Things that bug me…. – KMZ Digest

Shoe Envy

itsme — Mon, 26 Jan 2026 20:18:30 +0000

‘Diversity’ Doesn’t Include Disabled Veterans Like Me

itsme — Wed, 09 Oct 2024 21:28:02 +0000

Image credit: Pexels

Matthew Winans

September 11, 2024

At college campuses nationwide, the newest students are starting class, but I’m not among them. Many medical schools rejected my application, and when I asked why, several told me that my service in our nation’s armed forces didn’t matter, and that I should have spent more time proving my commitment to “diversity” and “equity.”

I served in the United States Army from 2012 to 2017. During my service, I intended to apply to the F. Edward Hébert School of Medicine, the military’s medical school, but health-related issues and a service-related disability cut my career short. After being honorably discharged, I set my sights on attending a civilian medical school to become a pathologist.

I never assumed I would be a shoo-in, nor do I believe veterans like me have some “right” to acceptance. Still, I thought my chances were strong because of my degrees in different fields, years of work history as a medical technologist in numerous hospitals, and other experiences. Plus, I thought my veteran status could help, given medical schools’ universal preference for diversity. In the 2022-2023 school year, only 154 matriculants were military veterans out of 22,712 in total. If varied experiences and backgrounds are what medical schools want, I figured I had a lot to offer.

Turns out, the medical schools don’t agree.

Take my experience with the Morehouse School of Medicine, a historically black college in Atlanta. I’m white, but it has a good reputation and is the closest medical school to my home. After my application was rejected, I requested reapplicant counseling, which helps you learn how to improve your chances in subsequent applications. In May, an admissions counselor told me that my MCAT score wasn’t high enough, even though I scored in line with the average Morehouse matriculant. I couldn’t get an answer as to why that wasn’t good enough. The counselor did tell me that I made a mistake by not discussing “equity” in my essay. Apparently, as a white man, I needed to show a special dedication to serving non-white patients.

The counselor also told me that my military service didn’t qualify as volunteering, even though we have an all-volunteer military. An associate dean of admissions at Georgia’s Mercer University School of Medicine said the same thing, disrespectfully equating my military service to a cashier’s job. I found myself wondering: What kind of volunteering do medical schools want? I found the answer in my reapplicant counseling session for the University of Alabama’s Heersink School of Medicine.

Once again, the admissions counselor dismissed the idea that military service constitutes volunteering. Instead, she said, I needed to volunteer at a “free clinic in a barrio” or an “inner-city soup kitchen.” When I asked why those kinds of volunteering were better, the counselor told me I needed to prove my “cultural competence.” I can’t imagine a member of another race being told they have to demonstrate cultural competence. In addition, it’s insulting to assume that volunteering is the best way to gain such competence. I served alongside a highly diverse group of soldiers, learning valuable lessons about different races, religions, and traditions. I’m also married to a Kenyan woman, have three biracial kids, and have traveled to East Africa many times.

What makes volunteering in a barrio or the inner city somehow superior to my numerous personal experiences? The answer is the same reason the Morehouse counselor wanted me to mention “equity.” It proves your devotion to the diversity-industrial complex.

It’s possible I was beaten out by more qualified applicants at these and other schools. There’s always someone better than you in life. However, after what I encountered at many medical schools, I’m not confident that the quality of my application was the deciding factor. If I had overtly capitulated to the DEI worldview, I bet I’d be starting medical school this fall. (Ditto, if I was non-white.) The Supreme Court may have banned affirmative action, but the medical advocacy group Do No Harm has shown that medical schools are finding numerous ways to make admissions decisions based on race. Since medical schools are openly disrespectful to the sacrifices of disabled veterans like me, what makes anyone think they won’t continue to unfairly and illegally elevate race?

I plan to apply to more medical schools this year, but I’m not optimistic about my chances. My ability to use the education benefits I earned through service to my country is controlled by race-obsessed administrators. In today’s politicized world of “diversity” and “equity,” I fear there’s no room for a disabled white male who joined the Army to defend his country instead of padding his resume by going to the barrio or the inner city and then boasting about it.

This article was originally published by RealClearPolitics and made available via RealClearWire.

intellectualtakeout.org/2024/09/diversity-doesnt-include-disabled-veterans-like-meSeptember 11, 2024

AUTHOR

Matthew Winans

PROFILE

Writing Disabled Voices

itsme — Wed, 07 Aug 2024 20:04:03 +0000

Journalists often struggle to cover disabled people.

Here’s what experts say about getting the story right.

Bonus: A primer on correcting the media when they get it wrong.

By Ryan Prior

October 6, 2022

Adobe stock images Generated with AI Sawyer0

We all want—need, really—to have our stories told. And it takes wise storytellers to do it, especially if we become unable to fully do it ourselves.As human beings, many of us, if not all, will be disabled at some point in our life. As journalists, our profession must take that fact into account, with stories portraying disabled people in ways that are dignified, accurate, and forward-thinking. One in four American adults lives with a disability of some sort, according to the Centers for Disease Control and Prevention. Some disabilities are obvious, but others may be more subtle, such as colorblindness, dyslexia, or problems during pregnancy.

At every turn, disability writing should strive to be free of stigma and hold space for disability pride. In this kind of reporting, human experience should be seen through a social lens. That means writers shouldn’t depict disability narrowly, as a problem to be solved, but rather as a lived identity to be framed with nuance and sensitivity. They should choose the right language and make sure to give disabled people the chance to speak for themselves.

Experts I spoke to for this story were universally emphatic on a particular point: Talk to disabled people when you write about disabilities. Many of those experts lamented that they frequently see journalists fail to do this. Laura Casey, who was a WSJ Trust Fellow focusing on disability coverage, noted that simply prioritizing disabled voices could reframe stories and get at the truth more accurately.

“Make an effort to ensure that the sources you speak to have life experiences that are representative of the heterogeneity of the disabled population,” she told me. “You’ll probably get a very different response to questions about public transit accessibility from a wheelchair user with a spinal cord injury versus a person with multiple chemical sensitivities.”

Casey has multiple chronic illnesses that are dynamic, affecting her in different ways at different times, so she requested that we do our interview via email. Had we done it over the phone, she said, she’d likely have been able to explain only about half of her points.

Casey’s altered interview arrangement illustrates a key point about accommodations for disabled sources in general. Reporters should build in flexibility when reaching out to disabled sources. That means allowing extra time for them to respond to interview requests and conducting the interview in whatever format they are most comfortable in, whether via text message or sign language or anything else. With sources from vulnerable or marginalized communities, it’s particularly important to explain the general practices of journalism (define “off the record,” for instance) to those who aren’t media trained. Publishing sensitive information, such as someone’s medical diagnosis, can be harmful if done in a cavalier way.

And allow disabled people to speak for themselves, rather than relying on the perspective of a caregiver or family member, who doesn’t have the actual direct experience.

Journalists should also understand that people with disability are news consumers and part of their audience. “If you are considered a consumer of news, then you are an audience that a news outlet must consider,” says Eric Michael Garcia, senior Washington correspondent for The Independent and author of We’re Not Broken: Changing the Autism Conversation. “When we don’t see them as an audience, we then feel a license and an authority to talk about them in a way we wouldn’t talk about other groups.”

Publishing sensitive information, such as someone’s medical diagnosis, can be harmful if done in a cavalier way.

USE LANGUAGE CORRECTLY

To clarify nuances around specific disabilities and terms, the National Center on Disability and Journalism offers an alphabetical style guide in multiple languages to explain concepts such as “abled-bodied” and “vegetative state.” Historically, language has been used to dismiss, disparage, and even to justify killing disabled people. Notions of what it means to be “stronger” and “weaker” have fueled the eugenics movement, and activists understand that words matter.

One of the most common discussion points in disability reporting is about using person-first language versus identity-first language. Prior to the passage of the Americans With Disabilities Act in 1990, an earlier generation of disabled activists favored person-first language (“person with a disability”), emphasizing their basic humanity. A younger generation, growing up with their rights enshrined in law, has felt more freedom to emphasize identity (“disabled person”). Whether to use one or the other can be decided on a case-by-case basis, depending on the community. The identity-first preference is particularly common in the autism community, as in “autistic person.”

If you’re not sure, ask the subjects how they would like their disability to be portrayed. We all want to be shown as fully dignified human beings. It’s preferable to write someone is “a wheelchair user” rather than “wheelchair bound.” I’ll admit I made this mistake in a story I wrote in 2019 and received several angry emails. I wish I, or my copy editor, had known better. Guides like this may help others avoid the same mistake.

And if you do make a mistake, listen and learn from the disability community. Let it be a teachable moment. In late 2021, Mykola Bilokonsky, an autistic software engineer, objected to language used in a promo for a CNN documentary about autism and marijuana (a show I worked on). He reached out to CNN’s chief medical correspondent, Dr. Sanjay Gupta, on Twitter, offering some gentle feedback on how to cover autism. In an essay, “How to Talk About Autism Respectfully,” Bilokonsky explains that Gupta asked for a phone call, took time to listen, and promised to report on the topic in a more nuanced way going forward.

DIVERSIFY YOUR TEAM

Many newsroom leaders make the mistake of not hiring disabled writers or commissioning stories from them. Consciously add disabled people to your team. You’ll be more likely to get the story right. An autistic reporter will write knowledgeably and authentically about autism. And because symptoms or experiences of one disease can resemble those of another, you may find that a writer who is hard of hearing is your most insightful reporter on “brain fog.”

Several years ago, the site Refinery29 was publishing its “Voices of Disability” package, a set of stories that at first did not have a dedicated editor. The outlet asked Kelly Dawson, a writer and media consultant with cerebral palsy, if she could serve as a guest editor for the series to ensure the coverage was correct. “I’m really surprised at how simple it is,” Dawson said at the time. “It really is me coming to the team, and them being, like, ‘OK, what are we doing this year?’ ”

We need disabled reporters holding truth to power on Wall Street, at the White House, and in the court system in O’Fallon, Illinois.

Dawson helped the team expand the inclusiveness of the stories, think intentionally about the colors used on the site, and incorporate alt text for all its images, for those with visual impairment. Adding voice recordings for all the stories helped not only blind audience members but also those who have trouble reading due to cognitive dysfunction.

When hiring disabled reporters or commissioning them for stories, know that lived experience isn’t bias. It’s wisdom.

Disability activist Alice Wong describes disabled people as “oracles” who see the world through a uniquely perceptive and profound lens. That’s a lens newsrooms can use to their advantage and is an important part of newsroom diversification. Newsrooms produce more vibrant stories when Black editors and queer producers and disabled writers make contributions and write stories about what interests them, whether that be medical research or Lord of the Rings.

Not all disabled journalists will want to be pigeonholed on the disability beat. That’s great. We need disabled reporters holding truth to power on Wall Street, at the White House, and in the court system in O’Fallon, Illinois. Issues of equal access and opportunity are not confined to the disability community. They’re universal.

DEPICT YOUR SUBJECTS WITH DIGNITY

A disability that isn’t outwardly noticeable can be no less life-altering than one that is. “The problem is that we only talk about it if it’s in the context of health, but disability impacts so many other issues, whether it’s being able to get a job or being able to get housing,” says Mia Ives-Rublee, director of the Disability Justice Initiative at the Center for American Progress. “Disability affects everything, and leaving it out of the conversation means you’re missing large parts of the picture.”

Don’t use disabled people as “inspiration porn.” The disability community often complains that their stories are framed as tales of overcoming adversity, while the harder journalistic work of exposing systemic injustice goes undone. There’s no substitute for reporting on the substantive policy issues. Even basic reporting about daily life can expose important truths. For the New York Times, reporter Amanda Morris followed one wheelchair user’s journey flying from Palm Beach, Florida, to San Antonio, Texas. Morris showed how air travel can be “embarrassing, uncomfortable, and perilous,” with wheelchair users enduring risks such as injury, loss of equipment, and lack of accessible bathrooms in order to fly.

Moreover, cheap inspiration porn can “otherize” disabled people. Don’t make them seem exceptional for doing normal things. “We know we live these lives,” says Vilissa Thompson, a social worker and founder of the self-advocacy organization Ramp Your Voice! “We know that we go to school. We know we can be doctors, we can be everything else. It’s society’s narrow viewpoint of who we are that allows inspiration porn to exist.”

If the story isn’t specifically about disability, and your subject just happens to be blind or to use a wheelchair, don’t give their disability more focus than it needs. In those instances, it’s just a fact of everyday life.

One pitfall is repeating disproved myths about post-viral illness being “all in your head,” even when hundreds of studies have shown measurable biological abnormalities that can persist for decades.

Know that people are relying on your coverage to tell the truth about their disease.

Just as in other areas of journalism, be careful about false equivalence. When there is overwhelming scientific consensus on a subject, being overzealous about finding dissenting views can actually misinform readers. One pitfall in disability reporting, for instance, is that some journalists writing about long Covid repeat disproved myths about post-viral illness being “all in your head,” even when hundreds of studies have shown measurable biological abnormalities that can persist for decades. Similarly, some voices in the scientific world question the evidence for certain chronic diseases that are widely acknowledged to be real. Giving those voices air, and not fact-checking longstanding myths, can implicitly feed into dehumanizing tropes about “takers and fakers.”

For instance, Janet Dafoe, whose son Whitney is disabled and cannot speak due to myalgic encephalomyelitis/chronic fatigue syndrome, told me that in 2015 she refused to allow a reporter to use her interview material if the reporter spoke to psychologists who doubted her son’s disease. Dafoe’s gambit worked. The resulting Washington Post story became a breakthrough moment for the global patient community and led to well-framed follow-up stories.

The first story I successfully pitched at CNN, in 2016, was about disabled Bolivian protesters marching in wheelchairs through the Andes toward the nation’s capital, calling the government out for meager disability pensions. The activists demanded increased disability benefits to help move closer to basic subsistence. But rather than sympathy, President Evo Morales’s regime met them with riot police and water cannons. It was a good story not because it was a disability story but because it was a human story about fully dimensioned people with a problem, a fight, and oh, what a journey.

Nearly every story we tell as a species is ultimately about how we reckon with suffering, how we build community, and how we deal with the inevitable frailty and deterioration of self. That’s not disability. That’s being human.

When You Are the Consumer:

Here’s How to Help Reporters and News Media Get the Story Right

By Ryan Prior

Our own stories are the most valuable possessions we’ll ever have. Especially for the most vulnerable and disabled people in a society, it’s essential to hold journalists accountable in getting these stories right. Readers can use a few principles to spot good disability reporting and help correct the media if they’ve gotten it wrong.

Look for authentic depictions

If a story is about disability, it should strive to center disabled voices. Full stop.

Pieces that go only as far as interviewing a family member or caregiver of a disabled person aren’t going directly to the source. Stories are always going to be more credible if they include input from those with lived experience. They can often be especially credible if they’re actually written by someone with a disability.

One of the most common errors in disability reporting is a tendency to focus on disabled people “overcoming” their conditions. This overemphasis on “inspiration porn” obscures the more important work of depicting the day-to-day realities of disabled lives. Stories that authentically report on bread-and-butter issues show the community as it really is, celebrating disability pride and recognizing there are many ways to be fully human. They also shine a light on injustices and ways to improve services.Beware of stories that regurgitate tropes framing disabled people as seeking benefits instead of working. In reality, disability insurance coverage is incredibly challenging to win, and most people who are on disability live below the poverty line.

Respond proactively and productively

As with every area of journalism, newsrooms are subject to human fallibility and make mistakes from time to time. As a reader, listener, or viewer, your feedback is integral to improving their reporting and maintaining public trust.Many outlets have built-in sections for reader feedback or letters to the editor. As part of the disability community—or any community—you can actively write op-eds or letters calling attention to important issues yourself. And you can pitch ideas or send story tips for reporters to investigate.

If you’re responding to a published story, many outlets include the contact information for writers in the article itself or on a bio page. Reach out directly to journalists with constructive criticism, build a relationship, and offer resources or contacts to help them produce a better story next time. As with any conversation, it pays to be respectful. If you’re calling a writer out publicly via Twitter, it’s especially helpful to present critiques gently. Don’t settle for calling them out for a mistake; strive to “call them in.” Convert them to an ally.Make your recommendations specific and actionable. Outlets can publish corrections after the fact if specific details are demonstrably false. And reporters can sometimes add details, usually with an editor’s note about what was changed or clarified after publication. Rarely will an outlet take the extreme step of retracting a story.

Don’t repost articles that frame stories in harmful ways; doing so just gives them more air they don’t deserve. Instead, focus on amplifying the stories that get the issues right, rewarding reporters and outlets for their good coverage.

In this era of rampant misinformation, being a critical reader is one one of your most crucial duties of democratic citizenship.

Ryan Prior is a journalist in residence at the Century Foundation and author of The Long Haul: Solving the Puzzle of the Pandemic’s Long Haulers and How They Are Changing Healthcare Forever. He is a board member of #MEAction and has written for CNN, STAT News, The Guardian, and many other news outlets. He lives in Atlanta.

openmindmag.org/articles/talking-to-the-disabled

Editor’s Note

We’ve seen intense debate over the years about how to appropriately describe women, members of minorities, immigrants, and nonbinary people—but there’s scant discussion of the language and sensitivity required for journalistic coverage of the disabled or those with chronic disease. In this essay, Ryan Prior, author of an upcoming book on long Covid, sets the record straight. Whether you are a journalist or a consumer of media, you’ll want to know how to avoid ableism or correct it when you see it in play. Our primer on sensitivity and appropriateness is the perfect place to start.

—Pamela Weintraub, co-editor, OpenMind

How COVID-19 Changed College Athletic Recruiting

itsme — Thu, 18 Apr 2024 21:57:40 +0000

Hoboken High School in Hoboken, New Jersey (Photo/Luigi Novi -Wikimedia Commons)

By Nicole McNulty

April 19, 2021

ARCELIA MARTIN, HOST: On average only about 6% of high school athletes go on to play sports in college. In a normal year, graduating seniors would be signed to their college teams by now. But COVID has disrupted this cycle. Nicole McNulty explores what that means for kids hoping to play sports in college.

NICOLE MCNULTY, BYLINE: Tyler Sims has been playing basketball since he was 9 years old. And like a lot of kids.

TYLER SIMS: My dream school is definitely Duke University. You know, I’ve been watching them since I was little. That’s my favorite basketball team.

MCNULTY: That would be tough enough any year. But with the pandemic it’s even harder. Tyler is a 17-year-old senior guard on the Hoboken High School boys varsity basketball team. Normally, coaches would be in the stands watching him play. But this year, they can’t watch in person. So his only way to get in front of them is his highlight reel. He had to make it himself. His friend filmed it. Here’s a clip of him making a layup in his red Number 2 jersey.

TAPE: [Basketball game.]

MCNULTY: Highlight tapes were always a part of the process – videos players make and send to colleges. But this year, his video might be his only chance. And his season was shorter. He’s played half as many games.

SIMS: I’m nervous, but at the same time, I’m very confident that, um, I’ll be in the hands of the right school. I’m pretty sure that I’ll play college basketball.

MCNULTY: Still, Tyler, like many other kids in the U.S., is now behind the ball. The recruiting process usually looks like this:

TIM NEVIUS: It’s about getting the athlete recognized by a college coach.

MCNULTY: That’s Tim Nevius, a lawyer who works with college athletes on eligibility and other issues.

NEVIUS: And then that coach making contact with them via email, telephone and establishing a connection and then offering a scholarship or a roster spot or admission.

MCNULTY: Nevius says the COVID disruption has created two major problems. One of them is what kids like Tyler are dealing with.

NEVIUS: Because of canceled seasons or postponement or the inability of coaches to travel, the athletes aren’t actually being seen playing their sports as they normally would.

MCNULTY: And the second problem? Overloaded rosters. Because of the pandemic, the NCAA extended college players’ eligibility. Coaches can hold onto their seniors for another year. That means fewer spots for high school hopefuls.

NEVIUS: For the incoming freshmen, then, that means that they’re faced with even a larger roster of juniors and seniors than they otherwise would have been.

MCNULTY: Take Bloomfield College in New Jersey, a Division II school. Gerald Holmes is the basketball coach there. He’s bringing back three of his seniors this fall. That only leaves room for three incoming freshmen. He might be able to take one more, but there’s another problem. This year the rules are more flexible for transfer students. They’re bigger, faster, stronger.

GERALD HOLMES: A lot of coaches would prefer to have a transfer versus a freshman. So, high school kids are taking the brunt of that.

MCNULTY: This year there are many new rules: each sport and division has their own. And the pandemic has changed a lot of them. An already complicated situation is worse — everyone from coaches to parents and students are confused.

HOLMES: It’s almost like the wild, wild west out there.

MCNULTY: For high school athletes, it’s a struggle to stand out. Holmes says he gets at least 100 emails a day from recruiting services and high school players. He agrees, the ripples of COVID are going to be felt in the recruiting process for years.

HOLMES: In reality, this is going to be a full cycle of four years, is going to be because a kid who is a freshman for me this year is still a freshman next year.

MCNULTY: The rules say that if a college player’s season was disrupted by COVID, they can play an extra year. As for Tyler, the 17-year-old in Hoboken, he sent his tape to a few schools. But no one knows when he’ll find out for sure about making a team. If he doesn’t get in this year, he’ll wait, keep training and try again next year.

Nicole McNulty, Columbia Radio News.

columbianewsservice.com/2021/04/19/how-covid-19-changed-college-athletic-recruiting

This story first aired on Uptown Radio.

About the author(s)

Nicole McNulty

Nicole McNulty is an audio journalist based in New York. She was born in Texas and spent her adolescence in Germany and Colorado. After traveling in her van for two years she now calls the city home. Her freelance print work can be found in The Boulder Weekly, The City Weekly and The West Side Rag. Nicole is currently studying at Columbia Journalism School where she’s focusing on crafting audio stories for Uptown Radio. Connect with Nicole on Twitter @nicole_mcnulty and via email nicole.mcnulty@columbia.edu

Moral Shaming: “You do You”

itsme — Fri, 29 Mar 2024 19:57:44 +0000

By Jill Neimark

November 4, 2022

Airline passengers, one unmasked and one wearing a face mask, await their flight at Ronald Reagan Washington National Airport after the Biden administration announced in April 2022 that it would no longer enforce a U.S. COVID-19 mask mandate on public transportation, following a federal judge’s ruling that the 14-month-old directive was unlawful. REUTERS/Kevin Lamarque

When people have different views about health and freedom, they misuse morality to demonize one another, letting policymakers and corporations off the hook.

One evening last September, Gavin Yamey, professor of global health at Duke University in Durham, North Carolina, dined indoors and tweeted a selfie of himself and his two tablemates—Chris Beyrer, director of the Duke Global Health Institute, and Gregg Gonsalves, a Yale epidemiologist and global health activist who won a MacArthur genius grant for his work on AIDS, global health, and social justice. Gonsalves has long been a voice for the vulnerable and disabled. Throughout the pandemic he lofted the torch of COVID caution and precautions, including masking, testing, vaccine boosts, and better ventilation indoors. He has been unafraid to critique those he regards as COVID minimizers, including President Biden himself (as in an article for The Nation, “No, Joe Biden, the Pandemic Is Not Over”).

Dining indoors these days certainly isn’t news. But within minutes, Pandora’s box had been flung open—unleashing an online tsunami of calumny directed entirely at Gonsalves. It was a moral condemnation of his life, his decency, his very self, based on this single, public act. Mike Hicks, one of Gregg’s online critics, summed up his view this way: “Does it make sense to engage in low-risk behaviors for 90 or even 95 percent of the time so you feel justified sticking a revolver to your head and pulling the trigger in a game of COVID Russian roulette?”

The reaction reveals a level of moral outrage increasingly entering debates over public health. For Gonsalves, it is concerning. “After three years of a pandemic we have to think about what’s sustainable,” he responds. Expecting responsible behavior from others is reasonable, but asking for totally, completely flawless behavior 100 percent of the time is not. “An absolutist moral framework pits us against each other and takes the public out of public health.”

We are now in the “You do you” phase of COVID-19, but that may be nothing new. Medical anthropologist Martha Lincoln of San Francisco State University notes that America has a long tradition of framing individuals as the most influential actors in their own lives, and this lets regulators off the hook. “We are reduced to looking to individuals as the major cause of and culprit for the outcomes that we’re living with,” she explains. “Diverting responsibility from institutions such as the CDC or the White House means that we can’t really locate a common enemy, and so enemies appear to be potentially everywhere. People may experience catharsis from identifying those who seem to be straying from the behaviors we think are correct. But it’s counterproductive.”

Instead of focusing on individuals, adds Gonsalves, “more lives can be saved when we shift the environmental and structural factors of society that throw us into the path of risk. The entire debate about individual interventions deals with downstream effects. Yes, individual interventions save lives, but they leave the larger sources of sickness unaddressed. It’s a ruse.” An analogy he likes to use is this: If you’re standing on the shore of a river watching hordes of people flailing as they drown in a fast current, you can either jump in and save one, or go upstream where you find the bridge has collapsed and needs to be repaired.

In America today, most of us are standing on that metaphorical shore, trying to decide whom to save from or blame for infection, climate change, staggering health care costs—one, two, ourselves, everybody, nobody? Moral frameworks about health can slide into our lives almost unnoticed and ignite self-righteous outrage as well as deeply felt betrayal, grief, or contempt. The result is more than toxic in today’s world, when so many engage in what molecular biophysicist Joseph Osmundson calls “these online clusterfucks of shaming, which never work anyway. Morality is so baked into our language of illness, it is almost the default setting, the language given to us to think about sickness,” he says. “It takes active, thoughtful work every day with every sentence one uses to reframe illness in ways that don’t make it a moral state.”

Mismoralization is exactly what it sounds like—the misapplication of the moral impulse in places where it does not belong and cannot help.

A powerful sense of right and wrong, of justice and injustice, forms early in life. Research has shown that toddlers as young as two are capable of judging what is fair and unfair. We may acquire an internal moral grammar in lockstep with the acquisition of actual language. But when moral frameworks spill into the realm of public health, we end up with what bioethicist Euzebiusz Jamrozik and his collaborator Steven Kraaijeveld have dubbed mismoralization.

Mismoralization is exactly what it sounds like—the misapplication of the moral impulse in places where it does not belong and cannot help. Mismoralization in public health can lead to shaming, blaming, and ultimately the fracturing of society. “Across societies,” write Kraaijeveld and Jamrozik in an August paper in Medicine, Health Care and Philosophy, “human beings are inclined to punish norm violations.”

“We as a culture don’t think about how policy makes people sick,” says medical historian Jim Downs, author of the book Maladies of Empire. “We’re much more willing to ask, ‘What did YOU do to become sick?’ As soon as you hear someone has lung cancer, the first question is ‘Do you smoke?’ That’s a moral question.”

At its worst, mismoralization leads to criminal sentences. Thirty-five U.S. states still have laws that criminalize exposing others to HIV, even though AIDS is now a preventable and treatable disease. In some states, the maximum jail sentence is still life in prison.

On the other side of the coin, getting infected with HIV has also been moralized. “I cannot count the times I’ve been told I brought HIV on myself because I couldn’t keep it in my pants,” says Gonsalves. “I deserved what I got.” Even now, he says, he occasionally gets emails and direct messages calling him things like “an AIDS-infected f%#@*t.”

During the 1980s and 1990s, when HIV infection and mortality rose and peaked, there was a kind of moral calculus that went like this, says Osmundson: “Did you get it from a monogamous partner who cheated? Well, that’s bad but not that bad. Did you get it at a sex party? Oh my God, you should be ashamed.”

If you didn’t wear a condom back then, you were seen as killing yourself and others, adds Liz Highleyman, a medical journalist specializing in HIV and other infectious diseases.

Last summer, when monkeypox swept largely through gay communities—most often transmitted, it appeared, during the physical intimacy of sex between men—old stigmas resurfaced. One epidemiologist who caught monkeypox told the Philadelphia Tribune that he was afraid people would think, “If you got monkeypox, you got it in a very slutty way.” Public health officials applied harm reduction principles that had proved effective in the fight against HIV, says Highleyman, but the public response was not so forgiving. As one tweet put it: “So Big Brother shut down your churches and businesses for Cov19, but won’t tell gay men to stop having orgies for monkeypox.”

We have a long tradition in this country of shifting blame to those who don’t deserve it.

When confronting illness or frailty, this tradition of moral outrage does not recognize the systemic failures that are the true drivers of illness. “United States history has often featured the criminalization of infection,” observes medical ethicist Harriet Washington, author of the book Medical Apartheid: The Dark History of Medical Experimentation on Black Americans From Colonial Times to the Present, which won the 2007 National Book Critics Circle Award for Nonfiction. Pellagra, for instance, was called a Black infectious disease that struck “African Americans because of their supposed penchant for living in filthy conditions.” It was actually a disease of malnutrition that largely afflicted the enslaved. It wasn’t until the 1920s that physician Joseph Goldberger discovered that the illness stemmed from nutritionally inadequate corn-based diets. Later researchers learned that the disease is due to a deficiency of the B vitamin niacin.

When the higher SARS-CoV-2 infection and death rate of African Americans was first documented, many causal theories tended to blame the victim, says Washington. She explains that some health officials asked whether higher drug or alcohol use, disparate genetics, or failure to don masks and shun crowds heightens Black Americans’ risks. Others, she says, invoked Blacks’ high obesity rate, although obesity is an American problem, not a racial one. “In any event,” says Washington, “obesity in African Americans is tied to living in “food swamps” where a dearth of affordable nutritious fare is worsened by saturation of tobacco and alcohol products whose marketing is targeted to racial groups.”

Tuberculosis, a scourge caused by Mycobacterium tuberculosis, surged in widespread epidemics in Europe and North America during the 18th and 19th centuries. Once it was understood to be an infectious disease, the sickness was moralized. Women and the poor were targeted—the former for apparent failures in keeping their houses clean, thus allowing tuberculosis to spread; the latter for living in squalid conditions that favored transmission and threatened the rest of society.

Early in the COVID-19 pandemic, a hundred Asian Americans were being attacked in this country every day, according to Washington. “People initially shun, exile, and then want to kill others who may be perceived as carrying dangerous infections.” Washington says this is an example of protective prejudice based on the fact that we are indeed more vulnerable to novel pathogens.

The principle is correct, but the application is often misguided. In the late 1800s, for instance, coastal West Africa was called “white man’s grave” because European soldiers and missionaries, exposed to infections to which they had no established immunity, died in high numbers there. Similarly, Native Americans succumbed to the strain of syphilis brought to the New World by European settlers. But where outbreaks of infection are concerned, “majority groups wrongly demonize minority groups,” Washington says, “avoiding them and then expelling them.”

We have a long tradition in this country of shifting blame to those who don’t deserve it. As anthropologist Lincoln points out, in almost every domain in American life where public health is at stake, large industries reflexively move their own responsibility out of view. For instance, nearly 60 years ago, a young lawyer named Ralph Nader wrote Unsafe at Any Speed, proving that car crashes were not caused only by “bad drivers “ but also by the auto industry’s unwillingness to spend on safety features like antilock brakes and airbags. During their long legal battle with the Justice Department over the opioid epidemic traced to its drug, oxycontin, Purdue Pharma and its owners, the Sackler family, shifted blame onto the individuals who became unwitting addicts. “Abusers aren’t victims; they are the victimizers,” Richard Sackler stated in one email. And the fossil fuel industry has long popularized the concept of an individual’s “carbon footprint” as a way to shift attention away from its own excesses—while individuals are left homeless from the wildfires, hurricanes, and vicious storm surges that are now commonplace effects of a changing climate.

These days it is the individual who is just plain tired of our current pandemic. That may be the case, but it does not constitute the basis of a valid public health response. It’s a form of manufactured futility that can be self-fulfilling. “A tired public is not an argument for public health policy,” says Lincoln. “So I understand why individuals are blaming other individuals. We all feel we’re trying to resolve a national public health crisis ourselves at home or online.”

What can we do to cope? First, recognize that “humans are gloriously messy,” says Osmundson. “We make mistakes, and there is no moral failing to wanting to have dinner with friends, eat pie when we’re on a diet, or have sex once without a condom. We have to build systems that are robust enough that these deeply human behaviors don’t lead to bad outcomes.”

If you lower your mask to take sips and bites at a wedding, should you be willing to go to jail for manslaughter, as queried in this tweet? If you insist that everybody wear a mask, are you robbing others of the opportunity to “richly connect, to fall in love, to live a full life”? Or are we shadowboxing to fill the vacuum left by the public health agencies that guide our national decisions—the CDC, the FDA, and the White House that presides over them both? “It’s not rocket science, what people need at a population level,” says Osmundson. “We need free health care, paid sick leave, an infrastructure that tackles public health head-on, and policy that reflects the fact that we function as a global superorganism.”

While we are nowhere close to that nirvana, we can stop hurling the slings and arrows of moral outrage at one another and join hands to demand more of our institutions, now and in the future. In that sense, we do have a moral obligation, for we are, as Gregg Gonsalves often says, “our brothers’ and sisters’ keepers. Even in our human imperfection, that’s all we’ve got.”

^{Jill Neimark is a writer based in Macon, Georgia, whose work has been featured in Discover, Scientific American, Science, Nautilus, Aeon, NPR, Quartz, Psychology Today, and The New York Times. Her latest book is “The Hugging Tree” (Magination Press).}

https://www.openmindmag.org/articles/the-moral-outrage-of-health-acts

Evolution of moral outrage:

itsme — Fri, 08 Sep 2023 20:47:46 +0000

I’ll punish your bad behavior to make me look good

Jillian Jordann

Ph.D. Candidate in Psychology, Yale University

Standing up for what’s right can come with a cost to the individual – but also a benefit.^{Michael Fleshman, CC BY-NC}

What makes human morality unique?

One important answer is that we care when other people are harmed. While many animals retaliate when directly mistreated, humans also get outraged at transgressions against others. And this outrage drives us to protest injustice, boycott companies, blow whistles and cut ties with unethical friends and colleagues.

Scientists refer to these behaviors as third-party punishment, and they have long been a mystery from the perspective of evolution and rational self-interest. Why should people invest time, effort and resources in punishing – even when they haven’t been harmed directly? While it’s clear that our punishment is motivated by moral outrage, that raises the question of why we developed a psychology of outrage in the first place.

Why punish, since it comes with a cost?

One theory is that people punish to benefit society. Social sanctions from peers can deter misbehavior, just as legal punishment does. To take an example from daily life, if Ted decides to criticize his coworker Dan for going on Facebook during work, Dan and others will be less likely to slack off, and the company will be more productive. Perhaps, then, Ted punishes Dan to promote a successful workplace.

Analysis of the world, from experts

However, this logic can fall prey to the “free-rider problem”: everyone wants to be at a successful company, but nobody wants to sacrifice for it. If Ted punishes Dan, Dan might exclude him from his upcoming party. Why should Ted take this hit?

One reason individuals might benefit from punishing is via rewards for deterring misbehavior: Ted’s boss might reward him for promoting company productivity by criticizing Dan.

In a recent Nature paper, my colleagues and I provide evidence for a different theory of individual benefits of punishment – one that can operate in conjunction with the rewarding process described above. We argue that individuals who punish can boost their reputations by signaling that they can be trusted. If Ted punishes Dan for going on Facebook, his other coworker, Charlotte, might trust that he won’t slack off if assigned to an important project.

Signaling one thing by doing another

To make our case, we first created a game theory model of third-party punishment as a “costly signal” of trustworthiness.

_{Have a look at my plumage; you know what this dazzling display means.}
_{Shanaka Aravinda, CC BY-NC-ND}

The concept of costly signaling originated with the example of the peacock’s tail. Female peacocks want to mate with males who have good genes, but they cannot directly observe genetic quality. So high-quality males woo females with elaborate plumage, which they can afford to produce only because they have good genes. It’s too energetically expensive for low-quality males to produce the same kind of beautiful tails; the cost of trying to do so would be enormous, and not worth the benefit of attracting mates by (falsely) appearing to be high-quality. So beautiful tails end up being a reliable signal for genetic quality. (The same logic can be applied to people signaling their wealth with extravagant watches or sports cars.)

Our model is based on the idea that, just as peacocks vary in their genetic quality, people vary in their incentives to be trustworthy. Imagine that Ted and Eric are both summer interns. Ted aspires to work at the company in the long run, while Eric just wants to add a line to his resume. Both Ted and Eric wish to be selected by Charlotte for the aforementioned project (as getting selected means getting paid more), but they will behave differently if selected. Ted has the incentive to work hard – even at the cost of his weekend plans – because doing so will boost his career prospects in the company. In contrast, Eric will get the line on his resume regardless of if he does a good job, so his incentive is to slack off and enjoy his weekend.

In situations like this, people like Charlotte (whom we call Choosers in our model) must decide whether to trust people like Ted and Eric (whom we call Signalers) – who are either trustworthy (like Ted) or exploitative (like Eric). Choosers cannot directly tell who is trustworthy – if Charlotte asked Eric whether he would work hard, he would say yes: he wants to get the raise! Thus, Choosers must base their decisions on costly signals. Can third-party punishment be such a signal?

We argue that the answer is yes, because the same factors that motivate people to be trustworthy often also motivate them to deter misbehavior via punishment. For example, Ted’s drive to get ahead in the company gives him an incentive to be trustworthy to Charlotte – and also to get rewarded by his boss for punishing Dan. Consequently, the benefit of impressing Charlotte, when combined with the reward from his boss, could be enough to outweigh the cost of punishing.

In contrast, because Eric doesn’t value a reward from his boss very much, he might not find it worth punishing Dan to impress Charlotte. As a result, punishment can serve as an honest and reliable signal of trustworthiness.

Next, we tested this theory using incentivized experiments where we had human subjects engage in a stylized version of the scenario described above. In our experiments, a Signaler subject had the opportunity to sacrifice money to punish a stranger who had treated somebody else selfishly. Then in a second stage, a Chooser subject decided whether to entrust the Signaler with some money – and then the Signaler got to decide how much of the money to return.

From theory to data: economic experiments on how people punish

The results? As predicted, Choosers were more likely to trust Signalers who had punished selfishness in the first stage. And they were right to do so: Signalers who punished really were more trustworthy, returning more money in the game. Furthermore, when Signalers had a more direct way to signal their trustworthiness to Choosers (by sharing money with a stranger, rather than punishing somebody for not sharing), they were less likely to punish – and Choosers were less likely to care whether they did.

Implications for human morality

By scolding in the office, are you actually broadcasting information about yourself? Workplace image via www.shutterstock.com

Thus, we provide evidence that punishing selfishness can act like a peacock’s tail – it can serve as a public display that hints at a quality (trustworthiness) that can’t easily be observed. We help resolve the “free-rider” problem by showing that individuals who punish others benefit from an improved reputation. And we help explain why we might have developed a sense of moral outrage in the first place.

Our theory can also speak to why people sometimes punish wrongdoing that could never affect them personally, even in the future. For example, why do men condemn sexism, even though they have no personal stake in wiping it out? One explanation may be to signal to women that they can be trusted not to behave in a sexist manner.

The signaling account can also help explain our fiery hatred of hypocrites who punish others for behaviors they engage in themselves. Such hatred seems strange when you consider that punishment can help society by deterring misbehavior – if you’re going to behave badly yourself, isn’t it better to at least chip in by punishing wrongdoing? Yet we think hypocrites are much more contemptible than people who behave badly but do not punish others. This perspective makes sense when you consider that hypocrites engage in dishonest signaling – their punishment falsely advertises to others that they can be trusted.

Finally, our theory sheds light on when punishment does – and doesn’t – benefit the group and society. Punishment generally deters misbehavior: when Ted punishes Dan to impress Charlotte and get rewarded by his boss, he is likely to improve workplace productivity. But people don’t always punish in the ways that are best for society. Ted may face similar incentives to punish Dan even if Dan has already been punished by others – or if Ted (but only Ted) knows that Dan’s perceived transgression was actually a well-intentioned mistake. Thus, people may engage in disproportionate punishment, or punish accidents, for the purpose of boosting their own reputations. These examples demonstrate that if punishment evolves to benefit individuals, we should expect imperfect outcomes for society when individual and collective incentives do not align.

Moral outrage and third-party punishment are key features of human morality, and set us apart from other animals. Our research suggests that the drive to punish has a self-interested side, and may exist, in part, to boost our reputations. This conclusion doesn’t undermine the moral good that often results from our drive to punish, but rather sheds light on its origins and its nature.

theconversation.com/evolution-of-moral-outrage-ill-punish-your-bad-behavior-to-make-me-look-good-55103

Why grammar mistakes in a short email could make some people judge you

itsme — Tue, 05 Sep 2023 20:32:48 +0000

Julie Boland, Robin Queen

I’m a cognitive psychologist who studies language comprehension. If I see an ad for a vacation rental that says “Your going to Hollywood!” it really bugs me. But my collaborator, Robin Queen, a sociolinguist, who studies how language use varies across social groups, is not annoyed by those errors at all.

We were curious: what makes our reactions so different?

We didn’t think the difference was due to our professional specialties. So we did some research to find out what makes some people more sensitive to writing mistakes than others.

What prior research tells us

Writing errors often appear in text messages, emails, web posts and other types of informal electronic communication. In fact, these errors have interested other scholars as well.

Analysis of the world, from experts

Several years before our study, Jane Vignovic and Lori Foster Thompson, who are psychologists at North Carolina State University, conducted an experiment about vetting a potential new colleague, based only on an email message.

College students who read the email messages perceived the writer to be less conscientious, intelligent and trustworthy when the message contained many grammatical errors, compared to the same message without any errors.

And at our own University of Michigan, Randall J. Hucks, a doctoral student in business administration, was studying how spelling errors in online peer-to-peer loan requests at LendingTree.com affected the likelihood of funding. He found that spelling errors led to worse outcomes on multiple dimensions.

In both of these studies, readers judged strangers harshly simply because of writing errors.

Typos vs. grammos

Over the last several years, we conducted a series of experiments to investigate how written errors change a reader’s interpretation of the message, including the inferences that the reader makes about the writer.

For our original experiments, we recruited college students to be our readers, and for our most recent experiment, we recruited people from across the country who differed widely in terms of age and level of education.

In all of our experiments, we asked our participants for information about themselves (e.g., age, gender), literacy behaviors (e.g., time spent pleasure reading, texts per day), and attitudes (e.g., How important is good grammar?). In the most recent experiment, we also gave participants a personality test.

In each experiment, we told our participants to pretend that they had posted an ad for a housemate and gotten 12 email responses. After reading each email, the participants rated the writer as a potential housemate, and on other factors like intelligence, friendliness, laziness, etc.

In fact, we had created three versions of each email. One version had no mistakes. One version included a few typos, e.g. abuot for about. Another version had errors involving words that people often mix up, such as there for their (we called these grammos).

Everyone read four normal messages, four with “typos,” and four with “grammos.” Different people read the other versions of each message, so that we could separate responses to the errors from responses to the message content.

Errors matter – but to whom?

In all of our experiments, readers rated the writers as less desirable if the emails included either typos or grammos. We expected this based on the earlier research, described above. In addition, people differed in their sensitivity to the two types of errors.

For example, college students who reported higher use of electronic media were less sensitive to the errors, though time spent pleasure reading had no effect. Prior research on writing errors had not compared types of errors, nor collected information about the readers, in order to see which reader characteristics influenced interpretation.

Both of these strategies for understanding how errors impact interpretation are unique to our research.

Perhaps the most interesting finding is from the experiment in which we gave participants the personality test. It measured the five traits considered to be important in personality research: extraversion (i.e. how outgoing or social a person is), agreeableness, openness to experience, conscientiousness and neuroticism (prone to anxiety, fear, moodiness).

This experiment involved adults who varied a lot in age and education, but those differences didn’t affect their interpretation of the writing errors.

Unlike the initial study with college students, use of electronic media had no effect. What mattered were the personality traits: people responded to the writing errors based on their personality type.

Responses to errors in emails depend on personality types.
Pesky Librarians, CC BY-NC-ND

People who scored high in conscientiousness or low on the “open-to-experience” trait were more bothered by the typos. People who scored low on agreeability were more bothered by the grammos. And people who scored low on “extraversion” were more bothered by both types of errors. In contrast, how people scored on neuroticism did not alter the impact of either type of error.

Remember, by being bothered we mean that the reader gave lower ratings on the housemate questionnaire to writers who made that type of error.

Why a short email could matter

Our findings – that our personality influences our interpretation of a message – complement other research that has found that our personality influences what we say and how we say it.

In 2015, Gregory Park and other researchers at the University of Pennsylvania and the University of Cambridge analyzed Facebook posts from more than 66,000 users who had also completed a personality test based on the same five personality traits that we measured in our study. They found the use of words like love, party and amazing are correlated with extraversion, while the words sick, hate and anymore are correlated with neuroticism.

This research built upon earlier work by researchers Tal Yarkoni and James W. Pennebaker.

Personality traits that influence reactions to writing errors.
Julie Boland, CC BY

While reading our research, two key points need to be kept in mind. First, we think that errors influenced readers’ perception of the writer mainly because the writer was otherwise unknown – the short email was the only basis for judgment. Second, we didn’t ask the readers how likely they were to point out errors to the people who make them.

So, it doesn’t necessarily follow from our study that your friends will view you more negatively if you don’t proofread your email messages, or that you can predict which people will call you on it based on their personality.

But, you might want to keep these findings in mind when you write for an unknown audience or when you read something from someone you don’t know.

theconversation.com/why-grammar-mistakes-in-a-short-email-could-make-some-people-judge-you-57168

‘I’m So Burned Out’: Fighting to See a Specialist Amplified Pain for Riverside County Woman

itsme — Thu, 13 Jul 2023 20:57:18 +0000

Teresa Johnson believes she was mistakenly given iodine before a CT scan in September 2022, triggering a severe allergic reaction resulting in extreme, chronic pain and neuropathy. “I would never wish this on anybody,” she says.
^{_{(COLBY TARSITANO FOR KFF HEALTH NEWS)}}

By Molly Castle Work

OCTOBER 10, 2023

SAN JACINTO — Teresa Johnson can’t escape the pain. It’s as if she’s getting pierced by needles all over her body, all at once. At night, she sometimes jolts out of sleep thinking bedbugs are attacking her. But it’s just the unfailing pain — day in and day out.

Johnson, 58, said her ordeal started in September 2022, when she went for a CT scan of her abdomen after a bout of covid-19. Though Johnson warned the lab she was allergic to iodine, she believes the lab tech used it in an injection, triggering an allergic reaction. She spent the next three weeks in the hospital, feeling as if her body was on fire.

When she was discharged to her home at the base of the San Jacinto Mountains in Riverside County, Johnson said, her quality of life deteriorated and her frustration mounted as she waited for her Medi-Cal plan to get her assessed by a specialist. She could barely walk or stand, she could no longer cook for herself, and sometimes she couldn’t even lift her leg high enough to step into the tub.

“I would never wish this on anybody,” Johnson said while rocking back and forth on the couch to still the pain. “You don’t know if you should cry, or just say OK, I can make it through this. It messes with you mentally.”

Johnson said her primary care doctor told her he wasn’t sure what triggered the pain but suspects it was compounded by the lingering effects of covid. Johnson, who is diabetic, developed neuropathy, a type of nerve damage, possibly after the allergic reaction caused her blood sugar levels to skyrocket, her doctor told her.

He referred Johnson, who receives care through California’s Medicaid program for low-income people, to an endocrinologist in March. But Johnson said she was not offered timely appointments, and it took more than six months, four referrals, multiple complaints to her health plan, and a legal aid group’s help to finally snag a phone call with an endocrinologist in mid-September.

Access to specialists — from gastroenterologists to cardiologists — has been a long-standing challenge for many Medi-Cal patients, especially those in rural areas or regions facing staff shortages. The Inland Empire, where Johnson lives, has the second-lowest supply of specialists in the state, according to the California Health Care Foundation. (California Healthline is an editorially independent service of the California Health Care Foundation.)

The state Department of Managed Health Care, which regulates most Medi-Cal health plans, requires plans to get patients in to see specialists within 15 business days, unless a longer waiting time would not harm the patient’s health. But the timeline often looks very different in reality.

“It’s hard to get a specialist to contract for Medi-Cal patients. Period,” said Amanda Simmons, executive vice president of Integrated Health Partners of Southern California, a nonprofit organization that represents community health clinics. “Specialists don’t want to do it because reimbursement rates are so low.”

Johnson said she made her first call in March to the endocrinologist assigned by her Medi-Cal insurer, Inland Empire Health Plan, and that the office offered her an appointment several months out. Over the next four months, she received three more referrals, but she said she got a similar response each time she called. When Johnson objected to the lengthy wait times, requesting earlier appointments, she was told there was no availability and that her condition wasn’t urgent.

“They told me it wasn’t important,” Johnson said. “And I asked, ‘How would you know? You’ve never seen me.’”

Esther Iverson, director of provider communications for the plan, declined to speak about Johnson’s case but said the plan makes every effort to meet the 15-day requirement. It can be challenging to meet the standard, she said, due to a lack of available physicians — especially for certain specialties, such as endocrinology and pain management.

She pointed to the nationwide physician shortage, which is more pronounced in rural areas, including parts of San Bernardino and Riverside counties, where the plan operates. She also noted that many physicians decided to leave the field or retire early due to burnout from the covid pandemic.

“God blessed me with an amazing family. They love me so much and take such good care of me. Sometimes I feel like a burden to them,” says Teresa Johnson, with 22-year-old granddaughter Iasia Bailey, who helps care for her. (COLBY TARSITANO FOR KFF HEALTH NEWS)

At the same time, she said, the plan’s enrollment ballooned to 1.6 million as eligibility expanded in recent years. Statewide, more than 15 million Californians are enrolled in Medi-Cal.

“The highest priority for us is timely access to quality care,” Iverson said.

During her quest, Johnson enlisted the help of Inland Counties Legal Services, which provides free legal representation to low-income residents. They called the plan multiple times to request earlier appointments but got mired in bureaucratic delays and waiting periods.

In one instance in August, after the insurer told Johnson it couldn’t meet the 15-day time frame, her legal representative, Mariane Gantino, filed an appeal, arguing that Johnson’s request was urgent. The insurer’s medical director responded within a few hours denying the claim, saying the plan concluded that her case was not urgent and that a delay would not cause a serious threat to her health.

“I’m so burned out after dealing with this for so long,” Johnson said in mid-September. “Why do they have the 15-day law if there aren’t going to be any consequences?”

A few days later, Johnson finally received the call she had been waiting for: an offer of a phone appointment with an endocrinologist, on Sept. 18. During the appointment, the doctor adjusted her diabetes and other medications but didn’t directly address her pain, she said.

“I’m in the same position,” Johnson said. “I’m still in pain. What’s next?”

Over the years, Johnson has worked a variety of jobs — from driving eighteen-wheelers cross-country to weaving hair — but her most consistent work was as a caregiver, including to her six children, 21 grandchildren, and three great-grandkids, with another great-grandchild on the way. Now, because of her extreme pain, the roles have been reversed. A daughter and granddaughter who live with her have become her full-time caregivers.

“I can’t do nothing. I can’t take care of my grandkids like I used to,” said Johnson, who sleeps most of the day and wakes up only when her pain medication wears off. “I was planning to take care of the new baby that’s coming. I probably can’t even hold her now.”

This article is part of “Faces of Medi-Cal,” a California Healthline series exploring the impact of the state’s safety-net health program on enrollees.

The hidden extra costs of living with a disability

itsme — Mon, 12 Jun 2023 20:29:16 +0000

By Muriel Generated with AI

Disability is often incorrectly assumed to be rare. However, global estimates suggest than one in seven adults has some form of disability.

The term “disability” covers a number of functional limitations – physical, sensory, mental and intellectual. These can range from mild to severe and might affect someone at any time across the lifespan, from an infant born with an intellectual impairment to an older adult who becomes unable to walk or see.

What is perhaps less well-known is that studies consistently show that people with disabilities are disproportionately poor. They are more likely to become poor and, when poor, are more likely to stay that way, because of barriers to getting an education, finding decent work and participating in civic life. Taken together, these barriers significantly and adversely impact their standard of living.

Calculating the cost

However, a new body of research reveals another major barrier, previously missing from most studies: People living with disabilities also face extra costs of living. Our team’s recent review of the evidence suggests that living with a disability may cost an additional several thousand dollars per year, adding up over time to be a significant financial burden on households.

People with disabilities may have more
basic necessities than people without.
Antonio Diaz/Shutterstock.com

Governments draw poverty lines at a level of income that they believe is sufficient to meet a minimum standard of living. Someone at the poverty line presumably has just enough resources to house, clothe and feed themselves at an acceptable level, and participate in the basic activities of being a citizen. Increasingly, countries provide cash benefits or food transfers to people below this poverty line so they are able to reach this minimum standard for basic resources.

The problem is that people with disabilities have extra costs of living that people without disabilities do not have. They have higher medical expenses and may need personal assistance or assistive devices, such as wheelchairs or hearing aids. They may need to spend more on transportation or modified housing, or be restricted in what neighborhoods they can live in to be closer to work or accessible services.

When this is the case, then some people with disabilities might appear “on paper” to live above the poverty line. But in reality, they don’t have enough money to meet the minimum standard of living captured in that poverty line.

In our recent review of the literature, we found that people with disabilities in 10 countries face large extra costs of living. These costs can range widely, from an estimated US$1,170 to $6,952 per year. In a developing country such as Vietnam, for example, the estimate stands at $595 for additional health costs alone.

We used a method called the standard of living approach, which estimates extra costs based on the gap in assets owned by households with and without disabilities. Extra costs accounted for a large share of income, from a low of 12 percent in Vietnam to 40 percent for elderly households in Ireland.

Comparing the costs of disabilities across countries is challenging. Recent studies measure what is actually spent, not what needs to be spent. Estimated costs might be less in developing countries not because it is less expensive to accommodate the needs of people with disabilities in those countries, but because the goods and services needed are not available. If wheelchairs or hearing aids are nowhere to be found, then a person cannot spend money on them.

This could lead to the paradoxical finding that, as a country starts becoming more inclusive, the measured costs of living with a disability could increase. But hopefully, at the same time, the ability of people with disabilities to work and go to school will also increase.

Unanswered questions

A woman is escorted from protest opposing cuts to Medicaid in front of Senator Mitch McConnell’s office on Capitol Hill on June 22, 2017.
AP Photo/Jacquelyn Martin

There is much we still don’t know about what it costs to live with a disability. In our comprehensive review of the literature, we found only 20 studies that estimated increased costs of living with a disability. The vast majority were from developed countries.

We need better information on how these extra costs may vary by type of disability, and how they may be affected by efforts to remove barriers to participation. For example, how would building a fully accessible public transportation system impact the extra transportation costs that people with disabilities face?

Our work also suggests we may need different income tests for people with disabilities when it comes to social protection programs. For example, should the income limit for receiving cash transfers or subsidized housing be higher for families with disabilities because they face these extra costs? Some countries, such as Denmark and the United Kingdom, provide benefits to support families with disabilities who bear these costs.

Another important question is whether these benefits are adequate. Do they allow people with disability and their families to reach at least a minimum threshold for standard of living? To what extent does this improve their participation in society or the economy?

Supporting people with disabilities

To address these questions, we need to monitor these issues over time. For that, we need more and better data on disability in different countries linked to good data on income, assets and expenditures. We recommend adding well-formulated disability questions to the standard household surveys currently used by most countries to chart their citizen’s wellbeing. The best example of such questions was developed under the aegis of the U.N. Statistical Commission via the Washington Group on Disability Statistics.

It’s also important to undertake qualitative research. For instance, focus groups and in-depth interviews would help researchers better understand the needs of people with disabilities in their own terms.

Policymakers also need to make social programs sensitive to the issue of extra costs associated with disability – for instance, in income tests and benefit amounts or through social health insurance programs. Our review has led us to believe that even well intended anti-poverty efforts and social protection schemes that do not take into consideration the additional costs of living with a disability will leave millions of people who have disabilities, and their families, in poverty.

Authors

Sophie Mitra-Associate Professor of Economics, Fordham University

Daniel Mont-Principal Research Associate in Epidemiology and Public Health, UCL

Hoolda Kim-Graduate Student in Economics, Fordham University

Michael Palmer-Senior Lecturer in Economics, RMIT University Vietnam

Nora Groce-Chair of Disability and Inclusive Development, UCL

itsme — Mon, 12 Jun 2023 20:07:50 +0000

Why grammar mistakes in a short email could make some people judge you

Julie Boland, Robin Queen

We were curious: what makes our reactions so different?

We didn’t think the difference was due to our professional specialties. So we did some research to find out what makes some people more sensitive to writing mistakes than others.

What prior research tells us

Writing errors often appear in text messages, emails, web posts and other types of informal electronic communication. In fact, these errors have interested other scholars as well.

Analysis of the world, from experts

In both of these studies, readers judged strangers harshly simply because of writing errors.

Typos vs. grammos

Responses to errors in emails depend on personality types.
Pesky Librarians, CC BY-NC-ND

Errors matter – but to whom?

Both of these strategies for understanding how errors impact interpretation are unique to our research.

This experiment involved adults who varied a lot in age and education, but those differences didn’t affect their interpretation of the writing errors.

Personality traits that influence reactions to writing errors. Julie Boland, CC BY

Remember, by being bothered we mean that the reader gave lower ratings on the housemate questionnaire to writers who made that type of error.

Why a short email could matter

Our findings – that our personality influences our interpretation of a message – complement other research that has found that our personality influences what we say and how we say it.

This research built upon earlier work by researchers Tal Yarkoni and James W. Pennebaker.

But, you might want to keep these findings in mind when you write for an unknown audience or when you read something from someone you don’t know.

Things that bug me…. – KMZ Digest

Shoe Envy

‘Diversity’ Doesn’t Include Disabled Veterans Like Me

AUTHOR

Matthew Winans

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Writing Disabled Voices

USE LANGUAGE CORRECTLY

DIVERSIFY YOUR TEAM

When hiring disabled reporters or commissioning them for stories, know that lived experience isn’t bias. It’s wisdom.

DEPICT YOUR SUBJECTS WITH DIGNITY

Know that people are relying on your coverage to tell the truth about their disease.

When You Are the Consumer:

Look for authentic depictions

Respond proactively and productively

Editor’s Note

How COVID-19 Changed College Athletic Recruiting

About the author(s)

Moral Shaming: “You do You”

When people have different views about health and freedom, they misuse morality to demonize one another, letting policymakers and corporations off the hook.

We have a long tradition in this country of shifting blame to those who don’t deserve it.

Evolution of moral outrage:

I’ll punish your bad behavior to make me look good

What makes human morality unique?

Why punish, since it comes with a cost?

Analysis of the world, from experts

Signaling one thing by doing another

From theory to data: economic experiments on how people punish

Implications for human morality

Why grammar mistakes in a short email could make some people judge you

What prior research tells us

Analysis of the world, from experts

Typos vs. grammos

Errors matter – but to whom?

Why a short email could matter

‘I’m So Burned Out’: Fighting to See a Specialist Amplified Pain for Riverside County Woman

The hidden extra costs of living with a disability

Calculating the cost

Unanswered questions

Supporting people with disabilities

Why grammar mistakes in a short email could make some people judge you

What prior research tells us

Analysis of the world, from experts

Typos vs. grammos

Errors matter – but to whom?

Why a short email could matter