Curso 3 Parte II

Diversity and Social Justice in Social Work
 "America's Elderly Prisoner Boom" ver

video e fazer exercicio
Module 3: Unpacking Intersectionality

 Module goals. Lecture
Patricia Hill Collins is one of the
many black feminist scholars who
have shaped our understanding of
intersectionality.
Intersectionality is commonly
discussed as a way of
understanding social location. That
is, how people experience inequality or disadvantage in society depending
on their multiple social identities.
Such as race, ethnicity, class, sexuality, religion, national origin,
age, and disability status. If people with different social identities are
treated differently within structural systems, such as education, criminal
justice, healthcare, employment or housing.
They have vastly different realities, lived experiences, and
opportunities to live full, meaningful, and healthy lives. Through the lens
of intersectionality, the effects of this type of discrimination become
cumulative. It combines, overlaps, or intersects to burden an individual's
daily existence.
Intersectionality is not a comprehensive theory in and of itself.
Rather it's a tool that helps us to analyze inequality as it affects individuals
caught up in multiple intersecting structural systems in society.
Think of intersectionality as a pair of glasses. Once we can view
people's experiences through an intersectional lens, we can see more clearly
and begin to develop strategies to entrust the systems of inequality.
As social workers, our goal is also to aid our clients in navigating
complex social problems and environments, even while we seek to reshape
those problematic social contexts.
We can't talk about intersectionality without revisiting our
discussion on power. According to the work of Patricia Hill Collins,
intersectionality operates within a matrix of domination. That is the overall 51
organization of power in society.
Any given matrix of domination is formed by multiple intersecting
systems of oppression and has both social and historical influences. For
example, you might analyze a power matrix whereby a client is impacted
by both racism and sexism.
Or ageism and ableism or discrimination against someone with a
physical or a hidden disability. These types of oppression form
intersections in the matrix of domination.
They tell us who is advantaged and disadvantaged in society based
on their multiple social locations. But power must also be analyzed across
domains. According to the work of Patricia Hill Collins, there are four
domains of power that should be considered when conducting an
intersectional analysis.
First, structural power consists of grand social systems such as law,
politics, religion, and economy. That organize power relations among
individuals in groups.
The structural domain helps to organize power relations within
society, and these are slow to change. Consider the need for laws on voting
rights for African Americans, marriage equality for LGBTQ individuals.
Or the Equal Pay Act intended to eliminate sex based wage
discrimination affecting women. It required large scale social movements
to change the structural power domain in each of these areas, sometimes
over decades or even generations.
In the words of Frederick Douglas in 1857, power concedes nothing
without a demand. It never did and it never will. Disciplinary power is like
the bureaucracy that keeps people oppressed under the weight of structural
power.
If anyone has ever worked within a large organization or
corporation, it's well known that bureaucracy otherwise known as red tape,
is often an act in the name of efficiency, surveillance, or rationality. It can
mask racism and sexism, squash resistance, or discourage solidarity.
Bureaucracies are notoriously slow to change. Next, hegemonic
power links and legitimizes all other forms of oppression, by establishing
oppression as the status quo. It's through this type of power that our
common language, images, ideas, and culture are infused with
Diversity and Social Justice in Social Work course 3

discriminatory stereotypes, racist, sexist, heteronormative, and ethnocentric 52
ideology.
And it's all as casual as the air that we breathe. Patricia Hill Collins
states that only when these products of hegemonic power are disbelieved
will they lose their impact.
Finally, interpersonal power operates in every day life. It consists of
the personal interactions and relationships that we navigate. Doing
intersectional work in this domain requires that we reflect on the ways in
which our own thoughts and actions contribute to the oppression of others.
Patricia Hill Collins highlights how often we have a blind spot as
humans. We easily see that oppression be it racial, economic, religious or
otherwise, that we experience ourselves.
And we readily identify when someone else like us also experiences
similar types of oppression. But that recognition comes at the exclusion of
being able to see other types of oppression is equally valid and important in
others.
In this way, someone who has themselves experienced oppression
in one form can become an oppressor by not acknowledging how someone
else has been disadvantaged in a different aspect.
Patricia Hill Collins states that oppression is filled with
contradictions. The matrix of domination contains few pure victims or
oppressors. Kimberle Crenshaw transformed our collective discussional
intersectionality when she published a landmark article in the Stanford Law
Review in 1993.
Highlighting intersectionality as the proper framework to
investigate violence and employment discrimination against African
American women.
She teased apart the systems that make use of racism and sexism to
disadvantage women of color on multiple levels. As you read the original
article, listen to Dr. Crenshaw speak about her work on intersectionality,
and try to extract at least two specific examples that she offered to highlight
power dynamics operating across domains.

53

54
 Watch & Reflect: Unpacking

Intersectionality
Watch the following TED talk and read the assigned article. Then in
the open response area below, identify two specific examples offered by
Kimberlé Crenshaw that illustrate structural, political, or interpersonal
power at work. Keep responses to 250 words or less.
Read the Article
 Kimberly Crenshaw: The Urgency of

Intersectionality exercise
I'd like to try something

new. Those of you who are
able, please stand up OK, so
I'm going to name some
names.
When you hear a name
that you don't recognize, you
can't tell me anything about them I'd like you to take a seat and stay seated.
The last person standing, we're going to see what they know. OK
(Laughter All right. Eric Garner. Mike Brown. Tamir Rice. Freddie Gray.
So those of you who are still standing, I'd like you to turn around and 55
take a look. I'd say half to most of the people are still standing. So let's
continue.
Michelle Cusseaux.
Tanisha Anderson.
Aura Rosser.
Meagan Hockaday.
So if we look around again, there are about four people still standing,
and actually I'm not going to put you on the spot. I just say that to
encourage transparency, so you can be seated. (Laughter)
So those of you who recognized the first group of names know that
these were African-Americans who have been killed by the police over the
last two and a half years.
What you may not know is that the other list is also African-
Americans who have been killed within the last two years. Only one thing
distinguishes the names that you know from the names that you don't
know: gender.
So let me first let you know that there's nothing at all distinct about
this audience that explains the pattern of recognition that we've just seen.
I've done this exercise dozens of times around the country.
I've done it to women's rights organizations. I've done it with civil
rights groups. I've done it with professors. I've done it with students. I've
done it with psychologists. I've done it with sociologists.
I've done it even with progressive members of Congress. And
everywhere, the awareness of the level of police violence that black women
experience is exceedingly low.
Now, it is surprising, isn't it, that this would be the case. I mean, there
are two issues involved here. There's police violence against African-
Americans, and there's violence against women, two issues that have been 56
talked about a lot lately.
But when we think about who is implicated by these problems, when
we think about who is victimized by these problems, the names of these
black women never come to mind.
Now, communications experts tell us that when facts do not fit with
the available frames, people have a difficult time incorporating new facts
into their way of thinking about a problem.
These women's names have slipped through our consciousness
because there are no frames for us to see them, no frames for us to
remember them, no frames for us to hold them.
As a consequence, reporters don't lead with them, policymakers don't
think about them, and politicians aren't encouraged or demanded that they
speak to them.
Now, you might ask, why does a frame matter? I mean, after all, an
issue that affects black people and an issue that affects women, wouldn't
that necessarily include black people who are women and women who are
black people?
Well, the simple answer is that this is a trickle-down approach to
social justice, and many times it just doesn't work.
Without frames that allow us to see how social problems impact all
the members of a targeted group, many will fall through the cracks of our
movements, left to suffer in virtual isolation.
But it doesn't have to be this way. Many years ago, I began to use the
term "intersectionality" to deal with the fact that many of our social justice
problems like racism and sexism are often overlapping, creating multiple
levels of social injustice.
Now, the experience that gave rise to intersectionality was my chance
encounter with a woman named Emma DeGraffenreid. Emma
DeGraffenreid was an African-American woman, a working wife and a 57
mother.
I actually read about Emma's story from the pages of a legal opinion
written by a judge who had dismissed Emma's claim of race and gender
discrimination against a local car manufacturing plant.
Emma, like so many African-American women, sought better
employment for her family and for others. She wanted to create a better life
for her children and for her family.
But she applied for a job, and she was not hired, and she believed that
she was not hired because she was a black woman. Now, the judge in
question dismissed Emma's suit, and the argument for dismissing the suit
was that the employer did hire African-Americans and the employer hired
women.
The real problem, though, that the judge was not willing to
acknowledge was what Emma was actually trying to say, that the African-
Americans that were hired, usually for industrial jobs, maintenance jobs,
were all men.
And the women that were hired, usually for secretarial or front-office
work, were all white.
Only if the court was able to see how these policies came together
would he be able to see the double discrimination that Emma
DeGraffenreid was facing.
But the court refused to allow Emma to put two causes of action
together to tell her story because he believed that, by allowing her to do
that, she would be able to have preferential treatment.
She would have an advantage by having two swings at the bat, when
African-American men and white women only had one swing at the bat.
But of course, neither African-American men or white women needed to

combine a race and gender discrimination claim to tell the story of the 58
discrimination they were experiencing.
Why wasn't the real unfairness law's refusal to protect African-
American women simply because their experiences weren't exactly the
same as white women and African-American men?
Rather than broadening the frame to include African-American
women, the court simply tossed their case completely out of court. Now, as
a student of antidiscrimination law, as a feminist, as an antiracist,
I was struck by this case. It felt to me like injustice squared. So first
of all, black women weren't allowed to work at the plant.
Second of all, the court doubled down on this exclusion by making it
legally inconsequential. And to boot, there was no name for this problem.
And we all know that, where there's no name for a problem, you can't see a
problem, and when you can't see a problem, you pretty much can't solve it.
Many years later, I had come to recognize that the problem that
Emma was facing was a framing problem.
The frame that the court was using to see gender discrimination or to
see race discrimination was partial, and it was distorting. For me, the
challenge that I faced was trying to figure out whether there was an
alternative narrative, a prism that would allow us to see Emma's dilemma, a
prism that would allow us to rescue her from the cracks in the law, that
would allow judges to see her story.
So it occurred to me, maybe a simple analogy to an intersection might
allow judges to better see Emma's dilemma. So if we think about this
intersection, the roads to the intersection would be the way that the
workforce was structured by race and by gender.
And then the traffic in those roads would be the hiring policies and
the other practices that ran through those roads.

Now, because Emma was both black and female, she was positioned 59
precisely where those roads overlapped, experiencing the simultaneous
impact of the company's gender and race traffic.
The law -- the law is like that ambulance that shows up and is ready
to treat Emma only if it can be shown that she was harmed on the race road
or on the gender road but not where those roads intersected.
So what do you call being impacted by multiple forces and then
abandoned to fend for yourself? Intersectionality seemed to do it for me. I
would go on to learn that African-American women, like other women of
color, like other socially marginalized people all over the world, were
facing all kinds of dilemmas and challenges as a consequence of
intersectionality, intersections of race and gender, of heterosexism,
transphobia, xenophobia, ableism, all of these social dynamics come
together and create challenges that are sometimes quite unique.
But in the same way that intersectionality raised our awareness to the
way that black women live their lives, it also exposes the tragic
circumstances under which African-American women die.
Police violence against black women is very real. The level of
violence that black women face is such that it's not surprising that some of
them do not survive their encounters with police.
Black girls as young as seven, great grandmothers as old as 95 have
been killed by the police. They've been killed in their living rooms, in their
bedrooms.
They've been killed in their cars. They've been killed on the street.
They've been killed in front of their parents and they've been killed in front
of their children.
They have been shot to death. They have been stomped to death.
They have been suffocated to death. They have been manhandled to death.
They have been tasered to death.
They've been killed when they've called for help. They've been killed 60
when they were alone, and they've been killed when they were with others.
They've been killed shopping while black, driving while black,
having a mental disability while black, having a domestic disturbance while
black.
They've even been killed being homeless while black. They've been
killed talking on the cell phone, laughing with friends, sitting in a car
reported as stolen and making a U-turn in front of the White House with an
infant strapped in the backseat of the car.
Why don't we know these stories? Why is it that their lost lives don't
generate the same amount of media attention and communal outcry as the
lost lives of their fallen brothers? It's time for a change. So what can we
do?
In 2014, the African-American Policy Forum began to demand that
we "say her name" at rallies, at protests, at conferences, at meetings,
anywhere and everywhere that state violence against black bodies is being
discussed.
But saying her name is not enough. We have to be willing to do more.
We have to be willing to bear witness, to bear witness to the often painful
realities that we would just rather not confront, the everyday violence and
humiliation that many black women have had to face, black women across
color, age, gender expression, sexuality and ability.
So we have the opportunity right now -- bearing in mind that some of
the images that I'm about to share with you may be triggering for some -- to
collectively bear witness to some of this violence.
We're going to hear the voice of the phenomenal Abby Dobson. And
as we sit with these women, some who have experienced violence and
some who have not survived them, we have an opportunity to reverse what

happened at the beginning of this talk, when we could not stand for these 61
women because we did not know their names.
So at the end of this clip, there's going to be a roll call. Several black
women's names will come up. I'd like those of you who are able to join us
in saying these names as loud as you can, randomly, disorderly.
Let's create a cacophony of sound to represent our intention to hold
these women up, to sit with them, to bear witness to them,
to bring them into the light. (Singing) Abby Dobson: Say, say her
name. Say, say her name. (Audience) Shelly! (Audience) Kayla! AD: Oh,
say her name.
(Audience shouting names) Say, say, say her name. Say her name.
For all the names I'll never know, say her name. KC: Aiyanna Stanley
Jones, Janisha Fonville, Kathryn Johnston, Kayla Moore, Michelle
Cusseaux, Rekia Boyd, Shelly Frey, Tarika, Yvette Smith.
AD: Say her name. KC: So I said at the beginning, if we can't see a
problem, we can't fix a problem. Together, we've come together to bear
witness to these women's lost lives.
But the time now is to move from mourning and grief to action and
transformation. This is something that we can do.
It's up to us. Thank you for joining us. Thank you. (Applause)
 Lecture
There are a couple of

helpful organizational principles
that guide the use of
intersectionality as a tool for
analysis.

First, critical inquiry refers to the ways in which people, as 62
individuals or groups, produce, draw upon, or use intersectional
frameworks in their daily lives.
As citizens with jobs, families, or as institutional actors. Working
at the intersections, includes using the experiences and struggles of
disenfranchised groups to broaden and deepen our understanding of human
life and behavior.
It can be particular challenging for applied fields, such as criminal
justice, education and public health, to tackle the intersections of social
inequality.
With regards to race, gender, sexuality, ability, migration, or
nationality. Reflect on why individuals encountering these public
structures, in particular, criminal justice, education, and healthcare, might
be disadvantaged depending on their particular marginalized social
identities.
Being critical means applying historical and social context to the
issue. Everything labeled critical, radical, or progressive, or even
intersectional, is not automatically oriented toward social justice.
Practices and policies within a given field like social work,
criminal justice law, education and health care may have varying levels of
commitment to social justice.
They also have varying socio-historical relationships to the
problems and the populations they seek to address. Critical inquiry has
roots in anti-colonial liberation, the women's rights movement, work on
desegregation and civilrights, and the sexual freedom movement.
The second helpful organizational principle that guides the use of
intersectionality as a tool for analysis, is critical praxis.

The very definition is translating an idea into action or 63
implementation. Examples of critical praxis include opening up various
entry points to engaging in multi-issue activism and coalition building.
Tackling interlocking forms of oppression, promoting democratic
involvement of marginalized groups. Helping social movements translate
their efforts into lasting practices.
Centering difference and making space for the multiplicity of
issues and voices when working for change.
Participatory action research is one methodology for an acting
praxis. It involves deep collaboration with the population being studied.
Allowing oppressed individuals the tools to interrogate and
intervene on the conditions of their oppression.
An authentic understanding of social problems requires the
knowledge of those directly affected by them. Here's an opportunity to
interact with your fellow students via a discussion post.
Briefly discuss in one or two sentences, how the lens of
intersectionality could help to frame the experiences of Muslims who
identify as LGBT.

64
 Listen & Reflect: Intersectional

Challenges exercise
 Lecture
What do you hear
in the stories on the
video that reflect a
complex intersectional
existence for these
individuals?
Some critiques of intersectionality as a tool of analysis include the
overuse of personal identity as a category of analysis. Some scholars
believe that focusing on complex personal identities will lead to an under
emphasis on the structural issues like class and power.
On the opposite side of the same coin, other scholars insist the
intersectionality over relies on fixed or essential group identities such as
race or gender.

Proposing that this can have a negative effect on group politics. The 65
underlying argument seems to be that a focus on group identities
suppresses the differences within a group.
For example, it becomes harder to make the argument that there is
wide variability and need or attention within a particular social identity. If
the larger social identity be it race, class, or sexual orientation or even
ability status is over emphasized.
Others argue that intersectionality focuses on the wrong kind of
identity.
That because intersectionality as a framework, a rose from examining
and centering the marginalized experiences of women of color.
It is too exclusionary to be widely applied to other groups or issues.
Finally, critics suggest that by focusing on the experiences of interlocking
and systemic oppression including domains of power.
Marginalized individuals who become overly sensitized leading to a
cycle where by tolerance and negotiation will be supplanted by perpetual
victimhood.
To the contrary of many of these lines of critique, the use of
intersectionality as a tool for interrogating systemic oppression at the
intersections of identity.
Has given space and language to the experiences of formally
marginalized populations beginning with women of color, and now
inclusive of every possible form of social analysis.
There is wide range in this framework to center complex personal
identities and experiences, while simultaneously revealing the ways in
which power, oppression, and privilege work together through structural
institutions to perpetuate inequality.
In this sense there is no wrong kind of identity that intersectionality
addresses. Many of our more nuance collective discussions around
experiences of marginalized populations has been made accessible to the 66
masses because intersectionality laid the ground work.
Many are now discussing things like micro-aggressions and implicit
biased in the context of intersectionality.
And gaining the tools to relate to different experiences as a result. Let
me introduce you to a well known theorist who pioneered strategies for
infusing public education with principles of social justice.
Paulo Freire produced the seminal work Pedagogy of the Oppressed to
outline education as a potential force for empowering disenfranchised
students.
Enhancing social justice initiatives in education and using the
experience of education as a practice context for freedom. Many of the
concepts he pioneer are reflected in educational practices around the world
today.
Go to the website freire.org and learn more about his life and
revolutionary work.
And then watch this brief video summarizing his views toward
education. Next, I'll sit down with a distinguished professor of social
worker to discuss how he implements Paulo Freire's concepts into his own
research with marginalized communities.

67
 A
Conversation with Ed-Dee Williams

So today we're
talking with a doctoral
student in social work
and sociology at the
University of Michigan,
Ed-Dee Williams, so welcome.
>> Thank you >> And I wanna ask you about your research. I wanna
ask you about some of the things that you study because I think that they
align really well with some of the things that we're talking about in the
course.
So I know that some of your research interests lie in black youth and
mental health. And I was wondering if you could talk to us a little bit today
about any opportunities that you have or things that you found in the
literature about examining the topic of black youth and their mental health
through an intersectional lens.
>> Yeah, so my research is around young black boys specifically. All
the rest of the black men kind of in general also.
I think in the literature and historically there's kind of a best view of
black men being this very monolithic, one-directional group. A lot of
researchers looked at them and studied them as a whole.

So my research, specifically, is looking at a very small subset of young 68
black boys.
So ages 10 to 17, usually looking at school settings and juvenile justice
settings, and trying to understand their experiences with mental health as
well as diagnosing behavior for black boys and mental health.
And so intersectionally, first of just splitting it down by age. So what a
young black male experiences, it's gonna be different than an older black
male.
What a black male in a school setting experiences is gonna be different
than a black male at work or in his community. And then mental health is a
big factor in what I study.
And so understanding how they experience, how they understand and
comprehend mental health and how mental health affects them long term.
How they grow with it? How they develop based on different diagnosis
or lack there of, that maybe they should've been diagnosed with?
So the intersectional approach is first off breaking it down by age, being
black male rather than just males in general. Being black males who,
maybe, should've received or have received mental diagnoses in the school
settings and juvenile justice settings.
And then trying to get a very specific understanding of their
experiences and not expecting the experiences to be the same for all of
them.
A lot of the work that you see on black men or black boys, is gonna,
even when talks about mental health, assumes that if one experienced
mental health in one way, that that's how all of them experience it or
understand it.
And so trying to find, or trying to prove or show that it's not just one
way to experience depression or bipolar disorder, or behavioral disorders.

And the outcomes are different across the board for these young black 69
boys. >> So I hear you saying that even the experience of mental health and
needs like depression should be viewed through an intersectional lens,
right?
That young boys and young men who have different social experiences
and identities may experience depression in different ways. Can you talk
more about the school context, and what some of the barriers might be to
young boys getting mental health treatment, who are in school?
>> Yeah, so school settings are very interesting in that they're usually
the first place where mental diagnoses are given to kids. Because it's the
first place where they're really, their behavior is kinda given a normal look-
through in a so-called normal lens.
Social behavior is kind of checked in those spaces. And so a lot of kid
come in and at home whatever they do seems normal because that's what
they've been doing for four to five years.
And when they get into school for the first time, teachers or faculty
members are saying that's not normal behavior for a kid or that's not how
they should be behaving.
And that's when they usually interact with, or first time you'll hear
about a mental diagnoses or something like that. So for black boys in
general, the literature has shown that they're under diagnosed for many
mental disorders.
So criteria wise they meet much of the criteria for a mental diagnoses,
ADHD, oppositional defiant disorder, bipolar depression, all these things
are severely under diagnosed.
And that could be a lot of things but my research is looking at stigma,
stereotypes and views of black males. So we expect them to be violent, we
expect them to be hyper masculine.

And so when we expect those things from them, when they show those 70
things, we don't naturally assume that there's maybe there's something
going on deeper than just this so called normal behavior.
So in school settings, especially lower income school settings, you're
more likely to see law enforcement officers, resource officers in those
settings.
In affluent schools which will be predominantly white usually, you're
more likely to see school counselors.
More resources for mental health, more resources for parents to interact
and to become more knowledgeable about mental health for their kids.
So for black boys in schools, understand their experiences and the
expectations we have on them as a society. Helps us understand why they
may be under diagnosed even though they meet criteria.
So low income, many are single parent homes. And not to stereotype,
but this is kind of the larger population.
You see a larger percent that fall into these categories, then when you
look at mental health diagnoses, that's the criteria they have for depression
or for PTSD or something of that nature.
We get black boys are significantly under diagnosed with those things.
>> Mm-hm, interesting. Can we also talk about, I heard you allude to the
differences in school context, right, school environment, right?
That in some of the more lower resource schools around the country
you might tend to see a more almost criminalized context in the sense that
you see more metal detectors.
And you may see more school resource officers, law enforcement
officers as opposed to school counselors. And so what role does that pattern
play and what we're calling the school-to-prison pipeline?
Well, first, talk a little bit about what the school-to-prison pipeline is
and then the role that these different school context play in perpetuating
that. >> Yeah, so the school-to-prison pipeline is kind of a theoretical 71
thought, but is also a very real thing for low income students primarily
based on their test scores, behaviors.
Then that cities and communities start to build prison systems based on
what they see. So when a school system has low test scores for
kindergarten and first grade students, they automatically start to put money
towards prison systems and institutional settings for these kids.
The expectation is that, that's where they're gonna end up. And so we
see across the board, states spend more money on prisons and juvenile
justice than they do on education.
And so, but then there's also this tracking system, so as kids go through
the school system based on their grades and their behavior, we start to track
them into a very specific role.
So we put them in training programs rather than AP courses. We put
them in gym classes instead of science classes in expectations that they're
not going to go into academia or to go into these kind of more sophisticated
professional roles.
And with that we also, the way we check their behavior becomes more
harsh. And because we're giving them harsh punishments, we know from
literature, that young black boys are three times more likely to be
suspended for similar behaviors than white boys.
We know black girls are six times more likely to be suspended for
similar behaviors than white girls. And we know that when you're
suspended from school or expelled from school, you're more likely to
interact with the criminal justice system at some point in your life.
And that could be for a plethora of things. It could be for, because
you're out of school, you have nothing to do. >> Tardiness.
>> Yeah, it could be because you're maybe having behavior issues and
those things aren't being checked or are not being addressed the right way.
So when you handle kids with harsh punishments and the research is 72
showing that those things actually don't work.
They actually heighten your chance of having a worse long term
outcome. That says a lot about how we deal with things in lower income,
predominantly black schools.
So as I said before, in an affluent, predominantly white suburban
schools, you're gonna see a lot more counselors, you see a lot more
services.
Teachers are more likely to work with parents, contact parents when
kids are misbehaving. Suspensions and expulsion still happen. I mean,
overall we have a more harsh punishment system in all our school systems.
But in affluent schools, those things are less likely to be used to deal
with behavior. >> So we have behavioral problems with children no matter
what context they're in.
Whether they're in a high income, affluent school district or they're in a
low income, low resource district, but it's the patterns and the practices and
the ways that we deal with children.
That contributes to which demographics of children disproportionately
end up in the criminal justice system through the pathway of school. Either
being kicked out from school, suspended from school, or coming into
frequent contact with law enforcement through their school.
>> Mm-hm, yeah, so there's recent research that shows that whenever a
school's ethnic minority population increases, the rate in which law
enforcement officers are brought in increases.
So when you have a larger black or Latino population in school, you're
more likely to have law enforcement officers or resource officers who use
handcuffs.

Who carry weapons, who use pepper spray, things like that to deal with 73
behavior. We've seen in media, time and time again, in which young kids
are being arrested and handcuffed.
Thrown out of chairs, dragged or body slammed by officers, these are
usually in lower income predominantly black schools.
You don't imagine those things happening in very wealthy or well-to-do
schools. The media presence around it will be chaotic in itself. And so if
you automatically bring in police officers, you're more likely to have
arrests because that's what police officers do.
They arrest, they're there to handle things, they arrest people. So if we
arrest kids, you're more likely to have them end up in criminal justice.
So their tracking the juvenile justice is the first step into larger criminal
justice systems as adults.
So this is kind of what my research goes back into understanding long
term effects of not diagnosing kids properly, of not treating them for
specific mental health disorders.
Many of the kids are arrested in these low-income schools, would meet
criteria for depression or PTSD or even oppositional defiant disorder, but
are under diagnosed.
They don't have the services in those schools, they don't have the
resources in those schools to do it. And so the quick way is to punish, to
suspend, to expel, arrest.
>> Mm-hm, very interesting. So I know that you're also doing some
projects with slightly older young men in the college setting, right?
That you're working with some of our colleagues in the school social
work on those projects. What are you learning about mental health as it
relates to young men who do make it to college.

Young African American men who do make it to college. And what are 74
you learning about that population in particular? >> Yeah, it's been really
interested work.
I mean the biggest thing I learned is that it's back to intersectional
approach where people, young black men do not experience mental health
in the same way. They don't understand it in the same way.
Even masculinity, they do not understand masculinity in the same way.
So working with these college aged boys, or men, excuse me, 18 to about
22, 23 years old.
Many of them have had experiences with mental health depression but
may not recognize that it's depression. So many of them would describe
depression and describe things they've gone through will say, no, I've never
been depressed, I've never known anybody who's had depression.
But then when they describe moments in their life when they were
feeling hopeless or feeling down, it's almost identical to what the criteria
would be before a major depressive disorder.
>> And are you finding that language makes a big difference in that?
>> Yes. >> And so it's not that young men of color who are in college don't
experience depression, but they may not call it the same thing.
>> Yeah, so the language is a big thing. And so assessing, I feel
hopeless and feeling suicidal they may say I'm just tired, I'm stressed out,
I've got a lot of things on my plate, and I've got a lot of responsibilities.
And they say it, and when you hear this, and even in the voice and the
way they say things, you really sound like you feel hopeless. And then
when you say that, yeah, that's a better way of explaining it.
And I'm like yeah, [LAUGH] that's the criteria for depression. And not
to diagnose or pathologize people but when you can get to a larger
understanding of their experiences.

That's when you can start to bring in resources and help. Suicide rates 75
are extremely high for college students, especially black or African
American college students.
Dropping out of school is a very common thing for college students
who don't have resources or don't have someone recognizing the symptoms
of depression.
Which is a common thing for any college student, especially, early in
their college career. But for black students who often are at predominantly
white institutions, who are coming from low income areas, or coming from
a predominantly black school.
Who maybe have never been around a space where students have
$100,000 income and are driving BMWs down the street.
And they're trying to figure out why they are catching the bus. Or why
they can't keep up in class because they didn't have AP courses in their high
school.
So their experiences with mental health are significantly different
though, also. So not just, well they talk about depression differently, but
how they deal with it is different.
Some of the men I've talked to have, they go to a gym and workout, hit
the punching bag. Some actually have talked to counselors and sat down
and received professional help.
Some don't talk about it all. Some will deny that they have any issues or
they talk to a girlfriend or friend about feeling stressed out, but they really
don't address it.
So that really gets into the idea that these black men are not monolithic
at all. That they have these very widespread experiences. >> Yeah.
>> Some are from low income, some are from wealthier families, some
are from middle class families, and even those from middle class and
wealthier families, some still won't go seek help.
I think the idea is that if you come from a more professional family that 76
you would recognize these things.
But there's many who are from middle class families who still don't
recognize the symptoms of depression, and still don't seek help, and still
don't have the resources that they need.
>> Yeah, that actually brings us all the way right back to this discussion
around the intersectionality of depression, if you will.
Because you're talking about young men who come from differen
backgrounds, different socioeconomic statuses, different types of families,
different geographic regions.
And they're all converging on a college campus but the way that they
see their symptoms of being tired or moody or feeling down.
Whether or not they use the language that they're depressed. All of that
is shaped by their intersectional experiences, what they've been exposed to.
How depression has been stigmatized in the past or in terms of how
they grew up. And so all of that kind of shapes their experiences and their
understanding of what they're feeling when they get to college and face
these additional burdens and challenges that maybe they have different
levels of preparation for.
Is that right? >> Yeah, definitely. It's really interesting to see the tools
that some of these young men have developed to deal with their
experiences or their stress levels.
Their pressure levels, that many of us as clinicians or as professionals
or professors won't say depression but they will say it's just stress or
pressure.
And so the tool kits that they have created from their experiences at
home, from the communities, is really interesting. And we would expect
kids from low income households to have higher level of depression and
have horrible ways of dealing with them.
But some of them have actually developed very safe and correct ways 77
of dealing with them. As compared to those from wealthier families who
often will deny that they have those issues, because if you come from a
wealthier family that's college-educated, you don't wanna be the one to say,
I'm not making it through.
As opposed to those who don't have much to compete with because
maybe they're the first one in their family to go to college. And so, just
getting there is a big deal, and so, making it through may not be as
stressful, or it could be more stressful.
>> Awesome, is there anything else from your own experience as a
doctoral student, from your own research or any of the research you've
participated in with other faculty members, that you'd like to share around
this topic of intersectionality?
The intersectionality of mental health or any of the experiences or
research that you've looked at on youth, and criminalization, and mental
health in school contexts.
Anything else you'd like to share? >> Yeah, I mean, I think when you're
doing work as a PhD student, intersectionality is gonna play a huge role in
the work that you do, and even just as a MSW or a clinician.
And if you don't take an intersectional approach to the work you're
doing, you're missing a significant part of someone's identity. I think it's
becoming more common to understand that people have these very
different identities that intersect at different points in their life.
And based on the space they're in, the time they're in, the context of the
space they're in, those identities are gonna be more salient or less salient.
So in the work that I've done, understanding how their identities and
these different things that intersect are more important to them, how that
affects the work that I do with them.

I think has been very important for me to try to consider. >> Awesome, 78
well, thanks for joining us today. This has been an interview with Eddie
Williams.
Again, he's a doctoral student in both social work and sociology at the
University of Michigan. And we look forward to continuing this
conversation on intersectionality

 A Conversation with Nkemka Anyiwo 79
Welcome back.
Now we have a wonderful
interview with a doctoral student
from the School of Social Work
and Developmental Psychology,
Nkemka Anyiwo.
So welcome, thanks for joining us. >> Thank you, I'm happy to be
here. >> So I'm really excited to talk to you about your research. And some
of the work that you're doing with youth.
And so I have a couple of questions about how you apply
intersectionality to that work. So I hear that you apply an intersectional
framework to analyzing the socialization of adolescents.
That you consider broad factors that shape adolescent development
and their ability to cope with life stressors. Can you tell me a little bit more
about that?
>> Yeah, so much of my work focuses on black adolescents in
particular. And I think about the ways in which race and gender shapes the
way that they're marginalized.
So often, when we think about discrimination, particularly for black
people. The forms of discrimination that we think about are often forms
that are more experienced by males, right?
So we think about being brutalized by police, or aggressive kind of
physical forms of marginalization. Where black girls may not be
experiencing those kinds of marginalization.
They might be being more harassed sexually. They may be, their
body might be objectified in different domains.

And so I'm interested in exploring the nuanced ways in which black 80
girls are marginalized and black boys are marginalized. And how it shapes
their well-being but also thinking about how are people in their lives
preparing them for that.
How are people in their lives telling them how to navigate
marginalization and discrimination?
What it means to be a black boy in America? What does it means to
be a black girl in America? And then also the coming of age. What does it
mean to be a black man?
And beyond outside of the context of marginalization, that being
prideful of the characteristics of black masculinity and being prideful of the
characteristics of black femininity.
So that's what I seek to explore in my work. >> Yes, I hear a lot of
intersection themes in the work that you do. And so do you find in your
work and in the literature that you're reading that African American youth,
in particular, they may not know the term intersectionality, but do you find
in the literature that they understand the concept, right?
That they are both black and a male, or African-American and a girl.
And that they are different parts of their experience and their personality
that is reflected in different parts of their identity.
Is that too complex for some of these youths to understand, or? >>
Not at all, not at all. I think, like you said, they may not know the term, per
se.
But they are aware of the complexities of their identities. So I
remember I did a workshop once where we asked, what does it mean to be
a woman? What does it mean to be black?
Now what does it mean to be a black woman? We had the
conversations with the kids, do you think that those things are different?
And they said yes, that there's particular.
Well, some kids say yes, some kids say no. Which is also like 81
showing the complexity by which people are kind of conceiving these
identities.
But it's like those unique things that black men have to deal with or
black women have to deal with like being strong.
>> And children pick up on that. >> Absolutely, I think the being
strong piece is a huge component, particularly for black girls, right?
As a woman, a black woman, you have to be stronger. You have to
navigate all these responsibilities, you have to be twice as good.
And manage these complex gender roles in addition to expectations
in society. So absolutely I do think that they picked up on those kind of
things.
>> Yeah, so I understand that you're really passionate about the way
that media shapes youth perceptions of themselves. >> Yes. >> Yeah, talk
to me a little bit about that, about the role of the media in shaping youth
perceptions.
In helping them cope, or being perhaps a negative influence in how
they see themselves. >> Okay, so I'm gonna kinda fall back a little bit and
kinda pull on my African American studies background.
>> Yes, sure. >> So for me, when I think about media, I really think
about the arts. And I think about the ways in which creativity in the arts has
been used historically, right?
In Africa, prior to colonization, they way that griots and all those
kind of things use- >> You're going deep. >> I am. >> Okay. >> But that's
the foundation.
>> May have to break that down later for the students. >> [LAUGH]
Okay. >> [LAUGH] >> But just like, that's the foundation that arts has
been used as a mechanism to pass things down.

Even in the institution of slavery, that messages and storage were 82
used to teach kids how to navigate oppression and how to survive. And so
recognizing that historical significance, I think there's importance to
explore that in contemporary times as well.
>> Historically, these early forms of media if you will have been an
empowering force, right? >> Yes. >> They've been used in a cultural sense
to reflect back to youth, the positive aspects of their culture to help them
remember good things about their ancestry and their history >> Exactly.
>> And they have been used to lift and to empower. >> Absolutely.
>> It may not be the way we use media today but definitely, at least in
African tradition started out that way.
>> Yeah, and I think even today, even if we look at the Civil Rights
Movement. In a lot of ways music became the soundtrack if you will of that
movement.
Like it became the way in which people talked about, or
marginalized, people marched to songs. In the black power era, people
marched to songs.
In the 90s, when people were anti-apartheid, you had artist that was
talking about discrimination of saying black, I'm proud.
All those kinda things. So the media has consistently been a
mechanism by which black people have taught kids to empower
themselves.
To know about their history, to know their heritage, and also resist
against marginalization. And so I'm interested in exploring and
deconstructing the ways that black media in particular socializes black
youth.
So when they see images in TV and they hear images, how does it
influence the way they perceive things? But also recognizing that media is
convoluted, it's complex.
And there's a lot of negative messages. In the same sense that you 83
might hear about empowerment and loving yourself, you might also hear
misogynistic kinda content. You might hear things that emphasize violence.
So how do we deconstruct these multiple messages that young
people are getting from media and think about how it plays a role in their
development.
>> Interesting, and so have you done that work yet or you just on the
kind of right at the beginning of framing that and looking forward to
perhaps doing a dissertation or something on that topic?
>> Absolutely, so I've done some of that work. So my Master's thesis
looked at, how does television usage predict adolescent's endorsement of
gender ideology, such as a strong black woman.
>> Wow. >> And then also mainstream, or traditional gender roles.
And so I found that, this is for black adolescents in particular, that
black adolescents who watch more black oriented content, The Fresh
Prince, these kinda dated shows.
>> Yeah. >> Watch that content have higher endorsement of the
strong black woman ideology.
>> Interesting, so they see those stereotypes perpetuated in black
media. >> Yes. >> Okay, and then they endorse them themselves?
>> Yes. >> Okay, interesting. >> Yes, and that's boys and girls,
which is important to think about. So what does it mean when a boy
perceives black women to be strong, what's the implications in terms of
how he relates to black women?
And then how does a girl internalize those things about black woman
who as she's developing into a woman? And then another project I did was
an after school program, which is a media literacy program.

Where we had young people develop, do a constant analysis of 84
television shows, to look at representations of black people on television.
And so the kids, they made up their own questions.
And they looked at representations and BET versus black oriented
kinda channel versus ABC. And they looked at differences in terms of skin
tone of characters.
Darker skin versus lighter skin characters, and then they presented
those findings In a workshop to a group of ninth grade students at their
school, to kinda educate them on stereotypes in media representations.
And I even actually presented it the University of Michigan. >>
Wow. >> Yeah, to a group of doctoral students. And engaged in
conversations about, the ways in which the media representations can
influence, how Black were treated in society.
>> Yeah. >> So in example of that. We kinda in that conversation,
we talked about the Mike Brown case. Mike Brown was an 18-year-old
young man, who was killed unarmed.
And a lot of the ways that he was discussed in the media, resembled
some historical gendered racial stereotypes about black men Such as the
brute.
This huge black man that was overpowering this white man, who
was actually around the same size as him. But how does that frame?
Or how does that frame how that incident happen for people? How
do they perceive it? Do they justify his killing, because of his physical
attributes or not? And then, what does that mean in terms of how young
black males are perceived broadly?
>> Yeah, so it sounds like both in the youth that you've worked. Also
with these kind of middle school aged kids that you've worked with, that
they all, again even if they don't have the language for it, have some
conceptualization of intersectionality.
That people can be seen through their multiple identities. That there's 85
more than one side of them, right? That impacts perhaps the conditions that
they experience in life, or the opportunities that they might have to be
successful.
>> Absolutely. >> It sounds like the kids are more than sophisticated
enough, to understand that. Even if they don't have the language for it.
>> Absolutely they're very much conscious of those things. >> Yeah,
I wanna take it back to a bigger theme which is social justice. Because
that's the topic of this entire course, right?
And throughout the course we're trying to hit on different conditions,
different circumstances, different determinants, that shape people's
opportunities to be healthy, to be fulfilled.
We look at environmental justice. We look at justice in education.
Justice in the criminal justice system. And so I wanna talk a little bit about,
what is the social justice goal of the work that you're doing?
You're doing work around, understanding how adolescents grow.
How they are shaped. How they develop. And how all of these external
forces play a role in their development. What's the social justice
implications of that? >> I think there's a couple of things.
One is, we know that marginalization in society exists. We know
that, there has been historical barriers, structural barriers, placed upon
Black people in particular, since they've been here. >> People of color
broadly.
>> And people of color broadly, absolutely. And other- >> Yeah,
and there are also folks who have low socioeconomic status, challenges
with disability or ability.
[CROSSTALK] >> Absolutely, so there's some many different
identities that are marginalized.

There's so many different groups of people, who have been 86
historically marginalized. And so then my work kinda seeks to understand
ways to promote, the ability of black youth to thrive.
Even in the midst of discrimination. But also empower them to resist
against marginalization. Whether it be racial marginalization or other
aspects of their identities that are marginalized, or all of the above, right?
If you're black and you identify as a LGBT. You're young person and
you have low SES, and you don't- >> Socio-economic status, right?
So you don't have the income, the education, or perhaps your parents
don't have the occupation, to climb the financial ladder in life.
Absolutely, absolutely. If you have all those challenges, then how do
we engage young people in creating a sense of agency, that they can resist
against that?
Because I think often in research we kind of talk about, okay, how do
we make young people resilient? How do we make them survive, right?
But the baseline shouldn't be survival.
The baseline should be thriving and doing well. And a part of
thriving and doing well, is resisting against the structures that create
oppression.
And so a part of what I do in my work, is empowering young people
to become educated about systems of oppression.
But to be also educated about the richness of their culture, of their
heritage, who they are. And also provide them with skillsets to address
policy to address issues in their community.
So that they are able to actively resist those things. >> Yeah, so it
sounds to me, and we actually talk in this course a little bit about theory.
And it sounds to me like you apply an empowerment theory,
empowerment framework to your work.

What does that look like? >> Absolutely, yeah. So I think, instead of 87
thinking about, so I think risk and resiliency frameworks are beneficial.
>> Yeah, can you just tell us just a little bit about, risk and
resilience? >> Yes, and so the idea that if that adolescent or people, have
particular barriers or risks, that contribute to these negative outcomes.
>> Sure, you grew up in a poor neighborhood. Or around a lot of
pollution. Or the school that you go to isn't the best.
All those things create risk factors. >> Absolutely. >> Right? And
so, they put stumbling blocks in your way, that you've gotta be aware of. Or
get some support in overcoming. Because you don't start out with the same
opportunities, maybe as other folks, right?
>> Absolutely. >> That's what risk is, okay. >> Absolutely, and then
there's these promoter factors. And promoter factors are factors that kind of
enhance your abilities to succeed.
So it might be being a very motivated person. Or having social
support in the household. Or having teachers who are well resourced.
And then there's protective factors, which can overlap with promoter
factors as well, which are factors that alleviate risk, right? So if you're a
young person that goes to a low-resource school.
But you have a parent that's very involved in your school. That is a
promotive and protective factor. So it alleviates the risk of you going to an
under-resourced school.
Because your parent is evolved and it's allowing you to maximize
that space, and thrive, and do well in the midst of those things. And so
these frameworks are nice in terms of thinking about, things that are
causing risk.
And that allow young people to survive and do well. But I think it
doesn't address the systemic issues, that contribute to what these risks are.

>> So for example, why is there a significant portion of students who 88
have to go to a low-resource school, right? And what is the underlying
reason?
It could be tax policy, it could be the way that we fund our schools,
right? That some school districts don't have what they need to be
successful.
>> Absolutely. >> Right, so those would be those larger issues. >>
Absolutely, absolutely.
And so that's a piece of the work that I do, that kinda seeks to
examine this. How do we empower people, to be able to be advocates of
change? So if you know that your district is funded, at a lower rate than the
school district that neighbors you.
And that you have a lot less books, and a lot less resources. We can
say, okay, work hard, and try to do well in the midst of that. But also, you
need more books.
>> [LAUGH] >> You also need more books. >> [LAUGH] >> You
also need more books. So then, you can provide young people with the
skillsets, to be able to identify what the problem is.
So educate themselves on, know the policies and things that shape
their issues. And should go to the board of education meetings and
advocate.
Or go to the State Capitol and advocate for themselves. And say hey,
these are things that we need, we see these things in the budget, why is it
that these things aren't being distributed in these ways?
And I guess another theory that kind of goes into this, is the social
political development theory >> Interesting, >> And social political
development, basically examines the way young people are aware of social
or structural issues, and their own status in society.

To the extents to which they actively engage in social political 89
justice. >> So your thought process is, and according to social political
theory, that children, just because they're children, does not mean that they
cannot be deeply involved in making social change.
Right, that they can also write to their policy makers. Or they can
also advocate and lobby in their own way. That they can be engaged in
social issues, even as youth. >> Absolutely. >> Yeah, and that they should
be.
>> Absolutely, absolutely, and I think a part of it is that, they are
often. And they have been, historically.
But I think that our challenge is being able to provide them with the
skill sets to be able to do that in different ways.
And young people are innovative. So going back into the media
piece, we see that in the Black Lives Matter movement in particular, black
youth have used media substantially to raise awareness.
Using hashtags on twitter to say, if I was shot, what picture would
they use? Would they use a picture of me looking like a thug, or how
society perceives a thug to look like?
Or they use a picture of me dressed in a suit? So- >> Or a graduation
photo. >> Or a graduation photo.
And then another hashtag was Oscars so white, right, talking about
the lack of black candidates. >> And the representation of actors of color in
media in general.
But also who are being awarded or being recognized for their
accomplishments in some of their more traditional spaces. >> Absolutely.
>> Yeah. >> And so young young black people have been very much
involved in those movements using those things to raise awareness about
social issues.

>> Yeah, and so the thought would be in the same way that we can 90
galvanize folks on Twitter, to raise awareness about issues and to try to
encourage social change.
We can also do that in our schools and communities. >> Absolutely,
absolutely. >> Yeah, I wanna also ask you, I know that you've been
working with some amazing faculty on projects around mental health.
And working with young African American men college age men,
and looking at their experiences with depression.
Any intersectional lessons out of that experience that you've learned
from doing research in that area? >> Absolutely, I think a piece of it is that
black men experience particular types of marginalization.
Have particular experiences that influence how they cope or how
they deal with stress. In addition, they're taught things about what it means
to be a black man.
So this goes back to the socialization piece. Is that a black man has to
be strong, stronger than the typical man. Black men have all these things
against them and have to overcome them.
They can't ask for help, they can't show emotionality. And so all
those things- >> So these are some of the myths, right, the lessons they've
been taught that influence how they cope when they do face a stressor,
perhaps in the college environment or elsewhere.
>> Absolutely, absolutely. And so those are things that kinda have
emerged in those experiences, which are influential in the way that they
deal with mental health.
So if you're stressed out and you're overwhelmed, who do you go to?
Even how they identify what a mental health issue is, right, or the source of
mental health issues.
Is mental health caused by you? Being that you're weak or you that
don't know how to manage.
Or is there something external that creates mental health issues? And 91
I hear, often, black men saying things like, yeah it's about you and how you
navigate things.
Versus recognizing that a lot of factors can contribute to mental
health. >> Absolutely, absolutely. So it sounds like one, people's
conceptualization of what depression is and where it comes from is also
influenced by their intersectional identities, right?
>> Absolutely. >> Depending on where they came from, how they
grew up, what lessons they were taught about mental health, about coping,
stress. And then back to this gender lens, what it means to be a man and
how men cope with stress.
And what they do, and whether or not they seek help. All of those
things kind of are influenced by intersectionality as well. >> Absolutely.
>> Yeah. >> Absolutely. >> Wonderful, are there any other lessons
from the work that you've done, the amazing research you're about to do,
that you'd like to share around any of these things around intersectionality,
youth engagement?
I just thought of something. And that is, we were talking about the
role of social work in helping youth to see themselves as empowered.
And encouraging youth to engage in their social world. >> Yes. >>
Right, and to make change. In particular, to make social change.
Anything you wanna share about that, about the role of social work?
>> Well, one thing I think is important to note is that the code of ethics in
social work, a part of the code of ethics is promoting the agency of the
client or people that you're working with.
And because of that, I think social work is uniquely positioned.
Because social work thinks about structural issues and social justice to
empower young people in that work.

So not just delivering services, not just speaking on behalf of, but 92
engaging this relationship building to support young people's ability to
address issues in their community.
That's not to say and I do wanna clarify this too, this not to say the
onus on social change is young people, right? That's not to say that young
people should have the sole responsibility for shaping or shifting things in
their community.
>> But they certainly should be at the table- >> Exactly, exactly. >>
When were talking about these kinds of things, right. And given an
opportunity to do what they can. And we should be encouraging them, and
we should be empowering them to know that they do have a voice in
shaping the future of some of these issues that are directly affect them.
And that there are tools that they can use, even as young people, to
contribute to the work that's being done. >> Absolutely. >> Yeah. >> Yeah.
>> Yeah, and that social work plays a big role in that. >> It does. >>
Yeah. >> I think it plays the most, in my opinion, I'm biased. >> Yeah,
well, we're social workers.
>> [LAUGH] >> [LAUGH] >> Well, I feel like it plays one of the
biggest roles in it. >> Yeah, mm-hm, absolutely. >> Yep. Well, I really
thank you for joining us today.
This has been a conversation with the future doctor Nkemka
Anyiwo, who is a doctoral student in social work and developmental
psychology at the University of Michigan. We thank you for joining us,
and we're gonna keep this conversation going in the course.
Module 4: Social & Cultural

Determinants of Health
 Module Goals 93
This module explores the underlying root causes of health
disparities and distinguishes between concepts such as health
differences and inequities. You will be introduced to the social
factors that shape disparate health patterns in the U.S., with a focus
on select populations. Finally, you will engage with podcasts, guest
interviews, and outside resources to enhance your understanding of
the barriers that certain populations face to accessing and utilizing
health-promoting resources
 Lecture
Health
Disparities adversely
affect groups of people
who have
systematically
experienced greater social or economic obstacles to health based on their
racial or ethnic group, religion, socioeconomic status, gender, age, mental
health, cognitive, sensory, or physical disability, sexual orientation or
gender identity, geographic location, or other characteristics historically
link to discrimination or exclusion.
Not all health differences are health disparities. For example, we
might expect to see more difficulties with mobility among older adults than
younger adults.

Or more instances of muscle injury amongst professional athletes 94
than the general population. These differences are not due to discrimination
or exclusion from opportunities.
According to Dr. Paula Braveman, a noted scholar of health
disparities, health equity is achieving social justice in health. This means
that no one is denied the possibility to be healthy for belonging to a group
that has been historically, economically, or socially disadvantaged.
This is the principle underlying a commitment to reduce and
ultimately eliminate disparities in health and their underlying social
determinants. Health disparities are the metric that we use to measure
progress toward achieving health equity.
Take a moment and read the article provided by Dr. Paula
Braveman, that elucidates the concept of health disparities. Then move
over to the discussion board and provide your own example of a known
health disparity, along with a source to back it up.
Social determinants of health are social and economic factors with
important direct effect or indirect effects on health.
There are some key social factors such as one's income or
educational attainment that are correlated to many health outcomes across
populations, racial ethnic groups, and communities.
Other social determinants are specific to a particular health
condition or certain populations that are disproportionately effected more
so than others. While health is deeply impacted by personal lifestyle
choices and access to and utilization of high quality medical care.
Health is also shaped by the conditions in which we live, work, and
go to school, and our social and economic opportunities to be healthy.
We cannot expect individuals and communities to be healthy
without the proper context of health-promoting resources that come from
our larger environment, and are shaped by multi-level policies.
The term social determinant of health, is often used to refer broadly 95
to any non-medical factor influencing health, including health related
knowledge, attitudes, beliefs or behavior.
These factors however, represent only the most down stream
determinants in the causal pathways influencing health. That is, the
outcomes you can most readily see.
But these outcomes are shaped by more upstream determinants.
Bigger, broader factors that shape the opportunities for health, contribute to
working in neighborhood conditions, and help determine the choices
available to those who are trying to prevent disease and live healthfully.
As of 2016, the United States ranks 42nd in the world for life
expectancy. Despite our wealth as a nation and the large proportion of
resources devoted to healthcare overall.
In the last few decades, the US has seen significant increases in the
number of individuals who have chronic diseases such as diabetes,
hypertension, heart disease, lung diseases, and cancer.
Certain racial and ethnic groups and individuals with fewer
socioeconomic resources are disproportionately burdened by cancer and
chronic diseases.
The Centers for Disease Control and Prevention note that health
disparities are not just evident in health outcomes in terms of diseases that
individuals acquire, but also at who has access to healthcare, who's
empowered and knowledgeable to engage in healthy behaviors.
And who's more likely to be exposed to health hazards such as lead
paint, respiratory toxins, pollution, or contaminated water, in their home,
work, or school environments.
My own research concerns the health disparities experienced by
African-American men. A culturally and socioeconomically diverse group

who experienced one of the heaviest burdens of cancer and chronic disease 96
in the United States.
With regard to cancer, the mortality rates for prostate, stomach,
larynx, and myelomas are still more than twice as high for African-
American men than non-Hispanic white men.
And despite decreasing cancer rates among much of the adult US
population, African-American men are not always benefiting from the
advances in cancer treatment and early diagnosis, that men other racial and
ethnic groups are.
Further, the life expectancy for an African-American men born this
year is approximately 71.8 years. Which is five years shorter than the life
expectancy for non-Hispanic white males.
Nearly seven years shorter than for African-American women. And
almost ten years shorter than the life expectancy for white women. As you
can see, there is a distinct racial and gender gradient to several health
disparities in the United States.

97

98
Read & Reflect: Identify Examples of Health

Disparities exercise
 Lecture
Now, let's discuss some

of the well researched, non-
medical factors that shape
health for different groups in
the United States.
With regard to neighborhood conditions, many, but not all studies 99
have found that neighborhood features are associated with health even after
considering a resident's individual level characteristics.
For example, one may not know when they move into a
neighborhood that that neighborhood places residents at risk for the adverse
effects of air pollution, such as asthma.
One may not know that the water flowing into homes is
contaminated by a nearby plant or business. Or that not enough grocery
stores exist in that area to provide healthy food options to all residents.
These are all conditions, along with services such as transportation,
trash removal and street lights, that shape a neighborhood resident's
opportunity to be healthy in their home and surrounding environment.
Similarly, the conditions of a workplace, where many working
adults spend the majority of their waking hours, has the power to expose
individuals to health risks.
Certainly individuals engaged in more physical jobs face the
potential for workplace injuries. In addition to those who stand for long
hours, or sit behind a desk all day.
There's a growing body of research on the dangers of being too
sedentary for our health. Other types of work may expose individuals to
constant mental health stressors.
Certainly social workers are one profession who must engage in self
care and be aware of their risk for burnout. The size, type, and support
provided by one's workplace could also determine whether someone has
employer sponsored health insurance.
The ability to leave work to get medical care for themselves or their
family members. And the ability to save for life after their working years.
All of these work related factors influence both physical and mental health
outcomes.
Educational attainment or the number of formal years of education 100
that one has, is one of the most powerful predictors of health and well-
being.
There are multiple pathways through which education can
determine one's health risks or outcomes. First, increased education affords
individuals the knowledge by itself, as well as the literacy to find and
understand information about living healthfully.
Research consistently demonstrates that individuals with higher
education are more likely to engage in health promoting behaviors. Both
because they have the additional knowledge of how to do so and the
increased education is linked with increased income.
That allows individuals to buy healthier foods, live in safer
neighborhoods and access higher quality health care. In this way,
educational attainment also impacts health through access to higher
income.
More stable working conditions and associated resources that
contribute to improved physical and mental health. Further, higher
educational attainment often increases ones access to social status.
Or networks of other individuals with resources and knowledge that
can be shared and leveraged for better health outcomes. In the United
States and many other societies, race or ethnic group is often an important
social factor that influences health.
Primarily because of racism. Racism refers not only to overt,
intentionally discriminatory actions and attitudes, but also to deep-seeded
societal structures.
That even without the intent to discriminate, systematically
constrain some individual's opportunities and resources on the basis of their
race or ethnic group.

The effects of racism on health, are a prime example of the concept 101
of embodiment. Derived from the field of social epidemiology,
embodiment is the literal, biological internalization, of the material and
social conditions experienced from conception to death.
No aspect of our biology can be understood. Absence knowledge of
contextual and historical influences on the individual life course.
There are several theories of how racism operates to disadvantage
health in certain racial and ethnic groups. The following theories are
conceptualized in reference to the racial discrimination and subsequent
health outcomes that African Americans experience.
But these theories have since been applied to a range of racial ethnic
groups and their experiences, as well. First, you may have heard of the
story, or even the myth, of John Henry.
John Henry was mythologized as The Steel Driving Man, or a rail
worker of great strength, who died of mental and physical exhaustion.
Moments after competing against a machine in a nail driving contest
around 1870 in West Virginia.
John Henryism was developed as a theory to explain how prolonged
high effort coping or sustained cognitive and emotional engagement with
psychosocial and environmental stressors.
Physiologically harms African Americans and individuals with low
socioeconomic status. When individuals are trying to free themselves from
entrenched systems of social and economic oppression they are repeatedly
exposed to psychosocial stressors.
Actively working at trying to eliminate these stressors increases the
heart rate and blood pressure. And over time, this develops into heart
disease and hypertension, among other stress related diseases.

Allostatic load is a concept that refers to the physiological burden 102
imposed by stress. It's the cumulative wear and tear on the body systems
due to repeated adaptation to stressors.
Similarly, weathering is the result of high allostatic load.
Weathering refers to the early health deterioration by African Americans at
all income levels.
As a consequence of the cumulative impact of repeated experiences,
with social and economic adversity, and political marginalization. When
persistent, high-effort coping, like John Henryism, results in acute and
chronic stress, these processes severely damage the body, and speed aging,
morbidity, and mortality.
Bio markers are substances in the body used to measure the
underlying social disparities in health.
Common bio markers include cortisol, sympathetic nerve activity,
blood pressure reactivity, cytosine production, and waist to hip ratios.
Allostatic load scores are used as an empirical measurement for
weathering.
Research indicates that African American women bear a larger
burden of allostatic load than African American men, white men, and white
women.
Due to the compounded experience of gender and racial
discrimination. Discrimination and bias experienced by individuals from
racial-ethnic groups not only occurs in the domains of employment,
housing, education, and other sectors of society leading to increased
internalized stress in subsequent health disparities.
Discrimination also occurs in health and medical context.
Unfortunately, a number of studies have established that African-American
patients, in particular, experience poor quality medical visit communication
than their white counterparts.
More recently, a study of the American Journal of Public Health, 103
was quoted as saying doctors tend to dominate conversations with African-
American patients.
Pay less attention to their personal and psychosocial needs and
make patients feel less involved in making decisions about their health.
That same study reported that two-thirds of doctors harbored unconscious
racial biases towards patients.
And that racial bias favoring whites was associated with greater
clinician domination of the medical dialogue for African American
patients.
And less positive patient emotional tone in the visits of their African
American patients. In addition, African American patients expressed less
confidence in their clinicians.
Perceived less respect from their doctors, liked their doctors less,
and were less inclined to recommend their doctor to their friends.
The majority of mental health and medical clinicians in the United
States are not African American. And so in order to obtain health care
African American patients must navigate a constant environment where
implicit bias may be operating on how they are being spoken to or treated.
Even patients with higher incomes, higher education, and more
prestigious jobs, experience discrimination in healthcare that may lead to
sub-optimal care.
Unfortunately, other groups such as LGBTQ patients, overweight
and obese patients, disabled patients, homeless patients and the elderly also
struggle with implicit bias affecting their health care experiences to varying
degrees.
Now, watch the three clips on disparities in pre-term birth and infant
mortality from the documentary Unnatural Causes. For a brief activity,
discuss why African American women at every socio-economic level have
higher rates of per-term birth and infant mortality. Than white women who 104
haven't finished highschool or
black women who immigrated here from other countries.

105

106
 Lecture
Consider how
pregnancy outcomes are affected
by racism and chronic stress.
And how racial differences in
birth outcomes are not reducible
to class alone.
Finally, revisit the concept of embodiment and discuss how it
applies to the experiences of African Americans in the clips. Health in the
United States is often patterned strongly along both socioeconomic and
racial ethnic lines, suggesting links between hierarchies of social advantage
and health.
Those with the lowest income and who are least educated are
consistently least healthy. For most indicators, such as infant mortality,
health status, healthy eating, and sedentary behaviors in children, and life
expectancy, health status, diabetes, heart disease, and obesity in adults,
even groups with moderate income and education levels were less healthy
than the wealthiest and most educated in the US.
According to the work of doctors Paula Braveman and David R
Williams in 2011 we have solid scientific evidence that early life
experiences affect children's cognitive, behavioral and physical
development, which reliably predicts their health in the short and long
term.
Children who live in homes with parents or caregivers who have
few socio-economic resources may receive less stimulation in the form of
reading and conversation than children from more well resources
households, leading to educational difficulties once in school.
Children living in higher poverty neighborhoods may have less 107
access to healthy foods, high quality education, or safe spaces to play.
However, we also know that effective early childhood
interventions can disrupt the link between early social disadvantage and
later poor health outcomes among children.
The first years of life are a critical window for supporting the
physical, emotional, behavioral, and cognitive development of children,
particularly those living in poverty.
Coping with daily life challenges can be particularly stressful
when one's financial and social resources are limited. According to doctors
Paula Braveman and David R Williams, stressful experiences such as those
associated with social disadvantage.
Including economic hardship and racial discrimination, may
trigger the release of substances in the body that can damage immune
defenses, vital organs and physiologic systems.
For example, prolonged stress can result in the body releasing
cytokines, that is inflammatory molecules released by cells, that can
promote or inhibit inflammation in response of stress or trauma.
Long term stress can also result in the body releasing cortisol. A
stress hormone which interferes with learning and memory, lowers immune
function and bone density, increases weight gain, blood pressure, and
cholesterol, and is linked to heart disease.
Stress can impair the body's ability to respond to vaccinations. It
can reactivate dormant viruses in the body like herpes, HPV, and HIV, And
influence the incidents and progression of cancer by decreasing the number
and activity of white blood cells that kill viruses, bacteria, and parasites in
the body.
Listen to this podcast on barriers that trans individuals particularly
those with complex health issues faced accessing healthcare.
Then visit the Center of Excellence for Transgender Health and 108
review some of the many resources available for transgender individuals,
researchers and clinicians who are supporting this population.
Finally, listen to the following conversation with Dr. Deirdre
Shires, assistant professor of social work at Michigan State University,
as she discusses her research on trans healthcare experiences.

109

Watch & Reflect: Racial Disparities in Women’s Birth Outcomes exercise 110
Watch the following brief documentary clips from Unnatural Causes, and

then discuss trends in infant mortality by race and socioeconomic status, and
related these issues to the concept of embodiment in the prompt below.
LU: The biggest myth about racial and ethnic disparities in infant
mortality is that people think that this has to do with just socio-economics
and that the disparities are really the consequences of racial differences and
socio-economic status. And it isn't that simple.
NARRATOR: Infant mortality among white American women with
a college degree or higher is about 4 deaths per 1000 births, but among
African-American women with the same level of education, infant
mortality is about 10 per 1000 births.
Almost 3 times higher. In fact, African-American mothers with a
college degree have worse birth outcomes than white mothers without a
high school education.
LU: Think about this: We're talking about African-American
doctors, lawyers and business executives and they still have a higher infant

mortality rate than non-Hispanic white women who never went to high 111
school in the first place.
So what I've been calling for is a rethinking of an old problem from
a new perspective.
And to really, rethink racial and ethnic disparities in birth outcomes
from a life course perspective. Simply put, that the life course perspective
posits that birth outcomes are the product of not simply the 9 months of
pregnancy, but really the consequences of differential exposures across the
life course of women of color.
We know that racism is stressful and we know that that stress can
impact on health in many different ways It creates this chronic wear and
tear on your body's systems to adapt.
It wears on the hormonal system It wears on the immune-
inflammatory functions It wears on your metabolic functions.
And over time, it creates an overload on all of these organs and
systems so that they no longer function optimally.
JONES: Everyday racism is like gunning the engine of a car without
ever letting up. In fact, people who've looked at blood pressures measuring
ambulatory blood pressures, for white folks and black folks--young folks,
see that the blood pressures might be the same during the day but at night,
the white folks blood pressures would drop and the black folks blood
pressures would stay the same.
And so it's like gunning the engine of that car, just wearing it out...
wearing it out, without rest. And I think that the stresses of everyday racism
are doing that.
LU: And then if you were to carry that into the pregnancy, then that
gets embedded in both the pregnancy physiology of the mother and the
developmental biology of the child.

We certainly have done a lot in terms of increasing access and 112
utilization of prenatal care especially among communities of color and yet
we've done very little to reduce prematurity rates.
I think that the problem is that with prenatal care you are trying to
cram all these good things into less than 9 months of prenatal care and then
expecting everything to turn out alright in the end. and to expect prenatal
care, in less than 9 months, to reverse all the cumulative disadvantages and
inequities that has been carried forth over a life course of differential
exposures, is probably expecting too much of prenatal care.
So if we're serious about improving birth outcomes and reducing
disparities we've got to start taking care of women before pregnancy and
I'm not just talking about that one visit 3 months preconceptionally, I'm
talking about when she's a baby inside her mothers womb... an infant, and a
child and an adolescent.
And really taking care of women and families across their life
course. If we really want to do something about improving their pregnancy
outcomes
 A Conversation with Jaclynn Hawkins
Welcome back.
We're here with Dr Jackie
Hawkins who is an
assistant professor in the
School of Social Work at
Michigan State University.

She's an expert in diabetes care and self management particularly 113
with African American and Latino men. And were gonna be talking to her
about her research today.
So thanks for joining us. >> Your welcome. >> Awesome. So in
this particular module were talking about social determinants of health and
that is how living condition, working conditions and policies shape people's
opportunities to be healthy.
Can you just talk a little bit about your work with diabetes. And
how social determinants play a role in the work that you do. >> So I work
mostly with low income African American and Latino men who are living
in Detroit, Michigan.
>> Mm-hm. >> And I completed my dissertation and looking at the
social determinants of diabetes health management behaviors in the Latino
and African American men who are living in Detroit.
And what I found and a lot of what the literature says is that things
like socioeconomic status, their educational background >> Their culture
and their levels of social support.
And more importantly and what I'm interested in, is gender. That
all of those things can serve social determinants of health.
So, the things that I just mentioned can influence whether or not a
man of color is diagnosed with diabetes. And whether or not they can
manage their diabetes and that in turn determines what types of health
outcomes they have.
So, in terms of socioeconomic status, which is a big social
determinant of health. With a man in Detroit, that I've studied, I've found
that being of low SES, can really have an impact on their resources, and in
particular, their access to health care services.
And their access to education when they do get a Diabetes
diagnosis, about what they should do to manage their Diabetes. >> Okay,
so I think I hear you saying the someone's SES, which again remind folks, 114
that's income.
>> Yes. >> Education, occupation. >> Right. Mm-hm. >>
Sometimes, and then by proxy, perhaps your exposure to your access to say
employment based health insurance >> Exactly.
>> All of those things play a big role in whether or not you're able
to whether or not you're diagnosed with type II diabetes >> Exactly. >>
And whether or not you are able to access health care >> Mm-hm.
>> Once you are diagnosed. >> Right. >> And just for folks you
may know what's the difference between type I and type II diabetes? >>
Pretend we're talking about type two.
>> Right, we're talking about type two diabetes, type one diabetes
is usually diagnosed early on- >> In childhood, right? >> In childhood.
And that's when the pancreas does not produce insulin. >> And
with Type II diabetes, it's usually diagnosed and linked more with
someone's physical activity and behavior patterns, eating patterns later in
life.
And that can lead to the difference is that the pancreas, it doesn't
manage insulin levels as well as it should. >> Yeah, so it sounds like
children who are diagnosed with diabetes, that's something that turns to be
genetic or somehow beyond your control.
But type 2 diabetes which is just typically diagnosed among adults,
that's something that we can work on with behavioral factors. >> Exactly.
>> Exercise, eating properly, things like that. >> And we are
finding more and more however that particular among African Americans
and Latino men that.
They're getting diagnosed earlier and earlier with type 2 diabetes.
>> Yeah, so I wanna go back to this gender component that you're
interested in.
Because we don't really talk about men's health and when we think 115
about diabetes for years I only thought about women and what happens
when women typically who may be overweight or obese experience
diabetes.
So what brought you to looking at men in general and then what
particular or unique barriers might men face around diabetes self-
management?
>> So what the statistics are telling us over the past 20 years
traditionally it was more likely to be diagnosed in women. >> Mm-hm.
>> Particularly in African American women and Latino women.
But what the data is showing us in the past 20 years is that men are actually
surpassing women in Type 2 Diabetes diagnosis rates.
And that those disparities get worse for African-American and
Latino men. Compared to non-hispanic white men. And what got me
interested in gender differences is a little bit personal, a little bit academic.
I have several of the men in my family and particularly my
grandfather and my, on both sides actually had diabetes diagnosis.
Died of diabetes related complications. My grandfather who was
close to you he was a double amputee as a result of diabetes. And he was in
a wheelchair for most of the second part of his life because of uncontrolled
diabetes.
So that really sparked my interest in undergrad, to pursue diabetes
in general, cuz it wasn't only affecting men, it was affecting women. But
then when I explored the literature, I found that there was much more
research on diabetes and.
In particular in African-American women. And less was being done
for African-American men and for Latino men. >> Yeah.
You mentioned this term disparities, which we've been also talking
about in this course. And I was wondering if you could clue us in onto
some of the specific diabetes disparities that could be affecting African- 116
American and Latino men.
So- >> So, are they more likely to experience limb amputations
like you mentioned? >> Yes. >> Or eye problems.
>> They're several times more likely to experience a variety of
diabetes-related complications and >> Those can include things that you
immediately think of, like a limb amputation.
But they can also include things like eye problems or loss of sight
or significant eye problems. It can include things like stroke.
Is a huge outcome of having uncontrolled diabetes and a variety of
other things, so. When, not only do African American and Latino men have
higher Type 2 Diabetes diagnosis rates.
They are several times more likely to experience these negative
health outcomes as a result of diabetes compared to Non-Hispanic white
men.
>> Mm-hm, absolutely. >> So we also talk a little bit in this course
about theory, and applying theory to real world issues. And I was
wondering if there are any theories that you use, health theories or social
theories, that you apply to your work, trying to understand this problem?
>> One of the big ones is the ecological framework. That you could
find in public health, there are similar framework in social work, their
personal environment framework that all of the graduate students you hope
will be familiar with at this point in social work.
[LAUGH] And what those really get at is helping to categorize the
different factors that determine. Health outcomes. And the different factors
that determine whether or not, for me what I'm interested in, is whether or
not the men engage in particular behaviors related to managing their
diabetes.

So the ecological framework, for instance, is really useful in 117
thinking about how some of the individual level factors might influence
whether or not a man goes to the doctor.
For instance, whether or not he's employed. And whether or not he
has employer-based health insurance. >> Or even sick days off if he does
need to go to the doctor's office.
Does he have the time to be able to go without fear of losing his
job. >> Exactly, exactly.
Something that I found in my work is that particularly among the
younger men who aren't retired yet, is having long work hours. I did some
focus groups with the Latino manager trade in particular who were finding
it difficult to make it to doctor's appointments, that outside of traditional
doctor's hours just because they worked long hours and couldn't- >> Get
there by 5 o'clock.
>> Get there by 5 o'clock. >> Yeah. >> And couldn't go on the
weekend or were just so tired when they got home, they didn't want to go to
the doctor.
And then the ecological framework also helps them looking at
more family, community level support. So in terms of family, what we
found is that if individuals in particular who are living with a chronic
disease like Type 2 diabetes, if they have family support that can really
increase, whether or not they engage in these self-management behaviors,
and so the opposite is also true.
Is if they're not getting support at home, and if whoever is
preparing the food is preparing unhealthy foods, and not involved in
helping them to manage their Type 2 diabetes, that can also have a negative
effect.

>> Yeah. So it sounds like it's actually a family disease. >> It is. >> 118
Right? Because if someone's trying to, make, change their behavior to eat
more healthy food, to watch their portion sizes, to get more exercise, and
hat's something that's really difficult to do all by yourself.
>> Exactly. >> People tend to need a lot of support to make those
changes. >> They do and so that kind of gets at that wider level of the
ecological framework which is the larger macro level in thinking about our
health care system.
And whether or not it focuses on the areas that we need to focus on,
to really help men of color manage their diabetes. So I'm a lot of, all
though, the healthcare system is catching on, a lot of it focuses on this
medical model that's focused on the individual.
And coming into doctor's appointments alone and seeing the doctor
and being done after that.
>> Yeah, being prescribed a medicine and you go home and you
work it out on your own >> Exactly, and what we're finding, or what I'm
finding with black and Latino men in particular is that that doesn't work >>
You need a more inclusive model that brings the family or the support
system.
>> To them. >> To them. >> Or makes it more accessible. >>
Yeah, absolutely. So we're both social work faculty members at different
schools who do physical health research.
I do research in the realm of cancer and chronic disease
communication, you do diabetes research. But that's a little bit uncommon
in social work, where we tend to hear about people doing a lot more mental
health, intimate partner violence, or child welfare research.
And so what do you think is social work's role in tackling a
physical disease like diabetes? >> Well, I can definitely talk from the
research perspective.
Our role is to help to advocate on the research side and also on the 119
practice side, but and much more so on the research side. I see my role in
social work, I bring a perspective to research that is often not found in other
disciplines, which is the supplied, I don't know if I'd call it a framework,
but this applied perspective in that social work we wanna make a difference
on the ground, and I feel like I bring that to the research that I do.
I do a lot of community based participatory research, where the
work that I do is really driven by the community and we're focused on
sustainability.
>> So the people who are being studied, in this case black and
Latino men with Type 2 diabetes are actually a part of the research process.
>> Exactly. >> Asking the questions, and helping with the focus
groups, and they are not just being studied but they're a part of creating the
knowledge.
>> Exactly. And so I see that as a role of social work in looking at
and helping communities to deal with these physical health disparities.
>> So in this course, we talk a lot about culture and the way that
culture shapes behaviors and outcomes and issues of justice. >> Right.
>> And so can you talk a little bit about how culture plays a role in
diabetes soft management with some of the groups that you worked with?
>> Yeah, so I guess I can talk a little bit about Latino men.
The work that I've done in Detroit with Latino men, and I met with
them and asked them about their, what they felt affected their diabetes self-
management behaviors.
One thing that came up was food. >> And the role of food in the
home. And- >> Food's powerful. >> [LAUGH] Food is very powerful.
>> People have a lot of memories around food. Comfort food. >>
They do, and the majority, a vast majority of the men, the low income

Latino men that I have talked with, have not, were not born in the US, and 120
bring a variety of food norms with them.
>> Symbolism, traditional foods. >> Exactly, and a lot of times,
certainly not always the case, but a lot of times it was the wife primarily or
the women in the family preparing the foods, and the kitchen was not
[LAUGH]- >> Was off limits. >> Yeah.
>> It was their job to prepare the food, and the men's job basically,
to eat. Sometimes, a lot of the time, the things that they were eating, some
of the things anyway, they were not compatible with, >> With trying to
control diabetes.
>> Exactly. >> I can imagine you're asking them to either learn
how to cook differently or learn how to cook, period. >> Right. >> And try
to figure out whether to remake some of the recipes that they are really
comfortable with in ways that might be healthier.
>> Exactly, and I, even myself has struggled with that being both
Latina and African American and wanting to eat those comfort foods that I
grew up eating, and [LAUGH] and a lot of times, I myself have even gone
to speak to a dietitian, and have spoke with doctors, have done planner
eating on healthy eating.
And there's this lack of cultural sensitivity as well in if you're going
to the doctor and he tells you to eat broccoli, or fruits, and what have you.
And that's not what you're used to eating, are there things that we can
suggest that are.
>> That fall into your cultural norms. >> Exactly. >> Or that
resonate with the way that you grew up or what you're accustomed to. >>
Right. >> And that could just be maybe adjustments made around.
Yeah, the way that food is prepared. >> Could we not put a lot of
lard, I mean it makes them taste delicious in the beans, but [LAUGH] can
we maybe Have this some kind of alternative to that.
>> Yeah. >> Mm-hm. >> You were saying before also that religion 121
plays an important role in shaping our help seeking behaviors. >> Right. >>
Whether or not we choose to go to the doctor, can you talk a little bit more
about that?
>> So I've found a couple of things. One is this idea of fatalism and
that this is what God intended for me. I am getting sick and it's inevitable.
This idea that I'm gonna get diabetes, everybody has diabetes. And
like I said, this is what God intended for me, so sort of a more of a fatalistic
view of [LAUGH] that influences whether or not someone manages their
diabetes.
>> We also call that an external locus of control, right? So instead
of me being able to be in control of my behaviors, what's gonna happen to
me is going to happen to me no matter what.
>> Exactly. >> Yeah, and so it makes it more difficult to encourage
someone to change their behavior if they think that what's gonna happen is
inevitable.
>> Right, and so that's a little bit more of a, maybe a not so helpful
role But in terms of positive, there are much more in my opinion positive
roles for religion, particularly in African Americans.
And my work in particular has found that for African American
men, social support and church attendance has, can have a positive effect
on whether or not someone, whether or not a man goes to the doctor.
>> Sure. >> We're not quite sure yet what exactly the mechanisms
through which church attendance is influencing their decisions to go to the
doctor but we can certainly speculate.
>> Yeah, that hearing positive messages from the pulpit or your
faith based leader. If you've got a group of other men who are working on
their health and that could certainly be a social network that is supportive.

>> And you and I even, we attended a men's health research fair 122
that was hosted in a church. I'm part of the research team right now that got
funding previously to do a diabetes intervention that is church based.
And what a lot of people don't know is that, they're actually, which
I didn't know, and actually. There are Parish nurses.
So- >> So churches often times either employ or have a volunteer
workforce if you will of healthcare providers. >> Right. >> Who are also
parishioners who can help to kind of spread healthy messages and provide
those services in the church.
>> In the church, spread healthy messages, screen people. When
they're coming in, take their blood pressure. >> Yeah. >> I encourage them
to go to the doctor.
>> Good. >> Yeah. >> That's fantastic >> So one of the questions I
like to close with is to ask folks what the social justice mission is of the
work that they're doing.
So I know you have a personal connection to the work that you do
through your own family.
But what's the social justice mission? >> In terms of social justice,
especially considering today's political climate in our current
administration I feel the role for social justice in my work related to
physical health disparities is that having meaningful and accessible health
care is a right.
It's not a privilege, it's not something that. >> Would be nice. >>
Would be nice, that we should work for.
Pull themselves by the bootstraps and then we can have healthcare.
It should be something regardless of income, regardless of racial
background, regardless of educational background that everyone should
have access to no matter where you live.

Whether you are on urban setting, whether you are in rural setting. 123
It should be a universal right. Like the right to bear arms, for instance.
If everyone has a right to own a firearm, we should all have a right
to go to the doctor and to get care that is meaningful and accessible to us.
>> Yeah, absolutely.
>> So for me, I really see that as a something as social workers, it's
a social justice issue, and that's something we should be advocating for. >>
Absolutely, and I think also when you think back to this gender lens that
we've been talking about, we don't talk a lot about men's health in this
country in general.
>> They don't talk a lot about [LAUGH] >> Yeah, and so I think
also And one of the very few areas where women may actually get a little
bit more of the attention is around health and healthcare.
>> It is. >> And men do tend to have shorter life expectancies.
And they tend to suffer disproportionately from some of these
diseases, because we're not talking about it.
>> Exactly. >> Or doing the research it. So all the more reason to
make sure that there aren't populations out there that are falling through the
gap.
>> Right, exactly. >> Awesome, well, very good. So this has been
a conversation with Dr. Jackie Hawkins, Assistant Professor at Michigan
State University. And thank you so much for sharing your research with us.
>> You're welcome.
 A Conversation with Dr. Deirdre Shires
 Visit the Center of Excellence for Transgender Health (new window)

124

125
Welcome back.
I'm here with Dr. Deirdre
Shires, she's an Assistant
Professor of Social Work at
Thank you for joining us
today. >> Thank you for having me.
>> You have developed quite an expertise in trans health,
transgender healthcare, and I'm really interested to hear about your work
today.
And so can you give us a bit of an overview before we delve into
your research specifically. So for example, how large is the transgender
population in the United States?
>> Sure. Well, what I study mostly is transgender health and access
to care. I'm interested in both transgender patients or people, and also
physicians and other healthcare providers.
So, this- >> And their relationships to or their service of 126
transgender individuals. >> Yes, exactly. Exactly.
And so, the transgender population is, it's small, but it's bigger than
we once thought. So, the current estimates are that about 0.6%, so a little
less than 1% of the population is transgender.
We used to think that the population was much smaller, but that
was because people were only counted when they were going to a surgeon
to get gender confirmation surgery.
And, now we have a little bit more information, because some
national surveys are asking about gender identity. And so we know that
there are quite a bit more transgender people than we thought years ago.
>> Yeah, absolutely. You've also done specific and are continuing
to do specific research on the healthcare needs and experiences of trans
individuals, but from their perspective, as well.
So bringing their voices into the research. Can you tell us a bit
more about that? >> Sure so a couple of organizations got together a few
years ago, back in 2007, 2008.
It was the National Center for Transgender Equality and the
National Gay and Lesbian Task Force, which are both located in
Washington, DC.
And what they knew was that there's just so little information out
there about transgender people and their experiences.
And so they, along with the, some community members,
researchers got together and designed a survey and they wanted to know all
about the discrimination and bias that transgender people experience.
And- >> And not only in healthcare, but in other facets of life as
well? >> Yes. So not only healthcare, but in school, at home, growing up-
>> Perhaps at work settings. >> Work settings, employment, housing, in
public places, like when you go shopping.
Really just sort of all these different experiences. Mistreatment by 127
police or in correctional facilities, they asked about just everything.
And so what they did was they sent out this online survey around
the country. And also sent paper surveys to a whole bunch of community
organizations, all the organizations they could find that serve transgender
people.
>> With the hopes that they could either capture folks either one
way, digitally, or in person through these community groups and liaisons.
>> Yes, yes, because what they thought is, of course, not
everybody has access to the internet and they would miss some under-
served populations or sub-populations if they didn't have paper surveys,
too.
So they did this in 2008 and 2009 and they were able to get over
6,000 transgender respondents.
So transgender people, gender nonconforming people, and people
who cross dress, sort of anyone kind of on this spectrum. So they found
that the discrimination that transgender people experience is just
widespread across the board.
And as part of this, they released a report and it's part of, the state
may also use some of the data available to researchers who wanted to look
more closely at specific questions.
>> Wonderful, so not the identities of these people, but kind of like
their de-identified, anonymous responses >> Yeah, all anonymous. Yes,
you will never be able to find these responses.
>> Yes. >> So they shared the data with me, I was not part of their
original team but they were willing to share their data with me.
And so what I did was look at kind of a subset about 1,500 people
that were transgender men. Cuz this is a group that is even more under-
studied than transgender people as a whole.
Most of what we know is about transgender women. >> And why 128
is that? Is it a smaller population?
>> It's a good question. I think partially because a lot of the
research that has been done is on HIV risk and HIV transmission, which is
a huge risk, mostly among transgender women, less so among transgender
men.
And, it is a slightly smart population too, so just a really under-
studied group. And so, what I looked at was, what kind of experiences do
they report having in a doctor's office or a hospital?
Do they experience any kind of discrimination or bias, using the
survey questions that were asked.
And so what I found was that over 40% of them reported that they
had been discriminated against somehow in a doctor's office or a hospital.
So that could include being verbally harassed. It could include
being denied services, or even being physically assaulted.
And some of the respondents did report physical assault. >> Wow.
And so you took that information, right, on these experiences, based on this
nationwide survey.
And you developed your own study from it, is that right? Or related
to it? >> I did, I did. So I had a lot of unanswered questions, once I had
finished this.
So there were some limitations of looking at these data. So one was
we didn't know, was it a doctor's office or a hospital? >> Mm-hm. >> If a
respondent was verbally harassed, it could have been something that
happened in the waiting room.
>> Right. >> Because when you- >> So maybe unrelated to their
experience with the healthcare provider, but with other patients who are in
the vicinity.

>> Sure, sure. And of course when you get healthcare, you walk 129
into an office, you sit in a waiting room, you talk to someone at the front
desk.
You usually meet with a medical assistant who takes your height
and weight, and your blood pressure, and asks you questions.
There are all these different people that you encounter kind of on
your way before you even get to the healthcare provider, right? And so, I
wanted to know more specifically about doctors, and health care providers,
and their role in this.
Because the piece of it that I wanted to know about was
transgender people saying that they were denied treatment. So it was over a
quarter of the sample saying they were denied treatment.
And what I wanted to know was, what kind of treatment were they
denied, was it transgender specific healthcare? >> Right, such as hormone
replacement therapy.
>> Mm-hm, yeah, so it could be hormone replacement therapy, or
surgeries, or anything, something that's specifically related to what I would
call gender affirming care >> Or is it just routine care, just basic.
>> Flu shots. >> I need a flu shot, I broke my leg, I have diabetes I
need to manage. I need cancer screening, things like that.
Just the basic, routine care that we all need. And so that's what I
really wanted to know after looking at this national survey. The National
Transgender Discrimination Survey is what it's called. >> Yeah.
>> And so what I did was I, in collaboration with some other
researchers, designed a survey and sent it out on online to over 300 doctors
in one health system.
>> Wow! >> One metro Detroit health system. And these were just
primary care providers. >> Mm-hm. >> So, they were internal medicine
physicians and providers.
They were family medicine and also obstetrician/gynecologists. >> 130
Mm-hm. >> All in general practice, so no specialists.
>> Mm-hm. >> I just wanted to see if you're a transgender person
just looking for routine care, or whatever a general doctor can provide,
what do those general doctors think about all this?
Do they Have any training on transgender health? Are there certain
barriers that they report? Are they biased themselves, and that's why they
don't wanna treat transgender people, or is it that they just feel like they
don't have enough training?
>> And this is all pretty novel, right? There aren't a ton of studies
out there that are looking at doctors' preparedness, experience, willingness
to work with trans patients, is that right?
>> That's right. There is very little information out there. >> Mm-
hm. >> There have been a couple of studies in the last few years, and none
focusing specifically on primary care.
>> Mm-hm. >> What we do know is that there have been a couple
of studies in medical schools and medical education.
That there's very little time spent on transgender health, or at least
historically there has been very little time spent on transgender health.
Maybe something like a third of medical schools talk about it at all.
And if they do, it's just a couple hours here and there. So it's not-
>> Over four years, right? >> Over four years of school- >> Right. >> Of
medical school.
Right, exactly. In the studies that ask also are really, they ask about
LGBT health. So that could encompass lesbian, gay, bisexual and
transgender.
So we don't even really know how much of that time is spent on
transgender health, specifically, so not much. So there's a little bit that we
know, but we really didn't know too much at all.
>> Yeah. So out of these 300 doctors that you reached out to, how 131
many or about how many got back to you? And what are some of the things
that you found?
>> So over half got back to me, about 52% responded to the
survey, which only took about 10 minutes to answer the survey.
And it was online and it was sent to their email so it was pretty
convenient to fill out. And so what I found is that about half of them had
ever seen a transgender patient, that they knew of.
Of course, some of them may have encountered a transgender
patient and the patient did not disclose their identity to them.
And we know from transgender people that they often don't
disclose their identity to doctors out of fear of bias or discrimination.
And so many of them had at least seen a transgender patient or
cared for a transgender patient in some way. >> Well, that's encouraging,
right, cuz you would think that, of course this is a large health system.
It's probably an urban center. And so, certainly if you repeated that
survey with more rural or suburban physicians, they may have less
exposure or they may have less knowledge.
Because perhaps they see a less diverse clientele. But it's
encouraging- >> Sure. >> To think that at least half of these physicians
have some exposure.
Some experience with working with trans patients. >> Sure, they
have some experience. And the question that I was really interested in was,
so whether they've seen a transgender patient, in some capacity or not, are
they willing to?
So are they willing to provide that care? And so what I asked
specifically is, are you willing to provide routine care? Just all the basic
services that we talked about.
And are you willing to provide hormone therapy?
And the reason I asked about hormone therapy is because that's a 132
service that primary care physicians can provide, right? They don't do
surgery, they don't do counseling.
They don't do all those other things. >> And also, primary care
physicians provide hormone therapy in other contexts, right?
So you think about women who might be experiencing menopause,
or teenagers, or any other type of illness, or need, in other populations, that
hormone therapy is within the scope of primary care, essentially.
>> Exactly, exactly. So primary care doctors prescribe birth
control. >> Mm-hm. >> They help with the management of thyroid issues.
>> Mm-hm. >> So there are many, many reasons that a primary care
physician.
>> So broadly, maybe not specifically, but broadly hormone
therapy is within the scope of knowledge, for example >> It's within the
scope- >> Of what a primary care provider- >> Yeah, it's within the scope
of knowledge.
>> Yeah. >> Yeah, exactly, exactly, and so I wanted to know sort
of what were their experiences? And what were they willing to do? Maybe
they haven't done it yet, but are they willing to do it?
>> Yeah. >> And so what I found is that most of them said yes, I'm
willing to provide routine care to transgender patients. >> And that's the flu
shots and treating the broken ankles and things like that.
>> Exactly. Basic stuff. About 3/4 of the group. But really I
would've expected 100%. Right?
Because that's what general doctors do. They provide basic care to
whoever needs it. >> So that means 25% of them maybe were not willing.
>> Were not willing, were not willing.

And this was a check the box kind of survey. And so I didn't sit 133
down and talk with them. I didn't hear exactly why they said that. But I
have some clues from some other questions that I asked.
And so then I also asked them, so in terms of hormone therapy, I
wanted to know, would they be willing to. If they have a new patient who's
transgender, who wants to start hormone therapy, would they be willing to
sort of initiate that?
Kind of write that initial prescription, figure out what the dosing is,
all that kind of stuff.
But then on the flip side, if they had a new patient who was already
taking hormones. Maybe they had seen an endocrinologist or another
provider.
They knew what the dose was. They had been taking it for awhile.
Would they be willing to just write the refill, right? So continue the
prescription.
>> Mm-hm, that some other physician has already kind of initiated
and- >> Yes, yes. >> Taken a look at. >> Because those are kind of two
different things.
>> Sure. >> And. >> One requires a lot more perhaps research and
engagement with the patient and almost responsibility for starting a new
course of treatment.
The other is kind of built on someone else's expertise, and work,
right? >> Sure, and so what I thought is maybe, some of the providers
would feel more comfortable knowing, this patient has seen an
endocrinologist, and gotten all set up, and they're ready to go, and I just
need to kind of monitor in the long term.
And that was true. So they were more comfortable with that. So
about half of the physicians, and other providers said that they would be

willing to write that refill, or I guess I should say type it in, because- >> 134
Everything's electronic now.
>> You don't write prescriptions, right, right. They don't really
write prescriptions anymore.
But much less, many fewer of them so that they would write that
initial prescription. Or initiate that. >> Responsible for helping someone to
start a new course of treatment.
>> Right, so that was about 20%. So quite a bit lower. >> Very
interesting. So your dissertation work focuses on this, on doctors'
willingness to treat patients. But you also looked at some religious and
political kind of nuances in the demographics of these physicians, right.
Because we were also interested in what is it not only about their
professional knowledge and capability, but also about their personal
characteristics that might kind of give us some nuance.
Or some deeper understanding into some of their willingness to
make these decisions about treating transgender patients.
Did you find anything interesting in the demographics? >> I did, I
did. Yeah, the first question was really how many of them are willing, how
many of them are not willing.
But then I wanted to kind of delve a little deeper and see which
providers are- >> Are more willing, right. >> Which providers are not
willing.
And what I sort of suspected is that some of it might have to do
with knowledge and training.
Some of it might have to do with personal experiences. And what I
found that it was really a little bit of both, right? So Providers, a lot of
providers just were lacking confidence.
They just didn't feel comfortable treating- >> Working with this
population. >> Working with this population. And that was true, even when
I controlled for knowledge and training and familiarity with these 135
guidelines and things like that.
So, what I suspect is that there is more to this conference than just
medical training. >> Or even exposure.
I had known someone who's transgender. Does that increase their
willingness to- >> Yeah. So, and sort of the personal side of things, what
was more important than even the training was just having met a
transgender person.
And that was more important than having treated a transgender
patient. >> Really. >> So having that personal experience was more
important than having the clinical experience.
I also asked, I used a scale that someone else developed to measure
transphobia. Which is kind of like homophobia, or negative attitudes
towards transgender people.
And, what I found is that physicians who reported more, or higher
levels, of transphobia were less likely to be willing to provide any of these
services.
There were also some religious differences but, because it was kind
of a smaller survey, there were about 150 respondents.
I don't want to say too much about the religious piece, but I think it
needs to be replicated in a larger [CROSSTALK] definitely. But it looks
like that religious identity might play a role too, absolutely.
>> Okay, awesome, interesting, very interesting. So what do you
think or what do you see as our next steps in doing this work?
So one of the larger goals is to improve health equity, or the access
to resources. Equitable, high quality healthcare for transgender people.
What do you think are our next steps kind of collectively?
And what do you see as the role of social workers in this healthcare
context in doing this work? >> Good question.
>> Yeah. >> I think there are a lot of different steps that we need to 136
take. So one is, I think the reason why providers and people, other people
working in healthcare may be uncomfortable or feel like they're not
knowledgeable enough about transgender population is because we don't
ask people in a way that they can easily revel their gender identity, if it's
not male or female.
So, if you think about all the forms you fill out, or the questions
that you are asked. >> Everything is very binary, right? >> Everything is
very binary.
So on your driver's license it's either M or F, there's no other
options. That's true of your birth certificate. It's true of most electronic
medical records.
So if a transgender patient comes into a provider's office and
maybe their ID says one thing, but they are saying, no, my identity is really
something else, it causes confusion and there's just really not a good way to
record that.
>> Right. >> And chances are, they're not gonna disclose their
status in that way. So, I think one of the first steps we need is to really start
recording things in a way that we know, who?
Where? Who are the transgender patients? >> Yeah. >> What are
their health, we need more research. >> Yeah. >> And we need more
information on this population.
But we also need to normalize diverse gender identities >> Mm-
hm. >> And not be asking people are you male or female? We definitely
need more options. >> Yeah.
>> And we need it to be, you know, normalized so that everybody's
asking this way, so it's just a routine part of practice. >> Yeah. Part of
healthcare.

>> So it's not up to a patient to essentially come out to a provider, 137
but that it's just asked in a way that makes it comfortable for everybody.
>> Yeah. That's good. >> So I think that's one, that's one place to
start. I mean I think, of course, training is also always important.
In terms of medical school, and nursing school, and any health
educators. In terms of social work's role, I think there's really a big role for
social workers.
So one reason is social workers are working in healthcare settings
more and more, and they're part of primary care teams more and more. So I
think there's kind of a role to smooth the path for transgender patients, to
help be an advocate for transgender patients.
And working with other members of the healthcare team who
might not be as knowledgeable.
Or might not have as much sort of background and cultural
competence as we as social workers do. >> So we can almost be educators
in our own right amongst the folks that we work with.
Healthcare teams that we're embedded in, or healthcare agencies
that we might work for. In terms of helping our colleagues understand the
language, understand culturally competent ways to work with and approach
transgender patients.
And kind of helping them to expand their kind of vocabulary, if
you will, and understand some of the considerations that they should be
thinking about when working with transgender patients.
>> Absolutely, I think social workers can be advocates and trainers
and really just, Yeah, sort of serve this role of kind of smoothing the path
for patients.
I think there is another piece. So, part of the medical transition, if
transgender people choose to go down that path, is receiving counseling
usually.
And social workers who are maybe not in a healthcare setting, but 138
are in a more of a clinical therapist type role may have transgender people
come to them who are interested in counseling.
And so I think, as a profession, we can get comfortable with that
and make sure that we are really competently providing the kind of
counseling that transgender people need as they're kind of going through
that process.
>> Absolutely, absolutely. There are undoubtedly many people
who see themselves as allies, and who want to be better allies and
supporters of transgender people.
Though, they may not be fully grasp what they can and should be
doing to better walk in those roles.
And so, what would you tell them, folks who want to understand
how to be better allies for the transgender community? What kind of
lessons can we draw from some of your work and your experience on the
ways that we can better support?
>> Uh-huh. >> Yeah. >> I think an important area is just to be
aware and really question when you see those forms or you see research or
you see people asking, are you male or female, to really challenge that.
And ask about whether, is there a different way we could be asking
that? Going back to kind of social workers, as we're involved in research
projects, maybe they have nothing to do with health.
Or we're involved in social service agencies or different types of
care. We can be making sure we ask about gender identity in an inclusive
way.
And making sure that our policies, and our agencies, are being
friendly and sensitive to transgender people.
>> Yeah, absolutely, so essentially using our voice where we can,
being advocates where we can.
Also, I would say improving our own personal kind of knowledge 139
around the issue so that we can then educate and help others to have a
better understanding of the issues as well. >> Absolutely.
>> Yeah, and then I know on a policy stand front, where in a place,
still, right, politically and Socially, where transgender rights are not
necessarily equitable in every state.
Is that right? >> That's right. >> Yeah. >> That's right. A lot of
policies, state and federal policies are really in flux right now.
And of course, the Affordable Care Act is in flux too. >> Mm-hm.
>> And so- >> And that had been one relatively recent avenue that
actually improved transgender healthcare to some degree.
>> Yes, that's right. And President Obama put into place some
executive orders that really help transgender healthcare be more available.
Including eliminating anyone who got federal funding, it could not
discriminate against transgender people, and in healthcare.
>> Mm-hm. >> So, there were some steps that were put in place.
It's sort of unclear what's gonna happen with- >> Going forward.
>> Going forward with some steps of those steps. >> Yeah. >> One
recent thing that happened was, in terms of data collection, and kind of
understanding who is the transgender community.
Is that the US Census was going to start collecting data on both
sexual orientation and gender identity.
>> So that we could actually have a more accurate national
snapshot of- >> Right, so we know, yes. >> Of gender identity in the
United States. >> Exactly, exactly, and that is now, it sounds like, off the
table.
So the next Census will not collect that information. >> Collect that
information, right. And data really fuels a number of things, right?

It fuels the resources and the funding that become available. 140
Because when you're aware of the proportion of a population, you're able to
direct more resources there.
It helps us to make policy decisions about things like healthcare
and housing and human rights. And so, all of these things that are attached
to needing to accurately assess who people are, where they live, how
they're being served.
That's what data helps with. And so we were in a position to
potentially have that at our disposal to be able to make better decisions and
now we may not.
>> Yeah. >> Yeah. >> Exactly. The census data is tremendously
important. So the field of social work and- >> Sure.
>> And many fields. >> Sure. >> And so we wanna know exactly
who is out there and we haven't asked these questions in the right way.
>> Right. >> And so it's disappointing, but I'm hopeful that that
will be added back in in the future. >> Yeah, yeah. So I just wanna thank
you so much for joining us today.
This has been an interview with Dr. Deirdre Shires. She's an
Assistant Professor of Social Work at Michigan State University. And we
thank her for her expertise.
 A Conversation with Brendon Holloway
Welcome back
everyone. I am here with one
of my favorite MSW

students, Brendon Holloway, and he's gonna be sharing some of his 141
experiences. So welcome.
>> Thank you. >> I am so excited to talk to you, not only cuz
you're one of my favorites, no offense to my other 70 students or so. But
because I know you're such a passionate advocate and educator around
transgender rights and transgender health.
And I can't wait to just ask you about some of your experiences
and whatever you wanna share. So first, I know that you have been doing
some work in the area of advocacy around transgender healthcare, and
I know that you also have an internship at a center called the
Spectrum Center. And I was wondering if you would tell us just a little bit
about what you do there, and why this is a particular area of passion for
you.
>> Yeah, so, at the Spectrum Center I'm the Education and
Training Graduate Coordinator. >> And, yeah, what I do there is I create
content and I facilitate workshops and trainings to anyone who requests it.
>> Okay. >> So it can be staff on campus, faculty, classrooms,
HR departments, community partners, it doesn't really matter who, we
usually accept the majority of them.
And then- >> And so they're asking for support around LGBT
health broadly, or trans-health specifically? >> LGBTQ topics broadly. >>
Okay. >> But sometimes it can be very specific to health, and I always do
one section that is solely on trans-health and the process of transitioning.
But yeah, that's basically what I do there. And aside from that,
I'm currently doing an independent study through the school of social work,
with Katie Doyle at Ozone House on a project that is creating an index of
trans affirming care providers in Southeast Michigan.
>> Wow, so essentially you're trying to create a directory- >>
Basically. >> For transgender individuals to know which healthcare
providers not only are willing to accept them as patients, but also are 142
perhaps more culturally competent.
>> Yes. >> And well trained in working with transgender
healthcare issues. >> Yeah, and the way that we do that is we have actual
transpeople who go into the facilities to assess the facilities.
>> Wow. Almost like, so, are they going in the course of their
regular care, or is this kind of like a reconnaissance, secret shopper type of
mission, where, they are trying to get a sense of that atmosphere and bring
back that information?
>> It's definitely more of a secret shopper. >> Okay [LAUGH].
>> Yeah, because I can go to my normal doctor, and I know
she's trans affirming. >> Right, right. >> But if I have someone else who
goes who may not know her and have that relationship, it could be a
different experience.
>> Absolutely, absolutely. How did you come to either develop
that project yourself, or was this already an initiative that you joined onto?
>> I developed the project myself, but really it was just
inspiration. Because when I moved to Ann Arbor from Nashville, I moved
here and I hadn't had proper healthcare back in Tennessee.
So after I got to Ann Arbor I realized that there were more
resources here but there still weren't as many that there could be.
So once I was able to access care and find a primary care
physician who is very accepting and affirming, I realized that other people
needed this type of care as well, because I had been neglecting my own
health needs.
>> Do you feel like some of your experience in Tennessee,
excuse me, [COUGH] was a function of policy, or of perhaps, not having
this resource that you're trying to develop, in terms of knowing where to
go?
>> I think it was a good mixture of the two. Our state legislature 143
in Tennessee is definitely more conservative.
And the bills that they pass are, bills that are similar to North
Carolina's anti-transgender bathroom bill. So they kind of created this very
hateful political climate and just climate in the state in general.
But I do know for a fact that there are trans-affirming health
providers in Tennessee. So I do think having this index would help trans
people who live there navigate that.
>> Yeah, so this could be a model for example that other
communities could replicate in terms of providing this resource.
>> Yeah, definitely. >> Awesome, awesome, awesome,
awesome. And so to the degree that you feel comfortable, will you tell us a
little bit about your experience?
And it could be whatever it is that you wanna share around
finding transitional care, around being a graduate student who is trans. Or
around finding community, even, here in Ann Arbor and other places that
you've been that have been affirming.
>> Yeah, so when I moved to Ann Arbor back in August,
[COUGH] I had no friends here, I had no resources here.
I had no idea where I was going to go to the doctor. And when I
moved here, I also hadn't began the hormonal or the surgical part of my
transition.
I had only just socially transitioned so people knew me as
Brandon, as he, him, as a male.
But definitely no hormones or any type of surgery. So when I
moved here I was very, very lucky to have met one person, her name is
Erica, she was one of your students as well.

>> I know Erica. Yes, I have the best students. >> I met Erica, 144
and Erica's from Ann Arbor, and had an entire queer community built
around her.
And she was able to introduce me to those people so. Pretty
much instantly after moving here, I was able to basically build a queer
family here in Ann Arbor. And then once I had the social support that I
needed, I had heard from the director of the Spectrum Center that there's
this place in Ypsilanti called Corner Health Center.
And he said that if you are under 26 years old, that you could go
there and that the care is trans affirming, and you could get a regular
primary care physician.
>> Wow. >> So I sought that out. >> What a great community
resource. But then you- >> Yeah, definitely. >> Yeah. >> And they also
offer, it's affordable care basically.
And so they offer- >> Some kind of sliding fee scale? >>
Sliding scale, yeah. >> Yeah. >> They offer a sliding scale, so you never
will pay more than $30 for an appointment.
>> Okay. >> So I took his advice and I went there.
And I met with this wonderful primary care physician named
Dr. Cathy Fessler. And then within a couple of weeks, she had prescribed
me hormones which are known as testosterone.
And I began testosterone on November the 11th. So having that
resource was just supremely helpful. I'm very thankful for Will at the
Spectrum Center. So, I think, just moving into Ann Arbor, meeting Erica as
a friend, being able to do my placement at the Spectrum Center really gave
me the support that I needed to externally thrive in my transition, and to
feel even better about myself.
>> Absolutely. And so, I know we just had a chat with Dr.
Dierdre Shire in a different conversation, where she was talking about
primary care providers who are not willing to provide hormonal therapy for 145
a number of different reasons.
And how that's a super important and critical barrier to
transitioning for transgender individuals.
And so I can only imagine how meeting an affirming doctor,
who's working in an affirming practice, who's connected to the community
that you trust.
How all of these things have just been phenomenal, in terms of
not having to overcome those same barriers that I know a lot of other folks
do face. >> Yeah, and that's 100% true.
I mean, when I was in Nashville, I went to three different
primary care physicians. And none of them were a good fit, they either
misgendered me or they didn't know correct terminology around body
parts.
And it was just always very harmful and I had asked one
primary care physician about prescribing hormones, and his response was I
would prescribe it if you actually were a man.
>> Really? >> Yeah, he was like if you needed testosterone
boost as a man I would prescribe it but since you're biologically a woman, I
can't do that.
>> Yeah. >> When, I mean he could do that. >> Right,
absolutely. Yeah so there's some of that, and when I talked to Dr Shire she
also talked about, the personal, religious and political affiliations of
physicians kind of having some type of impact.
We don't know to what degree, but some type of impact on their
willingness to treat transgender patients. And the barriers of that that posed
as well. >> Yeah, which is interesting, and I think that goes into another
topic of just kinda the divide between science and religion.

And doctors who are more willing to treat patients based on 146
religious preference, rather than the medical facts that are behind it. >>
Right, yeah. >> So. >> So, essentially, making clinical decisions based on,
kind of, personal beliefs?
>> Yes. >> Yeah, and where, in different parts of the country
where we see that. But also, it's anywhere, and you have no idea as a
patient, when you're walking in to meet a doctor for the first time we are
hoping he will care for you fully.
Right, whether or not that's those are things that they take into
consideration when deciding how they are going to treat you, whether or
not their personal beliefs are going to impact that treatment.
You have no idea. >> You don't. I mean, I know for me in the
past, if I've just had a simple cold I won't go to the doctor. Because I'm
afraid that I'm gonna walk in and be misgendered. >> Mm-hm. >> Or
before I have my name legally changed a few years ago, I was afraid that
they would use my former name.
>> Mm-hm. >> I think we could do better. >> Yeah, absolutely
>> Absolutely, we can do better. So we talk a lot in this course, and when
we took this class, I wanna say when we took this class together.
>> [LAUGH] >> But in fact, I actually taught the class
[LAUGH]. But when we had this class together last fall, we talked a lot
about intersectionality, right?
About people having multiple social locations and identities that
impacted how they had to walk through the world, right? Even though
every person is different and certainly every transgender person has a
different inter-sectional experience.
Talking broadly, can you just talk a little bit about some of those
intersections that we should be mindful of that impact the experience of
someone who is transgender.
Their ability to get healthcare, to get mental healthcare, to get 147
education, just any of those things that kind of meet at the crossroads, if
you will, in their life.
>> Yeah, and I know not to speak for all trans people. >> Yeah,
yeah, speaking very broadly. >> Yeah, very broadly. I know that some
major factors are definitely trans people who have some kind of mental
illness or an invisible disability.
I know that trans people are committing suicide at much higher
rates then our cis counterparts. So I know that that's something to be
extremely mindful of.
>> And actually, to touch on that really quickly, I know that in
this course I actually found a podcast. I wanna say it's through the company
or through the podcast service called choiceless that does a lot of work in
reproductive health care.
But I'm gonna post it to this course, but it actually looks at the
case of a transgender individual who is also a quadriplegic.
And the barriers that that person faces to getting not only
transitional care but, regular health care related to their disability because
they are trans.
And so, when you talk about the intersection of disability and
being transgender that's something that we don't talk enough about. >>
Yeah, I agree.
And as someone who is trans and as someone who also has been
diagnosed with depression, anxiety and PTSD, I can definitely confirm for
a fact that my insurance will not cover for me to receive mental health
treatment.
Even when listed as gender dysphoria, they still won't cover it.
So I know that that's a huge barrier. Aside from that I know another large
barrier in the trans community is socioeconomic status.
And a lot of times trans people, we end up getting kicked out of 148
our homes for coming out as trans.
I mean, this goes even broad to the LGBTQ community as a
whole. We're getting kicked out of our homes for identifying this way.
We're going into foster care.
We're just kind of being set up not to succeed. So I think that is
another really key intersection.
And I also know that trans people of color, specifically black
trans women, they're being killed at much higher rates. I don't remember
the exact statistic but I think the last time I looked it was like
one in four black trans women will either commit suicide or be
killed.
>> And we've seen actually a number of, there's a website, I
think, that tracks deaths of black trans individuals across the board in the
United States and kind of maps that against other population groups. And
it's found there's significantly higher rates of black trans women and black
trans individuals experiencing violence also at the hands of others.
>> Yep. >> Yeah, absolutely. >> Yeah I know that, I think it
was in 2015, 23 black transwomen were murdered, so.
>> Yeah, so when we think about intersectionality, we have to
consider where people are socioeconomically having not only family
support and the resources that may provide, but also educational issues as
well.
Are there any particular barriers that you can think of that
transgender individuals might face when trying to seek higher education?
>> Several, the first one that comes to mind is just lack of
financial help and financial aid. Because I know that for me, I'm rather
privileged in a sense because I'm at the University of Michigan, studying
social work.
But I'm also going $60,000 in debt to receive this education. But 149
I know that for a lot of the trans people I know that they're not even able to
access higher ed because they don't have the financial means to do so.
And universities aren't providing a strong enough financial aid
package especially for graduates students. >> Yeah, so people who want to
get that additional level of education, or who may wanna go into a very
specific profession that requires licensure or higher education, that there are
barriers to that.
There are pretty significant barriers to that. >> Yes, significant
barriers. >> You actually wrote a great piece a couple of years ago that was
published via Medium, that talked about what we can do better.
In terms of being institutions of higher education to make
education more accessible. Not only to trans individuals but also to all
kinds of marginalized groups. And you've had a couple of suggests,
affordability was one of those.
But there are also others. Any other kind of tips on what we can
do institutionally? >> Yeah, I think just being very intentional about
making sure marginalized people can access higher education.
I think the people who have the most intersections are the
people that we can learn the most from. So I think just making sure that A,
higher ed is affordable. But B, if it's not necessarily affordable, making sure
you're doing what it takes to get these people here at your institution.
I know a lot of trans people who they don't even bother to apply
to go to a community college or to a higher ed university just because
there's there's no financial resources.
So you're definitely that and I think if I recall correctly that Dr.
Shires mentioned when she came to speak to our class that the higher level
of education you have as a trans person, isn't it the more likely you're going
to be unemployed?
>> Yeah, well, it was the more discrimination that they faced, as 150
a matter of fact. And so it was kind of something to the effect of being in
these more privileged spaces, and having higher education, did not buffer
or protect trans individuals from experiencing discrimination at work or in
health care.
And so we think of higher education as something that is a
protected factor that tries to help people set them up a trajectory of success
with that.
But for trans individuals and for some other marginalized
groups sometimes that simply puts you in spaces where you're more likely
to be discriminated against than not.
>> And I think that goes to say a lot about higher education as a
whole. >> Yeah, yeah. I also want to talk to you about the role of social
work in general, right?
So here you are training to be a social worker. You're gonna be
a phenomenal one. And I know that we in social work are working very
hard to create inclusive spaces, to ensure that our faculty and staff
members, not only in our school of social work, but I'm sure across the
country Are equipped and capable and culturally competent and working
with trans students.
But what more can we do in the field of social work where we
already have this orientation towards social justice, but we can always do
more? What are some of the things that we might need to be thinking about
in terms of being better advocates and allies for transgender people?
>> Yeah, I think one thing that I always say is just donating to
organizations that support trans people. But aside from that, I think just
when you do meet trans people, making sure you're intentional about
making sure you're using their preferred name or the pronouns that they
choose to use.
>> Did you see that, so I have a question about that? So we do 151
this quite a bit in our school social work, declaring up front what our
preferred pronouns are so that we normalize that and make sure that
everyone has that out there.
And no one has to make that, has to feel like they are standing
out by having to declare what their preferred pronouns are as well.
How do you say that translating into the world of work, for
example? And so, I've been in organization's, or been a part of, been in
other spaces outside out of the school of social work where that's kind of a
knowledge shift, if you will.
And so how do we make that, how do we advocate for that, for
example, in spaces outside of social work? Making those places more trans
inclusive? Is there a better way that we could go about that?
>> I think, first of all, it definitely takes social workers to do
that. I mean we're the ones receiving the training to be able to advocate for
our clients.
But I think, too, just making sure that we're humanizing trans
people in the workplace. And saying, they are trans people here that you
may not know about, or we have trans clients who come into this facility
that may never tell you that they're trans or you may never be able to look
at them and tell that they're trans.
>> That's right. >> I think it just comes down to just overall
human decency and just disrespect for people.
And one recommendation I always have is that in the workplace
making sure that there is a gender neutral or a gender inclusive restroom for
people to use. >> Absolutely, and that's something easy that businesses and
agencies can do.

>> Yeah, and at the school of social work that's something that 152
they can do as well. I know that we have two single stall gender neutral
restrooms, but why not make all of your restrooms gender inclusive?
>> Right. >> So I think it's just comes down to kind of, with
trans people trying not to make us feel kind of segregated or isolated and
just trying to include us in.
If you wanna be inclusive, that means including people and
including all. So that would be one of my recommendations. >> Yeah,
when you go out and talk with HR departments and businesses about, and
educating them about not only about trans issues but also LGBTQ issues.
What are some of the tips that you provide for them, or
suggestions, on how to make their workplaces more equitable, more
accessible?
>> Yeah, so the first thing that I always point out is their
nondiscrimination policy. >> So adhering to what they already have in
place, or expanding it if it needs to be more inclusive.
>> Yep, and if their nondiscrimination policy only includes
sexual orientation, talk about including gender identity and gender
expression.
Because as someone who is basically on the job market right
now, that's one thing that I look for in all the places I'm applying at. >>
Absolutely, is this gonna be a place that respects me, that sees me as a
person, right, that is non-discriminatory? And that will back up those
policies with action if someone violates that.
>> Yeah, so that's definitely one of the main things I
recommend and look at. [COUGH] Aside from that though, it really just
comes back down to as an individual working to be a better ally.
And when you do come across a trans person, or you do meet a
trans person, respecting their pronouns, respecting their name. Being
mindful of not outing them. It's never okay to just be like, yeah, this is my 153
trans friend.
>> Right, cuz you don't if that person is comfortable being
outed, whether or not that they have expressed that they're ready to do that,
right. That that is a very personal and private decision that needs to be left
up to that person.
>> Yeah, and some trans people are out and one space but not
out in another. >> Absolutely. >> So I think definitely just being mindful
of that.
>> You said you talk with HR departments, you work with
perhaps some businesses, also perhaps universities, right, and educational
environments.
What about a school context? Have you had any experience
with K through 12 clients, or K through 12 in context or environment
schools where they needed more support on how to treat their LGBTQ
students?
>> No, I haven't. >> Haven't, not yet? >> The only thing that I
can think of that I've done is at Ozone House, they have a group called
Pride Zone, which is an LGBTQ group that meets every Wednesday night.
And I went there and I provided a workshop on what you need
to know about trans rights in a Post-Trump America.
>> Interesting. >> Yeah. >> Can you share a couple of those
tips for us? >> Yeah, so it was basically just talking about
ways to get your name legally changed quickly in the state of
Michigan. >> Because people are essentially afraid that with, and we'll
keep it broad here, but with a new administration that is not trans-
affirming, right?
>> Right. >> Or at least that seems to be the direction that
they're going. >> Right. >> That people feel like they need to take some
proactive steps to ensure that they are going to be recognized as who they 154
see themselves as in every space, and that includes taking legal measures to
affirm their identities.
>> Yep, and one major executive order that Obama signed was
allowing you to update your gender on your passport.
And all you needed was a letter from your primary care
physician or from a surgeon stating that you'd undergone proper medical
procedures to live as your new gender.
>> And so now your international identity, essentially your
main travel document, could reflect your gender identity. >> Yes. >>
Great.
>> And that's been in effect for few years now. So, I know that
a lot of people are very worried that Trump could take that away from us.
>> Or that that policy could be reversed and that avenue is no
longer available- >> Right. >> To have your governments match your
gender identity. >> Yeah, because once your government documents match
your gender identity, then your state license can match your gender identity
as well.
>> So state's essentially take their cue from the federal
government to some degree. >> Right. >> But there's still almost like a 50
state issue going on, because some states are more affirming around trans
rights than others, correct?
>> Yeah, and as someone who came from Tennessee to
Michigan, I can definitely confirm that. >> That experience is broadly
different, depending on what state you're in.
>> Yeah, because in the state of Tennessee, you can never
update your birth certificate. >> Okay, so whatever your birth certificate
says, you're stuck with it.

>> Yeah, except for your name, you can change your name on 155
it. But as far as your sex on your birth certificate, you can never change it.
But in the state of Michigan, you can change it.
>> Okay, interesting, interesting. >> Yeah, it's definitely state
by state. >> Yeah, so other tips beyond folks who had been kind of rushing
to get those legal documents changed?
Any other kind of new administration tips that people have been
trying to use to advocate for themselves? >> I know that, and I can't think
of the name of it off the top of my head, but I know that if you are
receiving some type of government assistance that certain fees can be
waived.
So like when you're applying for a passport or you're submitting
your documents to get a new birth certificate, that if you're receiving some
kind of government assistance- >> So it could be food benefits, it could be,
yeah >> Yeah, yep, that they will waive your fees for that.
>> So essentially if you're recognized by your state or local
government as being a low income person, that you might be able to get
fees waived in other aspects of government interactions.
>> Right. >> And to reduce those barriers to you having your
gender identity be recognized legally. >> And that is especially true For
going to court to get your name legally changed because there are some
significant fees associated with that.
>> Yeah, and it costs roughly between 250 to $500 depending
on the state that you're in to go through with a legal name change.
So I know that in the state of Michigan, and this isn't the case
for Tennessee, that they will provide assistance for that if you're receiving
some form of government assistance.

>> Yeah, so encouraging, so one of those tips would have been 156
encouraging people to make use of those resources. >> Yep. >> If they're
eligible.
>> Yep. >> Yeah. Any other instructional strategies that you
provide for your clients or folks that you've done trainings with around just
being proactive about how to protect themselves, protect their mental
health as well, in these kind of turbulent times.
>> I know at the Spectrum Center we have some programs that
you can go through that if you are a first-year student you can receive a
mentor who is LGBTQ.
So I definitely recommend the new students at U of M to go
through that. We also have My Voice panels which allow students,
community members, faculty and staff to sit on a panel that identifies
LGBTQ, and share their story depending on the classroom who request it.
So, for example, in 504 you could submit a request saying I
want a My Voice panel. And you could said I want a My Voice that
focuses on queerness intersecting with socioeconomic status.
>> Wonderful. >> So then we would send that out to all of our
panelists. They would respond, they could come in and provide that
resource and answer questions.
What a wonderful resource, we will definitely make use of that
in the fall. >> Yeah, so we do that, which I think is incredible. And then
aside from that really just, in my opinion it's very small things that you can
do to change your overall perception of being an ally.
I think being super mindful of people's pronouns, their gender as
a whole.
And just remembering that there's a person inside of there. >>
That at the end of the day, whether you understand someone's gender

identity or not, that you're treating people as human beings, first and 157
foremost.
>> Yep. >> Yeah, absolutely. I wanna close out by talking
about a project that you did for my class, selfishly, cuz it was so wonderful.
Where you were talking about LGBTQ, and I think trans-
specific, artists and musicians, and that this is a community that's really
kind of under recognized for their contributions.
Can you just talk a little bit about some of the folks that you
highlighted and why that particular topic was of interest to you? Yeah, well
it's definitely interesting to me because I love music, I'm very passionate
about music.
And I have noticed that there are incredibly talented trans
people who just never receive enough recognition. And a couple of those
artists I can highlight, one is a guy named Ryan Casada.
He is a musician out of New York who I met back in August
because I was the festival director of a pride event back in Tennessee.
And he was our headliner. >> Wonderful. >> So he is a great
musician, super knowledgeable. One thing about him that I really love is
that he never started hormones.
He likes singing with his natural voice. But he went through
with a the top surgery, which is a double incision vasectomy or a keyhole
depending on what you choose to do.
So, he's definitely one resource. And then, another artist that I
highlighted was Laura Jane Grace, who is the lead singer of a band called
Against Me!
>> Okay. >> And they're actually on tour right now with Green
Day. >> Very cool.

>> Which is pretty cool. >> Maybe we can provide some links 158
in the course so that if folks are interested, they can check out some of this
music.
>> Yeah. >> Yeah. Cuz these artists are super talented, and they
deserve recognition. >> Yeah, why do you think it is that we don't hear
enough about trans artists?
>> I honestly don't know, I think they're super talented people,
and totally stuff that you would hear on a radio, or just in general. I don't
know if it's because they're trans, or if it's just because they've maybe been
so upfront about being trans that people aren't giving them the chance.
But I will say that Laura Jane Grace from Against Me! has
definitely gotten some strong recognition and she actually just released a
book a few months ago called Tranny.
Which is typically an offensive term but she self identifies with
it, so I definitely recommend reading the book Tranny, too. >> Well that
reminds me also, are there any other resources, books, articles that you can
think of, just top of mind, that would be great resources for folks who
wanna be better allies, who wanna learn more.
Any great books that you've read or magazines around trans
issues. >> I know that there's a couple of Ted Talks too that people speak
about being trans and transness intersecting with queerness.
>> Mm-hm. >> And other intersections and one of my favorites
is by this person, their name is Lee, I don't remember their last name, but
they are a person of color, and also identify as trans- and they gave a really
powerful TED talk.
>> Good, we'll try to find that. >> I will send you the link. >>
Yeah, awesome. >> Yes. >> Well, is there anything else you'd like to
share? >> I don't think so, no.

>> This has been such a great chat. I hope that you also enjoyed 159
it. >> Yes, of course. >> I know it's gonna be incredibly beneficial for our
students and for folks who are wanting to learn more about trans issues and
trans health, as well.
So this has been an informative chat with my former student
first-year MSW student Brendan Holloway. Thank you for joining us.
Module 5: Criminal Justice

 Module Goals
You will be exposed to a broad overview of trends relating to various aspects of
the criminal justice system for adults and youth, as well as an array of resources
for continued exploration and learning. Social justice will be used as a lens for
understanding how criminal justice is patterned and administered in the United
States.

160
 Lecture
The criminal justice
system is an expansive set of
agencies and processes
established by local, state and
national government to control
crime and impose penalties on
those who violate laws.
According to the National Center for Victims of Crime, there's no
single criminal justice system in United States but rather, many similar
individual systems. The function of these systems depends on the
jurisdiction that's in charge. The jurisdictions could include the city, the
county, the state, federal, or tribal governments, or even military
installations.
Every jurisdiction has varying laws, agencies, and methods for
administering criminal justice processes. There are also many components
that compose the criminal justice system and processes.
These components include law enforcement who investigate
crimes, gather evidence of criminal activity, arrest people and testify in
criminal proceedings, and there are also prosecutors who work for and
represent the state or federal government.
According to the National Center for Victims for Crimes, it's a
prosecutor's job to review the evidence brought to them by law
enforcement, and to decide whether or not to file charges or decline to
pursue a case.
Prosecutors present evidence in court, question witnesses, and
decide whether to negotiate plea bargains with defendants.

Prosecutors often have the greatest discretion, or freedom in the 161
criminal justice system, to make choices about how and if a criminal case
will proceed.
There are also defense attorneys who represent clients against the
case brought against them by state or federal government.
When accused individuals do not have the financial means to hire
their own attorney, they're supposed to be assigned a public defender. But
access to attorneys for low income clients is highly variable by the state or
locality one lives in.
And often, the financial resources allocated by state and local
governments to public defender programs.
The documentary, Gideon's Army, available on Netflix, HBO Go,
and other streaming services gives an insight look at the difficulties that
public defenders face with limited resources to defend the most vulnerable
clients.
Take a few minutes and listen to the Reveal podcast, titled If You
Can't Afford a Lawyer, to learn more about what happens to the criminal
justice defendants with limited options for a public defender.
In the criminal justice system, there are also courts which are
overseen by judges, and to a lesser degree, magistrates.
Whose role it is to make sure that the law is followed in court.
Judges have the power to decide if someone is released before trial on bail,
and sets those terms.
They also accept or reject plea agreements and sentence convicted
offenders. Finally, the correction system is comprised of several
professionals who supervise convicted offenders when they are in jail, in
prison or in the community on probation or parole.
Corrections Officer should make sure that facilities that hold or
house offenders are secure and safe. However, a number of recent new
stories have emerged that draw attention to the deficiencies in both 162
government run and privately run jails and prisons, resulting in the death of
prisoners from neglected medical needs, suicide, starvation, dehydration, or
violence at the hands of prison guards or other inmates.
Now, let's explore a few select criminal justice topics with distinct
implications for social justice.
Due to the limited time, we can't possibly cover all of the many
important discussions happening nationally, but we will do our best to
provide a broad overview and extensive external resources to support an
introductory understanding for certain topics.
Just to reiterate, the conversation we're about to embark on is
limited in scope, and certainly not encompassing of the full sociohistorical
and intersectional nature of important criminal justice topics germaine to
the United States.
However, there are a number of inexpensive, comprehensive, and
highly accessible resources that can provide a fuller contextual picture of
these issues.
Consider reading one of the suggested titles. All providing well
written and highly sophisticated arguments that frame various aspects of
the criminal justice system through a social justice lens.
According to the Sentencing Project, the United States is home to
just 5% of the world's population but has 25% of the world's prisoners.
The US prison population has quadrupled since 1970, when it was
just above 327,000. The current prison population is over two million.
Historically and politically, the Nixon administration is credited
with initiating the cycle of mass incarceration, by largely criminalizing
African-Americans struggling with drug addictions, rather than increasing
available resources for treatment and rehabilitation.

As we'll see later in our discussion, these more compassionate and 163
effective approaches to reducing incarceration that are being advocated for
today are often patterned along racial and socioeconomic lines.
Racial trends in mass incarceration reveal that one in three black
males is expected to go to prison in his lifetime. That trend is just 1 in 17
for white males.
While Latinos are imprisoned at a rate that is 1.4 times the rate of
whites. And while black men only account for an estimated 6.5% of the US
population, they make up just over 40% of the US prison population.
We have scientific evidence to prove that African-Americans are
not for example, selling or abusing drugs at a higher rate than other racial
and ethnic groups.
But they are targeted for arrest and sentenced to longer sentences,
significantly more than for white Americans. For more information on this
topic on disparities and incarceration by race, take a look at the extensive
2016 report by Dr.
Ashley Nellis through the Sentencing Project titled The Color of
Justice, Racial and Ethnic Disparity in State Prisons.
Now, let's take a more nuance dive into the issue of mass
incarceration, by engaging with a report by the Sentencing Project, and
listening to at least one podcast on being poor and in jail.
Then, I want you to identify and post three trends from these
materials that describe the sociodemographic patterns in corrections.

164

165
 Listen & Reflect: Trends in Jails and

Prisons exercise
Listen to the NPR interview (opens in a new window) and then read the report
on trends in U.S. corrections (PDF). Then identify three trends related to race,
gender, age, socioeconomic status or other factors that you were not familiar
with before.
Is America Engaged In A 'Vicious Circle' Of Jailing The

Poor?
LISTEN·35:5035:50QUEUE
A-Digit/Getty Images
According to a report by the Vera Institute for Justice, there are more
than 3,000 local jails in America, holding more than 730,000 people on any
given day. Nancy Fishman, a project director at the Vera Institute,
tells Fresh Air's Terry Gross that jails "have impacted a huge number of
Americans ... many more than are impacted by state prisons."
The Vera Institute's report documents that
there are almost 12 million admissions to
local jails each year, representing about 9
million people. Most of those jailed, she says, are being held for low-level 166
offenses, such as drug misdemeanors, traffic offenses or nonviolent
property crimes. And, she adds, the majority are poor.
Enlarge this image

Fishman works with police, judges, prosecutors and defenders to create
fairer, more effective local justice systems, through a project called
the Safety and Justice Challenge.
Courtesy of the Vera Institute of Justice
Fishman notes that most of the people in jail are pretrial, which means
that they have not yet been convicted of anything. "They are legally
innocent," she says. "One of the great travesties, frankly, of jail admissions
right now is that we have people sitting in jail for long periods simply
because they can't afford to pay [bail]."
Fishman adds that being in jail often leads to increased poverty, because
many jails charge fees to their inmates. "That pass-through [in] jails is
damaging and has huge repercussions," she says. "You're talking about
people who often come in in fragile economic situations and end up that
much worse by the time they get out."
Interview Highlights
On the growth of the jail population
There's been tremendous growth over the past 40, 45 years in the size of
our criminal justice system, particular growth in the number of jails and the
size of the jails. We've seen a fourfold increase in the jail population in the
past 45 years, and along with that [has] been the construction of new and
bigger jails. And the reality is, a lot of the communities that have built
these jails don't have funds to support them. They're not supported by state
tax revenue, by federal tax revenue. They're supported by local community
budgets, and a lot of these places are not wealthy. They don't have a lot of
money to cover it, and so the solution has been to try to get that money
from the people who pass through the system.
But the challenge is, most of the people who are passing through that
system don't have the money either. So what we see is that people get
assessed fines and fees, all of these fines and fees, they can't pay them, and
that can end up driving them back into jail, which only increases the
pressure on the jail system and the justice system overall and makes it more
costly. So it's ultimately kind of a vicious circle.

On traffic violations being a major driver of jail admissions 167
It was interesting, we just did some work in Oklahoma City, and we looked
at just a week's worth of booking into the jail from the Oklahoma City
Police Department, and fully a third of the people who were booked into
jail were booked on traffic violations, and not DUI — everything but DUI,
we took DUI out of the mix. We're talking about just violations — broken
taillight, driving on a suspended license, failure to make a turn signal —
most people got three or four of them, some of them had, again, warrants
for not having paid other fines and fees, and that's sweeping them in.
Seventy-five percent of the people in that one week of admissions were

being booked into the jail for misdemeanors or lower. ... And only 5
percent of them were for any crimes against the person; in other words, not
necessarily violent crimes, but maybe something involved hitting another
person, etc.
On the cost of being in jail

In addition to having to pay bail, they are assessed a cost for their housing,
so it's as if they're in a hotel. ... There's a daily rate that they are responsible
for. They will have to pay the cost of any lab tests associated with their
case. They will have to pay the cost of drug testing.
If they apply for a public defender, a lot of places actually have a fee. You
have to actually pay money to apply for a public defender who you get
because you can't afford to be represented.
There are other costs — people get referred into programs, drug treatment
programs, or they're required to be drug tested when they're out, they have
to pay for those. They will often pay for the cost of probation supervision.
On the irony of bail

The irony of bail is that its initial purpose was to make it possible for
people to get out of jail, right? You couldn't be held in jail without a
finding of guilt, or prior to a finding of guilt, without having an opportunity
to get out. But the irony is that now bail really functions to hold people
in. .... This means that if you have money to pay bail, you can get out no
matter how dangerous you are, whereas if you are poor and all you've
committed is a traffic violation, which is one of biggest drivers, frankly, of
jail admissions in most places, you are going to sit in jail because $500 is a
lot of money to you.
On alternatives to bail

It seems remarkably simple, which is [that] one of the best ways of 168
increasing the likelihood that people will show up to court once they're
released is to send them a reminder. I think that's the first piece. A lot of
people with community ties can be released without bail, and they will
show up to court if you are providing reminders to do it.
The other thing to remember is that, in fact, most people, the majority of
people, do show up to court dates, and when people don't show up to court,
this is not El Chapo sitting in the tunnels waiting for Sean Penn and the
cameras to show up. These are people who live in the community, and the
reasons why people don't show up to court are they can't get of work, they
have child care agreements, they forgot the appointment, they never got
proper notice of the appointment, the appointment was changed, their
address was changed. And there are mechanisms that we can put in place
that are actually focused on getting people back to court that don't
necessarily involve bail.
 Lecture Theoretical v. Practical

Implementation of Policing Policies
Next, I want to turn our attention
to three complicated interactions
between law enforcement officials
and communities.
Though I'm using specific

cities such as New York city and
Ferguson, Missouri as examples, these types of interactions occur all over
the United States and communities representing a range of geographies.
The first law enforcement interaction with communities that we're
going to examine is broken windows policing practices.
Instead of listening to me explain the concept and practice of broken
windows, I want you to read directly from the source. In March of 1982,
George Kelling and James Q Wilson published an extensive article in The

Atlantic magazine advancing a certain perspective about the role of law 169
enforcement and communities.
I want you to read that original article. Then keep in mind the theory
of broken windows advanced by Kelling and Wilson as you listen to the
podcast about what happened when cities translated this 1982 missive into
actual policies.
Finally, read the brief New York Times article detailing the recent
court decision that dealt the most decisive blow to broken windows
policing tactics, particularly in New York City.
Then, complete the assessment by reflecting on the connection
between stop and frisk policies and broken windows as a broader approach
towards policing communities.
And list two specific ways that enacting these types of policing
practices confirm the fears of Kelling and Wilson about what might happen
if broken windows policing was fully enacted as they had theorized.
 Read & Reflect: Law Enforcement

Interactions with Communities exercise
1. Read the original Atlantic Magazine article (opens in a new window) 170
outlining the theory of “broken windows” policing practices.
160 YEARS OF ATLANTIC STORIES

Broken Windows
The police and neighborhood safety
GEORGE L. KELLINGJAMES Q. WILSON

MARCH 1982 ISSUE
SEYMOUR CHWAST
In the mid-1970s The State of New
Jersey announced a "Safe and Clean
Neighborhoods Program," designed to
improve the quality of community life in
twenty-eight cities. As part of that program, the state provided money to
help cities take police officers out of their patrol cars and assign them to
walking beats. The governor and other state officials were enthusiastic
about using foot patrol as a way of cutting crime, but many police chiefs
were skeptical. Foot patrol, in their eyes, had been pretty much discredited.
It reduced the mobility of the police, who thus had difficulty responding to
citizen calls for service, and it weakened headquarters control over patrol
officers.
Many police officers also disliked foot patrol, but for different
reasons: it was hard work, it kept them outside on cold, rainy nights, and it
reduced their chances for making a "good pinch." In some departments,
assigning officers to foot patrol had been used as a form of punishment.
And academic experts on policing doubted that foot patrol would have any
impact on crime rates; it was, in the opinion of most, little more than a sop
to public opinion. But since the state was paying for it, the local authorities
were willing to go along.
MORE IN THIS SERIES 171
Five years after the program started, the Police Foundation, in

Washington, D.C., published an evaluation of the foot-patrol project. Based
on its analysis of a carefully controlled experiment carried out chiefly in
Newark, the foundation concluded, to the surprise of hardly anyone, that
foot patrol had not reduced crime rates. But residents of the foot patrolled
neighborhoods seemed to feel more secure than persons in other areas,
tended to believe that crime had been reduced, and seemed to take fewer
steps to protect themselves from crime (staying at home with the doors
locked, for example). Moreover, citizens in the foot-patrol areas had a more
favorable opinion of the police than did those living elsewhere. And
officers walking beats had higher morale, greater job satisfaction, and a
more favorable attitude toward citizens in their neighborhoods than did
officers assigned to patrol cars.
These findings may be taken as evidence that the skeptics were

right- foot patrol has no effect on crime; it merely fools the citizens into
thinking that they are safer. But in our view, and in the view of the authors
of the Police Foundation study (of whom Kelling was one), the citizens of
Newark were not fooled at all. They knew what the foot-patrol officers
were doing, they knew it was different from what motorized officers do,
and they knew that having officers walk beats did in fact make their
neighborhoods safer.
But how can a neighborhood be "safer" when the crime rate has
not gone down—in fact, may have gone up? Finding the answer requires
first that we understand what most often frightens people in public places.
Many citizens, of course, are primarily frightened by crime, especially

crime involving a sudden, violent attack by a stranger. This risk is very 172
real, in Newark as in many large cities. But we tend to overlook another
source of fear—the fear of being bothered by disorderly people. Not violent
people, nor, necessarily, criminals, but disreputable or obstreperous or
unpredictable people: panhandlers, drunks, addicts, rowdy teenagers,
prostitutes, loiterers, the mentally disturbed.
What foot-patrol officers did was to elevate, to the extent they

could, the level of public order in these neighborhoods. Though the
neighborhoods were predominantly black and the foot patrolmen were
mostly white, this "order-maintenance" function of the police was
performed to the general satisfaction of both parties.
One of us (Kelling) spent many hours walking with Newark foot-

patrol officers to see how they defined "order" and what they did to
maintain it. One beat was typical: a busy but dilapidated area in the heart of
Newark, with many abandoned buildings, marginal shops (several of which
prominently displayed knives and straight-edged razors in their windows),
one large department store, and, most important, a train station and several
major bus stops. Though the area was run-down, its streets were filled with
people, because it was a major transportation center. The good order of this
area was important not only to those who lived and worked there but also
to many others, who had to move through it on their way home, to
supermarkets, or to factories.
The people on the street were primarily black; the officer who
walked the street was white. The people were made up of "regulars" and
"strangers." Regulars included both "decent folk" and some drunks and
derelicts who were always there but who "knew their place." Strangers
were, well, strangers, and viewed suspiciously, sometimes apprehensively.

The officer—call him Kelly—knew who the regulars were, and they knew 173
him. As he saw his job, he was to keep an eye on strangers, and make
certain that the disreputable regulars observed some informal but widely
understood rules. Drunks and addicts could sit on the stoops, but could not
lie down. People could drink on side streets, but not at the main
intersection. Bottles had to be in paper bags. Talking to, bothering, or
begging from people waiting at the bus stop was strictly forbidden. If a
dispute erupted between a businessman and a customer, the businessman
was assumed to be right, especially if the customer was a stranger. If a
stranger loitered, Kelly would ask him if he had any means of support and
what his business was; if he gave unsatisfactory answers, he was sent on
his way. Persons who broke the informal rules, especially those who
bothered people waiting at bus stops, were arrested for vagrancy. Noisy
teenagers were told to keep quiet.
These rules were defined and enforced in collaboration with the

"regulars" on the street. Another neighborhood might have different rules,
but these, everybody understood, were the rules for this neighborhood. If
someone violated them, the regulars not only turned to Kelly for help but
also ridiculed the violator. Sometimes what Kelly did could be described as
"enforcing the law," but just as often it involved taking informal or
extralegal steps to help protect what the neighborhood had decided was the
appropriate level of public order. Some of the things he did probably would
not withstand a legal challenge.
A determined skeptic might acknowledge that a skilled foot-patrol

officer can maintain order but still insist that this sort of "order" has little to
do with the real sources of community fear—that is, with violent crime. To
a degree, that is true. But two things must be borne in mind. First, outside

observers should not assume that they know how much of the anxiety now 174
endemic in many big-city neighborhoods stems from a fear of "real" crime
and how much from a sense that the street is disorderly, a source of
distasteful, worrisome encounters. The people of Newark, to judge from
their behavior and their remarks to interviewers, apparently assign a high
value to public order, and feel relieved and reassured when the police help
them maintain that order.
Second, at the community level, disorder and crime are usually

inextricably linked, in a kind of developmental sequence. Social
psychologists and police officers tend to agree that if a window in a
building is broken and is left unrepaired, all the rest of the windows will
soon be broken. This is as true in nice neighborhoods as in rundown ones.
Window-breaking does not necessarily occur on a large scale because some
areas are inhabited by determined window-breakers whereas others are
populated by window-lovers; rather, one unrepaired broken window is a
signal that no one cares, and so breaking more windows costs nothing. (It
has always been fun.)
Philip Zimbardo, a Stanford psychologist, reported in 1969 on
some experiments testing the broken-window theory. He arranged to have
an automobile without license plates parked with its hood up on a street in
the Bronx and a comparable automobile on a street in Palo Alto, California.
The car in the Bronx was attacked by "vandals" within ten minutes of its
"abandonment." The first to arrive were a family—father, mother, and
young son—who removed the radiator and battery. Within twenty-four
hours, virtually everything of value had been removed. Then random
destruction began—windows were smashed, parts torn off, upholstery
ripped. Children began to use the car as a playground. Most of the adult
"vandals" were well-dressed, apparently clean-cut whites. The car in Palo
Alto sat untouched for more than a week. Then Zimbardo smashed part of 175
it with a sledgehammer. Soon, passersby were joining in. Within a few
hours, the car had been turned upside down and utterly destroyed. Again,
the "vandals" appeared to be primarily respectable whites.
Untended property becomes fair game for people out for fun or
plunder and even for people who ordinarily would not dream of doing such
things and who probably consider themselves law-abiding. Because of the
nature of community life in the Bronx—its anonymity, the frequency with
which cars are abandoned and things are stolen or broken, the past
experience of "no one caring"—vandalism begins much more quickly than
it does in staid Palo Alto, where people have come to believe that private
possessions are cared for, and that mischievous behavior is costly. But
vandalism can occur anywhere once communal barriers—the sense of
mutual regard and the obligations of civility—are lowered by actions that
seem to signal that "no one cares."
We suggest that "untended" behavior also leads to the breakdown

of community controls. A stable neighborhood of families who care for
their homes, mind each other's children, and confidently frown on
unwanted intruders can change, in a few years or even a few months, to an
inhospitable and frightening jungle. A piece of property is abandoned,
weeds grow up, a window is smashed. Adults stop scolding rowdy
children; the children, emboldened, become more rowdy. Families move
out, unattached adults move in. Teenagers gather in front of the corner
store. The merchant asks them to move; they refuse. Fights occur. Litter
accumulates. People start drinking in front of the grocery; in time, an
inebriate slumps to the sidewalk and is allowed to sleep it off. Pedestrians
are approached by panhandlers.

At this point it is not inevitable that serious crime will flourish or 176
violent attacks on strangers will occur. But many residents will think that
crime, especially violent crime, is on the rise, and they will modify their
behavior accordingly. They will use the streets less often, and when on the
streets will stay apart from their fellows, moving with averted eyes, silent
lips, and hurried steps. "Don't get involved." For some residents, this
growing atomization will matter little, because the neighborhood is not
their "home" but "the place where they live." Their interests are elsewhere;
they are cosmopolitans. But it will matter greatly to other people, whose
lives derive meaning and satisfaction from local attachments rather than
worldly involvement; for them, the neighborhood will cease to exist except
for a few reliable friends whom they arrange to meet.
Such an area is vulnerable to criminal invasion. Though it is not
inevitable, it is more likely that here, rather than in places where people are
confident they can regulate public behavior by informal controls, drugs will
change hands, prostitutes will solicit, and cars will be stripped. That the
drunks will be robbed by boys who do it as a lark, and the prostitutes'
customers will be robbed by men who do it purposefully and perhaps
violently. That muggings will occur.
Among those who often find it difficult to move away from this
are the elderly. Surveys of citizens suggest that the elderly are much less
likely to be the victims of crime than younger persons, and some have
inferred from this that the well-known fear of crime voiced by the elderly is
an exaggeration: perhaps we ought not to design special programs to
protect older persons; perhaps we should even try to talk them out of their
mistaken fears. This argument misses the point. The prospect of a
confrontation with an obstreperous teenager or a drunken panhandler can
be as fear-inducing for defenseless persons as the prospect of meeting an
actual robber; indeed, to a defenseless person, the two kinds of 177
confrontation are often indistinguishable. Moreover, the lower rate at which
the elderly are victimized is a measure of the steps they have already taken
—chiefly, staying behind locked doors—to minimize the risks they face.
Young men are more frequently attacked than older women, not because
they are easier or more lucrative targets but because they are on the streets
more.
Nor is the connection between disorderliness and fear made only

by the elderly. Susan Estrich, of the Harvard Law School, has recently
gathered together a number of surveys on the sources of public fear. One,
done in Portland, Oregon, indicated that three fourths of the adults
interviewed cross to the other side of a street when they see a gang of
teenagers; another survey, in Baltimore, discovered that nearly half would
cross the street to avoid even a single strange youth. When an interviewer
asked people in a housing project where the most dangerous spot was, they
mentioned a place where young persons gathered to drink and play music,
despite the fact that not a single crime had occurred there. In Boston public
housing projects, the greatest fear was expressed by persons living in the
buildings where disorderliness and incivility, not crime, were the greatest.
Knowing this helps one understand the significance of such otherwise
harmless displays as subway graffiti. As Nathan Glazer has written, the
proliferation of graffiti, even when not obscene, confronts the subway rider
with the inescapable knowledge that the environment he must endure for an
hour or more a day is uncontrolled and uncontrollable, and that anyone can
invade it to do whatever damage and mischief the mind suggests."
In response to fear people avoid one another, weakening controls.
Sometimes they call the police. Patrol cars arrive, an occasional arrest
occurs but crime continues and disorder is not abated. Citizens complain to
the police chief, but he explains that his department is low on personnel 178
and that the courts do not punish petty or first-time offenders. To the
residents, the police who arrive in squad cars are either ineffective or
uncaring: to the police, the residents are animals who deserve each other.
The citizens may soon stop calling the police, because "they can't do
anything."
The process we call urban decay has occurred for centuries in

every city. But what is happening today is different in at least two
important respects. First, in the period before, say, World War II, city
dwellers- because of money costs, transportation difficulties, familial and
church connections—could rarely move away from neighborhood
problems. When movement did occur, it tended to be along public-transit
routes. Now mobility has become exceptionally easy for all but the poorest
or those who are blocked by racial prejudice. Earlier crime waves had a
kind of built-in self-correcting mechanism: the determination of a
neighborhood or community to reassert control over its turf. Areas in
Chicago, New York, and Boston would experience crime and gang wars,
and then normalcy would return, as the families for whom no alternative
residences were possible reclaimed their authority over the streets.
Second, the police in this earlier period assisted in that reassertion

of authority by acting, sometimes violently, on behalf of the community.
Young toughs were roughed up, people were arrested "on suspicion" or for
vagrancy, and prostitutes and petty thieves were routed. "Rights" were
something enjoyed by decent folk, and perhaps also by the serious
professional criminal, who avoided violence and could afford a lawyer.
This pattern of policing was not an aberration or the result of

occasional excess. From the earliest days of the nation, the police function
was seen primarily as that of a night watchman: to maintain order against 179
the chief threats to order—fire, wild animals, and disreputable behavior.
Solving crimes was viewed not as a police responsibility but as a private
one. In the March, 1969, Atlantic, one of us (Wilson) wrote a brief account
of how the police role had slowly changed from maintaining order to
fighting crimes. The change began with the creation of private detectives
(often ex-criminals), who worked on a contingency-fee basis for
individuals who had suffered losses. In time, the detectives were absorbed
in municipal agencies and paid a regular salary simultaneously, the
responsibility for prosecuting thieves was shifted from the aggrieved
private citizen to the professional prosecutor. This process was not
complete in most places until the twentieth century.
In the l960s, when urban riots were a major problem, social
scientists began to explore carefully the order maintenance function of the
police, and to suggest ways of improving it—not to make streets safer (its
original function) but to reduce the incidence of mass violence. Order
maintenance became, to a degree, coterminous with "community relations."
But, as the crime wave that began in the early l960s continued without
abatement throughout the decade and into the 1970s, attention shifted to the
role of the police as crime-fighters. Studies of police behavior ceased, by
and large, to be accounts of the order-maintenance function and became,
instead, efforts to propose and test ways whereby the police could solve
more crimes, make more arrests, and gather better evidence. If these things
could be done, social scientists assumed, citizens would be less fearful.
A great deal was accomplished during this transition, as both

police chiefs and outside experts emphasized the crime-fighting function in
their plans, in the allocation of resources, and in deployment of personnel.
The police may well have become better crime-fighters as a result. And
doubtless they remained aware of their responsibility for order. But the link 180
between order-maintenance and crime-prevention, so obvious to earlier
generations, was forgotten.
That link is similar to the process whereby one broken window

becomes many. The citizen who fears the ill-smelling drunk, the rowdy
teenager, or the importuning beggar is not merely expressing his distaste
for unseemly behavior; he is also giving voice to a bit of folk wisdom that
happens to be a correct generalization—namely, that serious street crime
flourishes in areas in which disorderly behavior goes unchecked. The
unchecked panhandler is, in effect, the first broken window. Muggers and
robbers, whether opportunistic or professional, believe they reduce their
chances of being caught or even identified if they operate on streets where
potential victims are already intimidated by prevailing conditions. If the
neighborhood cannot keep a bothersome panhandler from annoying
passersby, the thief may reason, it is even less likely to call the police to
identify a potential mugger or to interfere if the mugging actually takes
place.
Some police administrators concede that this process occurs, but

argue that motorized-patrol officers can deal with it as effectively as foot
patrol officers. We are not so sure. In theory, an officer in a squad car can
observe as much as an officer on foot; in theory, the former can talk to as
many people as the latter. But the reality of police-citizen encounters is
powerfully altered by the automobile. An officer on foot cannot separate
himself from the street people; if he is approached, only his uniform and
his personality can help him manage whatever is about to happen. And he
can never be certain what that will be—a request for directions, a plea for

help, an angry denunciation, a teasing remark, a confused babble, a 181
threatening gesture.
In a car, an officer is more likely to deal with street people by
rolling down the window and looking at them. The door and the window
exclude the approaching citizen; they are a barrier. Some officers take
advantage of this barrier, perhaps unconsciously, by acting differently if in
the car than they would on foot. We have seen this countless times. The
police car pulls up to a corner where teenagers are gathered. The window is
rolled down. The officer stares at the youths. They stare back. The officer
says to one, "C'mere." He saunters over, conveying to his friends by his
elaborately casual style the idea that he is not intimidated by authority.
What's your name?" "Chuck." "Chuck who?" "Chuck Jones." "What'ya
doing, Chuck?" "Nothin'." "Got a P.O. [parole officer]?" "Nah." "Sure?"
"Yeah." "Stay out of trouble, Chuckie." Meanwhile, the other boys laugh
and exchange comments among themselves, probably at the officer's
expense. The officer stares harder. He cannot be certain what is being said,
nor can he join in and, by displaying his own skill at street banter, prove
that he cannot be "put down." In the process, the officer has learned almost
nothing, and the boys have decided the officer is an alien force who can
safely be disregarded, even mocked.
Our experience is that most citizens like to talk to a police officer.

Such exchanges give them a sense of importance, provide them with the
basis for gossip, and allow them to explain to the authorities what is
worrying them (whereby they gain a modest but significant sense of having
"done something" about the problem). You approach a person on foot more
easily, and talk to him more readily, than you do a person in a car.
Moreover, you can more easily retain some anonymity if you draw an
officer aside for a private chat. Suppose you want to pass on a tip about
who is stealing handbags, or who offered to sell you a stolen TV. In the 182
inner city, the culprit, in all likelihood, lives nearby. To walk up to a
marked patrol car and lean in the window is to convey a visible signal that
you are a "fink."
The essence of the police role in maintaining order is to reinforce

the informal control mechanisms of the community itself. The police
cannot, without committing extraordinary resources, provide a substitute
for that informal control. On the other hand, to reinforce those natural
forces the police must accommodate them. And therein lies the problem.
Should police activity on the street be shaped, in important ways,

by the standards of the neighborhood rather than by the rules of the state?
Over the past two decades, the shift of police from order-maintenance to
law enforcement has brought them increasingly under the influence of legal
restrictions, provoked by media complaints and enforced by court decisions
and departmental orders. As a consequence, the order maintenance
functions of the police are now governed by rules developed to control
police relations with suspected criminals. This is, we think, an entirely new
development. For centuries, the role of the police as watchmen was judged
primarily not in terms of its compliance with appropriate procedures but
rather in terms of its attaining a desired objective. The objective was order,
an inherently ambiguous term but a condition that people in a given
community recognized when they saw it. The means were the same as
those the community itself would employ, if its members were sufficiently
determined, courageous, and authoritative. Detecting and apprehending
criminals, by contrast, was a means to an end, not an end in itself; a judicial
determination of guilt or innocence was the hoped-for result of the law-
enforcement mode. From the first, the police were expected to follow rules

defining that process, though states differed in how stringent the rules 183
should be. The criminal-apprehension process was always understood to
involve individual rights, the violation of which was unacceptable because
it meant that the violating officer would be acting as a judge and jury—and
that was not his job. Guilt or innocence was to be determined by universal
standards under special procedures.
Ordinarily, no judge or jury ever sees the persons caught up in a
dispute over the appropriate level of neighborhood order. That is true not
only because most cases are handled informally on the street but also
because no universal standards are available to settle arguments over
disorder, and thus a judge may not be any wiser or more effective than a
police officer. Until quite recently in many states, and even today in some
places, the police made arrests on such charges as "suspicious person" or
"vagrancy" or "public drunkenness"—charges with scarcely any legal
meaning. These charges exist not because society wants judges to punish
vagrants or drunks but because it wants an officer to have the legal tools to
remove undesirable persons from a neighborhood when informal efforts to
preserve order in the streets have failed.
Once we begin to think of all aspects of police work as involving

the application of universal rules under special procedures, we inevitably
ask what constitutes an "undesirable person" and why we should
"criminalize" vagrancy or drunkenness. A strong and commendable desire
to see that people are treated fairly makes us worry about allowing the
police to rout persons who are undesirable by some vague or parochial
standard. A growing and not-so-commendable utilitarianism leads us to
doubt that any behavior that does not "hurt" another person should be made
illegal. And thus many of us who watch over the police are reluctant to

allow them to perform, in the only way they can, a function that every 184
neighborhood desperately wants them to perform.
This wish to "decriminalize" disreputable behavior that "harms no

one"- and thus remove the ultimate sanction the police can employ to
maintain neighborhood order—is, we think, a mistake. Arresting a single
drunk or a single vagrant who has harmed no identifiable person seems
unjust, and in a sense it is. But failing to do anything about a score of
drunks or a hundred vagrants may destroy an entire community. A
particular rule that seems to make sense in the individual case makes no
sense when it is made a universal rule and applied to all cases. It makes no
sense because it fails to take into account the connection between one
broken window left untended and a thousand broken windows. Of course,
agencies other than the police could attend to the problems posed by drunks
or the mentally ill, but in most communities especially where the
"deinstitutionalization" movement has been strong—they do not.
The concern about equity is more serious. We might agree that

certain behavior makes one person more undesirable than another but how
do we ensure that age or skin color or national origin or harmless
mannerisms will not also become the basis for distinguishing the
undesirable from the desirable? How do we ensure, in short, that the police
do not become the agents of neighborhood bigotry?
We can offer no wholly satisfactory answer to this important
question. We are not confident that there is a satisfactory answer except to
hope that by their selection, training, and supervision, the police will be
inculcated with a clear sense of the outer limit of their discretionary
authority. That limit, roughly, is this—the police exist to help regulate
behavior, not to maintain the racial or ethnic purity of a neighborhood.

Consider the case of the Robert Taylor Homes in Chicago, one of 185
the largest public-housing projects in the country. It is home for nearly
20,000 people, all black, and extends over ninety-two acres along South
State Street. It was named after a distinguished black who had been, during
the 1940s, chairman of the Chicago Housing Authority. Not long after it
opened, in 1962, relations between project residents and the police
deteriorated badly. The citizens felt that the police were insensitive or
brutal; the police, in turn, complained of unprovoked attacks on them.
Some Chicago officers tell of times when they were afraid to enter the
Homes. Crime rates soared.
Today, the atmosphere has changed. Police-citizen relations have

improved—apparently, both sides learned something from the earlier
experience. Recently, a boy stole a purse and ran off. Several young
persons who saw the theft voluntarily passed along to the police
information on the identity and residence of the thief, and they did this
publicly, with friends and neighbors looking on. But problems persist, chief
among them the presence of youth gangs that terrorize residents and recruit
members in the project. The people expect the police to "do something"
about this, and the police are determined to do just that.
But do what? Though the police can obviously make arrests

whenever a gang member breaks the law, a gang can form, recruit, and
congregate without breaking the law. And only a tiny fraction of gang-
related crimes can be solved by an arrest; thus, if an arrest is the only
recourse for the police, the residents' fears will go unassuaged. The police
will soon feel helpless, and the residents will again believe that the police
"do nothing." What the police in fact do is to chase known gang members
out of the project. In the words of one officer, "We kick ass." Project

residents both know and approve of this. The tacit police-citizen alliance in 186
the project is reinforced by the police view that the cops and the gangs are
the two rival sources of power in the area, and that the gangs are not going
to win.
None of this is easily reconciled with any conception of due

process or fair treatment. Since both residents and gang members are black,
race is not a factor. But it could be. Suppose a white project confronted a
black gang, or vice versa. We would be apprehensive about the police
taking sides. But the substantive problem remains the same: how can the
police strengthen the informal social-control mechanisms of natural
communities in order to minimize fear in public places? Law enforcement,
per se, is no answer: a gang can weaken or destroy a community by
standing about in a menacing fashion and speaking rudely to passersby
without breaking the law.
We have difficulty thinking about such matters, not simply

because the ethical and legal issues are so complex but because we have
become accustomed to thinking of the law in essentially individualistic
terms. The law defines myrights, punishes his behavior and is applied
by that officer because of this harm. We assume, in thinking this way, that
what is good for the individual will be good for the community and what
doesn't matter when it happens to one person won't matter if it happens to
many. Ordinarily, those are plausible assumptions. But in cases where
behavior that is tolerable to one person is intolerable to many others, the
reactions of the others—fear, withdrawal, flight—may ultimately make
matters worse for everyone, including the individual who first professed his
indifference.

It may be their greater sensitivity to communal as opposed to 187
individual needs that helps explain why the residents of small communities
are more satisfied with their police than are the residents of similar
neighborhoods in big cities. Elinor Ostrom and her co-workers at Indiana
University compared the perception of police services in two poor, all-
black Illinois towns—Phoenix and East Chicago Heights with those of
three comparable all-black neighborhoods in Chicago. The level of
criminal victimization and the quality of police-community relations
appeared to be about the same in the towns and the Chicago
neighborhoods. But the citizens living in their own villages were much
more likely than those living in the Chicago neighborhoods to say that they
do not stay at home for fear of crime, to agree that the local police have
"the right to take any action necessary" to deal with problems, and to agree
that the police "look out for the needs of the average citizen." It is possible
that the residents and the police of the small towns saw themselves as
engaged in a collaborative effort to maintain a certain standard of
communal life, whereas those of the big city felt themselves to be simply
requesting and supplying particular services on an individual basis.
If this is true, how should a wise police chief deploy his meager
forces? The first answer is that nobody knows for certain, and the most
prudent course of action would be to try further variations on the Newark
experiment, to see more precisely what works in what kinds of
neighborhoods. The second answer is also a hedge—many aspects of order
maintenance in neighborhoods can probably best be handled in ways that
involve the police minimally if at all. A busy bustling shopping center and
a quiet, well-tended suburb may need almost no visible police presence. In
both cases, the ratio of respectable to disreputable people is ordinarily so
high as to make informal social control effective.
Even in areas that are in jeopardy from disorderly elements, 188
citizen action without substantial police involvement may be sufficient.
Meetings between teenagers who like to hang out on a particular corner and
adults who want to use that corner might well lead to an amicable
agreement on a set of rules about how many people can be allowed to
congregate, where, and when.
Where no understanding is possible—or if possible, not observed

—citizen patrols may be a sufficient response. There are two traditions of
communal involvement in maintaining order: One, that of the "community
watchmen," is as old as the first settlement of the New World. Until well
into the nineteenth century, volunteer watchmen, not policemen, patrolled
their communities to keep order. They did so, by and large, without taking
the law into their own hands—without, that is, punishing persons or using
force. Their presence deterred disorder or alerted the community to
disorder that could not be deterred. There are hundreds of such efforts
today in communities all across the nation. Perhaps the best known is that
of the Guardian Angels, a group of unarmed young persons in distinctive
berets and T-shirts, who first came to public attention when they began
patrolling the New York City subways but who claim now to have chapters
in more than thirty American cities. Unfortunately, we have little
information about the effect of these groups on crime. It is possible,
however, that whatever their effect on crime, citizens find their presence
reassuring, and that they thus contribute to maintaining a sense of order and
civility.
The second tradition is that of the "vigilante." Rarely a feature of
the settled communities of the East, it was primarily to be found in those
frontier towns that grew up in advance of the reach of government. More
than 350 vigilante groups are known to have existed; their distinctive
feature was that their members did take the law into their own hands, by 189
acting as judge, jury, and often executioner as well as policeman. Today,
the vigilante movement is conspicuous by its rarity, despite the great fear
expressed by citizens that the older cities are becoming "urban frontiers."
But some community-watchmen groups have skirted the line, and others
may cross it in the future. An ambiguous case, reported in The Wall Street
Journal involved a citizens' patrol in the Silver Lake area of Belleville, New
Jersey. A leader told the reporter, "We look for outsiders." If a few
teenagers from outside the neighborhood enter it, "we ask them their
business," he said. "If they say they're going down the street to see Mrs.
Jones, fine, we let them pass. But then we follow them down the block to
make sure they're really going to see Mrs. Jones."
Though citizens can do a great deal, the police are plainly the key
to order maintenance. For one thing, many communities, such as the Robert
Taylor Homes, cannot do the job by themselves. For another, no citizen in
a neighborhood, even an organized one, is likely to feel the sense of
responsibility that wearing a badge confers. Psychologists have done many
studies on why people fail to go to the aid of persons being attacked or
seeking help, and they have learned that the cause is not "apathy" or
"selfishness" but the absence of some plausible grounds for feeling that one
must personally accept responsibility. Ironically, avoiding responsibility is
easier when a lot of people are standing about. On streets and in public
places, where order is so important, many people are likely to be "around,"
a fact that reduces the chance of any one person acting as the agent of the
community. The police officer's uniform singles him out as a person who
must accept responsibility if asked. In addition, officers, more easily than
their fellow citizens, can be expected to distinguish between what is

necessary to protect the safety of the street and what merely protects its 190
ethnic purity.
But the police forces of America are losing, not gaining, members.
Some cities have suffered substantial cuts in the number of officers
available for duty. These cuts are not likely to be reversed in the near
future. Therefore, each department must assign its existing officers with
great care. Some neighborhoods are so demoralized and crime-ridden as to
make foot patrol useless; the best the police can do with limited resources
is respond to the enormous number of calls for service. Other
neighborhoods are so stable and serene as to make foot patrol unnecessary.
The key is to identify neighborhoods at the tipping point—where the public
order is deteriorating but not unreclaimable, where the streets are used
frequently but by apprehensive people, where a window is likely to be
broken at any time, and must quickly be fixed if all are not to be shattered.
Most police departments do not have ways of systematically
identifying such areas and assigning officers to them. Officers are assigned
on the basis of crime rates (meaning that marginally threatened areas are
often stripped so that police can investigate crimes in areas where the
situation is hopeless) or on the basis of calls for service (despite the fact
that most citizens do not call the police when they are merely frightened or
annoyed). To allocate patrol wisely, the department must look at the
neighborhoods and decide, from first-hand evidence, where an additional
officer will make the greatest difference in promoting a sense of safety.
One way to stretch limited police resources is being tried in some

public housing projects. Tenant organizations hire off-duty police officers
for patrol work in their buildings. The costs are not high (at least not per
resident), the officer likes the additional income, and the residents feel

safer. Such arrangements are probably more successful than hiring private 191
watchmen, and the Newark experiment helps us understand why. A private
security guard may deter crime or misconduct by his presence, and he may
go to the aid of persons needing help, but he may well not intervene—that
is, control or drive away—someone challenging community standards.
Being a sworn officer—a "real cop"—seems to give one the confidence, the
sense of duty, and the aura of authority necessary to perform this difficult
task.
Patrol officers might be encouraged to go to and from duty

stations on public transportation and, while on the bus or subway car,
enforce rules about smoking, drinking, disorderly conduct, and the like.
The enforcement need involve nothing more than ejecting the offender (the
offense, after all, is not one with which a booking officer or a judge wishes
to be bothered). Perhaps the random but relentless maintenance of
standards on buses would lead to conditions on buses that approximate the
level of civility we now take for granted on airplanes.
But the most important requirement is to think that to maintain

order in precarious situations is a vital job. The police know this is one of
their functions, and they also believe, correctly, that it cannot be done to
the exclusion of criminal investigation and responding to calls. We may
have encouraged them to suppose, however, on the basis of our oft-
repeated concerns about serious, violent crime, that they will be judged
exclusively on their capacity as crime-fighters. To the extent that this is the
case, police administrators will continue to concentrate police personnel in
the highest-crime areas (though not necessarily in the areas most vulnerable
to criminal invasion), emphasize their training in the law and criminal
apprehension (and not their training in managing street life), and join too

quickly in campaigns to decriminalize "harmless" behavior (though public 192
drunkenness, street prostitution, and pornographic displays can destroy a
community more quickly than any team of professional burglars).
Above all, we must return to our long-abandoned view that the

police ought to protect communities as well as individuals. Our crime
statistics and victimization surveys measure individual losses, but they do
not measure communal losses. Just as physicians now recognize the
importance of fostering health rather than simply treating illness, so the
police—and the rest of us—ought to recognize the importance of
maintaining, intact, communities without broken windows.
We want to hear what you think. Submit a letter to the editor or write to

letters@theatlantic.com.
1. Listen to the podcast episode (opens in a new window) on “broken

windows” and “stop and frisk” practices as they were enacted in New York City.
How A Theory Of Crime And Policing Was Born, And

Went Terribly Wrong
LISTEN·
Broken Windows

In 1969, Philip Zimbardo, a psychologist from Stanford University, ran an
interesting field study. He abandoned two cars in two very different places:
one in a mostly poor, crime-ridden section of New York City, and the other
in a fairly affluent neighborhood of Palo Alto, Calif. Both cars were left
without license plates and parked with their hoods up.
After just 10 minutes, passersby in New York City began vandalizing the
car. First they stripped it for parts. Then the random destruction began.
Windows were smashed. The car was destroyed. But in Palo Alto, the other
car remained untouched for more than a week.

Finally, Zimbardo did something unusual: He took a sledgehammer and 193
gave the California car a smash. After that, passersby quickly ripped it
apart, just as they'd done in New York.
This field study was a simple demonstration of how something that is

clearly neglected can quickly become a target for vandals. But it eventually
morphed into something far more than that. It became the basis for one of
the most influential theories of crime and policing in America: "broken
windows."
Thirteen years after the Zimbardo study, criminologists George L. Kelling

and James Q. Wilson wrote an article for The Atlantic. They were
fascinated by what had happened to Zimbardo's abandoned cars and
thought the findings could be applied on a larger scale, to entire
communities.
"The idea [is] that once disorder begins, it doesn't matter what the
neighborhood is, things can begin to get out of control," Kelling tells
Hidden Brain.
In the article, Kelling and Wilson suggested that a broken window or other
visible signs of disorder or decay — think loitering, graffiti, prostitution or
drug use — can send the signal that a neighborhood is uncared for. So, they
thought, if police departments addressed those problems, maybe the bigger
crimes wouldn't happen.
"It's to the point now where I wonder if we should back away from
the metaphor of broken windows. We didn't know how powerful it
was going to be. It simplified, it was easy to communicate, a lot of
people got it as a result of the metaphor. It was attractive for a long
time. But as you know, metaphors can wear out and become stale."
George Kelling
"Once you begin to deal with the small problems in neighborhoods, you
begin to empower those neighborhoods," says Kelling. "People claim their
public spaces, and the store owners extend their concerns to what happened
on the streets. Communities get strengthened once order is restored or
maintained, and it is that dynamic that helps to prevent crime."
Kelling and Wilson proposed that police departments change their focus.
Instead of channeling most resources into solving major crimes, they
should instead try to clean up the streets and maintain order — such as
keeping people from smoking pot in public and cracking down on subway
fare beaters.
The argument came at an opportune time, says Columbia University law 194
professor Bernard Harcourt.
"This was a period of high crime, and high incarceration, and it seemed
there was no way out of that dynamic. It seemed as if there was no way out
of just filling prisons to address the crime problem."
An Idea Moves From The Ivory Tower To The Streets

As policymakers were scrambling for answers, a new mayor in New York
City came to power offering a solution.
Rudy Giuliani won election in 1993, promising to reduce crime and clean
up the streets. Very quickly, he adopted broken windows as his mantra.
It was one of those rare ideas that appealed to both sides of the aisle.
Conservatives liked the policy because it meant restoring order. Liberals

liked it, Harcourt says, because it seemed like an enlightened way to
prevent crime: "It seemed like a magical solution. It allowed everybody to
find a way in their own mind to get rid of the panhandler, the guy sleeping
on the street, the prostitute, the drugs, the litter, and it allowed liberals to do
that while still feeling self-righteous and good about themselves."
Giuliani and his new police commissioner, William Bratton, focused first
on cleaning up the subway system, where 250,000 people a day weren't
paying their fare. They sent hundreds of police officers into the subways to
crack down on turnstile jumpers and vandals.
Very quickly, they found confirmation for their theory. Going after petty
crime led the police to violent criminals, says Kelling: "Not all fare beaters
were criminals, but a lot of criminals were fare beaters. It turns out serious
criminals are pretty busy. They commit minor offenses as well as major
offenses."
The policy was quickly scaled up from the subway to the entire city of New
York.
Police ramped up misdemeanor arrests for things like smoking marijuana in

public, spraying graffiti and selling loose cigarettes. And almost instantly,
they were able to trumpet their success. Crime was falling. The murder rate
plummeted. It seemed like a miracle.
The media loved the story, and Giuliani cruised to re-election in 1997.

George Kelling and a colleague did follow-up research on broken windows 195
policingand found what they believed was clear evidence of its success. In
neighborhoods where there was a sharp increase in misdemeanor arrests —
suggesting broken windows policing was in force — there was also a sharp
decline in crime.
By 2001, broken windows had become one of Giuliani's greatest
accomplishments. In his farewell address, he emphasized the beautiful and
simple idea behind the success.
"The broken windows theory replaced the idea that we were too busy to
pay attention to street-level prostitution, too busy to pay attention to
panhandling, too busy to pay attention to graffiti," he said. "Well, you can't
be too busy to pay attention to those things, because those are the things
that underlie the problems of crime that you have in your society."
Questions Begin To Emerge About Broken Windows

Right from the start, there were signs something was wrong with the
beautiful narrative.
"Crime was starting to go down in New York prior to the Giuliani election
and prior to the implementation of broken windows policing," says
Harcourt, the Columbia law professor. "And of course what we witnessed
from that period, basically from about 1991, was that the crime in the
country starts going down, and it's a remarkable drop in violent crime in
this country. Now, what's so remarkable about it is how widespread it was."
Harcourt points out that crime dropped not only in New York, but in many
other cities where nothing like broken windows policing was in place. In
fact, crime even fell in parts of the country where police departments were
mired in corruption scandals and largely viewed as dysfunctional, such as
Los Angeles.
"Los Angeles is really interesting because Los Angeles was wracked with
terrible policing problems during the whole time, and crime drops as much
in Los Angeles as it does in New York," says Harcourt.
There were lots of theories to explain the nationwide decline in crime.

Some said it was the growing economy or the end of the crack cocaine
epidemic. Some criminologists credited harsher sentencing guidelines.
In 2006, Harcourt found the evidence supporting the broken windows

theory might be flawed. He reviewed the study Kelling had conducted in

2001, and found the areas that saw the largest number of misdemeanor 196
arrests also had the biggest drops in violent crime.
Harcourt says the earlier study failed to consider what's called a "reversion
to the mean."
"It's something that a lot of investment bankers and investors know about
because it's well-known and in the stock market," says Harcourt.
"Basically, the idea is if something goes up a lot, it tends to go down a lot."
A graph in Kelling's 2001 paper is revealing. It shows the crime rate falling
dramatically in the early 1990s. But this small view gives us a selective
picture. Right before this decline came a spike in crime. And if you go
further back, you see a series of spikes and declines. And each time, the
bigger a spike, the bigger the decline that follows, as crime reverts to the
mean.
Kelling acknowledges that broken windows may not have had a dramatic
effect on crime. But he thinks it still has value.
"Even if broken windows did not have a substantial impact on crime, order
is an end in itself in a cosmopolitan, diverse world," he says. "Strangers
have to feel comfortable moving through communities for those
communities to thrive. Order is an end in itself, and it doesn't need the
justification of serious crime."
Order might be an end in itself, but it's worth noting that this was not the
premise on which the broken windows theory was sold. It was advertised as
an innovative way to control violent crime, not just a way to get
panhandlers and prostitutes off the streets.
'Broken Windows' Morphs Into 'Stop And Frisk'

Harcourt says there was another big problem with broken windows.
"We immediately saw a sharp increase in complaints of police misconduct.

Starting in 1993, what you're going to see is a tremendous amount of
disorder that erupts as a result of broken windows policing, with
complaints skyrocketing, with settlements of police misconduct cases
skyrocketing, and of course with incidents, brutal incidents, all of a sudden
happening at a faster and faster clip."
The problem intensified with a new practice that grew out of broken
windows. It was called "stop and frisk," and was embraced in New York
City after Mayor Michael Bloomberg won election in 2001.
If broken windows meant arresting people for misdemeanors in hopes of 197
preventing more serious crimes, "stop and frisk" said, why even wait for
the misdemeanor? Why not go ahead and stop, question and search anyone
who looked suspicious?
There were high-profile cases where misdemeanor arrests or stopping and

questioning did lead to information that helped solve much more serious
crimes, even homicides. But there were many more cases where police
stops turned up nothing. In 2008, police made nearly 250,000 stops in New
York for what they called furtive movements. Only one-fifteenth of 1
percent of those turned up a gun.
Even more problematic, in order to be able to go after disorder, you have to

be able to define it. Is it a trash bag covering a broken window? Teenagers
on a street corner playing music too loudly?
In Chicago, the researchers Robert Sampson and Stephen

Raudenbush analyzed what makes people perceive social disorder. They
found that if two neighborhoods had exactly the same amount of graffiti
and litter and loitering, people saw more disorder, more broken windows,
in neighborhoods with more African-Americans.
George Kelling is not an advocate of stop and frisk. In fact, all the way
back in 1982, he foresaw the possibility that giving police wide discretion
could lead to abuse. In his article, he and James Q. Wilson write: "How do
we ensure ... that the police do not become the agents of neighborhood
bigotry? We can offer no wholly satisfactory answer to this important
question."
In August of 2013, a federal district court found that New York City's stop
and frisk policy was unconstitutional because of the way it singled out
young black and Hispanic men. Later that year, New York elected its first
liberal mayor in 20 years. Bill DeBlasio celebrated the end of stop and
frisk. But he did not do away with broken windows. In fact, he re-
appointed Rudy Giuliani's police commissioner, Bill Bratton.
And just seven months after taking over again as the head of the New York
Police Department, Bratton's broken windows policy came under fresh
scrutiny. The reason: the death of Eric Garner.
In July 2014, a bystander caught on cellphone video the deadly clash

between New York City police officers and Garner, an African-American.
After a verbal confrontation, officers tackled Garner, while restraining him
with a chokehold, a practice that is banned in New York City.

Garner died not long after he was brought down to the ground. His death 198
sparked massive protests, and his name is now synonymous with the
distrust between police and African-American communities.
For George Kelling, this was not the end that he had hoped for. As a
researcher, he's one of the few whose ideas have left the academy and
spread like wildfire.
But once politicians and the media fell in love with his idea, they took it to
places that he never intended and could not control.
"When, during the 1990s, I would occasionally read in a newspaper

something like a new chief comes in and says, 'I'm going to implement
broken windows tomorrow,' I would listen to that with dismay because
[it's] a highly discretionary activity by police that needs extensive training,
formal guidelines, constant monitoring and oversight. So do I worry about
the implementation about broken windows? A whole lot ... because it can
be done very badly."
In fact, Kelling says, it might be time to move away from the idea.
"It's to the point now where I wonder if we should back away from the
metaphor of broken windows. We didn't know how powerful it was going
to be. It simplified, it was easy to communicate, a lot of people got it as a
result of the metaphor. It was attractive for a long time. But as you know,
metaphors can wear out and become stale."
These days, the consensus among social scientists is that broken windows
likely did have modest effects on crime. But few believe it caused the 60 or
70 percent decline in violent crime for which it was once credited.
And yet despite all the evidence, the idea continues to be popular.
Bernard Harcourt says there is a reason for that:
"It's a simple story that people can latch onto and that is a lot more pleasant
to live with than the complexities of life. The fact is that crime dropped in
America dramatically from the 1990s, and that there aren't really good,
clean nationwide explanations for it."
The story of broken windows is a story of our fascination with easy fixes
and seductive theories. Once an idea like that takes hold, it's nearly
impossible to get the genie back in the bottle.

The Hidden Brain Podcast is hosted by Shankar Vedantam and produced 199
by Maggie Penman, Jennifer Schmidt and Renee Klahr. Our supervising
producer is Tara Boyle. You can also follow us on Twitter @hiddenbrain,
and listen for Hidden Brain stories each week on your local public radio
station.
1. Read the New York Times article (opens in a new window)

detailing the court ruling that signaled the end of these practices.
 Lecture
The most explicit and well

documented case in recent history of a
criminal justice system encompassing both
police and court practices that both
discriminated against and exploited the
community members was in Ferguson,
Missouri.
The Department of Justice under former President Barack Obama
investigated the criminal justice system in Ferguson, Missouri. When after
the death of Michael Brown at the hands of a police officer, there were
weeks of protests that erupted in the city.
In addition to the disturbing images of militarized police
responses arising out of those protests, citizens continually reported
policing and court system practices that kept mostly low income residents
in a cycle of frequent police stops for minor infractions, court fines, debt
and incarceration.

All of this was happening in small city of only 6 square miles and 200
about 21,000 residents. Out of those 21,000 residents, at one point, 16,000
of them had outstanding arrest warrants.
That's over 67% of the residents in this small towns engaged with
the criminal justice system. This 2015 report issued by the Department of
Justice revealed a pattern of disproportionate and discriminatory contact
between police officers and the community, comprised of 67% of African
American residents.
Of that population, 85%% of vehicle stops between 2012 and
2014 were of African Americans. 93% of arrests were of African
Americans. 88% of use of force incidents were against African Americans
and 95% of residents jailed for two days or more were African Americans.
Further, the report found that police and court officials were
incentivized to make money from residents through steadily increasing
municipal fines, fees and forfeitures.
I'll post a link where you can read the full 105 page report
detailing these findings, if you'd like. But I do want you to take the time
and listen to former Attorney General Eric Holder discuss the findings and
outline specific examples of patterns and practices of law enforcement in
Ferguson, Missouri.
The disrupted, the sense of trust community members had in their
police officers and their court system.
Four specific issues come to mind. When we're counting the
national conversation we've been having in the United States over the past
three years, about law enforcements used a force mostly against citizens.
The first issue has to do with police officers killing unarmed
individuals.
And individuals who may be impaired or otherwise, unaware of
the need or unable to follow police directives before being killed, such as
individuals with a mental health issue or cognitive or hidden disability such 201
as those with autism.
The presence of a range of recording devices. Both offering the
police officer's point of view, such as dash cameras or body cameras or
recordings by bystanders has illuminated the moments before the deaths of
several mostly African American men at the hands of police.
These videos depicting someone's last moments on earth, either
by shooting, tasering, choking or otherwise has awakened the public's
demand for increased accountability, deescalation training.
And where necessary, criminal prosecution of law enforcement
who abuse their authority by taking the lives of individuals who do not
pose a threat to their safety or the safety of others.
However, prosecutors, grand juries and a sizable share of the
public often rely on the stated perceptions of police officers in the moment
of a killing as being in fear for their lives.
This is one of the most common justifications for fatally shooting
an unarmed person.
We know that perceptions can be based on biased and faulty
assumptions. Often, there is no officer held accountable, even in cases
where there is clear video evidence that an officer had limited reason to
fear a person.
No case is more illustrative of this phenomenon than the case of
Officer Michael Slager of North Charleston, South Carolina.
Mr. Slager shot Walter Scott five times in his back as he slowly
ran in the opposite direction of the officer after a routine traffic stop and
then appeared to plant a weapon near his body.
All of this was captured on camera by a bystander. In this case, a
jury declared a mistrial. Unable to unanimously decide on Officer Slager's
guilt. A 2015 report by the Washington Post, note that approximately 1 out
of every 10 people fatally shot by the police are unarmed while only 11 of 202
the 65 officers criminally charged with fatally shooting someone have been
convicted in the past 10 years.
Only about five officers each year are charged in fatal shootings
and indictments are slowly rising, but are often due to the public pressure
for greater accountability and the presence of video evidence.
Of note, there has been an uptick in the killing of African
American women, transwomen and other populations at the hands of law
enforcement and jail and prison corrections officers as well.
According to the National Institute on Drug Abuse or NIDA, in
2015, heroin and prescription pain pills belong to the same class of drugs
called opioids.
Opioid attach to molecules in the body called opioid receptors,
found on nerve cells in different organs in the body including the brain.
When opioid is connect with opioid receptors, individuals
experience a decreased perception of pain and increased feelings of
relaxation and happiness.
These reactions leave some individuals to abuse or misuse
opioids and become addicted.
It's not uncommon for individuals to switch from using
prescription pain pills to heroin which is often less expensive, more
accessible and creates a similar experience in the body.
The United States is now in the midst of an opioid epidemic with
approximately 91 individuals dying each day of opioid overdoses or related
complications. 2015, represented a peak in opioid-related deaths with
33,000 individuals dying from opioids alone.
What distinguishes this wave of drug abuse from others in the
past is that the abusers of opioids are largely white with a substantial
proportion originating from middle and upper income communities.
In fact, 90% of new heroin users over the past ten years have been 203
white.
As you might imagine, a largely white drug epidemic has
garnered a much different language, legislation, treatment approaches and
legal frameworks than past epidemics effecting communities of color.
The current opioid epidemic is commonly compared to the crack
cocaine epidemic of the 1980s.
And to a lesser degree, to the heroin abuse wave of the 1960s.
Take a moment and compare characteristics of each phenomena.
The different geographies, responses and framing of the
population of drug abusers and legislation enacted as a response. One
paradox of the opioid epidemic is that several studies have found that
African American patients in the healthcare system are significantly less
likely to be prescribed opioids to treat their pain related to easily
diagnosable and unseen injuries than whites are.
And this disparity persists, even when the numbers are adjusted
for other socioeconomic variables such as income.
According to Charles Land of the Washington Post in the 2016
article, the vast majority of doctors are white and are far more likely to
provide opioids to whites than blacks in situations where suspicion of drug
seeking is the greatest.
It's no great leap of racial paranoia to attribute this to bias or
prejudice. This bias is certainly part of the reason why African Americans
are less likely to be addicted to opioid-based pain pills, because they are
less likely to be issues an initial prescription for perfectly valid medical
issues.
I was particularly taken by this quote in The New York Times,
which sums up the perspective of many who were impacted by prior drug
epidemics in the US and treat it so very differently.
If you have an opportunity, please consider accessing the brilliant 204
Oscar nominated documentary by Ava Duvernay called The 13th. It
skillfully weaves together interviews with experts, politicians, victims and
archival images and footage to tell the story of mass incarceration from the
time of slavery to today.
You can't grasp our current state of affairs without delving into
and being able to critically assess the socio-historical influences.

This film is only available through Netflix, but it does offer a free 205
trial

 Lecture 206
To understand three current trends

in juvenile justice I want you to complete a
series of activities that will give you a
multidimensional sense of the issues with
regards to incarcerating youth.
Reflect on the experience
recounted in these materials, including
information offered by the National Human Trafficking Hotline website, an
excellent resource for practitioners working with youth who are frequently
targets for trafficking.
There's no doubt that social media in all of its forms has
transformed the public's relationship to and awareness of criminal justice
issues.
In fact, law enforcement are increasingly using social media as a
tool for gathering evidence, soliciting information on crimes from the
public, engaging with community members to build trust and managing the
reputation of law enforcement agencies.
It is community members, citizens, ordinary people, who have had
an extraordinary impact on galvanizing support for issues through social
media.
Hashtags like Black Lives Matter were some of the first to connect
people around common experiences and keep the world abreast of events
and happenings that would otherwise be filtered through biased media or
public relations, if they received any coverage at all.
We can't deny the powerful use of video often from cellphones to
document interactions with law enforcement and share them widely.

We have no idea of the stories of those who've died at the hands of 207
police, like Eric Garner if not for his death being streamed across the
world.
Our national and even global conversations and demands for
activism and accountability have shifted forever in just the past five years
because of the impact of social media and technology on criminal justice
interactions and experiences.
Take a moment and reflect on race, social class, age, geography
and even the role of social media in shaping the patterns of criminal justice
trends.
And also shaping our collective understanding of how criminal
justice operates differently, depending on who you are, where you are and a
host of other factors.
Social works has play a critical role in the criminal justice system.
We are often at the point of service for supporting individuals and
communities, from engaging with prisoners seeking re-entry to the
community, to supporting victims of crime and abuse, along with working
toward restorative justice where appropriate.
Social work practitioners are embedded in agencies to prevent and
stamp out human trafficking.
And we are on the front lines of advocating for more just local,
state, and federal policies for those who are incarcerated or formerly
incarcerated, and that includes advocating for more mental health services,
drug abuse treatment, stronger safety net programs, and anti-poverty
initiatives.
If as a social worker, you're interested in working within the
criminal justice system.
The possibilities are endless for opportunities to make a lasting
difference and impact the lives of those at risk for encountering the
criminal justice system or those affected by it such as victims and family 208
members.
Now lets listen in on a fascinating interview with Jared Williams.
 A Conversation
with Jarred
Williams

Hi, everyone, welcome back to Social Work 504. Today, it's my 209
privilege to interview Jarred Williams.
He is a Soros Justice Advocacy Fellowship finalist and we'll hear
more about what that means. Most recently, he was also a research
associate in the University of Michigan Law School.
And he's currently developing a nonprofit organization that he's
gonna tell us about, as well.
So welcome, Jared. >> Hey, thank you for having me. >> I am so
excited to talk about your story and about your research.
And I mentioned this very prestigious fellowship that you are a
finalist for, congratulations making it that far.
>> Thank you. >> Can you start by giving us a little bit of
background what the Soros Justice Advocacy Fellowship is, and how you
came to apply for that fellowship?
>> The Soros Justice Advocacy Fellowship is a fellowship from
Open Society Foundation, which is funded by George Soros. And the
purpose of the fellowship is to find young people, people that are
established in the criminal justice reform movement, and journalists that
can make a dramatic impact or show potential to make a dramatic impact to
decreasing incarceration.
And so, each year, there's hundreds if not thousands of applications
and you go through this long process.
Just last week, I went through my interview which is somewhat of a
grueling process, and so as of now I'm waiting for results.
>> Awesome, and so one of the reasons why I assume you made it
this far into this prestigious fellowship process is because you're doing
some incredible work in the area of prison reform and getting into the depth
of that.

But before we dig into your specific work, I know that you're an 210
expert and you have some great background knowledge on the context of
incarceration.
Particularly where the US is positioned globally in terms of
incarcerating its citizens. And that's something we're learning about in this
course. Can you just give us a little bit of background on that?
>> Sure, I think it's important to look at incarceration rates
from a global level and then maybe work the lens down to a more
national level, a state level, and then maybe how it even impacts certain
individuals.
And some examples of that and often heard statistic is that we have
5% of the world's population and we incarcerate 25% out of all the people
in the world.
And there's 7.5 billion people in the world, and there's more than
300 million people in the United States.
But of all those 750 billion people, that we have 25% of all the
people behind bars. >> So one of the reasons i really wanted to talk to you
is not only because you're doing this incredible work, looking at prison
closures but also that your work is informed by your personal story.
And that you're so generous in sharing your story, it's kind of like, a
lesson, a lesson to be learned essentially around the impact of incarceration
and making early mistakes on someone's later life trajectory if you really
want a longterm trajectory.
Do you mind sharing just a little bit about your story whatever you
feel comfortable sharing and how that kind of informed, bringing you into
the work that you do now?
>> Absolutely. I've more than open about it when I was just after
my 18th birthday,

I was driving around with a friend and there was a car that was 211
running, someone was warming up a car in front of their house.
And he was like, I bet you $100 you won't drive off in that car, and
so I said, I bet you I will, as a stupid 18 year old. And so, I did,
I drove off in the car, I drove around the block, and I parked the car
basically. One thing led to another and I ended up being arrested. And
eventually I had 54 court dates, I was sentenced to an indeterminate, which
means that you're eligible for parole, technically and there's various ways to
define that.
Five year sentence, so I got five years for my first offense. After six
months of incarceration I came before the judge, and they ended up giving
me 14 years of probation, which means that I have to report to a probation
officer basically every month for 14 years.
Now, you could look at that from two perspectives, is that I did
something wrong in society and I was punished in some way.
>> Mm-hm. >> And you can also look at it is. I didn't come from an
impoverished family, my family was middle class.
I had what anyone would probably consider the Brady Bunch
existence and the story could also be interpreted as, the story of mass
incarceration just doesn't impact impoverished communities or people of
color.
>> Or people of color, yeah, absolutely. >> Like, Brady Bunch type
families can get caught up in this mass incarceration, too.
And so, it's an important thing to know that the- >> So anyone in a
sense who makes a mistake, or has a youthful indiscretion, or makes a poor
decision, and does not have the resources to advocate for themselves, could
certainly be caught up in the same cycle as some of them who are visible
communities that we have to think of.

>> Absolutely. >> Yeah, and so what was the impact of having 14 212
years of state sanctioned kind of control over your life in terms of your
career prospects, your ability to move about freely, what was that
experience like?
>> At that time I had a full academic scholarship to Oklahoma State
University so obviously I had to leave school. >> Because at that time, this
was a felony conviction, and so at that time, that somewhat disqualified
you from attending that university.
>> Yeah, definitely being in prison disqualified [LAUGH] me from
do attending that university.
And so, when I got out, I mean I wanted to do right, prison at least
in the fact that you don't wanna go back is definitely I'd probably say
generalized impact on most people that are in that situation.
So I started working for a construction company, I'm doing like
made manual labor work. And then, they went out of business after six
months.
So I managed to save a few dollars. I applied for jobs. I applied for
jobs. Due to my commonal record, I was denied even access to any type of
job.
And kind of like somewhat of a last ditch of employment effort, I
went to McDonald's, and I tried to apply for a job at McDonald's. And
since there was a cash register in the building, they wouldn't give me a job.
And so, I kinda came to just feeling that I'm not wanting by the
United States due to nothing other than one youthful indiscretion. And so, I
left.
My friends were going to Florida to become a dive instructors and
so I would save like about 800 or $900. I went to Florida, became a dive
instructor, and I spent the next almost decade traveling around the world
teaching scuba diving.
I started in the Caribbean. Eventually I branched out. I backpacked 213
through Africa, India, and Asia and the inequality that you see that's maybe
less noticeable in some respects in the United States.
Once you make it to Africa and India and those types of countries, it
is extremely evident that there's this half that's completely poor, this half
that's completely rich, and nothing in the middle.
>> So the way that we're able to somewhat mask economic
inequality in this country, there are different systems through educational
systems or housing or employment that those inequalities become laid bare
in other nations essentially.
>> Right. >> And that was your experience and seeing that up close.
>> Absolutely. And I had this epiphany, I guess, that that scene
made me realize that all I was doing was running from a problem, and in
some respects, I had a unique I was in a unique position where I did have
an academic scholarship.
I didn't have the only barrier, per se to my overcoming this was a
criminal record which is no small barrier.
And so I ended up getting a job for an environmental organization
where I move to Maui, Hawaii. Where I took pictures of pectoral fins of
humpback whales for identification purposes.
That's how I did [INAUDIBLE] should think. And, I met the lady
that would eventually be my wife. And education was always of interest to
me.
And I realized that to overcome this type of barrier, that I felt, and
still feel, that education is one of those ways that it makes that possible.
So I started at a 3,000-person community college in Maui and I
went to this a whole year there. >From there I transferred to Honolulu
which has the University of Hawaii.

I graduated magna cum laude from there. I applied to lots of 214
graduate schools. And even at this point where I've shown at least some
type of redemption, some type of academic execs and intellectual curiosity,
still applying for graduate schools.
There was lots of applications where you had to check the box as
they say. >> Mm-hm, yeah. >> Have you ever been convicted of a criminal
record? >> Or of a crime.
>> Or of a crime, right? >> Yeah. >> And if they, and in so if you
checked that box, I mean you're basically required to give a mea culpa.
You're supposed to tell them what you were convicted of, how
you've changed and that process.
So then, your application goes to the dean of the entire college.
He does a risk assessment on you to see if they'll let you in, will
you, or do you present a risk to the school community.
I actually was accepted to some of those institutions, but I chose
Washington State University. So as of now, I am a PhD candidate, which
means that I've finished my course work, I've defended my thesis.
I'm writing my PhD. >> Your dissertation? >> My dissertation, and
I had the opportunity through networking and going to conferences I met
some influential people.
And after I was no longer required to be in the same geographical
locations to my graduate school, I decided to try to get work experience.
And so, I sent my resume to a few people and the University of
Michigan law school ended up getting it.
And they contacted me and I started working there and that's for my
professional career.
>> Yeah, what an incredible story about how you essentially
worked your way back to the United States.

After feeling like you were, there was no place for you here because 215
of having this felony conviction from this single indiscretion, right?
And so, I know that some of that was the inspiration for this.
Amazing cross-country project that you embarked on that I know is related
somewhat to your dissertation and also to your Soros Fellowship
application.
Tell us about how you ended up traveling the country and
documenting prisons. >> Well, I was doing my first year of graduate
school.
I was a research assistant for actually a former Soros justice fellow.
And, he was doing a research project on the economic impact of opening a
prison in a rural community.
He had written an article already and he was doing a follow up
article. >> Mm-hm. >> And so- >> So what does it add to that community
in terms of jobs?
>> Jobs- >> Opportunity to- >> Yeah, it does opening up a prison.
They were, the narrative was that if we open up a prison in these
rural communities it will provide jobs, it will provide income and prison
guards, you don't rent houses, they eat at diners.
It provides this economic boom, right? >> To a small town.
>> To a small town, a small rural town. And so he was doing a
follow up article and my job was to find all the prisons that had opened in a
certain period of time from 2010 to 2013.
>> Okay. >> Well, during my research process I started seeing that
prisons were closing and the mass incarceration peak was at 2009.
And that even though this was 2010, I was finding literally, and
ended up finding hundreds of prisons that had closed.
>> So we had hit our pinnacles essentially of incarcerating folks.

We were starting to actually, for the first time in a very long time 216
see a decline in the number of folks even at the state level and also at the
federal level, who were being put away for these long sentences, right?
>> Right. >> And so, as a part of your research and driving around,
you started to see that all these prisons that had opened up in this short
period of time were not sustainable, they were starting to close.
>> Right, and so I decided to try to figure out first of all, there was
no one that knew how many prisons were in this country.
And that's something that astounded me. >> So across level state-
>> Federal. >> [CROSSTALK] >> They could approximate it but would
be within a hundreds of prisons, so- >> Because there's no database where
you can go and say, hey, is there a new prison in a particular community?
There's no one who records that. >> Right, some federal statistics
try to do that, but the last census of adult correctional facilities by the
Bureau of Death Statistics, the last count they did was 2005.
And so basically from 2005 on they had no idea how many prisons
had opened, had closed.
The private prison industry was starting to come into the mix and so
I in some respects made it my mission in life to try to figure out how many
prisons are in this country.
Which would seem like, not that hard of a prospect to really but I
am. So I started looking at resources not only federal statistics that weren't
even available after a certain point, but like the Department of Corrections
websites.
But some of those hadn't been updated since 1966 in some respects.
>> In terms of the information because we didn't have websites in 66. But
the information that was posted, yeah. >> [CROSSTALK] Updated since
then.

And so it was just really a labor of love, I guess you would say. 217
Google searches, I called thousands of prisons. And at one point I started
making a list.
Some were more willing, and some were less willing to provide
information.
And so I made a list of prisons that were within maybe a 600 mile
radius of Washington State University which is in Pullman,
Washington on the border of Idaho and Washington. That, and
during one summer I decided to take a road trip. And to get inside of a
prison especially with a criminal record is extremely difficult.
But if you approach them as a researcher or as someone writing an
article, maybe they would take that as a journalistic piece.
And you framed that in a right way where you're not, cuz I wasn't
trying to hurt prisons.
>> Sure, your aim is not to close prisons down, it's really to
document a phenomenon.
>> Document, right, yeah, I'm a researcher, it's about facts, right? I
try as much as I can of course with well did you take our personal opinion
out of it.
And so, I took the three-month road trip and visited prisons just to
try. So when I would call them on the phone some people I felt would be
more apt to give me information if I was standing in front of them.
It was much easier for them to deny. And so I made a list of those
and went and visited prisons under the guise of but sometimes I felt
research article was the best way to approach it.
Sometimes I used the guise of article and maybe they assumed it
was a journalist or an article anyway. >> Sure.
And I was relatively successful. I would say I entered 75% of the
prisons that I got into when I was.
I would say I was successful in the same because documenting a 218
prison open or closed is helpful in this extent that we have those numbers.
But how many people are in those prisons and what are the racial
makeups of those prisons? And so- >> But also I think didn't your work
take it even deeper than that, you started looking at spatial clustering of
prisons, right?
>> Yeah, absolutely. >> And the way that politics played a role in
where prisons opend and closed, and the way that some of those economies
that we thought we're going to flourish under prisons were not necessarily
flourishing, is that right?
>> Absolutely, and maybe a simple comparison would be helpful,
let's say like a shopping mall.
A shopping mall, whether a shopping mall is successful or not
successful depends on a lot of facets.
>> Sure. >> Does the shopping mall have a movie theater? >> Is it
in a good location? >> Is it in a good location?
>> Sure. >> What kind of stores are in there? >> Parking, gotta
have good parking. >> Does it have good restaurants?
The quality and the types and the pricing of clothing there. So, a
prison is just an extreme version of any other type of business or
institution.
And so, when it comes to prisons the important factors are the
political environment. Are there harsh or less harsh sentencing policies- >>
So, the particular states legal and kind of policy directives around how
harsh they are on particular crimes, right?
>> Yep. >> For example, using your own life example. How long
they choose to institute a particular sentence for a particular crime.

And that's a very state level decision that could influence per se 219
whether or not they need a larger prison to hold people for a longer amount
of time.
>> Right, incarceration rates are a product of two things. How many
people are arrested and how long they're sentenced for.
Those are the two factors that lead to an incarceration rate. >> And
those are often state and even local decisions.
>> Yes, we don't have one state criminal justice system. We have 51
criminal justice systems including Washington DC. >> That are completely
kind of separate from the Federal system.
>> Disaggregated from each other without a doubt. And the same
sex marriage, the recent legalization in different forms of marijuana are a
perfect example of that.
You can walk into a legal marijuana shop for recreational use in the
state of Washington and buy an ounce of marijuana no problem.
If you got caught with an ounce of marijuana here in Michigan, they
use to have a mandatory but they've cancelled it and now, but they used to
have a mandatory minimum of 25 years.
And so, now people are imprisoned for things that are legal in the
United States- >> So, you can cross over a border for example and get
several years of prison for something that is decriminalized in the state next
door.
>> Right, it's always been framed as an economic issue. And that's
why generally the professor that I was working for was looking at the
economic impacts, because if you're speak- >> Of prisons.
>> Of prisons, because if you're speaking to policymakers that's
what they care about, they care about budgets.

And so, the first point I want to make is that an economic argument 220
is not going to solve incarceration. It has to be framed around a social
issue, that it's unfair, that it's unequal.
And so- >> So, saying that it doesn't make good dollars and cents to
let people out of prison isn't gonna convince anybody?
>> It isn't gonna convince anybody. >> Gotcha. >> But
unfortunately, the rise of mass incarceration which, by the way, in 1970
there was 350,000 people in prison.
And between 1900 and 1970 say, the prison population didn't
increase by 5%. And between the mid-1970s, 1974 to be specific, to 2009 it
increased by 5 times.
And so, at that point, 2009, we had 1.6 million people in prison and-
>> And I think we're at about 2.2 million today, right?
>> Well, and 700,000 people in jails, and so maybe this- >> In jails,
okay, so if you're combining folks who have been sentenced, and folks who
are waiting to be sentenced, but they're all incarcerated in some way, it
adds up.
>> Right, and this might be a time to make a distinction that might
be important, a simple distinction. And that is between incarceration rates
and imprisonment rates.
Incarceration rates are all the people that are in Federal, State and in
jails.
And an imprisonment rate would be people that are just in Federal
and State prison. And so, the jail population, the statistics are taken on
December 31st of each year, it's a snapshot, a single day.
And so, on that particular day, this year there was about 609,000
people on that particular day.

At the worst, there was 750,000 people, but that's not the whole 221
picture. In this country, in an average year, 12 million cycle in and out of
jails, just jails because they make bond, because they have short sentences.
And so, to say that 700,000 people have a jail experience in a year.
>> Is really underestimating that issue, right?
>> That's just the population on that one thing. But 12 million
people in this country go to jail every year. >> Gotcha, gotcha.
>> Which is this incredible statistic in my view. >> I also wanna
capture this piece of your work that looks at the impact of private prisons.
Because you have done some work that looked at almost like states
partnerships and we're seeing that quite a bit.
There's quite a bit of controversy around prison privatization, and so
you looked at kind of state partnerships with private prisons to some
degree.
And some of the decision making that happens around those
business relationships, if you will.
>> In the academic end either criminal justice reform that would be
called the prison industrial complex.
Because it's a much more broader and multifaceted and nuanced
issue than just a monetizing prison, right?
It's like, say, their Corrections Corporation of America going and
buying up a State prison, and then running it like a business, or managing it
like someone would manage a hotel.
>> So, for example, we think of a prison as a building, right?
A secure building, but there are hundreds if not thousands of
functions that have to happen in that prison, right?
So, for example, the people who work there are often not members
of that community but they may be contractors or contracted out through a
private employment agency.
The food that inmates or prisoners are served is typically not made 222
by folks who are local or by folks who work for that prison directly.
But they're actually a service provided by an outside company,
right, that's contracted to provide food.
Aramark, for example, is one of those companies we've heard a lot
of controversy about, particularly here in Michigan.
And so, you think about all of the different business contracts that
go into keeping a prison functioning that a state has to manage.
Should they choose to privatize versus have local community folks
working in that prison in all of these capacities?
>> And I would like to add, too, a really important factor is health
care is something that's privatized too and- >> So, even down to there's a
particular ambulance company you might call if an inmate needs to go to
the hospital.
>> Yeah, and people quite honestly die all the time in prison due to
relatively simple things, like hernias.
Or they're denied treatments that anyone would typically get that
end up seriously impacting, handicapping, or killing them on a regular
basis.
>> We've seen quite a few settlements and lawsuits. There have
been a series of podcasts and news stories that have come to light about
some of those very issues, as a matter of fact.
Absolutely, yeah. But I mean, you talking about food, the most
consistent one is having maggots and food that is not edible by any means.
>> Yeah, that actually happened right here in Michigan.
And so there was a case that came to light with the food servicer for
Michigan prisons, Aramark. So this company that was really providing not
enough calories, so inmates or prisoners were essentially being starved, in
some sense.
And then also the quality of the food, as you say, was infested, or 223
was rotten. And the state was paying millions of dollars a year to provide
this food, right?
>> Again, in many states, and in the current times this has changed,
but in some states it hasn't.
The states are required to give the nutritional value of a handful of
peanuts is typically what the states are required to feed, and in most
instances- >> In terms of protein, fat- >> Yeah, yeah, that's the whole
nutritional requirements.
So if they can meet that standard, which obviously might be a little
lower than it should be, then federally or legally they're doing their job.
>> Yeah, absolutely. And so any other lessons that you learned
around some of the dangers that we've run into, in terms of the privatization
of prisons?
And things that you've learned from your research on how
communities have negotiated these private partnerships?
>> A standard private prison contract, and they vary from state to
state, in the best case scenario, a private prison will buy a prison or manage
a prison for a state and it's a business transaction.
It involves a business contract. In the best-case scenario, the
contract is for 20 years andthe state guarantees that they will pay for 95%
capacity.
Meaning that whether the prison has 95% of its bunks filled with
prisoners, the states have to pay for those individual beds.
>> And so, there's a cost associated with each available spot for an
inmate, if you will.
And the states have agreed in many cases to pay the cost, whether
that inmate exists or doesn't exist.

>> Yeah, and some of those contracts are for over 99 years, and so 224
now you have a distinct invested interest.
>> They're on the hook. >> They're on the hook for filling prison
beds, they might as well.
And so now if you have a social institution, if we wanna use that
term, for a prison and running like a private corporation, that is built on
profits and growth.
And the contracts are a set price that a state pays for an inmate in a
bed. And so that price doesn't change.
The only way that you can have growth or have profits is to reduce
cost. And so reduce- >> So now meals should cost less, healthcare.
>> Meals should cost less and guards get paid less. There's less
guards per inmate ratio. And across the board, private prisons are more
violent. Phone calls, say, are more expensive. On average, if you make the
minimum wage in this country, you have to work for an hour and a half to
make a ten-minute phone call to a loved one that's in prison, so.
And all that comes through privatization, and privatization is spread
out. And so now that guards are being paid less, that lowers the income for
state run prisons.
And so private prisons don't just impact the people, the communities
of where the private prison is, it flushes out to you.
Now state prisons all of a sudden think, well, we don't need so many
guards, we don't need proper food.
>> Because they're setting standards. >> They're setting standards,
right.
Like I said, it's an economic issue in some respects. >> Absolutely.
>> Right. >> So what's happened in the research where you've gone
around looking in these communities at the impact of prison closings, for
example?
What has happened to some of these smaller more rural 225
communities where a prison has closed up shop?
>> It's similar to the research that the professor that I was doing the
research for, what he found I guess is important to say, just when a prison
opens does that- >> Create some type of long term boom.
>> And the answer to that across the board is no. Initially, the
construction of the prison might bring some economic benefit.
>> But that's a very short term thing, right? >> That's a very short
term thing. >> In two or three years those jobs are gone.
>> Right, and prison guards are unionized. Means that the longer
you're with a prison, the higher placement you have.
You have tenure. >> Seniority. >> Seniority, right? And so the
people of those individual counties, I think 85% of the time did not get
those jobs.
The jobs were taken by other prison guards that drove from other
counties. And so it actually- >> So the local impact is very minimal.
>> Or none, or it sometimes harms communities, because especially
now that prisons are closing, you have a structure that, you can't turn a
prison into a hotel very easily.
>> Or a school. >> Or a school, or any other type of community, so
that's a challenge, too, that we're facing.
>> What do you do with these empty prisons? >> What do you do
with these prisons? And they've come up with ingenious ways.
Movie studios have bought prisons. There's another justice fellow in
Sanford that has flipped prisons, is what he called it. And what he does is
he goes in, and the people that own prisons or states still have to pay
property taxes.
And so it still costs them money even if it's closed. So he goes in
and negotiates and they eventually sign the prison over to him for free.
And he has turned them into a place where juveniles are starting to, 226
maybe getting in trouble or at risk of getting in trouble, and he teaches
sustainable farming and things of that nature.
Norway, other countries have turned closed prisons in to people that
are waiting to get visas in those countries. And so there's become ingenious
ways to use those prisons, but it's challenging for us.
>> Yeah. >> What do you do with this superstructure? >>
Absolutely, so I wanna close out by talking about your nonprofit that's
under development.
I know that you are just going to do wonderful things. You have
already turned your own story into this incredible motivation to bring to
light all of these facts around the incarceration and the impact of prisons.
But what's the focus of this nonprofit that you're developing? >>
The focus of the nonprofit is that, it's a lady we know, Nicole Remsberg,
that I'm working with presently.
And she was responsible in Pennsylvania for implementing a mental
health risk assessment for juveniles in every county in Pennsylvania, which
is no small task.
And so- >> Sounds like a social worker. [LAUGH] >> It sure does.
And so I have expertise in prison closures. But criminal justice is a
multifaceted, and nonprofits are a multifaceted thing.
And so we want to make sure that we're not completely focused on
prison closures because prison closures is an end result, right?
We have to reduce capacity. In order to reduce capacity, that takes
things like sentencing policy changes, different ways of how we monitor
people, parole and probation after you get out of prison.
Diversion programs like drug, and so we're- >> So the goal is to
have fewer people to funnel into prisons so that prisons won't be necessary
to the degree that they are right now in terms of their scale and their scope.
>> Right, so we're just developing the framework, but I'm able to be 227
centered around my data and my expertise as far as prison closures.
But prison closures don't happen. The criminal justice system is
massive. We spend 80 billion dollars a year just on state prisons alone.
And maybe half of a trillion dollars on the criminal justice system,
in general.
And so to have a nonprofit that's just if you focus on prison
closures, those don't happen without involving lots of other nonprofits. And
so we're making kind of a consortium of people that we feel that changes
that need to be made.
And we are also identifying ways that you can close, closing a
prison is not by purpose.
That's not how I would measure success, because it impacts
communities. People lose their jobs.
And you go from closing one prison, and then those inmates are
transferred- >> They have to go somewhere else, right.
>> And now, instead of being triple-bunked in they're quadruple-
bunked in a cell. And so, there are states, like New York, that offer
economic incentives for private businesses to build factories there, to rehire
guards, to offer economic incentives to, quote, newer communities to hire
guards.
There's places like here in Michigan that sends legislators and a job-
mobile to the communities impacted by closure to offer retraining, re-
education, and so there's a proper humane and sustainable way to close a
prison.
>> Sure. >> And then it should take a little bit of time too, for the
communities to adjust.
A lot of times the prisons are announced on January and closed in
January. And that type of closure isn't humane.
>> Doesn't really leave a lot of time for that community, right. >> 228
Right, and so.
If you're given like say a six month window, in New York they're
required to give a year notice, that gives you time to also empty the prison
in a more natural sense.
To parole elderly inmates, to parole people that are really close to
parole. So, when you're actually transferring inmates at the closure process,
it's a smaller population.
>> Sure. >> Have less impact on prisons that they go to.
>> Sure, and it sounds like your non-profit that you're building is in
a fact bringing all of those voices to the table and trying to look at prison
closures through this kind of multi-dimensional lens and making sure that
community voices are heard, that processes are followed that also,
hopefully lead to decarceration, where it's responsible, that you're really in
effect trying to do that in a way that we haven't seen before.
>> Right. Because it's, the goal before was that prison closures lets,
there's two sides of prison closures.
There's the criminal justice reform side which wants policy changes-
>> Sure. >> They advocate, they demonstrate, they do, when they're trying
to, when a typical group tried to get social reform.
>> Mm-hm. >> But the reality of prison closures is a political
decision. >> Mm-hm, sure.
>> And, fortunately, since the, I say fortunately, but since the 2008
economic crisis, we found ourselves in a political position that had socially
minded Democrats and fiscally minded Conservatives.
Come together the more liberal people got worried, wanted more
social justice and the conservative side was worried about budgets.
>> Mm-hm. >> And so now we're in this incredibly unique time
where we have this strange bedfellows as you would say.
These people it's like- >> There might be some common goals 229
between them even if their intentions behind it are different.
>> Right, and I think it's important to note that it is not an us against
them scenario.
In some respects, and i'm not saying this broadly, but in some
respects, i'm willing to work with a conservative person that I might not
agree with on other social issues.
If we're all in agreement on prison closures and we have a plan
that's sustainable and reasonable I'm willing to work with that person and
that's what criminal justice reform organizations need to learn too.
If you're going to get something done it has to involve people that
you might not always be like-minded with.
No one agrees on every issue but if we agree on this issue, let's see
how we can work together, >> Absolutely.
>> And I think that's the political issue and it's changed, that people,
some criminal justice reform people are having problems with coping with
that in itself.
>> Yeah I think that's a wonderful way to end our discussion today,
and I just wanna thank you, Jared Williams, Soros Justice Advocacy
Fellowship Finalist we wish you the best of luck with that and we thank
you for joining us today.
>> Thank you very much I'm glad to share. >> So that concludes
our conversation students, and we look forward to chatting with you again
soon.
 Module 6: Environmental Justice
 Module Goals
230
You will explore patterns of environmental injustice through the events of
the Flint Water Crisis and with an intersectional understanding of the
communities most vulnerable to environmental hazards that exacerbate
poor health.
 Case Spotlight
A report by Julie Bosman on March
25th, 2016 covering the Flint water
crisis, also notes how quote, minorities
an the poor are treated differently
when it comes to environmental
matters.
Relegating them to some of the most

dangerous places in the country, suc as
flood-prone areas of New Orleans that were devastated after hurricane
Katrina.
Highly polluted parts of Detroit, and the Bronx And Cancer Alley in
Louisiana, where residents who live near factorie suffer disproportionately
from disease, end quote.
For more information about the specific locations and cases of

environmenta justice issues in the United States, check out the
Environmental Justice Atlas.
Zoom in and read about the more than 80 cases in the US alone where
environmenta injustice impacts the safety of food, air, water, built
environment.
And other issues most often effecting minority and low income populations
There are structural factors that perpetuate environmental injustice.
For example, according to Dr Jason Corburn of the University of California

Berkeley Racially segregated neighborhoods, which tend to cluster
economically disadvantage populations and people of color.

Were constructed and perpetuated through governmental housing policies 231
zoning regulations, discrimination in bank lending, an racially restrictive
covenants.
Particular geographic areas and neighborhoods are sometimes the only

places welcoming or affordable for vulnerable populations.
Those neighborhoods also often suffer from lower property values Meaning
less revenues for local school districts, closer proximity to industria
pollutions and fewer health promoting resources such as grocery stores.
As many American cities Flint was having a difficult tim recovering from
the great recession.
When the front water crisis began, the city was under emergency
management That's when the Governor appoints an administrator to over
see all city o municipality operation.
Most often the goal is cutting cost to prevent that city from going bankrupt
o manage it back to health if it already has gone bankrupt.
Michigan is one of the few states in the nation that has emergency
management law and uses them broadly and frequently Of interest in 2013
just before the Flint water crisis, one half of all African American resident
in the state of Michigan lived in a city under emergency management.
Unfortunately, emergency managers in Michigan answer directly to the

Governor.
They are not elected and their power to make decisions replaces the power
of loca mayors, city councils, and other locally elected governments.
They are not accountable to the people whose lives they make decisions
about And that's a large piece of the back story to the Flint water crisis.
Flint also has a history as an industrial city But as the auto industry shifted
and the many manufacturers who used to buil cars and car parts in Flint
closed down or relocated.

The city once bustling with over 200,000 people, was devastated The rising 232
unemployment rate contributed to rising crime and rising rates of arson.
Falling housing values and relatedly poorly performing an frequently

closing schools If you're interested in how the history of Flint over the past
30 year has set the stage for the Flint water crisis my I suggest a still
relevant documentary by Michael Moore titled Rodger and Me.
And an article about the fall of the auto industry in Flint which I'll post as
supplemental material.
Take a moment and review this brief timeline outlining the major events
that characterize the Flint water crisis.
Many less publicized, bu still significant events, are not represented here
For example, in June 2014 local officials mocked the residents of Flint on
television for complainin about the water quality and quote, wasting their
precious money on bottled water.
So please visit the up-to-date and interactive timeline published by the

Detroit Free Press for more thorough accounting.
After listening to this excellent, and award winning broadcast documentary

by Michigan Radio, on the story of one Flint resident who had a significant
role in bringing this crisis to light.
I want you to reflect on her experiences, an answer the three questions

about what you heard.
We can't really call the ever-changing happening around the Flint water
crisis, aftermath It has been three years since the crisis began.
But it took nearly two years for state officials an the governor of Michigan
to believe the residents of Flint To put their health, needs, and well-being
above financial considerations.
And stop sweeping this epic injustice under the rug So, in fact, the recovery
has just begun.

As recently as November 2016, the state of Michigan was appealing federa 233
court rulings that required them to deliver water to all resident who were
unable to maintain water filters in their homes.
The state has since settled that lawsuit an agreed to begin replacing a
fraction of the lead service water lines in the city.
To fund specialized early education programs for five years to keep some
water distribution centers open for another year, an other measures to begin
the process of healing for the festering wound.
In the interim, city residents have suffered from outbreaks of sometime

deadly legionnaires' disease and a harmful bacterial infection called
shigellosis.
That often is transmitted when people do not properly wash their hands.
In this case, likely because of the fears of exposure to lead contaminated

water.
In December 2016, former President Barack Obama signed a bill from

Congres to direct $100 million to the state of Michigan to aid in the Flint
recovery.
The EPA administrator has just begun dispersing those funds in March of
2017.
Despite these promising developments, residents of the City of Flint wh

already paid among the highest prices in the state of Michigan for water
services have recently lost their subsidies.
That the state was providing to each resident to reduce the monthly cost o
paying for contaminated water.
Now several residents are facing water shut offs.
Flint's former emergency managers are now facing criminal charge of false
pretenses, conspiracy to commit false pretenses misconduct in office and
willful neglect of duty.

Those emergency managers are Darno Early and Gerald Ambrose. 234
They joined one employee of Flint's Water Plant and eight state officials
including a state epidemiologist who is accused of misrepresenting water
testing data.
And the former leader of the Michigan Municipal Drinking Water Office.
Two officials have accepted plea deals and the rest are awaiting trial.
The longest and most painful recovery belongs to the residents of Flint.
Many of whom have completely lost trust and faith in their government an
whose daily lives have been impacted in every way possible.
Others are wondering what the long-term cognitive an behavioral effects

will be for their children.
Or what physiological price they will pay long-term fo lead exposure along
with three years of constant stress and worry.
In March 2016, the Flint Water Advisory Task Force appointed by

Governor Snyde to investigate the Flint water crisis and make
recommendations for the future.
Issued a scathing report that definitively stated that race an lower income
status of Flint residents certainly contributed to them bein the victims of
environmental injustice, in a way that more white an affluent communities
would never experience.
The report laid blame on a wide variety of state, local, and even federal
actors, an issued 44 recommendations for helping Flint to move forward.
You can read the full and final report of the Flint water advisory task forc
in the supplemental materials for this course.
Now, let's listen in on a discussion with Dr Vicky Johnson Lawrence who

has been working deeply with the residents o the Flint community for the
past several years.

 A Conversation with Dr. Vicki Johnson- 235
Lawrence
Welcome back everyone.
I am here with Dr. Vicki

Johnson-Lawrence. She is an
Assistant Professor of Family
Medicine in the Division of Public
Health and Adjunct Professor of
Epidemiology and Biostatistics at
And she's also a visiting Assistant Research Professor at the

University of Michigan Flint, Public Health and Health Sciences.
Welcome. >> Thank you. >> I'm so excited to talk to you today about
your work. You are working deeply with Flint residents on a number of
health issues.
And you have several projects going, and so I can't wait to kind of dig
into some of these projects. So I know that your work focuses quite a bit on
addressing social determinants of health and you have an specific focus on
multimorbidities.
Can you tell us what multimorbidities is and then how you came to do
this work combining epidemiological methods with community
engagements, with working with Flint residents.
>> Yes, so my interest in multi morbidities really stands from this

notion that people tend to have multiple issues going on and the chronic
disease prevalence in our country is relatively high.
And realizing that often times, we study diseases as individual entities

as opposed to the person who's managing multiple conditions brought me
to really think about when somebody has multiple chronic conditions.
And when they have to treat and care for free each, and ideally we'd
decide the notion of curing each one in the back of their minds.

>> Yeah, so multimorbidities in a nutshell is like not only you have a 236
potentially diabetes, but you could also have heart disease. >> That's right.
>> And one body can have multiple diseases, >> That's right.
>> And so what you're saying is our traditional notion is that we treat
the diabetes and the heart disease, but not the one person who is managing
multiple things?
>> And in clinical work there is a lot fo effort to treat them, but in
epidemiologic work, we tend to study them individually. But will adjust for
the other conditions people have as control variables or other pieces that
might complicate the original disease we're studying.
I'm suggesting we should study the package. And there's been work to
do this, so metabolic syndrome for example, is studying, in essence,
multiple cardiometabolic conditions.
>> And so we're talking about conditions that have to do with what?
Energy expenditure, with? >> Usually with the heart. >> Okay.
>> So metabolic syndrome for example, tends to look at diabetes

related risk factors. They look at blood pressure, they look at cholesterol
levels, they look at weight, and- >> So they kind of sound like regulatory
conditions. >> Right, for the metabolic system.
>> Right. >> So absolutely metabolic syndrome is one such

examination of multiple conditions, because we know they all increase
your risk of heart disease.
>> Right. >> And I think about the same sort of idea, but with the
relationships in mind for mental health than physical health. >> Interesting.
>> So that's where, much of my multi morbidity work focuses. On

people who are managing mental health concerns at the same time as
physical health concerns.
And how they can begin to think about curing them both, but
realizing they can both make their health situation much worse. So I've
been doing that for a number of years, thinking about prevalence, thinking
about some of the very descriptive epidemiologic approaches to
multimorbidity.

And I always get asked questions about which comes first? And I 237
might argue that for the person in this moment trying to manage them both.
The question of which comes first comes after the question of how do
I get rid of them both now? >> Right. >> And in Flint, as I've moved
toward a community engagement approach, more of my efforts have come
to address what do we now that we know I have both?
>> So you work quite a bit with the Flint community. You're also a
resident of the Flint Township community. >> That's right. >> Which is
adjacent to Flint. >> Yes.
>> And so why has your work centered in this area? Obviously, we
know there is a great need related to the Flint water crisis. But you're not
actually studying the Flint water crisis directly.
You're studying- >> Right. >> Some of these conditions that have
popped up or have developed in response to people living through the- >>
Absolutely.
>> Flint water crisis. >> So much of my work, I've said this a couple
times now, much of my work just comes repetitive. >> No, it's fine.
It's one of those academic terms that we use. >> Right. >> [LAUGH]
>> It's just what we do. >> It encompasses everything right. >> I'm a health
equity scholar, and I would really put that as one of my key titles.
And I say that because when we look at Flint, Flint has had a history
of disinvetment. >> Even before the water crisis.
>> Exactly. >> So businesses that have moved away and- >> That's
right. >> Left people without jobs. >> Right, and those sorts of issues have
been compounded in this community that's largely African American.
There's also a lot of economic struggle in this area, unemployment

levels are relatively high.We see that there are many people who have
housing related issues, there's housing stock problems.
When we look at all the issues that were present before the water
crisis. The experience of the water crisis really was an exacerbation of all
the negative impacts of all the things had happened for the last 40 years.

>> Yeah, so people who don't understand finer, have never been 238
there.
They might thing, my goodness, the Flint water crisis happened to a

regular city- >> Right.
>> That was running very smoothly before and then got hit with this
big catastrophe.
But in fact, this actually was the culmination of a number of different

dysfunctions if you will- >> Yes. >> That have been happening for years in
the public sphere that have impacted residents.
>> That is exactly right. And what I've heard since I've been there,
and I've been at Flint since 2013. Since that time I've heard many residents
say, we need more resources, we need access to information, we need
better healthcare.
And it's not that these resources aren't present. It's that residents are
having difficulty accessing them in a meaningful way for them.
And when I think about this work around multiple chronic conditions
and what causes them, I most certainly believe that stressful conditions.
And in particular, a history or a lifetime of stressful conditions makes it
more probable that we will have major chronic conditions happening
earlier in the lifecourse.
So if we think about models of the socioecologic model that talks

about how all of the different social infrastructures can influence one's
health.
I would say Flint is a demonstration of those various institutions- >>

Where you live? Where you work? >> That's right. >> All of these
environmental exposures really increase your likelihood of being
unhealthy. >> Right. >> In a number of ways. >> Very much so. >> Yeah.
>> And I think they're operationalized not just through the institutions
and the actions of such institutions. So for example, if we talk about
medical care.

We know medical institutions exist, and we know they do a very 239
good job at least from the clinical perspective of reaching out into the
community to make sure the resources are available.
But the stress that might be incurred in by the resident trying to get
you those services, it's what often overlooked or dismissed.
>> And everything is connected, right? >> It is. >> So you don't have
good transportation in a city where people tend not to have a car for some
reason, then that's gonna be a barrier to get any health care. >> That's right.
>> Absolutely. >> And I think sometimes we forget that one person
could have to manage ten of those, because they have to interact with a
variety of systems. >> Right.
>> And it can ultimately lead to stressful outcomes, stressful

management, or needs for stress management. And if that stress gets high
enough, and stays high enough, long enough, it contributes to chronic
disease risk.
>> And you're doing a relatively new project related to stress

management for Flint residents, is- >> Yes. >> That right? >> Yes. >> So
and it makes sense, because here you are giving us all this great context on
why, this community in particular might have a lot of stress.
Not only from living through the Flint water crisis, but generations
so- >> Yes. >> Kind of community based issues that haven't been
adequately addressed, what is your new project in tell?
>> So this new projects it's called the Flint Request, and it's resilient
seeing communities after stress and trauma. It's a project funded to the City
of Flint and it's fund of us SAMSA,
Substance Abuse and Mental Health Services Administration. >>

Okay, so it's a federal agency- >> Yes. >> That's giving money to the City
of Flint. >> Yes. >> That's working in partnership with academics like
yourself and researchers- >> Absolutely. >> To bring resources and
research and programs to the community. That's right.
And we are very much focused on building a trauma informed

community. And, this is where it gets interesting, in terms of how we think
about terminology.

>> Yeah, cuz [CROSSTALK] I hear this word trauma informed all 240
the time. >> That's right. And people say, well what are you talking about?
What does that mean?
And what I remind people of is we all go through a number stressors.

Some of these stressors feel minor, some feel like we can manage them
relatively simply.
But the water crisis for many people is an extended, complex, chronic
stressor. >> I mean this is our third year? >> Yes. >> We're three full years
in to them having, right.
>> And they're struggling to, not struggling in terms of having the
motivation to figure out what to do. But the fact of the matter is there are
many people who still don't trust their water source even though we know
that the recommendations are for them to use the filtered water.
So everyone living within the city limits is encouraged to put a filter

on their main water drinking sources and use that filtered water for their
daily needs. But for some, that can be a barrier or that can be a significant
influencing factor in what you do every day.
So there are many people who still use bottled water >> For
everything. For brushing their teeth, for cooking, for showering.
>> Right, because they may not trust their water source. And they
may not trust the information they are receiving, particularly given that the
people who were given, or the institutions that are delivering this
information are also the institutions that originally said the water was safe.
>> When it wasn't. >> Right. So now we're seeing people managing
this complex chronic stressor.
We are seeing people who feel that this stressor is so significant and
it's influenced so much of their lives that it's really traumatic for them. >>
Mm-hm. >> And so we talk about having a trauma informed community,
because we want everyone in our context.
Everyone that we're interacting with to have a framework for

interacting with people who have an experience different than yours. >>
Mm-hm. >> Or who may be going through something that is chronically
and consistently creating stress in their lives.

>> Yeah, and this kind of strikes me because I think about, I can't 241
imagine. Though I've read and listened to hours and hours of podcasts and
talked to other folks and tried to get a sense of what the experience must be
like to every single day wake up and this thing that we take for granted.
This is something that people have at the forefront of their minds in

every single thing that they do, right?
And I can only imagine, I'm thinking about some of the weathering
hypotheses. >> Right. >> Which students in this class will hear a little bit
about later.
That just, they talk about the daily wear and tear. That you don't
realize that even having to think so hard about where you're going to get
clean water.
Whether or not the water you're feeding your children or your elderly
parents is safe to drink, and what the long term consequences are going to
be.
That that stress is constantly wearing and tear on your biological

systems. And it's not something that you can see or touch, or that's at the
top of mind, but it's happening.
>> Right. >> And that means, like you were saying around multi
morbidity, that heart disease may happen to you. And it wouldn't have
happened to you normally, without this stressor, and it may happen to you a
lot sooner than normal.
>> Right, I completely agree, and this actually brings to bear why I
think about mental and physical health concerns concurrently.
If this is a major stressor, and this contributes to post-traumatic stress

reactions, then we should be very mindful of what the mental health
impacts of this water crisis will be.
Not just for those who are directly affected, ie those people who are
having to use bottled water or filtered water every day to do their regular
daily functions.

But also about those extended networks who care for them, and the 242
other people in their networks who may have been affected. That secondary
trauma is real.
>> So you could be a family member who doesn't live in Flint but
you have taken on some responsibility for helping that person get clean
water, or get to the grocery store, or take their kids in for medical visits to
make sure they're okay and that that.
So that secondary trauma is essentially being adjacent to someone

who has gone through a traumatic experience. And then some of that
filtering down to you.
>> Right. And it applies to people who, a lot of the conversation is

about who live in the city proper.
But what we've known now, what we've seen happen is that people
are leaving the city because they're looking for safer places to be in their
own eyes.
So if they move to an area where they no longer live in the city, thus
they may not have this bottled water issue per se everyday, but their
children still go to school in the city of Flint.
Or they work in the city of Flint. >> Right. >> It becomes an

experience that perhaps you're not experiencing this to the same intensity as
a resident. >> Yeah.
There's a residual there, right? >> That's right. >> Yeah. >> And to
me, those are some of the dangers of what's happened with the water crisis.
>> That you think that once you put a filter on someone's faucet,
they're cured, right?
That mentally, psychologically, they should have no more worries but

actually those are some lasting impacts.
>> They very much are. And they'll continue to have to do work with
those filters. They have to monitor their filters.
>> They have to change them. They're not permanent. >> And they
have to do it for any faucet for which they're using these water sources.

So it's it's not of limited impact. >> Yeah. >> It just keeps going. >> 243
Yeah. >> And that is really the concern I have when we talk about what
chronic stress does for our long-term health.
>> Yeah. >> And I worry about this. Much of the attention has been
focused on children aged zero to six. >> Mm-hm. >> And rightfully so.
Realizing that the impacts of lead toxicity can be long lasting and
damaging without proper response. >> Right.
>> So there's been significant effort to ensure that children have the
proper nutrition. That they're getting the medical services that they need.
That their families are getting the services that they need. That
children have access to the mental health services that they need.
In the school system, in the medical system and in the community,

but we also have the adults, that social network of adults who cares for
those children.
We have children aged 7 to 21 who will continue to need attention,

and they get a different level of attention.
Not bad, but we have to make sure we're operating in that same at the
same level of intensity for the other populations.
>> So for example, there are older adults? >> That's where I was
heading. >> I was thinking about who, I remember reading several stories
where people were having to go out and get their water, there was no door
to door delivery of free bottled water.
Well what do you do with homebound adults whocertainly can't leave

the house and can't carry home a case of 24 or 28 bottles of water.
What happens to them? Are we concerned about their health

exposure? >> Yes, and so I wanna make sure I present an accurate portrait,
or as accurate as I can, about the efforts that have been put in place.
So there have been many response is to these different sub-groups in

Flint to make sure that they have information access and that they have
water.

That they have bottled water delivered to them when needed, so there 244
have been a number of efforts to reach out to these less mobile or for
whatever reason, less successful populations to get them what they need.
When it comes to health outcomes though this is where I get very,

very interested and concerned about what our actions are to ensure that
older adults are not overlooked or dismissed in these efforts.
>> And also men as well, right? I know a good chunk of your
research looks at men's health. >> Mm-hm. >> Because that's a population
that we haven't really been talking about when it comes to Flint.
>> That's true. >> We've been talking about women. We've been
talking about children to a lesser degree, older adults. But just able bodied
men, who also are having health issues and maybe have long term exposure
issues, and mental health issues.
>> Yes. >> Related to living through the Flint water crisis, as well
that's a group that hasn't gotten much attention.
>> They certainly have not. I think some of the absence in attention.
It's really because of diversion, right.
Women carry children, children are cared for at least at start,

primarily by mothers. Now, I don't agree that that's the full picture so I'm
not trying to suggest that.
>> But what's limited resources, people kind of direct that attention to
these groups that they think are the most vulnerable. >> That's right. >>
And men tend to fall out of the picture.
>> Right, and I think there are bits of works, there are pockets of
work that are considering what might happen to men of the ages where they
are most likely to have children.
And what the impacts of lead toxicity could be for them. >> So it's
almost like some type of generational link. >> Very much.
>> Could, and these are just things people are exploring, but could
this lead exposure, perhaps it doesn't show up in the health profile of men
who've been exposed, but could they pass this down- >> Right. >> To
children in a future generation?

>> Right. >> Yeah. >> This lead exposure issue is creating, has 245
created a community wide series of concerns. And, The focus right now is,
of course, in trying to mitigate the negative impacts of not just the lead
exposure but
the stress related impacts as well.
And I think we're trying to figure out how to best use resources to
address the needs of the community overall.
And realizing there are limitations in funding, there will always be

limitations in what we can provide. Figuring out who can do what in the
most meaningful and impactful ways is a challenge that we're facing right
now.
And I think we're wadding through it as a community to figure out

who can do what. And who can meaningfully have impact with men?
Who can do it with children? Who can do it with women? Older

women? Older men? I'll also say that in my own personal anecdotal
experience, I went to a couple of the water distribution sites to help.
>> So these are places like fire stations and Red Cross kind of
centers. >> Not even, churches. >> Churches, yeah. >> Church parking lots
where they needed the water unloaded off of large trucks that had been sent
from other places.
And they needed to distribute the water. >> And then people come in
and get water. >> Right, those centers were predominantly operated by
men.
>> Interesting, interesting. And that's a story that hasn't been told. >>
Not often. I've seen more men at those sites unloading, making sure the
water delivery efforts were addressed effectively.
Then, I don't know that I had any prestanding expectations but that
was where I saw men active in this response.
And since then, and that's been over a year ago, a year and half ago
that that was true. But I'm interested now in thinking about how we address
the needs of the collective, being mindful of the needs of men.

Being mindful that the way that they might want to engage is 246
different. >> Yeah. >> Then how we might engage with women. >> Right.
>> Mindful that young men may have different perspectives on what they
can do and should do next than women.
>> To help their own community. >> Right, if you have young
women thinking about whether they'll have children and when that will
happen, I'm not sure that we know very much
about the perspectives of young men in that same vein.
I think there's lots of work to be done, is probably where this hits. >>
Yeah. >> And much to consider there. >> So I wanna get back also to the
work that you're doing on stress management, right.
>> Mm-hm. >> And so what does it look like to build a trauma
informed intervention, or program, that creates access points for people
who undoubtedly have this built up stress from living through this crisis?
>> So I'll start this by talking about a project that I had gotten going
earlier.
By earlier, I mean it was January through April in the year that the
declaration was presented, so last year. >> Okay. >> Last January through
April. I did a mindfulness study.
And the purpose of this mindfulness study was to address whether

mindfulness based activities, sustained over several weeks, would have an
impact on blood pressure management and stress management for older
African American adults.
>> And those are behaviors like breathing exercises? >> Yes,
meditating, thinking and being still, being in the moment is a lot of what
we focused on. And we, as society, we did show significant reductions in
blood pressure for our participants.
We had about 18 people to participate in this small study. And this

happened right as the declaration of the water crisis was made federally,
and just after it was made locally.
And residents who attended the program specifically commented

about having to manage this response.

And for some it wasn't a new responds it was an older one because 247
they had been marching and not been heard- >> Right. >> For the last
couple of years.
They were finding ways to deal with being dismissed. >> Okay, and
that was a part of what they were using the mindfulness to cope with.
>> Yes, very much. It turned out to be a very important and valuable
learning session because what I found is that contrary to common research
literature-
>> Knowledge or belief. >> Yes, mindfulness is just as effective in

marginalized and vulnerable communities.
And in my sample, older African American adults, as it was in some

of the other published studies that looked at mindfulness for improving
coping and stress management in other who are in chronic disease
populations.
So that work really motivated and fueled what we're doing now. >>
[CROSSTALK] This is one potential way to manage stress and perhaps we
could combine this with other methods to better support this community.
>> That's right, and so when you ask about what we're going to do to
build a trauma informed community, we are specifically thinking about
things that people can do as a family unit.
We're looking at efforts- >> So not like you come into this center and
we'll treat you and then you go home, but can we give you tools that you
can operate with in your own household that will help everyone.
>> Right. >> Yeah. >> And deliberately saying, what can we do that
integrates your normal daily activities so you can mindfully brush your
teeth, you can drive.
Well there are some efforts to do mindful driving. There's mindful

walking. There's several exercises, activities, that can be employed as a unit
that doesn't require you to sit still and keep small children still.
Because we all know that's a struggle. >> Right. >> Small people
don't- >> Sit still. >> Right. >> Yeah, they just not what they do.

>> It's not who they are. >> So meeting our community members 248
where they are is a really key part of what we're doing in the framework of
a trauma informed community.
>> Yeah. >> Another big piece of this is to make sure everybody has
the same information about what trauma informed means. So not assuming
that, so there's a lot of work around trauma informed systems in the health
care system.
So making sure that your providers are sensitive to what a traumatic

experience could have done to the patient.
Residents need that information too. There are many first responders,
for example, so when we talk about first responders often times we think of
an EMT.
We'll think of a police officer. We'll think of those people who are
going out to provide a service.
But I might suggest that in the community there are many first
responders as well. >> I think about school teachers. >> Yes, good
example.
>> Who are receiving these children everyday, working with them.
They're coming in fearful of drinking out of the water fountain at school.
>> That's right. >> Having gone through this experience at home,
seeing the stress that their parents are going through, and bringing that into
the school environment.
>> That's absolutely right. We also talk about bus drivers. We're
talking about folks who may work in the cafeteria.
We're talking about pastors, we're talking about all of those folks who
are likely to encounter someone in a highly stressed position.
If that is the case, we should all have this trauma in form and
knowledge and language to use when we're interacting with each other. >>
Yeah.
>> And that is what Recast is doing to begin this process of building a
new normal.

>> Yeah, do you find it difficult, or are there any barriers to helping 249
people understand the Flint water crisis in the context of being a

traumatic event.
Do people automatically say, absolutely, living through this and not

being believed and heard for quite a while, having everyone focus their
attention on you.
And then withdrawing that attention and moving on to the next thing,
which many people have done.
Are there any barriers to helping people see the Flint water crisis in
that light? >> If you're a community resident, the barriers are fewer than if
you're not.
And one of the efforts that we had underway, or that we implemented

to get a handle around how impactful the water crisis had been in terms of
behavioral health, was last year to do a CASPER survey.
CASPER is a community assessment tool for a public emergency

response, and it's done with support from the state and also with support
from the CDC. >> Okay, that's the Center for Disease Control and
Prevention.
>> Right, and so the CDC will come out and will help you organize a
plan to do community wide survey, systematic sampling approach to get a
handle on whatever topic you're interested in.
So for us, it was behavioral health response to the water crisis. And
going out, I did a few of the interviews as well. Going out, what I heard
from residents who were severely impacted, was this is certainly a
traumatic event.
But what I also heard from residents who perceived themselves to be

unaffected is that many of the other residents were blowing this out of
proportion.
They were suggesting that the impacts weren't real. But some of those
folks admitted outright that they would not drink the water.
So they were able to in some ways express discontent with the

experience of the water crisis as traumatic for other residents.
But not engaging or even thinking about how their own actions 250
suggest it might be a concern for them, too.
>> Right, and so these could be folks who perhaps have the
socioeconomic resources to put a whole house filter on.
Or to have bottled water delivered to the house, or even to move out

of the neighborhood. And so, they compartmentalized, in some way, the
massive effects on folks who don't have those resources.
And the way that this event could be, even more traumatic for folks
who don't have those mechanisms available.
>> They're being dismissed yet again. >> Yeah, yeah.
>> And, we see some of that, if you look at any of the online posts,
you'll see trolling to that effect in some capacity. And what I think is
important for us as we build this trauma informed community, is to
acknowledge that those folks will always have that perspective, or there
will always be those who have that perspective.
But it doesn't actually change the perspective of those who've been

impacted. And it's much more important to consider those who've been
impacted, if we plan to improve population health, realizing this is a major
community wide stressor that has influenced this whole population.
>> So the focus really should be on the people who have been at the
center of this crisis as opposed to the perceptions of this crisis on the
outside.
>> That's right. >> Yeah. >> So related to this topic of stress is some
work that you're doing on pain, and the experience of pain and how pain is
managed, particularly by people who are again in the center of this crisis.
What does that work look like? >> So I've been working with a team
here at the University of Michigan to get some additional training around
chronic pain.
>> That's a big topic right now, we've been talking about the opioid
epidemic, yeah. >> And when we think about stressful conditions and we
think about coping behaviors, there's often a lot of conversation about what

behaviors people employ to manage major stressors that they're 251
encountering in their lives.
But also conversation about the ways that these stressors might
manifest in the body.
>> Mm-hm, and one way is pain. >> That's right, stress pain. >>
Right, and so if you think about pain related to something that's a very
distinct injury, you fell off a ladder or you hurt your back at work, right?
But you don't think about pain related to the psychological trauma of
living through something and the manifestation of that trauma is feeling
pain. >> Very much, and if we look at post traumatic stress disorder, for
example, this is one place where this literature has unfolded to talk about
the ways in which persons with post traumatic stress disorders or symptoms
may have various forms of physical ailments that otherwise seem
untreatable, difficult to manage.
They may not have, there may be unresolved issues that are
psychological, or psychosocial in nature that show and manifest in the
physiological structure of the body.
>> So you can't necessarily see it, and diagnose it, but that doesn't
mean that person isn't feel it. >> That's right.
>> Yeah. >> That's what it gets to. And so I moved into this area of
chronic pain because I'm interested in multiple chronic conditions, realizing
that one of the main reasons people go to the doctor is when something
hurts.
You go because it doesn't feel good anymore. That is a form of pain

to me. And it may not be chronic initially, but if you don't resolve the initial
issue, the pain will become either recurrent or chronic.
Now that the water crisis has really exacerbated or really, enhanced
isn't the right word, but created a build up of sorts in terms of the stressors
people are facing, perhaps created some barriers to effective care
management for other conditions they already have.
I'm concerned that we may see peaks in some of these other physical
indicators of poor function, or poor quality of life, like pain. >> Yeah, and
you don't want people to feel like they have to turn to perhaps unhealthy

coping mechanisms to deal with that pain, hence, stress management and 252
some of the other resources that you're trying to put in place.
>> Absolutely, and ideally, we can think about the ways that healthy
living practices. So physical activity, paying attention to what we're eating,
having folks to talk to, so avoiding social isolation where possible, having
social support options, having peer support options, having community
engagement options will provide ways for people to cope and manage with
these various stressors.
And ideally if they're chronic conditions, physical chronic conditions

that might be positively influenced by these behaviors as well, then we're
winning. >> Yes.
>> But so to this point, some of my other work is really focused on

healthy living, what we can do to integrate stress management as part of
healthy living.
How we might integrate exercise and diet into effective pain

management strategies, especially those that don't rely on medication.
Really building this framework for healthy living that includes the
mind and the body and doesn't exclude one, realizing that there are some
effective ways to do it.
They're not popular ways to do it, per se. But there are some effective
ways that we can promote full body health. >> So what I loved about this
conversation is that a lot of the narrative around the Flint water crisis has
been on the kind of dysfunctional policy or government or the hassles that
residents have had to face, but without a real understanding of the inside
experience of those residents.
And also, without a lot of solutions around what we can do to better

support those residents. And so what I've really enjoyed, and what I think
our students are gonna really benefit from is from hearing from someone
who is embedded in this community, who's been doing this work for years.
And who's trying to bring solutions to some of these experiences that

are really deeply felt by the people who are affected, but maybe less
understood by those of us on the outside. >> Yes.

>> So thank you very much for joining us. This has been an 253
incredible and illuminating conversation with Dr. Vicky Johnson
Lawrence, who has too many titles to repeat. >> [LAUGH] >> And we
hope that you enjoyed this conversation.
 Listen & Reflect: the Flint Water Crisis

exercise
 Module 7 - Being a Culturally

Grounded Ally
 Module goals
You will explore the developmental process, roles, and
responsibilities of being an ally as a helping professional. Discussions will
center around culturally grounded approaches to working alongside
individuals, communities, and coalitions to advance an agenda of social
justice. Guest speakers will weigh in with strategies drawn from their
community-based experiences on effective allyhood.
 Lecture
When we ask individuals to be an

ally of other people or important issues,
we're moving beyond the realm of

support or positive regard.
Being an ally involves an

investment. Putting something on the
line to advance the agenda of another
individual, group, or issue.
Some of the lasting lessons I've learned on how to be an ally come 254
from the work of Frances Kendall, the author of the book, Understanding
White Privilege.
If you have an opportunity I recommend reading that book. Miss

Kendall thoughtfully and explicitly walks us through the experience of
working alongside and within communities that she did not grow up in.
She discusses the work of processing her own experiences and

emotions about doing social justice work without putting the burden on
vulnerable communities to assuage her guilt, answer her questions, or
unpack any baggage related to how she had been conditioned as a child.
The following lessons are drawn in part from that book

Understanding White Privilege on how to thoughtfully approach being an
ally.
We all know that there exists varying boundaries in norms depending

on the type of relationship.
In a similar vein, our allied relationships can vary depending on the

intentionality, authenticity, and degree of intimacy. The decision to be an
ally to an individual is often accompanied by a personal introspection.
We often become allies to individuals who for any number of reasons

face barriers to having their voices heard and respected in privileged places
like schools, workplaces, politics, and community organizations.
When we align ourselves with individuals who's voices are

marginalized, it's important that we respect their point of view and
interpretation of events and actions that may impact them.
It can get socially sticky or uncomfortable to publicly support

someone who is marginalized.
But being an ally requires that we be willing to hang in there and use
our platform and privilege to amplify the voices of others with less
visibility.
It's somewhat different to be an ally to an individual, than to advocate

for an issue. Instead of protecting and supporting one person, the goal shifts
to moving an agenda forward.

We are still required to be reflective and filter our actions and beliefs. 255
Through interrogating, who has privilege?. How that privilege is being
used?
And how words and actions are advancing the cause for social
justice? It's also important to view everything in its proper context.
The actions of individuals and groups on behalf of a particular cause

are often informed by deep history, interactions with environment, politics,
and institutions.
Our goal in being an ally is to accomplish something beneficial that

moves entire communities closer to their stated goals.
As we think about how to go about being an Ally to person or an

issue going forward, it's important that we will make mistakes in our efforts
to do good work.
We shouldn't use those mistakes as an excuse, but rather work to

promote a sense of inclusiveness and justice within the organizations that
we are a part of.
And also try to share the lane with marginalized groups and working
to change an organization. However, it can be quite a burden as a person
with a marginalized identity related to race or ethnicity, gender, sexual
orientation, religion, or disability status to be the person always pushing for
a more inclusive school, work place, or community.
It's our jobs as allies to relieve that burden by speaking up. Just know
there might be some emotional vulnerability in speaking up for others.
We should try to process those thoughts and feelings that arise from
being an ally or advocate with support of colleagues. Now, choose an issue
for social change or a group in which you can see yourself as an ally or
where you're already doing advocacy work.
Remember that your motivation for doing this work cannot be

feelings for guilt or shame about the privilege that you hold. Now complete
a brief reflection outlining the issue or group that you're interested in.

Now that we've talked a bit about being a ally, let's touch at some 256
specific strategies for working with individuals and groups in a helping
capacity.
First in working with individuals one on one, it's important to

remember social environment and levels and sources of social support
shape and influence ones behaviour and choices.
So, we must consider how individuals are situated in their larger

environment. And what resources and relationships they have access to?
Think of an individual as the center of a set of concentric circles,

surrounded by formal and informal networks. That might encompass
family, school Work, religious organisations or other community ties, the
physical neighborhood and a range of institutions that impact their daily
lives.
Individual should also be given full opportunity to share those story

and our work should be informed by people's narratives, where they came
from, what they've experienced.
We, as helper should be curious about the ways in which

opportunities, road blocks, and detours have shaped the journeys of the
individuals that we encounter.
And understanding those narratives is the foundation to seeing people

for who they are and working alongside them to help them reach their
defined goals.
Clinicians and families should work together in relationships based

on respect and equality.
Under the best circumstances, practitioners are embedded in their

communities, contributing to community building while working with
families to advocate for services and systems that are fair, responsive, and
accountable.
Petitioners also work with families to mobilize formal, and informal

resources, to support family developement. And engage with interventions,
that are flexible and continually responsive to emerging family issues.

One culturally grounded strategy for supporting work with families, is 257
affirming cultural elements valued by families such as racial and ethnic
identity and language.
When possible, we should strive to incorporate these valued elements

into interventional activities.
When engaging in culturally grounded social work and collation

building activities in community settings, it's important to remember that
racism, sexism, homophobia, xenophobia and any form of discrimination
Can become additional barriers to community development. And also

leaves community members powerless and marginizalied.
Social workers often help to organize communities, improve services,

and or administrate programs that promote well being.
When social workers are doing community based work, they are most
often collaborating with community members to help them build the skills
and
capacities to solve their own problems.

 Discussion: Motivation for Being an Ally 258
exercise
 Interviews
There are undoubtedly many people who see themselves as allies,
and who want to be better allies and supporters of transgender people,
though they may not fully grasp what they can and should be doing to
better walk in those roles.
And so, what would you tell them, folks who want to understand
how to be better allies for the transgender community?
>> I think an important area is just to kinda to be aware and really

question. When you see those forms or you see research or you see people
asking are you male or female, to really challenge that and ask about
whether, is there a different way we could be asking that?
Going back to kinda social workers, as we're involved in research

projects, maybe they have nothing to do with health, or were involved in
social service agencies, or different types of care.
We can be making sure we ask about gender identity in an

inclusive way, and making sure that our policies and our agencies are being
friendly and sensitive to transgender people.
>> Absolutely, so essentially using our voice, being advocates

where we can also, I would say improving our own personal kind of
knowledge around the issue so that we can educate and help others to have
a better understanding of the issues, as well.
>> One thing that I always say is just donating to organizations

that support trans people.

But aside from that, I think, when you do meet trans people, 259
making sure you're intentional about, making sure you're using their
preferred name, or the pronouns that they choose to use.
>> Did you see that? So I have a question about that. So we do

this quite a bit in our school.
Social work, declaring up front what our preferred pronouns are

so that we normalize that and make sure that everyone has that out there
and no one has to make that, has to feel like they are standing out by having
to declare what their preferred pronouns are, as well.
How do you see that translating into the world of work, for
example? And so, I've been in organizations, been in other spaces outside
of the school social work where that's a kind of a knowledge shift, if you
will.
And so, how do we make that, how do we advocate for that, for
example? And spaces outside of social work making those places more
trans inclusive?
>> First of all, it definitely takes social workers to do that. I

mean, we're the ones receiving the training to be able to advocate for our
clients.
But I think to just making sure that, like, we're humanizing trans
people in the workplace, and saying, there are trans people here that you
may not know about, or we have trans clients who come into this facility
that may never tell you that they're trans.
>> That's right. >> You may never be able to look at them and
tell that they're trans. >> That's right. >> And yeah, I think it just comes
down to just overall human decency and just respect for people.

>> Yeah. >> And like one recommendation I always have is that 260
in the workplace, making sure that there is a gender neutral or a gender
inclusive restroom for people to use.
>> Absolutely, and that's something easy that businesses and

agencies can do. >> Yeah, and like at the school of social work, that's
something that they can do, as well.
I know that we have two single stall gender neutral restrooms.

But why not make all of your restrooms gender inclusive? So I think it just
comes down to kind of, with trans people, trying not to make us feel kinda
segregated or isolated, just trying to include us in.
Like, if you wanna be inclusive, that means including people,

including all. So that would be one of my recommendations.
>> When you go out and talk with HR departments and

businesses, educating them not only about trans issues but also LGBTQ
issues, what are some of the tips that you provide for them?
Or the suggestions on how to make their workplaces more

equitable, more accessible. >> So the first thing that I always point out is
their non-discrimination policy- >> So adhering to what they already have
in place.
>> Yeah. >> Or expanding it if it needs to be- >> Right. >> More
inclusive. >> Yep and if their non-discrimination policy, only includes
sexual orientation, talk about including gender identity and gender
expression because as someone who is basically on the job market right
now that's one thing that I look for in all the places that I'm applying at.
>> Absolutely, is this gonna be a place that respects me, that it

sees me as a person that is non discriminatory?

And that will back up those policies protection if someone 261
violates that. >> Yeah, so that's definitely one of the main things that I
recommend and look at [COUGH].
Aside from that though, it really just comes back down to as an

individual working to be a better ally. And when you do come across a
trans person or you do meet a trans person, respecting their pronouns,
respecting their name.
Being mindful of not outing them. It's never okay to just be like,
this is my trans friend. >> Right.
Cuz you don't know if that person is comfortable >> Being outed
whether or not they have expressed that they're ready to do that.
That that is a very personal and private decision that needs to be

left up to that person.
>> Yeah, and some trans people are out in one space, but not out
in another. >> Absolutely. >> So I think definitely just being mindful of
that. Ozone House, they have a group called pride zone which is an
LGBTQ group that meets every Wednesday night.
And I went there and I provided a workshop on what you need to

know about trans rights and post Trump America. >> Interesting. >> Yeah.
>> Can you share a couple of tips for us?
>> Yeah. So it was basically just talking about ways to get your
name legally change quickly in the State of Michigan. >> Because people
are essentially afraid that with and we'll keep it broad here but with a new
administration that is not trans affirming or at least that seems to be the
direction that they're going.

That people feel like they need to take some proactive steps to 262
ensure that they're going to be recognized as who they see themselves as in
every space, and that includes taking legal measures to affirm their
identities.
>> Yep, and one major executive order that Obama signed was
allowing you to update your gender on your passport, and all you needed
was a letter from your primary care physician or from a surgeon stating that
you'd undergone proper medical procedures to live as your new gender.
>> And so, now your international identity essentially, your main
travel document, could reflect your gender identity.
>> Yes, and that's been in effect for a few years now. So I know
that a lot of people are very worried that Trump could take that away from
us. >> Or that that policy could be reversed and that avenue is no longer
available to have your government documents match your gender identity.
>> Yeah, because once your government documents match your

gender identity, then your state license can match your gender identity, as
well.
>> So states essentially take their cue from the federal

government to some degree, right? >> Yep. >> But there's still almost like
a 50 state issue going on, because some states are more firming around
trans rights than others.
>> Correct. As someone who came from Tenessee to Michigan, I

can definitely confirm that. >> That experience is broadly different
[CROSSTALK] know what state you're in.

>> Yeah, because in the State of Tenessee, you can never update 263
your birth certificate >> Okay, so whatever your birth certificate says,
you're stuck with it.
>> Yeah, except for your name. You can change your name on it,
but as far as your sex on your birth certificate, you can never
change it. But in the State of Michigan, you can change it. >> Interesting.
>> So it's definitely state-by-state. >> Yeah. So other tips beyond

folks who had been kind of rushing to get those legal documents changed,
and the other kind of new administration tips that people have been trying
to use to advocate for themselves.
>> I know that, and I can't think of the name of it off the top of
my head, but I know that if you are receiving some type of government
assistance, that certain fees can be waived.
So like when you're applying for a passport, Or your submitting

your documents to get a new birth certificate. That if you're receiving some
kind of government assistance- >> So it could be food benefits.
>> It could be, yeah. >> Yeah. Yep, that they'll waive your fees
for that. >> So essentially if you're recognized by your state or local
government as being a low income person- >> Yes.
>> That you might be able to get fees waived in other aspects of
government interactions. >> Right. >> And to reduce those barriers to you
having your gender identity be recognized legally.
>> And is especially true for going to court to get your name
legally changed. >> Because there's some significant fees associated with
that. >> Yeah, and it cost roughly between 250 to $500 depending on the
state that you're in to go through with a legal name change.
So I know that in the state of Michigan, and this isn't the case for 264
Tennessee, that they will provide assistance for that if you're receiving
some form of government assistance.
>> Yeah, so one of those tips would have been encouraging

people to make use of those resources, if they're eligible. >> Yep. >> Yeah.
>> Yeah, any other kind of instructional strategies that you provide for
your clients?
Or folks that you've done trainings with around just being

proactive about how to protect themselves, protect their mental health as
well, in these turbulent times. >> I know at the Spectrum Center we have
some programs that you can go through that if you're a first year student
you can receive a mentor who is LGBTQ.
So I definitely recommend the new students at U of M to go

through that. We also have MyVoice panels which allow students,
community members, faculty and staff to sit on a panel that identifies
LGBTQ, and share their story depending on the classroom who requested
it.
So for example, in 504 you could submit a request saying, I want

a MyVoice panel. And you could say, I want a MyVoice panel that focuses
on queerness intersecting with socioeconomic status.
>> Wonderful. >> So then we would send that out to all of our
panelists and then four or five- >> Whoever was able to respond they could
come in a provide that resource- >> Yes.
>> And answer questions. >> Yep. >> What a wonderful

resource.

We'll definitely make use of that in the fall. >> Yeah, so we do 265
that which I think is incredible. And then aside from that, really just, in my
opinion it's very small things that you can do to change your overall, Your
overall perception of being an ally.
I think just being super mindful of people's pronouns, their gender

as a whole, and just remembering that there's a person inside of there.
>> At the end of the day whether you understand someone's

gender identity or not, that you treating people as human beings first and
foremost.
>> Yep. >> I mean there was a time in my life long ago that I
thought being an ally was just I like this particular population.
When I know someone who has been oppressed in some ways. >>
Right, so I support them. >> Yeah, then I'm gonna help them out, right.
>> Right, right. >> And I make a differentiation, because I mean,

a lot of people say that we will support certain things, and to me support is
not just say, I like someone and I'm supporting it.
>> Right, no there's an action, right, there's an action component

to being an ally. >> Sure it's going to the demonstration or providing some
emotional support or financial support to your cause.
>> Showing up. >> Showing up somehow. So I used to think that

one could do those things, and I still think that one can do those things, and
that would make you an ally.
But clearly mean that this course has changed over time.
Nowadays, not every marginalized, and I put it in quotes because it's only
marginalized when we marginalize, right.

But groups that have been marginalized and oppressed in many 266
ways, there are conversations inside those groups about being an ally, being
someone that the group chooses.
So to what extent one can be an ally without sanction from the

group is up for discussion.
>> So essentially saying it is okay to support a community or an

individual who has been disenfranchised in some way.
But also that community or that individual should be empowered

to reach out for your support or want your support, that we can't just kind
of barge in- >> Exactly.
>> Essentially, and declare our intention to help without being

invited. >> Well because in some ways it could be actually be
misconstrued.
>> Sure. >> Or construed as, well as barging. >> Sure, like we're
not saviors, right. >> Exactly.
>> So, yes, so we have to kind of walk this really fine line around
wanting to provide help and support, but also being welcome in those
communities- >> Exactly.
>> And being seen as partners, and sometimes it takes some

relationship building to be invited in. >> Yes, and I think it's not too, I
mean this not to inhibit people from wanting to be allies and wanting to
help- >> But there's a way of going about doing even that work.
>> So a few things I mean I can send financial help to an

organization that is trying to help refugees for example.
But that does not necessary need to make me an ally to refugees,

it makes me someone who wants to support a particular cause.
>> Right. >> Right, I think as we approach groups and provide 267
more than more supports, I think we enhance our chances that the group
then now is interested in having us helping them.
And the maybe, I think it's easy to let someone call you an ally
then to call oneself an ally.
What I have learned over the years in terms of my research and

my teaching, is that if there's anything it really should be who you are,
right.
I mean, I think that what I have learned more than anything is

authenticity. It's to be that person that you really are when you go to sleep.
Where there's no pretense. There's nobody watching. It's only you

and your pillow. Now, in that moment, hopefully you are your most
authentic self. And try to reproduce that during the day with my students,
with my colleagues, and my collaborators.
Anywhere that I go. And I think that, what I get back by behaving
that way is this confirmation that people do see when you're being
authentic.
And I am not sure authenticity is the same thing. It looks the same
all the time. I mean some matching life is political, right. But even things
that are political I think we need to be very clear about them and not
pretend that they are not there.
I mean I'm not going to pretend that when I'm in a meeting

defining these 30 aims for particular research and what it is that we are
going to do.
I'm not going to pretend that I have the same exact power that
someone in the community who doesn't have a PhD has. >> Right.
>> Someone in the community who may have had a high school 268
diploma, who's extremely interested in doing the kinds of things that I do.
>> Sure, but does not have that level of knowledge or

connections- >> Or skill. >> Or skill, right.
So, would you say that it's kind of incumbent upon us as those
who are at the table, who are in the room when some of these decisions are
being made, to just find opportunities where we can to leverage that power,
to leverage that awareness?
Or to leverage that privilege that we bring and that that also is a

part of understanding our role as allies.
>> Absolutely, I mean I think that that's the first thing. It's really
creating the awareness of what's happening.
I think so much nowadays is about this funny fake reality of

things. It's almost like we are trying to talk about things and create
situations that look a certain way.
It has become this thing that making something look like

whatever it is. And I think what I try to do, and I think what we need,
totally is authenticity.
It's not trying to create a reality, it's be what the reality is. >> Yes,
yes, and bringing your authentic self to communities and causes and things
that you want to support, that you genuinely feel an affinity for, and
allowing people to take you as you are.
>> Yes. >> As opposed to presenting something that you're not.
And be sincere, right? I mean speak from your heart and

acknowledge the differences and acknowledge the similarities.

I mean this faded economy in collaborative research in teaching 269
where there is this thing about the collaborator from the community.
[INAUDIBLE] or the collaborating with the teachers being the student.
And I think that sometimes is that academy in many ways erases,

well if it doesn't erase, it obsequious some of the experiences that we may
have.
I'm not just a researcher, if 20 years ago and 10 years ago I

participated in research as well. It's not that I have never been a research
participant. >> Right, on that side of it, right, exactly.
>> So I have been there. I have lived in poor communities.
I'm not saying that ever researcher has the same history in their
lives. But I happen to be someone I cannot speak the language of someone
who's living in poverty today, but I know what poverty is from my own
personal experience.
Once you research it it doesn't mean it's the only thing that you
are. >> Right. >> And in my case I happen to be someone who has all the
work of a practitioner for the last 20 years.
>> Right. >> So I know what it is to be in a community based

organization and providing services to- >> And so you can leverage that
knowledge.
You can bring that to the table as well. >> Exactly, and I think
that even if you don't have those experiences, you meaning anybody who is
a researcher, That person, even without those experiences, still can work
collaboratively.
>> Absolutely. >> There's got to be something that one can see as
similarities. >> Yes.
>> And always acknowledging the differences and working to 270
build some kind of alliance. >> You need to be able to be analytic about
causes of injustice.
You gotta have an aspirational vision of what justice could be.

And there are lots of theories out there about what justice could be, and
some of them are not very compatible with social work values.
But if you don't know what they are, you can't challenge them or
edit them or change them. So I think you gotta have this bigger picture of
what you mean by justice that isn't just incremental.
>> Mm-hm. >> I think our actions are often need to be

incremental.
But you want- >> But our vision should be bigger. >> Our vision
should be bigger, and your actions should be headed somewhere and not
just whack a mole.
>> A problem pops up. You try to get that. >> And you solve that
one. You wanna solve that one in a way that moves you towards where you
wanna be, and doesn't just chipping away at problems.
I'm mostly self taught around social theories. Had a lot of

psychological theories when I was in school myself. But I do think thinking
about causes of things and where they come from and understanding also
what sustains injustice.
So, that you can at least maneuver around those things, or

hopefully reduce them or eliminate them, is important.
And I think theorizing, and having good skills for theorizing. And
that's not just content knowledge about the theories. It's really habits of
mind, and learning to think very analytically and to have multiple lenses
that you can put on and take off- >> To view a problem. >> To view a 271
problem or a goal or even to push your aspirations further than they are.
Since none of us live in a just world, we don't know what one

would look like.
You have to be able to imagine some of it. So that's what's gotten

me into this and I have just seen so many well intended people who have
all the best heart.
About what they're doing, contribute to injustice because they are

not able to analyze- >> Yes. >> How their own behaviors are actually
reinforcing. Or at least not challenging the sources of the injustice that
they're trying to help people do deal with.
>> Absolutely.
>> Well one thing I think is important though is that the code of
ethics and
social work.
A part of the code of ethics is promoting the agency of the client

or
the people that should working with.
And because of that, I think social work is uniquely positioned.
Because social work thinks thinks about structural issues and
social justice to empower young people that work.
So no just delivering services, not just speaking on behalf of.
But engaging this relationship building

to support young people's ability to address issues in their 272
community.
>> Yeah. >> That's not to say,
and I do want to clarify this too.
That's not to say that the owness on social change is young

people.
>> Right. >> Right,
that's not to say young people should have the sole responsibility
for shaping or
shifting things in their community.
>> But they certainly should be at the table.
>> Exactly. >> When we are talking about this things.
>> Exactly.
>> And given enough opportunity to do what they can and
to, we should be encouraging them.
And we should be empowering them to know that they do have a

voice.
In shaping the future of some of this issues that are directly

affecting them.
>> [INAUDIBLE] >> And there are tools they can use
even as young people to contribute to the work that is being done.
>> Absolutely, yeah.
>> Yeah and then social work plays a big role in that.
>> It does. I think it plays the most, 273
in my opinion bias.
I feel like it plays one of the biggest roles in it.
 A Conversation with Dr. Rogério Pinto
I am honored to be here with Dr.

Rogério Pinto.
He is an Associate Professor of
Social Work at the University of
Michigan.
And he's gonna be talking with us

today about his expanse of body of
work.
So, thank you for joining us.
>> My pleasure.
>> So I wanna talk with you to start about your work,
your expertise really, in community-based participatory research.
You're doing also work on transdisciplinary collaboration to improve
service delivery around HIV, is that right?
>> Yeah. >> Can you tell me
a little bit about that body of work?
>> Sure, and I've been caught anything to professional collaboration.
>> Yes, I'm sorry.

[LAUGH] >> No, you don't. 274
Because yeah, I actually published few papers, but
I call it transdisciplinary collaboration, but those things changed.
>> Yeah. >> And we change along the way.
Wow, community-based participatory research.
>> Yes. >> CBPR, so
we're gonna be talking about CBPR.
So that everybody knows what it is.
For a long time, I, even as a student, when I was doing my masters

program,
I had been quite preoccupied with the idea that all of the papers that I
read for
my classes were all about what the researchers were thinking about.
And what the researchers thought might be important for my clients.
And I felt there was always a voice that was missing there,
which was the voice of my clients.
>> Absolutely, what they want, what they need.
>> Exactly.
>> Yeah. >> And so
their preoccupation stayed with me along the way.
And when I became a doctorial student, I saw that there was a way
for
me as a researcher, as a doctoral student, but

as someone who is becoming a researcher- >> To kind of open a door 275
for
those clients, yeah.
>> To open the door for clients, and not only clients,
I mean gatekeepers in communities or
anyone who cares to have some opinions about the research that I was
about to do.
And so I tried from the very beginning,
to read as much as I could about community-based participatory

research,
CBPR, so that everybody remembers what it is.
And I developed, for many years now,
specific ways that I like to use the voice of communities to inform,
not only my research questions and how I ask those questions, but
also to inform the process of any kind of research that I do,
be it in New York City, or in Michigan, or in Brazil, or in Spain.
And what I call community here is not just clients,
it's practitioners, like- >> So stakeholders,
all kinds of stakeholders.
>> The stakeholders, all types, administrators.
It is very important to be thinking about research that will go back
to community-based organizations, research that will go back to

hospitals and
places where social workers are delivering services, and

hopefully, services that are evidence-based. 276
And so what community practice, what our research tries to do, and
what I have been
trying to do, is to involve as many voices from the very beginning of

the research.
So that when we have findings,
those findings can go back in a much more holistic and organic

fashion.
Well, what we know as researchers is that, that process of bringing

many, many,
many voices to the table can be messy.
>> Yeah. >> How do you navigate that?
How do you have, that your current project if I'm understanding

correctly has
hundreds of clinicians, right?
Over what 30 service agencies who are giving input and working
together,
how do you navigate and manage all of those voices?
>> So there are a few ways to do it,
I mean you can't involve everybody in the community.
I mean it's not even the purpose of community-based participatory

research.
But just as an example, so for many years,
I have been developing community collaborative boards.
And usually, research in the past, and we see a lot of people do

research that way.

You apply for the grant and you received the funds to do the research 277
and
at that point, you convene community advisory boards.
People will in some ways provide opinions and
expertise to the kinds of things that may be happening along the way.
My idea for community-based participatory research is that, and
I have done this for many years now.
I work with a group of people,
not everyone is involved in every single piece of research that I do.
But the people that I have been working with, some of them having
around me for
10 years, 12 years.
And the beauty of doing this- >> See if that is existing relationships.
>> When capacity, right,
I mean you teach a group of people about how to do research, how to

collect data.
How to look at the results, how to read and interpret results.
And those people go away, and then I have a whole new set of people
to work with.
What I try to do is to keep as many as I can, so that you have capacity

building.
And people who have now learned so many things about research,
don't have to be relearning it all over again.
>> Absolutely.
>> So I have worked with the collaborative boards for

many years, and so you go from one project to the other. 278
>> But there's some continuity.
>> There's some continuity- >> And
communities involvement in these projects.
>> Exactly. >> Okay.
>> So, for example, in New York City, I have a project that involves,
it's a long [INAUDIBLE] project, so we are interviewing practitioners

three times.
>> So, these are service providers?
>> These are service providers, and the baseline for this study was
379 people.
Of course, I'm not gonna be meeting with 379 individuals to learn

what
their voices are, in many ways, by collecting a lot of data from them,
I will know what it is that they are thinking about a number of issues.
But before I even go to them and ask them questions, there is a

collaborative board
putting together the questions that we are gonna be asking those 379
practitioners.
There is a committee of people involved in what is the process for
collecting those data?
Who will collect the data?
And so many of us actually go out in the field to collect the data
instead of hiring people who may not have any
knowledge about the projects- >> Or the community.

>> Or the community. 279
>> Right, and so many of the people who actually I involve in the
collaborative
boards, who were there to win the grant to be written.
I mean those individuals, who actually helped me, write the grants.
So we are all in many ways collaborate us on a grant that we all know

very well
about, because they help with specific aims, they help within
methodology.
>> Sure. >> And the beauty of doing those things,
one is the capacity building that we just talked about.
And the other one is that many of those collaborators work for
the agencies where we were collecting data.
>> So they're embeded in these communities structures-
>> In many ways.
>> In many ways, awesome.
>> Some could be practitioners, some could be administrators.
And so it doesn't guarantee that the findings
of this study will actually go back as a matter of course, but
it enhances the possibility that those results will get back to
the community-based organizations where they can then be used.
>> Absolutely.
>> One thing that we do as well,
in this particular project because it is longitudinal.

We have developed reports for the baseline, and 280
we're just in the preparation of another report, which we'll show the
longitudinal
changes that occurred among the 379,
but not quite 379, because we don't have 379 for the follow up.
But, as many as we should.
>> Yes, it happens all the time.
>> Yes, it's more than we thought would happen.
I mean one of the thing that practitioners, social workers and
many other types of practitioners who are employed.
In a community based organization would be much more,
would be very easy to follow up in terms of a longitudinal study.
>> Sure. >> Well it's not necessarily so.
They said it was funded in 2012.
At a time where HIV research and practice really changed

tremendously.
And many agencies actually lost funding.
They had been losing funding since 2008.
>> Yeah, and as a result they probably lost workers.
>> And they- >> So a lot
>> A lot of those folks who were a part of
your study and doing this community based participatory work may
have moved on.
>> And they did.

>> Yeah. >> So, you see not only initial retention, 281
in terms of like actually losing people >> But
just not even knowing where they are.
Because, they left the agency and as much as we try to track them.
I mean some people move out of state, it's a complicated thing.
But I think it's very telling, I mean one of the things that I
love to highlight in this line of study >> Practitioners are usually not
studied
longitudinally.
They are usually studied- >> So
that you get a snapshot of what practitioners think or
what their needs are, their relation to the population of interest.
But you don't necessarily track those changes over time.
>> Exactly. >> Yeah.
>> So this gave us an opportunity and
chose to see how the environment changed and ask the question.
I mean, is that any correlation and connection between the

environmental
changes and how practitioners change the way they think about
certain things and
how they practice >> HIV in particular,
right or HIV or individuals who experienced HIV.

>> And one of the things that we most I mean the major behavior that 282
we
are interested in is whether or not practitioners
helping clients to access HIV testing in primary care.
So those are very important behaviors that, and
it's simple when you think about it.
Of course, we must be making them before.
It's not so.
In the frequency that practitioners make those referrals.
It's very different from agency to agency, from practitioner to

practitioner.
So we are trying to learn what it is that actually in some ways

determine
>> Yeah.
>> How practitioners behave in relationship to many behaviors but
specifically about >> Those behaviors.
>> Those two behaviors.
>> Yeah. So you've done this work not only in the
United States, in New York in particular but also in other countries as

well.
>> Yes. Particularly in Brazil.
>> Yeah, any lessons about the difference in facilitating those

collaborations,
setting up those community based partnerships that have translated to
other countries or translated from your work in Brazil to the US.

Sure. 283
So the way research actually is conducted,
in Brazil it's quite different than it is in the United States.
Nothing with the dollars.
I mean, the dollars are basically the same.
I'll just give you a few examples.
For example, in the United States, it is common to give some

incentive for
someone to- >> Mm-hm, absolutely.
You want someone to participate in your research, you give them a

gift card.
Or you make it easier for them in some way to participate.
>> And so you may give them like a gift card for $30.
>> Right. >> So they would you know, in Brazil,
you can't do that.
I mean by law, you're not allowed to provide incentive.
>> So people have to participate of their free will and
there can't be any incentive.
>> Altruistically.
>> Okay. >> So then in any ways already
makes a different Right I mean as to who participates and who

doesn't.
Rates of participation are very high in Brazil.
And in Spain where I have done research as well,

there is no law in Spain that actually prohibits giving incentives, 284
but culturally and socially it's not encouraged.
So in those two places where I have done research,
I have not been able to provide incentives.
I mean you can provide refreshments or something.
>> Right, but certainly not a cash incentive.
>> No, you can't give cash incentives.
>> So it sounds like a big part of being a researcher who does work in
multiple
countries is having to be culturally grounded and what the norms,
not only the laws but also the social norms of those particular
societies.
And adjusting your research accordingly.
>> Well you're adjusting how you yes in many ways
>> How you recruit?
How you retain?
Covers of people.
How you ask questions?
I mean there are so many things that we can go on talking about.
>> Yeah.
>> Because it changes, the research is the same.
The methodology in terms of what the questions are and
the surveys might be the same or even the qualitative questions that
you might have.
But the way they are asked and 285
how the research is conducted can be quite different in that sense.
And another big difference in terms of working, I mean to what
extents can one do community based but research when you are in
another country.
Right, I mean the very idea of community for most people
is more geographically defined or it could be identification But
communities we usually think about them as being more

circumscribed.
But if you are doing participatory search, which is community based

in other country,
how does that work?
>> Right.
>> So it is a little different.
I don't have the same structure in terms of a community collaborative

boards
in Brazil.
But I do have a smaller structure with the individuals.
For example my research in Brazil is directly related to
the national unified health system.
So individuals who work for that system have become partners
>> Right
>> In the research and
the work and they have been extremely helpful

in determining a lot of methodologies that we have used For 286
example to collect data and then interpretation of the results as well.
But there is no collaborative structure in Brazil as I have in New York

City.
>> I'm still building one in Michigan.
I mean I've only been here just, >> Yeah, just two years.
>> A little over 2 years, >> But it's coming along and
the idea is to have a lesson structure that we'll continue to work

together
independently as to where the research is actually happening.
So what I'm trying to say a collaborative board in New York City.
Can be very helpful when you're doing research even if it is in

another country.
Because the diversity that you have inside of those collaborative

boards.
I make sure that the members of the collaborative boards
who are working with me are very different from me in a number of

ways.
Not only demographically, but they think in some ways.
>> Yeah your level of expertise.
>> Exactly. >> The knowledge theat they're bringing
about their own communities and their own experiences, absolutely.
>> So it's not that we do,
I like that you say just cause I say that's true all the time.

But the idea of collaboration is not to hold hands and do the same 287
thing together.
Is to do things that are different to have a particular outcome.
If I know exactly what it is that you know it doesn't make a lot of

sense for
us to do it together.
But, if you have a particular knowledge and I have a different

knowledge,
whatever it is that we do can possibly, >> Compliment one another.
>> Compliment one another.
>> To get to a common goal.
>> Exactly.
>> Absolutely.
>> That's the idea.
>> Yes.
I wanna turn this talking a little bit about this community wise project
that
are co-investigator on.
>> Sure. >> So, you recently hosted a community
wise art exhibition and fishbowl conversation, showcasing.
>> Here in Michigan.
>> Yes, here.
Showcasing community-based interventions
ground in a particular pedagogy using art and cognitive behavioral

therapy.
And the goal was to build critical consciousness among 288
individuals with a history of incarceration.
>> Yes. >> And so
I know that that's not your particular area of research but that you're
engaged
with other researchers who have this particular passion or doing this
work.
>> Absolutely.
And so, can you talk a little, I won't even try to pronounce but
I'm going to let you pronounce this particular philosopher's name.
But can you talk about who this work is informed by, and
why this concept of critical consciousness is at the center of working

with these
individuals who have been previously incarcerated?
>> Sure, so there are a few things for us to do here.
So we use community-based participatory research principles
to guide all the research that we did.
And what that means is to make sure that community participation

happens.
>From the inception of the project, and what I mean by inception is

not
the beginning, it's even before- >> It's the thought, right?
>> It's the thought of it.
>> So you go, instead of a very traditional kind of research

community

collaboration where a researcher says this is what I wanna study, and 289
let me go find a community who will let me study this thing amongst
them.
You go to a community and say, what is it that you need or
that you're interested in, and then let me work with you to create a
project
that might meet your needs, and then we walk through that project
together.
>> Yeah, then it's not always perfect, right?
>> Yeah. >> Because sometimes a community may be
very interested in doing something that I don't have the expertise to

do, right?
>> Sure, sure.
And another thing that happens sometimes, that the community may
be interested
in something that I agree 100% needs to be done, but there is no

grants to apply for.
>> That's right, yeah.
>> So it's a combination of actually, waiting for the right moment.
>> Having to find that fit, yeah.
>> And the beauty of working with the same communities and the
same individuals
in collaborative boards, is that sometimes the research that I wanna do

now,
because it is something, that my heart is asking me to do.
This funding should do may not necessarily be what it is we will be

doing in
two years. 290
So someone who was collaborating with me longitudinally may wait.
>> Until the moment- >> Until the moment it's right.
>> Sure. >> So
that's the other beauty of actually working with people longitudinally.
>> Yeah. >> So this project,
I'm the co-investigator.
>> Community-wise, [CROSSTALK] >> Community-wise, and
it is focused on individuals who have been previously incarcerated,

but
also individuals who have history of substance abuse and misuse.
>> Okay.
>> So those are the criteria that we used for this particular project.
It started in Newark in New Jersey.
>> Wow. >> With a professor in Rutgers University,
who is a friend and who is someone who I had been mentoring for
many years now.
>> Mm-hm, mm-hm.
>> And the idea of that project is to help individuals with those
his service to change their behaviors, but
not only using cognitive structures in the way that we see usually
being used.
>> Its kind of traditional therapeutic methods.

>> Where you work with someone to help them understand 291
something's bad,
which is to change that level of knowledge and skill.
So usually those interventions help people to change the knowledge

that they have or
enhance the knowledge that they have about a specific problem.
In this particular case, it could have been knowledge around

incarceration and
about substance use and misuse.
And then we also try to help those individuals change their attitudes
toward
the very behavior that they would like to change.
Such as today I may think that my attitude may
be it's okay to use drug ABC, drugs ABC.
So the idea is to change that attitude to something, well, maybe it is
okay to use ABC, but the quantity of it that I'm using Is not good for
me.
>> Sure. >> And so
maybe I will change my attitude toward that drug so I can change my

behavior.
>> And another thing that we try to change a lot is social norms, so
that individuals who might be performing a particular behavior need

support
from peers in order to help [CROSSTALK] >> And preferably peers

who are not
engaged in the behavior that they're trying to change, right?

Yeah. 292
>> Peers might be trying to make the same changes.
>> Right. >> So we need to change those norms where
change in the behavior becomes the social norm, etc.
So we can go on and on, but we don't have to.
But, so there are many cognitive things that one needs to change
In order to change a behavior, right?
>> And so what Community Wise does is they don't only use these
kind of traditional,
kind of behavioral tools, but they're also using art, is that right?
>> Exactly, so what we have tried to do is to use arts to
help people understand those cognitive structures.
But not only in terms of the individual,
the art that we use actually illustrate social contexts.
So the intervention includes six paintings.
And each one of them represents a particular social context
that we think in many ways shape how people feel and
how people think about incarceration and substance use and misuse.
>> So essentially, are you helping this person who's formally

incarcerated
to kind of see how they're situated in a bigger picture?
>> Exactly, and understand how the environment and the very
organizations and

the various structures that created the opportunities for them to use 293
drugs and
actually to see themselves in jail, actually, just as important.
>> Mm-hm. >> If
not more important to their behavior.
>> Right. >> Right?
So that the behavior is not happening in a vacuum.
It's the thing that's happening inside of your heads, right?
So that all your attitudes, all your knowledge and
all your social norms are being constructed inside of
your head without staying influenced of the environment.
>> Right. >> So
what those paintings help the individuals do is to begin to see
themselves in a social context that involves a lot of oppression.
Individuals who have histories of incarceration and
substance use and abuse very often have had very oppressive lives,
not only during the time that they had been living.
But if they are, for example from the Native American
community- >> Sure, or
could be some generational trauma.
>> Generational trauma in the African American community, and so
on and so forth.

So what this intervention tries to do is to understand oppression as 294
one
major factor that influences people's behaviors that lead them to

incarceration,
and to using and misusing different types of substances.
>> And so the way to modifying those behaviors is by understanding
oppression at a very structural level in the way we believe
this can be done is by developing- >> Critical consciousness.
>> Critical consciousness.
>> And in how one develops critical consciousness is by establishing

very
productive dialogues between and across individuals who are in the

same struggle.
So- >> So, seeing your experiences,
your traumatic histories and some of the factors that brought you to
this place
reflected in the experiences of others.
>> Of other people, so vis-a-vis other people's experiences.
And then as facilitators we help them understand where those

structures began
where they are coming from, how they develop and how they
influence behaviors.
And so, Oppression doesn't happen in a vacuum right?
One needs to believe what the oppressive forces are telling them
in order to behave in a certain way. 295
What we hope to do by developing critical consciousness,
is to help people understand that they have something to say about it.
>> Sure, there's some agency, if only to write a new story, right?
Or to tell yourself a new narrative about what the expected outcome

is.
>> What your life has been up to that point, and
what it is you wish your life to be from that moment forward.
In all this structure that we set up in terms of developing critical
consciousness, and tackle oppression as a major variable that is

determining
people's behavior Is based on the pedagogy of the oppressed, and

some other theories.
Critical consciousness being the central one,
that was put together by Paulo Freire.
Which is the person that, you will try to say his name.
So, Paulo Freire is an educator from Brazil.
>> Very well known.
>> Very well known.
Who, particularly in the 70's, developed this strategy of showing
individuals in groups pictures, drawings.
And help them having dialogues about oppression, and
oppressive forces, by seeing some of those forces in the pictures.
And then developing critical consciousness, which,

at the end of the day, is a very simple thing. 296
It's you being able to differentiate between what's real, and
what it is that you're being told is real.
>> Right. >> And becoming more curious to be-
>> About not only-
>> To discern-
>> Yeah, so not only your
own circumstances.
But also the structural forces that have shaped, kind of, the trajectory
of you and
people like you.
>> Exactly.
>> Yeah. >> As I was talking to
my colleague the other day.
It's helping people differentiate between, what's an fact and
what's an alternative fact.
In the way we see things, nowadays.
>> Right, absolutely.
>> So there's a construction of a reality.
And so, as someone who has more critical consciousness, you

become a better judge.
About the extent which, that reality is truly your reality.
Or it is somebody else's reality, that you're being told is your reality.

>> Sure. >> You're ugly, you are marginal, 297
you're bad.
>> Right. >> You're poor, you're all these things.
>> And you don't have much power to escape those circumstances,
right?
>> No. >> Right, yeah, absolutely.
>> So, having critical consciousness gives you the necessary
internal capacity and energy.
To ask more questions, and then become more aware.
>> Sure, is this an empowerment tool?
>> It's very much about empowerment.
>> Yeah,
do you use these concepts of critical consciousness in your own

teaching?
>> Yes, very much so, and in my research, right?
>> Yeah. >> In many ways, it guides my research.
In that, what I try to do in my collaborative board, and
any kind of research question that I have.
I mean, underneath it all, what I'm going for is social justice.
I mean, that's really what drives my research.
It's what drives anything that I do, in terms of my service.
>> Sure. >> And anything I do in terms of
my teaching.

Is to really help individuals, be it my students, 298
my collaborators, practitioners that I might be interested in.
Either develop critical consciousness, or become, each moment,
better aware of what it is that's happening around us.
And so with my students, the same kind of dialogue that I was talking
about before.
Those back-and-forth kinds of conversations,
that really make one become, not only more aware of things.
But more critical about information that they receive from the
environment.
>> A better filter, right?
>> A much better filter, so that's what I try to help my students

become.
Practitioners who can discern between what's real and what's not.
So that when they're providing services to their clients,
they can establish that same kind of relationship, right?
So in my classroom, I'm interested in developing a relationship with

my students
that's very much mutual and equal.
My teaching philosophy is really based on Paulo Freire's philosophy,
and what he believed, more than anything else.
That we have, within ourselves,
all the information that we need, not only to survive but to thrive.
>> Yeah, yeah.

>> And as a teacher, he believed, and 299
that's what guides my work, is that that knowledge is already there.
And what I may have, as a teacher, is a set of tools.
That I can use, to help my students bring that knowledge out.
And I'm not saying that one doesn't have to read a book, or whatever.
I want to make that very clear.
I mean, it's not that we have all the books that we need inside of our
heads.
But we do have the discernment, as to what it is that we need,
in order to behave in a certain way.
In the case of social work students,
it's how to be the best practitioners they can be.
So I make the assumption that we all have the knowledge.
And if we bring the tools that we have as teachers,
we can then build on that knowledge.
And create these skills, that we need to provide services, to do

research.
And to do whatever it is that we are trying to achieve.
>> Absolutely.
So, one of the things that we're doing in this course is,
we're trying to understand how to be better allies.
How to be better partners to individuals in communities who are

trying to affect
social change.
Are there any take-away messages that you have from your work, 300
from your extensive research, on how to be better allies?
How to partner with individuals and communities,
particularly marginalized communities, to help them make change?
>> That's hard, right?
I mean, because there are at least two ways of thinking about being an
ally.
I mean, there was a time in my life, long ago, that I thought, I mean.
Being an ally was just like, I like this particular population.
Would I know someone who has been oppressed in some ways?
>> So I support them.
>> Yes, and I'm gonna help somehow, right?
>> Right, right.
>> And I make a differentiation because,
I mean, a lot of people say that we'll support certain things.
And to me, support is not just, say, I like someone, and I'm supporting
it.
>> No, there's an action, right?
>> The support really needs work.
>> There's an action component to being an ally.
>> Exactly, yeah, it's going to the demonstration, or
providing some emotional support, or financial support.
>> Showing up, of course.

>> Showing up, somehow. 301
So I used to think that one could do those things, and
I still think one can do those things.
And that would make you an ally.
But clearly, I mean, that this course has changed over time.
Nowadays, marginalized, and I put it in quotes.
Because it's only marginalized when we marginalize, right?
The groups that have been marginalized and oppressed, in many

ways.
That our conversations inside those groups about being an ally,
being someone that the group chooses.
So to what extent one can be an ally,
without sanction from the group, is up for discussion.
>> So essentially saying, it is okay to support a community or
an individual who has been disenfranchised in some way.
But also, that community, or that individual,
should be empowered to reach out for your support, or want your

support.
That we can't just kind of barge in.
>> Exactly. >> Essentially, and
declare our intention to help, without being invited.
>> Well, because in some ways, it could be actually misconstrued, or
construed as barging.

>> Sure, like we're not saviors, right? 302
>> Exactly.
>> Yeah, so we have to walk this really fine line,
around wanting to provide help and support.
But also, being welcome in those communities, and being seen as

partners.
And sometimes, it takes some relationship-building to be invited in.
>> Yes and I think it's not to.
I mean, this is not to inhibit people from wanting to be allies, and

wanting to help.
I mean- >> But there's a way of going about
doing even that work, yeah.
>> Well, so a few things.
I mean, I can send financial help to an organization that is
trying to help refugees, for example.
But that doesn’t necessarily to make me an ally to refugees.
It makes me someone who wants to support a particular cause, right?
I think that, as we approach groups, and
provide more and more support I think we enhanced our chance
that that group there now is interested in having us helping them.
>> Mm-hm. >> And then I think it's easy to let
someone call you an ally than to call oneself an ally.
What I have learned over the years in terms of my research and my

teaching,
is that if there's anything, I mean it's really to be who you are, right? 303
I think that what I have learned more than anything is authenticity.
>> Mm-hm. >> It's to be that person that you really
are when you go to sleep.
Where there's no pretense.
There's nobody watching.
It's only you and your pillow.
>> Right.
>> And in that moment, hopefully, you are your most authentic self.
>> Mm-hm.
>> And try to reproduce that during the day with my students, with
my colleagues,
and with my collaborators.
>> Right.
>> Anywhere that I go and I think that's what I get back by behaving
that way.
Is this confirmation that people do see when you're being authentic?
And I'm not sure that authenticity is the same thing and
looks the same all the time.
>> Mm-hm. >> I mean so much in life is political.
>> Mm-hm.
>> Right?
But even things that are political, I think we need to be very clear
about them.
And not pretend that they are not there. 304
I mean I'm not going to pretend that when I'm in a meeting defining,
they study
aims for the particular research, and what is it that we are going to do.
I'm not going to pretend that I have the same exact power that
someone in
the community doesn't have a PhD has.
>> Right.
>> Someone in the community who may have had a high school
diploma-
>> Sure.
>> Who's extremely interested in doing the kinds of things that I'm
doing.
>> It does not have that level of knowledge, or connections or skill,

right.
>> So- >> Yeah, but so
would you say that it's kind of incumbent upon us as those who are at
the table,
who are in the room when some of these decisions are being made?
Just find opportunities where we can leverage that power,
to leverage that awareness, or to leverage that privilege that we bring.
And if that also is a part of understanding our role as allies.
>> Absolutely, I mean I think that that's the first thing.
It's really creating the awareness of what's happening.
>> Mm-hm. >> I think so

much nowadays is about this funny, fake reality of things. 305
It's almost like we are trying to talk about things and
create situations that look a certain way.
>> Mm-hm.
Mm-hm.
>> It has become this thing about making something look like
whatever it is.
>> Mm-hm.
>> And I think what I try to do and
I think what we need totally is authenticity.
>> Mm-hm. >> It's not trying to create a reality,
it's be what the reality is.
>> Yes, yes.
So bringing your authentic self to communities and causes and
things that you want to support that you genuinely feel an affinity for
and
allowing people to take you as you are.
>> Yes. >> As opposed to presenting
something that you're not.
>> And be sincere, right, I mean speak from your heart, and
acknowledge the differences.
>> Mm-hm.
>> And acknowledge the similarities.

>> Right. >> I mean this funny dichotomy in 306
collaborative research and teaching where there's this thing about the
collaborator
from the community or they collaborated with the teacher being the
students.
And I think that sometimes is dichotomy, in many ways erases-
>> Mm-hm.
>> Or, well if it doesn't erase,
it obscures- >> Mm-hm.
>> Some of the experiences that we may have.
>> Mm-hm.
>> I'm not just a researcher.
>> Sure.
>> 20 years ago, and 10 years ago, I participated in research as well.
It's not that I have never been a research participant.
>> Right, on that side of it, right, right, exactly.
>> So I have been there, I have lived in poor communities.
>> Sure.
>> Right, I mean,
I'm not saying that every researcher has the same history in their
lives.
But I happened to be someone,
I cannot speak the language of someone who's living in poverty

today.

But I know what poverty is from personal experience. 307
>> Mm-hm.
Mm-hm.
>> So once you are the researcher,
that doesn't mean that that's the only thing that you are.
>> Right.
>> And in my case, I mean I happened to be someone who has also

worked as
a practitioner for many years.
>> Right.
>> So I mean I know what it is should be in a community based

organization and
providing services.
To- >> So you can leverage that knowledge,
you can bring that to the table as well.
>> And I think that even if you don't have those experiences.
>> Mm-hm.
>> You, meaning anybody- >> Yeah.
>> Who is a researcher, that person, even without this experience,
is still can work collaboratively.
>> Absolutely. >> There's got to be something that one
can see as similarities.
>> Yes. >> And always acknowledging

the differences. 308
And working to build some kind of alliance.
>> Yeah, I agree.
I think that's a great stopping point.
I have really appreciated hearing about your work, your expertise.
The work not only domestically, but also abroad.
And I just really thank you for being here-
>> You're very welcome.
>> With us today. >> And pleasure.
>> Thank you.
This has been a conversation with Dr. Rogerio Pinto,
he's an Associate Professor of Social Work at the University of

Michigan.
So until next time.
Module 8: Resources and


Activities for Ongoing Social

Work and Social Justice Dialogue
 Listen & Reflect exercise

 Listen to the NPR podcast with Dr. Imani Perry and then answer the prompt
below.
 The Fabric of Our Identity

309
TRANSCRIPT
September 11, 2014
I M A N I P E R R Y : We are agents of our world, right? And so, you know,
we encounter tragedy after tragedy after tragedy, and so then we can become
sort of passive witnesses to all of these tragedies in our midst or we can be
actively engaged. And I think that’s a process of liberating oneself, to be
actively engaged in the world, and in the work of transforming it.
[Music: “Seven League Boots” by Zoe Keating]
K R I S T A T I P P E T T , H O S T : James Baldwin once said that:

"American history is longer, larger, more various, more beautiful, and more
terrible than anything anyone has ever said about it." These words inspired
Imani Perry when she wrote her scholarly book, More Beautiful and More
Terrible: the Embrace and Transcendence of Racial Inequality in the United
States.
Imani Perry acknowledges wise voices who say that we will never get to the
promised land of racial equality. She writes, “That may very well be true, but
it also true that extraordinary things have happened and keep happening in our
history. The question is, how do we prepare for and precipitate them?”
I took her up on this emboldening question at the Chautauqua Institution’s

2014 season, on the cusp of yet a new collective reckoning with the racial
fabric of American life.
I’m Krista Tippett, and this is On Being — in the first of a four-part
conversation about “The American Consciousness.”
[Music: “Into the Trees” by Zoe Keating]
M S . T I P P E T T : Imani Perry is a professor at the Center for African-

American Studies at Princeton University. She was born in Birmingham,
Alabama, where her grandmother was a domestic servant. When she was 7,
her mother matriculated at Harvard and took her to a Massachusetts world of
privilege.
But Imani Perry also grew up spending summers in inner-city Chicago with
her Jewish social activist father. Her upbringing was a joyful, disorienting
merger, she’s written, of “interracial parentage yet salt of the earth Blackness;
of multi-class identity; of Boursin cheese and watermelon, of starched Sunday 310
dresses and holey jeans.” I spoke with Imani Perry in Chautauqua’s outdoor
Hall of Philosophy. It was a day of intermittently dramatic rain, which you
may hear.
M S . T I P P E T T : So, Imani, I want to start, um, just by — I wonder if

you’d tell us about the religious and spiritual background of your childhood.
You know, however you would describe that now.
D R . P E R R Y : So, I am, um, what you would call a cradle Catholic, but
emerging out of — so, my, um, grandmother’s home parish is the Josephite
Parish, and Josephites went to minister specifically to African-Americans.
Um, and so, I was baptized Catholic, but it was in the midst of a kind of
radical liberation theology...
M S . T I P P E T T : And this was in Alabama?
D R . P E R R Y : I was born in Birmingham, Alabama, nine years after the

bombing of 16th Street Baptist Church just a couple of miles away from there.
Um, reared in the kind of traditional black southern working class family. Um,
but my grandmother was also — or and was also an extraordinary woman
who, uh, made sure all 12 of her children went to college, read every single
day, um, she was kind of an organic feminist. Um, deeply independent. And
then, my mother was an intellectual. She was a philosopher, initially, and, uh,
and an activist. She had been, um, a nun at first, so she...
M S . T I P P E T T : Oh, she had?
D R . P E R R Y : ...joined the convent, and then realized that wasn’t the

calling for her. That the movement was the calling for her. Um, and they
continued to have, over the course of my life, give me a wide array of
encounters and experiences. So I moved to Cambridge, Massachusetts, and
lived there, um, in Old Cambridge, right near Harvard University.
M S . T I P P E T T : And didn’t your mother go to Harvard then, at that

point?
D R . P E R R Y : Yes.
M S . T I P P E T T : Yeah.
D R . P E R R Y : Mm-hmm. She was a doctoral student at Harvard.
M S . T I P P E T T : Right. You — you went to, um, to the Concord

Academy.
D R . P E R R Y : I did. 311
M S . T I P P E T T : Which was a privileged place to be.
D R . P E R R Y : Mm-hmm.
M S . T I P P E T T : And one of the things you said is that you were the
second generation of black children in elite white schools. But you said the
knowledge of how to navigate such places had not been passed on to you.
D R . P E R R Y : Right. So, and I — I think, um, the knowledge of how to

advocate in an elite prep school hadn’t been passed on to me in part because
my parents hadn’t had that particular experience, although my mother had
gone to Catholic schools. But it was a very different sort of southern black
catholic experience.
D R . P E R R Y : Um, but also there wasn’t a kind of institutional

knowledge. I think the numbers really increased post-1970s in these sort of
elite New England prep schools. But they hadn’t yet really figured out how to
embrace diversity, um, both in terms of academic content, but also in terms of
helping us all develop a sense of ownership of the school.
M S . T I P P E T T : Right.
D R . P E R R Y : So, not just being a visitor, but it belonging to us.
M S . T I P P E T T : Which is kind of what the entire, like, every institution,

every American institution was going through at that point.
D R . P E R R Y : Absolutely.
M S . T I P P E T T : Um, you know, you — you have this lovely phrase that
you used about these contradictions. You talked about finding the sweet in the
bitter.
D R . P E R R Y : Yeah.
M S . T I P P E T T : Tell us what you mean by that.
D R . P E R R Y : Well, I, um, it’s actually a phrase that I shared with a lot of

younger students of color who came through prep schools. Because I, you
know, they could be in embittering experiences being in those places and
often times not just hostility from classmates. And I went to a progressive

school that, um, where people loved me and embraced me, and I loved my 312
school as well. But also, there was hostility in the town. You know, we got
called a lot of unpleasant names when we walked down the street in town.
M S . T I P P E T T : Really?
D R . P E R R Y : Oh, absolutely. I mean, you know there’s this — this

image that the south is the worst place for that, but, uh, Massachusetts can be
pretty bad with that. Um, and then there was also, you know, there were some
teachers who were very hostile to the idea of diversifying the curriculum. And
so, when you’d have a book by an African-American author, I had — there
was one teacher who said, well, we’re not going to talk about this in class.
You know, so there was — there were multiple ways that, even in a school
that had committed itself to diversity was — was struggling. And so for me it
was finding the sweet and the bitter was not to dismiss the reality that, um,
there were a number of painful experiences associated with being at school,
but also to not allow that to prevent me from finding joy.
M S . T I P P E T T : Mm-hmm.
D R . P E R R Y : Right, and building meaningful relationships and also

taking possession of the school. So, uh, you know, when I ran for senior class
president, I wasn’t saying to myself, well, they’ve never had someone who
looks like me as senior class president. Now, I knew that, you know, not
everybody was going to be enthusiastic about that, but, um, but I also knew
that I belonged in the institution.
M S . T I P P E T T : You also tell this great story about taking an aerobics

class, which was the thing people did back then. It was like the ’70s...
D R . P E R R Y : The ’80s.
M S . T I P P E T T : Yoga. Yeah, the ’80s. Um, and the music that

accompanied it which was not your music but then that you tuned in to these
late night shows, you discovered hip hop, and you say, “I listened in on the
generation to which I belonged."
M S . T I P P E T T : So tell us about what hip hop means to you and meant to
you.
D R . P E R R Y : Oh, wow. So there’s this sense, and I think this is

particularly true for the children of ’60s and ’70s activists, but I think it can be
a more generalized sense that, um, we sort of came to the party late. You
know, we missed the revolution. We missed the excitement. We missed the 313
activism. We missed the movement. Um, and there’s a sense, I think, that we
lived with a nostalgia for a time that wasn’t our own. You know, what hip hop
gave to me was, and this is before it was on the radio, and actually — and
before it was the way it is now, frankly. Um, it was much — had much
stronger political content, much more social commentary. I mean, it felt like
an eruption in — into um, the world of, uh, Reaganomics, and um, the
industrialization, and all of the suffering that was being felt, I think,
throughout — across the country, and particularly in urban centers. And here
was a music that was articulating a voice that was challenging the world,
right? Listen to me, listen to us, raise questions, all those sorts of things. And
so, um, you know, for me it felt like this is my moment, right? I, you know, I
thought I had missed it, and here, um, here was something, that emerged, in
my time. And it was incredibly nourishing, and it also, you know, the love of
language, the play with language for someone who is a voracious reader,
really captivated me...
M S . T I P P E T T : Hm.
D R . P E R R Y : ... you know, it was exciting to hear popular culture

embracing the kinds of words that I was trying to, you know, figure out in
school as well, so. Um, it was very, very important for my development.
M S . T I P P E T T : I’m Krista Tippett, and this is On Being. Today in a
public conversation with scholar of race, culture, law, and hip hop, Imani
Perry. We’re speaking as part of the Chautauqua Institution’s week on the
American Consciousness.
M S . T I P P E T T : So, I think we’ll — we’ll come back to hip hop in a

moment. Um, you went to — arrived at Harvard in 1994. And you — you got
a JD and a Ph.D., which was unusual and probably still is unusual. And it was
also, as you note, in the ’90s that scholarship, was really becoming alert to the
fact that as you say we were failing in our equality mission.
M S . T I P P E T T : You know, enough years had passed after that heyday of

the civil rights movement, and, um, you know, the promised land had not been
reached.
M S . T I P P E T T : Um, I want to talk about your — I don’t want to call it

an argument. I want, you know, your — your thesis, your — an idea that you
have proposed, um, that we think of ourselves in a time of post-intent racism,

or that we are in post-intent times. So describe you know, what you’re 314
defining there. What that is coming in over against.
D R . P E R R Y : Right. So, OK, so — the — my book starts with this

premise that on the one hand we’re a society where everybody is committed to
racial equality. You know, it’s — it’s generally considered bad taste, bad
form...
M S . T I P P E T T : And you really do — and you really do take that

seriously.
D R . P E R R Y : I absolutely take it seriously.
M S . T I P P E T T : Yeah. Yeah.
D R . P E R R Y : And yet, you know, in every area that you measure, you
see not just the evidence of the persistence of inequality, but that people act in
ways that disadvantage certain groups on the basis of race.
D R . P E R R Y : Right, and most heavily, this is directed towards black

people, black Americans, um, in the United States. And so, um, so for me, the
question is well, what’s happening? Why — why this disjuncture between our
stated purposes and our behavior? Um, and rather than saying I think people
are disingenuous, I’m actually — I actually spent time trying to figure out
what was actually motivating the behavior to disadvantage. And I think it has
a lot to do with, um, not just racial stereotypes, but narratives, um, and, uh,
categories and ways that we describe different spatial relationships. And I,
you know, I get this...
M S . T I P P E T T : Well, what do you mean by that, spatial relationships?
D R . P E R R Y : So, for example, well, just the simple term bad

neighborhood.
M S . T I P P E T T : Oh.
D R . P E R R Y : Or, ghetto. Right? And, um, the lesson to avoid those

places. The way that they’re described as, um, in — in really sensationalistic
terms, dangerous, disordered, chaotic. Um, and how that is connected to deep
disinvestment, right? It has economic consequences.
M S . T I P P E T T : And do you think that, um, that our use of that language
itself then makes those things more true...
D R . P E R R Y : Absolutely. 315
M S . T I P P E T T : ...to the extent there’s a reality behind it, it intensifies

that reality?
D R . P E R R Y : Yes. And it also dictates behavior. Um, for me this is such

a powerful example, because you always hear this and politicians say this
frequently. There’s this image that, um, black youth believe that doing well in
school is acting white. And people say this all the time. And it’s simply not
true. And so anyone who does comprehensive research on the subject says,
that’s not, in fact, true. And in fact, there’s the same kind of value for
education, so really, the different outcomes has to do with inequality of
opportunity or resources. And yet, this myth is so powerful that it gets trotted
out again and again, and so I think the consequences of the kind of mythology
are that then people interact with these youth in ways where they presume that
they’re not invested in education. Right? So, you know, these — these
narratives, these images, these — they dictate behavior. They guide us. And I
say "us" because it’s a cultural problem. Right? It’s not a kind of binary
problem, this race, and that race, it’s a cultural practice that we all learn, um,
living in this society.
M S . T I P P E T T : And I find this so much more helpful language. I mean,

you are talking about structural racism...
M S . T I P P E T T : Right? That’s one label to put on this. But that also

makes it abstract.
M S . T I P P E T T : And, you know, you’re taking out this motive, you

know, you’re — you’re saying — I mean, you’re — you’re explaining on a
very human level how one can not experience oneself to be racist, be against
racism, and yet behave in ways that support that lack of opportunity, and that
belittlement of other human beings.
D R . P E R R Y : Right. And I think, you know, I say post-intent, also,

because for me, um, I also want to get away from concentrating so much
about on what’s in people’s hearts. You know, because I want to focus instead
on the consequences for those who are subject to inequality. So, I say post-
intent, meaning that that’s not really what we want to focus on, whether or not
someone meant it. We want to focus on how people behave. How can we help
people behave in — in better ways, in more generous ways, in more equitable

fashion. Um, and, you see, because we see, you know, there’s both intentional 316
and unintentional.
D R . P E R R Y : But the point is the consequence, right?
D R . P E R R Y : And yeah, yeah.
M S . T I P P E T T : And that’s what we’ve — and what this also gets at for
me, I mean, something I think about a lot, as a journalist, as a person in media,
is, um, we so rarely hear the whole story about anything.
M S . T I P P E T T : And, you know, about anything, because of the way

we’ve defined news in the last 100 years, we hear about the extraordinarily
bad part of politics, economics, education or other kinds of people. I mean,
another example you’ve used in your writing is the South Bronx, right?
M S . T I P P E T T : I mean, that’s you know, just the South Bronx, I think,

many of us will have associations that come to mind with how, you know,
what kinds of statistics or — or bad news stories that are associated with the
South Bronx. But I mean, you know, you’ve — talk about like the two stories
of the South Bronx that are both true...
D R . P E R R Y : Right.
M S . T I P P E T T : ...for you.
D R . P E R R Y : Right. So, the South Bronx is also, I mean, it’s the site for
the creation of hip hop, but it’s this incredible cosmopolitan space. There are
people from all over the world who come together, right? There’s a — there
are beautiful landscapes or were — created by graffiti and — and the like. So
there’s, you know, there’s — it was and is a kind of rich, vibrant cultural
space. Um, and yet, that’s not part of the conversation.
D R . P E R R Y : About what the South Bronx is. Um, and the choice to
describe in one way or the other, of course, has policy consequences, because

if you say, well, there’s nothing there, so we can raze those buildings. Or 317
there’s nothing, you know, this has happened all across the United States.
There’s nothing there, so we can build a highway through that community,
right? To talk about spaces in — in — in a diminishing way actually means
that you devalue the people there, and it becomes very easy to treat them and
their neighborhoods as fungible.
M S . T I P P E T T : Right. Spaces which human beings inhabit.
M S . T I P P E T T : And also, the South Bronx is a real crucible of hip hop

movement, isn’t it?
M S . T I P P E T T : Of this musical force, which is so much bigger now than

it was when you first discovered it. And I want to talk about that because you
know you — you used the word nourishing a minute ago.
M S . T I P P E T T : In talking about hip hop. And that is not an adjective

that would come to mind probably for most of the people in this room...
D R . P E R R Y : Right. Yeah.
M S . T I P P E T T : ...when they heard about hip hop. I mean, you know,

and I just — here’s another thing that you pointed out. You know, you said,
“Most Americans today have internalized Ms. King’s belief that racism is
immoral. But the problem remains, when King said, ‘Let us be judged not by
the color of our skin, but by the content of our character,’ he was not prepared
for the widespread impugning of black character in the 21st century.” And I
think this matter of hip hop, which is just such a potent image now, especially
that we associate perhaps with black young men.
M S . T I P P E T T : Is a good example of associations made with black

character.
D R . P E R R Y : Absolutely. Yeah. I mean, and, you know, one of the

things that’s really, um, difficult in terms of talking about hip hop, because on
the one hand, and I, you know, earlier it was much easier for me, where I
could say, well, this music gets scapegoated, because all of the ills that we see
in hip hop, we see in other forms. Right? And that’s sort of the position I had 318
in the ’90s and the early 2000s. And really, um, in — in intervening 14 years
or so, right, it has become — what you get on the radio are the most popular
artists.
D R . P E R R Y : The content has become more and more narrow. It’s about
conspicuous consumption. It’s about, um, having lots of women. It’s about,
um, kind of masculinist violence, power. That kind of thing. And it actually is,
I think, in some ways the most extreme popular cultural forms of those things,
with the exception of action movies right now. Um, there is a much broader
landscape of the music, but those artists, by and large, don’t get signed to
major labels.
D R . P E R R Y : So I think one of the questions is why — and — and the —

the vast majority of the audience for hip hop is no longer black. Um, so one
question would be to ask, you know, why is this so desirable, right? And I do
think on some level it’s selling fantasies of what ghetto life is like, right?
D R . P E R R Y : Kind of prurient fantasies, things that are, you know,

verboten, and exciting. And so, um, but the circulation of that fantasy
absolutely has social consequences.
D R . P E R R Y : Um, and I think that this something that both people who
do — who have done scholarship on hip hop, but also, I think people in
communities across the country are just struggling with, you know. How do
we push back against what we are seeing in the music, even if it’s the music
that we love?
M S . T I P P E T T : I mean, I have a 16-year-old white son who loves hip

hop.
M S . T I P P E T T : But what I notice more than anything else, you know,

he’ll sometimes say, um, I’ll try to listen, and he’ll say no mom, you’re too
innocent. That’s not appropriate for you.

[laughter] 319
M S . T I P P E T T : Right? But — but what I — what I see that’s magic

about that music is how I watch that music go all the way through his body...
D R . P E R R Y : Oh, oh yeah.
M S . T I P P E T T : ...and yes, it’s popular music, but it’s poetic.
D R . P E R R Y : It absolutely — right, absolutely.
M S . T I P P E T T : You know what I mean ? There’s something in it that

transcends — and I really don’t spend a lot of time listening to the most
inflammatory lyrics...
D R . P E R R Y : Right.
M S . T I P P E T T : ...but I don’t worry about it, because there’s something

in it that’s powerful, that transcends whatever, you know, the things that you
could get upset about on the surface as well.
D R . P E R R Y : I think that’s true of some of the music. And I do think that

increasingly sound is more important than text. I think there was an earlier era
in which the words mattered more...
D R . P E R R Y : ...and I think with the rise of southern hip hop in particular

— even when someone is speaking, the sound and the vocalization and what
the artist is doing with the voice, it oftentimes is more important than what
they’re saying.
D R . P E R R Y : Um, so I do think that’s absolutely the case and, um, the

play with language is always exciting irrespective...
M S . T I P P E T T : Yes.
D R . P E R R Y : ...of the content. But I do think there is this — this

question, though that — that I think many artists are going to be increasingly
challenged to push. So if the words don’t matter that much, then might you
consider other words?
M S . T I P P E T T : Hmm. Yeah.

D R . P E R R Y : Right? I mean, you know, if — if — if the — particularly, 320
I think for — for women, for me, this is a particular concern for women in
poor, urban communities, and what the message is about their value I think is
um, somewhat alarming.
M S . T I P P E T T : But you, I mean, one of your books is about hip hop...
M S . T I P P E T T : ...and, um, you struggle with the music, with what’s

hard — challenging in the music to women, but you also really find a place
for strong...
M S . T I P P E T T : ...women in that music. And how — you have two sons.

Is that right?
D R . P E R R Y : I do.
M S . T I P P E T T : And how old are they?
D R . P E R R Y : 8 and 11.
M S . T I P P E T T : OK.
D R . P E R R Y : Yes. Um, and I — I regulate their music quite a bit.
[laughter]
M S . T I P P E T T : Um, you know, yesterday here, Roberto Unger, who

used to be your professor...
D R . P E R R Y : He was my prof. — he taught me Jurisprudence.
M S . T I P P E T T : ...told us that schools should be raising our children to

be prophets. And the title of your book on hip hop — hip hop was Prophets of
the Hood.
M S . T I P P E T T : Interesting allusion.
D R . P E R R Y : That is interesting.
D R . P E R R Y : Yeah, um, you know, and I don’t know. I — I think that’s 321
an interesting challenge, and I’ve never thought about whether schools can do
that. I see what he’s saying in — in — about sort of raising young people to
be prophetic in the sense of there’s a kind of preparation that will illuminate
them, um, in ways that can move us towards a better place.
D R . P E R R Y : I think the — the way that I was using, um, prophetic was
about a kind of illumination of ideas and arguments that are in places in the
society that were invisible to the larger society and so, in the sense that a —
that a prophetic voice, um, can emerge from a place that has been
invisibilized, that has been obscured, um, that’s what I was seeing in the
music.
[Music: “Love Is” by Common]
M S . T I P P E T T : You can listen again and share this conversation with

Imani Perry through our website, onbeing.org.
I’m Krista Tippett. On Being continues in a moment.
[Music: “Love Is” by Common]
M S . T I P P E T T : I'm Krista Tippett and this is On Being. Today with the
first in a four-part series of public conversations on “The American
Consciousness.” Imani Perry is a scholar of law, culture and race and a
professor at the Center for African-American Studies of Princeton University.
I spoke with her in front of a live audience at the Chautauqua Institution in

upstate New York just a few weeks before the shooting of 18-year-old
Michael Brown in Ferguson, Missouri reawakened questions lingering from
incidents like the death of 17-year-old Trayvon Martin — and the acquittal of
the man who shot him, George Zimmerman. Imani Perry has written
searchingly about what such events continue to mean, especially to the
generation of her young sons.
M S . T I P P E T T : So, ever since we elected an African-American

president, it seems that we, continue to revisit the problem that we still don’t
know how to talk about race.

M S . T I P P E T T : But, and we end up talking about it then in moments of 322
crisis. And I’ve — I’ve wondered, you know, something like the Trayvon
Martin shooting.
M S . T I P P E T T : I’ve wondered if, you know, it seems to me that the —

the moments when we then talk about it are so anguished and they seem like
imperfect moments, but having that said that, I started reading some of what
you wrote around those events and all the way through the trial and the
acquittal of George Zimmerman. And I — I questioned myself, whether that
really was an imperfect moment, or whether it’s as good a moment as any.
M S . T I P P E T T : So, I wonder if you would talk about, you know, what

does that particular event or an event like that, say to you about the American
consciousness, that it’s worth all of us continuing to reflect on after the fact.
D R . P E R R Y : So, part of what, um, the murder of Trayvon Martin

immediately registered for me is that this is, um, the sort of ultimate fear of
the mother of any black boy in this country. OK? Um, and I think that isn’t
necessarily widely understood. I mean, even in the midst of the trial, um, that
the concept that someone might murder your child with utter impunity and
there not be a remedy is real and has been real for — and — and it’s not just
mothers, it’s fathers, it’s aunts and uncles, right?
D R . P E R R Y : But that there’s some particular, I think, for me...
M S . T I P P E T T : As a mother of two sons, yeah.
D R . P E R R Y : As a mother of two boys.
D R . P E R R Y : And also, trying to explain it to them in a way that would

not have them walking through life constantly terrified.
D R . P E R R Y : Right? Because then my older son once said to me, you

know, and this was in relationship to several other incidents, where do I go if
there’s trouble if the police might even kill me? Right? You know. When I’m

innocent, right? And so, um, so I think that that you know, that is, I think, a — 323
a racial divide. I think that we have other ones with respect to the lives of
undocumented children. You know there are...
D R . P E R R Y : ...there are multiple, um, divides in that way, where we are

not fully cognizant of the experiences that other people in our midst are
having. Um, I think the moment was instructive, though devastating, um, in a
number of ways. One, this need — this discourse around Trayvon’s innocence
was really instructive, because I think Americans are — are unhealthily
obsessed with the idea of innocence. I mean, I think that’s part of the
impediment that we have in general with talking about race.
M S . T I P P E T T : The idea of innocence?
D R . P E R R Y : Because we want to be — I want to be innocent. I’m not

— I’m not this.
M S . T I P P E T T : Right. Right.
D R . P E R R Y : Right? So, but I also think there was this conversation

about is he innocent, is he not? Well, he skipped school once, he smoked
marijuana. I mean, this — all of these things, which are fully human, and
normal for young boys, be — suddenly become ways of suggesting that he
might have merited being...
D R . P E R R Y : ...murdered. Even that he might have fought back. Right?

So that there’s this, you know, there’s this image that what is required to be
acceptable, um, as a black boy, is the sort of image of perfection, no failure,
no mistake, no error ever.
D R . P E R R Y : But otherwise, uh, you can’t be given the benefit of the

doubt. I mean, for me, that is illustrative of one of the most powerful racial
discourses, right? This idea that always being suspect, right? Always being
likely to be guilty, and how that sort of acts as a kind of sort of hangs over,
um, one’s shoulders everywhere you go.
M S . T I P P E T T : I read, um, in what you wrote, and this is really

heartbreaking, you know that your son’s wept when they heard that George
Zimmerman had been acquitted.
D R . P E R R Y : Yeah. Yeah. 324
M S . T I P P E T T : Um...
D R . P E R R Y : Absolutely. Um...
M S . T I P P E T T : And also what I found, I don’t know, comforting in a

way, or you — helpful — was you — one of the things you talked to them
about was that you attended a rally afterward, and...
M S . T I P P E T T : ...and you said look at all these people who are around
us. And again, the reason I think that’s important just to note something very
practical like that is that it’s worth showing up at a rally.
M S . T I P P E T T : For your sons.
D R . P E R R Y : Mm-hmm. And I think for all of us, because I think that

particularly with what you — we talked about this idea of, um, kind of
structural racism, or the abstraction or institutional racism or inequality and
the like, I mean, we — we are agents of our world, right? And so, you know,
we — we encounter tragedy after tragedy after tragedy, and so then we can
become sort of passive witnesses to all of these tragedies in our midst or we
can be actively engaged. And I think that’s a process of liberating oneself, to
be actively engaged in the world, and — and — and in the work of
transforming it.
Uh, I mean, so it was meaningful for them, I think, for the other people to be
around, but I also think it’s meaningful for them for, um, kind of growing up,
becoming adults, becoming people who have some sense of civic and social
responsibility, because you know one could also say in some ways I can
protect them from so much, they are privileged children. Right? But they —
and so they have these fears, but they’re also relatively privileged, and yet, my
sense is that whether it has something to do directly with them or not, you
know, they have a responsibility in this world.
M S . T I P P E T T : Mm-hmm. Actually want to read — I — I think we’ll

do — we’ll open this conversation up. Before we do that, um, or as you might
be coming up to the microphone, I — I just want to dwell for a minute on this
beautiful blog post.

M S . T I P P E T T : You use this image — you started it by saying have you 325
ever seen a small plant that has a splint holding it up? Would you — would
you illuminate that image?
D R . P E R R Y : You know, I — I, um, I guess I think that, you know, the

work of nurturing development is always requires us to lean on someone else,
or to be there for someone to lean on, to facilitate, to, uh, to nurture it. And I,
you know, and I think that that’s how we should think about not just our
families, but as a — our cities, our states, our nation. Um, we are in a moment
where we are being socialized into the — an intense competition. I mean, I
think that’s everything is marketized. Every aspect of our lives is marketized.
And it creates a lot of anxiety. Right? Because we don’t want to be left behind
and left out. But I think the — the — the other side of that anxiety is that it
really isolates us from a sense of responsibility to each other. So for me, the
image, uh, you know, of kind of holding up a — a sprout is, um, powerful
because that’s what it takes. You know, sometimes we pretend like that’s not
what it took for us, but that’s what it takes for everyone.
M S . T I P P E T T : But it — I also like the image because it’s — this sprout

has its vitality. Right?
M S . T I P P E T T : It’s not...
D R . P E R R Y : No, it’s not passive.
M S . T I P P E T T : ...compensating for something, even.
D R . P E R R Y : No. It’s...
M S . T I P P E T T : It’s just allowing it to come into its own and...
D R . P E R R Y : That’s right.
M S . T I P P E T T : ...vitality. OK um, yes.
A U D I E N C E M E M B E R 1 : Um, in your article, uh, for the

Washington Post about the five myths of, uh, Brown versus the Board of
Education, you wrote about how some African-Americans, were — not
exactly against it, but were — one of the cost of it was giving up the
professional, institution of the black schools.

A U D I E N C E M E M B E R 1 : Would you expand on that? 326
D R . P E R R Y : Sure. So, one of the things, you know, that when we talk
about desegregation and Brown versus Board of Education that is often times
lost out in the story, uh, is that there was incredible loss of institutions. You
know, schools in, um, in the segregated south were community institutions,
um, they had, uh, body — they — the teachers and principals comprised a
large portion of the black professional class.
Um, so, and the dominant narrative is that the schools were just terrible. Well,
they were underfunded, and there weren’t enough of them, but many of the
schools were extraordinary. And what happened with desegregation, which
was a very long process, was that rather than integrating facult(ies) — you
know, teachers and integrating what is that — there was massive, uh, loss of
black professionals. Teachers who lost their jobs. Principals who lost their
jobs. And schools remained segregated. Right? Because of, um, white flight,
or private academies, and the like. And so, um, and there were people who
were concerned that this was what was going to happen. They were correct.
Now, I think that most people think well, this was a sacrifice, that was made
by the community in order to transform the nation. Um, I think they took out
that sentence in the Washington Post, but that’s really how I conceive of it.
And so, while schools were not integrated, and while much of the — many of
most important schools in many communities were lost, um, the other side is
that all of the public facilities were — were integra — all kinds, you know, it
led to the integration of higher education.
M S . T I P P E T T : Right. That point you made that it — that wasn’t just

about schools.
D R . P E R R Y : Right, no, it wasn’t just about schools, no.
M S . T I P P E T T : And it’s an example of how, um, we have too shallow a

memory 50 years on of a lot of things about the — the civil rights movement.
M S . T I P P E T T : We have just a few names we know.
D R . P E R R Y : Right. And even the — the — to focus on the charismatic

leaders as opposed...
M S . T I P P E T T : Yes.
D R . P E R R Y : ...to communities.
M S . T I P P E T T : Yes. 327
D R . P E R R Y : I mean, it was really communities and that they pushed the

leaders, um, to become what they were. Yeah.
M S . T I P P E T T : I’m Krista Tippett, and this is On Being. Today in a
public conversation with scholar of race, culture, law, and hip hop, Imani
Perry. We’re speaking as part of the Chautauqua Institution’s week on the
American Consciousness.
A U D I E N C E M E M B E R 2 : Thank you so much for such a wonderful

talk. I want to return to your point about the importance of language in
shaping consciousness and even framing a reality. You mentioned how
concerned you were about the devaluation of space, for example, the South
Bronx, and the role that language plays, but it seems to me perhaps you’re not
as concerned about the devaluation of women in hip hop lyrics. And I feel like
I’m missing something. Could you clarify, please?
D R . P E R R Y : Oh, that’s what I — part of what I was talking about was

absolutely the sexism and even misogyny in the lyrics. That’s what I was
referring to when I was talking about what is happening today in the music.
Um, you have conspicuous consumption, you have the — I — the treating of
women as possessions, exploitation of women, and the like, absolutely. Now,
I will say again, though, that is not characteristic of all of the music. That’s
who’s getting signed to major labels. Right? And so the responsibility doesn’t
just lie on hip hop. The major responsibility lies on the corporations, and also
the consumers of the music. And so, for me, the question is, why do people
want to buy music that communicates those messages? I think that that’s an
important question for us to ask ourselves.
A U D I E N C E M E M B E R 3 : The first, uh, questioner stole my question

so I’m going to ask you if you could elaborate on what you feel the, um,
future of for-profit education, for-profit schools, charter schools, magnet
schools, all of those things, is going to have in the black community and,
especially the lower-income areas of the country in the future.
D R . P E R R Y : Thank you. Um, for me, this is, uh, I think a really
important question as we’re see — we’re witnessing the privatization of
public education across the country. The push to charters, um, an entire
system becoming charter systems as is the case now in New Orleans. Um,
much of the conversation around it, which I think is really interesting, is
around African-American and Latino children. Much of that conversation’s
about the achievement gap. And by that they mean a racial achievement gap.

Um, and as opposed to, well, we can set that aside for a moment and say, we 328
could talk about an opportunity gap instead of an achievement gap. It might be
talking about something that’s actually more meaningful. But, that said, um,
one of the things that we’re seeing is that any problems that we see in public
education are worse when there’s less regulation. And so, I think that, um, the
consequence of this move towards privatization is going to be devastating, uh,
for the poorest children and for, um, um, black and Latino children in general,
even though there are some, you know, remarkable examples of successful
individual schools when we look at the picture overall. Um, I think that all of
us need to be concerned with what’s happening to public education.
A U D I E N C E M E M B E R 4 : Um, I guess my question is maybe two

parts. Um, one, if — if you could see one structural thing that you’d like to
see changed, what would it be? And — that would make the biggest
difference for African-Americans right now. And, on the second part of it is,
you know, nobody wants to think of themselves as racist, but a lot of people
who are white have no idea, like, how to be better allies. So, if you could kind
of magically transform our, you know, people's consciousness and, like, you
know, something that would help people be, a better ally, what would that be?
D R . P E R R Y : You know, I — I almost — I’m going to not really answer

your question, because I think that it is the process — it is in the process that
people are transformed, right? So, um, I talked about this a couple of days ago
in a talk that, I think, in terms of our, sort of, organizing efforts, um, to the
extent that we can be devoted to power sharing along lines of race, along lines
of class, right? That we can be committed to actually assuming that every
person at the table has meaningful contribution, who has meaningful
knowledge, right? That those sorts of things, I think, allow for multiracial,
multiclass, multi — what able bodied, disabled, that kind of — kind of
community that allows us to be transformed and also to transform the world
we live in.
So, I — I have such, um, hesitation for any kind of magic wand solution,
because I think that the way that we change is in the doing. Right? Uh, doing
things in a different way. I think, really out of school learning communities,
that are multigenerational, that, um, would be an incredibly important
movement, I think. And there are examples of them, but in all sorts of
communities, right? So, communities of values, I mean, I think this is a
wonderful example. But if we could really devote ourselves to creating many
of those, um, I think that also would lead to great transformation.
A U D I E N C E M E M B E R 5 : Hello, and thank you very much. I’m from

Rochester, New York. We’re working on a facing race, embracing equity
effort that gets at the structural racial bias that exists. Is there any other
community or communities that you are aware of that have actually made the
structural changes to reduce the racism in their particular community? And 329
then the second question I have for you is how does your spiritual life affect
how you go on from day to day?
D R . P E R R Y : That’s a fantastic question. So the first, I mean, I think

there are — there are, many examples, although not — the ones that
immediately come to mind are not necessarily non-profit organizations. I
mean, I think that, you know, the way — so I can think of various, you know,
activist movements, so, um, for me, uh, wonderful example would be there’s
sort of three-three moments of the Rainbow Coalition. Most of us just know
that Jesse Jackson, 1988 Rainbow Coalition. But in Boston, Mel King had a
Rainbow Coalition where he created alliances between workers, between
LGBT communities, um, women’s rights, class issues, et cetera, et cetera, and
race. And so, it was a model of actually doing organizing that allowed these
different communities to come together on equal footing. And I think that
that’s — that’s the the way to do it.
And I think actually institutional structures that follow from that type of
organizing, tend to be able to, um, uh, maintain that. And then there’s — the
first Rainbow Coalition was actually Fred Hampton, who doesn’t — who isn’t
imagined as someone who has that kind of vision, because he emerged out of
the Black Panther party. But he actually advocated a Rainbow Coalition of —
of working people, of various, uh, race before he was murdered. And so, um,
so I think there are — there are models, and I also think, um, John
McKnight’s asset-based community development model of organizing
suggests that — that approach as well. Um...
M S . T I P P E T T : And what’s — where’s that based? Or what...
D R . P E R R Y : It teaches an approach to community organizing that

assumes that everybody has assets and skills. It actually reminds me of Ella
Baker’s organizing in the Student Nonviolent Coordinating Committee, where
the thought was we’re not going to go to this, you know, these, uh,
communities in — in the Mississippi Delta and tell them what to do. We’re
going to facilitate the emergence of local leadership. We’re going to listen to
who amongst — who in this community has which sorts of skills, and then let
that emerge, you know, that kind of leadership emerge, um, somewhat
organically.
Um, and so it’s — it’s — in some ways, it’s similar to that. It’s sort of let’s
take inventories, opposed to assuming these — certain communities are filled
with deficit, what can people do? What do they know? What skills they have.
How, you know, how are they connected to this person? Or that person? And
so, um, I think those sorts of models are almost — are really — um, it’s hard
to just say — well, let me see how I want to say this. I think that can be more
effective than also than simply saying, we’re going to be less racist by having 330
different leadership. Right? Because I — I do think that we have to change the
way we think, how we examine the people we encounter. What assumptions
we make. And so, actually doing the work of sort of drawing that out, I think
is helpful in that regard.
Um, in terms of my spiritual life, um, and the work that I do, I — I think of all
the work that I do as being one, sort of guided by a higher purpose, I think,
being, I think the principles of being humane, and kind, and loving, and
against domination, and against brutality, are what const... — you know, it’s a
big part of what it means to be a good person and so, all of my work is
emerging from that place. And it’s also, um, in many ways, emerging from
wanting to continue the work of the people who came before me.
So, um, I think of my grandmother, who read every single day, who was one
of the most brilliant people I ever knew, and who — for whom there wasn’t
really much opportunity besides being a domestic laborer. And that there are
many people in the world similarly situated today. And so, um, I’ve — I
mean, I could go through the book. Every idea connects to something she said
to me, every single one.
M S . T I P P E T T : Hm.
M S . T I P P E T T : Um, I want — I want to come back just to this question

of the guidance you might offer to people here. There were some small things
that I found really use — helpful in your writing. Um, and this very much gets
at the idea of the American consciousness, that we are free not from but for.
D R . P E R R Y : Freedom to instead of freedom from.
M S . T I P P E T T : Freedom to, yeah.
D R . P E R R Y : Yeah. Because I think that freedom, you know, there’s a

kind of traditional libertarian conception of freedom which is like everybody
leave me alone, don’t bother me. And then I think a freedom to, is a — is a
kind of, I think, a liberation approach, which is really about how can we undo
domination that gets in the way of us living healthy lives. How can we
actually create things that are meaningful and joyful? And I — that’s what I
think of as freedom to. Um, you know, if you have a conception of freedom
that — it always sees other people reaching out to you as an incursion...
D R . P E R R Y : Then I think that’s a very limited and narrow conception of

freedom. Right?
M S . T I P P E T T : Yeah. That we are free to create the world we want to 331
live in.
M S . T I P P E T T : Um, and the other thing — the other small story, um,
you — you talked about in your own life, and with your sons, that there are —
that you even have found yourself ignored in a checkout line. Or just moments
where you have felt this racial gap. And that there — there have been people
who, you know, committed simple acts of grace, right?
M S . T I P P E T T : Somebody who said something.
M S . T I P P E T T : Somebody who stepped in.
D R . P E R R Y : Yeah. Yeah.
M S . T I P P E T T : And that that really is powerful and important.
D R . P E R R Y : It’s powerful and important, and I think we discount the

significance of those acts. But I’ll give you an example. We were in, um,
Mississippi taking — this was this summer, me and my sons, taking a bus to
Alabama. And a young man — we’re in line getting food, and a young man
— and he, uh, was Honduran. And actually was not, um, not fluent in English,
steps in front of us in line. And I said, excuse me, um, we're here and — and
he laughed and turned his back. And, you know, this is not unfam — I mean,
learning the codes of American racism happens very quickly. And I get a little
enraged at things like that.
D R . P E R R Y : So I pushed his food down and stepped back in front of

him in line. And — and my sons are now accustomed to that from me. Um,
and they said, well, why did he do that? And, sort of was trying to explain.
And then, when we got on the bus, um, I sat next to a Honduran woman who
was in the same group. Um, and we had the most beautiful, loving
conversation. She gave my children her blanket. She talked about, um, trying
to help and get her daughter to stay in high school. And — and when I told
them, I said, you know, if you read that single incident as reflective of the
entire community, then you shut off the possibility of this lovely time that we
had. Right?
And also, um, you know, there’s potential that he might be transformed by 332
witnessing her relationship with us, right? On — on that — on that ride. And
so, I mean, I think those, you know, we think that these things are so small
because the problems are so big, uh, but I think they matter. They matter.
M S . T I P P E T T : Thank you for that. And, I want you to read some of

your own words. And this was from that blog post that you wrote.
D R . P E R R Y : OK.
M S . T I P P E T T : I believe it was a blog post, or an article about after the

Trayvon Martin events and I think this is the one that started with the question
have you ever seen a small plant that has a splint holding it up? So, would you
just read this and I’m going to let...
M S . T I P P E T T : We’re going to close with you reading yourself.
D R . P E R R Y : “Because while on the one hand I am training my sons to

develop resilience in the face of the racial injustice they will encounter, I am
also training them to approach the world with full recognition and
appreciation of the wide spectrum of human beings, some of whom are quite
different from them. They know that they have an ethical responsibility to
humanity, animal life, and nature, to care beyond their immediate experiences.
We talk about gender and sexual orientation and disability and mental health,
along with race, ethnicity, and language. They are encouraged to be critical
and analytical, to use those enormous imaginations to journey into the interior
lives of others. Together we create gardens of possibility in the parched earth.
If we grow the babies up right, they just might redeem us all.”
[Music: “Black Rage” by Lauryn Hill”]
M S . T I P P E T T : Imani Perry is a professor at the Center for African-

American Studies of Princeton University and a faculty associate in the law
and public affairs program there. Her scholarly works include: Prophets of the
Hood: Politics and Poetics in Hip Hop, and More Beautiful and More
Terrible: the Embrace and Transcendence of Racial Inequality in the United
States.

M S . T I P P E T T : This is Lauryn Hill, one of Imani Perry’s favorite artists 333
with a hip hop reworking of the Sound of Music song “My Favorite Things.”
It’s called “Black Rage” and you can find the lyrics at onbeing.org. There you
can also listen again or share this episode and join in our ongoing
conversation in the wake of events in Ferguson, Missouri and elsewhere.
We’ve had a profound response to Courtney Martin’s column, “To Be White
and Reckon with the Death of Michael Brown”. Find all that and much more
at onbeing.org.
M S . T I P P E T T : On Being is Trent Gilliss, Chris Heagle, Lily Percy,

Mariah Helgeson, Chris Jones, and Bekah Johnson.
Special thanks this week to Robert Franklin and Maureen Rovegno at

Chautauqua Institution, and to Mitch Hanley.
Select one of the available podcasts below and listen to a detailed narrative about the
work that helping professionals and social workers engage in. In a brief post of 200
words or less, list the title of the podcast you selected, and provide one insight you
learned about the work these professionals do to support their clients. Did anything
surprise you?
Each link will open in a new window:
Culture & Identify
 Dr. Imani Perry (On Being)- The Fabric of Our Identity
Intersectionality
 Latino USA: Muslim & Latino: The complexities of intersectionality
 Matriarch of Spirit on Lake
Criminal Justice
 Buzzfeed's No One Knows Anything: Senators Mike Lee and Cory Booker
Discuss Criminal Justice Reform
 Criminal- Episode #45- Just Mercy (an interview with social justice activist 334
Bryan Stevenson)
 Reveal: "Justice for Some"
 PBS: Wait list grows as public defenders refuse cases in New Orleans
School Desegregation
 This American Life- “The Problem We All Live With”
 PBS Frontline Documentary: Separate and Unequal
 Segregation Now: Investigating America’s racial divide in education
 Embedded: What Happens When Your Town's Only High School Closes?
Environmental Justice
 Podcast- Reveal “Toxic Burden”
 Podcast- Reveal “School Haze”
 Flint Water Crisis Course - March 10, 2016 (University of Michigan Flint)
Professionals in Action
 The Social Work Podcast: Self-Psychology for Social Workers
 Only Human Podcast: Episode: "Me and My Therapist"
 The Social Work Podcast: A Zero Suicide World
 The Social Work Podcast: Guardian of the Golden Gate w/Kevin Briggs
 Slate Working Podcast: Shane’a Thomas, a psychotherapist, supports the mental

health of LGBTQ youth
Additional Social Justice Topics
 Reveal podcast: Voting Rights and Wrongs
 Podcast: Safety Nets Failing the Poor
 Podcast: People denied care at catholic hospitals
 Podcast: Can Someone Else’s Religion Legally Dictate Your Health Care?

 Video: Invisible Wounds: Life after military sexual assault and PTSD | Veterans 335
Coming Home
 Video: Re-thinking Sexual Assault Prevention in High School and College

(TED)
Annotate
 Resources
Power, Privilege, and Oppression
The Atlantic: The Power of Landlords (new window)
Interactionism, Functionalism, Conflict Theory, and More
Marshall Project’s “When Prisons Need to be More Like Nursing Homes”
Supplemental video on symbolic interactionism
Supplemental video on structural functionalism
Supplemental video on conflict theory
Criminal Justice
Supplemental material: Frontline Report-The Problem with “Broken Windows”

Policing (New Window)
Supplemental article: In Heroin Crisis, White Families Seek Gentler War on

Drugs (New Window)
Is America Engaged In A 'Vicious Circle' Of Jailing The Poor? (NPR Podcast) (New

Window)
When It Comes To Policing LA's Skid Row, What Tactics Work? (NPR Podcast) (New
Window)
NYTimes Article: When Addiction has a White Face (New Window)
 Share Your Experience

 We are very interested in strengthening and improving our 336
online learning experiences. We would love to get your
feedback on this course to help us identify what we're doing
right and what could use improvement. Please participate by
taking our short survey at the link below:
 Go to survey.
 The link will open in this same window for the purposes of
making it accessible to screen readers and other assistive
devices. You may need to manually navigate back to the
course afterwards. Thank you for participating!

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Diversity and Social Justice in Social Work

 "America's Elderly Prisoner Boom" ver

Module 3: Unpacking Intersectionality

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

 Watch & Reflect: Unpacking

 Kimberly Crenshaw: The Urgency of

I'd like to try something

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

There are a couple of

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

 Listen & Reflect: Intersectional

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Conversation with Ed-Dee Williams

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Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Module 4: Social & Cultural

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Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Read & Reflect: Identify Examples of Health

Now, let's discuss some

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Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Watch the following brief documentary clips from Unnatural Causes, and

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

 A Conversation with Jaclynn Hawkins

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Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

Diversity and Social Justice in Social Work course 3

 A Conversation with Dr. Deirdre Shires

 Visit the Center of Excellence for Transgender Health (new window)

Diversity and Social Justice in Social Work course 3