Tag Archives: Public Policy

How Can We Better Protect LGBTQ Students: Psychologists Take Action

Click to view slideshow.

By Joshua R. Wolff, PhD (Adler University); H.L. “Lou” Himes, PsyD (QuIPP); and Theresa Stueland Kay, PhD (OUTReach Utah)

Over the last year, we have witnessed regular news media headlines coming out of Washington, D.C. with a state of shock, horror, and anger. Specifically, we have been alarmed by the rollback of protections for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth and students.

We know from first-hand experience that LGBTQ students face many forms of discrimination which contribute to health disparities, such as increased rates of suicide and homelessness. Specifically:

  • I (Lou) have been gender non-conforming my whole life and I have faced harassment in educational institutions from elementary school through my doctoral studies.
  • I (Theresa) work with LGBTQ youth at an organization called OUTreach Utah. All too often, the youth I see are marginalized and bullied at home and at school. When they suffer at school, personnel frequently fail to protect these students. Even worse, faculty, staff, and administration often blame the youth for the fact that they are bullied.
  • I (Joshua) came out as gay at a faith-based college, Biola University, where I risked academic expulsion based solely on my sexual orientation, and realized I did not have any legal protections.

Together, we have each dedicated our careers as clinical psychologists to helping support LGBTQ people in the face of discrimination, which we have done through research, clinical services, and volunteering.

LGBTQ children and youth face daily roadblocks to their education and threats to their safety. This is a systemic issue and requires a systemic response.

Like many Americans, we have at times felt powerless against what seems to be an overwhelming recent assault on many of the most marginalized groups of Americans, including (but certainly not limited to) LGBTQ students. Hence, we asked ourselves “what can we do to help”? We decided to visit Washington, D.C. to talk to Members of Congress, including some who may not share our views, about the importance of protecting LGBTQ students.

Our first step was to contact staff at the APA to help us get started. We felt particularly fortunate to receive wonderful assistance from staff in the Public Interest and Education Government Relations Offices.

Prior to meetings with congressional offices, we connected with leading LGBTQ advocacy groups in Washington to learn about their current federal priorities and strategies. We met with the Human Rights Campaign, GLSEN, and the Trevor Project, as well as APA staff from the Safe and Supportive Schools Project. As a result, we learned about several important priorities. These included:

  • re-instating Title IX protections for transgender youth;
  • the ‘Safe Schools Improvement Act’ which would require schools to create plans to combat bullying, specifically including LGBTQ students;
  • fully funding Title IV (school climate improvement grants) of ‘Every Student Succeeds Act’; and
  • ensuring that federal surveys and surveillance systems  collect sexual orientation and gender identity data.

Further, we were alarmed to learn that the Trevor Project has seen a dramatic increase in the number of transgender youth calling their suicide prevention crisis hotline following the announcement of President Trump’s military ban for transgender service members. This provided a sobering reminder of how our government’s words and decisions affect those most vulnerable in our society.

Our meetings with these groups affirmed two clear messages:

(1) LGBTQ students need critical legal protections, and

(2) we need data to tell us how we can help.

We lobbied staff from the National Governors Association and the offices of Rep. Rob Bishop (R-UT), Rep. Katherine Clark (D-MA), Sen. Orin Hatch (R-UT), and Sen. John McCain (R-AZ) on these important legal protections and data collection. Among the issues raised by the advocacy groups we met with the day before, we talked about:

  • the high rates of LGBTQ suicide attempts and homelessness, as well as
  • the lack of Title IX protections that could reduce bullying and victimization of transgender students
  • the need for greater legal protections and data collection to end these health disparities.

Each of us explained why these issues are important to us personally, how they impact our work as psychologists, and how they affect the Members’ constituents. Unsurprisingly, some offices did not agree on how to address the concerns. But others were eager to listen, and shared concerns about the high rates of suicide attempts among LGBTQ youth and other health disparities. All of the offices agreed that there should be ongoing Congressional oversight of the Department of Education to continue to protect students, and asked us to follow up and continue the conversation.

The experience reminded us that advocacy isn’t a one-time deal, and it’s not just happening in Washington. Advocacy can happen through a phone call or an email to our Members of Congress. Hence, we will follow up with the various offices we contacted to remind them about the critical protections that LGBTQ youth need.

We encourage you to get involved, too. Join the APA Federal Action Network or get involved at the local or community level. Psychologists have a lot to contribute to advocacy, and it’s vital to make your voice heard.

 

Biographies:

Joshua R. Wolff, PhD, is an Assistant Professor in the Department of Psychology at Adler University in Chicago, IL. Further, he was a contributor to the U.S. government’s (SAMHSA/HHS) report, “Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth”. His current research is directed at developing evidence-based public health strategies to reduce suicide rates and health risk behaviors for SGM people in non-affirming religious environments by building partnerships with clergy and faith leaders.

Theresa Stueland Kay, PhD, trained at Biola University, a faith-based institution, and is a licensed psychologist in Utah.  She is also an Associate Professor of Psychology at Weber State University.  Dr. Kay also serves as Board Chair at OUTreach Utah, a nonprofit organization that serves and supports LGBTQ youth.

H. L. “Lou” Himes, PsyD, is a licensed clinical psychologist and president at QuIPP, the Queer Identities Psychology Partnership—a group psychotherapy practice in Manhattan, NY that focuses on providing psychotherapy and transition-related support for trans/queer individuals.  Dr. Himes uses they/them/theirs pronouns.


Filed under: Children and Youth, Health Disparities, Human Rights and Social Justice, LGBT Issues, Public Policy Tagged: advocacy, Capitol Hill, data collection, Every Student Succeeds Act, gender identity, health disparities, LGBT, LGBT health, LGBT rights, LGBT students, LGBT youth, Safe Schools Improvement Act, sexual orientation, student health, suicide prevention, surveillance, Title IV, Title IX, transgender, transgender youth

“All Politics is Local”: 5 Simple Tips for Becoming a Better Advocate

science march 1

By Amalia Corby (Senior Legislative & Federal Affairs Officer, APA Public Interest Government Relations Office)

 

Interest in our political process has dramatically increased across the U.S. since the last election. People want accountability from their elected representatives and are ready to engage on complex issues such as health care coverage, immigration, and tax reform. The demand for grassroots advocacy training has grown along with this increased engagement. Allow me to share a little secret that may eventually put lobbyists such as myself out of a job—being an advocate is easy. You likely already have all the tools you need!

 

Here are some tips to help you get started.

 

Tip 1: Show up!

Take advantage of opportunities to meet your Senator or Representative, visit their in-district offices, or to attend town halls. If you can’t meet face-to-face with your Member of Congress (MOC), spend time with one of their staff members. Congressional staff are young, sharp, and motivated to serve their constituents. They are the eyes and ears of the office and if they care about your issue, chances are they will talk to their boss about it.

 

Tip 2: Share a story.

If you’re able to secure a meeting, remember that Members of Congress love a good story. A personal connection to an issue, either in your personal or professional life, can make a huge difference. As a psychologist, you may have both a personal and professional connection to the issue—this is an amazing advantage—in sharing your story, you may also have the opportunity to talk about the underlying research or clinical implications tied to your concerns.

Before you talk to congressional staff, think not only about what you want to communicate, but why. What is your underlying motivation? Share it.

 

Tip 3: Know your issue.

Do you know the underlying legislation or funding mechanism tied to your concerns? News and the internet will give you some information, but this is also where your professional association, advocacy organizations, or fellow activists can help.

While at times there is a fair amount of crystal ball-gazing in Washington, the legislative calendar is somewhat predictable–for example, appropriations (funding) activity always ramps up in spring. Government relations offices will know what’s happening, bound to happen, might happen, or definitely will not happen.

 

Tip 4: Talk about it (respectfully).

Respectful political discourse has become increasingly difficult, and while social media can be a great way to communicate, it can create problems as well. Before you post, take time to think about your audience. What will your message contribute? Will it change anyone’s mind, or lead to further entrenchment? Is this conversation best had in-person?

Likewise, when you call your congressional office, be nice to the tired soul on the end of the line who has to field constituent calls all day. They will listen to your concerns, and take note for the MOC.

 

Tip 5: Act locally.

There are many opportunities to be a catalyst for change closer to home. Even in Washington, D.C., arguably the most political city in the U.S., city council seats go unchallenged for years.

State level legislation is another opportunity. Grassroots movements often begin in the states and eventually get attention on the national level. Hot button issues that are stagnant at the national level can move quickly in the states. In recent years, state legislation on firearms, abortion, and campus sexual assault reporting has changed the national discourse on these issues.

 

For more information on advocating for psychology, please check out APA’s Guide to Advocacy. While you’re there, please join APA’s Federal Action Network (FAN), an e-mail grassroots network to help interested psychologists advocate for their discipline. APA Government Relations Offices disseminate information and action alerts to FAN members focusing on recent or upcoming federal legislative or regulatory action of concern to psychology.

 

Additional Resources:

Our Science Directorate colleagues recently produced this advocacy training video.

Watch below:

 

For a list of useful advocacy tools, check out the APA March for Science page.


Filed under: Public Policy Tagged: advocacy, advocacy training, Congress, grassroots advocacy, policy, policy change, politics, public policy

“We Are One Tribe”: Fighting Forward Toward an AIDS-Free Generation

Group of Multiethnic Diverse World People

By Tiffany Grimes (Public Interest Policy Scholar, APA)

As we transition into a new Congress and presidential administration, it seems timely to reflect on the work achieved by the Office of National AIDS Policy and their achievements under the Obama Administration.   In December, I had the opportunity to attend “Moving Forward with HIV in America: Drawing Strength from Our Past and Empowering Today’s Leaders”, the Office of National AIDS Policy’s final public event during the Obama Administration to help mark World AIDS Day 2016. While I had always dreamed of visiting the inside of the White House, I envisioned my first trip to include visiting the West Wing and meeting President Barack Obama and First Lady Michelle Obama.  Yet, I had never imagined visiting the Eisenhower Executive Office Building. It was truly an honor to represent APA as a Public Interest Policy Scholar and share space in the South Court Auditorium with so many advocates and impactful leaders working to eradicate HIV/AIDS.

blog-aids-free-generation2

Wise and young leaders who all shared a common goal of working towards an AIDS-Free generation filled the room.  Dr. Amy Lansky, the Director of the Office of National AIDS Policy for The White House, who also reviewed the National HIV/AIDS strategy, welcomed us: 2016 progress report. George Fistonich, Policy Advisor for the Office of National AIDS Policy, walked us through the past eight years under the Obama Administration to reflect on the advancements that the administration has made in combating HIV/AIDS. There were very few dry eyes in the room, as we recalled the commitment and dedication of President Obama and those under his leadership to people living with HIV and HIV prevention.

The facilitators then held a panel and group discussion titled “Acting Together, Fighting AIDS”.  The panel was stacked with key figures in HIV/AIDS advocacy, including Dázon Dixon Diallo from SisterLove in Atlanta, GA.  The intersectionality was apparent across the room: so many identities occupying a safe space within the White House.  Individuals feeling comfortable to just be themselves and express their concerns, anxieties, challenges, accomplishments, joys, and hopes for the future. There is no way to deny that this was a very special occasion and a very special moment in time.

The conversation was spurred using clips from David France’s 2012 American documentary film about the early years of the AIDS epidemic, How to Survive a Plague.

As we watched scenes from the efforts of ACT UP and TAG, once again, tears started to fall around the room. One attendee described the presence in the room as a “funeral”, as many in the room expressed their anxieties and fears regarding what is to come for HIV/AIDS advocacy and care, in addition to concerns regarding the stability of recent advancements in LGBTQ, women’s, ethnic minority, and disability rights and equality.  The audience member reminded us that there is much to celebrate, because we have come so far. It is time for us to rise to the occasion, as the fight and work is not yet over.

The panelists shared their experiences working in HIV advocacy and emphasized the sentiment that it is necessary for us to work together across identities and join forces. They elaborated that supporting each other is more important now than ever and that HIV advocacy goes behind just working towards an HIV-free generation, but also towards equity for all people, regardless of gender, sexual orientation, ethnicity, citizenship, or ability status.  Many reminded us that there have been many challenges in the past, which we have managed to overcome, which is what we will continue to do.  Our current priority should be combatting stigma and discrimination against people living with HIV and increased efforts to reach those most affected (youth, MSM, women and transgender women of color) in the places most affected (the South).  Ms. Diallo highlighted that the face of the epidemic and the geography have changed, thus we must adapt our ways of engagement in activism accordingly.

Panelists and participants highlighted the need to address the shame surrounding HIV in communities of color, which can negatively influence HIV testing and treatment adherence.  Ms. Diallo expressed the idea that shame “does not mobilize, it immobilizes” and at the core we are all working to not be “othered” or to be treated differently. Dr. Rich Wolitski, Director of the Office of HIV/AIDS and Infectious Disease Policy for the U.S. Department of Health and Human Services, psychologist, and APA member gave inspiring closing remarks to end the panel discussion. Throughout the event, there were so many insightful thoughts and impactful experiences shared, but these words of Ms. Diallo followed me home:

“We are a tribe and this movement has brought us together.”

The HIV movement has brought us together because of our intersecting identities.  Therefore, may we come together as one as we continue to “fight-forward” towards health equity and an AIDS-Free generation.

What can you do to advance the fight towards an AIDS-Free generation?

Biography:

blog-aids-free-generation-grimes

Tiffany Grimes is a Public Interest Policy Scholar at the American Psychological Association and a fourth year PhD Candidate at The University of Georgia.  Her clinical and research interests are primarily focused in health disparities, specifically among people living with HIV/AIDS, LGBTQ individuals, ethnic minorities, and other marginalized populations.


Filed under: AIDS, Public Policy Tagged: National AIDS policy, world AIDS day

For Richer or Poorer: What Works to Reduce Poverty in America?

LDW_9517.JPG

By Annie Davis (Public Interest Policy Scholar, APA)

How can we improve the economic wellbeing of American families? This was one of the issues that dominated the 2016 election cycle, with each candidate proposing a different way forward. Across party lines, we can all agree that poverty is harmful for our society. Research from psychology links poverty to negative physical and mental health outcomes – particularly for vulnerable groups like children and older adults.[1]

So what do we know about programs that effectively alleviate poverty? Most of our poverty data comes from the U.S. census, but this excludes many benefits shown to boost economic mobility.[2]

The Supplemental Poverty Measure (SPM),[3] on the other hand, sheds more light.

The SPM provides a comprehensive picture of poverty in the U.S. by measuring household income, factoring in cash and non-cash benefits, and subtracting necessary expenses. This measure can be used to calculate the impact of individual safety net programs.

  • The Earned Income Tax Credit enables low- and moderate-income working individuals (primarily parents) to offset the impact of paying taxes, incentivize workforce participation, and provide income for necessary expenses. It raised 9.2 million people above the poverty line in 2015.
  • Supplemental Nutrition Assistance Program (SNAP) is monthly nutrition assistance for eligible low-income households to buy the food they need to be healthy. It raised 4.6 million people above the poverty line in 2015.
  • The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides support for low-income, nutritionally at-risk pregnant and postpartum women and young children (up to age 5), including food assistance, nutrition information, and referrals to medical and social services. It raised over 370,000 people above the poverty line in 2015.[4]

The huge impact of these programs adds to the massive reach of Social Security (26.6 million people raised above the poverty line).[5] These findings about the societal benefits of the safety net are consistent with data showing a 40% reduction in poverty since the beginning of the War on Poverty (and the creation of federal safety-net programs) in 1967.[6] The SPM unequivocally shows federal safety net programs work to protect low-income people from the harms of poverty, particularly those in marginalized groups.

The value of these programs is clear, not only in alleviating poverty but also in preventing the downstream effects of poverty on physical and mental health. However, these kinds of programs are constantly under threat in the current political climate. If they were to be further cut, as has been proposed, this would plunge more Americans into poverty, and the physical and psychological harms that ensue.

These include negative impacts on:

  • mental health,
  • family functioning,
  • cognitive functioning,
  • trauma/chronic stress, and
  • academic and professional success.[7]

APA will continue to advocate for programs that alleviate the burden of poverty. For example, APA has supported SNAP, the Earned Income Tax Credit, and the Child Tax Credit, programs that lessen families’ financial strain and food insecurity, thereby reducing toxic stress and improving mental health.

Moreover, APA has recently supported legislation like the Family and Medical Insurance Leave Act (S. 786/H.R. 1439), which would guarantee paid leave following the birth of a child or during a serious health condition, with positive impacts on child development, maternal mental health, and family relations.

Help APA stand up for vulnerable Americans! Sign up for our Federal Action Network to contact your representatives about these issues.

References:

[1] Evans, G.W. (2004). The environment of childhood poverty. American Psychologist, 59, 77–92. doi: 10.1037/0003-066x.59.2.77

[2] Bitler. M., & Hoynes, H. (2013). The more things change, the more they stay the same? The safety net and poverty in the Great Recession (NBER Working Paper No. 19449). Cambridge, MA: National Bureau of Economic Research. Retrieved from http://www.nber.org/papers/w19449

[3] Renwick, T., & Fox, L. (2016). The Supplemental Poverty Measure: 2015 [U.S. Census Bureau, P60-258(RV)]. Washington, DC: U.S. Government Printing Office.

[4] Renwick & Fox, 2016

[5] Renwick & Fox, 2016

[6] Wimer, C., Fox, L., Garfinkel, I., Kaushal., N., & Waldfogel, J. (2013). Trends in poverty with an anchored Supplemental Poverty Measure (Working paper 13-01). New York, NY: Columbia Population Research Center (CPRC). Retrieved from https://www.gc.cuny.edu/CUNY_GC/media/LISCenter/Readings%20for%20workshop/Madrick2.pdf

[7] Evans, G.W. (2004). The environment of childhood poverty. American Psychologist, 59, 77–92. doi: 10.1037/0003-066x.59.2.77

Flouri, E., Midouhas, E., & Joshi, H. (2014). Family poverty and trajectories of children’s emotional and behavioural problems: The moderating roles of self-regulation and verbal cognitive ability. Journal of Abnormal Child Psychology42(6), 1043-1056.

Hudson, C.G. (2005). Socioeconomic status and mental illness: Tests of the social causation and selection hypotheses. American Journal of Orthopsychiatry75(1), 3.

Manseau, M. (2014). Economic inequality and poverty as social determinants of mental health. Psychiatric Annals, 44(1), 32-38. doi:http://dx.doi.org/10.3928/00485713-20140108-06

Santiago, C.D., Wadsworth, M.E., & Stump, J. (2011). Socioeconomic status, neighborhood disadvantage, and poverty-related stress: Prospective effects on psychological syndromes among diverse low-income families. Journal of Economic Psychology32(2), 218-230.

Shonkoff, J.P. (2010). Building a new biodevelopmental framework to guide the future of early childhood policy. Child Development81(1), 357-367.

Yoshikawa, H., Aber, J.L., & Beardslee, W.R. (2012). The effects of poverty on the mental, emotional, and behavioral health of children and youth: Implications for prevention. American Psychologist67(4), 272-284.

Biography:

Annie Davis is a Public Interest Policy Scholar at the American Psychological Association and a fourth year Ph.D. student in Clinical Psychology at The Catholic University of America. Her clinical and research interests center on mental health interventions for young children living in poverty.

 


Filed under: Poverty and Socioeconomic Status, Public Policy Tagged: Child Tax Credit, Earned Income Tax Credit, paid family and medical leave, poverty, poverty reduction, public policy, safety net programs, SNAP, social safety net, Supplemental Nutrition Assistance Program, war on poverty

Historical Trauma in the Present: Why APA Cannot Remain Silent on the Dakota Access Pipeline

blog-standing-rock

By Susan H. McDaniel, PhD (2016 APA President)

Protesters being marked with numbers, put in dog kennels and shot with rubber bullets. These do not sound like events that should occur in modern day America. Unfortunately, according to media reports, these are some of the first-hand accounts of what is happening in North Dakota as protests escalate over the Dakota Access Pipeline.

For those unfamiliar with the dispute between environmental and human rights protesters on behalf of the Standing Rock Sioux Reservation and law enforcement, I would invite to you read the New York Times detailed summary of events. In short, there is a growing perception of injustice as a 1,172-mile oil pipeline that is slated to run from North Dakota to Illinois was rerouted near the Standing Rock Sioux Reservation due its potential threat of contamination to Bismarck, North Dakota’s water supply.

Native Americans have been historically marginalized and mistreated by the United States. For instance, not all States recognized Native Americans’ right to vote until 1957 and many tribes experienced great loss of life, land and culture as the result of State and Federal legislation.

According to the psychological literature, chronic, systemic loss and mistreatment, as described above, may lead to historical trauma in which the pain experienced by one generation transfers to subsequent generations through biological, psychological, environmental, and social means. Studies show that historical trauma is linked to health disparities, including increased likelihood of early death due to chronic liver disease and cirrhosis, unintentional injuries, assault/homicide, and suicide.

APA’s mission is to advance the creation, communication and application of psychological knowledge to benefit society and improve people’s lives.” This mission makes it incumbent upon our field and our association to speak out when the health and well-being of marginalized and other populations are being threatened and when possible to prevent trauma from occurring.

Due to the current proposed placement of the Dakota Access pipeline, we are concerned about possible leakage, which could harm the people of the Standing Rock Sioux Reservation. As psychologists, we are troubled by the potential for adverse neurological effects arising from exposure to oil-contaminated water.

In response to current events, I sent a letter on behalf of APA to President Obama with Dr. Jacqueline Gray, President of the Society for the Psychological Study of Culture, Ethnicity and Race (APA Division 45) that expressed:

  • Our support for the Administration’s hold on the construction of the oil pipeline near the Standing Rock Reservation, and praise for his consideration of alternate routes for the project; and
  • A request to urge law enforcement to show restraint as they try to diffuse the conflict.

It is critical that APA and the mental health community continue to show our support and bring attention to the issues impacting Native American communities and to help alleviate historical trauma.

In closing, I recommend you sign up for APA’s Federal Action Network to influence policy makers and make sure your voice is heard on critical issues in the future.

Dr. McDaniel is president of the American Psychological Association.

 

Image source: Flickr via Creative Commons.


Filed under: Culture, Ethnicity and Race, Health Disparities, Human Rights and Social Justice Tagged: #DAPL, #noDAPL, American Indians, Dakota Access Pipeline, environmental racism, health disparities, historical trauma, human rights, human rights abuses, law enforcement, Native Americans, police brutality, public health, public policy, racism, trauma, violence, water is life

Health and Healthcare Injustice: Why We Really Should Care About HIV Disparities

red aids ribbon in hand.

By Alyssa Arentoft, PhD (California State University, Northridge) & Monica Rivera Mindt, PhD (Fordham University & Icahn School of Medicine at Mount Sinai)

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr.

Perhaps nowhere are health and healthcare inequities so glaring as in HIV.

In the early years of the HIV epidemic, when we knew little about the virus and no viable treatment existed, HIV was viewed as a death sentence. During the 1990s and early 2000s, advances in medical and pharmacological treatment transformed HIV into a chronic, long-term condition. Concerns have now shifted from simply surviving HIV to living and hopefully thriving with the virus.

Much has changed since HIV first gripped the nation. Sadly, one thing remains constant—HIV continues to take its largest toll on our society’s most vulnerable, resulting in pervasive health and healthcare disparities.

So, what are health and healthcare disparities?

A health disparity exists when a particular group of people is more significantly affected by a condition than the general public.

“Affected” can mean:

  • Having higher rates of the condition, or
  • Having worse outcomes as a result of the condition, such as higher rates of medical complications, disability, or death.

A healthcare disparity refers to differences at the service level, such as access to healthcare coverage and medical treatment, as well as the quality of those services.

What health and healthcare disparities exist in HIV?

Prominent health disparities exist among:

  • African Americans
  • Hispanics/Latinos
  • Men who have sex with men (MSM)
  • Transgender people
  • People from low-income backgrounds

HIV+ individuals from these groups experience the following health and healthcare disparities:

  • Higher rates of HIV infection. For example, African Americans comprise 12% of the U.S. population, yet 41% of the HIV+ population. Latinos comprise 16% of the U.S. population, yet 21% of the HIV+ population.
  • Delayed HIV diagnosis
  • Less access to medical treatment for HIV
  • Lower quality healthcare
  • Lower likelihood of being prescribed HIV medication
  • Higher rates of death and disability
  • Worse cognitive or neurological outcomes

Why is this important?

By nature, health and healthcare disparities reflect injustices in our society, and those injustices can and should be remedied. As wage gaps widen and our population becomes increasingly diverse, these inequities will affect even more citizens.

From a social justice perspective, we must right these wrongs and protect the most vulnerable. From a health and economic perspective, the cost of not doing so is too great—if injustice is not ended, we all pay the price.

What do we need to do?

HIV has long been shrouded in stigma and HIV+ individuals often face discrimination. Therefore, we need to continue to:

  • Make efforts to de-stigmatize HIV and its treatment
  • Examine the complex relationship between these inequities and social, economic, environmental, cultural, and structural factors
  • Protect those at greater risk of contracting HIV
  • Identify and remove barriers to quality healthcare for those who become HIV+

We have a long way to go to eliminate these inequities in HIV, but we are making progress in reducing them.

Find out more about key initiatives such as the National HIV/AIDS Prevention Strategy (NHAS) and CDC’s Enhanced Comprehensive HIV Prevention Planning project (ECHPP).

Act Against AIDS is a CDC-sponsored website that lists different programs you can get involved in to help in the fight against AIDS.

To find out what APA is doing about HIV, visit the Office on AIDS webpage.

Humanity’s greatest advances are not in its discoveries, but in how those discoveries are applied to reduce inequity” – Bill Gates

 

Biographies:

Alyssa Arentoft, PhD, is an Assistant Professor of Psychology at California State University, Northridge. Her research explores brain-behavior relationships in disease states using a biopsychosociocultural framework. She is particularly interested in health disparities and health-related outcomes among underrepresented and disenfranchised populations. Her current work is focused on individuals with HIV/AIDS. Ongoing projects in this area include an NIMH-funded study examining longitudinal changes in the brain among HIV+ individuals as a function of HIV antiretroviral medication. Differences in healthcare quality between non-Hispanic white and African American participants, as well as factors associated with these differences, are also being examined.

Monica Rivera Mindt, PhD, is a Professor and Director of Clinical Training in the Department of Psychology at Fordham University. She also serves as Professor in the Departments of Neurology and Psychiatry at the Icahn School of Medicine at Mount Sinai. She is a board certified clinical neuropsychologist. Her interests are in a variety of neurological disorders, particularly neurodegenerative disorders such as HIV/AIDS. Over the past few years, she has conducted numerous neuropsychological evaluations within her private practice with a variety of populations, including traumatic brain injury, dementia, Spanish-speakers, and others. Her primary projects at this time include a study of the neurocognitive and sociocultural aspects of antiretroviral adherence among HIV+ Latino/a adults, as well as a study examining the neurocognitive effects of opiate replacement therapies among HIV+ and HIV- opiate users. Dr. Rivera Mindt also serves as a co-investigator on a multi-site study of the CNS effects of HIV in the era of combined antiretroviral therapy. She is also investigating the sociocultural aspects of neurocognitive test performance.


Filed under: AIDS, Health Disparities, Human Rights and Social Justice Tagged: aids, health care, health disparities, health equity, HIV, poverty, public policy, social justice

Health and Healthcare Injustice: Why We Really Should Care About HIV Disparities

red aids ribbon in hand.

By Alyssa Arentoft, PhD (California State University, Northridge) & Monica Rivera Mindt, PhD (Fordham University & Icahn School of Medicine at Mount Sinai)

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr.

Perhaps nowhere are health and healthcare inequities so glaring as in HIV.

In the early years of the HIV epidemic, when we knew little about the virus and no viable treatment existed, HIV was viewed as a death sentence. During the 1990s and early 2000s, advances in medical and pharmacological treatment transformed HIV into a chronic, long-term condition. Concerns have now shifted from simply surviving HIV to living and hopefully thriving with the virus.

Much has changed since HIV first gripped the nation. Sadly, one thing remains constant—HIV continues to take its largest toll on our society’s most vulnerable, resulting in pervasive health and healthcare disparities.

So, what are health and healthcare disparities?

A health disparity exists when a particular group of people is more significantly affected by a condition than the general public.

“Affected” can mean:

  • Having higher rates of the condition, or
  • Having worse outcomes as a result of the condition, such as higher rates of medical complications, disability, or death.

A healthcare disparity refers to differences at the service level, such as access to healthcare coverage and medical treatment, as well as the quality of those services.

What health and healthcare disparities exist in HIV?

Prominent health disparities exist among:

  • African Americans
  • Hispanics/Latinos
  • Men who have sex with men (MSM)
  • Transgender people
  • People from low-income backgrounds

HIV+ individuals from these groups experience the following health and healthcare disparities:

  • Higher rates of HIV infection. For example, African Americans comprise 12% of the U.S. population, yet 41% of the HIV+ population. Latinos comprise 16% of the U.S. population, yet 21% of the HIV+ population.
  • Delayed HIV diagnosis
  • Less access to medical treatment for HIV
  • Lower quality healthcare
  • Lower likelihood of being prescribed HIV medication
  • Higher rates of death and disability
  • Worse cognitive or neurological outcomes

Why is this important?

By nature, health and healthcare disparities reflect injustices in our society, and those injustices can and should be remedied. As wage gaps widen and our population becomes increasingly diverse, these inequities will affect even more citizens.

From a social justice perspective, we must right these wrongs and protect the most vulnerable. From a health and economic perspective, the cost of not doing so is too great—if injustice is not ended, we all pay the price.

What do we need to do?

HIV has long been shrouded in stigma and HIV+ individuals often face discrimination. Therefore, we need to continue to:

  • Make efforts to de-stigmatize HIV and its treatment
  • Examine the complex relationship between these inequities and social, economic, environmental, cultural, and structural factors
  • Protect those at greater risk of contracting HIV
  • Identify and remove barriers to quality healthcare for those who become HIV+

We have a long way to go to eliminate these inequities in HIV, but we are making progress in reducing them.

Find out more about key initiatives such as the National HIV/AIDS Prevention Strategy (NHAS) and CDC’s Enhanced Comprehensive HIV Prevention Planning project (ECHPP).

Act Against AIDS is a CDC-sponsored website that lists different programs you can get involved in to help in the fight against AIDS.

To find out what APA is doing about HIV, visit the Office on AIDS webpage.

Humanity’s greatest advances are not in its discoveries, but in how those discoveries are applied to reduce inequity” – Bill Gates

 

Biographies:

Alyssa Arentoft, PhD, is an Assistant Professor of Psychology at California State University, Northridge. Her research explores brain-behavior relationships in disease states using a biopsychosociocultural framework. She is particularly interested in health disparities and health-related outcomes among underrepresented and disenfranchised populations. Her current work is focused on individuals with HIV/AIDS. Ongoing projects in this area include an NIMH-funded study examining longitudinal changes in the brain among HIV+ individuals as a function of HIV antiretroviral medication. Differences in healthcare quality between non-Hispanic white and African American participants, as well as factors associated with these differences, are also being examined.

Monica Rivera Mindt, PhD, is a Professor and Director of Clinical Training in the Department of Psychology at Fordham University. She also serves as Professor in the Departments of Neurology and Psychiatry at the Icahn School of Medicine at Mount Sinai. She is a board certified clinical neuropsychologist. Her interests are in a variety of neurological disorders, particularly neurodegenerative disorders such as HIV/AIDS. Over the past few years, she has conducted numerous neuropsychological evaluations within her private practice with a variety of populations, including traumatic brain injury, dementia, Spanish-speakers, and others. Her primary projects at this time include a study of the neurocognitive and sociocultural aspects of antiretroviral adherence among HIV+ Latino/a adults, as well as a study examining the neurocognitive effects of opiate replacement therapies among HIV+ and HIV- opiate users. Dr. Rivera Mindt also serves as a co-investigator on a multi-site study of the CNS effects of HIV in the era of combined antiretroviral therapy. She is also investigating the sociocultural aspects of neurocognitive test performance.


Filed under: AIDS, Health Disparities, Human Rights and Social Justice Tagged: aids, health care, health disparities, health equity, HIV, poverty, public policy, social justice

Food Stamp Cuts May Put 1 Million More Americans At Risk of Hunger: What We Can Do About It

hungersnapcuts

By Sara Buckingham, MA (Public Interest Policy Scholar, APA Public Interest Government Relations Office)

 

How do you decide between heating your apartment, purchasing lifesaving medication, and eating?

As of April 1, up to 1 million more Americans will face that decision.

 

Who is affected by hunger?

Nearly 50 million Americans – including one of every five children – are at risk of going hungry (Coleman-Jensen, Rabbitt, Gregory, & Singha, 2015). Our largest and most effective solution to hunger is the Supplemental Nutrition Assistance Program (SNAP, or ‘food stamps’). SNAP provides food assistance to people below a certain income level, helping to prevent hunger. This assistance also frees up their income for other necessities, such as housing, utilities, and health care.

 

Why are so many people now losing SNAP benefits?

Under the current law, adults who are ‘fit for work’ and not caring for a child can only access SNAP for 3 months in a 36-month period, unless they are:

 

  1. working or in a training program at least half-time or
  2. in a state with a particularly high unemployment rate.

 

Prior to 2016, most U.S. states qualified for this unemployment exemption, but now, due to lower unemployment rates, only 10 states qualify, and 3 of them are doing away with the exemption voluntarily. However, lower state unemployment rates do not represent everyone’s day-to-day experiences. Chronically unemployed people have given up looking for work, skewing employment data, and local unemployment rates vary widely within states.

 

States with Newly Reimposed SNAP Time Limits in 2016

snapmap

 

 

a 19 states are required to reimpose the time limit: Alabama, Alaska, Arkansas, Arizona, Connecticut, Florida, Georgia, Idaho, Kentucky, Maryland, Massachusetts, Missouri, New Jersey, New York, North Carolina, Oregon, Pennsylvania, Tennessee, and Washington.

b Three states are voluntarily reimposing the time limit: Mississippi, South Carolina, and West Virginia.

c 7 states and the District of Columbia currently qualify for an exemption to the time limit: California, Illinois, Louisiana, Michigan, Nevada, New Mexico, and Rhode Island.

d All other states imposed the time limit prior to 2016, either due to no longer qualifying or voluntarily doing away with the exemption.

 

Why is hunger a health problem?

 

Hunger is a debilitating condition and plenty of research demonstrates its harms:

 

  • Physical – hunger is associated with higher infant mortality rates, vulnerability to illnesses and infections, and impaired physical development. It is also associated with chronic diseases, including hypertension, abnormally elevated levels of lipids in the blood, and cardiovascular health issues (Seligman, Laraia, & Kushel, 2009).
  • Cognitive – hunger alters mental functioning and can even stunt intellectual capacity (Gundersen, Kreider, & Pepper, 2011).
  • Emotional – hunger impacts psychological well-being. One study even shows that families’ lack of sufficient food, irrespective of their income, is associated with persistent depressive disorder and suicidality in adolescents (Alaimo, Olson, & Frongillo, 2002).
  • Socioeconomics – hunger has wide-reaching effects. For example, children who are hungry perform worse in schools, and people of all ages perform worse on tests, with negative implications for future economic success (Gundersen, Kreider, & Pepper 2011). As with any scarce resource, people who are hungry spend their mental energy on their hunger, which can narrow their focus and lead them to neglect other areas of their home or work lives (Shah, Mullainathan, & Shafir, 2012).

 

What can Congress do to address this problem?  

  1. Revise the rule so that unemployed individuals diligently searching for jobs qualify for SNAP benefits
  2. Expand the time-limit on benefits to better reflect the typical unemployment period. Over the past year, the average length of unemployment has ranged from 7 to 8 months (U.S. Department of Labor, 2016). In 2002 and 2008, bills were introduced in the Senate to do this (S. 1731, S. 2302).

There are a number of solutions to this crisis, but our government must act quickly to return SNAP benefits to up to one million people who will lose them this year. You can help! Join APA’s Federal Action Network to participate in our public policy advocacy efforts.

 

 

 

References:

 

Alaimo, K., Olson, C. M., & Frongillo, E. A. (2002). Family food insufficiency, but not low family income, is positively associated with dysthymia and suicide symptoms in adolescents. The Journal of Nutrition, 132, 719-725.

 

Coleman-Jensen, A., Rabbitt, M. P., Gregory, C., & Singha, A. (2015). Household food security in the United States in 2014 (Report Number 194). United States Department of Agriculture. Retrieved from: http://www.ers.usda.gov/media/1896841/err194.pdf.

 

Gundersen, C., Kreider, B., & Pepper, J. (2011). The economics of food insecurity in the United States. Applied Economic Perspectives and Policy, 33, 281-303.

 

Seligman, H. K., Laraia, B. A., & Kushel, M. B. (2010). Food insecurity is associated with chronic disease among low-income NHANES participants. The Journal of Nutrition, 140, 304-310. doi:10.3945/jn.109.112573

 

Shah, A. K., Mullainathan, S., & Shafir, E. (2012). Some consequences of having too little. Science, 338, 682-685. doi:10.1126/science.1222426

 

U.S. Department of Labor. (2016). Unemployed persons by duration of unemployment. Bureau of Labor Statistics. Retrieved from: http://www.bls.gov/news.release/empsit.t12.htm.


Filed under: Health and Wellness, Poverty and Socioeconomic Status, Public Policy Tagged: food assistance, food stamps, hunger, public health, public policy, SNAP cuts

No Progress, No Change: HIV Funding Stagnant for Third Year in a Row

HIV-Funding

By Sarah J. Javier, MS (PhD Candidate in Health Psychology at Virginia Commonwealth University)

On February 9, President Obama released his proposed budget for FY 2017. The $4 trillion budget included several provisions for research on clean energy, education, and Medicaid. However, for advocates of HIV/AIDS research, one thing was startlingly clear: HIV/AIDS is fast becoming an insignificant issue in Congress.

There are over 1.1 million people in the United States currently living with HIV and over 18% of those individuals have no idea they are infected. The devastation of the disease has resulted in over half a million deaths in the United States alone, and there are 50,000 people newly diagnosed with HIV every year.

In 2015, the Obama Administration updated the National HIV/AIDS Strategy (NHAS).  The updated Strategy restated the original NHAS vision in which the “United States will become a place where new HIV infections are rare, and when they do occur, every person … will have unfettered access to high quality, life-extending care, free from stigma and discrimination.” The updated NHAS makes clear that we still need sustained investments in HIV prevention and treatment.

However, this Administration has not backed up the strategy with needed resources. While the Federal government has provided vital funding to the National Institutes of Health (NIH) to research infectious diseases, the level allocated to HIV/AIDS research has remained flat for the past three budget periods. In addition, funding for Behavioral and Social Science Research (BSSR) has slightly decreased in the new budget proposal, indicating that this is also an area in which an increase in funding dollars is not of great interest.

Why invest in HIV/AIDS?

Government officials may ask why HIV/AIDS should remain a priority for Federal investment as opposed to other infectious diseases or autoimmune disorders. The answer to this conundrum lies in fiscal numbers. The cost of treating HIV multiplied by 50,000 new infections per year (an amount that has also remained stagnant over the past few years) equals a collective lifetime treatment cost of approximately $9.5 billion per year. Meanwhile, investing in evidence-based treatments and prevention programs could save nearly 5X that amount, i.e. $40.5 billion in lifetime healthcare costs by 2020 if we prevent 240,000 new infections. Forty billion dollars could make a huge difference to other national high-priority areas of investment, such as education and clean energy.

The importance of HIV/AIDS research.

Federally-funded research on HIV/AIDS has saved millions of lives globally. Had it not been for NIH-funded grants incentivizing HIV and AIDS research, we would not know the benefits of early initiation, treatment, and testing in curtailing the spread of the virus. Furthermore, grants from both the CDC and NIH have allowed independent researchers to discover prevention tools such as pre-exposure prophylaxis (PrEP) in blocking the onset of the virus among high-risk populations such as injection drug-users. Despite incredible advances in HIV/AIDS research, our work is not yet done. Scientists are on the brink of developing even more effective prevention tools such as microbicides and vaccines to prevent HIV transmission. Now is not the time to risk stopping further scientific progress by cutting the availability of federal funds for HIV research.  The proposed amount allocated to HIV/AIDS research is severely inadequate and needs to be increased to accelerate progress in discovering prevention tools and ultimately a cure.

The need for behavioral and social science research

The lack of investment in HIV/AIDS research reflects a bigger issue of a growing disinterest in behavioral and social sciences research. BSSR was quite obviously absent from the HIV/AIDS research priorities set forth by NIH this past year. The progression of HIV and the development of AIDS are not isolated to physical and immunological symptoms. Often, the disease is accompanied by mental health and in some cases, substance abuse issues not yet understood by the current body of research. BSSR is vital to understanding these issues in persons living with HIV so that we can treat them on a holistic level and improve their overall quality of life.

What can you do to help?

  • Find your representative to see what they are doing to serve the needs of the research community in your area.
  • Learn more about the psychological effects of HIV/AIDS by visiting the APA Office on AIDS website.
  • Sign up for our Federal Action Network to receive updates on APA’s important public policy advocacy efforts in Congress on the issue of HIV/AIDS.

Image source: iStockPhoto.com


Filed under: AIDS, Public Policy Tagged: aids, AIDS federal funding, AIDS research, AIDS research funding, HIV/AIDS research, National HIV/AIDS Strategy, public policy

No Progress, No Change: HIV Funding Stagnant for Third Year in a Row

HIV-Funding

By Sarah J. Javier, MS (PhD Candidate in Health Psychology at Virginia Commonwealth University)

On February 9, President Obama released his proposed budget for FY 2017. The $4 trillion budget included several provisions for research on clean energy, education, and Medicaid. However, for advocates of HIV/AIDS research, one thing was startlingly clear: HIV/AIDS is fast becoming an insignificant issue in Congress.

There are over 1.1 million people in the United States currently living with HIV and over 18% of those individuals have no idea they are infected. The devastation of the disease has resulted in over half a million deaths in the United States alone, and there are 50,000 people newly diagnosed with HIV every year.

In 2015, the Obama Administration updated the National HIV/AIDS Strategy (NHAS).  The updated Strategy restated the original NHAS vision in which the “United States will become a place where new HIV infections are rare, and when they do occur, every person … will have unfettered access to high quality, life-extending care, free from stigma and discrimination.” The updated NHAS makes clear that we still need sustained investments in HIV prevention and treatment.

However, this Administration has not backed up the strategy with needed resources. While the Federal government has provided vital funding to the National Institutes of Health (NIH) to research infectious diseases, the level allocated to HIV/AIDS research has remained flat for the past three budget periods. In addition, funding for Behavioral and Social Science Research (BSSR) has slightly decreased in the new budget proposal, indicating that this is also an area in which an increase in funding dollars is not of great interest.

Why invest in HIV/AIDS?

Government officials may ask why HIV/AIDS should remain a priority for Federal investment as opposed to other infectious diseases or autoimmune disorders. The answer to this conundrum lies in fiscal numbers. The cost of treating HIV multiplied by 50,000 new infections per year (an amount that has also remained stagnant over the past few years) equals a collective lifetime treatment cost of approximately $9.5 billion per year. Meanwhile, investing in evidence-based treatments and prevention programs could save nearly 5X that amount, i.e. $40.5 billion in lifetime healthcare costs by 2020 if we prevent 240,000 new infections. Forty billion dollars could make a huge difference to other national high-priority areas of investment, such as education and clean energy.

The importance of HIV/AIDS research.

Federally-funded research on HIV/AIDS has saved millions of lives globally. Had it not been for NIH-funded grants incentivizing HIV and AIDS research, we would not know the benefits of early initiation, treatment, and testing in curtailing the spread of the virus. Furthermore, grants from both the CDC and NIH have allowed independent researchers to discover prevention tools such as pre-exposure prophylaxis (PrEP) in blocking the onset of the virus among high-risk populations such as injection drug-users. Despite incredible advances in HIV/AIDS research, our work is not yet done. Scientists are on the brink of developing even more effective prevention tools such as microbicides and vaccines to prevent HIV transmission. Now is not the time to risk stopping further scientific progress by cutting the availability of federal funds for HIV research.  The proposed amount allocated to HIV/AIDS research is severely inadequate and needs to be increased to accelerate progress in discovering prevention tools and ultimately a cure.

The need for behavioral and social science research

The lack of investment in HIV/AIDS research reflects a bigger issue of a growing disinterest in behavioral and social sciences research. BSSR was quite obviously absent from the HIV/AIDS research priorities set forth by NIH this past year. The progression of HIV and the development of AIDS are not isolated to physical and immunological symptoms. Often, the disease is accompanied by mental health and in some cases, substance abuse issues not yet understood by the current body of research. BSSR is vital to understanding these issues in persons living with HIV so that we can treat them on a holistic level and improve their overall quality of life.

What can you do to help?

  • Find your representative to see what they are doing to serve the needs of the research community in your area.
  • Learn more about the psychological effects of HIV/AIDS by visiting the APA Office on AIDS website.
  • Sign up for our Federal Action Network to receive updates on APA’s important public policy advocacy efforts in Congress on the issue of HIV/AIDS.

Image source: iStockPhoto.com


Filed under: AIDS, Public Policy Tagged: aids, AIDS federal funding, AIDS research, AIDS research funding, HIV/AIDS research, National HIV/AIDS Strategy, public policy