I didn’t start out wanting to be a gun violence expert, and, arguably, I am not one. But violent events keep repeating and hitting closer and closer to home. My neighborhood grocery store, King Soopers, made headlines 2 years ago when 10 neighbors were killed there. Right now, we are focused on the devastating events in Buffalo and Uvalde and a shooting that killed 4 in Tulsa just yesterday. I can think of little else. I am also increasingly aware of the arguments about gun violence being caused by mental health issues. As a clinical psychologist and recently retired Teaching Professor at CU Boulder, my strategy for dealing with topics that make me uncertain is to look at the science. Today I’ve asked myself to do what I ask my students to do: Look at the science and beware the b.s.  

What are the facts about the supposed correlation between mental health and gun violence? Here’s what I found:

Over and over again, scientific studies have demonstrated that people with mental illness are more frequently victims of violence, rather than perpetrators of violence. Mental illness is not a reliable predictor of violence towards others, but is a predictor of suicide. People with serious mental illness are somewhat more likely than people without such disorders to commit violence, but that rate was only 2.9% in one large scale study. The risk increases to 10% if substance abuse is added. That means 90% to 97% of folks with serious mental health disorders do not commit violence. And some mental health symptoms, including particular symptoms of depression, are associated with lower rates of violence.

Mass murderers are a small but clearly very concerning group. A 2018 Federal Bureau of Investigation (FBI) study of 63 active-shooter incidents between 2000 and 2013 found that 25% of shooters were known to have been diagnosed with a mental illness of some kind, ranging from minor to more serious disorders. But, and this is important, the FBI study concluded that diagnosed mental illness is not a very specific predictor of violence of any type, let alone targeted violence.

In a country that already stigmatizes mental illnesses, blaming gun violence on mental illness further stigmatizes a population that is already struggling. The research demonstrates that it just not helpful from a predictive or explanatory standpoint. But there are other factors, including social, economic, and life history that are contributing factors to violence, including: 

• violent/angry thoughts; history of violence (not a mental health disorder)
• being in an unstable life situation (not a mental health disorder)
• being under stress, such as being bullied, going through divorce, job loss, and unable to cope (also not a mental health disorders)
• history of physical or sexual abuse (not a mental health disorder)
• disinhibition (that could be related to substance abuse, or even neurological immaturity) (not a mental health disorder)

Another factor is domestic violence – also not mental illness. We need to address the fact that 3 out of 5 mass shootings have been DV related and 68% either killed at least one partner or family member or had a history of DV.

A recent study reported that tremendous stressors (fear of death, social isolation, economic hardship, general uncertainty) from COVID-19 seem to have led to an uptick in mass shootings.

But here’s where the mental health and gun violence argument really falls apart: When we look at rates of mental health disorders around the globe about 1 in 7 people have one or more mental or substance abuse disorders. The US is no different – the rates of mental illness in US are comparable to rates in many parts of Europe, and a little lower than Australia, actually, but the rate of gun violence in our society is much higher: 25 times higher than in countries with similar economic development and similar social conditions.    

What’s the difference? Access to guns. This access makes our rates of violence so much more alarming and lethal.

This is not to say that mental health professionals can’t be helpful in this important and tragic problem in our society. How could mental health professionals help? 

• Advocate for increased access to mental health intervention for people who ARE in distress before violence or suicidality emerges. Ideally, these services could be available in schools, and require a significant increase in funding for school counselors and psychologists.
• Move towards models to accurately evaluate risk of violence. This tricky topic has been a focus of many scientific studies recently, because earlier efforts in this line of research were hampered by lack of funding for many years.
• Help individuals cope with after-effects of violence. Seventy-one percent of adults experienced fear of mass shootings as “a significant source of stress in their lives,”, according to a recent survey by the American Psychological Association.
• Help direct survivors of gun violence who exhibit posttraumatic symptoms and may need support for years to come.
• Help shape policy that can alleviate stressors on a broader scale.
• Voice, publicly and repeatedly, that mental health disorders are not THE culprit. They may sometimes be involved, but not in a reliable or predictable way. Instead, social, economic, cultural and psychological variables are in play here. The one thing that all of these instances of gun violence have in common is the availability of guns. Public policy and local ordinances must address this fundamental issue. 

So, that’s my summary of the mental illness argument.  It is a red herring that some folks hope will distract us from the real issue, which is ridiculous production of, access to and support for guns in the public square. I’ll keep studying. But my time—and yours I hope—is dedicated to action.

Dr. Tina Pittman Wagers is a clinical psychologist and Teaching Professor Emerita from CU Boulder. She taught classes in abnormal psychology, women’s mental health, and evidence-based psychological treatment for many years, and has also published in the area of psychosocial ramifications of Spontaneous Coronary Artery Dissection (SCAD).

Revisit this March 2018 interview with Jessica Fulton to celebrate her new position at the Joint Center for Political and Economic Studies as their Economic Policy Director. As their twitter description puts it the Joint Center is currently focused on the future of work and congressional staff diversity. Jessica generously gave her time last spring to Framingham State University students seeking to learn about careers in public policy for Black women.

Last month I got to interview Jessica Fulton via Skype to learn more about her career and her work. She is the External Relations Director at the Washington Center for Equitable Growth. Equitable Growth is a research and analysis organization that is dedicated to finding ways to promote broad-based economic growth. Before Jessica was at EG, she was the Outreach Director at the DC Fiscal Policy Institute, an organization that focuses on budget issues for the District of Columbia. Jessica is an alum of the University of Chicago, where she received her Bachelor’s degree in Economics, and of DePaul University, where she earned a Masters in Economic Policy Analysis. Our conversation—and the interview below—focused on my desire to get some pointers on how more young women of color can make a difference in social policy.

EO: What are your top pieces of advice to young minority women seeking to work in social policy?

JF: If you’re able, try to get an internship in DC so that you’re able to learn more about how things work here. There are a few organizations and Members of Congress that pay their interns, and that’s obviously ideal, but many don’t. If you’re unable to find a paid internship, and can’t afford to take an unpaid one, consider alternate ways of getting into policy work. I know people who got their start by working in a paid position on a campaign of a candidate they really believed in. Others found entry level assistant positions to get their foot in the door. You can also consider getting an unpaid internship and supplementing it with a part time job, which is what I did.

Also, it’s much easier to get a job in DC if you’re actually in DC. It’s really expensive to live here, but if you can come sleep on a friend’s couch for a bit, you can set up interviews, informational conversations, and networking opportunities that could get you some meaningful connections. You should also try applying for jobs with a local address on your resume if possible.

EO: How do you advise people to zero in on areas of focus?

JF: I think one of the most important things that you can do is to start to get to know people who are working on the topics that excite you most. Ask people you know for introductions to people who might be willing to sit down with you to do informational interviews. If you don’t have connections already, think about your networks. Are there alumni from your university who might be willing to speak with you? Do your professors know people who work in social policy? Talking to those people about what they do and what their days look like can be a great way to figure out what you want to do.

You should also try to sign up for newsletters from the particular policy organizations or Members of Congress that you’re interested in. That way, you can get to know more about the topics different organizations work on and what they actually do. This could be helpful in future interviews, but also may help you to figure out which specific issue areas you have a passion for.

EO: Why are young minority women so important to the work of social policy?  

JF: A good number of social policy issues disproportionately affect people of color, yet there are usually very few of us in the room when the problems or the solutions are being discussed. And while things are slowly getting better, often women of color, especially black women, aren’t at the decision making tables even if they are part of a policy organization. I think that’s actually really important. For example, when I walk into a room, I’m bringing my education and work experience, but I’m also bringing my life experience and that of my friends and family members. The other folks in the room have important perspectives as well, but my friends, family members, and even myself, are more likely to have experienced certain obstacles and situations that are more common in minority communities. So when I’m thinking about problems and solutions, I can’t help but to look at it through that lens as well. And I think in the end, when you consider how any kind of problem solving works, the most effective solution is one where you’ve considered a diverse set of perspectives to arrive at your conclusion.

Jessica Fulton is now Economic Policy Director for the Joint Center.  You can follow her on twitter at @JessicaJFulton, and follow them on @JointCenter. Eunice Owusu is a Council on Contemporary Families Public Affairs Intern and a 2018 graduate of Framingham State University in Sociology with a minor in Political Science.

And by she, I mean Eunice Owusu, a 2018 Framingham State University graduate. She walked across the stage, shook hands with the president of the institution while her family, friends, and plenty of others who look up to her, support her, and love her, cheered her on. Currently, Eunice is a cheerleading coach for South High Community School, building and creating a group that fosters a positive energy for supporting all of the teams they are motivating at every game. Filling the world and the people around her with positivity is only one of Eunice’s many strengths. Eunice is extremely talented in the art of makeup and began her very own business, Hint of Ebeauty, creating wigs. However, her passions do not stop there. Her interest in Family Law and Policy drives her future for changing the lives of low-income families and immigrant families through looking at the policies that effect these populations. Because of this passion, Eunice plans on attending graduate school next fall. In addition, because of what we learned in our course studying careers of Black women in public policy in Washington, D.C. I had the opportunity to learn more of who Eunice is, who Eunice was, and everything that Eunice will be:

TC: What did you learn through your independent study: From Margin to Center—women of color in policy? Why did you take the course and what did you learn about yourself?

EO: One of the biggest things I learned in this study was that in order to be the most confident Black woman, you cannot be afraid of your own voice. There is so much importance and weight in speaking up for those who cannot be at the table, when the table is full of those can never relate. The very few Black women proves that there is in fact racial disparities in American work life. But it is one thing to sit and complain rather than to become informed and aware. To be informed and aware is to make sure that our faces are necessary and are holding positions that lead to redirection of policy to benefit evenly and equally for everyone while bringing justice. Black women in policy such as Janelle Jones, Valerie Wilson, Angela Hanks, Misha Hill, Cherrie Bucknor, and Jessica Fulton all agree that educated Black women are needed and should not be afraid to speak up. For me, in the past, I shied away and became passive because of the fear of being “too passionate” or “too angry” in situations where my voice would have secured the change I wanted to see. It was important to me to see what women from similar backgrounds as my own did to get where they are today. This study became my motivating push to follow their footsteps while creating my own path into policy work.

The study was formulated by my professor, Dr. Virginia Rutter, who helped us to connect with Black women doing policy work in DC. I took this class to help me really figure out what I wanted to do in my graduate studies and what kind of career I can make out of my Sociology and Political Science background. It helped me understand what policy work actually is and what kind of things go into it on a day to day basis. To see first-hand what kinds of people are part of organizations such as the Economic Policy Institute and DC Fiscal Policy Institute really helped my understanding of what life after grad school could be like. To me, there is no formula or handbook on how to be a successful woman after college. The truth is that months after graduating from Framingham State, I’m still trying to figure out how to get to the next step. This study made me realize that my presence, my knowledge, and awareness of the community I come from can speak volumes in public policy.

TC: How do you feel your identity, as a Black woman, has impacted your experience in college?

 EO: My identity as a Black woman impacted my experience in college because of the fact that I knew that I was not “cut from the same cloth” as others. In other words, being an African woman in college that represented my entire family, immigrants, and the ones that live in my country, Ghana, college was less of finding myself and more of making sure I was making all the ones counting on me proud. That pressure alone was my motivation to make sure I was soaking up all the knowledge I could for the ones in family that didn’t make it past their first few years of high school; some, their first years of junior high. As a Black first-gen woman, my layers made me excited to study the main things that were affecting my family first hand: immigration, education, and income inequality.

My identity as a Black woman impacted my experience in college because it framed my passions in my studies. It motivated what classes I took and what kinds of organizations I joined. My dark skin tone combined with my intelligence shows people that not only are Black women capable, our ideas are worth listening to. While attending a white institution with undercover racial bias and people who always underestimate the minorities who attend the school, I was able to understand not only what it means to be a Black woman but what it means to be myself. From freshman year to post grad, I no longer find myself sitting in in the back and listening to others. I have become a brave voice potential of change in the communities I am a part of.

TC: What would you tell high school Eunice?

EO: High school Eunice was my most indecisive self. This is because I battled back and forth in whether or not I wanted to pursue family law or do something STEM related. I became the only one taking classes like human geography while my friends took classes like physics. Coming from an African family, the expectation to become a doctor or engineer or anything STEM related was the ideal and that discouraged me from following the beat of my own drum. I would tell high school Eunice that there is nothing wrong with making a career out of passions. There was no need to seek the approval of others because it didn’t matter what field I chose. What mattered for me was whether or not it fed my want to help others battling things that I witnessed and went through, coming from a single-parent-immigrant household. I would tell high school Eunice that nothing comes easy, but it will make sense in the end. I would tell her that studying something that you are passionate about is extremely important because that determines your ability to not only retain information but to apply just about anything.

Tasia Clemons is a 2018 graduate at FSU in Sociology with a minor in Spanish. She is currently a Hall Director and in the Higher Education and Student Affairs Administration program at Canisius College. Follow Tasia at @TasiaClemons. Eunice Owusu is a Council on Contemporary Families Public Affairs Intern and a 2018 graduate of Framingham State University in Sociology with a minor in Political Science.

It has been weeks since I have crossed the stage, shook the hand of my college’s president, smiled at my family in the audience, and received my Bachelor’s degree. It struck me knowing that I had finally got to that very moment. The moment I had been waiting and working at for four whole years, and a bunch before that. Although I can thank my family for the endless support, thank my friends for the long nights of studying, and myself for remaining determined through absolutely everything—I also must thank my professors. Especially the professor who allowed me to reach my fullest potential, push me past my limits, and allowed me to see that I am capable of achieving whatever goals I set for myself. Virginia Rutter, the professor for the independent study, Margin to Center: Black Women in Policy, facilitated the unique class, where we talked to a lot of great women, including  Cherrie Bucknor, a doctoral student in Sociology at Harvard University. Her research interests include class, race, gender, labor unions, and social policy. Previously, Cherrie Bucknor worked at the Center for Economic and Policy Research (CEPR) where she developed a series called Young Black America. Sitting across the table from her at lunch in Cambridge, I was able to hear all that she had to say about her series, her advice, and so much more:

TC: What advice do you have for Black women who want to attend an ivy league school?

CB: This is probably going to sound a bit ridiculous coming from someone who is currently at Harvard and who got their undergraduate degree from Penn, but I would encourage them to not necessarily strive to go to an “Ivy League School”, but to go to the school that they believe will be the best fit for them, both academically and emotionally. That should be the ultimate goal. As in many things in life, there will be sacrifices to make in these two areas (and others), but the goal should be to try and end up at the school that will maximize those two areas and others that are important to you. Oftentimes, when we think of college, we only think about the academic aspect. But, for me, both in the past and currently, the non-academic parts of my life on campus really help to keep me on a good page emotionally when I may be dealing with things in class or with my research that would otherwise keep me down.

I would also encourage them to speak with Black women who are already at the institution to hear from them what their experience has been like. Our experiences as Black women are unique in many ways and for me, it was invaluable to hear from the Black women who were already in my program. The Black women who paved the way for us will have advice on how to navigate the particular environment that you will find yourself in. Every school and department is different, with their own strengths and weaknesses, so it’s best to know as much going in as you can.

TC: What gets you through your days/moments when you are discouraged?

CB: The short answer to this would be “my people”. More specifically, I have a community of people, both in the Boston area and elsewhere who get me through the moments when I feel discouraged. This includes my parents, siblings, and other family members who have been on this journey with me since the beginning and who are just as invested in seeing me reach my goals as I am. The friends that I spent the past 5 years with in DC are just as much a part of my life as they were when I lived in DC. They are always there for me to vent to. They know just the right GIF or meme to send me that will make me literally laugh out loud.

Over the past year, I have also been lucky to develop friendships with fellow students in my department and throughout Harvard who I really vibe with on many different levels, whether it’s because we have similar research interests, political interests, experiences as scholars of color, or we watch the same TV shows or hate the same sports teams. While these friendships are relatively new, and some were unexpected, I can already tell that they will be “my people” for years to come.

Lastly, as I’ve mentioned above, the non-academic aspects of my life here also get me through the moments when I am discouraged. My work with our recently-certified graduate student union brings me so much joy because of the possibility of making Harvard a better place through the bargaining process. I have also been working with a great, diverse group of students who share my interest in prison abolition and who experience similar challenges as students of color on campus. Every week or so, I know that I’ll be sitting in a room with or on a conference call with people who are committed to doing good research and good work in our community. I feel very fortunate in that regard.

TC: Why did you choose to focus on Young Black America as a series when you were at CEPR? What was it like to conduct and then communicate this type of research?

CB: My Young Black America series was actually my first solo-authored work at CEPR and it was about 6 months into my time there. I say this all the time, but I definitely feel as though CEPR spoiled me as a young researcher. The latitude that I was given during my three years there was truly remarkable. This particular research came about because of a curiosity that I had. I really just wanted to answer the question “what’s going on with young Blacks in America right now”? As a young Black woman, I wanted to know how our community was doing. The recovery from the recession was going along too slowly in my opinion and I had heard a great deal about the experience of workers overall, or Black workers overall, and I wanted to see if the story was the same for young Blacks. I presented my idea to my office mentor and boss and they both were excited about it and basically told me that I could design the series however I want and they would support me.

Given the fact that many people associate educational attainment and success with economic success, I decided to do the first two pieces on recent data on high school graduation rates, college entrance, and college completion. The third piece was about employment and unemployment rates, and the last piece was about wages. The series told a story of increasing educational attainment that has not necessarily translated to significant gains in employment and wages, leaving persistent racial and gender gaps.

As I mentioned above, this series was my first solo-authored work at CEPR. The very first piece in the series also ended up leading to my first interview with a reporter. To say I was nervous would be an understatement. I went into our communications director’s office and proceeded to vehemently protest against doing the interview and how I was sure I would make a fool of myself. However, after a mini media training session, I gained some semblance of confidence, or at least enough to go through with it, and it went perfectly fine. To this day, I still get nervous and worry whenever I have to speak to a reporter or do a radio interview, but I just remind myself of this: what good is it to do research that you think is important if nobody hears about it?

***

TC: Cherrie made it clear. As I move out of the world of undergrad and maneuver my way into a whole new environment in graduate school, having, as she puts it, “my people” when I get discouraged is exactly what I need. What is an important take away is that having “my people” will not be enough. I must make sure that I am focusing on myself too—the things that make me happy, the moments that bring me joy, and I must value my self-care because being a woman of color, the external social forces in our society are working against me. They do not want to see me rise nor do they want to see women of color shine. However, I must understand that since I am a woman of color, my self-care is revolutionary… and the bonds I create with other Black women as my future unfolds will be too.

Tasia Clemons is a recent sociology graduate from Framingham State University as well as a graduate assistant Hall Director at Canisius College. She tweets at @TasiaClemons. Cherrie Bucknor is a doctoral student at Harvard University and currently working on two projects: examining the union wage premium for young workers in the United States overall and by race and education level, as well as a project titled “Race, Economy, and Polity in the Trump Era.” She tweets at @CherrieBucknor.

ACLU Lawyer Gillian Thomas’s book, Because of Sex, demonstrates that once a law is passed, the work has just begun. Thomas traces fifty years of court cases that interpreted the meaning of sex discrimination as established by Title VII of the 1964 Civil Rights Act. Thomas grips her reader from the start, opening the book with the controversial introduction of “sex” into the Civil Rights Act by Howard Smith (Democratic Representative from Virginia). To this day, scholars debate whether this addition was a sincere attempt to promote gender equality or a sexist joke aimed at derailing the Act. Ultimately, the clause stayed in and the Civil Rights Act passed prohibiting discrimination because of race, color, religion, national origin, and sex. However, as Thomas and other scholars have pointed out, because “sex” was a last minute addition to the law, its meaning received little attention from Congress. Therefore, it has been up to the courts to interpret what sex discrimination looks like. This is where Thomas spends the majority of her book.

Thomas argues that Title VII has led to “revolutionary” legal and cultural change and consequently “transforming what it means to be a woman who works” (p. 229). Each chapter of Because of Sex tackles one court case that made its way to the Supreme Court and set precedent for the interpretation of sex discrimination in employment. This case study approach allows Thomas to introduce her readers to all the players involved in each of these cases, giving background and historical contextual information that brings each case to life. For example, I’m very familiar with Price Waterhouse v. Hopkins, wherein sex stereotyping was ruled sex discrimination after Ann Hopkins was denied partnership for her management style and told to go to charm school. What I didn’t know was that after winning her case, Hopkins was offered $1 million to NOT return to work at Price Waterhouse. Hopkins turned them down and rejoined the firm after fighting them in the courts for nearly a decade. According to Thomas, Hopkins became a fierce advocate for diversity in the firm, which explains in part why now you can see Price Waterhouse on top lists of workplaces promoting diversity. What really hit home for me was how long these landmark cases take and how life moves on for the plaintiffs in the meantime. Their names may go down in legal precedent and/or history books for changing the direction of sex discrimination law, but in the meantime, they have to pay the bills. And as someone suing for employment discrimination, that isn’t always easy.

This is a book that fellow wonkettes may pick up for a quick and informative read. It may not be a book for academics looking to cite new research. Thomas does not situate her book within a larger literature, her argument lacks a theoretical or empirical contribution, and her methodology of choosing which cases to analyze is unclear. However, Thomas writes with a narrative style that makes reading legal cases accessible and enjoyable.   Let’s face it – reading about the law can be quite dry and boring even to those of us who are sincerely invested in its nuances, idiosyncrasies, and possibilities. Thomas uses her legal expertise and experience to translate the law for everyday readers. I especially appreciated how she threw in important procedural details to those of us who do not practice law. For example, she shows how a case moves from a district court, to an appeals court, and, if their petition is accepted, to the Supreme Court. Once at the Supreme Court, Thomas explains that there is no trial. Instead, each side’s lawyer has thirty minutes to present their argument and it is expected for the justices to jump in immediately and ask questions. Therefore, lawyers typically practice their argument through moot courts or assemblies of their peers, anticipating the questions justices may ask.

Because of Sex would also be a great supplementary text in college courses. For instance, I can imagine assigning sections of it in a Gender and Work course to help my students understand the various forms of sex discrimination. In my experience, the only form of sex discrimination college students know about is wage inequality. The case studies in Thomas’s book provide clear illustrations that sex discrimination can also involve denying employment to mothers, height and weight restrictions, discriminatory pension plans and leave policies, sexual harassment, and sex stereotyping in promotion decisions.   Thomas’s book could also pair well with legal mobilization literature, providing tangible examples of how people consider their legal rights, the various actors involved in advocacy, and how legal cases connection to larger social movements.

Because of Sex by Gillian Thomas is a good introductory text for folks looking to explore how courts have interpreted sex discrimination since its introduction to the Civil Rights Act.

Heather Boushey, Executive Director and Chief Economist at the Washington Center for Equitable Growth, discusses French economist Thomas Piketty’s new book on global economic inequality and spells out its relevance for feminists.

Some months ago, I had the opportunity to read the advance copy of Thomas Piketty’s new book Capital in the 21st Century. We’ve all heard a lot about the book since then—I’ve counted 700 pages of reviews (including my own). We’ve heard about how Piketty argues that unless the rate of return (aka “r”)  on capital is brought down, below or at least closer to the rate of growth (aka “g”), inequality will continue to rise. Economists have been debating his ideas ever since. But, one thing haunting me throughout the book was a question about what his findings meant for women and, so, inspired by Piketty, I picked up my Jane Austen anthology.

When I started rereading Pride and Prejudice, I wasn’t exactly sure what I was looking for. I very quickly found myself immersed in the tale of Elizabeth Bennet, her sister Jane, and their quest for happiness. Any Austen reader knows that the heroine’s happiness depends on her finding an appropriate mate, and that appropriate is defined as a man with a sufficient stock of capital to provide her with a lifetime of income. For Austen’s heroines, there is always a tension between this economic reality and what her heart wants. She knows that a good income is not the only factor in her future happiness, but she also knows that there’s no happiness without it.

That is certainly the case for Elizabeth Bennet. When I was a young woman reading for the first time about how Miss Bennet comes around to loving Mr. Darcy, I was—as Austen intended—struck by how constraining her life was, and yet how eloquently Austen described her situation. Miss Bennet was smart, capable, and someone who I could imagine as my friend. But, the world she lived in was terrifying. She is constrained by the reality that her life will be defined by her choice of spouse. Feminists laud Jane Austen for elevating the interior lives of women and the economics of marriage markets in the 18th century and for making clear these enormous constraints on women’s choices.

Thomas Piketty points the reader to the novels of Austen and Henri Balzac in order to illustrate how in a period of high wealth inequality young people make choices about their lives based on marrying well, not pursuing professional goals. He uses the example of Rastignac, who has to decide whether or not to pursue the hand of an heiress or pursue a career as a lawyer in order to demonstrate the economic inefficiency of an economy where success depends on inheritance not on developing one’s own skills and productivity. This is what Piketty means when he says that the “past devours the future.”

Piketty’s prognosis for the economy is frightening. Using an enormous amount of data from around the world, Piketty has brought to the fore the empirical fact that income inequality calcifies into wealth inequality. We already have income inequality at the same level as it was at the dawn of the 20th century. Relative to a century ago, more of today’s high incomes are derived from wages than from capital. Piketty argues that, over time, however, the share of income from capital will rise as today’s high earners save a portion of their income and pass it on to the next generation, creating greater wealth inequality in the process. Women should take heed of this.

The 20th century saw enormous forward momentum towards equality for women and racial and ethnic minorities, as well as for children, the disabled, and other groups suffering discrimination. In the United States, the Civil Rights Act of 1964 made it illegal to discriminate against someone based on the color of their skin or their sex. The breaking down of barriers to education and participation in working life has benefited women (and their families) enormously. Mothers are now breadwinners or co-breadwinners in two-thirds of U.S. families. This greater employment and economic participation has also benefitted the economy. For example, Stanford economist Peter Klenow and his colleagues found that up to a fifth of the total growth in the U.S. economy between 1960 and 2008 was due to the opening up of professions to women and minorities. In my own work with Eileen Appelbaum and John Schmitt, we found that women’s added hours of work since 1979 have added 11 percent to the U.S. gross domestic product.

This was possible because we lived in an economy where an individual can succeed and earn a living through developing skills and participating in the labor market. However, if economic success is again increasingly defined by inheritances, as it was in Austen’s day, those who had been excluded will continue to be so. Since wealth is typically associated with a family, not an individual, a family’s economic situation will be elevated over individual achievements. This will hardly be good for gender equality, or equality along any other axis.

As the Piketty mania took hold—it actually hit number one on Amazon.com in the first few weeks after its release–there was only one other woman, besides myself, that I knew of, Kathleen Geier, who published a review of the book. While scores of men debated r, g, and the substitution of labor for capital, women were strangely absent from the debate. I would like to encourage more women, and especially more feminists, to pick up Piketty’s tome and give it a read. It’s a good book and what you learn may be quite important for your and your children’s economic future.

Looking ahead to Mother’s Day and Father’s Day, I encourage readers to check out Chloe Bird‘s latest post for The RAND Blog. In “Assessing and Addressing Women’s Health and Health Care,” Bird explains the knowledge gaps and emphasizes the benefits of changing our approach to health research:

Gender-stratified research can produce more effective decision tools and interventions, and in turn improve both women’s and men’s health and health care.

I have featured her work on women’s cardiovascular health in a past post: it’s an excellent example of why we need to pay attention to sex/gender differences when aiming to improve health care.  Bird cautions of the dangers of failing to make the necessary revisions:

Until access, quality, and outcomes of care are tracked by gender, inequity in treatment will remain invisible and consequently intractable.

As we move forward with the Affordable Care Act, it is important to pay attention to the new assessments and tracking of the quality of care.  In the words of Bird, “This tracking should take gender into account so that disparities in health care and outcomes become visible and get the attention they deserve.”

2011 brought us two top-selling autobiographical takes on female aging. Jane Fonda’s Prime Time asks readers to explore everything from friendship to fitness to sex, with a goal of having us accept that “people in their 70s can be sexually attractive and sexually active.”  Betty White’s If you Ask Me (And Of Course You Won’t) offers readers a candid and often humorous take on the last 15 years of her life. White warns of the pitfall of our youth-centric culture: “So many of us start dreading age when we’re in high school. And I think that’s really a waste of a lovely life.”  While these celebrity authors paint provocative personal portraits of aging, I’m drawn to the new book by Colgate sociologist Meika Loe, Ph.D.: Aging Our Way: Lessons for Living from 85 and Beyond (Oxford University Press) charts her three-year journey following the lives of 30 diverse “elders” (women and men ages 85 to 102 years old), most of whom were aging at home and making it work.

Adina Nack: How did your last book on the Viagra phenomenon lead you to your new book on the ‘oldest old’?

Meika Loe: For The Rise of Viagra I interviewed elder men and elder women partners of Viagra users. It became clear that ageism impacted their lives and was a key ideology that propelled the Viagra phenomenon forward. Afterwards, I missed those interactions with elders and wanted to know more about their experiences aging at home. Aging Our Way ended up being a book that focuses more on elder women’s experiences, voices that had been marginalized, if not completely absent, from the media coverage of the Viagra phenomenon.  In the 85+ age group, women outnumber men by almost 3 to 1, and close to 80% of elders living at home alone are women. Too many people assume that research on elders is sad and depressing, in comparison to research on Viagra. To the contrary! I find elders’ stories inspirational. Aging Our Way features the lessons I learned from them – lessons for all ages.

AN: Aside from the Viagra interviews, what inspired you to focus on this group of people who are all more than twice your age?

ML: I was extremely close with my grandparents and great-grandparents growing up. More recently, I rent a room from a village elder in the small town where I work. Living with her, an invisible world opened up to me – a world of widows caring for one another and collectively attending to quality of life, mostly in the absence of biological kin.  Like, Carol, my seventy-something landlady, who gets a check-in call from octogenarian Joanne every morning at 8 a.m. Then Carol calls 98-year-old Ruth. All of these widows have lived alone in their homes within 10 square blocks of each other for decades, and now they constitute a social family. Once in a great while, when Carol cannot reach Ruth, she’ll grab the extra key and head to her home to make sure everything is okay. One time she found Ruth on the floor.

AN: That must have been scary – so, even with this type of ‘morning phone tree’, isn’t isolation a problem for these women and men aging alone?

ML: Yes, like most of us, elders attempt that delicate balancing act between dependence and independence every day. So, while many of these elders value independent-living, they’re also adept at building social networks. Ruth H. is committed to making a new friend every year of her life: she reaches out to my campus’s Adopt-a-Grandparent group and has five student walking partners this year, all new friends. That said, aging alone comes with its share of isolation and risk, and I’m reminded of Elizabeth, a Navy veteran and high school English teacher who insisted on living alone in her home, amidst her longtime friends and neighbors, despite her children’s pleas for her to move to Georgia. Elizabeth recently passed away during Hurricane Irene. She was inspecting her basement for flooding and must have fallen. This is such a sad story, but Elizabeth would not have wanted it any other way: she said she wanted to die with her boots on.

AN: Do women have an advantage over men when it comes to longevity and aging?

ML: Social epidemiologists Lorber and Moore have shown that women live longer but not necessarily healthier lives. Traditional gender roles take their toll: often, women prioritize caring for others for so long that their own health suffers.  Perhaps as a result, women have higher rates of chronic illness and depression. At the same time, many of the women I followed are enjoying a chapter in their lives where they can focus on themselves, their communities, their gardens, and their own health. Shana, 95, says things like “Now I am finally living for myself. Now I can focus on me.” Most women have lifelong gendered skill-sets for self-care: systems for food preparation, cleaning, bathing, budgeting, and reaching out to others. The men I followed are less adept at those skills: they had never been expected to cook and clean. So men, like Glenn, told me about having to learn these skills after the loss of their spouses.

AN: Does caretaking of others really end at age 85?

ML: Caretaking continues, often in new and familiar ways.  I think of Olga, age 97, caring for her grandson every weekend and putting aside a few dollars every day for her daughter who is battling cancer.  In her subsidized senior housing community, she delivers hot meals, hems pants, and runs errands. By caretaking, Olga feels a sense of community, a web of support. When she needs assistance, she has options and knows where to turn. So contrary to expecting nonagenarians to be sickly and dependent, many not only receive but also give care.

AN: Talk of cutting Social Security and Medicare has been in the news – how did you see these programs impacting elders’ lives?

ML: I have to admit – in my 30s, I see money going out of my paycheck—and I remind myself that that money is put aside for when I need it – I just hope it will be there! Through this research I saw how and why programs like Medicare and Social Security matter. For example, Juana worked in factories her whole adult life, and her small Social Security check keeps her hovering above the poverty line, able to afford rice and beans for the family and to pay for cable TV so she can watch her beloved Yankees.  Medicare covers annual doctor’s visits that likely keep her from spending time in the emergency room, a more expensive cost for society. Like most elders, she depends on Social Security for a significant portion of her income.

AN: Why should we all – not just the elders in the U.S. – read your book?

ML: Undergrads come to my Sociology of Aging course with all sorts of preconceived notions. They dread aging, seeing it as synonymous with depression, disease, and death. Our ageist society has taught them that aging equals loss, and they’re surprised to learn about elders who are aging on their own terms: coordinating self-care, combating isolation and loneliness, and exercising autonomy and control – sometimes in the face of disabilities and chronic illnesses. We all benefit from learning creativity, connectivity and resiliency from our elders. They teach us crucial lessons about all stages in life: living in moderation, designing comfortable spaces, constructing social families, appreciating humor and touch, and building social capital.  And, let’s face it, if we’re lucky, then we will all be elders soon enough.

Okay, I’ll admit it – ever the STD researcher, I was tempted to focus on the recent NYT article, “A Vaccine May Shield Boys Too.”* Instead, I dedicate this month’s column to a recent news item that has not attracted a lot of attention: the FDA issued an advisory warning against the use of mesh implants that are routinely used for surgical repairs of pelvic floor damage.  Warning: This post contains medically accurate language which some readers might find disturbing. (It also contains new medical findings that all readers should find disturbing!)

First, it’s important to know what the pelvic floor is and what functions it serves: in addition to this image from 1918’s Gray’s Anatomy, check out a newer medical illustration included in a recent LA Times article.  This muscular structure has the demanding job of supporting the uterus, bladder, urethra, the walls of the vaginal canal and rectum. In other words, it’s pretty darn important.  Without functional pelvic floor muscles, women can experience urinary incontinence, fecal incontinence, and uncomfortable/painful sexual intercourse.  (Not to mention, it’s more than a little disconcerting to have to manually push your prolapsed organs back into place.)

Surgical repairs of this type of damage are often done to correct prolapses of the uterus and surrounding organs which, to put it bluntly, can feel “as if something is falling out of your vagina.”  The problem is that the mesh devices used in many of these surgeries may be harming the sexual and reproductive health of many of the tens of thousands of women who have surgery each year for prolapse.

You might be wondering, how many women are at risk for pelvic organ prolapse?  Cigna say the top risk factors are full-term pregnancies (which stretch the pelvic floor), the strain of childbirth, and having a hysterectomy (surgical removal of the uterus).  On a recent episode of his TV show, Dr. Oz shared the estimate “almost 50% of women will experience some form or prolapse in their lifetime.”

Thousands of women opt for prolapse surgery every year, and many of these surgeries have involved the use of mesh implant devices to support torn/damaged pelvic floor tissue.  As noted in a July 14^th LA Times article, “The advisory was issued after an increase in reported complications involving the device.”  This article also describes complications as including “pain and urinary problems,” as well as, “erosion, when the skin breaks and the device protrudes, and contraction of the mesh that leads to vaginal shrinkage.”  Back in 2008, the FDA’s Public Health Notification and Additional Patient Information documents cited 1,000+ reports of these kinds of serious complications but considered them to be rare.  Fast forward to 2011 when these serious complications “have jumped fivefold,” no longer rare.

So, how does this impact a woman’s sex life?  The FDA notes, “Both mesh erosion and mesh contraction may lead to severe pelvic pain, painful sexual intercourse or an inability to engage in sexual intercourse.”  And, male partners of these women are also at risk: “men may experience irritation and pain to the penis during sexual intercourse when the mesh is exposed in mesh erosion.” 

With the FDA deciding to not remove the mesh implants from the market, did they do enough to protect patients?  Some experts say, “No.”  Dr. Diana Zuckerman of the National Research Center for Women & Families points out that these mesh implants have been used, “despite no clinical trials, no testing on humans to see if they’re actually safe and effective.”  It is time to advocate strongly for research and development of pelvic floor surgical repair techniques which do not involve the use of synthetic mesh implants.

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*This article sheds very little new light on a topic I wrote about over a year ago forMs. Magazine and blogged about back in 2009 – Gardasil is not simply the ‘cervical cancer’ vaccine its initial branding advertised; it also offers several potential health benefits for boys and men. 

Yesterday marked the one-year anniversary of President Obama signing the Affordable Care Act.  I encourage everyone to become familiar with what the Act has already accomplished, as well as the plans through 2015 (see an interactive timeline online).

Today, I dedicate this month’s column to reflecting on one of the new consumer protections that is scheduled to become effective January 1, 2014, No Discrimination Due to Pre-Existing Conditions or Gender:

Before the Affordable Care Act became law, insurance companies selling individual policies could deny coverage to women due to pre-existing conditions, such as cancer and having been pregnant. 

A WhiteHouse.Gov fact-sheet describes the ways in which, “The Affordable Care Act Gives Womem Greater Control Over Their Own Health Care.”  When I first read it, even as a feminist medical sociologist familiar with health care inequities, a few lines jumped out at me:

Right now, a healthy 22-year-old woman can be charged premiums 150 percent higher than a 22-year-old man.

Less than half of women have the option of obtaining health insurance through a job.

Today, maternity benefits are often not provided in health plans in the individual insurance market.

I appreciate the many positive effects this law has on women, men and children, but I find myself asking: why did the Affordable Care Act not include this provision — to eliminate discrimination to due to gender — among its original 2010 provisions?  A comparable provision was effective as of September 23, 2010 for children:

…health plans that cover children can no longer exclude, limit or deny coverage to your child under age 19 solely based on a health problem or disability that your child developed before you applied for coverage.

Now, don’t get me wrong, I’m all for protecting children’s rights to receiving coverage.  As a mom, I understand the instinct to want to protect one’s child before one’s self.  However, it feels like the policy-makers did not take into account the body of research on the direct correlations between maternal health and child health.  To put it simply, an unhealthy mom is not good for the health of her child — whether or not her child has excellent or poor health care coverage.

For example, a 2005 article in the journal PEDIATRICS documents research findings that,

“Maternal depressive symptoms in early infancy contribute to unfavorable patterns of health care seeking for children.” 

Another 2005 article examined the psychological and physical health of adult caregives of children with cerebral palsy and found that:

The psychological and physical health of caregivers, who in this study were primarily mothers, was strongly influenced by child behavior and caregiving demands…These data support clinical pathways that require biopsychosocial frameworks that are family centered, not simply technical and short-term rehabilitation interventions that are focused primarily on the child.

It’s easy to imagine the ways in which a child’s health might suffer if her/his primary caretaker has poor mental and physical health.  And, solely providing health care to the child did not necessarily improve the health outcomes of the caregiving moms.

One more example along the lines of the effects of maternal depression is the case of pediatric asthma.  A 2007 article in the Journal of Health Economics reports a study which shows:

…treatment of mother’s depression improves management of child’s asthma, resulting in a reduction in asthma costs in the 6-month period following diagnosis of $798 per asthmatic child whose mother is treated for depression.

Our health care system will likely save more money once we end insurance company discrimination on the basis of sex/gender.  Now, I recognize that not all women are mothers, but the overwhelming majority of mothers are women.  So, if the gendered division of labors in most families remains such that moms are primarily in charge of maintaing and protecting the health of their children, then wouldn’t we want these caregivers to have access to affordable, quality health care before 2014? 

That said, I am grateful that this law passed and hope that we will continue to work on ways to strengthen coverage for all Americans.