Last weekend, Trump’s executive order blocking travelers from seven majority-Muslim countries, banning all refugee resettlement for 120 days, and banning resettlement of Syrian refugees indefinitely, sewed chaos at airports across the US, with Customs and Border Patrol agents detaining legal permanent residents, people traveling with valid visas, and refugees. Massive protests at airports broke out in response. When acting Attorney General Sally Yates refused to defend the executive order, Trump fired her. The provisions affect refugees at all stages of the vetting and resettlement process, as well as people on many kinds of visas that previously enabled them to travel, live, study, and work in the US. Trump also reinstated Secure Communities, a deportation policy first enacted by George W. Bush, which outlaws and threatens to defund sanctuary cities. A leaked draft executive order would end Deferred Action for Childhood Arrivals, making the Dreamers vulnerable to deportation.
Although Trump promised this week to maintain Obama’s executive actions extending non-discrimination protections to LGBTQ employees of federal contractors, a draft executive order broadening “religious freedom” to discriminate would effectively override any such protections.
Reuters reported that the Trump administration wants to redirect the federal Countering Violent Extremism monitoring program away from white supremacists and other right-wing extremists to focus almost exclusively on Muslims, despite the fact that right-wing extremists kill seven times as many fellow Americans as Muslim attackers.
The New York Times reports on plummeting rates of unionization among California farmworkers. The chairman of the Agricultural Labor Relations Board resigned recently, citing the fact that less than 1% of farmworkers in California are represented by unions and that in his three years heading the ALRB, he received a single petition for union representation. “Mr. Gould says a major factor for the decline of organized farm labor is the fear that undocumented workers have of dealing with the government. Around half of the Californian agricultural work force is in the country [without documentation]. ‘There is not only no incentive to complain but there is no incentive to become involved with government in any way,’ Mr. Gould said. California’s agricultural industry is bigger than ever. It produces roughly a third of all fruits and vegetables grown in the United States and has about a third of the nation’s farmworkers.”
The Atlantic examines the growing divide and policy disputes between blue cities and red states, with a focus on the threat of preemption: “State legislatures have put their oar in on issues ranging from the expansive to the eccentric. Common examples involve blocking local minimum-wage and sick-leave ordinances, which are opposed by business groups, and bans on plastic grocery bags, which arouse retailers’ ire. Some states have prohibited cities from enacting firearm regulations, frustrating leaders who say cities have different gun problems than do rural areas. Alabama and Arizona both passed bills targeting “sanctuary cities”—those that do not cooperate with the enforcement of federal immigration laws. Even though courts threw out much of that legislation, other states have considered their own versions.”
The New York Times tells the story of how the Standing Rock protest over the Dakota Access Pipeline originated with an anti-suicide campaign by a group of Native American teenagers in the Cheyenne River Reservation.
Men who committed crimes as teenagers and are serving long or life sentences at San Quentin offer their “Brief But Spectacular Take” on doing time on PBS News Hour. They reflect on their life experiences, which included exposure to gangs, violence, and poverty; and on the crimes they committed. “After being incarcerated for 27 years, I was open and honest about the murder that I committed. It was the looks of empathy as opposed to the looks of judgement, that created a shift in my mindset,” one man said. “I am not blaming my past or the traumatic experience for the crimes I committed, but I do understand it was a contributing factor to what I did and I do take total responsibility for it.”
Mother Jones profiles Baltimore Health Commissioner Leana Wen, who believes that substance abuse and addiction are at the root of many of the city’s public health problems: “The issues of addiction tie into every part of our city: poverty, health disparities, mental health, unemployment, lack of housing. Traditionally, it's been seen that if you have an addiction, it's a moral failing. It's a personal choice. Now, we're calling it a disease.” Reducing stigma is part of the city’s three-pillar approach to addressing substance abuse, along with providing access to naloxone and treatment.
Ontario, Canada’s Ministry of Health laid out its plan for promoting mental health and wellbeing in the province, a cross-sectoral approach that includes addressing stigma, applying a Health Equity Impact Assessment Tool, and working with indigenous communities to develop approaches that support “Holistic response/prevention combining clinical and cultural/land-based programming, to stabilize communities in crisis.” The plan includes initiatives in education, housing, and justice.
A blog in Health Affairs predicts that repealing the Affordable Care Act could make the opioid crisis worse by increasing the number of uninsured people and reducing access to care for substance use disorder, particularly in states with some of the highest rates of deaths due to drug overdoses: “Repealing the ACA will remove coverage for SUD treatment and prevention from millions of Americans, leaving a gap in care when it is most needed.”
Orange County builders are converting old shipping containers into homes as part of an effort to address homelessness among veterans, KPCC radio reports.
Claire Pomeroy, the head of the Lasker Foundation and a doctor, wrote an opinion piece for HuffPo noting the need to invest in research on the social determinants of health. Lawmakers should “take heart” in initiatives like Accountable Health Communities, she says: “This “experiment” in upstream investment will provide valuable insights into the efficacy of new funding models to address social determinants…..Research to develop a stronger evidence base, and identify important factors that can and must be addressed, can serve as a foundation for health care design.” A second opinion piece in the Health Affairs blog argued for the need for “a shared definitional framework of what success looks like in addressing social needs. The lack of common definitions for interventions addressing social needs makes comparison across populations and interventions difficult, and it jeopardizes efforts to understand how such interventions impact overall value, i.e. cost, experience, and health outcomes.”
Presumptive HHS head Tom Price said he would move forward on accountable care organizations though gave few details on how. “Price said the success of accountable care organizations created under Obamacare has been ‘modest to date’ and that the alliances are not a ‘silver bullet.’ He did call them an important tool and promised to chart a path forward for them,” Politico reported.
NACCHO released its 2016 National Profile of Local Health Departments which presents the newest data on local health department funding, workforce, programs, and partnerships.