Cure-alls and Remedies

Going Upstream: Prisons and the Social Determinants of Health

Posted on May 12th, 2014

A couple of weeks ago, I joined with hundreds of other students and scholars at Johns Hopkins for a conference on prisons and the social determinants of health. The star of the conference was this story:

One day three men were fishing in the river when they noticed a baby floating towards them. Two of the men jumped out of their boat to save the child, and the third brought the baby and the boat to shore to care for it. As they stood around comforting it, one of the men spotted a second baby floating downstream! As he ran back towards the river, he was shocked to see his friend turn and run upstream. “What are you doing?!?” he cried. “There’s a baby in the water!” His friend shouted back over his shoulder: “I’m going to find the asshole throwing kids into the river!”

It was repeated and referenced throughout the day; it is a story about root causes and priorities, and it’s quite appropriate in a public health context where there’s always a tension between treating the symptoms or identifying the etiology. “Going upstream” means looking for the systematic and institutional causes of the illnesses and deaths public health workers encounter every day. We have to save the babies in the water, but we can’t ignore how they got there.

What we heard time and time again at this conference was a curious mix of ideas and arguments: on the one hand, many of Baltimore’s and America’s worst public health problems could be laid at the feet of the mass incarceration of its least advantaged residents. The nexus of poverty and educational failures were closely correlated with racism and prisons, and these were closely correlated with premature mortality, disease, and lost capacities. Put simply: prisons are one of the primary mediating terms for the creation of disparate health outcomes for whites and blacks.

And yet: we heard from a number of scholars who tried to give us a window onto criminality and delinquency through the neurobiology of adolescent impulsivity or the experience of substance abuse and dependency. These scholars didn’t even mention these racial disparities, and so they seemed to offer us little hope of a connection between the putative objectivity of brain and addiction science and the clear biases in arrests, prosecutions, convictions, and incarcerations. We even heard from one scholar who spent a long time touting his credentials and then accused African-American men of “compensatory narcissism.” (What was *he* compensating for?)

by Flickr user John Watson

Each panel was punctuated by a student poet from Dew More Baltimore, and these sizzling lyrics gradually seemed to impress the speakers that they could not ignore race any more. As the day went on, we heard from Elijah Cummings and Eddie Conway. We heard from a group of formerly incarcerated men who ran non-profits working on reentry and job placement. And we started to hear more talk of solutions: ways to reduce the number of people in jail, divert juveniles from the school-to-prison pipeline, and deal with substance abuse issues. David Kennedy‘s work with SafeStreets is designed to reduce the number of crime victims, and as a side effect reduce the number of people incarcerated: this is certainly laudable work worthy of all the celebration it has received, but it’s not really about abolishing prisons so much as it is about better-managing policing to increase efficacy,  reduce costs, and mitigate harms. In that sense, it’s meliorist rather than abolitionist. It goes upstream, but does it go upstream enough? Or does it tarry there in the water because there are lives to be saved right now?

What I never heard was a response to Vesla Weaver‘s challenge from the beginning of the day: African-Americans who encounter the criminal justice system are increasingly socialized with a dual logic: they are held responsible for the outcomes in their lives, while being actively disenfranchised in the decisions that will affect the conditions that produce those outcomes. The language of personal responsibility is rampant, even in public health; yet we know that demographic and institutional factors will play a major role in shaping outcomes. Disenfranchisement is the ultimate “up stream” moment; building social capital and public health seems to require re-enfranchisement.

Of course, Weaver herself didn’t tell us how to accomplish that. And so I return to Elinor Ostrom: you have to create an alignment between responsibility and the power to act. Ostrom showed that institutions can “crowd-in” responsibility: those who will experience the consequences of an action have to be the ones who control it. Civic capacities are hampered by medical and social incapacities, but at the same time civic capabilities can produce better outcomes in medicine and the economy.

Right now, we seem committed to more expert management of disenfranchised populations, and so we continue to create the mismatched logic of powerless responsibility and unaccountable power. The alternative is to let the Dew More poets take center stage and ask the scholars to wait for the intermission.

Philosophical Tone; or Kissing Strangers

Posted on March 12th, 2014

My old friend Leigh Johnson has a piece cowritten with Ed Karazian up today at New APPS on tone and civility in philosophy. I’ve already had some things to say in the comments there, but I haven’t done a good job of responding to the substance of what they wrote, so I wanted to take a few minutes for that here.

Now, as I understand it, the argument Leigh and Ed make is that we cannot expect philosophy to function like a community; instead, it should function like the ideals of cosmopolitan life identified with Jane Jacobs (and I would also argue, with Iris Marion Young) where a community of strangers mostly fails to make contact and experience a shared togetherness, and as a result the kinds of cloying closeness of some communities is avoided. Diversity and pluralism flourish in such cities, where neighborhoods create opportunities for community if it is wanted, but always with alternatives, with exit options, and with a mass of co-citizens who we can safely ignore. In cities, we do not feel that we must be friends with everyone we meet; in communities we feel that we are already joined by friendship even with people we have yet to meet (and soon there are no new people at all, we’ve met them all.)

What Leigh and Ed argue is that civility codes (and to a lesser extent professional codes of ethics) are attempts to recapture the communal life by enforcing chumminess and friendship, or worse, naked attempts to maintain exclusions at the cost of those who fail to live up those codes:

What is or is not permitted as acceptable speech or behavior, what is or is not viewed as “anti-social,” “un-professional” or “un-collegial”—that is to say, what strikes the ears of community members as resonating with an inappropriate “tone”—will always be defined and policed according to the norms of that group’s social interchange, norms that are determined by those to whom such norms are the most advantageous.

They go on to assure us that the worst offences and assaults on the dignity of colleagues and students already are legislated, and then to suggest that to go further, to require friendship, is a mistake:

Hearts and minds, on the other hand, ought not and cannot be legislated. It is at the level of hearts and minds that our (professional philosophers’) real problem lies.  Before we sign on to any program that mandates certain attitudinal dispositions, we ought to think seriously about the extent to which those initiatives in fact work to further discredit and marginalize the very voices they are intended to protect.

Norms of collegiality can be used to exclude those who don’t fit and haven’t fit into the community, so anything that smacks of legislating away the rough edges should be a non-starter. But there is nonetheless a challenge here in our polis, the challenge of our need to co-habitate in a profession where we are not friends, to engage in a project called philosophy without the collaborations and shared projects that it would seem to require. While I think we should preserve a place for snark and rough and tumble dialogue, I don’t think that means we have to give up on the idea that we’re all in this together.

My issue with tone arguments in philosophy is just that I like disagreements a lot. I take it that one of the real privileges and pleasures of doing philosophy as a profession is ferreting out those people with whom one disagrees on substantive issues and going to work exploring and articulating and perhaps even resolving those disagreements.

In this, the rough-and-tumble of the philosophical world is a good thing: it’s an opportunity to spar a bit with interested others and Others (and there is no doubt that I learn that most from those who I find the most Other.)

So here is my purely selfish suggestion for a civility code: let’s find a way to have boisterous disagreements about matters of shared concern that control the amount of damage done so that, at the end of the day, we can shake it off and wake up again tomorrow to fight again. I understand that we do have to embrace the idea that there are diverse and plural communities of philosophy, and that not everyone wants to make themselves available to spar with everyone else. I should say that I understand that conceptually, but I haven’t yet met those philosophers. No matter who they are, no matter what group they belong to, I’ve always found philosophers to be the type who want to talk it out, fight it out, and so on, even (or especially) with those who they think are the most deeply wrong or wrong-headed.

Any code of ethics for this group would certainly enforce a kind of “fitting in,” because what norms do not have insiders and outsiders? But like the art world, I want to believe that this community of philosophers is, at its best, a community where one fits only by not fitting, by being an irritant and irritated by each other. What Rawlsian doesn’t glory in the critiques of Rawls from Mills and Pateman? What dualist doesn’t crave a good argument with a passionate naturalist? What skeptic doesn’t like a nice tussle with a naive realist?

I think we need each other too much to alienate each other for good. Who else can put up with us than our fellow philosophers? Who else cares about the arguments and ideas enough to go line-by-line and tear them apart?

One objection I envision is that this is too unserious an approach. When we’re talking about prisons or torture or death we can’t afford to just spar; we need to fight, and win, because if we don’t the opposing ideas could contribute to injustice or damnation. In that sense, doing philosophy for joy is maybe a bit privileged, when there are folks doing it for survival. But I can’t help thinking that we could use the joy, all of us and especially those who do philosophy out of necessity, too.

Can’t we, even as strangers, even with our history of alienation and able white male cisgendered supremacy, find something worth sharing? Aren’t we all émigrés from elsewhere, rootless and stateless and clutching at this profession for something more than a nine-to-five?

Strangers don’t have to ignore each other, and they don’t have to fight. Sometimes, they can kiss. Consider this video my proposal:

What are the ruling ideas today? Is “College For All” among them? (Doubts-that-don’t-change-our-practices edition)

Posted on January 17th, 2014

by flickr user ChrisM70

by flickr user ChrisM70

I’ve just finished an article on higher education and the liberal arts, and it’s full of hope and comes to some definite conclusions about particular ways that an education in the liberal arts is valuable. It’s out for peer review right now, which means that if the reviewer is googling phrases maybe she’ll find this, so I want to say up front: I believe in what I wrote there. But I also have doubts about the progressive push towards education for all, the idea that through education we can all shed the demands of material labor, or that the value (and cost!) of an education should be totally disconnected from its role is securing a job.

The Economist recently gave voice to this particular error in its article on how technology will increasingly be automating office workers out of their jobs, which will widen the already broad inequality between those who must compete with machines and computers, and those whose jobs cannot (yet) be reduced to an algorithm. Here’s how they put it:

The main way in which governments can help their people through this dislocation is through education systems. One of the reasons for the improvement in workers’ fortunes in the latter part of the Industrial Revolution was because schools were built to educate them—a dramatic change at the time. Now those schools themselves need to be changed, to foster the creativity that humans will need to set them apart from computers. There should be less rote-learning and more critical thinking.

Technology itself will help, whether through MOOCs (massive open online courses) or even video games that simulate the skills needed for work. The definition of “a state education” may also change. Far more money should be spent on pre-schooling, since the cognitive abilities and social skills that children learn in their first few years define much of their future potential. And adults will need continuous education. State education may well involve a year of study to be taken later in life, perhaps in stages.

Yet however well people are taught, their abilities will remain unequal, and in a world which is increasingly polarised economically, many will find their job prospects dimmed and wages squeezed.

What value, then, is an education, if it won’t prevent the technological obsolescence of our skills? Put simply: if there are going to be ditches (which are required for plumbing, among other things) then there are going to be ditch diggers, or ditch-digging-machine-operators, or ditch-digging-machine-programmers. The move to automation replaces many operators with a few programmers, enriching the educated programmer at the expense of the uneducated operator, and that’s the move that should concern us, since it violates a basic rule of maximin: the people hurt are both more numerous and more needy than the people helped.

The standard economic argument is that lower prices help the poorest the most, and that freedom from unskilled labor allows workers to do something more rewarding, something that requires an education but cannot be imagined under the current political economy that requires so many to dig ditches. It’s like the old joke:

An industrialist is visiting a construction site and watching a newly-invented steamshovel in its first job. The union foreman complains that its job could be done by a dozen men with shovels, each earning a decent wage. The industrialist retorts it could be done by a hundred men with spoons.

Usually I prefer state-level redistribution through a basic income guarantee, but sometimes I think it makes more sense to fight for higher wages for the folks doing the digging than it does to hope that everyone will be able to escape that life if they could only get a Bachelor’s degree or a PhD. That hope in education has an ideological function that exceeds its aspirational and inspirational effects.

“The ideas of the ruling class are in every epoch the ruling ideas…”

So wrote Karl Marx in the The German Ideology. I’m not entirely sure that there is a single ruling class in American politics, in the sense Marx articulated it, but if there is one, it’s the folks with Bachelor’s degrees, the modern bourgeoisie. We are often-enough regaled by politicians with solicitations to the “middle-class” or “working Americans” that we might be tempted to identify these groups as the ruling class, but about 60% of the population participates in the workforce, and exactly 60% of the population are in the middle three quintiles of income sometimes identified as the middle class. I would argue that these groups are too large to have conjoined interests or ideas.

On the other hand, we are sometimes assured that the very rich and very few (for instance, the top 1%) are in fact governing the US, and that the masses don’t perceive the truth of this dominance because of ideology. If I’m right about the college educated, then it’s much too convenient to limit the ruling class to bankers and stock brokers and identify neoliberalism as the ruling idea; if the traditional bourgeoisie still exercises a great deal of control, then even the very rich must still win over that larger group in order to maintain their wealth. Arguably the 99% v. 1% language of Occupy was a clever rhetorical strategy for enlisting the support of the larger ruling class with the interests of the proletariat. It may be that billionaires manipulate the agenda, but the baseline agenda the wealthy are trying to steer is set by the merely well-off.

Another possibility is that that larger class really does share class interests with the 1%, so Occupy was unsuccessful because the ruling class’s ideas can’t be moved by rhetoric if its interests are at stake. (As I understand it, this is Marx’s point: ideology is believing that ideas matter more than practices.)

So what does that class (to which I and my readers probably belong) have in common?

  • We are college educated.
  • We work in offices, with computers.
  • We are employed, and if we are in relationships we probably cohabitate with our partners who are also employed.
  • We live in cities or “suburbs” which have been adopted by some metropolitan area.
  • We own our own home (though this may be changing.)
  • We often don’t live near where we were born, or in the same city as our families.
  • We are likely to work in education, health-care, technology, management, or the public sector.
  • Our careers tend to benefit from globalization.
  • We are predominantly white.
  • We have very little contact with police, prisons, or the criminal justice system unless we are employed by those institutions (which many of us are.)

If what I’ve described above is correct, then perhaps these would be the ruling ideas:

  • Education is for everyone, and more equal educational access will create a more equal society.
  • Office-work is difficult and valuable, and education ought to prepare us for it.
  • Jobs and workplace regulations are the primary mode by which the state ought to see to the public’s good.
  • Marriage is good for everyone; even homosexuals should marry.
  • Urban life is better than rural life.
  • The American Dream should require (and subsidize) home ownership even if that punishes renters and those too poor to afford a home.
  • Family ties matter less than economic success.
  • Education, health-case, technology, and the public sector are the “best” jobs and ought to be subsidized.
  • Globablization is good.
  • Race is irrelevant.
  • The criminal justice system should supply entertaining plot lines for movies and television, but it is not otherwise relevant. Probably most people in prison belong there.

To be clear, while I’m not advocating these ideas, I believe (or act as if I believe) many of them. If those ideas are fundamentally aligned with my class-interest, it would be more surprising if I didn’t believe them. It’s not simply a coincidence that those with the most power and influence in society never have their fundamental interests questioned in our politics. That’s what makes them ideological, that these aren’t partisan issues: no one contests the value of education or marriage, and very rarely do they contest the important of home ownership.

Another possibility is that the top 20%-30% of Americans are not members of some ruling class, that the class is either much smaller than that or that there really isn’t such a thing as as single ruling class any longer, just a number of different social groups that align themselves in ways that they can succeed and govern on some topics and not others. For instance, none of the possible ruling ideas I mentioned included things that are quite clearly also governing American culture and politics, like support for the elderly through Medicare and Social Security (unless you think the elderly are the true ruling class), or America’s military role in the world (unless you think the military is the ruling class). Ideas like meritocracy and personal responsibility, patriotism and faith are frequently rejected by the richest two quartiles, precisely because they conflict with the values instilled by higher education and urban life.

If those ideas are also “ruling” in some way, then we would expect that those who hold them would be the true ruling class if all ruling ideas must belong to the ruling class. Perhaps instead, ruling ideas come from all the classes. Indeed, other ideas aren’t even “ruling ideas” so much as deeply felt constitutional claims, like the important of markets and prices for mediating our economic interactions, the idea that personal property and capital property should be governed by similar rules, or the assumption that inequality can ever be justified by increased productivity or merit. These ideas no longer have their source in a single class, even if they once did, just as in some sense American’s deep commitment to the idea of democracy and one-person-one-vote is a classless idea, at least in the US.

(It should be pointed out that what I have just written in the last paragraph is almost precisely the position being lampooned by Marx in The German Ideology. Ironic, eh?)

I worry that the cultural promotion of the value of education is ideological, often, because I both benefit from it and yet also regularly watch how “College For All” seems to be disadvantaging a lot of my students. My fellow progressives who rail against the false equality of opportunity that makes the poor think they will someday be millionaires ought to understand why college can’t be an exit from the working class for everyone. Sure, anyone can be a millionaire or good at college, but everyone can’t. It’s a meritocratic institution, not an equalizer, and very little of the so-called college wage premium goes to those who graduate from community colleges and unselective four year universities. The inequality is built into our political economy!

I mean no disrepect to my students, either. I don’t think it’s disrespectful to appreciate the priorities of those who are actually choosing between homework and subsistence labor, for instance, or attendance and childcare. I’ve only been working at an unselective institution for three years, after seven years at selective universities, and the difference is palpable. I watched one student’s children so she could take exams without leaving them accessible to her abusive ex. She barely passed, and we both called that a victory: she hadn’t had much time to study, and had to read her notes through a hell of a black eye. Was education really the most important thing to do for her? What did she learn that she’ll remember later?

What about the student who I have cried with because she is dying from cancer: her husband just left her because the chemo makes her not want to have sex, and all she wants to do is graduate before she dies? Or the student who discovered she was pregnant and came to me because she didn’t know what to do? Or my student whose brother was shot and broke down in class? Or my student who was followed into class and physically threatened? Or my student who thought she had to be a nursing major until she realized she was really good at philosophy, but is still majoring in nursing to be practical? Or my student who asked me to help him figure out how to transfer when he realized that the only way he’d get a good education in computer science was if he left us? Or my students who are also incarcerated?

I’m not saying that they don’t deserve an education: they do! Those are almost all people who will have college diplomas or already have them. Most of them are women. They won’t dig ditches, but they will work in jobs that only require a college degree nominally, where the skills they’ve often failed to learn are irrelevant. The diploma will prove that they have grit and conscientiousness, and give them a leg up in a job market where signaling such things are necessary, but they, like most people, will not remember what Modus Ponens is or how the the Rawlsian original position is supposed to help us think about justice.

There’s a difference between saying, “Right now, you have more important things to do than your logic homework, and that’s okay,” and saying, “Because you are poor, you don’t deserve a college education.” My students in prison are much better academically than the ones who are free, just because they have the time to focus on their studies, and I think there is a lot of value in the work that we do together. But no Pell Grants means no credit, and a felony record means that the skills they learn may never be put to work.

Maybe there’s a difference between “deserving” and “needing” an education. Most people don’t need a college diploma, certainly not to do their jobs, and probably not to be good citizens. They need a union or a basic income guarantee or a social minimum or a citizen capital grant or workplace democracy. But increasingly the only people who still have unions and political power are the people who also have college degrees, and those of us in that group like to pretend that increasing subsidies for bourgeois students (our kids) will help the ditch-diggers, too. That’s a bit too convenient, isn’t it?

I have some questions about violence

Posted on December 22nd, 2013

11736It looks like I’ll be co-teaching a course on violence with Daniel Levine in the spring, and I have some questions:

  1. Is it just me, or do philosophers rarely talk about violence? We talk a lot about killing, and war, and punishment, and even torture. We talk about peace and non-violence. But “violence” doesn’t come up often, and when it does it’s often (as in the Frankfurt School) mythologized or dealt with through a kind of negative theology. Am I right about that?
  2. Clearly there are some related concepts, like cruelty, domination, coercion, etc. But what do they tell us about violence? Is violence the worst thing that humans can do? Compare violence to cruelty, domination, destruction, and harm; are these the components of violence, or its frequent companions?
  3. Where does sexual violence fit? Is it an intensification, a different kind, or a mixture of violence and other things like domination and cruelty?
  4. More basically: is violence a natural kind? Is there a specific phenomenality attached to it, i.e. is there something all instances of violence are “like”? Or is it a family resemblance term? (Or is it worse than a family resemblance term, we don’t even know what it means in all the contexts where we’re using it?)
  5. Who is more violent: a sniper or boxer?
  6. Who is more violent: a drone operator or a torturer?
  7. Which is more violent: a bomb or a prison cell extraction?
  8. Is an explosion always violent? Are fireworks “controlled violence” or are firebombs “violent and destructive fireworks”?
  9. Why do we continue to speak as if peace is passive and violence active, even after generations of non-violent activists have shown us how active peace can be? What’s the bias, there?
  10. Can words and arguments be violent, or is it just that some words are backed by institutions of violence? Like, can philosophy be violent, or does it only get a little violence rubbed off on it when it’s justifying war or torture or the actual embodied violence of the state? Put another way, is an argument or aa discourse violent only insofar as it is an implicit but authentic *threat* of physical violence?
  11. Contrariwise: can violence be expressive?
  12. War is way more violent than most people  even give it credit for being, I think. There is a lot of peripheral violence, destroyed communities, and lost capacities, even in “just” wars. So is interstate and civil war more violent than totalitarianism? Is “legitimate” state violence better or worse than “illegitimate” non-state violence? Are they equal, i.e. violence is violence is violence?