks said "yes," while 46% of whites agreed.  African-American perceptions of discrimination were lower here than in similar recent polls, but may reflect the fact that people of all races typically perceive greater mistreatment in the larger society than they do in their own community.  Interestingly, people from racial groups other than Caucasian and African American--lumped together as "others" in the survey analysis--were most likely to answer yes to this question, at 59%.

These poll results, along with other research and events on the ground, suggest that Americans may be ready for a conversation about race that goes beyond the traditional model of discrimination as violent bigotry and recognizes bias as something we must identify and overcome as a nation--through policy as well as personal behavior.  And unlike the Washington Post/ABC poll, that conversation will expand from the familiar black/white paradigm to acknowledge the full diversity of our communities. 

In the weeks to come, The Opportunity Agenda will be sharing new research, as well as new tools, that can help to move that conversation forward through Election Day and beyond.

Stay tuned.

60th Anniversary of the Universal Declaration of Human Rights

Yesterday was the 60th Anniversary of the Universal Declaration of Human Rights, a ground-breaking document initiated and championed by the United States and Eleanor Roosevelt.  Frank Knaack of the ACLU Human Rights Program writes about the significance of the Universal Declaration in the United States and where we are today in fulfilling the promise of "the foundation of the modern human rights system":

The UDHR laid the foundation for a system of rights which are universal, indivisible, and interdependent. The UDHR does not differentiate between civil and political rights on one side and economic, social, and cultural rights on the other. It realizes that in order to properly enjoy one set of rights, you must also be able to enjoy the other. As is often noted, one cannot properly exercise their right to vote, think, or live if they have no food, housing, or basic health services. It is from these principles that the modern human rights treaty system (international human rights law) was born.

[...]

While much of the focus on the human rights record of the U.S. government is in the context of foreign policy and the so called “war on terror,” including the rendition, torture, and indefinite detention of foreign nationals, and vis-à-vis its high rhetoric on spreading freedom and democracy throughout the globe, it is of equal importance to look at the state of human rights at home. From the government’s inadequate response in the wake of hurricanes  Katrina and Rita; to pervasive discrimination against racial minorities in the areas of education, housing, and criminal justice, including death penalty; to imposing life sentences without the possibility of parole on juveniles; to abhorrent conditions in immigration detention facilities, it is clear that the U.S. government has failed to abide by its international obligations.

While the struggle for universal human rights is far from over, there has been great improvement in the fight to bring human rights home. More and more non-governmental organizations (NGOs) and individual activists in the U.S. are utilizing the human rights framework in the domestic advocacy and litigation. At the latest session of the U.N. Committee on the Elimination of Racial  Discrimination (the treaty body that monitors state compliance with the Convention on the Elimination of All Forms of Racial Discrimination), there were more than 120 representatives from U.S.-based nongovernmental organizations (NGOs) in Geneva, Switzerland, who briefed the Committee members and provided additional information to counter the misrepresentations and omissions of the official U.S. government report on the state of racial discrimination in the U.S. This information, in turn, led the Committee to conclude that the U.S. should make sweeping reforms to policies affecting racial and ethnic minorities, women, indigenous people, and immigrants. The Committee’s recommendations garnered domestic and international media attention, and were followed by a three week official visit to the U.S. by the U.N.  Special Rapporteur on Racism. This visit by the Special Rapporteur further opened up opportunities for domestic NGOs to utilize the international human rights framework, as was evidenced by the successful public education and media outreach campaigns conducted by local NGOs throughout the US during this visit. As this shows, human rights advocacy has become an effective tool for social justice advocates in the U.S. to use to press for change and enhance the protection of basic human rights.

The Opportunity Agenda is dedicated to bringing human rights home.  We are proud to work with coalitions such as the U.S. Human Rights Network and the Human Right to Health Capacity Building Collaborative to build the national, state, and local will to make human rights a real and effective tool for realizing American opportunity.

U.S. Human Rights Reports and Tools from The Opportunity Agenda:

• Human Rights in the U.S.: Opinion Research with Advocates, Journalists, and the General Public
• Unequal Health Outcomes in the United States: A Report to the U.N. Committee on the Elimination of Racial Discrimination
• Policy Brief: Healthcare, Opportunity, and Human Rights at Home

Six Years Later, Health Disparities by Race and Ethnicity Persist

Amidst the energy and momentum for health care reform in the United States, it is important to remember that getting an insurance card into everyone's wallet is not the same as guaranteeing equal access to quality health care.  Recent studies have shown that, in America, health is not just about having insurance or paying bills: it's also, unfortunately, about the color of your skin.

The Lancet, a journal of global medicine, published an article this last Saturday (free registration required) on persisting racial and ethnic disparities in health, six years following the groundbreaking Institute of Medicine study, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.  The Opportunity Agenda Research Director and primary editor of the 2002 IOM study, Brian Smedley, is quoted in the Lancet article:

“As the report's study director, I was pleased to see that Unequal Treatment prompted a sober discussion in health policy, academic, and political circles”, Brian Smedley, former senior programme officer at the US Institute of Medicine, wrote in a blog to mark the latest issue of the journal Health Affairs, which includes research on health disparities. “But ultimately the report failed to prompt passage of significant new federal legislation or spur the Department of Health and Human Services to adopt its core recommendations. As a result, little has been done, in my view, to systematically address the problem.”

Citing some of the papers in the latest issue of Health Affairs, called Disparities: Expanding the Focus [paid subscription required], he said that some of the most shocking health care gaps that were not documented when Unequal Treatment was published, were found in mental and oral health care. Meanwhile, the biggest gains in life expectancy occurred among the best-educated Americans.

Because of the failure of HHS to adopt recommendations to reduce disparities, and the stalling of major legislation in Congress to address disparities, many of the inequities identified half a dozen years ago are still prevalent.  In very real terms, this means that communities that often have the most need for quality health care are the ones that receive the least of such care. 

Lifting the Curtain

Last week I got on the B train from Brooklyn to Manhattan at 5:30 am.  It was early for me, but the train was packed with regulars.  They were not Wall Street titans or corporate moguls.  Not lawyers or accountants.  The train was filled with low-income folks, overwhelmingly people of color, on their way to work.  Many were going to, or even returning from, the first of several jobs that they do every day to make ends meet and support their families.

And so, it was especially jarring to open the paper and read Hillary Clinton’s words in an interview with USA Today:

"There was just an AP article posted,” Clinton said, “that found how Senator Obama's support among working, hardworking Americans, white Americans, is weakening again, and how the, you know, whites in both states who had not completed college were supporting me."

Upon reflection, I realized that what was remarkable about Clinton’s comments was that she had explicitly made the connection between white Americans and “hard working Americans.”  Politicians from both parties have been making the connection implicitly in voters’ minds for decades, but rarely has a major politician lifted the curtain on that troubling narrative.

Throughout the 1980s, Ronald Reagan told the story of the "Chicago welfare queen" who had 80 names, 30 addresses, 12 Social Security cards, and collected benefits for "four nonexisting deceased husbands," fleecing taxpayers out of "over $150,000."  The story turned out to be untrue, but Reagan kept telling it.  Just as important, Reagan’s audience understood the mythical Welfare Queen to be an African-American single mother, even though most women on welfare in the 1980s where white, and even though this particular woman did not actually exist.  Reagan was tapping a longstanding stereotype and understood that he did not have to—and shouldn’t—make the racial connection explicitly.

A decade later, when Bill Clinton touted rewarding Americans who “work hard and play by the rules,” and “ending welfare as we know it,” the subtext of poor people of color was also in the background.  Who, exactly, were the people who were not working hard and breaking the rules?  The phrase tapped the sub-conscious—and inaccurate—script that millions of Americans carried in their heads.

What’s remarkable about Hillary Clinton’s comment is that she actually made explicit what Reagan and Bill Clinton had kept below the surface: the stereotype that people of color are lazy and dependent on “big government.”

Unfortunately, many progressive organizations and leaders continue to use the “hardworking Americans” and “playing by the rules” narratives, perhaps unaware of what that triggers in their audiences, or how it is experienced by many people of color. 

It’s time to move to a narrative that honors hard work, perseverance, and honesty without playing on racial stereotypes and division.  We can start by breaking the predominant frame and showing, as well as telling, the real story of America’s working poor, including the low-income people of color who work hard every day.

"Brave New Laws" by Alan Jenkins at OurFuture.org

Check out The Opportunity Agenda Executive Director Alan Jenkins' new column, "Brave New Laws," at the Campaign for America's Future blog, Blog for Our Future.  Jenkins discusses the need for new, proactive laws that recognize what technological advances and scientific research have clearly demonstrated--that many Americans are still at risk of discrimination:

A growing body of research shows that, while old fashioned bigotry has declined, subconscious stereotypes and implicit biases continue to pose daunting barriers to equal treatment in health care, education, and the criminal justice system, among other sectors. Particularly compelling is the work of Harvard’s Project Implicit (https://implicit.harvard.edu/implicit/), which shows that we all carry around subconscious biases based on race, gender, religion, and other human characteristics that often influence our decisionmaking. The Institute of Medicine at the National Academies, among others, has found that such biases can influence health care and other decisions, including by professionals who have no conscious intention to discriminate.

Despite this established research, the courts have interpreted the Constitution’s Equal Protection Clause, as well as Title VI of the Civil Rights Act of 1964 (which bars racial discrimination in federally funded programs), to address only intentional efforts to harm people of a particular group. Because that reading fails to respond to the realities of modern exclusion, Congress should amend Title VI, and the next Administration should advocate a reading of the Constitution that embodies the Framers’ intention to eradicate discrimination, in its evolving forms, from our nation’s institutions.

Read the full column here.

You're Invited to a Hill Briefing on CERD and Health Inequality

Here's an event that folks interested in health equity and human rights might want to attend ...

Congressional Briefing on Health Inequality and the Convention on the Elimination of All Forms of Racial Discrimination (CERD)

The U.S. government recently filed a required periodic report to the United Nations on the nation's progress toward the elimination of racial discrimination. The report cited progress in many areas, including health and health care. The U.N. CERD Committee agreed with some aspects of the report but noted that the United States has failed to recognize and remedy instances where facially-neutral policies contribute to inequality in health and health care.

To address these issues, several dozen non-governmental organizations and individual scholars, under the leadership of the Poverty and Race Research Action Council, prepared a "shadow" report, Unequal Health Outcomes in the United States (available at http://www.prrac.org/pdf/CERDhealthEnvironmentReport.pdf), that illustrates instances of non-compliance with CERD in the right to health, health care access, and treatment, and outlines steps to correct them.

You are invited to a special briefing with some of the collaborators on this report to learn of the extent of racial inequality in health and environmental health, their causes, and actions that government can take to address them. This panel discussion, moderated by Brian Smedley of The Opportunity Agenda, will feature presentations from Katrina Anderson of the Center for Reproductive Rights, Steve Hitov of the National Health Law Program, Rea Pañares of Families USA, and Philip Tegeler of the Poverty and Race Research Action Council, and will take place on April 24 from 1:30pm - 3:00pm in room HC-8 of the Capitol. To RSVP for the briefing, please call or email Kara Forsyth of the Raben Group at (202) 223-2848 or KForsyth@rabengroup.com. All are invited, but seating is limited and priority will be giving to Congressional staff and members.