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    Gay Rights… What Should be the Social Work Response?

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    by Deona Hooper, MSW

    I want to share an article that was brought to my attention yesterday by a very close family member. This particular article was especially impactful for him because he recently shared with our family that he is gay. He is an awesome human being, well-educated, cares about his community, and he is doing everything a parent would want for their child. Why should him being gay matter? Well, for some in our family….it does! It was not accepted very well by his parents. Despite, everyone seeing gay mannerisms in him as far back as when he was three to four years old.

    Although he may never be allowed to bring his partner to family events, I make sure that he knows they are always welcome at my home. I do not want him to be isolated from his support system or dread coming home, but I must admit that I have not always been this progressive. I grew up with conservative christian values in the South, and the South its difficult enough being a minority.

    However, the pain that I have experienced and witnessed caused a change in my views. I had a best friend who was  a woman, a minority, and openly gay. For the majority of my adulthood, we worked at the same places. Most of my adult life, we were friends, but her being gay was the elephant in the room. I tried to be supportive, but she would always say,”You don’t understand”. She had a very limited support system, rejected by her church, and at times harassed at work. Yet, she always got through it.

    In 2007 on December 27, she committed suicide with her police service weapon. She always struggled with depression, and I didn’t understand this internal conflict  for a lifestyle she lived openly. She was very apprehensive about seeking mental health services because her fitness for duty may have come into question. I didn’t know anything about LGBT support services or getting her connected with people who could identify with the pain she was feeling. I just wanted her to get over it, and I thought she did.

    The last few months of her life were a complete lie, and she had convinced me and everyone around her that she was alright. She said that she was in a relationship and working extra shifts in which I didn’t question it. It wasn’t unusual for us not to hang out when she was with her girlfriend. Although I would meet whoever she was dating, I never broke bread with any of them.

    Today, I truly regret it, and I can’t imagine how that must have made her feel. I miss my friend everyday, and I will never get the opportunity to have the conversations that I wish we should have had. She wasn’t in a relationship and she wasn’t working extra shifts. She left no note, and I have no idea about what was going on with her in the last moments of her life. Bringing awareness to this issue is the only way that I know how to honor her memory.

    Social workers provide 69 percent of all mental health services in the United States. Are social workers contributing to the mental health crisis of the LGBT community’s increase in suicides by failing to proactively do outreach to this community? We must assess if our own prejudices are preventing the creation of early intervention services and proper assessment of issues when conducting home visits. I have noticed a shift in the social work profession that is moving closer towards conservative values. What impact will this have on treatment if the primary mental health service providers do not want to work with the LGBT community?

    This is not a blog post that I had planned to write, but I think this is an important discussion needed within the social work community. You may disagree or agree with gay rights, but a plan must be devised to deal with the uptick in suicides within the LGBT community today. Where do you stand on the issue?

    I have included an excerpt written by Perry Noble with a link to the full article as follows:

    Let me begin by saying I absolutely LOVE Ben & Jerry’s ice cream. (Gonna go ahead and tell you that Oatmeal Cookie Chunk is THE BEST flavor I’ve EVER had!!)

    A few years ago I went to Wal Mart (the closest thing to hell I can imagine…that and the DMV), found my favorite flavor and decided to tweet that I was purchasing some Ben & Jerry’s ice cream…and doing so “unleashed the hounds” in a sense. Honestly, I’ve never experienced anything like it, “Christians” began @ replying me on twitter condemning me and scolding me for buying this product because apparently Ben & Jerry’s supported gay rights/same sex marriage.

    Honestly, it bothered me. Because, first of all…I wasn’t trying to make a political statement I was simply trying to get some chunky monkey and some oatmeal cookie crunch. I like ice cream…I believe it will be served in heaven (with ZERO calories)! And second, it has broken my heart the way that many who claim to follow Christ have treated those who are homosexuals. We’ve yelled at them, ignored them and in some cases damned them to hell without EVER sitting down and actually having a conversation with someone who is gay. Read More

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    Deona Hooper, MSW is the Founder and Editor-in-Chief of Social Work Helper, and she has experience in nonprofit communications, tech development and social media consulting. Deona has a Masters in Social Work with a concentration in Management and Community Practice as well as a Certificate in Nonprofit Management both from the University of North Carolina at Chapel Hill.

    Health

    Study Shows Immune Cells Against Covid-19 Stay High in Number Six Months After Vaccination

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    A recent study by Johns Hopkins Medicine researchers provides evidence that CD4+ T lymphocytes — immune system cells also known as helper T cells — produced by people who received either of the two available messenger RNA (mRNA) vaccines for COVID-19 persist six months after vaccination at only slightly reduced levels from two weeks after vaccination and are at significantly higher levels than for those who are unvaccinated.

    The researchers also found that the T cells they studied recognize and help protect against the delta variant of SARS-CoV-2, the virus that causes COVID-19. According to the U.S. Centers for Disease Control and Prevention, the delta variant — currently the predominant strain of SARS-CoV-2 in the United States — causes more infections and spreads faster than earlier forms of the virus.

    The study findings were first reported online Oct. 25, 2021, in the journal Clinical Infectious Diseases.

    “Previous research has suggested that humoral immune response — where the immune system circulates virus-neutralizing antibodies — can drop off at six months after vaccination, whereas our study indicates that cellular immunity — where the immune system directly attacks infected cells — remains strong,” says study senior author Joel Blankson, M.D., Ph.D., professor of medicine at the Johns Hopkins University School of Medicine. “The persistence of these vaccine-elicited T cells, along with the fact that they’re active against the delta variant, has important implications for guiding COVID vaccine development and determining the need for COVID boosters in the future.”

    To reach these findings, Blankson and his colleagues obtained blood from 15 study participants (10 men and five women) at three times: prior to vaccination, between seven and14 days after their second Pfizer/BioNTech or Moderna vaccine dose, and six months after vaccination. The median age of the participants was 41 and none had evidence of prior SARS-CoV-2 infection.

    CD4+ T lymphocytes get their nickname of helper T cells because they assist another type of immune system cell, the B lymphocyte (B cell), to respond to surface proteins — antigens — on viruses such as SARS-CoV-2. Activated by the CD4+ T cells, immature B cells become either plasma cells that produce antibodies to mark infected cells for disposal from the body or memory cells that “remember” the antigen’s biochemical structure for a faster response to future infections. Therefore, a CD4+ T cell response can serve as a measure of how well the immune system responds to a vaccine and yields humoral immunity.

    In their study, Blankson and colleagues found that the number of helper T cells recognizing SARS-CoV-2 spike proteins was extremely low prior to vaccination — with a median of 2.7 spot-forming units (SFUs, the level of which is a measure of T cell frequency) per million peripheral blood mononuclear cells (PBMCs, identified as any blood cell with a round nucleus, including lymphocytes). Between 7 and 14 days after vaccination, the T cell frequency rose to a median of 237 SFUs per million PBMCs. At six months after vaccination, the level dropped slightly to a median of 122 SFUs per million PBMCs — a T cell frequency still significantly higher than before vaccination.

    The researchers also looked six months after vaccination at the ability of CD4+ T cells to recognize spike proteins atop the SARS-CoV-2 delta variant. They discovered the number of T cells recognizing the delta variant spike protein was not significantly different from that of T cells attuned to the original virus strain’s protein.

    Although the study was limited because of the small number of participants, Blankson feels it pinpoints areas that merit further research.

    “The robust expansion of T cells in response to stimulation with spike proteins is certainly indicated, supporting the need for more study to show booster shots do successfully increase the frequency of SARS-CoV-2-specific T cells circulating in the blood,” says Blankson. “The added bonus is finding that this response also is likely strong for the delta variant.”

    Along with Blankson, the members of the study team from Johns Hopkins Medicine are study lead author Bezawit Woldemeskel and Caroline Garliss.

    This study was supported by the Johns Hopkins COVID-19 Vaccine-related Research Fund.

    The authors do not have financial or conflict of interest disclosures. 

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    Health

    Poverty, Racism and the Public Health Crisis in America

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    Although extreme poverty in the United States is low by global standards, the U.S. has the worst index of health and social problems as a function of income inequality. In a newly published article, Bettina Beech, clinical professor of population health in the Department of Health Systems and Population Health Sciences at the University of Houston College of Medicine and chief population health officer at UH, examines poverty and racism as factors influencing health.

    “A common narrative for the relatively high prevalence of poverty among marginalized minority communities is predicated on racist notions of racial inferiority and frequent denial of the structural forms of racism and classism that have contributed to public health crises in the United States and across the globe,” Beech reports in Frontiers in Public Health. “Racism contributes to and perpetuates the economic and financial inequality that diminishes prospects for population health improvement among marginalized racial and ethnic groups. The U.S. has one of the highest rates of poverty in the developed world, but despite its collective wealth, the burden falls disproportionately on communities of color.” The goal of population health is to achieve health equity, so that every person can reach their full potential.

    Though overall wealth has risen in recent years, growth in economic and financial resources has not been equally distributed. Black families in the U.S. have about one-twentieth the wealth of their white peers on average. For every dollar of wealth in white families, the corresponding wealth in Black households is five cents.

    “Wealth inequality is not a function of work ethic or work hour difference between groups. Rather, the widening gap between the affluent and the poor can be linked to unjust policies and practices that favor the wealthy,” said Beech. “The impact of this form of inequality on health has come into sharp focus during the COVID-19 pandemic as the economically disadvantaged were more likely to get infected with SARS CoV-2 and die.”

    A Very Old Problem 

    In the mid-1800’s, Dr. James McCune Smith wrote one of the earliest descriptions of racism as the cause of health inequities and ultimately health disparities in America. He explained the health of a person “was not primarily a consequence of their innate constitution, but instead reflected their intrinsic membership in groups created by a race structured society.”

    Over 100 years later, the Heckler Report, the first government-sanctioned assessment of racial health disparities, was published. It noted mortality inequity was linked to six leading causes of preventable excess deaths for the Black compared to the white population (cancer, cardiovascular disease, diabetes, infant mortality, chemical dependency and homicide/unintentional injury).

    It and other reports led to a more robust focus on population health over the last few decades that has included a renewed interest in the impact of racism and social factors, such as poverty, on clinical outcomes.

    The Myth of Meritocracy

    Beech contends that structural racism harms marginalized populations at the expense of affording greater resources, opportunities and other privileges to the dominant white society.

    “Public discourse has been largely shaped by a narrative of meritocracy which is laced with ideals of opportunity without any consideration of the realities of racism and race-based inequities in structures and systems that have locked individuals, families and communities into poverty-stricken lives for generations,” she said. “Coupled with a lack of a national health program this condemns oppressed populations such as Black and Hispanic Americans, American Indians, and disproportionately non-English speaking immigrants and refugees to remain in poverty and suffer from suboptimal health.”

    Keys to Improvement

    The World Health Organization identified three keys to improving health at a global level that each reinforces the impact of socioeconomic factors: (1) improve the conditions of daily life; (2) tackle the inequitable distribution of power, money and resources; and (3) develop a workforce trained in and public awareness of the social determinants of health.

    The report’s findings highlight the need to implement health policies to increase access to care for lower-income individuals and highlight the need to ensure such policies and associated programs are reaching those in need.

    “Health care providers can directly address many of the factors crucial for closing the health disparities gap by recognizing and trying to mitigate the race-based implicit biases many physicians carry, as well as leveraging their privilege to address the elements of institutionalized racism entrenched within the fabric of our society, starting with social injustice and human indifference,” said Beech.

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    Culture

    What Do You Know About Disability Cultural Competence?

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    Recently, I had the opportunity to give a webinar on disability cultural competence to social service workers, but was met with many blank stares. As a disabled social worker myself, I often notice that the disability community is not recognized as a cultural group. Disability is also not considered as a social identity in diversity considerations, despite the ways the community feels about it. Frankly, our field has a long way to go when it comes to developing disability cultural competence. Let’s see if we can change that.

    Why the We Need to Prioritize the Disability Community

    You may be asking yourself, why all the focus on disability? Well, the disability community comprises 26 percent of the adult U.S. population – that’s one in four Americans according to the Centers for Disease Control. Among children under the age of 18, estimates suggest that 4.3 percent of the population is disabled according to the U.S. Census from 2019. This means that social services workers are interacting with the disability community all over! It’s also important to note that disability transcends race, ethnicity, gender and other social identities, as seen in the graphic below (courtesy of Courtney-Long, Romano, Carroll, et al., 2017). So we need to remember to be intersectional in our  practice – these are not siloed communities.

    Courtesy of Courtney-Long, Romano, Carroll, et al., 2017

    Importance of Disability Identity

    I’d like to transition now to talking about the importance of having a disability identity. Some people identify as disabled from a cultural perspective. Some people are not even aware that this is an option and you can open their eyes to the world of disability as a resource for them. In other words, for some, this is a missed opportunity to connect to a supportive network. For others, it’s a choice not to identify as disabled either due to stigma, internalized ableism or other beliefs. The idea is that developing a strong disability identity is super helpful with your long-term well-being. And in order to do this, you have to both connect with the disability community and with disability culture. So what is that?

    What is Disability Culture?

     

    In short, disability culture is the “sum total of behaviors, beliefs, ways of living, & material artifacts that are unique to persons affected by disability.” It’s essential for social service workers to be tuned in to disability culture so they can leverage it to connect with their clients. And let’s be clear, disability culture does NOT consist of disability service programs. Where we really see disability culture come alive is on social media sites, such as Twitter and Instagram. You can follow some of the major disability culture hashtags to see the dialogues and debates that are hot in our community right now, such as: #DisabilityTwitter; #DisabilityVisability; #DisabilityAwareness; #IdentityFirst; #DisabilityLife; #Spoonie,#SpoonieLife, and more.

    You may notice that the last two hashtags included the word “spoonie.” This derives from “spoon theory,” which is an actual theory based on a metaphor about how much mental and physical energy a person has to accomplish their activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The disability community talks about how many “spoons” they have as a unit of measurement of energy – and sometimes refers to themselves as spoonies. Please note that in teaching you this, I am helping you to develop your disability cultural competence.

    How Build Disability Cultural Competence

    Other ways to build up your disability cultural competence are to check out the Disability Visibility Project, which tells the stories of diverse members of the community in wonderful ways. And there are a range of organizations, such as Sins Invalid, which founded the disability justice movement. You can also read the 10 principles of that movement in this short document. This will help you to tune in to the disability pride movement. We have a pride month and a pride flag too, it happens in July.

    When it comes to engaging in disability competent practice, we need to develop knowledge about disability culture and disability history. We can also consider taking the following steps to round out this competence:

    First, we need to examine our own attitudes about disability and engage in reflective practice around that. You can consider your own implicit bias about the disability community through Harvard University’s Project Implicit test about ableism, or through social worker Vilissa Thompson’s guide to checking your own ableism.

    Second, developing disability cultural competence over time also includes a careful look at the terminology we are using and respecting disabled people’s choice of identity-first language in many cases. You can read more about that here and throughout that site. The Harvard Business Review also has a thoughtful essay on why you need to stop using particular words and phrases. It’s a great resource and helpful read for many.

    Third, we also need to think respectfully about disability etiquette and how ideas play out in different parts of the disability community. One should presume competence about us – all of us! We ask that you respect our bodily autonomy, speak to the person and not their companion/interpreter, ask before you help, be sensitive about physical contact/equipment contact, don’t make assumptions about capacity, listen to us, don’t assume you know better and if you are in doubt about what to do, ask! Writer Andrew Purlang sums up his disability etiquette request as follows:

    • Don’t be afraid to notice, mention, or ask about a person’s disability when it’s relevant — but don’t go out of your way!
    • Offer to help, but make sure to listen to their response, respect their answer, & follow their directions
    • Don’t tell a disabled person about how they should think about or talk about their own disability
    • Don’t give unsolicited medical, emotional, or practical advice
    • Don’t make a disabled person responsible for managing your feelings about their disability, or for your education on disability issues
    • If you make a mistake, just say you’re sorry and move on. Don’t try to argue that you were right all along.

    Now What?

    Taken together, these steps, learning disability culture, and examining our own attitudes about disability, go a long way towards the development of disability cultural competence. But none of it will do any good if we are not fighting for disability access and disability inclusion, which are central issues for the disability community. Many people think that issues of access were solved by the passage of the Americans with Disabilities Act of 1990. But the implementation of that law is fraught and embattled, and there is lots of work to be done on the access front. Take a look at these simple guides below. They will go a long way in helping to engage the disability community and making us feel welcome! Above all, remember our movement’s rallying cry, “nothing about us, without us!”

    Website Accessibility

    Accessible Social Media Guide

    Meeting Accessibility

    Webinar Accessibility

    Public Event Accessibility

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