All posts by Mike Schadone

Academia, Society

A Reevaluation of Social Responsibility

There are many facets to social responsibility, and it appears to me that many people confuse the social aspects and the responsibility aspects. Merely advocating for social programs without applying a sense of responsibility is dangerous to society however well-intentioned the program might be. After reading other’s thoughts on social responsibility, I find that my views have not changed much, if at all.

American society is guided by rights and responsibilities as enumerated in the U.S. Constitution and its Bill of Rights with the Declaration of independence setting the foundation. As we approach domestic national policies, we should always refer to these documents to guide our actions. In addition, when thinking or acting globally, we should also consider the rights and responsibilities that we enjoy as American citizens and apply them graciously to those abroad.

Domestically, race relations seems to be a continual problem (Banton, 2002). If the approach to this problem simply referred to the founding documents, we would not have furthered the social inequalities by introducing civil rights and affirmative action:

  • Age Discrimination in Employment Act of 1967;
  • Air Carriers Access Act of 1989;
  • Americans with Disabilities Act of 1990;
  • Architectural Barriers Act of 1968;
  • Civil Rights Act of 1866;
  • Civil Rights Act of 1964;
  • Civil Rights Act of 1991;
  • Equal Pay Act of 1963;
  • Exec. Order No. 11246, 1965;
  • Fair Housing Amendments Act of 1988;
  • Rehabilitation Act of 1973.

It has been argued, according to Fullinwider (1980), that adoption of affirmative action through the legislation of civil rights creates reverse discrimination, or a propensity to overcompensate discriminating against one subset of people by discriminating against another – usually the subset that was perceived to have benefit from the original discrimination. I do admit that the legislation, the public opinion and practices, and the judicial review do not aim to promote inequalities, but as a mere accident, they do. The solution should have been very simple: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness” (Declaration of Independence, 1776). By incorporating the virtues that this country was founded upon, there is only one reasonable and responsible expectation of the people within society, and that is to treat all people with respect and dignity. This is my view of how to be socially responsible. Walters (2002) echoes my position and writes:

What is personal social responsibility? Someone who is socially responsible, more often than not, recognizes that his behavior affects others, and holds himself accountable for his actions. The opposite may be someone who automatically blames an external source for his or her troubles, or whose behavior might consistently be perceived by others to be inconsiderate or rude. In a best-case scenario, a socially responsible person endeavors to have a positive effect on others, and enriches her environs. Such a person has the intention and takes action to ensure that his or her behavior makes a positive contribution, or at least is neutral and doesn’t “pollute” others or the social (or actual) atmosphere. (para. 2)

Additionally, there has been much discussion about our society’s role on the global level. What responsibilities do Americans have towards their global partners? No matter if we are discussing local issues, statewide or national issues, or international issues, my response remains the same: so long as you do not infringe on the rights of others, do as you will. This concept is what I believe to be the only logical conclusion when considering the sum of American societal values and responsibilities.

As mentioned, social responsibility can describe both active or passive roles. Civic engagement, on the other hand, is simply being socially active, though not necessarily responsible. Civic engagement, according to Michael Carpini (2010) of the Pew Charitable Trusts, is defined as “individual and collective actions designed to identify and address issues of public concern” (para. 2). These actions, typically honorable and ethical, may cause what I refer to as collateral damage. A good example of this is going green. Many of us appreciate the planet and want no harm to come to our environment, so some have advocated outlawing the use of Edison-type incandescent light bulbs, favoring compact fluorescent light bulbs (CFLs). In fact, as of 2014, all incandescent light bulbs will be outlawed in the United States (Energy Independence and Security Act of 2007). According to the EnergyStar website (“LightBulbs,” n.d.):

If every American home replaced just one light with a light that’s earned the ENERGY STAR[, or compact fluorescent light bulb], we would save enough energy to light 3 million homes for a year, save about $600 million in annual energy costs, and prevent 9 billion pounds of greenhouse gas emissions per year, equivalent to those from about 800,000 cars. (para. 1)

Sounds great, but what of the mercury? CFLs rely on a mercury vapor (in addition to argon) within the fluorescent tube, so if the bulb were to break, which they often do, mercury would leak into our environment. Mercury is not poisonous, right? Wrong! The National Institute for Occupational Safety and Health (2001) recommends an 8-hour time-weighted limit of exposure maximum of 0.025 mg/m3 (or, 25,000 ng/m3). According to a study by the Maine Department of Environmental Protection (2008):

Mercury concentration in the study room air often exceeds the Maine Ambient Air Guideline (MAAG) of 300 nanograms per cubic meter (ng/m3) for some period of time, with short excursions over 25,000 ng/m3, sometimes over 50,000 ng/m3, and possibly over 100,000 ng/m3 from the breakage of a single compact fluorescent lamp. (p. 7)

Many lighting fixtures, including chandeliers, can hold three, four, or more of these bulbs at a time, multiplying the mercury vapor concentration for each bulb broken. This legislation creates a hazardous situation that needlessly endangers lives and restricts our freedom to choose.

In conclusion, we as a society must understand that there are consequences to our actions, and we must take responsibility for our actions. We can certainly have disdain for the status quo as well as envision a Utopian civilization where there is no bad and only good. Unfortunately, we are bound by our physicality and our geography. So long as we must obey the laws of physics, we must understand that for every action there is an equal and opposite reaction. What, then, are the consequences of civic engagement? Honestly, there may be no negative consequence of activism so long as the activist remains socially responsible. The socially responsible person will ensure that the positive of action will outweigh the negative of inaction so long as the negative of action does not contribute to the negative of inaction. More simply stated, if it will hurt society more to change, then change is not the answer.

References

Age Discrimination in Employment Act of 1967, 42 U.S.C. § 1983 (West 1968)

Air Carriers Access Act of 1989, 49 U.S.C. § 1374 (c) (West 1986).

Americans with Disabilities Act of 1990, 42 U.S.C.A. § 12101 et seq. (West 1993).

Architectural Barriers Act of 1968, 42 U.S.C. §§ 4151 et seq. (West 1968).

Banton, M. (2002). Race relations. In D. T. Goldberg & J. Solomos (Eds.), A companion to racial and ethnic studies (pp. 90-96). Malden, MA: Blackwell.

Carpini, M. D. (2010). Civic engagement. Retrieved from http://www.apa.org/education/ undergrad/civic-engagement.aspx

Civil Rights Act of 1866, 42 U.S.C. § 1982 (a) (West 1998).

Civil Rights Act of 1964, 42 U.S.C. § 2000 (a) et seq. (West 1998).

Civil Rights Act of 1991, 42 U.S.C. § 1981(a) (b) (3) (West Supp. 1992).

Declaration of Independence. (1776).

National Institute for Occupational Safety and Health. (2001). Documentation of the threshold limit values and biological exposure indices (7th ed.). Cincinnati, OH: Author.

Energy Independence and Security Act of 2007, P.L. 110–140 § 321 (2007, December 19).

Equal Pay Act of 1963, 29 U.S.C. § 206 (West 2000).

Exec. Order No. 11246, 3 C.F.R. 339 (1964-1965), reprinted in 42 U.S.C.A. § 2000e app. at 28-31 (1982).

Fair Housing Amendments Act of 1988, 42 U.S.C. §§ 3601-3619 (West Supp. 1989).

Fullinwider, R. K. (1980). The reverse discrimination controversy. A moral and legal analysis. Retrieved from http://eric.ed.gov/ERICWebPortal/contentdelivery/servlet/ERICServlet?accno=ED292213

Light bulbs (CFLs) for Consumers. (n.d.). Retrieved from the EnergyStar website: http://www.energystar.gov/index.cfm?fuseaction=find_a_product.showProductGroup& pgw_code=LB

Rehabilitation Act of 1973, 29 U.S.C. § 794 (West 1998).

Walters, J. (2002, August). Taking social responsibility personally – Be the change you wish to see in the world. Retrieved from http://www.learningplaceonline.com/workplace/ethics/ personally.htm

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, Society

Social Responsibility:

Socially Responsible Groups at Work

I have always considered myself socially responsible as well as individually responsible, but I hold views regarding responsibility that many might disagree with. While I focus on identifying groups that I feel exemplify the concept of social responsibility, I will also identify traits of each group that allow these groups to align with my view of social responsibility.

On the global stage, many people feel that it is the responsibility of our government to represent us in matters of philanthropy (citation needed). I disagree. I feel that it is our personal responsibility as individuals to take on charitable roles. There are organizations that provide direction and goals of charitable contributions, which allows simplification in giving. One of these groups, and the first group I wish to discuss, is the American National Red Cross (http://www.redcross.org). As stated in their corporate documents:

The purposes of the corporation are … to provide volunteer aid in time of war to the sick and wounded … to act in matters of voluntary relief … as a medium of communication between the people of the United States and the armed forces … and in mitigating the suffering caused by [peacetime disaster], and to devise and carry out measures for preventing those calamities. (Congressional Charter of The American National Red Cross, 2007, p. 2)

The American National Red Cross provides means for individuals to be charitable whether in service (as an employee) or financially (as a donation contributor). The Red Cross has created such an infrastructure to support their operations that no individual could ever outperform them logistically.

Focusing on the service aspect of giving, the second group I will discuss is Doctors Without Borders/Médecins Sans Frontières (MSF; http://www.doctorswithoutborders.org). Created in 1971 by doctors and journalists in France, MSF has provided a high level of allopathic and osteopathic care to destitute, war-torn, and disaster regions of the world. MSF was the recipient of a Nobel Peace Prize in 1999 for their work in almost 60 countries around the world. By providing a high level of medical care to areas of the world that have little to no availability of medicine, MSF works extrinsically to improve the health of the people. I feel that a more intrinsic approach would work better to reduce health disparities in these areas. For example, if MSF added an educational aspect of the aid that they deliver, they would allow the people to develop a more comprehensive medical education system and eventually care for themselves. Enterprising individuals within each society, however, could do this more effectively themselves as many other civilizations have done in the past.

Finally, I will present the group that I feel empowers my society the most by advocating freedom and Constitutional values: the Cato Institute (http://www.cato.org).

The mission of the Cato Institute is to increase the understanding of public policies based on the principles of limited government, free markets, individual liberty, and peace. The Institute will use the most effective means to originate, advocate, promote, and disseminate applicable policy proposals that create free, open, and civil societies in the United States and throughout the world. (About Cato, n.d., para. 1)

The Cato Institute is heavily engaged in preserving the American way of life and disavows any policy that is detrimental to the United States. Further, the Cato Institute presents libertarian ideas throughout the world, promoting peace, liberty, and a free society. Though some influential individuals might be able to promote the same ideas, the Cato Institute is able to rely on the expertise of a number of people in order to provide the most pointed policy reviews and recommendations.

Some of these groups serve ideologies that are at odds with my beliefs, but the work that they do is generous and honest. My only caution to these groups is that while they are providing services to people who, for whatever reason, cannot do for themselves, they should also concentrate on providing education and training so that the people may be able to serve themselves appropriately in the future. Self-reliance is lacking commodity around the globe.

References

About Cato. (n.d.). Cato Institute. Retrieved from http://www.cato.org/about-mission.html

Congressional Charter of The American National Red Cross. 36 U.S.C. §§300101-300113 recodified 2007. (2007, May).

Academia, Society

Occupational Social Responsibility

According to Barendsen (2007), my profession is a caring one. I am a paramedic and I serve my community. I am also a firefighter who serves his community without compensation. It could be said that I blur the lines between my professional and personal life, but I enjoy great satisfaction doing so. I am by nature a very socially responsible person, but I extoll the virtues of taking personal responsibility. As a paramedic, I have a mantra: we combat stupidity.

As Barendsen (2007) points out, “workers in caring professions typically describe themselves as filling in or taking over a responsibility that others have abandoned” (p. 173). Everyone at some point in their lives makes stupid decisions. This is part of human learning, but some of these mistakes can unfortunately be lethal. This is where I feel that I make a difference in the lives of others. Driving too fast, smoking, eating too many fatty foods, or incidences of drunken abilities (in Texas, we had a saying that no good can from the statement: hey, hold my beer; watch this!). We all make these mistakes, thus we are all prone to stupidity from time to time. I enjoy the fact that many times I can help to allow others to learn from these mis-steps and reduce the lethality of their decision matrix.

There are times, however, that I have to get away from my occupation for my own sanity. I enjoy a number of hobbies and friends with varying interests that I can rely on to take my mind off of the worries of work. Also, attending school gives me added balance in the personal development side of life. Though attaining my degree will certainly better my professional outlook, I am seeking a degree solely for personal achievement. The prevalence of burnout in my profession is extremely high (Felton, 1998; Neale, 1991), so I make great efforts to balance and separate my personal life from my professional life. Admittedly, this is difficult at times because I am almost always on call.

References

Barendsen, L. (2007). Service at work. In H. Gardner (Ed.), Responsibility at work: How leading professionals act (or don’t act) responsibly (pp. 172-195). San Fancisco, CA: Josse-Bass.

Felton, J. S. (1998) Burnout as a clinical entity — its importance in health care workers. Occupational Medicine, 48(4), 237-250. doi:10.1093/occmed/48.4.237

Neale, A. V. (1991). Work stress in emergency medical technicians. Journal of Occupational and Environmental Medicine, 33(9), 991-997.

Academia, Society

Social Justice vs. Social Responsibility

Recently, I find myself reacting the most to the progressive social justice movement. Social justice, “often employed by the political left to describe a society with a greater degree of economic egalitarianism, which may be achieved through progressive taxation, income redistribution, or property redistribution” (Social justice, n.d., para. 2), is a political push towards socialism. I do not view this movement as socially responsible, and I will explain why.

I was a high school student during the Clinton presidency, and when he announced a national rebate based on the federal surplus of tax dollars. Though I believe the economic boon was due to comprehensive reforms under President Reagan, I will give President Clinton credit for maintaining it as long as he did. It was at this point that I decided that I needed to understand politics and economics in a way that would allow me to make more responsible choices as a voter. Since then, I have watched as Presidents Clinton, Bush, and Obama have squandered our money for their supporting political allies, forsaking the people of the United States.

I had considered myself a Democrat until I took the time to understand the simplistic nature of economics. Obviously disagreeing with left-wing politics, I analyzed the right and found much more of the same waste, fraud, deceit, and callousness in the Republican party. I found that I had to understand my own values before I could vote again. My values are much more in line with the libertarian philosophy that once made this country great. Libertarianism is about freedom, freedom to make choices, freedom to succeed, and most importantly, freedom to fail. For failure is the greatest teacher and motivator.

The United States is heading for a disastrous economic climate where millions of people who rely on government subsidy will find themselves without benefit. Government-subsidized social programs, such as welfare, Medicare, et al., are meant to be stop-gap measures designed to temporarily fix problems to extend the time available to find more permanent solutions. For welfare, short-term use precludes this necessity, but abuse assures the programs demise.

The greater social responsibility is understanding that as a member of our great society, and in order to help many, we need to support the survival of our society. This means that we, the individuals, need to be self-sufficient. This means that we, the communities, need to be self-sufficient. This means that we, the states, need to be self-sufficient. This means that the next larger government is there to help the next lower government recover from the unforseeable. As individuals, we need to rely on ourselves, our families, our neighbors, and our community before asking for a hand-out from the state, and we should never have to ask for hand-outs from the federal government.

This post may seem like political ideologue drivel, but I assure the reader that it is not. Some, like the author of our class text, would have you wave a sign for the sake of political or environmental activity (Loeb, 2010, p. 10), but I argue that if we all minded our own homes with such conviction, then no one would dare stand up to advocate diminishing us as people. So long as an action benefits society, it is socially responsible. And, I am socially responsible.

References

Loeb, P. R. (2010). Soul of a citizen (2nd ed.). New York, NY: St. Martin’s Griffin.

Social justice. (n.d.). In Webster’s online dictionary. Retrieved from http://www.websters-online-dictionary.org/definitions/Social+Justice

Academia, Society

Defining Social Responsibility

Good and bad (or, evil) is as abstract an idea as happiness and sorrow or love and hate. Philosophers have created quite a name for themselves while devoting time to understanding the logic behind these abstract emotions. They have certainly tried even when there is no logic to speak of. Aristotle (350 B.C.E./1908) had gone to great lengths to explain the meaning and purpose of good. Unfortunately, this act of explanation seems more to have been an attempt to conceptualize ideas based on limited knowledge. After all, if we think something is good, then we thought it; therefore, it is a product of the mind and should be further thought about, or so philosophers would think. There is certainly a logical fallacy to many of Aristotle’s correlations. Aristotle describes the nature of man, “Now the mass of mankind are evidently quite slavish in their tastes, preferring a life suitable to beasts…” (Aristotle, 350 B.C.E./1908, p. 8). He continues, then, to juxtapose lower man with his sense of men of high regard, “…people of superior refinement … identify happiness with honour…” (Aristotle, 350 B.C.E./1908, p. 8). Although he continues to acknowledge the “superficial” (Aristotle, 350 B.C.E./1908, p. 8) quality of this comparison, it seems obvious that Aristotle is judging values based on an already prescribed value system. These fallacies, however, can be forgiven based on the underdeveloped states of these notions of value and virtue. Aristotle appears to have brought the abstract concept of good to light and available for many to contemplate. This, I believe, is good.

As Aristotle (350 B.C.E./1908) continues in his progression and digression of thoughts on virtues, he does seem to uncover a worthwhile virtue that is worthy in and of itself: happiness. Speaking in particular to Aristotle’s golden rule, or “a disposition to choose the mean” (Aristotle, 350 B.C.E./1908, p. 38), by maintaining a life devoid of excess and deficiency, one lives a virtuous life and strives towards attaining happiness. Aristotle also posits that, because of the nature of the mean between excess and deficiency, there can be no excess or deficiency of the mean.

As a health care provider, I see the effects of living a vicious life. Just a few hours ago, I responded to a woman suffering from chronic obstructive pulmonary disease (COPD). She probably acquired this disease from years of smoking tobacco. As a smoker, I know from seeing these patients how deadly and devastating smoking tobacco products can be; however, I still smoke. I do value the education that has been circulating to help smokers to quit (American Heart Association, n.d.; Centers for Disease Control and Prevention, n.d.). As the mantra goes, knowledge is power. As a libertarian, however, I do not appreciate government restricting my right to smoke in certain private establishments based only on the risk to myself and others that might choose to frequent such establishments (An Act Concerning Secondhand Smoke in Work Places, 2003). I also do not appreciate the extreme taxes that I have to pay, though I do understand the impact on the health care system and the necessity of covering the associated costs of treating patients with COPD, though health care costs would actually increase by 4 to 7% if every person in our society quit (Barendregt, Bonneux, & van der Maas, 1997). Having mentioned that, I would probably support any referendum that made tobacco illegal.

Social responsibility, by definition, means to act within the values of society. As a free society, this concept places burdens on social change. It would be irresponsible of us to change our society without considering the ramifications. What will this change mean for us? What will this change mean for our children? Our grandchildren? To me, social responsibility requires social change by education and example, not imparting change by force. To me, this is responsible social change. Responsible social change will provide a concrete vision for attainment instead of some abstract conceptual utopia that never seems attainable, anyway.

References

American Heart Association. (n.d.). Cigarette smoking and cardiovascular disease. Retrieved from http://www.americanheart.org/presenter.jhtml?identifier=4545

An Act Concerning Secondhand Smoke in Work Places. 2003 CT Public Acts 03-45. 23 May 2003.

Aristotle. (1908). Nichomachean ethics (W. D. Ross, Trans.). (Original work published in 350 B.C.E.). Retrieved from http://books.google.com

Barendregt, J. J., Bonneux, L., & van der Maas, P.J. (1997). The health care costs of smoking. New England Journal of Medicine, 337, 1052-1057. doi:10.1056/NEJM199710093371506

Centers for Disease Control and Prevention. (n.d.). Smoking & tobacco use. Retrieved from http://www.cdc.gov/tobacco/

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.

Academia, Health Care, Society

Cognitive Development

“Children are naturally curious” (Kail & Cavanaugh, 2010, p. 98), and that is a good thing. The authors are describing a premise of Piagets theory of childhood cognition development. Piaget’s theory is based stages of adaptive learning and identifies stages associated with key development: infancy, school age, preteen, and adolescence. According to Piaget, in infancy, cognition is very basic and focused on sensorimotor schemes that the child forms based on experiences. As the child ages, Piaget claimed, these schemes become more complex. During school age, children start to form schemes based less on function and more on appearance. Preteens, on the other hand, start to understand emotion, individualism, and relative constructs. Adolescents build upon these relative constructs adding abstract thought processes which continues to build their problem solving skills well into adulthood. Vygotsky’s theory of cultural impact on cognitive development stresses that the individual and the environment are interactive, and this interaction has an impact on learning. Scaffolding, or building on information already known, effectively identifies where instruction is needed. Coupling Piaget’s understanding of cognition development with Vygotsky’s understanding of learning environments, a focused efficiency in teaching could be attained.

As we age, though, physiologic neural processing slows and the brain atrophies (Thibault, Gant, & Landfield, 2007). These changes cause information processing to slow bidirectionally, that is as input and output, and accelerates a functional decline in brain activity as we age. This is not a reversal of development but a systematic failure of physiologic processes. The effects of aging on brain tissue directly effect cognition as neural networks of synapses breakdown. Though this process is inevitable, researchers suggest certain diets and moderate exercise that can mediate the damaging effects of aging on cognition (Bugg & Head, 2009; Gómez-Pinilla, 2008).

References

Bugg, J. M. & Head, D. (2009). Exercise moderates age-related atrophy of the medial temporal lobe. Neurobiology of Aging. Advance online publication. doi:10.1016/j.neurobiolaging.2009.03.008

Gómez-Pinilla, F. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience, 9, 568-578. doi:10.1038/nrn2421

Kail, R. V. & Cavanaugh, J. C. (2010) Aging: A lifespan view (Laureate custom ed.). Mason, OH: Cengage Learning.

Thibault, O., Gant, J. C., & Landfield, P. W. (2007). Expansion of the calcium hypothesis of brain aging and Alzheimer’s disease: Minding the store. Aging Cell, 6(3), 307-317. doi:10.1111/j.1474-9726.2007.00295.x

Academia, Health Care, Public Health, Society

Cultural Influences on Health Disparities

Disparities in the availability, access, and delivery of health care are a great and growing concern. Some of the factors leading to disparite health include race, socioeconomic status, and gender (Chen, Martin, & Mattews, 2006). Chen et al. describes how race and socioeconomic status are major factors in the United States, based on the Healthy People 2010 data (U.S. Department of Health and Human Services, 2000). According to the results of this study, our public health efforts seem to be misguided. As the researchers of this study indicate, “race and SES effects on child health are best understood in concert, rather than separately” (p. 705). The differences in race and socioeconomic status are a factor only to White and Black children when looking at prevalence rates for activity limitations and circulatory conditions, as illustrated by Chen et al. in Figures 1 and 2. These figures show that higher education actually has a small but negative effect on the health status of Asians and Hispanics while having a dramatically positive effect on Blacks. Additionally, in Figure 3, Chen et al. show a significant negative effect of education on incidence rates for acute respiratory conditions. There is no significant relationship for the same with regards to Whites or Blacks.

This study shows that there are certainly correlations between race, economic status, and differences in the health status of children in America, but these factors might only be relative. We need to understand if other factors can be identified as causative. In order to explain how Whites and Blacks share correlations while Asians and Hispanics share correlations, we might consider the length of time each population has been exposed to American culture. Whites and Blacks have been in America for over 300 years while Asians and Hispanics have migrated more recently. In addition, there is also evidence of attitude and preference differences for minorities towards health care, though the Institute of Medicine (2002) marginalizes this phenomena in their study.

As a health care provider and regardless of the causes of disparities in health status, it is advisable that I understand these causes so that I may better direct a patient’s care with a holistic understanding of the patient.

References

Chen, E., Martin, A. D., & Matthews, K. A. (2006). Understanding health disparities: The role of race and socioeconomic status in children’s health. American Journal of Public Health, 96, 702-708. doi:10.2105/AJPH.2004.048124

Institute of Medicine. (2002). Unequal treatment: What healthcare providers need to know about racial and ethnic disparities in health. Retrieved from http://www.nap.edu/html/unequal_treatment/reportbrief.pdf

U.S. Department of Health and Human Services. (2000). Healthy people 2010: Understanding and improving health. Washington, DC: Author.

Academia, Emergency Management, Health Care, Public Health, Society

Immunization and Infectious Disease Mitigation

Cultural Models of Immunization and Infectious Disease Mitigation

The members of some communities, such as Puerto Rico, do not understand the scope and severity of some infectious diseases until they become infected (Pérez-Guerra, Zielinski-Gutierrez, Vargas-Torres, & Clark, 2009). The lack of a basic understanding of illness and infection poses a roadblock to mitigating disease transmission within the community. For Pérez-Guerra et al., the perception of severity and mitigation is important as they investigate the difference in attitudes towards dengue infections because dengue cannot be controlled by vaccine and must be mitigated by community participation in mosquito abatement activities. Other infectious diseases, however, can be controlled by vaccine, but efforts to limit infection are met with ignorance or misconceptions (Lau, Griffiths, Choi, & Tsui, 2010; Leask, Sheikh-Mohammed, MacIntyre, Leask, & Wood, 2006).

Public health officials, in concert with community leaders, should seek to educate affected communities about the infectious diseases they face along with effective mitigation strategies and the importance of vaccination, if available. Coreil (2010) describes the importance of cultural models in “[gaining] a deeper understanding of the cultural context of behavior” (p. 83). If behaviors are not understood, then it will be difficult to redirect them. Reaching out to community leaders has the added effect of allowing the leaders to alter the message just enough so that it might be effectively communicated to the community.

Providing a cultural health model allows for a larger scope of audience while effectively tailoring the message so that most of the target audience will appreciate the nature of the message. Approaching health behaviors from a cultural stand-point also offers the advantage of allowing peer support to propagate messages through out the community. This might be especially true when dealing with a multitude of subcultures where the message might better be disseminated via interpersonal means. Eventually, the message will be received by many individuals who will begin to have discussions with others in the community. For communities where individuals are not likely to speak to each other regarding personal health-related matters, the cultural health model allows a general message to reach each individual.

References

Coreil, J. (Ed.). (2010). Social and behavioral foundations of public health (2nd ed.). Thousand Oaks, CA: Sage.

Lau, J. T. F., Griffiths, S., Choi, K. C., & Tsui, H. Y. (2010). Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. BMC Infectious Diseases, 10(139), 1-13. doi:10.1186/1471-2334-10-139

Leask, J., Sheikh-Mohammed, M., MacIntyre, C. R., Leask, A., & Wood, N. J. (2006). Community perceptions about infectious disease risk posed by new arrivals: A qualitative study. The Medical Journal of Australia, 185(11/12), 591-593. Retrieved from http://www.mja.com.au/public/issues/185_11_041206/lea10999_fm.pdf

Pérez-Guerra, C. L., Zielinski-Gutierrez, E., Vargas-Torres, D., & Clark, G. G. (2009). Community beliefs and practices about dengue in Puerto Rico. Pan American Journal of Public Health, 25(3), 218-226. doi:10.1590/S1020-49892009000300005