August 3, 2020

Sentenced to Perpetual Poverty: Social Determinants of Economic Health for Children of Incarcerated Parents

    In general terms, the formula for improving health and well-being can be reduced to two simple actions increase protective factors and reduce risk factors. In reality, however, such course of action is much more complex because protective and risk factors are multilayered and cannot necessarily be disentangled from the multisystemic constructs from which they are formed. Health outcomes measure the intersection of multiple factors such as socioeconomics, behavior, and policy as they relate to various populations. Children of incarcerated parents, like any population, develop from the causal chain of these various factors, which lead to measurable outcomes in health, function, and well-being.

    Parental incarceration is considered one of the ten most adverse childhood experiences and are linked to a range of negative health outcomes throughout the child’s life course. However, the intersection of social determinants associated with incarceration, such as poverty, mental health issues, and multisystemic racism, cannot be isolated. As such, whether the health outcomes are due to the incarceration itself, to other experiences, or the combination thereof, remains unclear. What is clear is that parental incarceration is a punishment shared by the children left in its wake, who are vicariously sentenced to a lifetime of economic disparity.

Dimensions of Impact

            The economic hardship faced by children of incarcerated parents is led by an array of increased risks that lay the groundwork for disadvantage. These risks involve higher rates of psychological trauma, depression, anxiety, aggression, antisocial behavior, and juvenile delinquency. Academic and school-based problems are also prevalent and include increased rate of suspension, academic failure, drop-out, and extended absences. Stigma associated with incarceration contributes to stress proliferation and poorer overall physical health outcomes. These factors contribute to long-lasting harm regarding the children’s education and income, often restricting economic mobility across generations.

Population and Disparity

            The numbers are alarming. More than 50 percent of incarcerated people in the United States are parents to children under the age of 18-years, totaling 2.7 million children. More than 5.7 million children (one in 12) will experience the impact of parental incarceration during their childhood. What is perhaps most disturbing is the associated racial disparity: compared to 3.6 percent of White children, 24.5 percent of Black children will have an incarcerated parent before their 14th birthday.

    The racial disproportion cannot be viewed without also recognizing three correlating statistics. First, two-thirds of all incarcerated parents are serving time for non-violent crimes. Second, the Black population is statistically no more likely to commit crime than the White population, yet Black people are incarcerated at six times the rate of White people. Third, just 25 years ago, one in every 125 children had an incarcerated parent, but despite crime having since steadily decreased, the figure has shifted to one in every 28 children. From this perspective, the social structures that determine economic health outcomes for children of incarcerated parents are the same structures that built mass incarceration, took particular aim at the Black community, and expected the children to “pick themselves up by their bootstraps” despite far-reaching barriers and inequalities.

Social Determinant: Anti-Drug Policies

            In 1980, there were approximately 500,000 Americans behind bars. Over the following decades, the incarcerated population increased by 300 percent to 2.3 million (more than 1 in 100) adults. The onset of mass incarceration connects to America’s antidrug crusade, which implemented sudden and harsh penalties for drug-related crime. In 1982, the Reagan administration officially announced the United States’ War on Drugs. Between 1980 and 1984, federal law enforcement budgets increased from 165 million dollars to over two billion dollars and continued to increase by the billions throughout the decade. Simultaneously, substance use education, treatment, and prevention services’ funding were dramatically reduced.

            During this time, the Anti-Drug Abuse Acts of 1986 and 1988 were signed into law, which mandated minimum five-year sentencing for people convicted of a drug offense including first time offenders. The Clinton Administration of the 1990s expanded upon punitive sentencing and signed into law a 30-billion-dollar crime bill, enlarging state and local police forces even more. The bill also authorized the “three strikes and you’re out” law that mandated life sentences for third time drug offenses. Incarceration rates exploded, the magnitude of which was unprecedented in world history, and Black communities, still reeling from cumulative oppression, were again disproportionately targeted.

Social Determinant: Multisystemic Racism

            Historically racist housing and education policies resulted in on-going segregation and economic disparity within Black communities. The anti-drug movement weaponized these disparities by implementing policies and procedures aimed at policing and punishing Black communities, despite strong evidence illustrating they were no more likely to participate in drug activity than other races. In fact, studies indicated that White people were almost twice as likely to be in possession of illegal substances than people of color; yet, stop and frisk procedures utilized racial profiling tactics that resulted in disproportionate arrests of Black people.

    Critical statistics to consider regarding mandatory sentence policies are that White people used both cocaine and crack cocaine at higher rates than Black people; however, Black people used cocaine at much lower rates than White people. Despite crack cocaine being more prevalent among White people, Black people were arrested at a much higher proportion and consequently stigmatized as the harborers of the crack cocaine epidemic. Uncoincidentally, from 1986 to 2010 when the Fair Sentencing Act was passed, possession of crack cocaine resulted in a minimum sentence 100 times more severe than sentences for possession of powder cocaine. The structural racism within the criminal justice system weakened the already vulnerable economic health of poor communities, particularly Black populations. It also perpetuated harmful stereotypes that shaped the perception of who was deserving and undeserving of economic support.

Social Determinant: Access to Resources

            In the United States, a strong predictor of one’s economic achievement is their parent’s income. Another obstacle put in place by anti-drug policies was exclusion from antipoverty programs after any one felony drug conviction including possession of marijuana. While ostensibly aimed at deterring offenders, it concurrently punished their children, who were also evicted from public housing, denied food and housing assistance, and burdened by their parent’s inability to access student loan benefits. This form of material deprivation for children of incarcerated parents intensified economic instability, particularly for Black households, and suppressed intergenerational mobility.


Next Steps for Social Work Practice

            Social work ethics are anchored in commitment to upend oppressive structures that obstruct human rights and social justice. Additionally, social work believes that individuals should be granted access to the resources necessary to develop freely and without domination from others in order to fully realize their potential. With respect toward these standards, social workers share a responsibility in promoting the well-being of children of incarcerated parents. To do so requires social work practice affiliate with progressive ideology committed to major policy reform including the following.

 

·      Repeal the war on drugs by reducing the length of sentences for non-violent crime and expanding alternative forms of rehabilitation in order to reduce separation of children and their parents.

 

·      Reinvest funds allocated for militaristic policing into the expansion of vital community resources aimed at addressing and preventing the root causes of crime, such as education and job training, substance use treatment, mental health services, mentorships and other opportunities for youth.

 

·      Pass laws that prohibit employers from asking about criminal history on job applications in order to improve reentry employment opportunity and economic mobility.

 

·      Remove lifetime restrictions from welfare benefits for people with felony convictions in order to ensure individuals’ and families’ basic needs are met.

 

·      Undo multisystemic privilege and oppression by identifying and dismantling policies and institutions that reinforce racism.

 

·      Promote change in community attitudes, beliefs, and social norms that perpetuate harmful stereotypes and place stigma on vulnerable populations.



Conclusion

            Forty years later, the war on drugs has managed to cost taxpayers more than 51 billion dollars each year, propel the United States into the highest incarceration rate in the world, reinforce multisystemic racism, and radically fail to curtail drug use. Overdose deaths, drug-related violence, and substance use disorder all continue to climb, while Black communities continue to suffer more acutely under the cumulative damage of grossly unequal criminal justice treatment. All the while, children impacted by parental incarceration are increasingly left behind with mounting disadvantage. The health, function, and well-being of these children and the generations to follow requires that we as a society put our policies on trial and judge them not for their intent, but for their impact.

June 22, 2020

Identifying Political Discourse in Social Welfare Policy: The Inaccessible Right to Affordable Housing in the United States

        In every state throughout the United States, full-time minimum wage workers do not earn enough to afford modest housing. For instance, Massachusetts, where the minimum wage worker earns 12 dollars an hour, requires 113-hours per week in order to afford fair market rent for a two-bedroom rental. Kentucky, where minimum wage remains 7.25 dollars, requires 82-hours per week. In terms of cost burden, extremely low-income renters (those at or below the poverty line or 30 percent of the area median income) experience the most acute struggle; however, broad gaps exist between income that exceeds minimum wage and housing cost demands. The problem with inadequate wages is compounded by the national shortage of more than seven million affordable homes.

            Various programs including public housing projects and tenant-based rental assistance, known as Section 8, attempt to combat the unaffordable housing problem. These programs are allocated funds predominately through the U.S. Department of Housing and Urban Development (HUD) and are administered by nearly 3,800 state and local public housing agencies who determine eligibility based on area median income. The assistance benefits approximately 10.4 million people within 5.2 million households; however, an additional 23 million qualifying people are unable to receive assistance due to limited funding.

Populations and Impact

            As a direct consequence to structural determinants including past and current discriminatory policies, people of color are more likely to fall into the category of extremely low-income renters. In comparison to six percent of White non-Hispanic households, 20 percent of Black households are extremely low-income renters. This is followed closely by 17 percent of American Indian or Alaska Native households, 15 percent of Hispanic households, and 10 percent of Asian households.                

            Among recipients of rental assistance, 68 percent are people with disabilities, children, or elders, and 60 percent of the remainder come from working households. For qualifying non-recipients, 75 percent pay more than half their overall income on rent, and more than 500,000 people experience homelessness. Moreover, an estimated 1.3 million children currently live in unstable housing situations including shelters, hotels and motels, as well as in combined family households.

            Families who lack access to decent, affordable housing are at increased risk of socioeconomic disparity by way of intermediary determinants, such as poor-quality education, reduced access to health care, limited employment opportunity, and increased exposure to crime. Affordable housing interest groups, led by the National Low Income Housing Coalition, insist that improved access to affordable housing will offset negative determinants, reduce intergenerational poverty, and increase economic mobility. However, on-going, conflicting political discourse, reflected by various political ideologies, disagree on the approach to take to resolve the affordable housing crisis.

Competing Sides: Neoliberalism and Social Democracy

            Perhaps the quintessential divide among neoliberal and social democratic thinking is in regard to what constitutes an inherent right of an individual. From the neoliberal perspective, the free market is the preferred method for establishing conditions necessary to meet society’s basic needs, namely by way of supply and demand. Therefore, it is the inherent right of the individual to enter into the free market with use of individual preferences as a tool for influencing consumer demand. In turn, the self-regulated free market meets the demand, undoing the need for government involvement. By neoliberal standards, the path to affordable housing can be met by appealing and adhering to market forces. Yet, neoliberal policy has been the dominant force since the 1970s and a national shortage of more than seven million affordable homes remains. So, why isn’t supply meeting demand?

        Current neoliberal policymakers point to government intrusion as the primary interference with the market’s ability to operate effectively. Specifically, strict government housing regulations are seen to drive home prices significantly above home production costs, leading to less, not more housing production. Were the market to be left to its own devices (unregulated) as neoliberal ideology intends for it to be, the individual freedoms, competition, and privatization that encompasses the free market would naturally prevail, and the gap between needs and resources would close, effectively eliminating the need for the welfare state.

        In stark contrast to the neoliberal agenda, social democracy deems it necessary that the government, not the market, promote the economic well-being of the people. Under social democracy, rights of the person include the right to a dignified standard of living that extends beyond basic need and allows for full participation in society. Affordable housing, therefore, is intrinsically linked to the social democratic belief in equal opportunity. Even further away from individual-minded neoliberal ideology, is the social democratic value in solidarity (i.e., the good of the community rather than the rights of the individual). Income inequality, for example, should be narrowed and introduced only when the collective population has established community-agreed upon standards of living.

        While current neoliberal paternalism treats society as individuals possessing an equal clean slate in the ability to achieve economic success, social democracy recognizes on-going and cumulative systemic disadvantages, which divide and maintain disparity among members of society. In order to shape a more equal society, social democracy proposes drastic changes to structural policy and vast expansion to the welfare state. This includes progressive taxation, government regulation of private ownership, increased affirmative action, and government redistribution of resources. These changes, in the social democratic view, are needed in order to more justly balance the distribution of power, unravel oppression, and further ensure that no group becomes dominant.

Conclusion: The Social Work Perspective

            The idea and benefit of the free market as presented by neoliberal ideology, is misleading at best. Capitalism takes an individual approach to economic enhancement and overtly appreciates that where there is demand, there is profit opportunity. Simultaneously, capitalism inherently understands that when demand crosses into the realm of need, what was once opportunity becomes power. In regard to affordable housing, this power includes the ability to reduce housing quality while increasing its cost, and to confine affordable housing to poorly resourced areas, effectively exacerbating conditions of oppression and domination. In short, need for affordable housing in an opportunistic, capitalist society places distributive power into the hands of those who seek to benefit the most: the owners of the means of production.

            Social work is anchored in an approach that seeks to preserve the common values of human rights and social justice in order to enhance power, experiences, and opportunities for all members of society. Housing is a fundamental human need, the quality of which shapes the education, safety, occupation, and health outcome of individuals and families. High cost of basic needs, like housing, coupled with structural low wages, forces consumers further into submission and perpetuates poverty. As neoliberal policymakers cling to an idealistic version of the free market, while simultaneously ignoring the reality and influence of capitalism, disparities among socioeconomic status continue to accumulate.

            Like other ideologies, social work is a system of ideas and ideals, one that encompasses a human right model. In order to advance basic rights including access to affordable housing, social work must openly join forces with progressive instruments of change and more deliberately incorporate the views of social democracy into its code of ethics. There is no magic policy design that alone can upend disparity within society until the underlying issues of multi-systemic privilege and oppression are dealt with. Social work must be leaders in movements aimed at changing the political discourse away from vilifying socialist values and toward embracing equality as a social goal. To do so will require a revolution in civil, political, and social rights.

June 10, 2020

DEATH & GRIEF The Living Funeral: A Celebration of Life Before Death

The living funeral challenges traditional notions of grief rituals by honoring the person and offering a meaningful way to say goodbye prior to death.
Below, 79-year old Grace Stephens embraces her son, Dean Roberts, at her celebration of life party.

Frequently Asked Questions: Living Funerals

WHAT is a living funeral?
The underlying purpose of the living funeral is to create an experience for the person being honored, a lasting memory for the guests, and an opportunity to express love and communicate the influence bestowed upon one another during life.
Much like life, the living funeral is a deeply personal experience. There are many interpretations, with some being casual, others formal, some small, others large, some joyful, and others more somber and reflective.

WHO is a living funeral for?
Typically, in North American culture, living funerals are for individuals who have been given the diagnosis of a life-threatening illness. However, living funerals are also designed by and for people without illness, but whom recognize the unpredictability and inevitability of mortality.
Essentially, a living funeral is for the living.

WHY do people choose to have a living funeral?
The most common reason for a living funeral is for loved ones to gather together, honor, and reflect upon a person's life with the recognition that the person's time is limited. It is a meaningful way to say goodbye.
"When a colleague died suddenly of a heart attack, Morrie went to his funeral. He came home depressed. "What a waste," he said. "All those people saying all those wonderful things, and [he] never got to hear any of it."
- from the book, Tuesdays with Morrie, by Mitch Albom

HOW long have living funerals been around?
Many people have not heard of living funerals as they are only recently beginning to emerge. In the United States, the evolution of America's Right to Die Movement has influenced the rising trend of the living funeral. In Japan, a change in the way that old age is perceived has prompted the use of living funerals.

The Living Funeral in the United States


How the debate over the right to die led to the unfolding of the living funeral 

The Beginning: Debate concerning the choice for merciful death at end-of-life begins

Awareness of the death experience is initiated

Concept of "Rite of Farewell" during terminal illness is discussed

Discussion expanding the concept of patient rights is promoted

Conversation concerning individual autonomy and personal values evolves

Debrief on the Living Funeral in the United States

Holly Little Van Straaten, SW 636: Death & Grief
(5 minutes)

Personal Stories

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MEET GRACE
Grace Stephen's "Royal Party"

------------------------------

MEET LISA
Lisa Tremont's "Goodbye Bash"
(3.5 minutes)
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MEET BETSY
Betsy Davis' "Last Work of Art"

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MEET JIL
Jil Finnegan's "Last Day"
(10.5 minutes)


The Living Funeral

JAPAN
Overview of Seizensō (生前葬), the Living Funeral in Japan
Holly Little Van Straaten, SW 636: Death & Grief
(6 minutes)



IMPACT
"Dying persons are our teachers since by accepting the limited time left in their lives, they can focus on what is truly important and meaningful." – K. Doka
Miriam Swaka teaches us how to say "I love you" at her living funeral.
(3.50 minutes)


What impact does the Living Funeral have on the grief process for families and loved ones?
Some people are granted the time to involve those they love in their dying process. However, when families learn about a loved one's life-threatening illness, they often struggle with how to talk about it. Some reasons for this include:
Fear of saying the wrong thing
Fear of own mortality
Guilt/shame about what has happened in the past
Denial regarding the possibility of death

What to remember and how to respond to the Living Funeral?

Be respectful. It is not unusual for people who experience life-threatening illness to speak of the illness as a turning point in their lives. They may feel that because of their illness they have reconstructed their priorities, and may wish to enrich the quality of their remaining time. A living funeral may symbolize this for the person. It is important to be respectful of the end-of-life decisions a person makes even if you do not understand or agree.
Listen well. While the initiation of a Living Funeral demonstrates open awareness of the life-threatening illness, it does not mean the person is not also experiencing complicated responses, such as fear, anger, sadness, and/or hope. Be prepared to listen to the person as they express their array of feelings even if the feelings seem to change frequently or contradict. Listening is powerful.
Allow tears and laughter. Honest responses are a valuable part of the open awareness experience with a person who has a life-threatening illness. Grief is an emotion, and it is okay to cry, laugh, or both at the same time.
Listen well to Morrie Schwartz (Tuesdays with Morrie) as he shares his perspective on dying.
(1.06 minutes)


Covid-19 Impact on Living Funerals


Holly Little Van Straaten, SW 636: Death & Grief
(3.15 minutes)




Thank you for taking the time to learn about this topic.
Holly

SOCIAL PROBLEM: GRANDPARENTS RAISING GRANDCHILDREN



In Gloucester, Massachusetts, Elle, a single, 75-year old great-grandmother is raising her two great-grandchildren (ages 5 and 8)Elle became caretaker to the children four years ago when their biological mother (Elle's granddaughter, whom Elle also raised) was no longer able to care for them due to her struggle with an opioid addiction. The children’s father is serving a life sentence for a crime he committed while engaged in substance use. The courts awarded Elle full guardianship of the children until they turn 18, at which point, Elle will be 88-years old. Now, at 75, an age typically experienced by retired elders, Elle continues to work in order to support the children, while balancing the responsibilities of home life, the children’s special education needs, and her own naturally declining health.

According to the 2014 United States Census, there are 2,631,546 grandparents raising grandchildren, of whom 39% are over the age of 60. Within this group, 58% remain in the workforce and one in five lives below the poverty line. Experts point to the opioid epidemic as a main factor in the rise of grandparents raising grandchildren as well as the increasing number of children entering foster care . According to the Adoption and Foster Care Analysis and Reporting System (AFCARS), children placed in kinship foster care increased from 34% in 2008 to 40% in 2014.



While grandparents raising grandchildren can be beneficial for the child in comparison to their placement being in foster care or group homes with non-relatives, consequences to the problem remain wide-ranging for families. This includes the disruption of life plans, such as postponement of retirement, depletion of retirement savings and/or assets, and isolation from critical social networks. Furthermore, trauma stemming from the neglect and abuse that ultimately led to the removal of the child, presents additional challenges including the need to navigate behavioral and mental health services. Likewise, children exposed to substance abuse prenatally may have temporary or permanent developmental issues requiring ongoing health and education services. Amidst these challenges, many grandparents provide dual care toward both their grandchild/ren and their adult child struggling through addiction and/or related legal, mental health, and financial issues. Some of the most requested services from grandparents raising grandchildren are kinship navigation services, financial and legal assistance, counseling, and respite care.



Efforts to address the problem include the Supporting Grandparents Raising Grandchildren Act, a law passed unanimously in 2018 that establishes a Federal Advisory Council to support grandparents and other relatives raising children. However, strategies remain necessary and include the need for preventative services, such as substance abuse treatment, mental health services, affordable childcare, and in-home supports. Critical to the success of prevention is protection of Medicare and Medicaid as well as the implementation of accessible, affordable, quality health care for all. With the support of practitioners and policymakers and improvement of and access to services, grandfamilies can experience better outcomes, and communities can come together in order to more effectively combat the opioid and substance abuse crisis.