August 5th, 2008 §
Causation is impossible to prove in empirical studies. Yet Scientists emphasize causality in scientific studies. Only through necessary proofs can things be known to exist in a cause and effect relationship. This claim to knowledge is also evident in epidemiology where necessary causes are looked for. This bias has resulted in difficultly in finding good reasons to say that a factor and a disease are related. This confusion is shown by the use of the black box analogy to provide support for causation. The idea of the black box is most often used when physical determinants for disease cannot be necessarily ascertained. We are used to thinking of physical bodies as acting according to the laws of physics and therefore being determinant in nature. But when we look at other factors it becomes clear that the casual factors of disease can not be known to exist necessarily and therefore have a necessary effect.
When looking at disease factors one must look at not only the physical factors but also in some cases the chemical, biological, ecological, environmental, and sociological factors. When talking about factors that lead to disease multiple factors may be involved and more often than not these factors are not all physical.
But according to science in order for science to be useful it must establish a cause effect relationship. Hume define a necessary and sufficient condition as being that in which if the cause does not exist then the effect will not exist either (Olsen, 2003). This criterion is rarely if ever demonstrated.
The philosopher Hume pointed out that what we know is based on experience and therefore we cannot know the necessary antecedents that result in consequential determinants or even if this determinant nature exists (Karhausen, 2000).
What is called counterfactuals increases this confusion. While we can know that in a hypothetical argument if the antecedent is true and the consequent is false that the claim is false. Yet material claims are different from counterfactual claims. If I am in Mexico then I am in North America. This is true when I am indeed in fact in Mexico. But this conditional claim is also true if I happen to be in Africa and this fact has no bearing on the truth value of the claim that if I am in Mexico I am also in North America. Yet also the material claim is still true. If the claim that one is in Mexico is false (e.g., me being in Africa) and the consequent that therefore I am in North America is still a true claim! This is the nature of hypothetical statements which are borne out in beginning logic truth tables. So we cannot make a claim that if there is or is not a causal factor that the disease will not invariably occur.
Proving some factor is causal has been the “holy grail” in science. We can’t know by observation whether a factor has a causal effect on something else. All we know is through observation which in itself is limited by the possible number of observations a certain probability that something might occur. Because this falls short of the necessary and sufficient conditions desired in hard science an attempt is made to adopt what may seems to be somewhat arbitrary criteria to firm up this supposed causal relationship. These criteria are production, necessary causes, sufficient– component causes, probabilistic causes, and counterfactuals.
Production is simply referred to a cause that “produces” an effect contrary to something that does not and is therefore not causal, but the nature of production and even how it is different from causation is unclear and is therefore an elusive concept.
Necessary causes are incorporated in the concept of sufficient causes. One reason the necessary and sufficient criterion is seen as flawed is because most diseases are not the result of a specific (e.g., sufficient) cause. This may vary not only because of the irregularity of causal factors, but also temporal consideration as well as non-biological factors.
Sufficient-Component causes attempts to address the fact that most disease does not have a singularly specific “genetic” factor. While this may provide framework for a variety of necessary causes the problem still exists asking which factor is most prominent, (e.g., including dose response factors), and do the individual factors rely on other independent factors? “A model of causation that describes causes in terms of sufficient causes and their component causes illuminates important principles such as multicausality, the dependence of the strength of component causes on the prevalence of complementary component causes, and interaction between component causes” (Rothman, 2001). There is no doubt that there are a lot of variables to keep in mind and because of this the value of this idea may be drawn into question.
Probability factors may seem to fit in best with a statistical model but while necessary and sufficient conditions may be referred to in a probabilistic fashion, probabilistic measures cannot be talked about in a necessary manner. A probabilistic way of talking about physical phenomena is especially problematic for scientific disciplines. Like relativity theory and quantum mechanics, nary the twain shall meet. One main shortcoming is that if the criterion is probability then one cannot truly predict if a causal factor will result in an outcome thus contradicting the spirit of medical research.
Finally there are counterfactuals. Counterfactuals make a distinction between causation and mere correlation which is essential in any study but does not by itself result in a definition of causation. While the counterfactual is not inconsistent with necessary causes it does not provide a rationale for arriving at a necessary cause (Parascandola, 2001). Whether something is true (ontology) or whether something can be known to be true (epistemology) are both dependent on the counterfactual argument in the particular conditional statement to arrive at useful information and this distinction is often a source of confusion. The ceteris paribus condition is essential. While one may not know if “the contaminated Broad Street well is a cause of the cholera epidemic; when it is the case that if the Broad Street pump was shut down, the cholera incidence would decrease”. Yet problems can result with this too. For if malaria is thought to be the result of swamp gas and we drain the swamp and therefore eliminate malaria, it turns out the conclusion was false. In order to use the counterfactual validly one must be sure that the consequent is true when the antecedent is true otherwise no useful knowledge may be obtained.
Establishing causation for chronic diseases is difficult. Many chronic diseases have many factors and the relationship between these factors cannot always be known. A sufficient-component approach may be useful in much chronic disease especially if the risk factors can be easily identified. Nevertheless a probabilistic approach may be more efficacious because the weight of the individual risk factors may not be known.
More effective for infectious disease may be looking at necessary and sufficient conditions (i.e., the infective agent producing tuberculosis). Production as well could be very useful if it can be shown that for example when someone has AIDS they invariably have the HIV virus although even this does not show proof of direct causation. As also has been shown, the counterfactual can be used most efficiently shown from the example of shutting off the Broad Street pump by denying the true consequent and therefore righting the Broad Street wrong.
References:
Karhausen, L.R. (2000). The Elusive Grail of Epidemiology. Medicine, Health Care and Philosophy, 3:59-67. Retrieved January 3, 2008, from http://proquest.umi.com/pqdweb
Olsen, J. (2003). What Characterizes a Useful Concept of Causation in Epidemiology? Journal of Epidemiology and Community Health, 57(2). Retrieved January 3, 2008, from http://proquest.umi.com/pqdweb
Parascandola, M., Weed D.L. (2001). Causation in Epidemiology. Journal of Epidemiology and Community Health, 55(12). Retrieved January 3, 2008, from http://proquest.umi.com/pqdweb
Rothman, K.J., Greenland, S. (2001). Causation and Causal Inference in Epidemiology. American Journal of Public Health, 95(S1). Retrieved January 3, 2008, from http://proquest.umi.com/pqdweb
July 28th, 2008 §
Kidney disease is a common malady across populations. There are many causes of this disease and there seems to be a socio-economic component. In the US kidney disease tends to have a less favorable outcome among those of a lower income. This population tends to be made up of racial and ethnic minorities who are disproportionately represented in this US population with kidney disease.
A common problem when trying to address the issue of the prevalence of disease among economically disenfranchised elements of the US population, that is if the problem is determined by socio-economic status or is it the result of racism as well as racism that has been institutionalized. This problem is especially difficult to decide when one considers the history of racism and its impact on present day institutionalized racism.
Finding a link between racism and kidney disease is necessary to address the problem. While socio-economic status may seem to be the prime mover behind the disparity between better outcomes for those that are economically better off than those at the bottom of the economic scale, the determinacy of racism must be ascertained in order to address the problem of kidney disease successfully.
Ordinarily one might wonder if higher rates of kidney disease are the result of racism or the result of socio-economic factors caused by racism which results in less favorable outcomes. In order to address the problem of kidney disease in racial and ethnic minorities this issue must be resolved. Is the solution to address socio-economic conditions, institutionalized racism or face to face discrimination?
If it were socioeconomic factors that determine kidney disease then these determinants would have to be addressed. To address this problem more money would need to be put into health care and a program of preventive care would need to be instituted. Access to health care would need to be improved by those lower on the economic ladder so that health outcomes could be improved. Oftentimes though if programs are in place that provide access to services and these services do not improve health outcomes then there is the impulse to blame the victim.
But perhaps further evidence of racism among those of lower socio-economic status and a lower education level is shown by the fact that even with equitable insurance coverage and access as well as similar health insurance within the same system of care in the same managed care plan, the result is still for poorer outcomes among minorities (Bierman, 2002). Yet there are other factors that can lead to a less successful outcome in those of minorities. Those of lower socio-economic class find themselves more subject to arrest (Brooks, 2008). Also this group is more likely to be victims of crime, more likely to have housing problems, and to be families with single mothers more likely to have child care issues. All these factors can result in less adherence to a treatment regimen and must be controlled in any study.
More likely though is the other alternative. Most probably racism is the cause because minorities are the victims of a history of racism and face institutionalized racism as well as personal racism. Racism being largely unconscious and entitlement that is assumed by those higher on the economic ladder, especially whites, can make the health care provider blind to the causes of the poorer health outcomes of racial and ethnic minorities when basing their opinion strictly on socio-economic factors especially in the case of kidney disease.
It is clear that those of lower social and economic stature have a higher rate of kidney disease and are at a greater risk of death. Illegal drug use in the inner city causes higher rates of hypertension, acute and chronic kidney disease. Socio-economic factors are determinants of a higher rate of asthma, diabetes mellitus, hypertension, tuberculosis and chronic kidney disease. Cocaine use is thought to be a cause of the progression of kidney disease.
There is a greater likelihood of increased mortality and lower placement on kidney transplant waiting lists. Strictly socio-economic factors are often looked at when health insurance limits the ability of patients to pay for drugs used for the maintenance of immunosuppression in transplant patients which is limited to three years. (Nzerue, 2002)
The claim is made that racial bias is difficult to determine in surveys of physicians and other health care providers by looking at physician behavior or medical records although subtle biases are suspected which may influence physician’s therapeutic decisions. There are documented difficulties in communication between those of a lower socio-economic class and physicians who harbor negative personal perceptions of the less affluent and lower educated (Nzerue, 2002).
There are documented instances of a disproportionate less favorable outcomes among those of lower socio-economic classes among African Americans and Mexican American communities of microalbuminuria and macroalbuminuria (Tareen, 2005). But it is difficult to determine the exact factors that result in this outcome.
“Education directed toward patients and physicians is important for overcoming the many cultural differences in health beliefs and behaviors that contribute to both the risk and progression of Chronic Kidney Disease (CKD)… Adherence to referral and treatment for CKD may be improved when patients feel they receive health recommendations in a respectful and culturally considerate manner. Increasing the number of minority physicians practicing within their own communities may further help to reduce some cultural barriers” (Norris, 2005).
One study makes a strong claim of racial and ethnic disparity in low socio-economic groups. Referral and initiation of dialysis, adequacy of dialysis and anemia management-with non-white patients are usually at a disadvantage. For example Whites and Asian Americans are more likely to be placed on peritoneal dialysis compared with African American and Native Americans. “Factors in treatment for kidney disease are not completely explained through socio-economic determinants. Factors such as cultural bias, … physician bias and communication barriers all contribute to lower peritoneal dialysis among certain minority groups” (Gadegbeku, 2002).
Another issue that comes out in this study is that there is what is termed “Transplantation Reluctance.” It seems clear that while there are socio-economic factors that lead to a higher incidence of kidney disease and less favorable outcomes, it seems clear that racially specific differences can be eliminated [and identified] when a multi-faceted approach is adopted (Gadegbeku, 2002).
Much remains to be done to eliminate socio-economic, racial and ethnic biases that permeate the health care establishment. By separating the socio-economic factors from the racial factors one can institute strategies which address these shortcomings that are the direct result of racism.
Only through determining the racial and ethical component in this equation can disparities that deprive African Americans, Latino American and Native Americans access to affordable, effective and fair health care provision. Only in order for society to be just and enabling minorities to be effectively brought into the health care establishment will discrepancies between minorities and whites be addressed.
References:
Bierman, A.S., Lurie, N., Collins, K.S., & Eisenberg, J.M. (2002). Addressing racial and ethnic barriers to effective health care: The need for better data. Health Affairs, 21(3), 91.
Brooks, D., Charleston, J., Dowie, D., Gabriel, A. I., Hall, Y. B., Hiremath, L., Lightfoot, T., Sika, M., Smith, W. C., Wang, X. (2008). Predictors of Participant Adherence and Retention in the African American Study Of Kidney Disease and Hypertension. Nephrology Nursing Journal, 35(2), 133-42. Retrieved July 16, 2008, from ProQuest Medical Library database. (Document ID: 1470818171). http://proquest.umi.com/pqdweb?did=1470818171&sid=2&Fmt=3&clientId=29440&RQT=309&VName=PQD
Gadegbeku, C., Freeman, M., Agodoa, L. (2002). Racial disparities in renal replacement therapy. Journal of the National Medical Association: Racial Disparities in Kidney Disease, 94(8), 45S-54S. Retrieved July 16, 2008, from ProQuest Medical Library database. (Document ID: 160201271). http://proquest.umi.com/pqdweb?did=160201271&sid=2&Fmt=4&clientId=29440&RQT=309&VName=PQD
Norris, K. C., et al., (2005). Unraveling the racial disparities associated with kidney disease1. Kidney International, 68(3), 914-24. Retrieved July 16, 2008, from ProQuest Medical Library database. (Document ID: 1014509361). http://proquest.umi.com/pqdweb?did=1014509361&sid=2&Fmt=6&clientId=29440&RQT=309&VName=PQD
Nzerue, C.M., Demissachew, H., & Tucker, J.K. (2002). Race and kidney disease: Role of social and environmental factors. Journal of the National Medical Association, 94(8), S28-S39.
Tareen, N., Zadshir, A., Martins, D., Pan, D., Nicholas, S., & Norris, K. (2005). Chronic kidney disease in African American and Mexican American populations. Kidney International, 68(S97), S137-S140.
May 25th, 2008 §
Health cannot and should not be focused on some while ignoring others. Living in a country that plays lip service to equal rights for all often neglects the material needs to many. Nowadays with services being cut and wealth being appropriated by the upper classes health care for the poor has suffered greatly. Because of the history of racial discrimination the distribution of poverty weighs heavily on certain ethnic groups especially Blacks, Latinos, and Native Americans. It is clear that racism has been used as an excuse and has become institutionalized to justify consciously or not the inequitable distribution of wealth.
To disregard the health of some is unjust in a society and it is clear that the role of those who care about the health of others is that the greatest efforts must be taken to address the health of all no matter what obstacles stand in the way. This tradition is in fact an essential part of a mission of public health. Justice is viewed as so central to the mission of public health that it has been described as the field’s core value (Gostin, 2006).
Contributing Factors in Health Disparity
Traditional US society revolves around white male privilege. All social structure reflects European values. The white settlers eliminated any threat to their rule. The native people were largely exterminated, and the African were kidnapped and forced to work as slaves. It’s ironic that in the land of the free so many people have been denied their rights. Racism was intentionally integrated into the social structure and has subsequently become institutionalized.
The impact of racial discrimination is profound and in order for there to be improvement in health outcomes racism must be addressed. Strategies for measuring the depth of discrimination are readily available. For example for any one objective, progress toward the elimination of racial and ethnic disparities is measured in terms of changes in the relative difference between the best group rate and the rate for each of the other racial and ethnic groups…Disparities can also be viewed in terms of burden – that is, the number of people with limitations, risk factors, adverse health conditions, or health care access problems (Keppel, 2007).
Some make the claim that if one wants to they can pull themselves up by their bootstraps but when lacking even the most basic services this is most certainly impossible. Living in an impoverished neighborhood decreases ones survival odds. Inner city pollution and lack of fresh food as well as crime decrease survival odds. The negative impacts of these variables on individual people can be considered as the impact of one lacking in social capital. Nevertheless strategies to address a deficit of social capital are not sufficient as other unrecognized factors may exist.
The things many take for granted are not available to some in society. Intervening in communities to increase their levels of social capital may be ineffective, create resentment, and overload community resources, and to take such an approach may be to “blame the victim” at the community level while ignoring the health effects of macrolevel social and economic policies (Pearce, 2003).
In a society where wealth is not equitably distributed and where institutionalized racism exists certain minorities are going to suffer greatly. In the UK an example of the economic impacts are for instance that infant mortality rates for a social class V, that of unskilled manual workers, are twice that for a boy born into the professional and management classes, a social class I. In the USA, race and ethnicity are major factors (Anonymous, 2006).
In order to address inequitable health outcomes one must get to the root cause of these outcomes. A common opinion is that socio-economic considerations are central yet little investigation is done in the US regarding the impact of these socio-economic factors but focuses on racial inequalities almost exclusively. This is in contrast to Europe, where health statistics have routinely included socioeconomic data. The net effect has been to remove from view – and from policy discourse-the pervasive patterning of US health disparities by socioeconomic position within and across racial/ethnic groups, as well as to retard understanding of the contribution of racial discrimination to US racial/ethnic health disparities (Krieger, 2005).
Another error that commonly occurs since the criteria for analysis of health outcomes depends on ethnic factors only, often to address this inadequacy categories of racial identifiers are used inexactly to model socio-economic factors that result in unequal health outcomes. The easy availability of “racial” identifiers in public health databases has led researchers to sometimes use “race” as a crude proxy for economic inequality (Williams, 1997).
It is clear that socioeconomic factors are not the only reason that minorities suffer greatly in the USA. New immigrants not familiar with the language, customs and religion may suffer a well. Language is always a big barrier and this is particularly true for older newly arrived immigrants. Practitioners not familiar with the ancestral cultures of new immigrants may not be able to provide the services they need.
For example Mexican families are extended families and decisions are made by the group and not by any individual such as the patient themselves. Also the male patriarch in the clan must be consulted in any matter that must be decided. In non-native speakers it is important to have an independent interpreter rather than having the patient’s children or grandchildren doing the interpreting. One reason for this is that those translating may hide the severity of the issue at hand to protect the feelings of the patient. Also if a child is involved then this will give them a position of authority something that may be resented by the clans extended family. These and other oversights may have unforeseen consequences for care.
Achieving Positive Health Outcomes
There must be sensitivity to racist behavior in society and institutional racism. Steps must be taken to address racism in society and ensure that an economic distribution of wealth exists to adequately fund excellent health care for all. It is not enough to see that different ethic groups are treated the same. This will only result in poverty being equally distributed among ethnic groups. Rather efforts must be made to recognize those things that hold people down and rob them of their social capital, and we must empower the poor of all ethnic groups and involve them in their own care.
A thorough self examination must be instituted by the practitioner to understand ones own biases so that one can understand how these biases effect interaction with others, especially other ethnic groups. Also an effort must be made to be sure health care facilities in all areas are able to provide support services to any population regardless of the economic stature of the supported area. Only with this infrastructure can all segments of a population be served. Only when these resources are available including preventive care, acute and chronic care, including healthy lifestyle classes can people’s health outcomes be improved.
Observations For Health Science Research
The US medical system has fallen into disarray. There is no doubt the health care in the USA is unparalleled in sophistication and the superiority of treatment. The problem lies in the fact that so many are not insured and therefore lack access to health care. The poor who have no insurance have largely been thrown to the wind. Without preventative care death rates are much higher. With preventative care much chronic disease can be prevented. Avoiding poverty can enable people to eat healthier diets rather than being dependent on the local burger stand.
In 1988, the Director General of the WHO was already concerned that, “public health has lost its original link to social justice, social change and social reform” (Hancock, 1999). Twenty years later, the lack of accountability by public health practitioners remains the same. Health promotion must recover its original role and challenge social inequalities in health (Ridde, 2007).
The object of this endeavor is not to evoke an ideology of a redistribution of wealth but that this endeavor is really is a question of science. The task will be to demonstrate an evidence-based way to reduce socioeconomic disparities and to show that this improves health outcomes (Gostin, 2004). The evidence of racial and ethnic disparities in health outcomes is overwhelming. Excess deaths and excess morbidity and disability are clearly prevalent among racial and ethnic minority elders (Johnson, 2002).
The average health status of members within every society on earth increases in a stepwise fashion as one ascends from the bottom of the social ladder (defined, variously, by income, education or occupation) to the top (Hertzman, 2001). Ultimately to address this problem justly commensurate health services must be made available to all.
References:
Anonymous, Measuring progress on health disparities. (2006). The Lancet, 367(9526), 1876. Retrieved May 12, 2008, from ProQuest Medical Library database. (Document ID: 1060415791). http://proquest.umi.com/pqdweb?did=1060415791&sid=8&Fmt=4&clientId=29440&RQT=309&VName=PQD
Gostin, Lawrence O et al. (2004). The Future Of The Public’s Health: Vision, Values, And Strategies. Health Affairs, 23(4), 96-107. Retrieved May 12, 2008, from ABI/INFORM Global database. (Document ID: 661524771). http://proquest.umi.com/pqdweb?did=661524771&sid=8&Fmt=3&clientId=29440&RQT=309&VName=PQD
Gostin, Lawrence O et al. (2006). What Does Social Justice Require For The Public’s Health? Public Health Ethics And Policy Imperatives. Health Affairs, 25(4), 1053-1060. Retrieved May 12, 2008, from ABI/INFORM Global database. (Document ID: 1083916871). http://proquest.umi.com/pqdweb?did=1083916871&sid=8&Fmt=3&clientId=29440&RQT=309&VName=PQD
Hertzman, Clyde (2001). Health and human society. American Scientist, 89(6), 538-545. Retrieved May 12, 2008, from Research Library database. (Document ID: 87509292). http://proquest.umi.com/pqdweb?did=87509292&sid=8&Fmt=3&clientId=29440&RQT=309&VName=PQD
Johnson, Jerry C. et al (2002). Health and social issues associated with racial, ethnic, and cultural disparities. Generations, 26(3), 25-32. Retrieved May 12, 2008, from Research Library database. (Document ID: 275408581). http://proquest.umi.com/pqdweb?did=275408581&sid=8&Fmt=4&clientId=29440&RQT=309&VName=PQD
Keppel, Kenneth et al. (2007). Improving Population Health And Reducing Health Care Disparities. Health Affairs, 26(5), 1281-92. Retrieved May 11, 2008, from ABI/INFORM Global database. (Document ID: 1339614071). http://proquest.umi.com/pqdweb?did=1339614071&sid=5&Fmt=4&clientId=29440&RQT=309&VName=PQD
Krieger, Nancy et al. (2005). Painting a Truer Picture of US Socioeconomic and Racial/Ethnic Health Inequalities: The Public Health Disparities Geocoding Project. American Journal of Public Health, 95(2), 312-23. Retrieved May 12, 2008, from ABI/INFORM Global database. (Document ID: 820516561). http://proquest.umi.com/pqdweb?did=820516561&sid=8&Fmt=6&clientId=29440&RQT=309&VName=PQD
Pearce, Neil et al. (2003). Is social capital the key to inequalities in health? American Journal of Public Health, 93(1), 122-9. Retrieved May 12, 2008, from ABI/INFORM Global database. (Document ID: 277203851). http://proquest.umi.com/pqdweb?did=277203851&sid=8&Fmt=4&clientId=29440&RQT=309&VName=PQD
Ridde, Valéry (2007). Reducing social inequalities in health: public health, community health or health promotion? Promotion & Education, 14(2), 63-7, 111-4. Retrieved May 11, 2008, from ProQuest Medical Library database. (Document ID: 1302586891). http://proquest.umi.com/pqdweb?did=1302586891&sid=5&Fmt=3&clientId=29440&RQT=309&VName=PQD
Williams, David R (1997). Missed opportunities in monitoring socioeconomic status. Public Health Reports, 112(6), 492-4. Retrieved May 12, 2008, from ProQuest Medical Library database. (Document ID: 23988208). http://proquest.umi.com/pqdweb?did=23988208&sid=8&Fmt=3&clientId=29440&RQT=309&VName=PQD
May 8th, 2008 §
What does slavery mean? Oftentimes in this country we think of blacks on a plantation driven by their plantation masters. But slavery means much more than that. Slavery can be children forced to work. Slavery can be women and female children forced into prostitution. Slavery can be immigrants who become an illegal class forced to do whatever is demanded by their masters. Even according to Marx working for a minimum wage is a form of compulsion and therefore he would consider it slavery. In examining these topics I will look at political aspects, economic, sectoral, ethical and environmental and human rights perspectives on slavery focusing on prostitution.
Politics and Slavery
Slavery is a victimless crime. Slavery can be very profitable for the host governments. Oftentimes government overlooks slavery in their own countries because business’ profit. For example migrant workers who are here illegally are hired by the host country with full government knowledge of this practice. Little is done to alleviate this problem because of this profit accrued. When migrants complain about the terms of their employment they are liable to being turned over to authorities to be deported. Because of this migrants here illegally are exploited, do not receive minimum pay in many cases and receive no benefits.
Child labor has been abolished in the US but it is clear that child labor is being used around the world. In poorer countries child labor is needed by poor families to survive. One reform of capitalism brought about by Karl Marx was to clamor against child labor. In the 19th century child labor was used often. Children were used in the mines and were often the victims of mine collapses.
Prostitution can be classified as slavery as well although this might not always seems so obvious. Trafficking in prostitution includes both women and female children. Oftentimes women in poorer countries are told that they will be going to another country as actresses, or simply to work in manual labor but when they arrive at their destination, even with their parent’s knowledge who sold them into slavery, are employed in brothels often under terrible conditions. This is referring to trafficking in people. Oftentimes females turn to prostitution as a consequence of war.
But even with this classical definition of slavery women are often in servitude to “pimps” often supplied drugs by their pimps to enforce compliance. In the USA where prostitution in most places is outlawed they are subject to arrest and imprisonment and being charged with felonies, abused by their Johns without the ability to complain if they are beaten or raped, susceptible to STD’s.
There have been many cases of women being used in time of war. One example was the comfort women during WWII. These women are held against their will and are little more than raped by the Japanese soldiers. Abuse of women and children happens most often during times of war. Sometimes this rape occurs near the field of battle. Oftentimes it is the result of a refugee crisis where people lose there homes and their ways of making a living and must flee to another country to survive. Without money and skills they fall victim to predators that control them and may even lock them up.
Children especially female children are often used in the prostitution trade. Children get a higher price especially virgins. This involves human rights abuses as all slavery does. Children are unable to consent and this is in addition and true of adult prostitutes that lack any practical skills, drug addicted, emotionally disturbed and therefore are unable to make any choices.
It’s interesting to note that in more egalitarian societies prostitution does not necessarily exist. There were Native American tribes that had no prostitutes perhaps because there were no Victorian norms.
Slavery and Economics
Some might argue that when one doesn’t share in the profits of a corporation and must work for wages in spite of the degree of profits made by the bosses, this too has been referred to as slavery, what Marx called wage slavery. Under wage slavery a worker is paid a subsistence wage that is just enough to be able to produce the largest amount of profit for the capitalist. That is the slave is paid enough to buy food and clothes, have a house, be able to provide for one’s children. While providing for one’s children might not be seen as necessarily and serving to refute the brutality of the ruling class in fact the children too must be cared for because they provide the future wage slaves on which companies depend.
There is some question whether slavery is a natural outcome of modern society. Slavery in some form has seemed to exist in nearly all societies. The Jewish slaves in ancient Egypt, slavery in ancient Greece, the Islamic slave trade and the British slave trade or as some would argue the replacement for slavery, wage slavery. Is this the natural human condition? Are we composed naturally of like rulers and ruled like pack animals?
How did this slavery come about? “The bloody story that Marx told in this chapter is of the expropriation of the commons through the process of enclosure (the forcible imposition of private property on the landscape through the planting of hedges and violent enforcement of exclusive rights), which prevented the landless from providing for themselves in any way other than working for wages they would then use to pay for things they once had made (here specified as yam, linen, and woolens). “The expropriation and eviction of a part of the agricultural population,” Marx explained, “not only set free for industrial capital, the laborers, their means of subsistence, and material for labor; it also created the home market” (Johnson, 2004).
Prostitution and ethics
This puritan ethic and Christianity in general drives the capitalistic machine. The possessions one owns determine how well one is favored by God; this is referred to as the Christian work ethic. Someone sensual in nature and not self-denying is not godly. Also sex for money is a form of instant gratification and not self-denial mandated by common decency.
Asking if slavery is the natural condition is one question but what constitutes slavery is another.
Prostitution is often a form of slavery. In puritan societies prostitution is thought to be sinful. There was little prostitution in some Native American societies and certainly one reason for this was that sex was not frowned on. It was reported by settlers that the Native American men often walked around with erect penises and exhibited no shame. This was considered to be sinful to walk around in this manner as nudity and especially sexual arousal in public was and is verboten.
Certainly those that are the most powerless in societies around the world and in the USA as well are women. And reducing women to their basest element is the “whore”. This is the worst type of women and all women must escape this scarlet letter. Women occupy the lowest class in society often burdened with children but the absolutely most debased are the women prostitutes. These women live in one sort of servitude or another. Whether they are on the street being raped, beaten, verbally abused, imprisoned, addicted, infected they are the lowest of the low in regards to class. There is no evidence of Julia Roberts in pretty women as the romantic prostitute but one is more reminded of Jane Fonda’s “Klute”.
Very rarely do prostitutes comprise the almost socially acceptable high priced call girls that are so famous for bringing down politicians with their ill repute. But prostitutes form an important function in US society. There supply release for workers and soldiers who do not have access or the financial wherewithal to acquire wives and raise a family. These prostitutes substitute for lovers and actually can engage of seeming throws of passion when the love making is commenced.
Slavery and Society
According to Hegel history is the result of spirit coming to know itself. In order for one to have any sort of self understanding one must be sufficiently conscious. This understanding of oneself comes to fruition when one confronts another. This determines ones orientation toward the world and the two types are the master and the slave (Stewart, 1995).
Master/slave dialectic Hegel says slavery is an outgrowth of history. When two people meet in this original position one fears life over freedom and becomes the slave and the master values freedom over life and becomes the master. According to Hegel this becomes the natural condition (Kilian, 1981).
Marx a student of Hegel talks about slavery as the natural outgrowth of capitalism. In the US all actions are determined by ones class seemingly undifferentiated from the caste system of India. The masters control the mechanizations that run the capitalist enterprise. They control the means of production while the workers only control their own labor. The legitimate workers can provide “useful” labor while prostitutes comprise an illegal immoral caste.
And through prostitution not only in the act are they enslaved but because of the evilness of the enterprise prostitutes if convicted of prostitution in many jurisdictions are imprisoned and many times charged with a felony leaving any hope of more acceptable gainful employment by the wayside. So as slaves on the street they become slaves in prison for punishment of their misdeeds. It’s fitting that the US with the lofty standard of being the land of the free becomes the land of the most imprisoned. And like all criminals, the jails prisons are the repository of the poor, the mentally ill, and those of ill repute.
Those that are charged with a felony which prostitutes are often convicted are left no possibility for the future and made them even less able to resist the machine that ground them down. And like prostitution people like normal workers are treated as a commodity. Being the most powerless in society and around the world treated as goods or commodities in the human person rather than being a product of labor these unfortunates are the first to fall victim to the vicissitudes of war.
Prostitution and Human Rights
Almost two-thirds of the world’s child workers are in Asian countries. These children are often made to work 10 to 15 hours a day, seven days a week, in cramped and squalid conditions in factories, on construction sites, for domestic service, and in brothels. Under these circumstances, children are denied a basic education, their health tends to be poor, and they are deprived of the chance to lead a normal family life. Since the start of the Asian financial crisis two years ago, children have increasingly become involved in dangerous and illegal activities (Brandon, 1999).
Four million persons are moved illegally from one country to another and within countries each year, a large proportion of them women and girls being trafficked into prostitution. The United Nations International Children’s Emergency Fund (UNICEF) estimates that some 30 percent of women being trafficked are minors, many under age thirteen. The International Organization on Migration estimates that some 500,000 women per year are trafficked into Western Europe from poorer regions of the world (Leuchtag, 2003). It seems clear that prostitution is one primary source for the spread of AIDS. Though the Thai government denies it, the World Health Organization finds that HIV is epidemic in Thailand, with the largest segment of new cases among wives and girlfriends of men who buy prostitute sex (Leuchtag, 2003).
A typical form of debt bondage is reported in the following:
The report contained dozens of interviews and testimonies of women who found themselves trapped in debt bondage and servitude. One of those women, Miew,2 spent more than two years working as a hostess in a so-called dating snack bar. She served drinks at the bar and accompanied clients to nearby hotels to provide sexual services. She had been recruited in Thailand with the promise of a generous salary each month, but when she arrived, she was told that she would have to work without any compensation whatsoever until she paid off a debt of 5 million Yen, about $43,000 U.S. Dollars. Her manager immediately confiscated her passport. Miew believed that if she tried to escape she would be caught either by the Japanese gangs or by the police. She was housed under constant surveillance in an apartment just next door to the bar. Motion sensitive lights tracked the movements of all the women in the apartments, making it impossible for her to go out without being noticed. After working there for two months, Miew’s debt had actually gone up, not down. The debt ballooned to 6 million Yen, about $51,000 U.S. Dollars, which included the cost of room, board and so-called protection fees, as well as a substantial fine for giving her phone number to her parents, a forbidden act. All the fines and expenses well exceeded the amount that she had actually been able to repay on her debt.3 (Vandenburg, 2002)
The protocol on “trafficking in persons” provides the first definition of that term in a legally binding international instrument. It defines such trafficking as the recruitment, transportation, transfer, harboring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation (Murphy, 2001). This exploitation includes prostitution. UNICEF estimates that I million children are trafficked into prostitution each year in Southeast Asia alone (Meier, 2000).
Often times it is thought that the US is largely immune from trafficking in prostitutes but the evidence does not show this. It is estimated, as documented by the State Department and others that 2 million women and children are trafficked globally, and more than 50,000 women are sold into U.S. brothels.
With the destruction of homes and the ruin of people’s life’s many have turned to prostitution.
Things are not so different in other parts of the world. The U.S. State Department’s June 2005 trafficking report says the extent of the problem in Iraq is “difficult to appropriately gauge” but cites an unknown number of Iraqi women and girls being sent to Yemen, Syria, Jordan and Persian Gulf countries for sexual exploitation. (Bennet, 2006).
Arrangements for prostitution are typically made as follows and a love relationship is implied, perhaps to cover the shame: In Iraq, there are no red-light districts, and Halla and other prostitutes don’t walk the streets. They typically meet their clients through friends. Aya Abbas Latif, 22, talks about being “married” three times to customers. Another friend, Nada Baqr, 31, refers to being in love with one of her “boyfriends.” (Cha, 2004).
Engaging in prostitution, especially with the newly impoverished or refuges has serious consequences for the inhabitants and soldiers. [P]lacing some girls into brothel beds, where they are subject to ongoing serial rape, so that girls on the streets won’t be assaulted doesn’t work. The men who violate the girls in the brothel beds learn that the forcing of sex on a body is an accepted norm. They are far more likely to rape the girl on the street than they were before they raped the prostituted body. And far more likely to come home and rape those “decent” American girls next door (Falconberg, 2006).
In addition to prostitution in Iraq, many Iraqi refugees are forced to sell there bodies in other countries. Syria has taken in the lion’s share of Iraq’s refugees, (International, 2007). This prostitution is the direct result of destitution and often times the prostitute sells themselves so their families can survive. When families’ savings are gone, some women have fallen prey to sex traffickers, and girls and boys as young as 8 are drawn into prostitution in a desperate effort to help pay for basic necessities. (Anonymous, 2007).
That Iraqi girls and women are selling sex may not seem shocking, but prostitution is especially taboo for Arab women. “In this culture, to allow your daughter to become a prostitute means you’ve hit dirt bottom….The shame can even lead to “honor killings,” in which women are slain by their husbands or relatives for tainting the family name (Phillips, n.d.)
Iraqi women in Syria fall victim to the local prostitutes who accuse the Iraqi prostitutes of transmitting AIDS. A rumor circulating Damascus claims several policemen have contracted AIDS from Iraqi whores. The word on the street is that the Syrian regime is so upset about the situation, it has to jail and deport every Iraqi convicted of prostitution (WorldNetDaily, 2008). Many of these women and girls, including some barely in their teens, are recent refugees. Some are tricked or forced into prostitution, but most say they have no other means of supporting their families. As a group, they represent one of the most visible symptoms of an Iraqi refugee crisis that has exploded in Syria in recent months. (Zoeph, 2007).
All slaves including prostitutes and child laborers are more likely to be infected with HIV. According to the International Labor Organization (ILO), approximately 250 million children between the ages of 5 and 14 work in developing countries and many of them are in danger of AIDS because lack of access to health care or being subject to sexual exploitation and drug addiction (ILO, 2008).
The Future of Health and Slavery
With the increased disparity between rich and poor it seems clear that slavery is going to continue to be a large problem around the world. The intensity of war and therefore displaced children and women could contribute to continued and even increasing suffering and displacement. But this can be avoided. With NGO’s and government funding (I read today that President Bush has proposed more money for poor countries because of the impending food crisis), charitable organizations, the intervention of the WHO and the World Bank as well as the efforts of the Micro Loan lenders perhaps much of this catastrophe can be avoided. Only time will tell.
As far as prostitution is concerned generally, it is here to stay. Without changing the legal status of those that engage in prostitution and empowering these women, prostitutes will continue to be exploited and these women will continue to suffer greatly.
References:
Anonymous (2007, October) Iraq’s Abandoned Refugees. . America, 197(9), 5. Retrieved April 4, 2008, from Research Library database. (Document ID: 1352609221).
http://proquest.umi.com/pqdweb?did=1352609221&sid=5&Fmt=3&clientId=29440&RQT=309&VName=PQD
Bennett, Brian (2006, May). STOLEN AWAY. Time, 167(18), 37-38. Retrieved April 4, 2008, from ABI/INFORM Global database. (Document ID: 1031478091).
http://proquest.umi.com/pqdweb?did=1031478091&sid=3&Fmt=3&clientId=29440&RQT=309&VName=PQD
Brandon, John J. (1999, November 22). The exploited child despite a treaty to protect children, enforcement is hollow and weak :[ALL Edition]. Christian Science Monitor,p. 9:1. Retrieved April 30, 2008, from ProQuest National Newspapers Premier database. (Document ID: 46528078). http://proquest.umi.com/pqdweb?did=46528078&sid=3&Fmt=3&clientId=29440&RQT=309&VName=PQD
Cha, Ariana Eunjung (2004, June 24). The Cost of Liberty; In a Chaotic New Iraq, A Young Widow Turns to Prostitution :[FINAL Edition]. The Washington Post,p. C.01. Retrieved April 4, 2008, from ProQuest National Newspapers Premier database. (Document ID: 654706041).
http://proquest.umi.com/pqdweb?did=654706041&sid=3&Fmt=3&clientId=29440&RQT=309&VName=PQD
Falconberg, Suki (2006, April). A Rape in Iraq: Rape, Brothel Rape and Prostitution in Wartime. Off Our Backs, 36(2), 20-22. Retrieved April 4, 2008, from Research Library database. (Document ID: 1117783731).
http://proquest.umi.com/pqdweb?did=1117783731&sid=5&Fmt=3&clientId=29440&RQT=309&VName=PQD
International Labor Office (2008) ILO Action Against Trafficking in Human Beings http://www.ilo.org/wcmsp5/groups/public/—ed_norm/—declaration/documents/publication/wcms_090356.pdf
International: The plight of the refugees; Iraq and Syria. (2007, November). The Economist, 385(8555), 62. Retrieved April 4, 2008, from ABI/INFORM Global database. (Document ID: 1383995721).
http://proquest.umi.com/pqdweb?did=1383995721&sid=4&Fmt=3&clientId=29440&RQT=309&VName=PQD
Johnson, Walter (2004). The Pedestal and the Veil: Rethinking the Capitalism/Slavery Question. Journal of the Early Republic, 24(2), 299-308. Retrieved April 30, 2008, from Research Library database. (Document ID: 670707341). http://proquest.umi.com/pqdweb?did=670707341&sid=1&Fmt=3&clientId=29440&RQT=309&VName=PQD
Kilian, Martin A. et al. Marx, Hegel, and the Marxian of the Master Class: Eugene D. Genovese on Slavery The Journal of Negro History, Vol. 66, No. 3 (Autumn, 1981), pp. 189-208
Association for the Study of African-American Life and History, Inc. http://www.jstor.org/stable/2716915
Leuchtag, Alice (2003). Human right, sex trafficking, and prostitution. The Humanist, 63(1), 10-15. Retrieved May 1, 2008, from Research Library database. (Document ID: 274836021). http://proquest.umi.com/pqdweb?did=274836021&sid=1&Fmt=3&clientId=29440&RQT=309&VName=PQD
Live Video Retrieved on April 6, 2008 from http://www.livevideo.com/video/rclark23/94FB9F4B1F7C462191FD479768966810/young-iraqi-refugees-forced-in.aspx
Meier, Eileen (2000). Legislative efforts to combat sexual trafficking and slavery of women and children. Pediatric Nursing, 26(3), 329-30. Retrieved April 30, 2008, from ProQuest Medical Library database. (Document ID: 69303977). http://proquest.umi.com/pqdweb?did=69303977&sid=1&Fmt=3&clientId=29440&RQT=309&VName=PQD
Mohajerin, Shadan Kapri (2005). HUMAN TRAFFICKING: MODERN DAY SLAVERY IN THE 21ST CENTURY. Canadian Foreign Policy, 12(3), 125-132,8. Retrieved April 30, 2008, from Research Library database. (Document ID: 1131074771). http://proquest.umi.com/pqdweb?did=274836021&sid=1&Fmt=3&clientId=29440&RQT=309&VName=PQD
Murphy, Sean D (2001). International trafficking in persons, especially women and children. The American Journal of International Law, 95(2), 407-410. Retrieved April 30, 2008, from Research Library database. (Document ID: 76291007). http://proquest.umi.com/pqdweb?did=76291007&sid=1&Fmt=4&clientId=29440&RQT=309&VName=PQD
Phillips, Joshua E. S. PeaceWomen: Women’s International League for Peace and Freedom (n.d.) Unveiling Iraq’s Teenage Prostitutes. Retrieved on April 6 from http://www.peacewomen.org/news/Iraq/June05/Iraqiteens.htm
Stewart, Jon The Architectonic of Hegel’s Phenomenology of Spirit Philosophy and Phenomenological Research, Vol. 55, No. 4 (Dec., 1995), pp. 747-776
Vandenberg, Martina (2002). COMPLICITY, CORRUPTION, AND HUMAN RIGHTS: TRAFFICKING IN HUMAN BEINGS. Case Western Reserve Journal of International Law, 34(3), 323-333. Retrieved April 30, 2008, from ABI/INFORM Global database. (Document ID: 536101131). http://proquest.umi.com/pqdweb?did=536101131&sid=1&Fmt=3&clientId=29440&RQT=309&VName=PQD
WorldNetDaily (2008) Frome Joseph Farah’s G2 bulletin Iraq prostitutes ‘invade’ Syria: But, in counteroffensive, girls from Damascus accuse those from Baghdad of spreading AIDS. Retrieved on April 6, 2008 from (http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=42403
Zoepf, Katherine (2007, May 29). Iraqi Refugees, in Desperation, Turn to the Sex Trade in Syria. New York Times (Late Edition (east Coast)), p. A.1. Retrieved April 4, 2008, from ProQuest National Newspapers Premier database. (Document ID: 1278475221).
http://proquest.umi.com/pqdweb?did=1278475221&sid=4&Fmt=3&clientId=29440&RQT=309&VName=PQD
ZOEPF, KATHERINE (2007, June 3). Iraqis turn to prostitution in Syria / Financial woes lead many girls to enter the sex trade :[2 STAR , 0 Edition]. Houston Chronicle,p. 21. Retrieved April 4, 2008, from ProQuest National Newspapers Premier database. (Document ID: 1281452021).
http://proquest.umi.com/pqdweb?did=1281452021&sid=4&Fmt=3&clientId=29440&RQT=309&VName=PQD
April 25th, 2008 §
Consistency and Congruency
The United Nations Global Compact addresses problems international business’ encounter around the world in large part because of their global reach. Through their voluntary association with the United Nations Global Compact many of these issues can be examined . Important issues addressed in the Global Compact regard labour, the environment, anti-corruption and human rights. Yet the United Nations Global Compact in regards to human rights, especially in relation to labor and human rights is too parochial. In the Global Compact Principle 4 defines compulsory labor where it states the following: It is the work or service of prisoners if they are hired to or placed at the disposal of private individuals, companies or associations involuntarily and without supervision of public authorities.
Slavery in the Global Compact’s sense has been made narrow and thought of in the classical sense. Slavery is often thought of as a locally accepted practice like black slavery was in America where the masters were the pillars of society and no shame was associated with slave possession. In this case slavery was based on race although slavery does not necessarily depend on racial distinctions and can be based on class, gender and national status. Nowadays rather than slavery only being based on ownership of the slave in the US, it has become in the US as being the exploitation of someone who has been branded in some way as being “illegal”.
Slavery and Immigration
Slavery is found to be in more niches than is commonly realized. The UN Global Compact seems to miss much of the stigma that persists in slavery. One aspect that that is often overlooked is the exploitation of “illegal” Mexican immigrants. While some citizens in the US are trying hard to buck the trend like Idaho’s “welcome the stranger” ad campaign, the general trend seems to be otherwise (Russel, 2007). These destitute people are so desperate to come to this country that even the Mexican government publishes comic books to warn of the dangers (Hawley, 2008). Undocumented Mexicans are subject to arrest at any time. Latinos here illegally are subject to deportation and now find authorities are targeting entire apartment complexes to arrest those here illegally (Huber, 2008) In the workplace if “illegals” complain about treatment on the job they are subject to dismissal and ever being turned over to the immigration authorities for deportation. Oftentimes the legal status of these employees is well known.
The global compact does not address this human rights issue. For example illegals working may not be considered by the compact compulsory labor but when one considers that jobs are disappearing in Mexico, largely because of US and Mexican trade policy, that the migrants are compelled to come here for work. Its’ a survival issue. Once here since they are here illegally they have no rights and are at the mercy of their employers. This is a form of compulsion and therefore a form of slavery.
Slavery in a larger context
When talking about human and labor rights one must consider the quality of life as well as the conditions of their servitude. A more all embracing idea of slavery needs to be adopted. Whether people are considered illegal like immigrants or “illegal” criminals like the incarcerated it must be remembered that regardless of their status they are human beings and according to the US constitution all people have god given inalienable rights by the virtue of being human. In spite of their legal status they deserve and are even required to not have their human rights violated whether it be with torture where cruel and unusual punishment is used or in labor because none shall be treated as slaves. With the privatization of the prison system in the US is ongoing, exploitation due to racism and genderism and more important classism is rampant in the US and this model is being exported around the world (Erikson, 2006).
It is necessary to look at the Global Compact from and even larger perspective. When talking about the human rights of prisoners, the issue seems to be that those incarcerated should not be put in the service of other private individual and companies according to the compact. But in the US the prisons have been largely privatized. Rather than prisoners being exploited by individuals they are exploited by the whole prison industrial system. It was never thought that the prison system would become a system for profit.
It’s no accident in the US that those that are the least powerful comprise the majority of the prison population. While Blacks and Hispanics have been the most likely victims of the war on crime which is ostensibly the war on drugs the number of women and especially black women is expanding astronomically. Black women imprisoned rose 828 percent between 1986 and 1991 (Rolison, 2002). It’s no accident that those that are among the most powerless in US society and for that matter around the world (e.g., black women) are the population whose rate is growing the fastest. Since the advent of the war on crime prisons have become little more than repositories of the powerless and the poor and the mentally ill now subject to the whims of big business. As time goes on the nature of prisons have become standardized sometimes run by the same company in multiple countries (Davis, 2001).
Recommendation to the UN Secretary General
Since slavery is often performed at the behest of their private masters and at the very least slaves are driven to work to avoid punishment, it is rather unremarkable to note that slavery and the for profit institutions are inexorably linked. Industry must understand that in addition to providing a healthy environment for one to work, adequate pay for one to subsist and the workers right to avoid discrimination, these private organizations must also be cognizant of the fact that some practices involve workers rights and therefore human rights and must be looked at more closely.
In examining this way of looking at companies and profit one must consider all instances where labor is forced not only among those who are “deserving”, but also for those that are looked at as being illegal in their very being and therefore denied basic human rights. With the privatization of industry and the profit motive, the problem of this denial of human rights can become even more pronounced when these masters are only considering the bottom line while creating a new slave caste.
References:
Davis, Angela Dent, Gina (2001). Conversations: Prison as a border: A conversation on gender, globalization, and punishment. Signs, 26(4), 1235-1241. Retrieved April 23, 2008, from Research Library database. (Document ID: 76016986). http://proquest.umi.com/pqdweb?did=76016986&sid=3&Fmt=3&clientId=29440&RQT=309&VName=PQD
Eriksson, Anna (2006). Review of Global Lockdown: Race, Gender, and the Prison-Industrial Complex. Review of medium_being_reviewed title_of_work_reviewed_in_italics. Social Justice, 33(4), 194-198. Retrieved April 23, 2008, from Research Library database. (Document ID: 1282212441). http://proquest.umi.com/pqdweb?did=1282212441&sid=1&Fmt=3&clientId=29440&RQT=309&VName=PQD
Hawley, Chris Solache, Sergio. (2008). Mexico draws dire picture for migrants :Comic books show risks in graphic detail. USA TODAY,p. A.9. Retrieved April 23, 2008, from ProQuest National Newspapers Premier database. (Document ID: 1466154971). http://proquest.umi.com/pqdweb?did=1466154971&sid=1&Fmt=3&clientId=29440&RQT=309&VName=PQD
Huber, Diane (2008). Fundraiser helps immigrants: Cafe raises awareness of plight of Hispanic communities. McClatchy – Tribune Business News, Retrieved April 23, 2008, from ABI/INFORM Dateline database. (Document ID: 1442969121). http://proquest.umi.com/pqdweb?did=1442969121&sid=1&Fmt=3&clientId=29440&RQT=309&VName=PQD
Rolison, Garry L et al., (2002). Prisoners of war: Black female incarceration at the end of the 1980s. Social Justice, 29(1/2), 131-143. Retrieved April 23, 2008, from Research Library database. (Document ID: 208056251). http://proquest.umi.com/pqdweb?did=208056251&sid=3&Fmt=4&clientId=29440&RQT=309&VName=PQD
Russell, Betsy Z.(2007 November). Welcoming campaign: Groups try to buck fear, intolerance. McClatchy – Tribune Business News. Retrieved April 23, 2008, from ABI/INFORM Dateline database. (Document ID: 1382531751). http://proquest.umi.com/pqdweb?did=1382531751&sid=3&Fmt=3&clientId=29440&RQT=309&VName=PQD
United Nations Global Compact
http://www.unglobalcompact.org/AboutTheGC/TheTenPrinciples/Principle4.html
March 6th, 2008 §
There are different theories about the state of disease in the world. Some feel that as countries become developed communicable disease will invariably decrease and non-communicable chronic diseases will dominate. This position is taken when referring to the global burden of disease. When thinking about the global burden of disease one is thinking about not only mortality but also morbidity with the consequent impact on the quality of life. Highly infectious diseases tend to have a higher mortality rate compared to the long term morbidity rate of chronic non-infectious diseases and morbidity and mortality must both be looked at to get a clear understanding of the overall impact of disease.
The other perspective addressed is referred of as the third epidemiologic transition which states that while antibiotics have lowered the incidence of infectious diseases and eliminated others, new diseases, especially zoonotic diseases are appearing and former pathogens through natural selection are quickly becoming resistance to antibiotics and therefore these pose and even greater threat to the world’s population.
These two positions tend to be contradictory. When looking at the global burden of disease it appears that microbes are permanently on the decrease thanks to technological advances while the position emphasizing the third technological transition asserts that they are eemerging and are a real threat, maybe greater than they have ever been. There seems to be no connect between the two positions.
Technology is often seen as a sort of panacea which makes possible urbanization and the centralization of healthcare and with a market driven economy people’s needs are better addressed. But as a result of urbanization there has been environmental degradation and therefore for instance the invasion of new niches by disease such as the Lyme tick or the Hanta virus infected rodents bringing about contact with humans. Also with urbanization it makes it easier for certain diseases to spread. Diseases like influenza spread quickly through a population and can be transported internationally quickly.
Yet with urbanization and technology disease spread can potentially be addressed by better monitoring systems which can result from the better use of technology. Computerized databases with accurate reporting would simplify monitoring of disease and would more adequately address the risk of disease spread. With increased technology new treatments can be found and vaccines can be created.
Whether microbes seem to be getting the upper hand over the long term and whether further technological advances will be able to rebut immediate microbial treatment resistance is open to question. While it may be difficult to continue to create effective antibiotics, because of technological advancements different strategies may become available. More sophisticated strategies to addressing microbe antibiotic resistance may be found, and with the new field of genetic engineering by addressing specific genetic weakness in microbes. This is one hopeful strategy to address the HIV virus.
Therefore it is unclear whether disease will be more completely controlled in the future. Present evidence shows some diseases on the rise such as AIDS, Staphylococcus, Malaria, Cholera, Tuberculosis and others. The future is unclear. But promising new strategies and theories are being implemented. Perhaps there will be a better time for control of these deadly threats in the future.