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Racial disparities make it harder to ‘die well’

MINNESOTA SPOKESMAN – RECORDER — African Americans experience an earlier onset and greater risk of what may be referred to as lifestyle-related diseases — cardiovascular disease, stroke and diabetes. More than 40 percent of African Americans over the age of 20 are diagnosed with high blood pressure, compared to 32 percent of all Americans.

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By Jason Ashe and Danielle L. Beatty Moody

The world got an idea recently from 92-year-old Buddhist monk and peace activist Thich Nhat Hanh, who popularized mindfulness and meditation in the U.S. The monk returned to his home in Vietnam to pass his remaining years. Many admired his desire to live his remaining time in peace and dignity.

Researchers from the University of California-San Diego recently did a literature search to understand what Americans might consider to be a “good death” or “successful dying.” As can be expected, their findings varied. People’s views were determined by their religious, social and cultural norms and influences.

The researchers urged healthcare providers, caregivers and the lay community to have open dialogues about preferences for the dying process.

As scholars who study social health and human services psychology, we found something missing in these conversations — how race impacts life span. It’s important to recognize that not everyone has an equal chance at “dying well.”

Black population and ill health

Take the disease burden of the African American population.

African Americans experience an earlier onset and greater risk of what may be referred to as lifestyle-related diseases — cardiovascular disease, stroke and diabetes. More than 40 percent of African Americans over the age of 20 are diagnosed with high blood pressure, compared to 32 percent of all Americans.

In addition, the Centers for Disease Control and Prevention report that the likelihood of experiencing a first stroke is nearly twice as high for African Americans compared with Whites. African Americans are more than two times more likely to experience a stroke before the age of 55. At age 45, the mortality rate from stroke is three times higher for Blacks compared to Whites.

This disease burden consequently leads to their higher mortality rates and overall shorter life expectancy for Blacks compared to Whites.

And while the life expectancy gap differs by only a few years, 75.3 for Blacks and 78.9 for Whites as of 2016, research suggests that African Americans suffer more sickness. This is due in part to the increased prevalence of high blood pressure, obesity and diabetes in this population.

Genetics, biological factors and lifestyle behaviors, such as diet and smoking, help explain a portion of these differences. However, researchers are still learning how race-related social experiences and physical environments affect health, illness and mortality.

Access to health care

One factor is that African Americans have historically underutilized preventive medicine and healthcare services. They also delay seeking routine, necessary health care — or may not follow medical advice.

One study found that during an average month, 35 percent fewer Blacks visited a physician’s office, and 27 percent fewer visited an outpatient clinic compared with Whites. “The only time I go to the doctor is when something is really hurting. But otherwise, I don’t even know my doctor’s name,” said a young African American male during a research study in Chicago.

There are reasons for this mistrust. Researchers who study medical mistrust argue that high-profile cases of medical experiments are still playing a role in how African Americans view healthcare systems and providers.

In the past, physicians have intentionally done harm against people of color. A well-known case is the “Tuskegee Study of Untreated Syphilis” in African American men, which lasted from 1932 to 1972.

In this clinical study, 399 African American men who had already contracted syphilis were told that they were receiving free health care from the government. In fact, doctors, knowing their critical condition, were awaiting their deaths to subsequently conduct autopsies and study the disease’s progression.

Even though penicillin had been proven to treat syphilis by 1947, these men were denied the treatment.

Why discrimination matters for health

Other studies suggest that regardless of their knowledge of past medical abuse, many African Americans have low levels of trust in medical establishments.

“Doctors, like all other people, are subject to prejudice and discrimination,” writes Damon Tweedy, author of Black Man in a White Coat: A Doctor’s Reflections on Race and Medicine. “While bias can be a problem in any profession, in medicine, the stakes are much higher.”

Unfortunately, these fears are underscored by empirical evidence that African Americans are less likely to receive pain medication management, higher quality care, or survive surgical procedures.

In addition, a growing body of literature has established that experiences of discrimination are extremely harmful to physical and mental health, particularly among African Americans. This research adds to the body of evidence that experiences of discrimination harm people’s health and may contribute to the increased rates of premature decline and death among Blacks.

What does it take to SOTdie well?

As African American scholars, we argue the “art of dying well” may be a distant and romantic notion for the African American community. African Americans are also exposed to earlier and more frequent deaths of close loved ones, immediate family members and friends.

Their increased “vulnerability to untimely deaths,” writes Duke University scholar Karla Holloway, shows African Americans’ lack of access to equitable and fair paths in life.

Before defining “a good death,” American society must first begin to fundamentally address how to promote quality living and longevity across all racial groups.

Story republished with permission from The Conversation.

Jason Ashe is a doctoral student in human services psychology at the University of Maryland. Danielle L. Beatty Moody is an assistant professor of behavioral medicine at the University of Maryland.

This article originally appeared in the Minnesota Spokesman-Recorder

Bay Area

California Moving into Next Budget Year With a $31 Billion Surplus, Analysts Say

“Under our current law and policy approach, we estimate the general fund revenue will reach $202 billion in the budget year and result in a surplus of about $31 billion for that budget year,” said Gabriel Petek, legislative analyst of the State of California, referring to LAO’s projections for fiscal year 2022-23.

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California has the strongest economy of any state in the country with an estimated Gross State Product of $3.0 trillion. If it were a country, California would be the fifth-largest economy in the world.
California has the strongest economy of any state in the country with an estimated Gross State Product of $3.0 trillion. If it were a country, California would be the fifth-largest economy in the world.

By Tanu Henry, California Black Media

California is expected to move into the next fiscal year, which begins July 1, 2022, with a whopping $31 billion surplus, according to estimates from the independent Legislative Analyst’s Office (LAO).

The LAO announced the anticipated surplus during a news briefing last week.

“Under our current law and policy approach, we estimate the general fund revenue will reach $202 billion in the budget year and result in a surplus of about $31 billion for that budget year,” said Gabriel Petek, legislative analyst of the State of California, referring to LAO’s projections for fiscal year 2022-23.

Petek said the large surplus reflects a number of trends. Among them are surpluses in the state current operating budget, money left in the economic reserve from the last fiscal year, higher revenues than projected for the last two years, etc.

“Revenue collections have grown rapidly in recent months, coming in over $10 billion ahead of budget act expectations so far this year. Underlying this growth is a meteoric rise in several measures of economic activity,” LAO report reads.

That windfall in the state reserve could mean a rebate for taxpayers or more money for education and other public spending.

State spending is expected to reach a cap set by California voters through a ballot measure in 1979 called the Gann Limit. When that happens, the state is compelled to return money to taxpayers by lowering taxes, sending out rebates or spending money on education.

Salena Pryor, president of the California Black Small Business Association (BSBA) says she is encouraged by the investments the state has made to aid small businesses and to improve the overall economic outlook for Californians most impacted by the pandemic.

She hopes the state will use monies from the surplus to sustain some of its initial investments.

“There is still a lot more work to do. Forty-one percent of Black small businesses have closed permanently due to COVID-19, so further investments into start-ups and restarts would greatly benefit our community,” she said.

California has the strongest economy of any state in the country with an estimated Gross State Product of $3.0 trillion. If it were a country, California would be the fifth-largest economy in the world.

“California has no peers – continues to have no peers. We are world-beating in terms of our economic growth,” said Gov. Gavin Newsom, speaking at the California Economic Summit earlier this month.

“In the last five years, no western democracy has outperformed the state of California. The United States has not… Germany, Japan, the U.K… no other western democracy has outperformed this state in our economic output of 21% GDP over the last five years.”

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Activism

New California “Strike Force” Gives Teeth to State Housing Laws

California Attorney General Rob Bonta said that California’s 17 million renters spend a significant portion of their paychecks on rent, with an estimated 700,000 Californians at risk of eviction. High home purchase costs — the median price of a single-family home in California is more than $800,000 — have led to the lowest homeownership rates since the 1940s.

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The Housing Strike Force will address the shortage and affordability crisis by enforcing state housing and development laws in the attorney general’s independent capacity and on behalf of the DOJ’s client agencies.
The Housing Strike Force will address the shortage and affordability crisis by enforcing state housing and development laws in the attorney general’s independent capacity and on behalf of the DOJ’s client agencies.

By Antonio Ray Harvey, California Black Media

To advance housing access, affordability and equity, California Attorney General Rob Bonta announced earlier this month the creation of a Housing Strike Force.

The team, housed within the California Department of Justice (Cal DOJ) has been tasked with enforcing California housing laws that cities across the state have been evading or ignoring.

The strike force will conduct a series of roundtables across the state to educate and involve tenants and homeowners as the state puts pressure on municipalities failing to follow housing rules and falling short of housing production goals set by the state.

“California is facing a housing shortage and affordability crisis of epic proportion,” Bonta said. “Every day, millions of Californians worry about keeping a roof over their heads, and there are too many across this state who lack housing altogether.

“This is a top priority and a fight we won’t back down from. As Attorney General, I am committed to using all the tools my office has available to advance Californians’ fundamental right to housing.”

The Housing Strike Force will take “an innovative and intersectional approach” to addressing the housing crisis, focusing on tenant protections, housing availability and environmental sustainability, housing affordability, and equitable and fair housing opportunity for tenants and owners.

Bonta also launched a Housing Portal on the Cal DOJ’s web site with resources and information for California homeowners and tenants.

The strike force will enlist the expertise of attorneys from the Cal DOJ’s Land Use and Conservation Section, the Consumer Protection Section, the Civil Rights Enforcement Section, and the Environment Section’s Bureau of Environmental Justice in its enforcement efforts.

“California has a once-in-a-generation opportunity to address its housing crisis, thanks to the historic $22 billion housing and homelessness investments in this year’s budget. But it’ll only work if local governments do their part to zone and permit new housing,” Governor Gavin Newsom said. “The attorney general’s emphasis on holding cities and counties accountable for fair housing, equity, and housing production is an important component to the state’s efforts to tackle the affordability crisis and create greater opportunities for all Californians to have an affordable place to call home.”

According to the National Association of Real Estate Brokers (NAREB), the level of Black ownership nationally has decreased below levels achieved during the decades when housing discrimination was legal.

The 2020 census reports that there was a 29.6% gap between homeownership rates for African Americans and whites. Homeowners accounted for 44.6% of the Black population as compared to 74.2% for whites.

“Blacks have made little, if any, strides at closing the homeownership gap. Systemic discriminatory regulations and policies continue to thwart any meaningful effort at increasing Black homeownership,” Lydia Pope, NAREB’s president, said.

In California, the DOJ reports that over the last four decades, housing needs have outpaced housing production. It has caused a crisis that stretches from homelessness to unaffordable homes.

Despite significant effort, the DOJ stated that California continues to host a disproportionate share of people experiencing homelessness in the United States, with an estimated 150,000 Californians sleeping in shelters, in their cars, or on the street.

Bonta said that California’s 17 million renters spend a significant portion of their paychecks on rent, with an estimated 700,000 Californians at risk of eviction. High home purchase costs — the median price of a single-family home in California is more than $800,000 — have led to the lowest homeownership rates since the 1940s.

Due to decades of systemic racism, these challenges have continuously and disproportionately impacted communities of color. For example, Bonta said, almost half of Black households in California spend more than 30% of their income on housing, compared with only a third of White families.

In addition, less than one in five Black California households could afford to purchase the $659,380 statewide median-priced home in 2020, compared to two in five white California households that could afford to purchase the same median-priced home, the California Association Realtors (CAR) said in a February 2021 statement.

The percentage of Black home buyers who could afford to purchase a median-priced, existing single-family home in California in 2020 was 19%, compared to 38% for white households, CAR stated.

“Just as the price for a single-median home reaches a new record of more than $800,000 in California, everywhere you look, we are in a housing crisis,” Bonta said during the virtual news conference on Nov. 3.

“Among all households, one in four renters pays more than half of their income on rent.”

The Housing Strike Force will address the shortage and affordability crisis by enforcing state housing and development laws in the attorney general’s independent capacity and on behalf of the DOJ’s client agencies.

Earlier this year, Newsom signed Assembly Bill (AB) 215, enhancing the attorney general’s concurrent role in enforcing state housing laws.

AB 215 was designed for reforms, facilitating housing development and combating the current housing crisis.

Newsom also signed Senate Bill (SB) 9 and SB 10 in September, legislation designed to help increase the supply of affordable housing and speed up the production of multi-family housing units statewide.

Authored by Senate President Pro Tem Sen. Toni Atkins (D-San Diego), SB 9 allows a homeowner to subdivide an existing single-family residential lot to create a duplex, triplex, or fourplex.

In response to SB 9, homeowner groups have formed across the state to oppose it. The groups are citing challenges they anticipate the law will bring to their communities, from garbage collection to increased risk of fires.

Livable California, a San Francisco-based non-profit that focuses on housing, is one of the groups that opposes the new laws.

“Senate Bill 9 ends single-family zoning to allow four homes where one now stands. It was signed by Gov. Newsom, backed by 73 of 120 legislators and praised by many media. Yet a respected pollster found 71% of California voters oppose SB 9,” the Livable California website reads.

“It opens 1.12 million homes in severe fire zones to unmanaged density — one-sixth of single-family homes in California,” the message continues. “SB 9 could reshape, in unwanted ways, hundreds of high-risk fire zones that sprawl across California’s urban and rural areas.”

But Newsom says the laws are urgent and overdue.

“The housing affordability crisis is undermining the California Dream for families across the state, and threatens our long-term growth and prosperity,” Newsom said in a Sept. 16 statement.

SB 10 was designed for jurisdictions that want to opt-in and up-zone urbanized areas close to transit, allowing up to 10 units per parcel without the oversight of the California Environmental Quality Act (CEQA).

“Passing strong housing laws is only the first step. To tackle our severe housing shortage, those laws must be consistently and vigorously enforced,” said California State Sen. Scott Wiener (D-San Francisco), chair of the Senate Housing Committee. “I applaud Attorney General Bonta’s commitment to strong enforcement of California’s housing laws.”

The Housing Strike Force encourages Californians to send complaints or tips related to housing to housing@doj.ca.gov. Information on legal aid in your area is available at https://lawhelpca.org.

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Barbara Lee

Infrastructure Bill Will Expand Internet Access, Boost Transit, Rep. Barbara Lee Says

“For decades, underinvestment in our physical and social infrastructure has widened the economic gap, put communities at risk, and exacerbated racial and economic inequality,” said Congresswoman Barbara Lee. “And it’s not just a lack of investment. Too often, the infrastructure that we built created more inequality. This infrastructure law now advances equality, equity, and environmental justice unlike any law we have ever seen before.”

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Rep. Barbara Lee with Meg-Anne Pryor, apprenticeship coordinator for Operating Engineers Local 3. Photo courtesy of Barbara Lee’s Press office.
Rep. Barbara Lee with Meg-Anne Pryor, apprenticeship coordinator for Operating Engineers Local 3. Photo courtesy of Barbara Lee’s Press office.

By Post Staff

At a joint press conference on Wednesday, Bay Area Congresswomen Barbara Lee and Nancy Pelosi touted the impact the recently passed infrastructure bill will have on the Bay Area.

“For decades, underinvestment in our physical and social infrastructure has widened the economic gap, put communities at risk, and exacerbated racial and economic inequality,” Lee said. “And it’s not just a lack of investment. Too often, the infrastructure that we built created more inequality. This infrastructure law now advances equality, equity, and environmental justice unlike any law we have ever seen before.”

In regard to environmental justice, Lee points out that billions of dollars will be dedicated to building low-to-no emissions buses and expanding access to EV charging network. “These are critical investments for communities in my district that have suffered from higher levels of air pollution and childhood asthma rates,” she said.

The law will also provide internet access to low-income families across the state. “During the pandemic, we have seen that internet access is an equity issue for kids in East Oakland and other parts of my district, and we need to close that gap,” Lee said.

Besides their individual districts, the Congresswomen pointed out how much California as a whole will benefit from billions in investment to improve highways and bridges, public transportation, and water infrastructure.

“Also, it will help to protect communities like Oakland and Berkeley from another devastating wildfire like the one we experienced 30 years ago,” Lee said. “We are now moving full speed ahead to pass the rest of President Biden’s economic agenda through the Senate to significantly cut the costs of childcare, reduce childhood poverty, address the climate crisis, increase affordable housing, and make other meaningful investments in the quality of life of our families.”

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