The State of Opportunity in America (2009) Released

The Opportunity Agenda is pleased to announce the release of our 2009 State of Opportunity in America report. The report documents America’s progress in protecting opportunity for everyone who lives here, and finds that access to full and equal opportunity is still very much a mixed reality.

By analyzing government data across a range of indicators, this update of our 2006 and 2007 reports assesses our progress in attaining opportunity for our nation as a whole, as well as for different groups within our society. The report paints a vivid picture of opportunity at the dawn of the current economic crisis. But even before the downturn, different American communities experienced starkly different levels of opportunity. The nation has made great strides in increasing opportunity in some areas and for some communities, but many groups of Americans are being left behind in ways that hard work and personal achievement alone cannot address.

These past few years have seen an economy in turmoil, impaired financial mobility, marginal prospects for educational advancement, and a broken health care system. These conditions thwart the nation as a whole as it strives to be a land of opportunity for the 21st Century. At the same time, women, people of color, and moderate- and lower-income individuals and families are being hardest hit and left behind as they face multiple barriers to opportunity.

These barriers are a problem not only for individuals and families, but also for our economy and nation as a whole. They also present an opportunity. Addressing them now would translate to thousands more college graduates prepared for a 21st Century global economy, millions of healthier children in stronger communities, higher wages and greater productivity for American workers, far fewer mortgage defaults and bankruptcies, and far less strain on our social services and justice system. Conversely, the areas of improved opportunity revealed by our analysis represent a foundation and lessons on which to build as the nation works to restore the American dream for everyone who lives here.

To download the report, please visit http://opportunityagenda.org/stateofopportunity.

Dr. King's Modern Legacy

In the days just before and after Dr. Martin Luther King Jr.'s 80th birthday, I had the opportunity to visit two places that are integral to his modern day legacy: Washington, DC and the Lower Ninth Ward of New Orleans.  As I witnessed the inauguration of Barack Obama as the nation's 44th president, I thought of Dr. King's admonition, in his 1963 I Have a Dream Speech, that "we cannot be satisfied as long as a Negro in Mississippi cannot vote and a Negro in New York believes he has nothing for which to vote." Despite some continuing problems at the ballot box, this was an election about which Dr. King could be truly satisfied; African Americans turned out in record numbers to elect the nation's first African-American president.

In the same speech, Dr. King reminded the nation that "when the architects of our republic wrote the magnificent words of the Constitution and the Declaration of Independence, they were signing a promissory note to which every American was to fall heir. This note was a promise that all men, yes, black men as well as white men, would be guaranteed the `unalienable Rights' of `Life, Liberty and the pursuit of Happiness.'"

For anyone who's visited the Gulf Coast recently, it is obvious that America has defaulted on this promissory note, insofar as the people of the Lower Ninth Ward--overwhelmingly poor and African-American--are concerned.  The world witnessed in 2005 how our government left the region's people to drown in their homes and suffer unspeakable conditions in the New Orleans Convention Center and Superdome.  More than three years later, that abandonment continues.

There's more...

Announcing "New Progressive Voices"

The Opportunity Agenda is pleased to help announce, on behalf of the Progressive Ideas Network, the release of a new collection of essays outlining a new long-term vision for America.

"New Progressive Voices: Values and Policy for the 21st Century" brings together leaders from a wide array of organizations, of different backgrounds, to present a bold, progressive agenda for America's future.  Integral to the project is a commitment, not to just presenting a new direction, but also realistic approaches to solving our collective problems.

From the collection's introduction:

In recent decades, progressivism has faltered. It was conservatives who developed and moved the big ideas, while progressives triangulated, tweaked, and tinkered. Since the 1960s, progressives have been running on the fumes of the New Deal and Great Society, confining themselves largely to narrow issue silos and poll-tested phrases and positions. Content to play defense in many of the major political battles of the day, they have all too often been cowed into submission by the vitality and confidence of the other side.

Now that is changing. Instead of obsessing about what we are against, progressives have begun to think about what we're for -- to prepare once again to play our role as agents of bold ideas and political and social transformation. Finding new confidence and imagination, we have begun to renew our intellectual capital. The essays in this volume draw on that new store of capital to sketch the outlines of a progressive agenda for 21st-century America.

Our own Executive Director, Alan Jenkins, contributed an essay to the collection.  You can read "The Promise of Opportunity" here.

Read more from The Opportunity Agenda here.

There's more...

Six Years Later, Health Disparities by Race and Ethnicity Persist

Amidst the energy and momentum for health care reform in the United States, it is important to remember that getting an insurance card into everyone's wallet is not the same as guaranteeing equal access to quality health care.  Recent studies have shown that, in America, health is not just about having insurance or paying bills: it's also, unfortunately, about the color of your skin.

The Lancet, a journal of global medicine, published an article this last Saturday (free registration required) on persisting racial and ethnic disparities in health, six years following the groundbreaking Institute of Medicine study, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.  The Opportunity Agenda Research Director and primary editor of the 2002 IOM study, Brian Smedley, is quoted in the Lancet article:


"As the report's study director, I was pleased to see that Unequal Treatment prompted a sober discussion in health policy, academic, and political circles", Brian Smedley, former senior programme officer at the US Institute of Medicine, wrote in a blog to mark the latest issue of the journal Health Affairs, which includes research on health disparities. "But ultimately the report failed to prompt passage of significant new federal legislation or spur the Department of Health and Human Services to adopt its core recommendations. As a result, little has been done, in my view, to systematically address the problem."

   

Citing some of the papers in the latest issue of Health Affairs, called Disparities: Expanding the Focus[paid subscription required], he said that some of the most shocking health care gaps that were not documented when Unequal Treatment was published, were found in mental and oral health care. Meanwhile, the biggest gains in life expectancy occurred among the best-educated Americans.

Because of the failure of HHS to adopt recommendations to reduce disparities, and the stalling of major legislation in Congress to address disparities, many of the inequities identified half a dozen years ago are still prevalent.  In very real terms, this means that communities that often have the most need for quality health care are the ones that receive the least of such care.

The Lancet provides one New Yorker's story:

   

James North, a 50-year-old African-American, had borderline cardiac function but had been admitted to hospital only once when he went to see Neil Calman in the Bronx, New York City.

   Mr North meticulously recited the medications he was taking and explained how he controlled his congestive heart failure by monitoring his weight and adjusting his diuretics.

   "I could not provide Mr North with all that New York's great health-care institutions had to offer. He knew that. He often tried to teach me that and was just as often amazed that I was unable to accept it", wrote Calman in the Bronx Health REACH Coalition newsletter in autumn last year.

   Mr North's case provides a vivid illustration of the inequalities in health care received by minorities in the USA. His cardiologist never thought of referring him to a heart-transplant centre and it took three separate interventions from Calman to get him a consultation. The echocardiography lab sent him home after Mr North was 10 minutes late because he had to keep stopping to rest on his walk there on a windy day. The pharmacy refused to refill his insulin syringes without a written prescription, even though he had been going to the same place for 2 years.

As the article points out, these differences in the type and quality of care received cannot be explained away by differences in insurance coverage or socioeconomic factors, such as levels of education or income.  Perhaps emphasizing that Mr. North is not alone in his experiences,

   

A New York State Department of Health study found that although African-Americans have the highest rate of hypertension and cardiovascular disease, the use of diagnostic testing, such as cardiac echocardiography, was very low for them. Sophisticated treatment, such as bypass surgery, was also administered less often in comparison with white people.

Similarly, a report authored by The Opportunity Agenda and over 30 other organizations and scholars, submitted earlier this year to the U.N. Committee on the Elimination of Racial Discrimination, Unequal Health Outcomes in the United States found the following with regards to racial and ethnic disparities in American health and health care:

   

* The 2006 National Healthcare Disparities Report found that, across a range of measures of health care access, Latinos received equivalent care as whites in only 17% of the measures, and that access to care had worsened from previous years for Latinos on 80% of the study measures.
    * From 1999 to 2004, the proportion of white senior adults (over 65) who did not receive a pneumonia vaccine dropped from 48% to 41%, but for Asian American seniors rose from 59% to 65%.
    * Insured African American patients are less likely than insured whites to receive many potentially life-saving or life-extending procedures, particularly high tech care, such as cardiac catheterization, bypass graft surgery, or kidney transplant.
    * People of color are more likely to receive undesirable treatment than whites, such as limb amputation for diabetes.
    * And even in routine care there are disparities.  Black and Latino patients are less likely than whites to receive aspirin upon discharge following a heart attack, to receive appropriate care for pneumonia, and to have pain--such as the kind resulting from broken bones--appropriately treated.

As stated in The Opportunity Agenda's report on health care in New York City, Dangerous and Unlawful, a health care system that is "too expensive, too far away, too inconvenient for working families, too insensitive to our language needs and cultural differences -- in short, too far out of reach for too many" is a dangerous system that is costly to all Americans, contributing to skyrocketing costs and diminishing our quality of life.  More importantly, however, a system that is inequitable, where the language you speak or your appearance may determine whether you receive potentially live-saving care, is one that violates our values of equality and community, and builds unlawful barriers to accessing the shared American dream of opportunity.

There's more...

Spotlight on the U.S. - Mexico Border

 

 

What do our border policies say about our values as a nation? President Obama committed to dispatching up to <a href="http://www.whitehouse.gov/sites/default/files/Letter_to_Chairman_Levin.pdf">1,200 National Guard troops to the U.S.-Mexico border and is asking Congress for $500 million for increased law enforcement in the Southwest</a> and for other border protection tools. The White House is calling the maneuver &quot;a multi-layered effort to target illicit networks trafficking in people, drugs, illegal weapons and money.&rdquo;&nbsp; But in practice, beefing up border enforcement under existing federal programs has only drained our government resources, has put into serious jeopardy our commitment to due process under the law, and has presented serious human rights implications.&nbsp; For example, Operation Streamline, an existing Department of Homeland Security program, was instituted in 2005, and mandates the federal criminal prosecution and imprisonment of all people who cross the U.S.-Mexico border unlawfully.

What do our border policies say about our values as a nation?

President Obama committed to dispatching up to <a href="http://www.whitehouse.gov/sites/default/files/Letter_to_Chairman_Levin.pdf">1,200 National Guard troops to the U.S.-Mexico border and is asking Congress for $500 million for increased law enforcement in the Southwest</a> and for other border protection tools.

The White House is calling the maneuver &quot;a multi-layered effort to target illicit networks trafficking in people, drugs, illegal weapons and money.&rdquo;&nbsp; But in practice, beefing up border enforcement under existing federal programs has only drained our government resources, has put into serious jeopardy our commitment to due process under the law, and has presented serious human rights implications.&nbsp;

 

For example, Operation Streamline, an existing Department of Homeland Security program, was instituted in 2005, and mandates the federal criminal prosecution and imprisonment of all people who cross the U.S.-Mexico border unlawfully.

 

 

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