Tag Archive for: Substance Use Prevention

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.

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.

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.

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.

Black Vaccine Hesitancy Stems from a Long History of Medical Racism

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Dr. Susan Moore, a Black medical doctor, recently died of COVID-19. She documented her experience leading up to her death, including being denied pain medication and proper treatment. Despite being a doctor, speaking in medical terms, and understanding the protocols, Dr. Moore was sent home and died just a couple of weeks later. In her videos, Moore blamed her poor treatment on medical racism. And, while some contest this kind of claim, medical racism in the U.S. has been ongoing since, well, since Black people came to this country in chains. The abuse, neglect, and unethical experimentation is well documented today.

At no time in history has the health of Black Americans equaled that of White Americans. From the days of slavery until now, the White medical community’s policies, practices and prejudices have had an enormous impact on the health of Blacks. When Africans began populating this country, mainly as slaves and second class citizens, many White doctors were taught and subscribed to the notion that Blacks required different treatments because they could tolerate more pain and had unpredictable reactions to medications. Therefore, White physicians were rarely careful or sensitive when treating Blacks.

James Marion Sims, widely recognized as the father of modern gynecology, came to prominence by performing shocking experiments on enslaved women while also forcing them to perform domestic duties and serve as nurses in his clinic. One of his patients was an 18-year-old named Lucy, who suffered incontinence after giving birth. During her procedure a few months later, Lucy was on her hands and knees, screaming in pain for an hour while a dozen doctors watched. Dr. Sims performed the same surgeries on White women, but with anesthesia.

The notion that Black people do not experience pain similar to White people still exists. A 2016 study by the University of Virginia revealed a significant number of White medical students and residents held false beliefs about the biological differences between Blacks and Whites, including that Blacks have thicker skin and do not feel pain as acutely. These notions show up in practice, even among children. A study of nearly one million children with appendicitis revealed that Black children were less likely than White children to receive pain medication for moderate and severe pain.

Another particularly egregious example of medical racism occurred in an operating room at the Medical College of Virginia in Richmond in 1968. A 54-year-old African American factory worker, Bruce Tucker, fell at work and hit his head. He was taken to the hospital unconscious. When the doctors rushed him to the operating room, they did not attempt to revive him. Instead, they harvested his heart and kidney for a white patient who needed them. No effort was ever made to contact Tucker’s relatives. It is still unclear today as to whether Tucker was actually brain dead, as the surgeons declared.

There are many accounts in history books, medical literature, and other periodicals about unethical and immoral medical procedures on Blacks due to racist attitudes and practices. The Tuskegee experiment is a well-known example. From 1932 to 1972, Black men in Tuskegee, Alabama, who had syphilis were recruited for a medical study to determine the course of the disease. The men were informed they had “bad blood” (at the time, the term encompassed several medical problems, including syphilis) and that they would receive free health care from the government. None were ever given antibiotics, despite the treatment being available. This horrific practice only came to light in a newspaper story.

So, here we are in 2021 amid a raging pandemic, where Blacks are dying disproportionately. A vaccine is available and a lot of media attention has been focused on the “vaccine hesitancy” of Blacks. It’s no wonder, considering our history. A cynical view would be that the attention paid to Black vaccine hesitancy is not because of an outpouring of sympathy for our COVID-19 death rate but because the U.S. won’t reach herd immunity without the participation of at least some Blacks getting the vaccination. America needs us but has a hard time admitting it.

Blacks have a lot to offer America. Indeed, look at the votes from the presidential election and the January runoff in Georgia. Black voter turnout is credited with changing the political tide of this country.

If a Black physician can’t get proper care in a hospital, what chance does any Black person have? Non-Blacks must recognize this disparity and speak up and speak out when seeing these racist practices. Non-Blacks should also take some time to study African American history, at least during this month, to discover how much Blacks have done and continue to do for this country. We believe, like any other American, that this is our home. We want to live a productive life and contribute to societal progress. But how long will it take for America to see that Blacks love this country even though this country seems not to love us?

Author:
Cynthia Nickerson
Media Advocacy Specialist

Cynthia Nickerson is a media advocacy specialist 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.