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Facing Alcoholism:

The Socioeconomic Survival of the Cheyenne River Sioux

 Contributers:

  • Belinda Floyd
  • Monique Madison
  • Lisa Meador
  • Cheryl Nelson
  • April Oldenburg
  • Michael F. Schadone
  • Caprise Snyder
  • Melissa Torrey
  • Carlos Vargas

 

Alcoholism is an individual and social disease that affects people all over the world. It has varying degrees of severity based on the amount and length of consumption. There are risks associated with the use of alcohol that vary from social consequences to physical health risks (World Health Organization [WHO], 2010). Alcoholism has been linked to various acts of crime more often than illicit drugs (Lovekin, 2002). The causes of alcoholism vary, and include poverty, use as an escape mechanism, genetics, and societal pressure. Some people choose to use alcohol because of pressure from family and friends, and some just want to experiment. There are also some that just want to get away from painful emotions (Medicine.Net, Inc., 2010). Poverty is also often cited as a leading cause of alcoholism (Cedra, 2010).

Because of their ability to negatively impact those around them, those addicted to alcohol should not be ignored but rather, to be socially responsible, we must recognize the fact that their illness needs to be treated as a disease . World wide alcohol is related to the cause of 2.3 million pre-mature deaths, and is the 5th leading cause of premature disability and death. It is also the causative factor in over 4 percent of the worlds burden of disease (WHO, 2010).

Very few communities are immune to the problem of alcoholism and the Cheyenne River Sioux Tribe is no exception. Many tragedies have occurred from their alcohol addiction, including homicide, suicide, motor vehicle fatalities, and increased violence (Shepard, 2007). We will explore the causes and effects of alcoholism and its impact on the Cheyenne River Sioux Tribe. We will then make recommendations, and propose solutions to minimize the occurrence and negative effects of alcoholism in the community.

The Situation Today

The Cheyenne River Sioux Tribe is a Native American tribe located in South Dakota. They have a history thousands of years old, and great pride in the traditions of the community. They honor Mother Nature and the land that they live on, which has been a part of their culture from its beginnings. Like most Native American tribes they have had their ways of life tested by the world around them, and have uncountable injustices thrust upon them (Milbrodt, 2002; Swenson, 1994; White, 1978). The Cheyenne River Sioux Tribe has built a history and a homeland that they would like to preserve long into the future. While they fight to keep traditions alive and remain solid as a culture they also fight the modern difficulties that ensue (French & Hornbukle, 1980; Mizrach, 1999).

According to a report by the Department of Interior, Ziebach County, which is home to the Cheyenne River Indian Reservation, has a poverty rate of 54% (as cited in Ortman, 2010). The jobless rate among tribal members is 88% (Ortman, 2010). This tribe, like many others, is plagued by “alcoholism, suicide, crime and a sense of abandonment” (Ortman, 2010). This area was also hit by devastating storms during the past winter. The Chairman of the tribe, Joe Brings Plenty, questions why it must take a disaster of this magnitude to get the attention of a government that he feels has “broken its treaty obligations to care for Indians who gave up their land to make way for white settlers” (Ortman, 2010, para. 3) . It is our aim to investigate conditions and issues that surround this tribe. These very conditions and issues may well be at the root of the high rate of alcoholism among the members of this tribe. Alcoholism is a large social problem in the tribe, and finding ways to alleviate and educate members is an important need. Alcoholism is not a singular disease; it affects the culture and traditions as a whole (French & Hornbukle, 1980). It can compromise the future success of a person and the group they belong to (A.D.A.M. Inc, 2009).

It will be our goal to determine what conditions led to the alcoholism problem now experienced by the tribe, and what information, help, and programs are available, and to build upon that knowledge to provide whatever assistance we can with the disease of alcoholism in the tribe.

Poverty

Poverty is both the cause and consequence of many of the problems that Native American communities face, like alcohol addiction. It is a vicious cycle which the current economic climate only makes worse. The standard response to poverty is economic development. However, poverty in Native American communities cannot be separated from its historical context. Native Americans live in places chosen for them by the American government, the result of an invasion designed to take over their lands. The Cheyenne Sioux Tribe website refers to the creation of the American West as we know it “after most Native American peoples were ‘safely confined’ on reservations” (Cheyenne River Sioux Tribe, 2009, para. 1). In time that overt hostility has turned into neglect, while poverty has become severely entrenched. Contrary to popular belief, most tribes are not wealthy from gaming.

While history may be a root cause of poverty in Native American communities, we are powerless to change history. We can only address the present and future, while acknowledging the past. Therefore, the development solutions that we recommend acknowledge the unique traditions and history of the Cheyenne River Sioux tribe. In Development as Freedom, economist Amartya Sen (2000) talks about freedom as an end and a way to create development. In this context, freedom is more than being free of negative circumstances, like freedom from oppression. Also critical to his notion of development, is the development of capabilities within individuals and communities – the freedom to do. In this case, our recommendation is based on economic development that permits the Sioux the freedom to live consistently within their beliefs and traditions.

Connection to the land is essential to Native American thought (Rodgers, n.d.). Creating economic development opportunities that are consistent with this connection allows the Sioux to live a holistic life, break out of the cycle of poverty and escape some of the pressures that lead to alcoholism. We recommend an initiative to support Sioux businesses that uphold traditional principles, such as the creation of a line of organic food products, the manufacture of biodegradable packaging or the marketing of solar energy. Also critical to the success of this effort would be encouraging education in relevant fields, and the establishment of high wage jobs that persuade young people to stay on the reservation.

Escape

When people talk about escaping from things that are going on in their lives, there’s only so far that they can get away from those things or problems. That is, people can physically remove themselves from a stressful area, like a home fraught with arguing family members, but they cannot physically remove the memories of those arguments from their mind. Many experiences make people want to escape or run away from or forget about those experiences, and there are a variety of ways that people attempt to do this. Those methods of escape can be both positive and negative; some people meditate to relieve stress, while others exercise. Unfortunately, one of the most common, yet severely negative escape routes involves the use and abuse of alcohol. Because of its effects on the person consuming the alcohol, such as lowered inhibitions and the euphoric effect which can seem to alleviate stress and worry, alcohol often succeeds in providing an escape that some people look for, but only temporarily. Afterwards, however, the stress and worry can return, propelling the user to consume more alcohol to prolong the escape, which often progresses alcohol use to alcohol abuse.

Native American communities are beset with a multitude of problems, which include poverty, racism and discrimination, high rates of unemployment, issues maintaining their ethnic identity in a country with a different dominant culture, depression, and suicide (Martins, Widoe, Porter, Chebon, & McNeil, 2006). While the aforementioned social problems do not constitute an exhaustive list of problems faced by many Native Americans, they certainly provide insight into the kinds of problems that some Native Americans may attempt to escape from when using or abusing alcohol. With poverty topping the list of social conditions that plague Native American communities, it is not surprising that between 2005 and 2008 36% of Native Americans aged 18 or older living in poverty binged on alcohol compared to the national average of 25% (Substance Abuse and Mental Health Services Administration, Office of Applied Studies, 2010). Unfortunately, the Cheyenne River Sioux Tribe is not immune to these social problems.

Attempting to reduce the high rate of alcohol abuse as a means of escape within the Cheyenne River Sioux Tribe, requires one to tackle the problems that the members of this community are seemingly attempting to escape from. Poverty, unemployment, and discrimination seem like insurmountable obstacles to overcome when trying to eradicate those social conditions that tend to lead to alcohol abuse as a means of escape or relief from stress and worry. With the current U.S. economy being unstable, poverty and unemployment have stricken several U.S. communities, not just Native Americans. With that said, solutions like creating jobs and improving the economy will take years for the positive effects to be felt. While this is a long-term goal, which will prove to eradicate poverty, alternative means of combating this problem are available, and may produce good results that are not contingent upon something that is out of the individual’s control, such as the economy. Promoting Alcoholics Anonymous programs, psychological counseling, and group therapy are some options for the Cheyenne River Sioux Tribes. The concern, however, is whether these solutions, typical of the dominant American culture, will be accepted or rejected by a community, which strives hard to maintain its separate and historical identity. Certainly, culture and tradition will have to play a role.

Pressure

The disease of alcoholism can begin for many reasons (A.D.A.M. Inc., 2009). Factors range from genetics, poverty, familial and family patterns, and pressure from outside sources, such as peer pressure. In this section we will look at the link between outside pressure, and alcoholism in the Native American.

A person’s environment can have a dramatic link to the cause of alcoholism (A.D.A.M. Inc., 2009). A child may grow up with alcohol around them and see family members drinking and it may become familial (Milbrodt, 2002). A child may feel like it is a normal thing that adults do, and grow up emulating that family picture. It can make a child more prone to becoming an alcoholic later in life, because they have not been exposed to something different, and the peer pressure is harder to ignore. As a child growing up around the over- consumption of alcohol, it becomes harder to ignore peer pressure as they get older, even if it is something they have seen as a negative family pattern (Milbrodt, 2002). A article in the Journal of American Indian Education, linked peer pressure, alcoholism and family structure to illustrate the problem.

They are products of a society where alcohol abuse is not considered deviant behavior […] where poverty is the norm, where teenage pregnancy is sanctioned, where parents and relatives are often in trouble with the law, and where peer pressure takes the form of family pressures as well. (Bowker, 1992, “Results of the study” para. 5)

Although the causes of alcoholism are complex, there is a great deal of research determining how societal and peer pressure develop into such a damaging condition (A.D.A.M. Inc., 2009). Many of the factors that cause a dependence on alcohol include anger and dissatisfaction in life, unrelieved stress, and emotional difficulties, as well as social and peer pressure (A.D.A.M. Inc., 2009). Some people choose to use alcohol because of social factors such as pressure from their family, and others may feel peer pressure from their friends. Parents and family members may not realize the damage that alcohol can do, and how it can affect their family relations. Sometimes family has the power to make people feel the need for alcohol. Sometimes family members tend to criticize their own family members, which may lead the person to drinking. Sometimes consistent arguments, as well as influence from friends may lead to heavy drinking. The factors are numerous, but in the arena of stimulus from an outside source, the causes stem from pressure around the person deciding to drink.

Alcoholism is a serious problem. It is the leading cause of unintentional deaths (French & Hornbuckle, 1908). Children are affected by the alcoholic parent’s behavior. Sometimes this may lead to child abuse or child negligence (ChildAbuse.com, 2010). Family members of alcoholics often feel embarrassment, sadness and fear of their love one (Parsons, 2003). Children of alcoholic parents struggle with depression and confusion, often not knowing if their loved one is somewhere hurt (Parsons, 2003). There are times that family members become fearful of their love ones. Alcoholics may become violent to their family members. Children sometimes blame themselves for their parent’s drinking (Parsons, 2003).

Anxiety of Identity

In a historical overview of Native Americans it can be seen that loss of cultural identity, leading to low self esteem and identity anxiety, is a contributing factor in the high rates of alcoholism among this culture (French & Hornbuckle, 1980). Teresa Milbrodt (2002) writes that “Native Americans have been put at high risk for alcoholism due to a history that they cannot forget” (p. 7). She shows that the Lakota people have suffered a loss of culture through abuses of Native Americans by white settlers and governmental policies spanning hundreds of years. Current conditions are a result of past events that have created a breakdown of the traditional structure of the tribe. Changes such as federally run boarding schools that the children were required to attend, changes in the traditional gender roles, and shifts in family traditions have left the tribe culturally adrift.

Many of the students who were sent to these federal boarding schools returned to the reservations feeling ashamed of their cultural heritage. They then migrated to urban areas where they felt equally out of place. In their eyes they “had no place in any society” (Milbrodt, 2002, p. 8).

Gender roles also underwent severe changes when the Native Americans were forced onto reservations. Men were no longer able to hunt, and the government even tried to outlaw spiritual practices such as ceremonies, dances and warrior societies. Men felt unable to provide for their families. The hunt and the ceremonies also determined a man’s status within the tribe. Again, the changes in tribal structure left members feeling unsure of their place in society. Confined to the reservations, men “lost their status and cultural identity” (Milbrodt, 2002, p. 10).

Government policies also effected the family traditions. Policies were implemented to restrict travel and tribal members were unable to visit family and friends, which was an important way of keeping traditional stories and history alive, as well as reinforcing kinship identity. These family traditions provided an important support system. Tribal members note that when the family system is not strong enough, members do not get the support they need; “with the loss of family came the loss of the identity” (Milbrodt, 2002, p. 12).

History has, through the destruction of the social system, led to a lack of identity within the Lakota culture. It has been noted that “this loss of cultural identity is also one of the major contributions to the high rates of alcoholism on reservations” (Milbrodt, 2002, p. 14).

Underlying Issues

Alcoholism and related disorders are directly impacted by socioeconomic status, educational level and rates of unemployment (Shiraev & Levy, 2010). The Cheyenne River Sioux Reservation is an impoverished reservation in Zwiebach and Dewey Counties in South Dakota. The U.S. Census Bureau shows that Zwiebach’s poverty rate in 2008 was 54%, while the rate for Dewey was slightly lower at 38% (as cited in Ortman, 2010). The are many possible factors that contribute to this high rate of poverty.

The unemployment rate is extremely high at 88% (as cited in Ortman, 2010). Jobs are scarce in these counties, which are located some distance from urban areas. The infrastructure, the water and electrical systems, throughout the reservation are outdated and failing. This limits new growth, and therefore also limits new job opportunities. This infrastructure has been further impacted by the severe storms of the past winter, leaving the community even more distressed. Unlike many other reservations the reservation does not offer gambling, which provides many job opportunities for other reservations (Ortman, 2010).

According to Education Officials the extreme poverty of the reservations is impacting student success. The graduation rate among Indian students is only about 30%, as compared to the overall graduation rate throughout South Dakota of 75%. This is attributed to the poor physical condition of schools. Also of concern is the lack of qualified teachers, as well as outdated texts and limited supplies (Brokaw, 2010).

While all of these may be contributing factors in the issue of alcoholism, it is also important to look at the correlation aspect of this cycle. It is hard to determine which factor is causing which. Alcoholism is a vicious cycle that is hard to break. Does the poverty rate lead to alcoholism or does the alcohol rate contribute to the poverty level? Black Elk (2010), of the Oglala Lakota, describes the values of the Lakota nation as a circle:

You have always noticed that everything an Indian does is in a circle and that is because the Power of the World always works in circles, and everything tries to be round…The sky is round, and I have heard that the earth is round like a ball, and so are all the stars. The wind, in its greatest power, whirls. Even the seasons form a great circle in their changing, and always come back to where they were. The life of a man is a circle from childhood to childhood, and so is everything where power moves. (p. 6)

The cycle of poverty and alcoholism is one which we would like to help break.

Solution Proposal

According to Martins et al. (2006), “Native Americans have endured social, racial, and economic oppression but have persevered despite these struggles” (para. 39). Native Americans have experienced discrimination, oppression, disease, enslavement, and war, since the first European settlers arrived in North America. The negative treatment that Native Americans have been exposed to has created negative psychological effects that tend to be transmitted across generations, which creates a stronger cultural bond but promotes isolationist attitudes towards the majority culture, causing separation and marginalization. Co-opting the stresses of previous generations when they themselves are faced with oppression or marginalization, Native Americans, because of their unique cultural history, may suffer a form of intergenerational post-traumatic stress disorder. Some, however, are able to succeed in assimilation and integration, but this outcome requires effort and energy to maintain the acculturation. Native American youth who leave home to attend college tend to exhibit generalized anxiety, more so than those youths who attend college closer to home. This may be a manifestation of anxiety of identity when relating to the majority culture (Allen, 1973; Bowker, 1992; Martins et al., 2006, Milbrodt, 2002).

Native Americans are prone to certain health problems more than are other segments of the population. For example, there are high rates of type 2 diabetes, heart disease, obesity, and alcoholism among Native Americans. The rate of type 2 diabetes is four times the national average for American Indian elders, affecting one in five. Consistent with the general population, however, heart disease is the leading cause of death for Native Americans. In comparison to that of other racial and ethnic groups, the life expectancy of Native Americans is appreciably lower. According to the work of Everett Rhoades, reasons for this discrepancy may include poverty, greater risk of interpersonal violence, increased abuse of substances, vehicular accidents, and greater rates of disease (e.g. diabetes). (Martins et al., 2006, para. 19)

Native Americans share several mental health risks due to common sociocultural factors, such as poverty, poor health care access, and the isolation and lack of opportunity felt living on some of the reservations (Han et al., 1994; Martins et al., 2006, Milbrodt, 2002). The most common mental disorder among both children and adult Native Americans is depression, raising the risk of suicide tremendously, especially with concomitant substance abuse (French & Hornbuckle, 1980; Martins et al., 2006; Milbrodt, 2002; Ogden, Specter, & Hill, 1970).

Although the strong cultural and ethnic identity shared by Native Americans may contribute to stress and depression, participation in cultural and ceremonial activities may prove to be protective against the same stress and depression (Martins et al., 2006). Additionally, Martins et al. (2006) describes how the strong family emphasis that many Native Americans value may prove protective against psychological distress.

Substance abuse may also be combated with traditional cultural treatments, such as sweat lodges, the Red Road, and the Recovery Medicine Wheel (a 16-step program that utilizes a culturally important facet of circular attribution rather than linear progression; Martins et al., 2006). However, it is important to note that the problem is not entirely socioeconomic. According to growing genetic research, Native Americans are known to posses certain genetic variations that raise their risk of alcohol dependency (Edenburg et al., 2006; Ehlers, 2010; Mulligan et al., 2003; Spillane & Smith, 2007; Wall, Carr, & Ehlers, 2003; Wall, Garcia-Andrade, Thomasson, Carr & Ehlers, 1997). This fact may be detrimental to any substance abuse counseling if neither the counselor nor the patient understand the ramifications.

Economically, Vinje (1996) finds that although, focusing on governmental and private employment rates and promoting natural resource management and manufacturing typically fall short of economic goals, education is a sustainable mainstay requirement for reducing poverty levels. Gaming is certainly a viable option (Feinstein, 1994; Pommersheim, 1984), but as Vinje points out, it frequently “falls short in its objective” (p.427). Expandinging the economy should certainly remain a high priority goal as it will not only create a more comfortable life for those living on the reservation, but it will also decrease the psychological burdens to allow more happiness in their lives (Pickering, 2000; Pommersheim, 1984; Vinje, 1996).

Conclusion

The Sioux are a great people with a rich culture and expansive history. Unfortunately, some of the reservations, specifically the Cheyenne River Sioux reservation, find themselves battling elevated incidences of alcoholism, interpersonal violence, depression, and suicide. We feel that there is no singularity in this problem, and the focus and solution need to be comprehensive in order to be effective.

The Sioux tend to be marginalized, which is a lasting symptom of the intolerances and mistreatment that have been thrust upon them since the European settlement of North America. As the Sioux have been relegated to reservations of land that the United States government felt were of little use to the nation, it is understandable that the Sioux had a difficult time finding economic value in the land that was kept separate from the majority European culture. This, in addition to the misguided attempts at forcing the Sioux into acculturation, has continued to marginalize the Native American tribe to a point where a negative psychology is so pervading as to be transmitted from generation to generation. Depression is now prevalent throughout the Sioux tribe.

In order to provide an escape from the daily strife of a poor economy and lower sense of self, some may feel the need to turn to mind-altering substances. This reliance on drugs and alcohol may provide the psychological relief sought, but it does nothing to better the community and increases the incidences of violence, whether aimed at others or self-directed. Additionally, recent findings have suggested that Native Americans have a predisposition, genetically, to alcoholism. The addiction of alcohol in the company of mental distress usually leads to a singular conclusion: suicide.

As stated, the Sioux have a rich cultural history, and should rely on their knowledge of nature and the traditional values to create comprehensive programs which address these issues holistically (i.e. involving the whole person and their community). These programs, however, should not focus on preventing negative issues so much as they should promote a reacceptance of the traditional values, leading to a maximal appreciation of the life skills required to reinvest themselves in their community. The Sioux concept of family is one that promotes health and stability by encouraging a reliance on not only the community but themselves as well.

With more of the community involved in creating a better life on the reservation, there is a better chance of individual members creating their own personal economies, which in turn will better the economy of the reservation and other reservations surrounding them.

The answer is circular.

References

A.D.A.M., Inc. (2009). Alcoholism. New York Times. Retrieved October 12, 2010, from http://health.nytimes.com/health/guides/disease/alcoholism/causes.html

Allen, J. R. (1973). The Indian adolescent: Psychosocial tasks of the plains Indians of Western Oklahoma. American Journal of Orthopsychiatry, 43(3), 368-375. doi:10.1111/j.1939-0025.1973.tb00807.x

Bowker, J. (1992). The American Indian female dropout [Electronic version]. Journal of American Indian Education. Retrieved from http://jaie.asu.edu/v31/V31S3ame.htm

Brokaw, C. (2010, August 19). Tribal officials: Indian education needs money. Indian Country Today. Retrieved from http://www.indiancountrytoday.com/living/Tribal-officials-Indian-education-needs-money-100893284.html

Cedra, M. (2010). The relationship between neighborhood poverty and alcohol use: estimation by marginal structural models [Abstract]. Epidemiology, 21(4), 482-489. doi:10.1097/EDE.0b013e3181e13539

Cheyenne River Sioux Tribe. (2009). A new creation after a great flood. Retrieved from http://www.sioux.org/English/turtle_island.php

ChildAbuse.com. (2010). The relationship between parently alcohol, drug abuse and child maltreatment. Retrieved from http://www.childabuse.com/fs14.htm

Edenberg, H. J., Xuei, X., Chen, H., Tian, H., Wetherill, L. F., Dick, D. M., … & Foroud, T. (2006). Association of alcohol dehydrogenase genes with alcohol dependence: a comprehensive analysis. Human Molecular Genetics, 15(9), 1539–1549. doi:10.1093/hmg/ddl073

Ehlers, C. L. (2010). Genome-wide scan for self-rating of the effects of alcohol in American Indians. Psychiatric Genetics, 20(5), 221-228. doi:10.1097/YPG.0b013e32833add87

Elk, B. (2010). Oglala Sioux tribe: Pine Ridge Indian reservation. Retrieved from http://www.oglalalakotanation.org/About_the_Tribe_files/History%20of%20Oglala%20Sioux%20Tribe.pdf

Feinstein, M. S. (1994). Cheyenne River Sioux Tribe v. South Dakota, Indian gaming, and the State’s Eleventh Amendment immunity: Where will the conflict in the circuits fuse? South Dakota Law Review, 39(604). Retrieved from http://heinonline.org/HOL/ LandingPage?collection=journals&handle=hein.journals/sdlr39&div=27&id=&page=

French, L. A. & Hornbuckle, J. (1980). Alcoholism among Native Americans: an analysis. Social Work, 25(4), 275-280. Retrieved from SocINDEX with Full Text database.

Han, P. K., Hagel, J., Welty, T. K., Ross, R., Leonardson, G., & Keckler, A. (1994). Cultural factors associated with health-risk behavior among the Cheyenne River Sioux [Abstract]. American Indian and Alaska Native Mental Health Research, 5(3), 15-29. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/791883

Lovekin, K. (2002). Alcohol linked to crime more often then drugs. University of California, Riverside, Newsroom. Retrieved October 13, 2010, from http://newsroom.ucr.edu/ news_item.html?action=page&id=165

Martins, R. K., Widoe, R. K., Porter, C. A., & McNeil, D. W. (2006) Native Americans. Encyclopedia of Multicultural Psychology. Retrieved from http://www.sage-ereference.com/multiculturalpsychology/Article_n159.html

Medicine.Net, Inc. (2010). Alcohol Abuse and Alcoholism, Retrieved October 13, 2010, from http://www.medicinenet.com/alcohol_abuse_and_alcoholism/article.html

Milbrodt, T. (2002). Breaking the cycle of alcohol problems among Native Americans: Culturally-sensitive treatment in the Lakota community. Alcoholism Treatment Quarterly, 20(1), 19-44. Retrieved from SocINDEX with Full Text database.

Mizrach, S. (1999). Natives on the electronic frontier: Technology and cultural change on the Cheyenne River Sioux reservation [Doctoral dissertation]. doi:10.1.1.26.1012

Mulligan, C. J., Robin, R. W., Osier, M. V., Sambuughin, N., Goldfarb, L. G., Kittles, R. A., … & Long, J. C. (2003). Allelic variation at alcohol metabolism genes (ADH1B, ADH1C, ALDH2) and alcohol dependence in an American Indian population. Human Genetics, 113(4), 325-336. doi:10.1007/s00439-003-0971-z

Ogden, M., Spector, M. I., & Hill, C. A. (1970). Suicides and homicides among Indians. Public Health Reports, 85(1), 75-80. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC2031630/pdf/pubhealthreporig01049-0079.pdf

Ortman, W. (2010, February 8). Some still without power, water, after two weeks. The Native American Times. Retrieved from http://www.nativetimes.com/index.php?option=com _content&view=article&id=3035:some-still-without-power-water-after-two-weeks&catid=54&Itemid=30

Parsons, T. (2003, December 14). Alcoholism and its effect on the family. AllPsych Journal Online. Retrieved from: http://allpsych.com/journal/alcoholism.html

Pickering, K. A. (2000). Lakota culture, world economy. Lincoln, NE: University of Nebraska Press. Retrieved from http://books.google.com

Pommersheim, F. (1984). Economic development in Indian country: What are the questions? American Indian Law Review, 12(2), 195-217. Retrieved from http://www.jstor.org/ stable/20068258

Rodgers, T. (n.d.). Native American poverty: A challenge too often ignored. Retrieved from http://www.spotlightonpoverty.org/

Sen, A. (2000). Development as freedom. New York, NY: Knopf Doubleday.

Shepard, P. (2007, February 28). The honor the youth organization. Message posted to The Honor the Youth Spiritual Run, archived at http://www.htyspiritualrun.blogspot.com/

Shiraev, E. B. & Levy, D. A. (2010). Cross-cultural psychology. Boston, MA: Allyn & Bacon.

Spillane, N. S. & Smith, G. T. (2007). A theory of reservation-dwelling American Indian alcohol use risk. Psychological Bulletin, 133(3), 395-418. doi:10.1037/0033-2909.133.3.395

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2010, June 24). The NSDUH Report: Substance use among American Indian or Alaska Native adults. Retrieved from http://www.oas.samhsa.gov/2k10/182/AmericanIndian.htm

Swenson, C. W. (1994). South Dakota V. Bourland: Drowning Cheyenne River Sioux tribal sovereignty in a flood of broken promises. South Dakota Law Review, 39(181). Retrieved from http://heinonline.org/HOL/LandingPage?collection=journals&handle=hein.journals/ sdlr39&div=13&id=&page=

Vinje, D. L. (1996). Native American economic development on selected reservations: A comparative analysis. American Journal of Economics and Sociology, 55(4), 427-442. doi:10.1111/j.1536-7150.1996.tb02641.x

Wall, T. L., Carr, L. G., & Ehlers, C. L. (2003). Protective association of genetic variation in alcohol dehydrogenase with alcohol dependence in Native American Mission Indians. American Journal of Psychiatry, 160, 41-46. doi:10.1176/appi.ajp.160.1.41

Wall, T. L., Garcia-Andrade, C., Thomasson, H. R., Carr, L. G., & Ehlers, C. L. (1997). Alcohol dehydrogenase polymorphisms in Native Americans: Identification of the ADH2*3 allele. Alcohol & Alcoholism, 32(2), 129-132. Retrieved from http://alcalc.oxfordjournals.org/ content/32/2/129.full.pdf+html

White, R. (1978). The winning of the West: The expansion of the western Sioux in the eighteenth and nineteenth centuries. The Journal of American History, 65, 319-343. Retrieved from http://www.jstor.org/pss/1894083

World Health Organization. (2010). Alcohol. Retrieved October 13, 2010, from http://www.who.int/topics/alcohol_drinking/en/

Politics, Technology

Drawn into Politics

When I reflect on my realization that I had to be more politically and economically fluent, I recall a number of campaigns designed to urge the younger generation of voters to the polls. The most prolific one was Rock The Vote! (RTV!). In the midst of the current debates, I draw a correlation to how the younger voters were urged to the polls and how today’s Tea Party movement is drawing political commentary from the older and younger generations, alike.

RTV!, created at the Ministry of Sound nightclub in London in early 1996, has advocated comprehensive voter registration focusing on the younger demographics (Cloonan & Street, 1998; Hoover & Orr, 2007). The result, in some minds, is a prevalence of uneducated and uninvolved voters; however, according to Hoover and Orr (2007), the Rock the Vote campaign did little to increase the voter turnout within the 18 to 24 year-old demographic. Though I did vote following the RTV! campaign, I cannot say that the campaign had any effect on my likelihood to visit the polls. Instead, RTV! appeared to revive party politics by appealing to popularity-driven politicians in an environment of “the affection and admiration which audiences give to their idols” (Cloonan & Street, 1998, p. 36). RTV! may have reached its goal of 20 million votes from the younger demographic, but it was still only 10% of all voters as every demographic turned out in higher numbers for both the 2000 and 2004 elections (Hoover & Orr, 2007).

Though a bunch of individuals with their own ideologies, the Tea Party formed through a grass-roots movement to promote very simple founding principles of the American experiment: Constitutionally limited goverment, fiscal responsibility, individual liberty, and free markets (Tea Party Patriots, 2010). Discussing the impetus of the Tea Party, Marcuse (2010) counters that “if the displacement could be countered and redirected towards its actual causes, it might strengthen rather than conflict with progressive resistance” (para. 1). He seems to miss the mark.

In both instances, groups of individuals band together to promote a goal. For RTV! it is to maximize youthful voting. For the Tea Party, it is to underscore the purpose of our government. These are just two fine examples of individuals gathering together to have their voices heard in a way that might not be possible without the others. Whether you wish to change society or maintain its importance, groups are typically heard faster and louder than individuals, but integrity and honesty both demand that you act in accordance with your ideals, first, before rabble-rousing a group into action.

References

Cloonan, M. & Street, J. (1998). Rock The Vote: Popular culture and politics. Politics, 18(1), 33-38. doi:10.1111/1467-9256.00058.

Hoover, M. & Orr, S. (2007). Youth political engagement: why rock the vote hits the wrong note [Excerpt]. In D. M. Shea & J. C. Green (Eds.), Fountain of youth: strategies and tactics for mobilizing America’s young voters (pp. 141-162). Lanham, MD: Rowman & Littlefield. Retrieved from http://books.google.com

Marcuse, P. (2010). The need for critical theory in everyday life: Why the tea parties have popular support [Abstract]. City, 14(4), 355-369. doi:10.1080/13604813.2010.496229

Tea Party Patriots. (2010). Mission Statement. Retrieved from http://www.teapartypatriots.org/mission.aspx

Academia, Health Care, Politics, Public Health, Society

Addressing Health Disparities

It is troubling to many people to see any person suffering in our society. It is even more troubling to see inequality extend to whole ethnic and racial groups within our society. We certainly do not want to be an unjust society, and we certainly want every member of our society to benefit from the technological gains made in the last century.

One of the more troublesome areas that many view as unjust is health and health care. It is unfortunate that some members of our society suffer from disparities in health. For instance, immunizations and vaccines for most of the common deadly pathogens are readily available, yet many people fail to immunize themselves or their family.

Immunization and vaccination programs have eradicated smallpox and polio and have all but eliminated the threat of measles in the United States (U. S. Department of Health and Human Services [DHHS], 2000). With influenza and pneumonia causing 30,000 to 41,000 deaths in the U. S., annually, the importance of vaccinating against these diseases is quite evident. Obviously, lacking immunity to a deadly pathogen is a disparate condition of health status, and Hispanic and African American populations are vaccinated with less frequency than Whites. How are these issues being addressed?

On the international level, the United Nations (2009) is addressing health disparities by attempting to eradicate poverty on a global scale. Unfortunately, many of these global initiatives have created an environment rife with economic turmoil that we are just now starting to see and understand. Though the premise of helping people out of poverty is very noble, the reality seems to be that we can only offer means for people to help themselves. Otherwise, we risk thrusting whole populations into a world they know nothing about, setting them up for failure. Poverty is based on local economy, and I believe that these interrelated problems are best addressed on the local levels with assistance from states, nations, and global endeavors. The people must direct their own path for a successful transition. They must take responsibility for their own successes and failures.

The United States addresses these concerns on a federal level, offering guidance to states and municipalities in ways to address them. One of these methods is a report from the U. S. Department of Health and Human Services. Healthy People 2010 (DHHS, 2000) has two stated major goals: 1) to increase quality and years of healthy life, and 2) to eliminate major health disparities. There are also 467 objectives in 28 focus areas designed to further these two major goals. Immunization is one of these focus areas.

According to the CDC’s National Center for Disease Statistics (2010), the goal of achieving a 90% immunization rate for children 19-35 months of age is close to being reached. The combination diphtheria, tetanus, and pertussis (DTP) vaccine (85%) and pneumococcal conjugate vaccine (75%) are the only two recommended childhood vaccines that are not being administered at least 90% of the time. According to DHHS (2000), the goal for DTP vaccination was 80% in 2000. It appears that this goal has been reached and exceeded.

Conversely, older adults, age 65 and greater, are at an increased risk of contracting illnesses that could be prevented by vaccination. “In 1999 approximately 90 percent of all influenza and pneumonia-related deaths occurred in individuals aged 65 and older” (Centers for Disease Control and Prevention, Office of Minority Health and Health Disparities, 2007, para. 2). DHHS (2000) does not state a quantitative goal for vaccinating noninstitutionalized older adults, though it does mention a need to “increase the proportion of noninstitutionalized adults who are vaccinated annually against influenza and ever vaccinated against pneumococcal disease” (p. 42). In 2000, 46% of the population in the U. S. were vaccinated against pneumococcal disease, and 64% were vaccinated against influenza (DHHS, 2000). In 2009, pneumococcal disease vaccinations increased by 15%, whereas influenza vaccinations increased by only 3% (Centers for Disease Control and Prevention, National Center for Health Statistics, 2010).

Striving to eliminating health disparities is a noble endeavor; however, the mere fact of attaining this goal contributes to the increase of health care disparity. By increasing the health care delivery model for one at-risk population, we must accept negative gains in the delivery of health care for all other populations. This is an example of the law of conservation describing the divisional nature of finite resources: when an isolated system undergoes change, its change in entropy will be zero or greater than zero (Negi & Anand, 1985). This concept is better stated as it applies to the zero-sum game of our economics today. Kathleen Madigan (2010), in a Wall Street Journal blog post, stated, “More spending in one area has to be financed by less purchases elsewhere” (para. 5).

Two conclusions can be drawn from observing this phenomena in health care. First, if people are spending their health care dollars on other staples, such as food, clothing, and shelter, then we should see a decline in the health of individuals that are making these choices. Second, within health care, in order to increase a focus on one population, an equal negative effect will be seen in all other population groups.

In all aspects of health care delivery, care should be taken to ensure just and equitable delivery of care regardless of socioeconomic factors, race, gender, religion, or creed. All people should have access to the minimum required care in order to maintain a healthy and productive life. We can counsel and educate our patients and clients to best health practices, but we cannot, however, force people to choose health over other facets of their lives.

References

Centers for Disease Control and Prevention, National Center for Health Statistics. (2010). Immunization. FastStats. Retrieved from http://www.cdc.gov/nchs/fastats/immunize.htm

Centers for Disease Control and Prevention, Office of Minority Health and Health Disparities. (2007). Eliminate disparities in adult & child immunization rates. Retrieved from http://www.cdc.gov/omhd/AMH/factsheets/immunization.htm

Madigan, K. (2010, August 3). With wallets thin, consumers face zero-sum game. Real time economics: Economic insight and analysis from the Wall Street Journal. Retrieved from http://blogs.wsj.com/economics/2010/08/03/with-wallets-thin-consumers-face-zero-sum-game/

Negi, A. S. & Anand, S. C. (1985). The second law of thermodynamics. A textbook of physical chemistry (pp. 241-289). Retrieved from http://books.google.com/

United Nations. (2009). The millenium development goals report: 2009. Retrieved from http://www.un.org/millenniumgoals/pdf/MDG_Report_2009_ENG.pdf

U.S. Department of Health and Human Services. (2000, November). Healthy People 2010: Understanding and improving health (2nd ed.). Washington, DC: U. S. Government Printing Office.

Politics, Technology

Free Market

I have purchased many products developed in other countries in the past, including electronics, clothing, and vehicles. To be honest, I have never considered the multi-dimensional ramifications of such purchases. In my view, the purchase of any product that is made available for purchase, whether imported or domestic, contributes to the economy of the United States. In Free to Choose, Milton Friedman (1990) outlines how a free market, driven by personal interest, creates a paradigm where interaction serves only to benefit each party of a transaction. Under Friedman’s concept, the market ultimately causes responsible purchasing, as the consumer drives the market. This differs greatly to the capitalism engaged in the United States, which promotes what is refered to as crony-capitalism. This is certainly an abomination of what the free market is intended to provide. As Friedman purports, “a predominantly voluntary exchange economy … has within it the potential to promote both prosperity and human freedom” (p. 11). Consideration of special interest over general interest will degrade this ideal.

According to Ridgeway (2007), the World Bank and the International Monetary Fund have destroyed cultures in their attempts to provide for participation in the international markets. Unfortunately, opportunistic people have taken advantage of the situations created. This is what laws are for. Proper legislation and political pressure would allow a government to interact on the world market utilizing methods acceptable to the people. The sovereign government of a people is responsible to and for the people. Governments trade with other governments and their people. It is the choice of both governments, and ultimately the consumers, to do business with each specific entity. I posit that if a certain government abused the governed populace for the sake of increasing world trade, then the responsible governments of the world should, in fact, put pressure on the producing government to alter its model. This would require a moral commitment, however.

Whenever an opportunity for growth presents itself to a community, the community is going to change. Technology will change landscapes as certain needs prevail over lesser needs. It is the responsibility of each culture, whether indigenous or colonial, to preserve their history and culture. Abuses, though, should not be tolerated. I believe that it would be important to not purchase products produced in such manner that would offend one’s sensibilities. For example, the genocide of a people is not excusable solely for the use of the wood on their land. I, for one, would not allow that producer to profit from me.

References

Friedman, M. & Friedman, R. D. (1990). Free to choose: A personal statement (First Harvest ed.). Retrieved from http://books.google.com/books

Ridgeway, S. (2007, July). Globalization from the subsistence perspective. Peace Review, 19, 297–304. doi:10.1080/10402650701524659

Politics, Public Health, Technology

Conquest of Indigenous Populations

The native Americans of the Great Lakes region were thankful for the opportunity to trade fur with the multitude of nations that presented themselves in friendship from the 14th to the 17th centuries (Reader’s Digest, 1978, p. 149). It was the conquest of land, ordered by King James I and King Charles II, that negatively affected the indigenous populations (p.149). It was this progressive agenda that marginalized the native Americans and ultimately caused King Philip’s year long war as well as other campaigns against the white settlers of the east coast (p. 152). Throughout this time, many tribal nations were decimated by other nations while competing for trade of the more powerful weapons the white settlers could provide. The tattered tribes would move and join in alliances with other defeated tribes to minimize the possibility of a recurrence and to ensure procreation and ultimate tribal survival (p. 152). This intermingling surely had an effect on the biological make-up of the various tribal nations. I feel that much of the negativity could have been avoided with a simple sense of respect.

Currently, there are many indigenous peoples facing a number of problems with colonization. The aborginal women of Ontario, Canada, are a specific example of how an overall lack of respect leads to the marginalization of a whole culture. “Aboriginal women have a lower life expectancy than non-aboriginal women, and higher incidences of diabetes, HIV/AIDS, tobacco addiction, and suicide (up to eight times the rate experienced by other women)” (as cited in Ontario Native Women’s Association [ONWA], n.d., p. 4). To address these concerns, the community has formed organizations like ONWA and the Native Women’s Association of Canada to provide a unified voice to advocate for improved status for aboriginal women in Canada. As their position paper states, “the ONWA makes recommendations for future actions to begin the process of initiating the necessary changes with a special focus on the need for grassroots control, activism, and leadership development for Aboriginal women” (p. 1). In addition to advocating for the equality of aboriginal women, the ONWA also advocates for the environment recognizing the increasing levels of waterway pollution and other environmental concerns.

Thus far, the ONWA has developed programs to address health concerns, gambling addictions, workforce development, housing and justice (ONWA, 2010). As a grassroots activist organization, the ONWA appears to be gaining ground for the equality of aboriginal women in Ontario.

References

Ontario Native Women’s Association. (n.d.). Contemporary issues facing aboriginal women in Ontario: An Ontario Native Women’s Association position paper. Thunder Bay, ON: Author.

Ontario Native Women’s Association. (2010, May 27). About us. Retrieved from http://www.onwa-tbay.ca/aboutus.htm

Reader’s Digest. (1978). In J. A. Maxwell’s (Ed.), America’s fascinating Indian heritage. Pleasantville, NY: Reader’s Digest Association.

Politics, Technology

What Would We Do Without Our Natural Resources?

Connecticut has a vast supply of wood and still records the existence of at least 22 operational sawmills (State of Connecticut, 2007). The area produces many different types of wood. The hardwoods produced in Connecticut include red oak, white oak, maple, ash, and birch. The softwoods include red pine, white pine, and hemlock. From the State of Connecticut (2007), “sawmills have played an important part in Connecticut history since the mid 1600’s. Early communities were constructed around working sawmills and their presence assured a steady flow of forest products for use in Connecticut’s homes, farms and businesses” (p. 4).

In addition to the economic benefits, the forests of Connecticut provide important environmental roles, such as the prevention of soil erosion and mitigation of air pollution. “A healthy forest promotes clean air, clean water, and a better-regulated climate” (Flounders, 2006, p. 13). It would be disastrous if Connecticut lost this valuable natural resource, right? Wrong.

According to the Flounders (2006), before the European settlers arrived in Connecticut, the land was a vast forest. The advent and proliferation of farming across the State deforested 75% of the land by 1820. Much of the environmental fall-out caused some of the farms to falter. Industry and the Civil War had even more negative repercussions for the area’s farms.

As an increasing number of farms became abandoned, nature took over (Flounders, 2006). Flounders (2006) describes how ”without human interference, the vegetation of abandoned fields underwent a series of changes” (p. 35) to create Connecticut’s “Second Forest” (p. 35). Ultimately, the original deforestation eventually lead to a forestry boom in the late 1800’s. Currently, Connecticut’s forests “[cover] 1.9 million acres, or 60% of the State” (p. 37).

When dealing with renewable natural resources, the economy is the primary impetus of change. When plentiful, the focus is to utilize the resource. As the resource becomes less available, it becomes more difficult to earn a living producing the resource, and there is more pressure to change occupations. This is purely supply and demand.

In conclusion, the inhabitants of the State of Connecticut relied heavily on the forests before the area was colonized by the European settlers. This colonization required such a use of wood that it resulted in the devastation of all but 25% of the State’s forests. As the wood supply decreased and demand for workers in other professions increased, the land was abandoned and left to a natural course. Forests grew once again, and the land is now well distributed with forests. Though it is not the center of the economy for Connecticut, there remains about two dozen sawmills that continue to produce wood for a variety of purposes. It is important to both consider the ramifications of depleting our natural resources and remember that it might be wise to leave some things to nature.

References

Flounders, H. T. (2006). Connecticut Statewide forest resource plan. Retrieved from http://www.ct.gov/dep/lib/dep/forestry/forest_resource_plan/fplanall.pdf

State of Connecticut, Department of Environmental Protection, Division of Forestry. (2007, June). Connecticut primary processor directory. Retrieved from http://www.ct.gov/dep/ lib/dep/forestry/forest_practitioner_certification/primaryprocessors.pdf

Emergency Medical Services, Politics

Conversations in the Back of the Ambulance

MS: So, we have about a half-hour ride to the other hospital. Would you be willing to help me out with a project for my anthropology class?

AP: Sure, we’ve been having quite a conversation so far.

MS: Okay, for the record and because of medical privacy concerns I will acknowledge your participation with the initials AP for Anonymous Participant. Also, I have to make sure that I note the generational differences between us.

AP: Well, that shouldn’t be too hard to do.

MS: No, certainly not. For documentation sake, let us say that you are in your 70’s, and we can leave it at that.

AP: I’m closer to eighty, though?!

MS: Wow, can’t even do a guy a favor!

AP: HA! So, what are these questions? I imagine it’s how to pick up the ladies, right?

MS: Yeah, sure, let’s start there! Actually, I wanted to ask more about your views growing up. Politics, religion, et cetera.

AP: Well, let’s start with religion. I think that will be the easiest.

MS: Okay, religion.

AP: Well, let’s see… I grew up in a fairly Protestant family. I mean, we went to church every Sunday and all, but we were never overly religious.

MS: Would you say that you were tolerant of other religions, or did you view your religion as the true religion of your god?

AP: Oh, no! We were very tolerant. We would never look down on anyone else because of their beliefs, especially their religious ties. The only problems that I have ever had with people were, well, the neighborly scuff – whose fence is on whose property – and, of course, mechanics. $1000 to install a $25 part… highway robbery for sure! And, I am sure I won’t like you too much after I get your bill!

MS: Obama will take of that, though, right? Actually, I do want to talk about your political views here in a minute, but let’s keep on religion for now. Do you think your views of religion have changed much over the years?

AP: Well, that’s tough to say. I’m pretty old, and I know that I’m gonna die pretty soon. It makes you think, you know? I mean, I know I want to make sure that I get a chance to tell the kids and the grandkids how proud I am of them, and I pray to God every day that I will get that chance. They all live in different States, so it’s tough to get them all together, lately. But, I find myself talking to God a lot more these days, but I am not sure if I believe in Him any more than I used to, as an adult, I mean. As a kid, he’s like Santa Claus or the Tooth-fairy; you believe in Him for no other reason than you were told to.

MS: Yeah, that’s kinda where I’ve been. I can understand that there might be a consciousness that is ultimately responsible for our creation, but I am not sure if I believe he knows what exactly he has created. Accidental or otherwise, we do exist, and it would only make sense that something put this in motion. Maybe I’m a theist, but mostly I don’t think about it. I’m usually agnostic or atheistic. Perhaps, I’m an agnostic theist?!

AP: Well, when you get as old as me, you want to make sure you are on the good-boy list.

MS: That’s Santa?!

AP: Close enough.

MS: Alright, let’s talk politics. I’ll keep it simple at first. George Washington, good or bad?

AP: Good, no great! He was a great man, Washington.

MS: Tyler?

AP: Who?

MS: Abraham Lincoln?

AP: Great!

MS: Wilson?

AP: What? Woodrow Wilson? Ungh… That was an evil man. Let me tell you about Wilson. Wilson is why this country is the way it is. I imagine that others before him wanted to do some of the things that he did, but sheesh, Wilson was the one that got it done. And, done, indeed, it is.

MS: What was so bad about Wilson?

AP: Have you ever heard of the Great Depression? That was Wilson’s work, there. Yeah, it happened a few years after he died, but the framework was his alone. Who were those other two guys? They came after Wilson…. I can’t think.

MS: Harding and Coolidge?

AP: That’s them. I remember my father telling me that if it weren’t for those two, Hoover wouldn’t have had a chance. Hoover was actually in office during the start of it, the depression. Lucky for me, I don’t remember it. In fact, don’t remember him. I think the first President that I can remember was F.D.R. He was the war President. As far as I recall, though, I think Hoover just ran with the Wilson plan, killing everything Harding and Coolidge did to fix the problems.

MS: So, I’m guessing you are a Conservative? A Republican, perhaps?

AP: I remember waving the flag for Roosevelt, so I guess I was a Democrat, then, you know, at twelve years old, or however old I was then… probably more like nine or ten. But, as I got older, especially from the time the war ended, I started paying attention to politics. I’ll tell you, it makes not one lick of difference if the guy is black, brown, yellow or white; if he’s a politician, he’s both a liar and a thief! We have had very few politicians that were honorable men, very few. And, these Progressives, well, they are the worst of them. This Obama is one of them.

MS: Yes, I believe Obama is a self-proclaimed Progressive.

AP: And, it shows. Wilson was a Progressive. Too many of them are. And, they don’t tell you! That’s the worst of them. They tell you what you want to hear, you elect them, then they do this about-face and spend, spend, spend us into oblivion. Looking back, this is certainly not my father’s country anymore. Ford was good, though. He never gets any recognition.

MS: So, Ford, good; Wilson, bad. Is that right?

AP: Yup!

MS: Interesting. I’m going to have to read up on Ford a bit more. You mentioned something about race a minute ago: “Brown, black, yellow, white”, something. What are your views on race relations in the United States?

AP: Oh, no… You aren’t gonna like me much after this conversation, but I’ll be honest. I always try to be honest.

MS: Okay, Ben Franklin, let me have it.

AP: Ha! Well, I can honestly… heh, honest… say that I have no problem doing business or maintaining friendships with anyone of any race, nationality, or creed. The problem that I have is the laziness and the sense of entitlement that many people have today. Fifty years ago, you didn’t see that, not like today, anyway. It’s just unfortunate that the minorities tend to have this attitude, this air of you’re not better than me, so give me money so I don’t have to work.

MS: Ahh, so the Progressives rear their ugly heads once again!

AP: Exactly! And, that’s what I was talking about. It’s this idea that if we give them money, they will use it to rise up and overcome poverty or something. Almost magical thoughts of levitation, if you will. One day, they will learn that if you keep giving people stuff, there will come a time when they forget how to earn it. Same with me. I’m sure that if the government sent me a check every week for not working, at some point, I would become complacent and not work. I doubt it, but it is possible I guess.

MS: Is it the government’s place to give out all of these entitlements?

AP: Again, I’m old, but I’ve made a pretty decent living for myself over the years. Medicare is a horrible system, but between that and my other insurance, at least you’ll get paid!

MS: Well, I’m not too worried about that. You sign my form, and that’s all I care about for payment. We have people!

AP: Yeah, tough guys always have people. But, community… community and family is what we need to get back to. That used to be enough. Granted, there were times that were really tough, especially for my family when I was born and right before. We had tough times, but we got through them. We were smart about it. We trusted that it couldn’t last too long, and it never did.

MS: Well, one thing that I’ve noticed is the propensity of my generation to move away from family. I think we rely on the internet for communication and planes, trains, and automobiles to visit from time to time.

AP: Well, we had a farm. When the family has a farm, you help run it. Actually, I think it was the farm that kept our heads above water all those years.

MS: I always wanted a farm. Is it still in the family?

AP: Nah. None of the kids wanted to keep it up. It is hard work running that farm, but we sold it off, paid our debts, and invested the rest. Pretty much been living on that after we retired.

MS: So, what was life like on the farm? I mean, family life specifically.

AP: Well, our farm was a part-time venture, so to speak. I would wake up, do some chores, have breakfast, go to work, come home, do some chores, eat dinner, do some chores, go to bed, and repeat. Don’t get me wrong, I enjoyed the hell out of it. The kids helped out when they were old enough, but the wife kept the whole ship running smooth. If it weren’t for her… well, let’s just say I wouldn’t still be here.

MS: Television and movies about years ago seemed to marginalize women. The wives cooked, cleaned, did the laundry, had babies… you’re laughing?

AP: My wife cooked, cleaned, did the laundry, had babies, sure, but I cooked, I cleaned, I did laundry, and I was very involved in the raising of our children. Don’t let those programs fool you. Family was family. We did it all. In fact, we both left for work at about the same time, though she would get home sooner than me. She only worked around the corner.

MS: You are describing a very concerted effort at keeping house and home.

AP: If you find a young woman to love, you take good care of her, and she will take good care of you. I remember a few guys that would mistreat their ladies, but back then, well, back then, we took care of things like that. Times get tough, but don’t mistreat your lady.

MS: Speaking of your wife, she said that she would meet us up here. So, I should give her all the respect in the world?

AP: Anything less, and I’ll smack you one!

MS: It seems chivalry ain’t dead!

AP: Not as long as I’m around, and I ain’t going anywhere, yet!

MS: No, it seems that you will be around to cause her grief for a little while longer, at least, but not with me. It seems like we’ve arrived. It was absolutely great hearing your story. I am honored. Is there anything that you would like to add?

AP: Yeah, tell the driver not to hit so many bumps next time!

MS: He’ll be opening the doors here in a minute. You can tell him yourself. Thank you again.

AP: Anytime, but next time, come by the house. I don’t need another ambulance bill!

MS: Understood.

As a paramedic, I enjoy many benefits. The single best benefit is certainly the ability to meet new people and talk to them. For this assignment, I felt it best to rely on the random nature of my job to gain the perspective of someone I have never met before. There are limitations, though, to this method of choosing a potential informant for this interview. Paramedics are bound by confidentiality, and though the informant granted express permission to use his words and his story, I could not ask him to waive his rights under the Health Insurance Portability and Accountability Act (1996). I felt that the limitation was not an undue hardship, and the benefits of gaining such a random perspective far outweighed the benefits of identification of the informant.

The informant that I interviewed was a 70-something year-old gentleman who was more than eager to share his story with someone so interested in listening. The most important discovery of the entire interview was that we all have interesting life lessons to share. If only more people would stop to listen, important lessons could be taught.

It is very important to note that this interview was conducted during a time when the informants mortality was in question. I feel that this opportunity is unique in the honesty and conviction of the responses to my questions. We started the interview by talking about religion.

The informant and I feel that we have quite the same religious background and beliefs (personal communication, June 2010). When I approached the topic of religious tolerance, he seemed to be more cognizant of character and overall morals separate from specific religious practices. This thought reinforced some of my core beliefs about the human condition, about how we are moral creatures.

Discussing politics gave me some real insight into how earlier Americans might have viewed the progressive versus conservative debate originally (Anonymous, personal communication, June 2010). I am sure that the informant is not an exemplar of all twentieth century American political thought, but he was able to draw some parallels with the current political environment. Tough times arise and people tend to get nervous about economic survival. It is easy to conceive that an incomplete understanding of politics and economics fuels the debate on both sides of the issues.

From politics, we moved on to discuss his view of race relations in the United States. Interestingly, it seems as though my informant might have been resigned to accept that he might have some racist tendencies until I asked him his thoughts and understanding of race (personal communication, June 2010). It turns out that he was slightly mistaken. My informant realized, during our conversation, that it was not racial differences that he was upset about but a general lack of motivation seen in many people over the years. It is just an unfortunate twist that he associated this laziness with racial stereotypes. Though we changed the subject quite abruptly, I could sense a rebuilding of his understanding of racial differences. It was good to see such a thing take place.

Family was strong throughout my informants life (personal communication, June 2010). Whether we were speaking of being raised by post-depression era parents or farm life with his own family, there was always cooperation to make the family structure work. I took exceptional notice during this portion of the interview. In the contemporary United States, I have noticed a disintegration of family and community. In childhood, I recognized the meaningfulness of family bonds and community spirit. I wonder how this changed. My informant describes a time that was not particularly easy on him or his wife, but they remained loyal to each other and to the family, specifically. Today, it outwardly appears to makes more sense for some to seek a better alternative at the first hint of difficulty or trouble. This is not what family means to either of us, and I am glad to see an example of how things work out pleasantly in the end.

Our interview ended with a particularly entertaining joke about him protecting his wife from any irresponsible comments that I might make (Anonymous, personal communication, June 2010). I am sure that he did not feel that he had to actually protect her from me, but I think he felt that he needed to make me understand how much he cared for his wife. Man to man, an idle threat seems to convey a universal understanding between men, whether serious or joking. I am glad to have witnessed this show of strength. I am sure that he is contemplating the fact that he will not be around much longer. I hope that he understands that he would leave his wife with good people in the world. I believe that this discussion was the impetus for my patient to realize that the world outside of [his neighborhood] is not a hostile or unfriendly world. I also think he realized that he will not be here forever, and his wife will be taken care of by the community that he supported for so long. I am glad to be a part of that community.

References

Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, §1177, 110 Stat. 2029 (1996).

Politics, Technology

Indigenous People

In order to define a term, such as “indigenous peoples”, one must examine the words that make up the phrase. “Peoples” are collections of societies, and “indigenous” implies nativity or autochthony. I have always considered “indigenous peoples” to be those societies that have an intrinsic relationship to the land inhabited. Ergo, when a society is provided for by the land, the act of habitation changes the land, and that land changes the society in a fundamental way. Whenever this is true and can be applied to a society, then it is a society of indigenous people.

The largest difficulty in defining or categorizing human beings is the resultant scale upon which they are measured as a group. I do not hold such inclinations as to group and sort people based on ethnicity, societal values, economics, or any other humanly devised subjective measures. The United Nations (2008) requires a society to be impoverished or suffer some other gross inequality in order to claim indigeny. I feel that this approach only serves to feed ideologic notions by marginalization and deprives the society from a rightful claim. By attempting to create a system to help indigenous peoples from inequality, the United Nations has sought to identify these peoples and have instead cast a definition upon them. Certainly, this is a problem.

References

Secretariat of the United Nations Permanent Forum on Indigenous Issues, Division for Social Policy and Development, Department of Economic and Social Affairs. (2008). Resource kit on indigenous peoples’ issues. New York, NY: United Nations. Retrieved from http://www.un.org/esa/socdev/unpfii/documents/resource_kit_indigenous_2008.pdf

Health Care, Politics, Public Health, Society

Reducing Philanthropy to Political Commentary

In searching the typical news outlets for stories related to health care reform, be it local or national, I cannot help but notice that health care reform is the news. The factions are split, and the bias is evident. As the news outlets lean more to the left of the political spectrum than ever before, it is almost impossible to research the real issues at hand. Wading through the political views to glimpse a meaningful patient-focused agenda is quite difficult lately.

An article written by Randall Beach (2009) of the New Haven Register focuses on a group of doctors that rely on charity to provide health care to a select adult population who do not qualify for Medicaid and make less than $20,000 per year. Unfortunately, this article, like so many others, reduces philanthropy to political commentary.

Our current health care system is fragmented, and many people believe health care reform is needed (“54% Say Major Changes Needed”, 2009). As Dr. Peter Ellis is quoted, “Our motto is: ‘Health care reform starts at home'” (Beach, 2009, p. 3). It does not make sense, however, to provide Universal Health Care at the cost of our failing economy. Dr. Ellis’ group, Project Access, has secured funding from private sources, including the Hospital of St. Raphael and Yale-New Haven Hospital staff, the Aetna Group, the Community Foundation for Greater New Haven, and the New Haven County Medical Association Foundation. Additionally, 350 local care providers are associated with the project. This is a grassroots effort at helping to care for our neighbors, and as far as I have read, it seems to be a reasonable and responsible attempt to mend some of the local disparities to health care access.

Though I commend Mr. Beach for covering such a newsworthy story, it serves no one to inflame the current health care debates with political posturing by the media. I believe that the recent passing of health care reform will do nothing but create more clutter and complication for us to untangle when we finally have the financial stability to address the issue responsibly and realistically. In the meantime, I, like Project Access, will continue to volunteer my time and medical services to my community.

References

Beach, R. (2009, December 28). Doctors giving health care reform a head start. New Haven Register. Retrieved from http://www.nhregister.com/articles/2009/12/28/news/new_haven/a1_mon_nedoctors_art.prt

54% Say Major Changes Needed in Health Care System, 45% Disagree. (2009, October 2). Rasmussen Reports. Retrieved from http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/october_2009/54_say_major_changes_needed_in_health_care_system_45_disagree

Academia, Health Care, Politics, Public Health, Society

Health Care Reform

In beginning this endeavor, I found it initially difficult to find anything related to health care legislation that I would be inclined to support or oppose in a letter to my Congressman. I tend to rely on the elections in order to convey my political positions. After studying some of the recent legislation, I found that the only premise that interested me was the adoption of The Patient Protection and Affordable Care Act of 2010 and the related Health Care and Education Reconciliation Act of 2010. Unfortunately, attempting to find credible dialogue on the internet regarding these laws is both impractical and near impossible. The special interest groups are leaning to their respective extremes. With commentary not proving trustworthy for factual insight, I relied on the Congressional Budget Office and the full text of the laws to cement my position. Using the aforementioned information in conjunction with Senator Lieberman’s contact information from the U. S. Senate website (http://www.senate.gov), I formulated a letter to him outlining my economic concerns (see Appendix).

I understand the grandeur of the idea of universal health care. I applaud the debates of how best to offer affordable or free health care to ever citizen of the United States. Unfortunately, as a nation, we are not fit in our financial means to proffer such an expensive entitlement. As Goodson (2010) reports, many of the initiatives outlined within the law are not guaranteed to be successful. This at an increased cost of $390 billion over the first 10 years (Elmendorf, 2010).

To ensure that my points were valid, I researched the approval ratings of these laws. According to WashingtonWatch.com (2010), approximately 80% of respondants do not favor the passing of these laws. More scientifically, however, a consistent range of 54 – 58% of Americans favor repeal of the laws, while 63% of senior citizens agree (Rasmussen Reports, 2010).

References

Elmendorf, D. W. (2010, March 20). Manager’s amendment to reconciliation proposal [Letter to the Honorable Nancy Pelosi]. U. S. Congress, Washington, D. C. Retrieved from the Congressional Budget Office website: http://www.cbo.gov/ftpdocs/113xx/doc11379/ Manager%27sAmendmenttoReconciliationProposal.pdf

Goodson, J. D. (2010). Patient Protection and Affordable Care Act: Promise and peril for primary care. Annals of Internal Medicine. Advance online publication. Retrieved from http://www.annals.org/content/early/2010/04/15/0003-4819-152-11-201006010-00249.full

Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152 (2010).

Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148 (2010).

Rasmussen Reports. (2010, May 17). Health care law: 56% Still Want to Repeal Health Care Law, Political Class Disagrees. Retrieved on May 22, 2010, from http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/march_2010/health_care_law

WashingtonWatch.com. (2010). P.L. 111-148, The Patient Protection and Affordable Care Act. Retrieved on May, 22, 2010 from http://www.washingtonwatch.com/bills/show/111_PL_111-148.html

Appendix

Michael F. Schadone
[REDACTED] Woodstock, CT 06282

The Honorable Joseph I. Lieberman
706 Hart Office Building
United States Senate
Washington, DC 20510

May 22, 2010

Re: The Patient Protection and Affordable Care Act of 2010

 Dear Senator:

 My name is Michael Schadone and I am a nationally registered critical care paramedic working in Northeast Connecticut. I am writing you today because I do not support the recent legislation referred to as The Patient Protection and Affordable Care Act of 2010. I urge you and your colleagues in Congress to repeal this law. I believe that our efforts aimed at improving the economy will, in itself, dramatically reduce the disparities in access to health care.

Under the auspices of a progressive government, our country has seen many times of woe. Bigger government and higher rates of spending have driven our economy into the ground. It was only the idea of smaller government and trust in the American entrepreneur that ever caused unemployment rates to drop to less than five percent. More people gainfully employed means more people with access to affordable health care. Is this not our goal? In Europe, economic systems are collapsing. Many of the countries with universal health care have tax rates approaching 70 percent (including ‘value-added tax’). It is commonly held that suppressing the spending power of the citizenry will surely lead to a collapse of the free market, the basis of our economy. I certainly do not want the United States of America to resemble Greece, Portugal, Spain, or Cuba. We are the Great Experiment, and so far, it is working. I fear, though, not for much longer.

I favor universal health care just as I favor universal education and other entitlements but not at the expense of our country. Improvements to the economy will put us in a position to gain strength and enable us to afford such a sweeping paradigm shift in health care. More importantly, a better economy will allow us to do it properly. I urge you to focus on the economy and repeal this dangerous law.

 Sincerely,

Michael F. Schadone