Monday, October 22, 2007

Utterly Appalling

A recent report identifies that the Millennium Development Goals in the area of maternal death are woefully off target. This critical issue is something that is often overlooked when health policies and practices are being implemented in international development. This absence is a a crucial one and one that I can't honestly understand. As has been noted by distinguished authors like Amartya Sen, health costs are much lower in countries that are just implementing health policies. This is because the initial steps taken to set up a clinic or extend the range of health care professionals in most developing countries is much smaller.

Another important aspect that is identified in the article is the estimated twenty million unsafe abortions that go on every year. This is a significant contributing factor to maternal death. Safe, legal, and accessible abortions are something that must exist as the need for them is always there. The article does not identify how many of these unsafe abortions are actually illegal but it can be assumed that many unsafe abortions are the result of nation wide bans on abortions. This forces all women, even those who have life threatening pregnancies, to have a "back-alley" abortion.

The report concludes that one reason for such little progress is that in many societies women are viewed as nothing more than a vessel for reproduction. This extremely disheartening conclusion indicates the importance of positive action on behalf of women all over the world to increase their status. Cultural relativism must have its place in discussion of international development, but it cannot be used as a tool to allow domination of marginalized populations.

Saturday, October 6, 2007

Time to Abstain from Abstinence

While those in the public health field have been familiar with this finding for some time it is worth reiterating the point in light of even more evidence that identifies the inadequacies of abstinence education. This report is particularly damning in light of the position of abstinence education as the only form of sex education that is able to receive federal funding. This sort of extreme ideological policy without any concern of its effectiveness typifies the policies of the Bush administration and its backers in Congress (in such wide ranging fields from health care to the Iraq war). Teaching that sex is bad in school stands no chance of competing with the rampant hyper-sexualized messages that teens see throughout popular culture. The report identifies that teaching students about the use of condoms and their importance in preventing the spread of diseases and reducing the risk of pregnancy are much more effective. While academic literature has never been the way in which Bush and his supporters have constructed their policies, it can be hoped that those who replace them take this sort of work into account when attempting to clean up the mess left by those currently in power.

False Contrition

Despite China's supposed attempt to reign in bad business practices, a recent report found that some of the merchandise for the upcoming 2008 Summer Olympics in Beijing has been produced under such deplorable practices as child labor, forced overtime, and extremely low wages. Along with other recent problems such as lead paint in childrens' toys and poisonous contamination of pet food, it is difficult to argue that a sufficient regulatory industry exists for products made in China.

This sort of behavior is accepted as normal in the global economy and does not bring much outcry. The entire business of hosting the Women's World Cup and then the Olympics in totalitarian state that abuses its people is disheartening at best and a crime against humanity itself at worst. I fail to understand how we can justify such close ties with such a despicable and deplorable regime. If it didn't have as much capital or as large of a consumer base, there is no way we would be as involved with it (see Myanmar, Syria, North Korea). The fact that companies and countries are willing to make condolences and refrain from criticizing Chinese policies is one of the largest failings of public morality of our time. The money we invest in China is used daily to repress and create fear within an already troubled country. While we see photos of the massive amount of development and consumerism in the ports and cities, we don't see the rampant extreme poverty experienced by those in the rural areas. While engagement with all forms of government is important in the international system, such unquestioning patronage to China is dangerous and provides no carrots or sticks (international relations terms for rewards or punishments, respectively) for them to move toward democracy or more adequate worker protections for their wide range of businesses. The brutal repression of democracy movements in China continues and companies like Google continue to uphold the abhorrent "Great Firewall" while still claiming some level of ethical business. It will be interesting to look back and see how these facilitators of oppression are viewed when the history of this time is written.

Neo-Liberal Morality as a Life Lesson

Most people by now have probably heard of The Secret, one of the newest crazes in the "self-help" genre. While normally I don't pay much attention to them and find their premises often mildly pointless, The Secret really struck me as unusual. The underlying ideas about social reality reflect much of the cultural zeitgeist in the Western capitalist world, particularly that of the United States. Notions of personal responsibility, individual efficacy, and blaming the victim all play a central role in creating a mythos that embodies the neo-liberal ideology that has come to infiltrate nearly all areas of American life.

The Secret argues that you need to put positive energy out into the world and it will come back to you in the form of the wishes that you have made. The positive energy focuses on simply telling the universe telepathically what you would like (be it consumer goods, health, love, etc.). While I am all for positive thinking, this movement takes it to the level of cultish psychobabble. Those who are failing in life are not making their wishes to the universe in a sufficient way. Much of The Secret is focused on bringing in material goods as well such as cars and houses. This individualist ideology comes at a time of hyper-selfishness and extreme consumerism; The Secret reflects both of these tendencies. Similar to other ideologies of its ilk, it does not even attempt to identify the role of social and structural factors in the creation of life opportunities (which is not surprising in the least given that it is simply a "self help" book"). While I never cease to be amazed by the mystical inclination of the American public, The Secret plays upon the biases and under education within the United States to create another self help movement to bilk people out of their money as they go in search of even more money.

Future Plans

I am unsure if I will be going on for my PhD directly after my MA. This is because at some level I have become disillusioned with a large part of academia. I feel that many of the debates that are carried out between the smartest people in the world are more semantic than substantive. While two researchers may, for the most part, agree on some fundamental issue, they are split on something like the "level of analysis" or whether a particular hypothesis adequately takes into account context. Though the differences may seem huge to the individual researchers, the policy prescriptions that would come out of them often seem rather similar.

Currently I plan to work within the field of public policy. For me public policy or possibly an activist oriented NGO would be a good place for me. I am interested in working on what I see as issues of substance. I really enjoy studying issues of inequality and neo-liberalism. I think that neo-liberalism is an overarching hegemonic social structure that affects our daily lives in a myriad of ways. These include things as distant as the rise and fall in the value of the American dollar and as close as the price of food and gas. Most interesting for me is that it represents a fundamental shift in the way governments think about legislation and their role in public policy.

Through my graduate work I have come to focus specifically on health and health policy as an important area of legislation. For me health policy represents a fundamental social good that the state must play a role in for it to function adequately. The pitfalls of health for profit can be seen through the structural inadequacies and inequalities that are experienced throughout the U.S. system. The argument goes that the market can provide goods and services at a lower cost and more efficiently than with government "interference." In the empirical literature on health we see no support for this notion. The U.S. has some of the least efficient health distribution and the highest per capita costs for health in the world. While this post is not about health policy per se, I do see myself as working towards fundamental changes in health in the U.S. I appreciate and plan to use a wide range of empirical and qualitative academic literature to inform the policies that I eventually will work toward. I feel confident enough in my training to be able to interpret the literature and create informed and relevant measures that could be implemented at a wide range of levels of government. Though I still think that it is important for my work to face the scrutiny of peer review. For that I plan to still look at trying to publish in academic journals. Simply the creation of "gray" papers doesn't sufficiently fulfill my ideas about the role of a sociological researcher, even in the realm of public policy.

Wednesday, October 3, 2007

Irresponsible and Negligent... What's New?

The Bush administration has again struck a blow against appropriate and prudent public policy. Bush has vetoed a bill that would extend basic health care insurance coverage to 10 million children who parents earn too much to be eligible for Medicaid but cannot afford insurance on their own. In recent polls it was found the policy was favored by over seventy percent of Americans. This in a country that is traditionally against social spending, even for the poor. The fact that Bush said that he vetoed this measure because it was too big of an increase in spending is impossible to justify in light of the billions spent each year on subsidies to large companies and pointless military purchases and research. It is difficult to comprehend how providing unneeded subsidies to those who don't need it is unquestioned while providing health care to children left behind by the system is considered a burden. The audacity of Bush to attempt to prove that he is a "fiscal conservative" at this point is bewildering. Even Republicans realize that he is not and never has been a fiscal conservative. Hopefully Congress can push through the desperately needed bill and get back with more "important" business like flag burning amendments.