Legislation that voids millions of American citizens of its Constitutional right to have a democratic government has been introduced to the House claiming to help Puerto Rico overcome its fiscal problems. Rep. Sean Duffy of Wisconsin introduced H.R. 5278, the Puerto Rico Oversight, Management, and Economic Stability Act known as PROMESA, a bipartisan bill that claims to hold the “right people accountable for the crisis,” while shrinking the size of government and creating an independent oversight board to help get Puerto Rico into fiscal health.
This bill states that PROMESA “holds supremacy over any territorial law or regulation that is inconsistent with the Act or Fiscal Plans.” This bill eliminates any illusion of democracy in the colony and comes with harsh austerity measures, as well as the “authority to force the sale of government assets,” yet somehow forgets to address economic development for the island.
PROMESA states that the President of the US will appoint every member of the oversight board whose responsibilities include ensuring the payment of debt obligations, re-structure the workforce, reduce or freeze public pensions while supervising the entire budget of the Commonwealth government, its pension system, public authorities, leases and contracts with union contractors and collective bargaining agreements. It also includes a provision to lower the minimum wage in the island to a paltry and laughable $4.25.
Nearly all economists agree that a reduction in the minimum wage would only cause Puerto Ricans to have even less purchasing power and coincidentally happens to be a great way to keep a nation poor, more dependent on the US, and thus, sadly, impotent and unlivable.
The proposed bill states that if the governor or legislature of Puerto Rico isn’t in agreement with any recommendation, the oversight board can take any “action as it determines to be appropriate” to implement its recommendations. Under PROMESA, anyone who obstructs the oversight board or its decisions can be imprisoned.
An oversight board is a point of contention in Puerto Rico as it faces local elections this November. As different groups lobby in favor or against of PROMESA, others like different groups of the private sector lobby in favor of allowing Puerto Rico to declare bankruptcy. Still, despite a promise by Paul Ryan to take action before March 2016, Congress has yet to take meaningful action that will tackle the root of the real problem.
Meanwhile, over 7,000 social workers are at the front lines living and seeing firsthand the effects of the ongoing economic crisis and its social effects. However, social services are currently dwindling due to austerity measures as over 50% of children live in poverty in Puerto Rico. Social work positions get eliminated due to budget cuts; new openings for case managers, service coordinators, and social technicians are the trend. These positions call for the same academic preparation as a social worker despite paying $7.25, the federal minimum wage. The Colegio de Trabajo Social, a leading organizing group of the profession in Puerto Rico, is against an oversight board.
While many wait for Congress to act, thousands of Puerto Ricans leave the island each week for the United States in hopes of better opportunities as their beloved island undergoes a humanitarian crisis that has yet to resonate with Americans on the mainland, especially the social workers who are bound to fight for social justice.
Migration waves are not new to Puerto Rico. Shortly after Operation Bootstrap, a 1948 economical project that sought to develop the island into an industrial nation, showed signs of slowing down, officials concluded that the problem was an oversupply of labor: population growth needed to be controlled. One of the ways to achieve this, besides the mass sterilization of women without their knowledge, was by promoting better opportunities and working conditions in the US.
Between the 1950s and 1970s, over 250,000 Puerto Ricans left the island, primarily for New York City. Sixty years later, as a new migration wave brings a new generation of Puerto Ricans to the United States due to an ongoing humanitarian crisis, it’s disheartening the lack of support social work organizations in the US have given to its peers in Puerto Rico.
While much has been said about the $72 billion dollar debt Puerto Rico has amassed since the enactment of its Constitution in 1952, one thing remains the same: average Puerto Ricans are suffering. Pensions are on the brink of insolvency, social services are being eliminated, schools are being closed, and unemployment hovers around 12.2% — more than double that of the mainland, and a number that doesn’t even take into account those who have given up on finding a job entirely and are now part of the informal economy.
To understand this, the island’s economy must be understood as one based on tax incentives and entirely dependent on United States policies, since the inception of Operation Bootstrap in 1948. These tax incentives lost relevancy at the end of the 1950s due to an increase in average salaries of manufacturing and the inability to compete with the new markets that were now open to the US after the implementation of the “General Agreement on Tariffs and Trade.” As a result of the oil embargo of the 1970s, Puerto Rico’s economy started to shrink. To prevent economic collapse, the government absorbed the jobs lost in the private sector, making it the primary employer on the island.
It was during this decade that the decline of the economy lead the central government to incur extreme debt in order to finance the island’s burgeoning industrialization. Keep in mind, Puerto Rico didn’t then — and still doesn’t today — have the power to negotiate its commercial treaties, maritime tariffs and duties, or to negotiate prices for purchasing oil. As a colony, it is entirely dependent on any restrictions and limitations placed on it by the United States government.
Instead of addressing these issues as the result of a structural problem, two federal patches were implemented: the approval of Section 936 of the Internal Revenue Tax Code in 1976, and food stamps for Puerto Ricans in 1977. The elimination of section 936 under President Clinton resulted in the closing of important manufacturing companies and thus contributed to the loss of thousands of specialized and high-paying jobs.
When finally fully phased out in 2006, Section 936 catapulted Puerto Rico into a deep economic recession in which all important economic indicators waned. When the Great Recession hit the mainland two years later, only furthering a retraction of the country’s GDP, Puerto Rico’s already battered economy was unable to recover. Lacking the autonomy to set its own fiscal and monetary policy, it had little choice but to wait for its colonizer to act.
When social conditions worsen and violence increases, more people are in need of services, which result in higher stress, burnout and turnover for social workers. It’s at a time like this, when social workers are needed and the government must supply the resources needed for them to do their work.
As a response, social workers in Puerto Rico have proposed Bill 2705, “Law of Social Work Professionals in Puerto Rico,” which would temper and regulate the profession to the current reality of the island. The bill would establish academic requirements and promote the highest ethical standards to achieve social justice, the defense and implementation of human rights while caring for the best interest of Puerto Rico’s citizens. So far, very few if any social work organizations in the United States have lent their support to their peers in Puerto Rico, not even those in cities with high population of Puerto Ricans.
After all, social workers in Puerto Rico are bound by the same National Association of Social Workers Code of Ethics as we are in the United States. We must uphold standard six of the Code, which establishes our ethical responsibilities to the broader society. Puerto Ricans are American citizens and as such social workers and social work organizations have a moral obligation to stand by them and join their fight.
Study Shows Immune Cells Against Covid-19 Stay High in Number Six Months After Vaccination
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.
“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.
Poverty, Racism and the Public Health Crisis in America
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.
When Giving Thanks, Don’t Forget Yourself
As we give thanks at the holidays, it’s easy to overlook someone important: your past self.
While it’s well documented that gratitude toward others can improve wellbeing, two University of Florida scientists find that gratitude toward your past self also has benefits.
Does thanking yourself seem a bit…selfish? The researchers, UF psychology professor Matt Baldwin, Ph.D., and undergraduate student Samantha Zaw, think not.
“Despite the fact that past gratitude is self-focused, it reminds people that they’re part of a bigger story and that they have the power to grow,” Baldwin said. “It’s possible this promotes a pay-it-forward type of mentality.”
Gratitude is what psychologists call a self-transcendent emotion, one that lifts us out of the everyday and expands our perspective, which can help us get along with each other better. In a recent experiment, Baldwin and Zaw asked participants to write brief gratitude letters. The first group thanked someone else, the second thanked themselves, while a third, the control condition, wrote about a positive experience they’d had. Zaw and Baldwin then surveyed the participants about their self-perception after writing the letter. Although the results are not yet published, early analysis shows that the exercise gave the other- and self-focused gratitude groups a sense of redemption and helped them feel they were morally good people. However, the group that wrote to themselves scored higher on both measures.
The past-self group also saw a benefit the others didn’t: an increase in the self-awareness measures of clarity, authenticity and connectedness.
“Unlike gratitude toward others, being appreciative of ourselves carries an added benefit of truly understanding who we are and feeling connected to ourselves,” said Zaw, a McNair Scholar who has been working with Baldwin since her freshman year as part of UF’s Emerging Scholars Program.
Zaw and Baldwin’s research — the first known data gathered on past-self gratitude — was inspired by a Reese’s cup. When Baldwin’s co-worker, boredom researcher Erin Westgate, returned to the office after pandemic lockdown, she was delighted to discover a peanut butter cup she had squirreled away in her desk.
“She texted me like, ‘Oh my gosh, my past self left my future self a Reese’s,’” Baldwin recalled. “I was like, ‘Wait a second. You’re expressing gratitude towards something your past self had done. We have to study this.’”
As Zaw and Baldwin dug into previous studies, they found plenty on gratitude toward others and a few on self-compassion, but nothing on past-self gratitude. They designed the letter-writing experiment to test its effects, presenting their findings at the Society of Southeastern Social Psychologists in October and at the upcoming meeting of the Society for Personality and Social Psychology in February.
If you’re curious about the benefits of self-gratitude, Zaw offered a way to try the experiment at home, maybe as a new Thanksgiving tradition. Take a few minutes to write a thank you message to someone else, and another to yourself for something you did in the past. Sharing what you wrote could foster connections between loved ones, she said, but the exercise can also pay dividends if you try it on your own.
“At Thanksgiving and Christmas, we focus on other people, but self-care is really needed too, especially if we want to feel more clear about ourselves,” she said. “Maybe it can even lead to a better vision for ourselves for the next year.”
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