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Posts By Crommunist

0 I get e-mail

  • July 27, 2011
  • by Crommunist
  • · blog · civil rights · free speech

Regular readers will remember a couple of weeks ago when I went to Amsterdam and stuck it to the reactionary jerk-offs that wanted to burn one of my favourite books. Well I dedicated that post to the author, Lawrence Hill. Mr. Hill’s books have been a major source of inspiration for me both as a writer and as someone interested in race. I sent him a copy of my post, thinking that he’d appreciate knowing that his fans aren’t down with the whole ‘book burning’ thing:

My name is Ian Cromwell, and I am a big fan of your work. You can certainly understand how dismayed and enraged I was when the group in the Netherlands threatened to burn your book over something as silly as misunderstanding the title. I share your outrage over book burning, as I am myself a staunch supporter of free speech as a fundamental right and key to our cultural survival.

I was recently in Amsterdam for a conference, and I took the opportunity to visit the same park where the book burning took place. I brought my own copy and took a couple of pictures, as basically a one-finger salute to the Philistines that think that fire is an appropriate response to disagreement in this century (without bothering to read first, clearly).

They’re up on my website (https://crommunist.wordpress.com/2011/07/11/this-post-is-for-lawrence-hill/). If you would like copies of them, please do not hesitate to contact me. I am looking forward to your next book, and cannot fully express my appreciation for the way your work has helped clarify some feelings I always had but couldn’t really put into words.

Yours sincerely,

Ian Cromwell

I was pleasantly surprised when I got this response:

Hello Mr. Cromwell,

Thanks so much for your words (and photos) of support, with regard to those who were burning the cover of my book in  The Netherlands.  It meant a lot to me to hear from you, and from others who were equally appalled to learn that Mr. Groenberg was planning to burn the book in Amsterdam. I join you in your feelings about freedom of speech as a fundamental right and key to our cultural service (although I would draw the line at hate speech). You probably know that I wrote an opinion piece for The Toronto Star about the book burning:

http://www.thestar.com/entertainment/article/1012068–what-lawrence-hill-tells-dutch-group-planning-to-burn-his-book

If you are willing to send a photo or two to me, for my own personal archives, I would be very grateful.

Wishing you all the best with The Crommunist Manifesto! Great title for a blog!

Sincerely,

Lawrence Hill
mail@lawrencehill.com

In the common parlance of the internet, squeeee! While I think we’d have a lot to hash out with regards to our stances on hate speech, I’m really happy that he wrote me back. I’m going to see if I can parlay this into an interview someday.

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0 Cynicism giving way to optimism

  • July 26, 2011
  • by Crommunist
  • · blog · Canada · First Nations · good news · law · politics

In my earlier post today I mentioned in passing that I was cynically optimistic about some of the changes I’ve seen in how governments in Canada think of and behave toward First Nations communities. I think when I wrote that I fully intended to explain what I meant, but for whatever reason (read: laziness) I didn’t. I’ll take this opportunity to do just that.

I am all for governments, corporations and other large, powerful entities doing the right thing. I think it’s fantastic when an oil company pledges to clean up a spill, or when a politician crosses the partisan divide to vote for something that is ethically right, even if it isn’t expedient with her base. I’ve tried to be mostly fair with the Catholic Church when it does things that are in line with secular morality. However, in each and every one of those cases, I am immediately suspicious of the motive behind the action. Is the oil company trying to cover up the fact that it caused the spill? Is the politician trying to brand herself as ‘centrist’ or curry favour with a power interest group? Is the Catholic Church not raping children anymore, or just trying to get people to stop equating “Catholic priest” with “child rapist”?

In light of my cynicism (which I think is reasonable and justifiable), it can be hard to get too optimistic about things. To be sure, I am generally optimistic that life will get better over time – that has been the story of humankind throughout history. However, whether a specific story represents a genuine step forward for society or a clever act of obfuscation is a judgment call I often have a difficult time making.

For example, this:

After years of conflict, including a Supreme Court of Canada battle, the Taku River Tlingit First Nation of northwest British Columbia signed a land and resource management and shared decision-making agreement today with the provincial government — the first of its kind in B.C. Premier Christy Clark said the agreement creates 13 new protected areas and provides resource development opportunities and investment certainty in more than three million hectares in the Atlin Taku region. She added that is the size of all of Vancouver Island.

<snip>

“We are emerging from a dark period in our history with hope and promise,” said Taku River Tlingit First Nation spokesman John Ward. “It’s so great to come out of the darkness and silence we’ve experienced for so many years and be acknowledged.” Ward said the land use agreement gives aboriginals a say on how industry “can access and conduct themselves in our traditional territory.”

It is my cynicism that is preventing me from jumping up and down and doing cartwheels all around my apartment right now (well, that and the fact that I have never been able to do a cartwheel). This kind of thing is exactly how not only the political system is supposed to work, but the legal system. The courts are supposed to overrule the government when it acts in its own best interests rather than those of its people. First Nations people should control their own lands and not only have a stake in how they are managed, but to reap the benefits of resource exploitation. This deal is likely to mean infrastructure and industry jobs for people living in the region – if these positions are structured properly it could mean real long-term development and sustained economic strength in the region.

That’s the optimist in me talking. Considering the number of First Nations bands that have complained about corruption in their leadership, and considering the ease with which groups that have abundant resources but little education on how to manage them get exploited by multinational interests, my inner optimist is losing the arm-wrestling match to my inner cynic. Until we see a sea change in the way we think of First Nations issues, and how First Nations communities are supported/encouraged to grow, I don’t see this as resulting in anything more than more money in the hands of a few people while the general quality of life remains unchanged.

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0 First Nations push for political action

  • July 26, 2011
  • by Crommunist
  • · blog · Canada · First Nations · health · politics

Once again my apologies for not posting on time this morning. I am still working through a backlog of stuff at home and at work that has piled up as I’ve been on the road. I will endeavour to have these posts up on time for the rest of the week, but my ‘free time’ is not yet my own. I really do appreciate your patience.

Despite lack of evidence to the contrary, I am acutely aware of the fact that this blog only really ever discusses racial issues along black and white lines. I don’t mean that I look at these issues as clear right and wrong, but that I tend to focus on issues that are centred on black and white people. This isn’t an accident – this particular divide is the one I am the most familiar. Growing up the way I did, the black/white dichotomy is the one that has been the most apparent to me my whole life. My bias towards this issue is not simply borne of familiarity, but from recognition of the fact that I can comment on these communities as an insider. It is not so for other racial/ethnic communities in Canada, and in the interest of letting people tell their own stories I often watch pitches go by when I think I could do more harm than good if I swung at them (N.B. – the last time I played baseball I was in high school).

I have, for a few years now, theorized that there is much that unites the black and First Nations communities in North America. Despite our disparate histories, First Nations face many of the obstacles that black people faced in the mid-20th century. Public perception of First Nations people is often negative, and their problems are blamed on their own lack of “personal responsibility” rather than a product of the evident systemic abuses that stretch back through history. To be sure, the problems facing First Nations communities are unique, and so are their solutions, but there is enough commonality in my eyes to justify feeling a sense of kinship.

None of this is to say that I feel qualified to express an opinion on issues facing First Nations communities, only to say that I react viscerally when I read things like this:

Nearly three-quarters of first nations in Canada rely on water systems that are classified at a medium or high risk of not meeting safety standards, a national study finds. The independent report examined the drinking water and wastewater systems on nearly 600 first nations. Just over one-third were classified in the high risk category.

You wake up in the morning, you brush your teeth, maybe you take a shower. You cook some breakfast, you head to your job or your school. No big deal, happens every day, for millions of Canadians. Except for those Canadians that don’t have access to clean water. It’s chilling to think about how fundamental access to clean water is. For the vast majority of Canadians, we live in circumstances that allow us to take clean water for granted. So much so, in some cases, that we actually think it’s reasonable to look with disdain on the water we do have and pay billions of dollars a year for a bottled version of the same product.  Not so if you’re a member of a First Nations band.

Does everyone remember the major crisis over water safety in Walkerton, Ontario a few years back? We were all dumbfounded, myself included, to learn that regulation had slipped to such an extent that in one of the very few countries in the world that can really describe itself as “first world”, people were dying of contaminated water. There can be no safety, no development, no security, and certainly no trust in the government, when there is no access to clean water. It’s fundamental to how we live. And apparently, we’ve been dragging our heels on providing it to a particular group of Canadians. Encouragingly, the problem seems to be one of capacity – lack of training in how to use a water system – than one of contamination. I call this encouraging because it is a clear problem with a clear and simple solution, something that is usually quite rare.

The larger issue, however, is the level of inattention with which we (as non-Aboriginal Canadians) treat our First Nations sisters and brothers. I am cynical, yet hopeful when I see signs that the story might be changing for the better:

Canada’s aboriginal leaders are calling for co-operation between the premiers and the federal government on social and economic issues. Aboriginal communities need help coping with emergencies such as flooding and forest fires, the leaders said at talks in Vancouver, where provincial and territorial premiers are holding their annual Council of the Federation meetings. In prepared remarks to the premiers, Shawn Atleo, national chief for the Assembly of First Nations, called the issue of crisis and emergency management “urgent,” given the flooding and fires in 2011 alone.

I don’t know much about Shawn Atleo as a person, but his and my politics when it comes to these issues are very much in line. He is not afraid to point out failures in the system, but his proposed solutions are not simply “more funding”:

The communities need resources and training in emergency management along with long-term security plans so they can better respond to a crisis, Atleo said. This would include “major work,” like permanent dikes in areas prone to flooding, road upgrades, and evacuation centres. Temporary housing would also be required for those forced out of their homes.

What he is talking about is a level of response that is commensurate with the level of crisis, which sounds completely fair to me. Above that, though, he’s pointing out the need for training and capacity building – help us help ourselves. That has to be the approach with any marginalized community – not because it’s politically expedient but because it is the only long-term solution to the problems that face those communities. Where I step off the conservative talking points is that I think that the government should be more engaged in this process – not less.

To bring it back to my original point, I am uneasy about making pronouncements about what is best for First Nations communities in Canada. God knows they’ve experienced enough cases of outsiders coming in and trying to dictate their best interests. I will, however, never hesitate to stand up and shout my disapproval when my government fails to protect my fellow Canadians, or my approval when someone articulates something that I think is a good idea. Issues facing the minority only start to get fixed when they are seen as problems by members of the majority.

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3 You’re not “a racist”; you’re just racist

  • July 26, 2011
  • by Crommunist
  • · blog · critical thinking · crommunism · psychology · racism

This past weekend I was chatting with a friend of mine about a variety of topics, including the tragic shootings in Norway. He was trying to establish that the event was an isolated incident by one crazy person, while I was suggesting that those kinds of things don’t happen in a vacuum. I pointed to a parallel argument I had when it comes to hate groups like Blood and Honour – the extremists are often the outliers of a group that holds similar views but would stop short of violence.

His response was fairly typical: “well there are always going to be some racists out there, but that doesn’t mean everyone is responsible.”

He was wrong, for reasons that I discuss in the linked post above, but it was the language he used that particularly irked me. “Some racists” is not a phrase I could ever see myself using, except in an unthinking moment. Not only is it an unwieldy phrase that could be convicted for abuse of the English language, it tips its hand as to how deeply the speaker misunderstands the origins and mechanisms of racism. I’ve touched on this discussion before, but I would like to talk explicitly about why this phrase is either a) meaningless, or b) profoundly ignorant.

First, we must revisit our operational definition of racism. Please note that I am using the term ‘operational definition’ intentionally – I use this definition for my own purposes, but it means many different things to different people. I think that my definition is the most accurate I’ve come across (obviously), but others would disagree. The chief component of my definition is that racism happens when attitudes or beliefs about a racial group are ascribed to an individual. Essentially, it makes the assumption that a person’s racial background provides sufficient information to predict their behaviours, which is not supported by evidence. This is to say nothing of the fact that the attitudes or beliefs about a group could be (and often are) fundamentally flawed.

It becomes fairly clear, when we consider this definition, that all people are potentially susceptible to this kind of heuristic thinking. I am sure that I have gone on rants about what “conservatives” do and do not believe, when conservativism does not necessitate given beliefs on any topic – rather conservative thinking tends to lead to a cluster of beliefs, many of which are often shared by those that describe themselves as “conservative”. It is a cognitive shortcut, but one that oversimplifies a process that is important to understand – what the mental scaffolding supporting conservative beliefs (or liberal beliefs) is. Simply labeling people as “conservatives” masks that thought process, putting effect in the place of cause.

Similarly, I rankle whenever someone uses the phrase “a racist”, because it commits the same error. Racism is a cognitive process, and as such exists as the engine behind actions and attitudes, rather than their essential component. Calling someone “a racist” suggests that there is some kind of binary state of ‘racist’ and ‘not racist’ in which people can exist. It supposes further that when someone performs an action or voices an attitude that is itself racist, that it is their existence in the first of these binary conditions that is primarily responsible – as though there is something organically racist within them that doesn’t exist in the general population. You know, the general population of ‘not racists’.

Of course it’s trivially easy to recognize the fallacious thinking at work here. All we have to do is look back over the last few decades and note the monumental rate of spontaneous remission that happened in ‘racists’. A sudden seroconversion that has removed all the malignant racist cells and replaced them with healthy non-racistocytes. Or, perhaps racism isn’t quite so simple as that. When we see racism as simply a product of human cognitive shortcuts, the idea of being “a racist” starts to fall apart. After all, if we’re all susceptible to racist thoughts and behaviours (that are, for most of us, subconscious), then can anyone be described as “not racist”? Does it exist on some kind of continuum like the DSM where people that exhibit a certain pattern of behaviour can be diagnosed with “racist personality disorder”?

No. Racism is best understood as the product of ideas, both conscious and unconscious, about other people, and our tendency to try and reduce people to convenient labels (like… oh, I dunno… ‘a racist’). I can certainly understand why people like to use this term, because it allows them to preserve their self-concept of being a good person and scapegoat racist activities as the product of “racists”. Once blame has been assigned in this way, then the speaker can dust her/his hands off and say “it’s not my problem – I’m not a racist.” However, that simply means the problems never get solved, because the only people whose self-concept allows them to brand themselves as being “a racist” are proud of that appellation.

This is why I am in favour of using my own definition of racism, because it renders the idea of being ‘a racist’ completely ridiculous. While it may be convenient to describe people as being ‘a racist’, it distracts from what is actually happening behind the scenes in such a way as to increase societal inertia when it comes to dealing with race issues. It is far more accurate and useful to think of racism as a set of cognitive conditions that encourage a certain kind of behaviour – conditions that are present in us all. What this allows us to do is confront our own biases – no matter how uncomfortable they might make us – and in so doing, make positive changes to minimize the harms they may cause.

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0 Late post

  • July 25, 2011
  • by Crommunist
  • · blog · Uncategorized

I have had visitors from out of town this past week, and have been unable to find blogging time. I have a post sketched out for today, but it’s not written yet. My apologies to those of you who were hoping to read a new Monday Thought Piece today – it will go up, I’m just not sure when. Your patience is appreciated.

2 Movie Friday: Fear of Numbers

  • July 22, 2011
  • by Crommunist
  • · blog · bmusic · science

It’s no secret that I’m a big fan of Neil DeGrasse Tyson. Here’s why:

When Carl Sagan died, there was a hole left for a science educator that could engage with average people and get them excited by new scientific concepts. I feel like that role has gone to Dr. Tyson, though I’m sure he would forswear the comparison. I had a conversation with a couple of friends and raised the point that like basic math skills and basic language skills (although still not in many cases), it should be a prerequisite of having a career as a scientist that you can communicate your research with ordinary people (i.e., non-scientists). If the scientific community can’t manage to bring the fire of the gods to the people (I am making a Prometheus allusion), then what are they (we) doing this for?

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0 Crisis in Somalia

  • July 21, 2011
  • by Crommunist
  • · blog · Canada · news · politics

I am growing increasingly concerned with the situation in Somalia. It is a problem that can very quickly develop into a major international crisis with wide-spread human and policy implications. It is within our power to act now to avoid it, but it doesn’t seem that this crisis is getting much traction with world governments.

I have written down some of my thoughts over at Canadian Atheist:

So even if you don’t buy the hippy-dippy “human suffering” and “think of the children” arguments usually put forward to elicit aid in times of great human need, you’ve got to realize that this is a crisis that effects you personally. If we act now, we can put the genie back in the bottle – if we wait too long, then we’re all going to have a much bigger problem on our hands. A problem we may not be able to solve.

I’ve written a letter to my MP (more on that later, once I get a response from her directly), and hopefully there will be some pressure on the federal government to take the lead on this. It affects them directly, and they can avoid a shitstorm on a planetary scale if they react now.

Anyway, read the article over at CA, and keep an eye out for this issue. If you can afford it, consider donating a few dollars to the humanitarian aid effort.

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4 Same planet, different worlds

  • July 21, 2011
  • by Crommunist
  • · blog · psychology · race · racism · religion

“Intersectionality” is a word that is new to my lexicon – a lexicon that constantly expands as I delve deeper into the anti-racist and feminist literature. The word intersectionality refers to (so far as I can tell) the way in which identical variations in one variable can elicit a differential result based on a third variable that doesn’t seem to be related. For example, men and women have good reason to react differently to seemingly-innocuous stimuli, like being approached for sex late at night on an elevator. It is not the nature of the stimulus on its own, but the intersection of the stimulus with the third variable of gender that determines the nature of the response.

Those of us familiar with multivariate regression modeling (yes – this is the single lamest thing I have ever bragged about on the internet) can easily wrap our heads around this concept. For others, it can become quite difficult to grasp how something that might seem completely unrelated to an event could completely change the way we react to that event. To help illustrate the concept, and to tip my hat to one of my favourite comic artists, I am entitling this post Same Planet, Different Worlds.

For historical reasons, race and religion in the United States are not independent variables. However, in a scientific sense there is no biological or chemical reason why, for instance, black people would be more religious than white people. However, we do see an interesting intersection between race, religion, and attitude toward interracial marriage:

Pew’s February Political Typology Poll asked people about recent trends in American society. Pew asked if “more people of different races marrying each other” was good or bad society. Overall, only nine percent of Americans said it was bad for society. However, 16 percent of white evangelicals said this, more than twice the opposition found among other Americans (7 percent). The survey found that 27 percent of Americans overall said more interracial marriage was good for society, compared to 17 percent of evangelicals.

The first thing I want to draw your attention to in the above excerpt and figure is the difference that simply being religious makes on one’s attitude toward interracial marriage. When compared to those who reported having no religion, far fewer Christians look at an increase in marriages that transcend racial barriers as a positive outcome for society. There is nothing inherent in Christianity stating that racial groups are created separate. That kind of idea has been imprinted onto Christianity in the United States since the days of Emancipation, but it is not biblically doctrinal. That being said, because it has become doctrine in many branches of American Christianity, it is no surprise to me that religion would have this effect.

The second thing to look at, however, is the effect that being black and religious has on these attitudes. While the number who view such marriages positively is more or less neck-and-neck with their coreligionists, the number that view them negatively is tiny. It is the intersection of the dueling identities of ‘black’ and ‘Protestant’ that fuels this outcome. Because ‘miscegenation’ is still anathema to the American Christian,* there can be no approval of race mixing. However, at the same time black people have remarkably different attitudes toward interracial marriage. Because of the prevailing societal attitudes about the different races, there are remarkably different social implications for a black person in an interracial marriage than a white person.

I have tried my best so far to avoid using judgmental language in this discussion. It’s difficult, because obviously the subject of interracial marriage is very personal to me. However, I have to remain mindful of the fact that these peoples’ opinions are the product of their environments, rather than some deficit in their character (more on that on Monday). That being said, I can definitely attack the ideas they hold with no restraint, which I will do now.

The kind of evil that fuels the nearly 20% of white evangelical Christians is possible only when you think your small-mindedness is justified by some kind of divine mandate. While there will always be some hateful people in every group, please let these findings put to rest the idea that Christianity makes people more tolerant or better people. What it does, what all religions do, is give people permission to throw aside introspection and thought-based ethics in favour of easy answers and a false sense of superiority. Considering the insular nature of many evangelical communities, the lack of exposure to dissenting opinions simply serves to make matters worse.

I have a sneaking suspicion that most people I know would think that “doesn’t make much of a difference” is the ‘correct’ answer. After all, we are told we are not supposed to have feelings about race, either positive or negative. Personally, if I were asked this question I’d say that more intermingling of racial groups is definitely a good thing for society, since it furthers the erosion and blurring of the lines separating racial groups. When you have kids whose parents are two different ‘things’, then it’s kind of difficult to see either one or the other as superior (though God knows South Africa tried).

To bring it back to my original point, it’s important to recognize that ‘intersectionality’ is a real force, and understanding it is key to understanding why members of a group might have different reactions to an event. It’s certainly important to understand if you, for instance, want to increase the number of visible minorities in your political movement (wink wink, nudge nudge).

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*It is important at this point to note that I don’t think that all Christians in the United States are race-baiting hate mongers. I am merely making the point that this type of ‘safeguarding’ of ‘racial purity’, when couched in religious language, comes from a uniquely American brand of Christianity.

0 The entrenchment of disparity

  • July 20, 2011
  • by Crommunist
  • · blog · critical thinking · education · race · racism

I spent a great deal of time last week talking about disparities – differences in access and achievement – that exist along sex or racial lines. Wednesday’s post looked explicitly at a topic that is dear to my heart: education. Education is, in my opinion, the key to societal progress. It is not simply enough to know stuff – we have to be skilled at appraising the truth about the stuff we know, and in finding new ways to test that knowledge. That is what it is to be educated, and when a group of people is held back from obtaining those skills, it has far-reaching effects. When one group is deprived while another has access, we begin to see widening disparities.

But, while education is a major part of what is needed for a group of people to make progress, it is not alone in the pantheon of resources in which we see major disparities. Submitted for your scrutiny, here is a top 10 list of career areas in which black people are disproportionately underrepresented:

  1. Teaching
  2. Law
  3. Science and Technology
  4. Academia
  5. College Athletics
  6. Advertising
  7. Construction
  8. Media and Telecommunications
  9. Health Care
  10. Fashion

These positions are better fleshed out in the article itself, but even a cursory glance at this list paints a pretty bleak picture. The order I’ve listed these fields is the order in which they’ve been printed in the article, but I think a better story can be told if we can group them thematically. If you’ll allow me, I’ll point to some trends I see in this list.

Black people don’t lead (#1, #4, #5, #8)

Everyone can point to teachers that changed their lives. I had Ms. Mooney in high school, and Drs. Anthony and Ward in my undergraduate that laid down the foundation for a lot of my professional life through constant encouragement and support. While I wasn’t involved in sports (I was a drama kid – there were more girls in the school play than on the football team), I know many people who received mentorship and guidance from their coaches. Media figures also help young people develop their ideas and expose them to differing perspectives on the world.

The underrepresentation of black people in these fields means that there are few black role models in leadership positions. We know from psychology that modeling is one of the principal ways that humans learn, and actually differentiates us from many other animal species that learn through a more trial/error process. In absence of models in the black community in leadership positions, an unconscious equivalence between non-black skin and leadership (or, conversely, the lack of association between black skin and leadership) becomes more deeply entrenched as generations pass.

Black people don’t innovate (#2, #3, #4)

A modern nation is defined by its laws. Most of the major fights happening in Canada and the United States are happening in the courts. Indeed, many of our political leaders come from the legal sphere. Beyond the simple legal battles, the developed world doesn’t make its money through manufacturing or agriculture anymore – it does it by developing new and innovative ideas and technologies. Because we have a big slice of the world’s money, we’re the only ones that can really afford to test new ideas and “waste” time on avenuesof research that don’t immediately pan out.

When black people are disproportionately excluded from the fields of law, science and academics, we find ourselves outside the process looking in. Instead of being a part of the process of choosing and developing innovative ideas, we are instead relegated to observing them (whilst hoping they aren’t used to our disadvantage, which they often are). As I noted with the lack of black faces in the halls of political power, an absence of black people in the decision-making process means that people make decisions on their (our) behalf, often without having any first-hand knowledge of the issues we consider important.

Black people don’t contribute (#7, #9)

There is a certain level of pride and ownership that comes with building things, or with caring for each other. Beyond the simple instrumental utility of having a bridge or mending a broken bone, public works help bring us together as a society. When someone can point to a building and say “I helped build that” or to a child and say “I helped deliver her”, it reminds us of how connected we are to each other and how important our communal sense really is to our day-to-day lives.

When one group is removed from that process, however, they can become alienated. I’ve seen this with First Nations groups who reject intervention by government, not because it’s ineffective, but because they had no hand in building it. Not only could black people begin to feel like outsiders, but we also begin to be seen as outsiders that aren’t helping. It doesn’t take too exhaustive a perusal of white supremacist writings to uncover the pervasive myth that white people built our country, and everyone else is just there to sponge off of “their” hard work.

Black people don’t control our own brand (#6. #8, #10)

The longer I do this kind of writing, the more I get the feeling that what antiracists like myself are actually doing is a type of brand management – we are concerned with the way black people (or pick your group of interest) are perceived and portrayed by the public. Media outlets, commercial interest, and other industries concerned with image are what help create, sell, and defend a brand. If I can be so callous and mechanistic about a serious topic, we really are talking about taking control of our own public face.

However, when we see our group missing from the ranks of those that really sell that brand, then we have little control over how we are seen. When our news outlets, our advertising and our haute couture are run by people who may not have the most favourable impression of black folks, it’s no wonder that negative perceptions pervade our popular culture.

So we see the kinds of employment disparity at play here can have effects that reach far beyond simple lack of certain types of jobs. They have significant impact in a larger culture that dictates how we think of certain groups. This difference doesn’t simply stop with those who are unemployed – it means that there is less likely to be a next generation of people who are more interested in challenging the status quo. Far from racism becoming eradicated, we are more likely to see an organic type of segregation that has the effect of Jim Crow laws, without the need for legislation.

Once again, and I grow more convinced on this point as I learn more, if we are interested in seeing these disparities fade, then we need to make an active concerted effort. Simply sitting idly and waiting for the situation to resolve spontaneously will have the effect of allowing these non-intentional types of racism become cemented. The article from which the list is taken raises this issue, and points to efforts that have been made to balance the scales. However, without public support these programs come under fire by those who think that giving someone a leg up is cutting the legs out from under someone else.

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4 Health care; we still live in the world

  • July 19, 2011
  • by Crommunist
  • · blog · critical thinking · health · medicine · science

So as you may have deduced from yesterday’s marathon post, I am back from my trip. While I spent the first week in sunny and beautiful Amsterdam, I spent the second week in sunnier Toronto – my old home. This trip wasn’t all pleasure though; in fact, I was traveling for business. I don’t talk about this on the blog often, but I work as a health economist. Basically, health economics is a branch of research concerned with resource allocation and decision-making in health care. We look at alternative methods of health care delivery, technologies, programs, etc. and apply the scientific method to work out which options are worth the investment of time, energy, and (ultimately) money. The goal, at least for me, is to maintain the public health system so that it is viable in the long term.

The biggest problem with public provision of health care (or really, any kind of health care provision) is that there are a finite amount of resources available. At every turn, we are confronted by the fact that while costs of care are climbing steadily, the amount of money available to fund treatment can’t even come close to keeping up. At some point, while we’d like to see that everyone gets all the treatment she/he needs and would like, we have to draw a line.

Sometimes we get in our own way a little:

A B.C. woman with a rare, serious skin disease can’t understand why the province refuses to cover a one-time treatment that would likely put it into remission — but will pay for much more expensive treatment that only helps relieve her symptoms…

Dermatologist Gabriele Weichert wrote to PharmaCare, recommending a one-time treatment with Rituximab instead. The drug is approved for treatment of rheumatoid arthritis and other conditions, and Weichert said the drug has also shown much better results in treating pemphigus.

So here it seems there is a clear-cut case where government bureaucracy is getting in the way of medical decision-making. We’ve got a disease, a drug that treats it (at lower cost, no less), and a bloated, inefficient system that won’t cover the cost of the medication because it’s not on “the list”. Pretty shocking, right? Well, until we read this:

A spokesperson for PharmaCare told CBC News approval was denied because Health Canada has yet to approve Rituximab for treatment of pemphigus. Using it to treat that condition is considered “off-label”.

Rituximab is part of a class of drugs called ‘monoclonal antibodies’ that basically mimic the body’s own immune response to foreign proteins. When a strange substance (in immunology, called an “antigen”) enters the body, it is recognized by the white blood cells. They form a chemical impression of the proteins that make up the antigen and begin creating antibodies. Those antibodies coat the foreign protein, signalling other blood cells to envelop and destroy them. Sort of like adding bacon bits to an otherwise-unpalatable salad. Monoclonal antibody drugs do this, but for tumour cells (which are not recognized as ‘foreign’ because they come from the body’s own tissue).

As you might suspect, these drugs are typically used for cancer. Using rituximab for skin disease is indeed an ‘off-label’ usage, and those can be potentially disastrous. The kind of cowboy prescription involved in giving treatments for which efficacy is not established can have potentially fatal consequences, as we’ve seen in the furore around so-called ‘Liberation Therapy’ for multiple sclerosis. The problem here is that there is likely never going to be the kind of trial that we would consider sufficiently strong evidence to justify covering rituximab for use in this setting – the disease is just too rare.

So why not just give it anyway? It’s medicine, right? What possible harm could there be in prescribing it? Well… how about death?

Four people with rheumatoid arthritis have died after being treated with Rituxan, says the drug’s manufacturer, which has issued safety information about the medication in conjunction with Health Canada. None of the deaths caused by a severe infusion-related reaction occurred among Canadian patients, Hoffmann-La Roche Ltd. said in a release.

All drugs have potential adverse effects, and some of those effects might be fatal. Doctors know this, which is why they take such precaution with filling prescriptions (well… that’s debatable I suppose). Giving a medication for an indication that is unknown may result in a miraculous cure, but it might also kill the patient. Because of the vast divide in knowledge between the doctor and the patient, and the unique level of trust that characterizes that relationship, physicians must be extremely careful in the advice they give. When the stakes are high, patients will often leap at opportunities for cures without really understanding all of the variables involved.

This is the tightrope that the health care system must walk every day. If they adhere to the rules and regulations too strictly, they run the risk of undertreating patients, or promoting practices that are inefficient and ineffective. Relax the rules too much and they run the risk of seeing patients die from inappropriate or experimental treatment at the hands of well-intentioned but ultimately misguided care providers. There are horror stories on either side of this divide, which can be (and are) milked in order to shift policy and public opinion.

There is no perfect solution to this set of problems. Different countries employ a variety of different approaches to find a way to maximize patient autonomy whilst simultaneously protecting them from the consequences of their own ignorance. Whenever there are failures, they should be brought up and discussed. The key to any system is one that is not so intractably bound by regulation that it cannot respond to times of crisis (like in the treatment of pehphigus), but not so flexible as to undermine its own ability to safeguard its stakeholders.

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