Tag Archive for: Policy & Systems Change

A Perfect Storm: When Climate Change, Racial Justice, and Mental Health Collide

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April is a busy month for mental health awareness: National Minority Health Month, Alcohol Awareness Month, and Stress Awareness Month. When you add in Earth Day, this is a good time to remember that stewardship of the planet goes hand in hand with safeguarding mental health. After all, clean air and water, safe neighborhoods, and intact social networks are part of the social determinants of health. But when they are compromised or destroyed by Mother Nature, it can cripple a community’s ability to cope. This can lead to stress, anxiety, depression, and self-medication through substance use.

Communities of color are most vulnerable to the effects of the 21st century’s biggest challenge – climate change. With fewer resources and systemic racism in post-disaster recovery, they disproportionately suffer from injustices brought on by droughts, intense storms, destructive wildfires, and catastrophic flooding.

Environmental Justice is Racial Justice

Junee Kim knows this all too well. She is a high school student in Montgomery County, MD, and a climate activist with the BIPOC Green New Deal Internship program.

“One of our environmental goals is to hold the school district accountable to their commitment to electric buses, but they have drifted away from that by buying more diesel ones,” said Junee, a sophomore at Watkins Mill High School in Gaithersburg, MD. “I’m worried for my generation and the ones after us,” she said. “Many of my peers are stressed about climate change, but there isn’t a whole lot of awareness of how climate change impacts mental health and how to deal with it.”

Junee describes climate change as especially scary for underprivileged people and people of color because they are the ones most affected. “Not only will Earth deteriorate, but the gap between the ‘haves’ and the ‘have nots’ will continue to widen.”

If there was one silver lining brought on by Hurricane Katrina in 2005, it was the urgency to address the racial disparities and social injustice brought on by climate change and natural disasters. Research continues to show that non-white neighborhoods are more likely to be impacted by flooding, as experienced by Black and Hispanic communities during Katrina and later by Hurricane Harvey in 2017.

Elevated temperatures from global warming also highlight the struggles of low-income, inner-city neighborhoods, which are mostly inhabited by people of color. These areas are often trapped in “heat islands” where temperatures are much higher than surrounding areas with more green space. Residents of these neighborhoods are less likely to have an air-conditioner or a car that they can take to a “cool zone” compared to a predominantly white neighborhood. Exposure to such intense heat increases the risk of heat stroke, heat exhaustion, and heart attacks. Alcohol, drugs, and heat just don’t mix. They exasperate the underlying physical conditions or lead to new ones.

The Intersection of Climate Change, Mental Health, and Substance Misuse

The trauma caused by Katrina caused many of the displaced disaster victims – mostly Black – to turn to substance use. In Houston, one in four Blacks said their mental health had gotten worse and 11% of Blacks report they increased their alcohol use as a result of Harvey.

The West Coast doesn’t fare much better with its climate challenges. In California, devastating wildfires resulted in an uptick in prescription pill use. Researchers from Columbia University Mailman School of Public Health recently found that hospital visits from alcohol and drugs increased as a result of rising temperatures due to climate change.

Policy Responses and Adaptation Strategies

Because climate change is a complex and divisive issue, solutions can be equally perplexing. It requires a multi-faceted approach that integrates public health, social justice, and environmental science and technology. Most importantly, it must be community-driven, with those most impacted having a seat at the table.

One crucial aspect of a policy response is to be proactive rather than reactive. This means prioritizing interventions that promote community resiliency in under-resourced neighborhoods and communities of color, both in terms of physical infrastructure and mental health by doing the following:

  • Prioritize households with residents who are low-income, elderly, disabled, or non-English speaking in evacuation plans.
  • Demystify the process of receiving post-disaster aid by increasing the health and financial literacy of community members.
  • Establish mental health services and community support systems well in advance of natural disasters that equip individuals with healthy coping mechanisms that do not involve substance use.
  • Incorporate programs into high schools that foster advocacy and build resiliency, such as a resident leadership academy or Mind Matters.
  • Build a network of ‘trusted messengers’ – the people who carry out public health strategies within their communities.

“The first step is just understanding the effects climate change has on mental health,” according to Junee. “And only then can we address the resiliency part.”

Author:

Meredith Gibson
Media/GIS Director, IPS

Meredith Gibson is the Media/GIS Director at the Institute for Public Strategies. She uses geographic information systems (GIS) and media advocacy to promote systems and policy changes that contribute to healthy, safe, vibrant, and equitable communities.

As 2024 Ushers in a New Silent Opioid Epidemic, Securing LGBTQ+ Spaces is the Answer

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As seen in WeHo Times

In the shadows of the ongoing opioid crisis that continues to grip our nation, a new silent epidemic has emerged that has gone virtually unnoticed. While the opioid epidemic has commanded national headlines and sparked urgent conversations about substance use disorders and treatment, the LGBTQ+ community continues to remain shrouded in silence – left in a battle to combat this crisis alone. Homophobia today contributes to more overdoses than ever before and our divisive politics stand in the way of saving the lives of our LGBTQ+ neighbors.

The tragic reality is that homophobia in our country continues to persist on a regular basis. The stigmatization and discrimination faced by LGBTQ+ individuals often leads them to adopt unhealthy behaviors to cope – many of which predisposes them to a long-term struggle with substance use disorders. In 2020, LGBTQ+ individuals were found to use substances at nearly double the rate of the overall population. Consequently, LGBTQ+ individuals often enter treatment with more severe substance use disorders when compared to their heterosexual counterparts. While schools and community organizations have attempted to foster safe spaces to curb this pattern, our challenging and divisive political climate has hindered progress.

Over these past few years, nationwide anti-gay policies and legislation have threatened the safety of LGBTQ+ individuals. In 2022, Florida Governor Ron DeSantis introduced the controversial “Don’t Say Gay” bill. Meanwhile, the University of Houston closed its campus’ only LGBTQ+ resource center in response to the passing of Senate Bill 17, which banned diversity, equity, and inclusion initiatives in higher education institutions. LGBTQ+ books across the US have been banned from libraries and schools with many believing that the art of drag poses a greater threat to our nation than deadly firearms.

Gay bars, which to many in the LGBTQ+ community are seen as safe havens for gathering, have been on a steady decline. A report by The Washington Post states “all gay bar listings declined by 37 percent between 2007 and 2019, the number of queer bars serving people of color declined by 59 percent, and bars for lesbians declined 52 percent.” Due to their decline, a large piece of safety and comfort is lost for many in the LGBTQ+ community. On top of that, those who are in the recovery community may want to avoid gay bars so as to not give in to pressures or temptations of alcohol.

With the unprecedented amount of vitriol the LGBTQ+ community is facing, now is the time to mobilize and unify efforts toward a positive paradigm shift. If our goal is to eliminate this new silent epidemic, we need to coalesce and diversify safe spaces for the LGBTQ+ community. While creating safe spaces is an arduous feat, history has also shown that unified efforts can achieve remarkable progress.

When HIV/AIDS was dubbed a silent epidemic during the 80s, The ACT UP coalition was formed to end misinformation, re-invigorate political action, and shift the public narrative surrounding the deadly disease. Founded by members of the LGBTQ+ community, they mobilized public awareness campaigns, staged demonstrations and most importantly, gathered members together to discuss the problems in an inclusive manner. The organization’s activism eventually propelled ACT UP to be an internationally recognized group, becoming a favorite choice for resources and information on HIV/AIDS for the LGBTQ+ community.

ACT UP was instrumental to the change in public perception of HIV/AIDS, paving the way for advancements in the social and scientific aspects of the silent epidemic. If we want to tackle this new silent opioid epidemic head-on, we must commit to mobilizing in a manner similar to ACT UP to end LGBTQ+ overdoses. One of our first steps should be creating more community spaces for LGBTQ+ people that are affirming and sober.

There is an urgent need for more LGBTQ+ spaces and events that do not have access to drugs and alcohol. Coffee shops, bookstores, and community centers should take initiative to host LGBTQ+ activities and become cornerstones for inclusive community building.

Cuties, a Los Angeles coffee shop that opened in 2017, was founded with the intention of providing a safe space for members of the LGBTQ+ community that was not focused around alcohol and substance use. They would host a variety of events at the cafe quickly becoming a hotspot for many of its patrons. Unfortunately, the brick and mortar coffee shop closed its doors in 2020 due to the COVID-19 pandemic, and its untimely closing has contributed to the dwindling presence of LGBTQ+ safe and sober spaces.

It is essential to support local LGBTQ+ meeting spaces. To be an ally to the LGBTQ+ community, reaching out to local school districts, chambers of commerce, and business owners to host LGBTQ+ nights is a first step in the right direction. For people who identify as LGBTQ+, the time is now to connect with our fellow LGBTQ+ neighbors and mobilize movements for safe and sober areas, which will pave the way for healthier,  and safer substance use practices. Even if these actions feel out of reach, simply talking to your families and neighbors about LGBTQ+ acceptance and sharing your own story of acceptance can move us toward a future where sexual identity does not put one at risk for an overdose.

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Darwin Rodriguez is a program manager at the Institute for Public Strategies and oversees the Safer WeHo Coalition in West Hollywood.

Taxing Alcohol to Protect Public Health and Safety Is a Good Thing

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Most people cringe at the idea of paying more taxes, including on alcoholic products. But when weighed against the cost that alcohol puts on communities, healthcare, and society, a strong case exists that more taxing is necessary.

An alcohol tax is a type of excise tax that is applied to beer, wine and spirits at the time of purchase. Generally, these taxes are implemented for two purposes. First, the financial benefit to taxing the sales of controlled substances is obvious. As demonstrated through historically high sales of alcohol leading into and following the COVID-19 pandemic, as well as historical state revenue from these measures, taxes on controlled substances can represent a significant proportion of total tax dollars going to the state—despite making up a small percentage of total taxes.

Second, these taxes are intended to have a preventative effect on substance use by disincentivizing drinking—especially excessive drinking. As one of the major causes of acute and chronic disease and illnesses, alcohol consumption is a key concern for state public health officials by placing a tremendous financial and material strain on healthcare, emergency responders, and social services, as well as adjudication and workplace productivity costs. These costs are broadly passed on to residents and community members.

Rather than keeping up with the rising costs to public health and safety of alcohol, taxes on alcohol are either remaining stagnant or even being lowered. Essentially, alcohol is a commodity that generates $10.2 billion in revenue from taxes, yet results in a loss of $249 billion in costs to society. The disparity is stark.

Despite many states’ goals to reduce excessive and life-threatening alcohol consumption, several still fail to fully utilize taxes as a public health tool. California, for instance, languishes behind many other states in its alcohol excise taxes, charging pennies on the dollar for the sales of distilled spirits when viewed alongside comparable geographies—as much as ten times less than other states like Washington and Oregon.

One step that some states can take is to change regulations regarding alcohol taxation. One specific example is to categorize “alcopops”—pre-mixed boozy beverages like Four Loko and Mountain Dew Hard—as distilled spirits rather than malt beverages. This puts their sales prices much higher and is hypothesized to present a greater barrier to purchase, specifically for youths at risk of being enticed by marketing and packaging.

Increasing numbers of community members, prevention specialists, and lawmakers are understanding the damage alcohol causes and leading advocacy efforts to raise alcohol taxes. States like Illinois and Maryland, for example, have taken bold steps to increase alcohol taxes and have seen dramatic reductions in impaired driving and fatal alcohol-related motor vehicle crashes. It’s a steep climb for advocates of alcohol harm prevention to reverse decades of stagnant tax policy, but the benefits of increasing excise taxes on alcohol will become apparent to communities when issues like calls for police service, DUI crashes, and other alcohol-related harms are reduced.

For the families of the hundreds of thousands of men, women, and children who die each year from alcohol-related harms, it’s past time for lawmakers to acknowledge that alcohol excise tax rates and the public health costs of alcohol are dramatically out of alignment.

Author:

Michael Pesavento
Communications Specialist

Michael Pesavento is a Communications Specialist in the San Diego County office. He serves on the Binge and Underage Drinking Initiative that aims to reduce harms and responsibly regulate drug and alcohol usage in the San Diego area.

How the “Housing Theory of Everything” Can Help Explain Alcohol and Other Drug Problems

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Up until the 1980s, common knowledge held that preventing addiction to substances, be they narcotic drugs, tobacco, or alcohol, were issues to be dealt with at the individual level through education and grounded in a moralistic knowledge of what is right and wrong.

Since then, attitudes about how to prevent drug and alcohol misuse have been scaled up, no longer focusing on the individual, but instead, on the community, in what has come to be known as “upstream prevention.”

This strategy seeks solutions that address a plurality of root causes that lead to alcohol and drug disorders. A great example of such a pluralistic root cause for substance use disorders is an unfortunately common issue throughout the U.S.: housing insecurity.

The “housing theory of everything” is a phenomenon that implies the U.S.’ housing shortage contributes to a broad range of societal problems such as inequality, climate change, disease, and stagnant population growth. A case can also be made for throwing substance use disorders into the mix as a consequence of the nation’s housing shortage.

Housing as a basic need

Housing is a fundamental necessity of human health, fulfilling both physiological and safety needs. However, the U.S. is experiencing an unprecedented housing crisis, in large part because housing development hasn’t kept up at the same pace as population and job growth.

This is especially true in the nation’s largest metropolitan areas. Last year, approximately 20% of the U.S. population reported they were very likely facing foreclosure, and 14% likely facing eviction.

When individuals become unsheltered or are facing some type of housing insecurity, stress and anxiety can be dramatically exacerbated. This is due in part to the ripple effects of not having a stable and secure place to eat or sleep.

For example, individuals experiencing homelessness may find it difficult or near impossible to secure a job, as employers often require a stable address for employment. Similarly, things like physical and mental hygiene become difficult, if not impossible, to attend to when housing is not immediately available.

These compounding issues have a cascading effect on health and well-being and can lead to self-medication with drugs and alcohol.

“The Housing Theory of Everything”

Are substance use disorders a cause or an effect of housing insecurity? On this, experts disagree. But what we do know is that there is a strong association between housing insecurity and poor mental health, thus supporting the theory that one’s housing situation is determinative of a range of health outcomes.

Whether it is struggling with the anxiety of rising housing costs, an inability to pay rent, or uncertainty about where the next meal and place to sleep will be, many Americans are turning to common coping mechanisms: drugs and alcohol.

And as consumption of these substances increases, so do poor health outcomes as suggested by increases in healthcare costs to treat substance-related diseases, emergency department costs, alcohol-related traffic fatalities, and domestic violence.

This last fallout from alcohol and drugs – domestic violence – concerns many housing advocates. Approximately 80% of homeless mothers with children are victims of domestic violence. Many victims flee their abuser with scant economic resources, little family support, or no solid place to land.

Housing as a stabilizing factor toward mental health

Providing housing that is safe, clean, affordable, and accessible doesn’t completely solve the entire homelessness crisis, but is a good first start. When a basic need like housing is met, we can start to see a general decrease in self-medicating habits, as well as a greater community impact through less burdensome social services.

The State of California has enacted legislation that commits over half a billion dollars to housing and services for individuals struggling with mental health and substance use disorders. This effort is a fundamental starting point for addressing the link between housing and substance use, providing treatment beds for over 1,000 Californians experiencing homelessness.

However, programs like this fall short by treating housing insecurity as the result, rather than the cause, of substance misuse. Instead, we need to focus efforts toward programs aiming to thwart housing insecurity at its root. By providing stability and security, we can eliminate many of the anxieties that contribute to substance use disorders, and we can make a meaningful difference.

Author:

Michael Pesavento
Media Advocacy Specialist

Michael Pesavento is a Media Advocacy Specialist in the San Diego County office. He serves on the Binge and Underage Drinking Initiative that aims to reduce harms and responsibly regulate drug and alcohol usage in the San Diego area.

Group of community advocates banning together

Creating a Prevention Campaign That Works

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Lessons learned from tobacco control hold value for future efforts

In 1880, James Albert Bonsack filed a patent on an invention that would eventually pit industrial growth against public health.

Bonstack’s invention could roll hundreds of cigarettes a minute, revolutionizing the tobacco industry and creating a product that would see thousands of percentages of increases in use over just a few short decades.

Tobacco industrialists saw tremendous potential for profit in this new, portable and cheap cigarette. This signaled the beginning of what would become almost a century-long campaign to sell consumers a highly addictive, highly carcinogenic product. And it worked!

Over 100 years since Bonsack filed his original patent, communities everywhere are still subjected to the fallout of the “smoking boom” of the 1900s, and new smokers are created every day through products like flavored tobacco and e-cigarettes/vaporizers.

But all hope is not lost. In the decades since, public health professionals have advanced policy and enforcement measures around tobacco, and have learned important lessons in the process.

Many early attempts to create tobacco prevention campaigns framed much of the issue as one of personal choice. Most of those campaigns regarded the individual smoker as the important unit of change, believing that if you can change the thinking of an individual through education and appeals to reason, then you can halt a behavior in an entire population. However, we have since learned this narrow focus has a very limited effect.

Instead, modern prevention strategies have shifted the focus from individual knowledge, behavior and attitudes as the “unit of change” to acknowledging the role of policy, systems and “environmental factors” in shaping individual behavior. In this context, environmental factors include factors like the way a neighborhood is built, the types of businesses that exist there, the amenities and spaces available to residents and even transportation. In tobacco prevention, it also includes the devious marketing tactics of Big Tobacco.

When focusing on these environmental factors, modern prevention campaigns focus on influencing policy to produce community-level change. Democracy at any level, from the local city council all the way to state and federal jurisdictions, plays a role. Focusing on policy, rather than individuals, provides resources for enforcement and maintenance of policies.

Despite the understanding that smoking was already a population-level health hazard, smoking prevention in the 1970’s and 80’s approached it as an individual choice; something for people to stop doing on their own.

It wasn’t until studies began showing the effects of second and even thirdhand smoke exposure (especially on children) that conversations about prevention began to elevate on a national level. In 1990 the federal government instituted its ban on smoking in airplanes for U.S. domestic flights, a policy which expanded worldwide thereafter. In the early 2000s, many cities and local jurisdictions in the U.S. began implementing indoor smoking bans, and as of 2018 nearly 30 states had totally banned the smoking of cigarettes indoors. These broad policy changes reflect efforts at the federal, state and local levels by public health professionals and advocates to create evidence-informed changes that promote healthy decisions and reduce access and exposure to harmful substances like tobacco.

Even now, initiatives like IPS’ Smoke-Free Multi-Unit Housing (MUH) project aim to implement smoking restrictions in residential spaces where secondhand tobacco exposure can impact people’s health, with a goal to implement transformative, equitable policy strategies that keep residences free of harmful tobacco smoke and other carcinogens.

As prevention efforts continue to hone in on effective strategies, one element remains consistent: community. Involving community members and welcoming their input instantly elevates any campaign, and is absolutely vital to creating sustainable change after a campaign’s conclusion. Prevention professionals have learned that it is important to work with community members to develop a plan that meets them where they are, to create a shared language with residents that embraces policy and systems change, and to invest in the capacity of the communities so that residents can continue this important work.

Efforts to reduce smoking-related problems are far from over. Despite successes like California’s recent successful ballot measure that will ban flavored tobacco products, issues with nicotine and tobacco will persist. Youth access and second-hand exposure are likely issues that will take decades of work to address. However, through the efforts of dedicated public health professionals—and with a lot of patience—we can learn from our successes and failures to bring strong, coherent campaigns that truly influence population-level change.

Let’s not let those lessons go up in smoke.

 

California’s New Composting Law Takes on Climate Change

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It’s no secret that the first to be impacted by the devastating effects of climate change are those who are already the most vulnerable. The startling and unprecedented changes to the natural world—caused, at least in part, by human activity—individuals that are already struggling are likely to bear the burden of environmental collapse. Already, researchers indicate that the impacts faced by these communities can be far more widespread and immediate than many might expect.

For example, an obvious impact of climate change is rising average temperatures; we feel it, summer after summer as the thermometer ticks ever upward. However, less expected are the secondary effects these changes might have—things like fewer opportunities for healthy outdoor time and worse mental health outcomes. These effects are exacerbated in communities where inequalities are most pronounced. For low-income communities where amenities like air-conditioning and insulation are fewer and further between, the effects of increased global warming will be felt most severely. 

That’s why it is important to look for “upstream” solutions to environmental issues. By addressing the root causes of a problem rather than its symptoms we can prevent harm, such as increased global temperatures, as well as its trickle-down effects, like impacted mental and physical health.

In that vein, California has recently begun to implement SB 1383—dubbed “California’s Short-Lived Climate Pollutant Reduction Strategy”—in earnest. This legislation was introduced in 2016 by then-Governor Jerry Brown, and broadly sets goals for the reduction of methane emissions in the state. 

Methane (CH4) is a leading contributor to atmospheric insulation, 25 times as potent a contributor as carbon dioxide (CO2). That ratio makes methane a major target for emission reductions, as pound-for-pound, methane accounts for much more atmospheric insulation—and thus, temperature increase—than do even pollutants from fossil fuels. That’s why bills like SB 1383 are working to reduce the amount of methane we release in California. 

One way to reduce methane emissions is by lowering the amount of organic waste being decomposed in municipal landfills. This entails creating proper composting sites for the separation of food and yard waste and redirecting organic matter that would otherwise end up creating methane into more productive areas. One such redirection is the distribution of the created compost to local farms, parks, and gardens.  

But what would this look like in practice?

We can look to state and local municipalities for examples of success in creating a buffer between vulnerable communities and climate effects. Often, these localities can address the specific needs of their community members more acutely than broad strokes approaches by other governing bodies.

For example, in 2018 the Institute for Public Strategies (IPS) partnered with San Bernardino County residents who were advocating for the City of Pomona to allow them to use a vacant city-owned property to create Pomona’s first urban farming project. The project—titled ECOFARM—focuses on composting to support climate change mitigation and alleviate environmental justice burdens on the immediate community. The city could not deny the efforts of the residents and voted unanimously in favor to allow the use of the vacant lot for the ECOFARM free of cost.  The ECOFARM was funded by a grant secured by residents from the California Environmental Protection Agency. Residents used the funds for basic infrastructure development, acquisition of tools and supplies, soil, irrigation, essential farm labor, as well as a variety of educational programming around nutrition and environmental justice. 

But the options for addressing both community and environmental issues at once are not limited to farming and gardening projects. Outside of SB 1383, California agencies are providing some direct assistance to local jurisdictions. Just this year the California Natural Resources Agency released millions in grants to local jurisdictions to use in environmental projects. Highlights from these grant releases include the agency’s Youth Community Access and Environmental Enhancement and Mitigation programs, each of which awarded over $10M for everything from greenspace cleanups to park improvements and youth outdoor programs.

Obviously, these programs are not the ultimate solution to climate change; that responsibility lies at the highest levels of government and industry and should be prosecuted with all the vigor we can muster. However, state and local level programs are an important push toward improving both environmental wellbeing and mental and physical health outcomes, especially for youth. Moreso, the push to reduce methane emissions—a high-level upstream initiative—made way for materially impactful local changes.

As the global climate faces significant changes in the immediate future, our adaptation to these new conditions must strategize prevention efforts that prioritize the health and safety of marginalized communities. Future regulations and policies can learn from this upstream approach to designing solutions. A world with less food waste is a world with fewer methane emissions; a world with working public transport is a world with fewer polluting cars; a world with more available, livable housing is a world with fewer children sleeping on our streets.

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Author:

Michael Pesavento
Media Advocacy Specialist, IPS

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

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.

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.

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.

Up in Smoke: Marijuana is Erasing Decades of Progress Toward Smoke-Free Environments

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Download ‘Up in Smoke’ Infographic.

A recent Los Angeles countywide survey of 13,500 residents revealed pervasive public exposure to marijuana* smoke in parks, schools, apartment buildings, business complexes and outdoor spaces. Completed in 2019 by the LA County Prevention Provider Network, the survey found, for adults ages 26 and up:

  • 77% reported smelling marijuana in adjacent apartments (21% all the time)
  • 76% reported smelling marijuana in parks (22% all the time)
  • 75% reported smelling marijuana in business complexes (16% all the time)
  • 70% reported smelling marijuana in schools.

Youth were no exception. Seventeen percent of youth respondents reported exposure to marijuana in public all the time and 14% reported frequently.

The findings indicate a dramatic reversal to the years of progress that reduced California residents’ exposure to secondhand smoke. Before the legalization of recreational marijuana, California was considered America’s non-smoking section. In 1995, it was the first state to ban smoking tobacco in nearly every workplace and indoor public spaces. In the following years, the ban extended to restaurants, bars, taverns, and gaming clubs.

More recently, in 2016, California enacted multiple tobacco control laws that closed loopholes in the state’s smoke-free laws, including defining e-cigarettes as a tobacco product and prohibiting vaping wherever smoking is not allowed. For decades, the state’s strong tobacco laws were widely considered to have protected people – and youth in particular – from secondhand smoke.

Today, the tide seems to be turning. Public health experts cite two primary concerns about pervasive public exposure to marijuana smoke. For one, research shows that secondhand marijuana smoke contains many of the same cancer-causing substances and toxic chemicals as tobacco smoke and can create harmful cardiovascular health effects, including atherosclerosis, heart attack, and stroke.

“Smoke is smoke. Both tobacco and marijuana smoke impair blood vessel function similarly,” said Matthew Springer, cardiovascular researcher and associate professor of medicine at the University of California, San Francisco.

Additionally, the normalization of marijuana smoke could influence youth use. Research shows the more marijuana use is seen as normal, the more likely youth are to try it. A 2014 survey by ABC News Radio found that three times the number of youths whose parents smoked marijuana reported smoking it themselves (72%). Only 20% of youth respondents reported smoking marijuana whose parents didn’t smoke. A 2017 study published in the U.S. National Library of Medicine found that teens mentioned the widespread use of marijuana by people they know and its legalization as evidence that marijuana is not harmful. According to the study, “the findings suggest that normalization of marijuana use is taking place.”

Beyond the public health implications, the LA County survey found marijuana smoke is bothersome. Seventy-three percent of respondents indicated some measure of annoyance, reporting marijuana smoke bothered them extremely (31%), very much (17%), moderately (14%), or slightly (11%).

These issues become more pressing as increasing numbers of states change their marijuana laws. In last month’s election, voters in Arizona, Montana, New Jersey, and South Dakota legalized marijuana for recreational use, joining the 11 states that had already done so. Policymakers in those states could look to California as a bellwether for what’s ahead.

So what can be done about it?

First, if a state legalizes marijuana, state and local jurisdictions should move quickly to define smoking to include the smoking of marijuana as well as the use of electronic smoking devices. New laws must be clear and comprehensive to avoid loopholes. In March 2019, for example, LA County expanded its smoke-free laws by clearly articulating its existing ban on tobacco products at beaches, parks, and government buildings, including electronic cigarettes and marijuana.

Second, the public must be educated on new smoking laws and on the true impact of marijuana smoke. While misinformation about secondhand marijuana smoke abounds, the data in an ever-emerging research landscape makes clear that secondhand marijuana smoke has negative health impacts. Smoke-free laws that include marijuana will better protect workers and the public from all forms of secondhand smoke and vapor.

Third, public health professionals must always be at the ready to push back on the motivated, profit-oriented marijuana industry. According to the Non-Smoker’s Rights Foundation, marijuana industry representatives could use tactics from the tobacco playbook, including loosening terms like “public” in ways more favorable to their purposes of normalizing marijuana use everywhere.

The truth is, a safe public environment is 100% smoke-free. It is possible to return to the clean air gains that were made with a renewed commitment in 2021 – by engaging health partners, the public and legislators at the state, county, and local levels. Let’s get to work.

* IPS’s corporate standard is to use the term ‘cannabis.’ For the purposes of this Hot Topic, IPS is reflecting the language used in the L.A. County Marijuana Public Smoking Initiative.

Author:
Sarah Blanch
Vice President of Organizational Development, IPS

Sarah is responsible for developing and implementing tactical plans that support the vision, mission, goals and growth of the agency. Sarah leads IPS projects in Los Angeles County, where she oversees the implementation of policy-focused initiatives intended to improve public health and safety throughout the City and County of Los Angeles.