Tag Archives: health disparities

Difficult Dialogues Spring Public Forum: Health, Infrastructure, and the Environment

This spring’s Difficult Dialogues Public Forum, held on April 13, featured three of the 2020-2022 Faculty Fellows: Dr. Andrea Gore (College of Pharmacy);  Dr. Ben Hodges (Cockrell School of Engineering, Civil, Architectural, and Environmental Engineering); and Dr. Katherine Lieberknecht (School of Architecture, Community and Regional Planning) speaking on the topic of “Health, Infrastructure, and the Environment.” Each panelist spoke briefly, followed by conversation moderated by HI Director Dr. Pauline Strong.

Dr. Lieberknecht’s presentation focused on the importance of including local knowledge in climate planning. She heads a National Science Foundation-supported collaborative project located in Dove Springs that seeks to find ways to integrate community knowledge into city efforts to contain flooding and ameliorate extreme heat. Lieberknecht identified three kinds of infrastructure planners consider when designing solutions: the built environment; the ecological environment; and the social environment. Using seasonal flooding as an example, the built environment includes structures such as levees; the ecological environment includes efforts to create green space; and the social environment includes communication networks within communities. Local knowledge incorporates information about all three. Community members know which storm drain always backs up, which route to the grocery store is shadiest in the heat of summer, and who organizes community responses. The Dove Springs project is still in its beginning stages—the research began roughly 6 months ago, and some aspects have been hampered by C19 restrictions—but Lieberknecht and her academic and community partners hope that its findings will help planners and communities design more robust climate solutions.

Dr. Hodges followed. He opened his presentation by sharing a simple fact: global warming means increasing rain, increasing rain means more floods. Floods happen for three reasons, Hodges explained. Rivers exceed their banks; storm surges overwhelm coastal areas; and “water bombs,” localized intense rainstorms. Cities are not currently designed to manage such storms. Design criteria must change. But civil engineering solutions operate almost exclusively from a cost benefit analysis.  Wealthy people live on the most valuable land, so it’s that land that civil engineers strive to protect. Hodges pinpointed a dilemma in infrastructure planning: when changes are made to mitigate undesirable circumstances, such as flooding, property values rise. Gentrification often follows, driving the original residents out. How can engineers and city planners create solutions that preserve communities instead of displacing them? Hodges suggested a few ways to change current practices. Firstly, he encouraged more interdisciplinary work to provide more holistic understandings of the problems and possible solutions. He promoted investment in ripping out concrete and asphalt to create new green spaces, and stressed the importance of building codes in addressing infrastructure inequities. He also proposed that cities begin thinking of eminent domain as a tool to bring more valuable properties into green space.

To close the panel, Dr. Gore brought a more direct focus on health outcomes. Since the “chemical revolution” of the World War II period, synthetic chemical production has increased dramatically. Many of these chemicals allow us to have products that make our lives easier or more convenient. However, their production often causes pollution that harms both human and non-human life. Gore described her research on endocrine-disrupting chemicals, or EDCs, which she defined as “a chemical that interferes with any aspect of hormone action.” Hormones, she explained, affect brain development and behavior regulation, among other factors. She emphasized two points: EDCs have adverse effects on brain health, and these adverse effects can affect the health of future generations. We’re all exposed to EDCs, primarily through food. Chemical contamination harms wildlife as well as human life, which Rachel Carson demonstrated in her 1962 book, Silent Spring. As the planet warms up, the polar ice caps melt, and chemicals once trapped in the ice are released into the air and water. While it would be impossible to avoid all exposure to EDCs, Gore offered some actions we all can take in order to minimize risk. She advised microwaving in glass containers rather than plastic; drinking filtered water, not bottled water; and eating fresh produce—organic, if it’s affordable—instead of industrially processed food.

A lively discussion followed. Participants discussed the tension between local and national needs when addressing infrastructure issues, and the need for context-informed solutions. Lieberknecht cited the need to “think with equity.” Solving these issues requires thinking holistically, including conversations about living wages, affordable housing, and access to healthy food. While all agreed that community cultures of care are important, they stressed that it’s the role of municipalities to step up and address problems.

Several resources were shared by the panelists and participants in the chat. Some are linked below.

City of Austin Climate Equity Plan 

Planet Texas 2050

“Editorial: An International Riposte to Naysayers of Endocrine-Disrupting Chemicals” Andrea Gore

“Policy Decisions on Endocrine Disruptors Should Be Based on Science Across Disciplines: A Response to Dietrich et al.” Andrea Gore, et al.

The Death and Life of Great American Cities Jane Jacobs

The Economy of Cities Jane Jacobs

Palaces for the People: How Social Infrastructure Can Help Fight Inequality, Polarization, and the Decline of Civic Life  Eric Klinenberg

Thinking in Systems and other work by Donella Meadows

Water 4.0: The Past, Present, and Future of the World’s Most Vital Resource David Sedlak

Scale: The Universal Laws of Life, Growth, and Death in Organisms, Cities, and Companies Geoffrey West

 

Photo of the 2015 Halloween flood in Austin, TX courtesy of the City of Austin

Controversy and Conversation Resources: “The Apple Pushers”

The April 1 meeting of “Controversy and Conversation” discussed issues raised by the film “The Apple Pushers,” a documentary featuring New York City’s Green Carts Program, an initiative intended to bring greater access to fresh fruits and vegetables to neighborhoods with little opportunity to purchase fresh produce.

HI’s program coordinator, Dr. Melissa Biggs, a food studies scholar, began the discussion. While the film used the terms “food desert” and “food swamp” to describe the neighborhoods served by the Green Carts, she suggested the concept of “food apartheid.” Introduced by activist Karen Washington, “food apartheid” refers to the systems of economic inequality and racial and environmental injustice that permeate our food system.  Biggs asked participants to consider perspectives critical of the “obesity epidemic” framework. The inequities that create food apartheid  contribute to health problems of many kinds.

The introduction served as a starting point for a conversation that touched on the food ecosystem of Austin, changes in shopping and eating due to the COVID 19 epidemic, and food insecurity in rural areas and on college campuses. Zach Shlachter, one of our Austin Public Library partners, described his work with the Eating Apart Together Initiative, a city-sponsored program that came together during the pandemic to help feed unhoused people.

Lucas Alvarez, also of the APL, compiled a list of resources available through APL for those who would like to explore these topics further: APL Resource List “The Apple Pushers”

Below are other resources mentioned during the discussion

City of Austin Food Resources:

Some Local Food Organizations

Austin-Focused Readings and Resources

UT Campus Resources and Initiatives

Readings on Food Justice and Food Systems

Provocative Works on Racial Injustice and Health Inequity from Recent HI Visitors

By Dr. Sarah Ropp, HI Difficult Dialogues Program Coordinator and Andrew W. Mellon Engaged Scholar Initiative Fellow

The Humanities Institute is privileged to welcome outstanding visiting scholars, performers, and activists to UT each year as part of various programs, including the Cline Centennial Professorship in the Humanities, the Distinguished Visiting Lecture Series, and the Difficult Dialogues Public Forums, among others. We have gathered together a few resources by recent visitors that speak to racial injustice and health inequities in a number of different formats, from books and articles to video and music.

Rita Charon, MD, PhD

In September 2016, the Humanities Institute welcomed Rita Charon as its ninth C.L. and Henriette Cline Centennial Visiting Professor. Charon is Professor of Medicine and founder and Executive Director of the Program in Narrative Medicine at Columbia University. Her Distinguished Public Lecture for the Humanities Institute, entitled “The Shock of Attention: Bodies, Stories, and Healing,” can be viewed at this link

Upcoming Event: On Thursday, July 16, 2020, at 1pm CDT, Charon will be participating in an online conversation hosted by the Modern Language Association entitled “Medicine, Narrative, Power, and Pandemic,” along with physician and fiction writer Aakriti Pandita. They will respond to the questions, “How can narrative and the humanities help us understand this pandemic? And how can they make medicine smarter, more equitable, and more effective?” Register for the event HERE.

Alondra Nelson, PhD

In 2018, Alondra Nelson delivered a Humanities Institute Symposium keynote lecture on her book The Social Life of DNA: Race, Reparations, and Reconciliation after the Genome (Beacon Press, 2016) as part of the Distinguished Visiting Lecture Series. President of the Social Science Research Council (SSRC) and the Harold F. Linder Professor of Social Science at the Institute for Advanced Study, she has produced a number of recent works that speak to intersections between race, social inequality, health care, and activism:

Article: In “Society after Pandemic,” Nelson asks, “How do the social conditions exposed, exacerbated, and created by the novel coronavirus demand that we substantively rethink our ideas of society and, therefore, some of the prevailing assumptions of social science?” This is the inaugural essay in the SSRC’s “Covid-19 and the Social Sciences” series.

Teaching resource: The #coronavirussyllabus is an open-access, living list of texts for teaching about Covid-19 in social, historical, and political context, from scholarly books and articles, to music, visual art, and film, to podcasts and videos. Nelson initiated this crowdsourcing effort with the Twitter hashtag #coronavirussyllabus, inviting contributions from around the globe and across a wide variety of disciplines.  

Video: Recently, Nelson participated in a virtual roundtable hosted by the Modern Language Association entitled “Is Higher Education Learning from the Pandemic?” along with Cathy N. Davidson and Christopher Newfield. 

Book: Nelson’s contributions to scholarship on health equity and racial justice date to at least 2011, when she published her first book, Body and Soul: The Black Panther Party and the Fight against Medical Discrimination (University of Minnesota Press), which argues, “The Black Panther Party’s understanding of health as a basic human right and its engagement with the social implications of genetics anticipated current debates about the politics of health and race.”  

(Photo credit: Daniel Cavazos)

Eric Klinenberg, PhD

In fall 2018, Eric Klinenberg was the featured speaker for a Difficult Dialogues Public Forum on “Climate Change, Social Infrastructure, and Inequality,” hosted by the Humanities Institute and Planet Texas 2050. Klinenberg is Helen Gould Shepard Professor of Social Science and Director of the Institute for Public Knowledge at New York University. Klinenberg’s work explores the failures of social infrastructure in moments of crisis, especially for historically neglected populations.

Video: “The Chicago Heat Wave, 20 Years Later” is a talk given by Klinenberg at the 2015 Chicago Humanities Festival that picks up the ideas presented in his 2002 book Heat Wave: A Social Autopsy of Disaster in Chicago (University of Chicago Press). In this book, the publisher writes, “Klinenberg uncovers how a number of surprising and unsettling forms of social breakdown—including the literal and social isolation of seniors, the institutional abandonment of poor neighborhoods, and the retrenchment of public assistance programs—contributed to the high fatality rates” of the record-breaking 1995 Chicago heat wave. 

Book: In Palaces for the People: How Social Infrastructure Can Help Fight Inequality, Polarization, and the Decline of Civic Life (Penguin Random House, 2018), Klinenberg argues that “the future of democratic societies rests not simply on shared values but on shared spaces: the libraries, childcare centers, churches, and parks where crucial connections are formed.”

Article: “Worry Less about Crumbling Roads, More about Crumbling Libraries,” a September 2018 Atlantic article, presents Klinenberg’s basic thesis for Palaces of the People

(Photo credit: Daniel Cavazos)

Martha Redbone 

The Humanities Institute, in partnership with Native American and Indigenous Studies and Texas Performing Arts, was honored to host Martha Redbone for a fall 2019 Difficult Dialogues Public Forum entitled “Indigeneity, the Land, and Storytelling” along with Angelo Baca and Anne Lewis. Redbone is a Native and African American multi-award-winning musician and storyteller celebrated for her roots music embodying the folk, indigenous, and mountain blues sounds of her childhood in the Appalachian hills of Kentucky. 

Theater: This clip presents “Caught My Eye,” a song from Bone Hill, Redbone’s interdisciplinary theater work, which premiered in 2015 at Joe’s Pub in New York City (Redbone also presented Bone Hill: The Concert at Bass Concert Hall in February 2020.) Redbone explains, “Bone Hill is the true account of my ancestors, of post-slavery, and people of color working in the coal mines of Appalachia amid the laws of Jim Crow and our survival as the original people of that land as the world changes around us through the generations.” 

Album: Redbone’s most recent album is Garden of Love: Songs of William Blake. Of the album, Anastasia Tsioulcas of NPR writes, “Martha Redbone’s music chronicles the crossroads of the American experience. Born in Kentucky and of Cherokee, Choctaw and African American descent, Redbone combines folk, Appalachian, soul and Native tradition in a group of settings of poetry by William Blake – a startling idea, perhaps, but one that brims with potency and freshness.” 

“On Another’s Sorrow” is a song from the album that resonates particularly deeply at the current moment, asking: “Can I see another’s war and not be in sorrow too?”

“How Sweet I Roamed” is another song from the album that, Redbone writes, could have been the prelude to I Know Why the Caged Bird Sings.” 

Other Songs: Redbone performs her version of “Drums,” originally written by Peter La Farge, at the 2018 Smithsonian Folklife Festival. The song is a testament to the violence of forced removal and state “education” and is a part of the permanent collection at the National Museum of the American Indian in Washington, D.C. “You may teach us of this country’s history,” the song goes, “but we taught it to you first.” 

Redbone performs the slave spiritual “No More Auction Block” in 2017 in the Brooklyn Academy of Music (BAM) Howard Gilman Opera House in association with Voices of a People’s History of the United States.  

The Changing Health Disparities Landscape

An opportunity for hope?
By William B. Lawson MD, PhD, DLFAPA

I am old enough and fortunate enough to see and appreciate the changes that have occurred over the past half century in the health care system, especially regarding mental health. I still vividly remember visiting a state mental hospital where a great uncle spent much of his life. The building had all of the negative aspects of an institution including limited resources and communal showers. But then chlorpromazine (thorazine), a drug used for treating certain mood disorders, was invented and he was able to spend the rest of his days at home with his family. Fast-forward several decades, when I began my career as a psychiatrist, I was part of a team that completed a study with clozapine, the first antipsychotic that was demonstrably superior to others.  Again, I saw the wonders of medical technology as people with severe mental illness once relegated to back wards in chronic institutions were able to engage in meaningful relationships and live productive lives. Relative to the rest of medicine, treatment of the mentally ill is relatively young and the wonders of new advances and treatment long seen in antibiotic therapy and cancer treatment are still emerging in psychiatry.

Continue reading The Changing Health Disparities Landscape