This Election Cycle, Vote with Redistricting in Mind

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California received a facelift this year in the form of a dramatic new redistricting plan that leaves the state’s political landscape barely recognizable, yet full of opportunities for new representatives to lead their regions. The changes have come at all levels of government, from city councils to Congress. They provide new opportunities for some communities to address neglected public health issues, but may also prevent other communities from strengthening their quality of life.

The politically independent California Citizens Redistricting Commission conducted the state’s redistricting process following the 2020 census data. The commission was tasked with considering census population data, complying with the federal Voting Rights Act to prevent discrimination against minority groups, and incorporating public opinion into the redistricting process. Now, the commission is being scrutinized for its map-drawing processes and potential biases.

The drama behind the scenes is spilling over into public conversations about Congressional and statewide representation as new districts have significantly shifted population density and demographics. For example, California will be losing a Congressional seat for the first time in state history. In a legislative process where every vote counts, losing a seat can shift party lines and tip the power balance dramatically. These reallocations of power may be one of the reasons why 48 members of Congress have decided to not run for reelection. Of the 23 Democrat Representatives not seeking reelection, three are from California.

For other California incumbents whose terms end in 2022, such as State Senator Patricia Bates of District 36 in San Diego, the new district lines could lead to shifting party power and favor new candidates of the previous minority party. Senator Bates’ Republican-leaning District 36 is now being replaced by District 38, which possesses a Democratic majority voter base. This change will require an entire reassessment of the party powers in districts throughout California, as new voter bases demand different priorities from their representatives.

Redistricting has also given more power to historically marginalized communities. The Public Policy Institute of California reported that the new district maps have 16 majority Latinx districts compared to the previous 10. With a population located in low-income communities, leaving them more vulnerable to less healthy environments, having greater representation for marginalized groups at the state legislative level is key in meeting the public health priorities for these communities.

What does this all mean for the future of public health policy in California and our nation as a whole? While redistricting may sometimes feel disruptive to the democratic system, it also has the opportunity to empower diverse groups to influence the health outcomes they want. Local and state government programs and community-based organizations have a responsibility to make a conscious effort to fill in the gaps of support created by redistricting, which has affected vulnerable communities throughout the state.

For example, former Assembly member Lorena Gonzalez recently resigned to become CEO of the California Labor Federation. Her 80th District assembly district was redrawn, which would have put her in competition with Assemblymember Dr. Akilah Weber for the 79th District seat. Her seemingly innocent career transition left community members to deal with problems like air pollution and high ozone levels without the help of their elected representative. Assembly District 80 encompasses the southern region of San Diego County including San Ysidro and Chula Vista, which suffer from air pollution and high ozone levels, leading to adverse health impacts like high asthma rates.

One of the most effective means of creating healthy community change is through the voters themselves. Constituents have significant power to engage in the legislative process by contacting their representatives, working with legislators to address public health issues, and voting for politicians that will address relevant problems in the most vulnerable communities.

While the moving pieces of California’s political landscape take time to fit into their new places, residents can influence what candidates and issues will be the focus of their attention. The power to address harmful environmental factors and public health disparities lie with community members. There is no need to wait for change to happen. We can influence how our communities take shape, by prioritizing the health and well-being of those around us.

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Author:

Maxwell Johnson
Prevention Specialist

Maxwell Johnson is a resident of downtown San Diego and a prevention specialist for the Binge and Underage Drinking Initiative at the Institute for Public Strategies. He graduated from SDSU with a degree in Political Science and Communication.

Juneteenth at IPS: Historical Oppression and Upstream Prevention

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On June 19, 1865, U.S. General Gordon Granger led federal troops to Galveston, Texas — one of the few remaining areas of the deep south that had held resistance late into the Civil War. As General Granger stepped foot on that arid soil, he brought with him orders which stated that all slaves were to be set free. These words, stated over two years after the Emancipation Proclamation, marked what many consider to be the “official” end of slavery in the United States, as those freed in Texas that day were many of the last slaves to be informed of their liberation.

This year, on June 19, 2022, the United States will be recognizing Juneteenth as a holiday following its enshrinement at the federal level in 2021. The Institute for Public Strategies will also be recognizing Juneteenth as a paid company holiday. IPS’ formal recognition of Juneteenth as an important date represents our organizational commitment to serving and elevating the voices of African American communities to address their unique needs and visions.

As practitioners of population-level prevention programs, IPS initiatives address the root causes of health disparities, which are frequently the result of inequitable community conditions and social injustice.  To prevent harm and improve public health and safety, IPS focuses on policy and systems change to achieve healthy, safe environments and provide for equal opportunity so that everyone in a community can thrive—this elevates the health of entire communities, rather than focusing on the health of select individuals. That’s why, when discussing the issues relevant to African American communities, context is key. Issues that have plagued neighborhoods for decades—nearly centuries—did not crop up overnight. In fact, quite the opposite: history shows that many of the persistent issues faced by African American communities are rooted in systemic and institutional inequities.

In areas like San Diego County, IPS initiatives encounter these structural injustices across programs. For example, IPS San Diego’s Binge and Underage Drinking Initiative (BUDI) often sees evidence of systemic inequity in things like the concentration of liquor outlets in neighborhoods of color—areas that were often formerly “redlined” by racist housing practices. Moreso, despite African Americans often drinking less on average than other demographic groups, predatory marketing practices by alcohol manufacturers are often targeted toward young Black people.

These are only a few instances of unequal and unfair treatment toward African Americans by just one industry—Big Alcohol. However, they represent just a few blips along a spectrum of injustice leveled against Black communities stretching all the way back to before that historic date on June 19, 1865.

In fact, many slaves brought from West Africa to the Americas during the early slave trade were bought for gallons worth of rum—a product of the very same sugar cane from plantations already employing slave labor. Thus, the history of African slavery in the Americas is also inextricably linked to its production of alcohol. This metaphor can be extended even further to describe how alcohol was historically used to control enslaved peoples; drunkenness was discouraged, except around the holidays when alcohol was liberally distributed to keep slaves from thoughts of revolt or insubordination. This mentality then informed later laws like Black Codes and Jim Crow which would enforce strict penalties for drunkenness in public—if you were Black.

Despite the long and storied history of the use of alcohol as an oppressive tool toward Black communities, this topic represents just one way in which a single IPS initiative encounters the deep history of injustice toward communities of color.

For example, in 2020 after the City of Adelanto passed legislation that proclaimed racism as a public health crisis, staff at IPS San Bernardino affirmed our organizational commitment to the value of Black lives and communities. This effort presents several opportunities for staff collaboration with the City of Adelanto, including educating BIPOC youth about engaging with local government and working with high-risk businesses to develop ways they can contribute more positively and equitably to the community. Along with other partnerships—like The St. Joseph Foundation’s Heart & Soul initiative and the Reimagine Our Communities Coalition (ROC)—IPS San Bernardino continues to exemplify allyship for Black health and safety.

Despite the hurdles IPS encounters working on our projects, we believe in creating equity and fairness in health and safety. This means learning from, engaging with, and elevating the voices of the communities we serve. Reverend Bolivar Flores, IPS’ newest member of its Board of Directors, summed up this mission:

“IPS wants to create a healthy community by creating economic opportunity, keeping residents safe by preventing crime, and focusing on equality for all. […] They have partnered with community groups throughout the nation to advance policies on issues related to public health, safety, equity and social justice. I believe the best way to create change is by defining the underlying issues and devising plans to resolve them, and IPS’ work on policy and systems change exemplifies that. […] Seeing that ambition to help a community rebuild into a safer city and create a brighter future for its residents is very inspirational.”

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Author:

Michael Pesavento
Media Advocacy Specialist

Michael Pesavento is a Media Advocacy Specialist in the San Diego County office.

Tackling the Alcohol Culture on College Campuses: Do Late Night Programming Alternatives Work?

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Imagine thousands of college students, gathered in a carnival atmosphere, some playing inflatable games, others climbing a rock wall, many dancing under the moonlight to a live band. Here and there, small groups are huddled together, with smiling faces, taking selfies. But wait… something is missing. None of them are holding those ubiquitous red plastic cups, the ones young people always have when they’re partying, the ones that hold their alcoholic drinks.

Why? Because this is a special kind of event, part of San Diego State University’s Aztec Nights, a series of late-night activities organized to meet students’ social needs. Held during the beginning of the school year, it’s where new and returning students get a chance to mix and mingle in a healthy atmosphere, grab free cookies, stickers, water bottles, get their caricatures drawn, or participate in a dozen other fun activities – all free of charge, and all free of alcohol.

It should be noted that these events are not promoted as alcohol-free, just as a way to have fun. However, they are specifically designed to draw students away from alcohol-based activities at bars, clubs, and house parties, especially during the beginning of the school year when students are establishing new attitudes and behaviors. And research has shown that this approach works, reducing substance misuse and associated harms.

Such problems have long plagued colleges and universities. In addition to declines in academic performance, excessive drinking has been associated with personal injuries from fights, vandalism, property damage, sexual harassment and assault. Many deaths have also resulted from alcohol poisoning occurring during house parties where heavy drinking is the norm. And with binge drinking rates hovering around 40% for decades, college-based prevention programs have been unable to stem the tide.

The reason, according to an article published by The Chronicle of Higher Education, is that efforts have been focused mostly on education, providing information about the hazards of drinking and the benefits of a healthy lifestyle. What is needed, is to focus directly on the drinking culture, which is based on the idea that excessive drinking is not only normal, but an essential part of the college experience. However, because it has become so very entrenched on college campuses, this culture is highly resistant to change.

This is where alcohol-free late-night programming comes in. By offering multiple opportunities for socializing in lower-risk settings, such programs provide another way – besides alcohol-based activities – to facilitate peer bonding and establish social networks. Students need these two functions in their formative years, which they have traditionally acquired through the drinking culture. But no longer, not where LNP has been implemented.

So, how does it work? The key is to hold events on campus on Thursday, Friday, and Saturday nights, during the young-adult prime social times of 9 p.m. to 2 a.m. To compete with the alcohol scene, the events need to be of high quality and designed to appeal to young people. Examples include free movies, carnivals, dances, live music, comedy, casino nights, magic shows, video games, or arts and crafts. Such activities are also scheduled for the first six weeks of the school year, when students are at the greatest risk, according to research.

Recognizing the value of LNP, many universities have adopted them as part of their overall prevention strategy. In addition to SDSU, these have included Stanford, Penn State, Ohio State, and several others. But these programs can be expensive, costing from $200,000 – $300,000 per year, and complex to implement. So, it’s difficult to get them up and running. However, data reflect it’s worth the effort as alcohol-related problems typically cost more than $1 million a year for an average size university.

For those working with colleges on such an effort, the following guidelines are offered to help overcome the challenges and achieve a successful outcome.

  1. Administrative Support is Crucial
    Most LNPs have been helped along by administrative staff within the Division of Student Affairs who acted as a champion for the program. Often this included the formation of a task group to assess the problem and investigate possible solutions. Involvement of student government and other key stakeholders is also important. So, conducting outreach to raise awareness about the value of LNP among appropriate administrative personnel is a good way to get started.
  2. Goals & Objectives
    Changing the campus culture is an appropriate goal. Objectives include organizing numerous large-scale events on campus and promoting them with branding designed to establish a new ethos of health and safety for the university. This is what SDSU has done with its Aztec Nights program. However, for a new program, starting with a goal of just diverting students away from alcohol-based activities is more advisable. Transferring one or more already-popular events to late-night hours would be a reasonable first step.
  3. Infrastructure
    Planning and organizing of events are usually done by an office within Student Affairs. Implementation is carried out by in-house staff with support from students clubs and organizations. Funded by mini-grants, such groups submit a proposal specifying the theme of the event, its cost, and expected attendance. Program staff provide support with event setup and breakdown as well as promotional activities.
  4. Funding
    Funding is dependent on administrative support. During its initial years, a program may have to rely on soft money, such as contributions by various donors on a year-to-year basis. With a more established program, such as SDSU, funding has been institutionalized as a part line item in the general budget. It should be noted that SDSU’s program was started with strong administrative support secured through research showing the program’s effectiveness.
  5. Evaluation
    Evaluation should at least include surveys of event participants to obtain data about attendance, student satisfaction, and any drinking on the night of the event. A more thorough evaluation would also measure the impact of LNP on rates of binge drinking and its consequences over time. Learnings should be used to improve the program’s operation as well as program success in reducing alcohol-related problems, which would be helpful in securing additional funding.

The establishment of an LNP, whatever form it takes, is not expected to eliminate all alcohol-related problems. Instead, it should be part of a comprehensive program that includes education, policies that are consistently enforced, and referrals for treatment for students in need. But despite such limits, LNP has shown to be an effective tool to address what has been for years an intractable problem, a tool that should be considered by all institutions of higher education.

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Author:

Dan Skiles
Consultant, IPS

Dan Skiles is a consultant and former Executive Director at the Institute for Public Strategies, a Southern California-based nonprofit that works alongside communities to build power, challenge systems of inequity, protect health, and improve quality of life.

Do Harm Reduction Practices Help People Stop Using Drugs?

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Drug overdose deaths reached a record high during the pandemic. By April 2021, more than 100,000 people died from an overdose, a 30% increase over the prior year, according to government statistics. The trend has some public health and elected officials looking toward a solution that some would consider radical: harm reduction. For the first time, the Substance Abuse and Mental Health Services Administration (SAMHSA) is targeting more than $30 million in grants for harm reduction efforts. The Centers for Disease Control and Prevention (CDC) is partnering with SAMHSA to establish a Harm Reduction Technical Assistance program to support syringe service programs. In California, health officials and some legislators are looking at harm reduction as they consider realistic ways to decrease the harmful effects of drug use.

Harm reduction is a set of practical strategies and ideas aimed at reducing the negative consequences associated with drug use, according to the Harm Reduction Coalition. Harm reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

Perhaps the best known harm reduction strategy is syringe exchange, where workers give people who use drugs clean needles in exchange for their dirty ones. Additional harm reduction methods include:

  • Medically assisted treatment for opioid use disorder
  • Medication to reverse opioid overdoses (Naloxone)
  • Safe smoking supplies to help injection users find a less harmful method of use
  • Supervised injection sites, which have shown promise as a solution in European countries
  • Overdose prevention education
  • Fentanyl test strips (strips that test drugs for cross-contamination with fentanyl)
  • Education, therapy, and discussion groups aimed at helping active drug users minimize harms to their health through managed, reduced, or safer drug use

Harm reduction practices are not new. Europe has had harm reduction programs for many years. In the U.S., a few syringe exchange programs were started during the AIDS crisis in the 80’s and 90’s to prevent the sharing of needles and to slow the rapid rise in disease among injection drug users. According to the CDC, there has been a decrease in HIV diagnoses attributable to those early syringe exchange programs.

Declines in HIV and Hepatitis C infections have also dramatically reduced healthcare spending. The estimated lifetime cost of treating one person living with HIV is almost $450,000. Hospitalization in the U.S. due to substance use related infections alone costs over $700 million annually.

Harm reduction strategies are intended to keep users alive and healthy, without judgment or pressure to stop, until they are ready to seek treatment or quit. Syringe services programs (SSPs), for example, can reduce overdose deaths by teaching people who inject drugs how to prevent and respond to a drug overdose, providing them training on how to use naloxone (a medication used to reverse overdose), and providing naloxone to them. Importantly, SSPs facilitate entry into treatment for substance use disorders by people who inject drugs. People who use SSPs show high readiness to reduce or stop their drug use. There is evidence that people who inject drugs and work with a nurse at an SSP or other community-based venue are more likely to access primary care than those who don’t. SSPs have also partnered with law enforcement, providing naloxone to local police departments to distribute it more broadly in populations that need it.

Despite its demonstrated successes, there are concerns that harm reduction is giving people a license to freely use drugs. Former California Governor Jerry Brown vetoed a bill to create syringe service sites in San Francisco three years ago, calling it “enabling drug use.” This kind of stigma has prevented many communities from even considering harm reduction programs. Stigma is based on a perception, long-standing in the U.S., that substance users are bad and immoral rather than suffering with a chronic condition requiring care and treatment. Those who argue for harm reduction say it doesn’t enable drug use, rather, it encourages safer methods of use until abstinence is possible. Still, intense stigma persists. According to the Harm Reduction Journal, it is this intense stigmatization that aggravates, rather than ameliorates, the ability to engage people struggling with drugs into an abstinence model.

In the past year alone, the climate around harm reduction has dramatically shifted. Most states are expanding access to fentanyl test strips and Narcan and increasing funding for harm reduction programs. New York state just began its first safe injection site pilot program, opening two locations in Manhattan in November of 2021. A bill is also now winding through the California legislature. SB57 proposes hygienic spaces where trained staff will provide sterile supplies and connections to health resources and treatment. If more states and communities adopt harm reduction strategies, we’ll continue to get a better picture of whether or not it can impact the crisis of overdose deaths we’re facing.

Authors:

Dean Ambrosini
Prevention Coordinator, IPS

Dean Ambrosini is a Prevention Coordinator at the Institute for Public Strategies for the West Hollywood Project, based out of IPS’s LA office.

Cynthia Nickerson
Media Advocacy Specialist, IPS

Cynthia Brooks Nickerson is a Media Advocacy Specialist at the Institute for Public strategies, supporting IPS’s prevention projects across Southern California.

Unleashing the Power of Prevention: Looking Forward, Public Policy is the Answer to High Health Care Costs

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An ounce of prevention is worth a pound of cure. That statement, submitted by Benjamin Franklin to the citizens of Philadelphia in 1736, was originally a warning to be vigilant about fire prevention. Still relevant after almost 300 years, that timeless phrase has become an American proverb. And its wisdom, it’s fair to say, has been almost universally accepted. Whether it’s speed bumps in a residential neighborhood, routine maintenance on the family car, or the annual medical checkup, prevention has become incorporated into our daily lives.

Another example would be the household fire extinguisher, of which, we can be sure, Ben Franklin would be proud. But Franklin had more than that on his mind when he drafted his essay on prevention for the Pennsylvania Gazette. To be sure, he urged the citizens of Philadelphia to take precautions that would ensure safety in their homes. But he also recommended the adoption of several public policies, measures enacted into law that would protect the entire community. In addition to regulations about the design of hearths, these included the organization of volunteer fire brigades and the licensing of chimney sweeps.

This forward-thinking approach, using public policy to circumvent potential hazards, is still one of our most effective tools to ensure public health and safety. Known as population-level prevention today, it has been successfully applied to many of our most pressing problems. For example, laws making workplaces, restaurants, and bars smoke-free can reduce heart attack hospitalizations by 8–17% according to the Center for Disease Control. And traffic-related fatalities have been significantly reduced over the years though the mandatory use of seat belts along with .08 alcohol consumption laws and DUI enforcement operations.

Controls on alcohol and tobacco products have always been a priority for prevention because they are associated with so many health-related problems.  In fact, data show that each of them, along with unhealthy diet and physical inactivity, plays a role in one or more of the top five causes of death in America: cancer, heart disease, stroke, diabetes, and injuries and violence. Of course, in a free society, we can’t compel people to do what’s good for themselves. But we can structure the environment in such a way that there are incentives for adopting healthy behaviors and disincentives for unhealthy ones.

The essence of population-level prevention is going upstream to address the root causes of illness and injury. Such initiatives are usually spurred by the work of nonprofit agencies, mostly with support from state agencies and private foundations. However, despite their success, resources to expand their use, such as funding from the federal government, have been limited. For example, even though 75% of our healthcare costs in America is attributable to preventable conditions, only about 3% of funds is spent on prevention, and most of it comes from states and local municipalities.

The costs involved here are enormous. In 2019, U.S. spending on healthcare – both mental and physical – reached $3.8 trillion, or $11,582 per person. That would amount to about 18% of the nation’s gross domestic product. What’s more, while these expenses have been growing for decades, the percentage spent on prevention has been declining. As such, the reason for the escalating cost of healthcare is not an increase in disease, but our reliance on treatment.

Access to treatment is important, especially for racial and ethnic minorities who have been historically underserved. But we can never expect to hold down the cost of healthcare unless we change our priorities and provide more funding for population-level prevention. More than three-quarters of Americans (76%) support this approach to healthcare reform, according to the Robert Wood Johnson Foundation. Overall, they found that prevention rates higher than providing tax credits to small businesses and prohibiting health insurers from denying coverage based on health status.

But we need to do more than just provide more money. In our work to address the root causes of illness and injury, we need to go even further upstream and consider the context in which they occur. It’s not enough to attribute our problems to the irresponsible behavior of certain individuals. Nor should we rely on singling out the bad actors in the business world who perpetuate them for profit.

 

These are systemic problems, all of which are interrelated and each of which depends on the others. We may not realize it, but they spring mostly from community conditions like poverty, inadequate housing, availability of healthy foods, racism, crime, and violence. That’s why the status of a person’s health depends largely on their zip code, which makes it clear where our prevention dollars should be spent.

In the final analysis, we’ve only scratched the surface in our prevention efforts. It’s time we go deeper and make the investment that’s required to meet the challenges we face.

Author:
Dan Skiles
Consultant, IPS

Dan Skiles is a consultant and former Executive Director at the Institute for Public Strategies, a Southern California-based nonprofit that works alongside communities to build power, challenge systems of inequity, protect health, and improve quality of life.

Immigration is Mutually Beneficial. When will Americans Learn this Lesson?

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As seen on the San Diego Union-Tribune.

As “the land of opportunity,” the United States has always had a tradition of welcoming immigrants. Indeed, as we all learned in high school, our country was built by such people. Mostly poor, uneducated and unskilled, more than 20 million immigrants came to America between 1880 and 1920. Despite opposition and resentment, they survived and prospered all while helping to build the greatest economy in the world.

America’s experiment in democracy deserves the credit. By bringing in new people with new ideas, it fostered competition, creating what became widely known as American exceptionalism. And it worked. Not just then, but even today, with almost half of America’s Fortune 500 companies being started by immigrants or the children of immigrants.

Now we are experiencing a new wave of immigrants flooding across our southern border with Mexico. Mostly people of color, they have mainly come from El Salvador, Guatemala and Honduras, fleeing oppression and violence in their home countries. More recently some 15,000 immigrants, many from Haiti, established a tent city near a Texas border crossing. But they all came here seeking a better life, just like those others did more than 100 years ago

After all this time, it seems like Americans would understand how immigration is a mutually beneficial process. On the one hand, it reinforces the U.S. economy on a systemic level, and on the other, it transforms the lives of immigrants on an individual level. In the final analysis, we need each other, especially now in the wake of the COVID-19 pandemic that has America suffering a labor shortage.

Unfortunately, America has still has not learned this lesson. Consumed by prejudice and intolerance, especially against racial and ethnic minorities, opponents fail to see the potential benefits. Just as their predecessors did more than a century ago, they fear the worst: increased crime and violence from a generation of freeloaders who present nothing but a burden on America’s economy.

Such ideas have been fostered by misinformation and spread through social media and political rhetoric. Growing in intensity every year, the problem has now reached a boiling point. Yet the facts paint a completely different picture. When we look at the research, we find that most new arrivals are law-abiding, hardworking and loyal, perhaps even more so than the rest of us.

First of all, contrary to the stereotypical depiction, new immigrants are not chronically in need of health care and other social support. Instead, they are healthier than expected when entering the country, willing to work and contribute to society. This is especially true for refugees like those seeking asylum in America. The federal government does pay the initial cost of their resettlement, but over their first 20 years of residency, they pay it all back and more in taxes.

What about the “rapists” and “murderers” we’ve heard about? The worst of the worst, coming across the southern border to wreak havoc and disorder? Again, these stories are intended only to frighten and build political opposition. The truth is that crime rates among immigrant populations are actually lower than those of native-born Americans. According to a landmark study by the Cato Institute, a conservative think tank, even people who have entered the country illegally have lower rates of conviction. In fact, 45 percent lower when comparing the 2018 conviction rates of undocumented immigrants in Texas to those of native-born Americans in Texas. Moreover, the data shows that rates of violent crime go down as immigration increases.

These data are not only clear but conclusive. Rather than being a burden, immigrants are a good investment in America’s future. Even so, many people — 42 percent, according to a 2019 Gallup poll — remain convinced that immigration leads to crime.

Why do so many cling to these false beliefs? Alex Nowrasteh, one author of the Cato Institute study, may have the answer. It “could be that people who don’t like immigration could just ascribe all types of negative behavior to [immigrants] in order to justify their dislike.”

It’s time to leave such false narratives behind. History has proved them wrong. Today we know the truth. It was diversity that made America great — diversity of people and ideas, brought together in a free and open society where everyone has the chance for a better life.

America has come a long way since its beginnings, and it has been an uphill battle. But through war, civil strife and political upheaval, the country has been steadily moving beyond its racist past.

It is time to celebrate people of color and welcome a new era of freedom and prosperity. Let’s not let petty biases and prejudice stand in the way.

Author:
Dan Skiles
Consultant, IPS

Dan Skiles is a consultant and former Executive Director at the Institute for Public Strategies, a Southern California-based nonprofit that works alongside communities to build power, challenge systems of inequity, protect health, and improve quality of life.

Our Right to Protest is Under Assault

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“Speak up, speak out, get in the way. Get in good trouble, necessary trouble, and help redeem the soul of America.” — Congressman John Lewis

Peaceful protestors have been redeeming the soul of America since its founding. They are among our nation’s heroes. Labor rights, women’s suffrage, civil rights, gay rights, voting rights, reproductive rights, environmental protections – all of these were spurred on through protest. Whether you enjoy a 40-hour work week, visiting the beach without oil rigs blocking out the sun, or your right to use public transportation without restriction based on the color of your skin, protestors deserve much of the thanks.

Women would have undoubtedly won the right to vote, but it was the suffragists who got it done. And the United States would have eventually withdrawn troops from Vietnam, but how many thousands of unnecessary deaths were prevented by protestors who kept the pressure on? Protestors aren’t ahead of their time. They make now the right time by appealing to our national conscience, educating the public about injustice and keeping pressure on the status quo.

Just as America’s progressive movements have relied on public protest to grow and succeed, so have they faced powerful interests working to stop change. Today, legislators are passing laws making protests more difficult, illegal in some states, and potentially lethal in others.

Since January 2017, 230 anti-protest bills have been introduced in 45 states. Thirty-six have been enacted. And 51 are pending, according to a US Protest Law Tracker created by the International Center for Not-for-Profit Law. An analysis of the bills by ICNL uncovered four themes that thread through the anti-protest legislation being proposed and adopted in some cases. As reported on the ICNL website, they include extreme penalties for offenses commonly related to protests; vague and overbroad provisions that can capture peaceful protesters; expanding liability; and encouraging violence against protesters. One example from legislation adopted in Florida protects a person from civil liability if they injure or kill a protestor with their vehicle when the victim is participating in a riot. The law also redefines a riot as an assembly of three or more people.

Let that sink in for a moment. A predominantly peaceful protest of people exercising their constitutional right to free speech and assembly, being mowed down by an angry motorist who disagrees with them and the driver gets a pass.

By intimidating protestors, legislators are attempting to hinder progress. These laws are an assault on our right to protest and cry out for our attention and our outrage. When you see legislators advocating for restrictions like these, look behind the curtain. Dig deeper. What interests are they really trying to protect? Think about the progressive reforms we enjoy that would have been unjustly delayed, or perhaps prevented, by laws like these. Protesters are heroes in our American story. The people who John Lewis said “got in the way … to renew the soul of our nation.”

Alcohol is Hurting Women

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October is Breast Cancer Awareness Month. During this time dedicated to women’s health, it would be remiss not to reflect on a dramatic truth – women are drinking more than ever, and unfortunately, alcohol use is correlated to cancer.

Although 5-10% of breast cancers are attributed to genetic history, we now know alcohol is causally related to breast cancer. Even consumption of up to one drink per day is associated with increased risk of alcohol-related cancers (mainly breast cancer). Risk appears to be higher among heavy drinkers and binge drinkers, but even light drinkers have elevated risk.  

What does this mean for women? A lot, according to recent data. Women are closing the gender gap in alcohol consumption, binge-drinking and alcohol use disorder. What was previously a 3-1 ratio for risky drinking habits in men versus women is closer to 1-to-1 globally. The COVID-19 pandemic of 2020 has only added to this trend. According to a RAND Corporation study, women have increased their heavy drinking days by 41% compared to before the pandemic. This is due in part to the prolonged psychological stress and increased anxiety, particularly for women with children under age 18. 

Adding to the problem, the alcohol industry is turning a blind eye to the breast cancer connection and aggressively targeting women. “Pink-washing” is a common practice. Multiple brands co-opt the pink ribbon with packaging taglines such as “Join the Fight- Drink Pink”, or “Helping Women Now.” Lower calorie alcohol options are abundant and intended to appeal to women. Overall, the industry ensures alcohol availability is pervasive. The message? Consumption is appropriate for every occasion.

So what can be done?  A combination of education and policy approaches are the best way to reduce alcohol consumption and cancer rates. Most women are unaware of the link between alcohol and cancer. According to the Public Health Institute, 17% of women don’t know that drinking has a negative impact on their breast health. A 2017 telephone survey found that just 39% of respondents knew drinking alcohol increases one’s risk of getting cancer. 

Policy changes could include incorporating cancer warnings on alcohol bottles and cans – a measure being advocated for by several consumer and public health groups. Increases in alcohol tax so the industry shares the burden of harm are not only reasonable, but also appear to impact rates of binge drinking. Limiting alcohol availability and youth access to alcohol does as well. 

In a culture where alcohol is oftentimes marketed as synonymous to a good time or promoted incorrectly as a means of stress release, policy changes like these can lead to more informed behavioral decisions and healthier lifestyle choices. The bottom line is, reducing alcohol intake also reduces breast cancer risk. We can all have a role in breast cancer prevention.

Find out if you qualify for a free or low-cost mammogram here.

Author:
Susan Caldwell
Senior Program Manager, IPS

Susan Caldwell is a Senior Program Strategist at the Institute for Public Strategies, a Southern California-based nonprofit that works alongside communities to build power, challenge systems of inequity, protect health and improve quality of life.

Fact or Fiction

Misinformation About COVID-19 is a Crime that Should Have Consequences

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As seen on the San Diego Union-Tribune.

Some people’s staunch allegiance to misinformation about COVID-19 was sadly unmistakable at a San Diego County Board of Supervisors meeting on Aug. 31 when the board declared health misinformation a public health crisis. Despite opposition from close to 200 people and hostility from some of speakers at a 15-hour meeting, the board became the first in the nation to take such a stand.

Unfortunately, the rancor the supervisors witnessed was hardly unique. False narratives have been creating havoc at public meetings throughout the country. The rejection of science is being confused with patriotism. Violence and hate speech are being cloaked in the American flag. And climate change is being questioned still.

U.S. Surgeon General Vivek Murthy has warned that people are dying because of misleading or inaccurate information about the efficacy of vaccines, which have proven to be highly effective. Most people believe the science, but many, being misguided or uncertain, still resist being vaccinated, enabling more contagious variants of the virus to proliferate.

Consisting of false narratives, conspiracy theories, distortions, and outright lies, misinformation is created by special interest groups for political and/or financial gain. Then it is spread through the mass media without any regard for the consequences.

Such false narratives present a threat to more than public health. They can also be linked to the record levels of violence that are currently plaguing the United States. The murder rate increased around 29 percent from 2019 to 2020 — the largest one-year spike in murder since national record-keeping began in 1960 — so even though overall crime decreased last year, 2020 was the most violent year in the 21st century. There were around 21,500 murders in 2020.

In that same span, there were 7,759 hate crimes reported in the U.S., the most in 12 years, targeting communities of color, the LGBTQ community and various ethnic groups, among others. Evidence shows these events are driven by hate speech, a type of false narrative that has been increasing throughout the world, in online forums and even political discourse. The fallacy behind hate speech is that a certain group poses a threat, which generates fear that the threats are real and will somehow impact them.

Some question the willingness of people to believe such obvious propaganda. But history shows that when ideas are repeated often enough, people’s tendency to believe them increases. That is especially true when they come from a source that seems credible, like a person of authority or an evening news broadcast. Even ideas that seem bizarre can be accepted as truth if they are spread widely throughout the population. This principle was used by Nazi propagandists during World War II to spread the idea that Jewish people were evil blights on society and deserved to be eliminated.

False narratives also play a role in events related to climate change, including the drought, ravenous wildfires, and massive floods that are causing widespread death and destruction worldwide. In this case, the false narrative is denial. The science is well-established, and the counterarguments are complete without merit, reminiscent of when the tobacco industry tried to convince us that smoking doesn’t cause cancer. Nonetheless, people who reject mainstream climate science persist, accusing reputable scientists of having hidden agendas and nefarious motives.

Some suggest that social media platforms such as Facebook should do a better job of filtering out phony stories. While this is probably a good first step, more attention should be paid to the role played by the mainstream news media in the distribution of misinformation.

Such media outlets are relied upon to give people the facts they need to make crucial decisions about their health, safety and welfare. But many of them, some trusted by tens of millions of people, have clearly been responsible for perpetuating false narratives on a regular basis. Driven by financial gain, their entire business model seems to be focused on building their audiences by creating fake news stories, ones that are simply based on whatever conspiracy theories are popular on a given day.

The Fox News Channel has, by far, the broadest reach and the most misplaced trust, specifically with its shows “Tucker Carlson Tonight,” “Hannity” and “The Ingraham Angle.” Other problematic broadcast media outlets include One America News Network and Newsmax TV, but neither of them have the widespread and mainstream influence that Fox News has.

Perhaps most important of all, people need to be well-informed for our democracy to function.

The news media has always been protected by the doctrine of freedom of the press. But when a particular outlet spreads lies that work against the public interest, it should lose that protection.

In such cases, we should hold such outlets accountable by enacting truth in news reporting laws, which could be modeled after the truth in advertising laws we have now.

Most mainstream media outlets are responsible, but if a rogue operator continuously and intentionally violates its public trust, it should have its broadcast license suspended. It’s as simple as that.

Author:
Brenda Simmons

Brenda Simmons is CEO/President of the Institute for Public Strategies, a Southern California-based nonprofit that works alongside communities to build power, challenge systems of inequity, protect health and improve quality of life.

We’ve Overcome Stigma and Prejudice, Now Let’s Overcome Drugs and Alcohol

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Pride Month sprang from the 1969 Stonewall Uprising in Manhattan. What began as an impassioned march to Central Park to commemorate the riots is now a month-long celebration at huge festivals in cities around the world, promoting dignity, equality, and self-affirmation for the LGBTQ+ community. However, as we wrap the 51st annual Pride Month, it’s important to reflect on another aspect of our community that doesn’t elevate us. In fact, it drags us down: disproportionately heavy alcohol and drug use.

Individuals in the LGBTQ+ community are 90% more likely to use alcohol and drugs than their heterosexual counterparts. More than a third (38%) of LGBTQ+ aged 18 and older reported past year marijuana use, compared to 16% reported by the overall adult population. Opioid use (including misuse of prescription opioids or heroin use) was also higher, with 9% of LGBTQ+ aged 18 or older reporting use compared to 4% among the overall adult population. In 2015, past-year meth use prevalence was more than four times higher among gay men compared to straight men. In West Hollywood, an LGBTQ-centric city, recent surveys indicate open meth use at events (74%) and at bars and clubs (68%) was an issue harming the community.

Why the heavy use of drugs and alcohol? It’s not so difficult to understand. For one, bars and clubs have been a central gathering place for us for decades, providing refuge, connection, and escape from prejudice. Alcohol has long been a backdrop in the areas where we have felt safe.

It is also largely a question of stress, self-esteem and mental health. Compared to their straight counterparts, LGBTQ+ individuals report a disproportionately higher prevalence of Adverse Childhood Experiences (ACEs) – traumatic or stressful life events. A 2020 study published by the Center for American Progress revealed a dramatic picture of measures taken by LGBTQ+ Americans to avoid discrimination: more than half of respondents (54%) had hidden a relationship. Over one in three had moved away from family (32%), changed the way they dressed/mannerisms (35%) and avoided public places (33%). Alcohol and drugs, in addition to being socially normative for our community, have long been used as a poor coping mechanism and escape from internalized homophobia, rejection and shame.

So what can we do about it? It requires a comprehensive approach that includes important policy and social norms changes. On a policy level, the adoption of reasonable practices that optimize LGBTQ-centric entertainment districts — including addressing excessive bar and club density, operational mismanagement and community impact — is crucial. Pride events are another area where important policy shifts are required.

The “Tobacco Policies and Alcohol Sponsorship at Lesbian, Gay, Bisexual, and Transgender Pride Festivals: Time for Intervention” study observed that, while sexual health promotion is common at pride events, few events have policies promoting health in other areas. The study finds that while reducing and/or eliminating alcohol sponsorship of Pride events is challenging in the near term, “…we believe it is critical to renew a conversation about critically appraising the marketing efforts of industries that sell products that disproportionately target and harm LGBT+ communities and communities of color.”

There is also tremendous progress to be made shifting away from alcohol and drugs as a normative part of our culture. Alcohol-free gathering spaces and events can be cultivated by public health practitioners, LGBTQ-centric organizations, Pride organizers and public officials. The City of West Hollywood, for example, has sponsored a large alcohol-free space at LA Pride that attracts thousands of attendees for the past seven years.

Powerful messaging and initiatives from influencers and organizations that highlight health, wellness and self-esteem will make a dramatic impact over time in changing our community’s attitudes about drugs and alcohol. It’s especially important for those who are newly coming out.

Pride is a time to celebrate all that is great about our community – all that we’ve contributed and how far we’ve come. Now’s the time to look squarely at the problematic drinking and drug use that has long plagued us and that, tragically, is born from a long history of discrimination and prejudice. Everything is already shifting for our community and this can too. A 2010 poll of 1,500 people who are already out, found that among the over-60s, the average age they had come out was 37. In the group aged 18 to 24, it was 17. What a tremendous indicator or our progress toward self-acceptance and with it, health, wellness and self-love.

Happy Pride.

Author:
David R. Shorey
Program Manager, IPS

David R. Shorey is a Program Manager at the Institute for Public Strategies, a Southern California-based nonprofit that works alongside communities to build power, challenge systems of inequity, protect health and improve quality of life.