Reflections on Teaching Against White Supremacy During a Time of Social Rupture and Transformation

Social Justice and Social Work is a foundational course required for all social work students in the master’s of social work program at Portland State University. Although the course has long focused on interrupting oppressions including White supremacy, teaching the course during the fall of 2020 required a nimble dance between our familiar modes of teaching and the need for spontaneous adaptation and creativity. The unique landscape for this course included teaching the course remotely (Zoom), inside a university embattled around the arming of its security force (that killed a Black man in 2018), in a city targeted by an armed federal response to the racial uprising led by Black Lives Matter, in a state with a long history of White supremacy and Black exclusion, and under a federal administration explicitly aligned with White supremacy. This paper offers a reflection of our teaching about and against White supremacy during this unique moment in time. We position our writing at the intersections of teaching and activism, of hope and uncertainty. It is from our shared commitment to the abolishment of White supremacy that the following tenets were derived, grounding our experimental teaching in complexity, complicity, and social transformation: (1) remembering for the future, (2) attending to collective grief and rage, (3) bringing the streets (racial uprising) into the classroom, and (4) repurposing the classroom for social transformation.

Food Insecurity in Households of People with Autism Spectrum Disorder during the COVID-19 Pandemic

ObjectivesTo explore differences in food insecurity for individuals and families of people with autism spectrum disorder (ASD) during the COVID-19 pandemic by individual, family, and neighborhood characteristics.MethodsWe surveyed a convenience sample of households of people with ASD. We calculated food insecurity using items from the US Census Bureau’s Household Pulse Survey..ResultsOver half of all respondents reported being food insecure (51.8%). Respondents who reported being food insecure were more likely to be minority, have a high school education or less, be on public insurance or uninsured, live in urban/rural communities, and say that their community is not supportive. The majority of respondents did not get free food or groceries (53.2%). Food insecure respondents who got free food was most likely to get them from schools (34.2%).ConclusionThis is the first study of its kind to explore food security in households of people with ASD. The pandemic has exacerbated existing neighborhood disparities. The federal response to food insecurity caused by the pandemic needs to be further explored especially for preferred and medically necessary foods for people with ASD.

Giving Pharmacists Provider Rights

Changes to our health care system, robotics and health care mergers among them, are forcing pharmacists into expanded provider roles, yet federal policymakers are failing to act on these changes. State lawmakers are acting but not swiftly enough. A federal response, including recognizing pharmacists as health care providers and making them eligible for independent Medicare reimbursement, will be necessary to enable pharmacists to fill their role in our health care system. Policymakers have an opportunity now to respond proactively to a changing climate in health care by clarifying the boundaries on pharmacists’ services, particularly those boundaries regarding direct patient care and the appropriate reimbursement level. In doing so, policymakers may also alleviate some of the scope of practice “turf wars” health care providers engage in and incentivize better patient care and lower health care costs.

The role of power-addiction and maladaptive denial in the US federal COVID-19 response

PurposeGiven the substantial resources of the United States, the failure of the American federal response to coronavirus disease 2019 (COVID-19) has been both tragic and avoidable. The authors frame this response as an artifact of power-addiction among administration officials and examine the US federal response to the COVID-19 pandemic through the lens of maladaptive denial by government officials, including President Trump.Design/methodology/approachThe authors use qualitative research methods for this study by analyzing key events, public statements by administration officials from multiple credible media reports and US federal government websites. The authors analyzed these data using Weidner and Purohit's (2009) model describing maladaptive denial in organizations and power-addiction among leaders.FindingsThe authors' analysis identifies maladaptive denial – and the concomitant power-addiction – as significantly contributing to the Trump administration's failed response to COVID-19. Maladaptive denial and power-addiction characterized Trump as a candidate and for the three years of his presidency preceding the COVID-19 crisis. Whatever normative “guardrails” or checks and balances existed in the American system to restrict the administration's behavior before the crisis were ill-equipped to significantly prevent or alter the failed federal response to the pandemic.Originality/valueThe article applies the model of maladaptive denial in organizations (Weidner and Purohit, 2009) to the public sector, and explores the lengths to which power-addicted leaders and regimes can violate the public's trust in institutions in a crisis, even in the US, a liberal democracy characterized by freedom of political expression. While organizations and change initiatives may fail for a variety of reasons, this case revealed the extent to which maladaptive denial can permeate a government – or any organization – and its response to a crisis.

COVID-19: through the eyes through the front line, an international perspective

COVID-19 is continuing to ravage the globe. In many Western Countries, the populous has not embraced public health advice which has resulted in a resurgence of the COVID-19 virus. In the United States, there is an absence of a coordinated Federal response. Instead, frontline workers and average citizens are having to cope with extensive mixed messaging regarding mask usage and social distancing from the highest levels of government. This has resulted in the United States not being able to achieve a low level of infection since the pandemic began. In addition, many citizens hold a profound belief that individual freedoms must be preserved, even at the expense of public health; and view the wearing of masks as renouncing this right. These engrained political beliefs can be traced back to the late 1800s. The response of the United States has also been hampered by a highly cost-efficient healthcare system, which does not provide universal care and has a just-in-time supply chain, with far too few supplies in reserve. This efficiency prevented a rapid scaling up of the healthcare response, which resulted in severe deficiencies in available personal protective equipment (PPE) and healthcare staff. To compound issues many healthcare staff are not provided an economic or healthcare safety net. Other frontline workers, such as those who work in transportation and food services, are working under even greater adversities. Many of these workers are from diverse backgrounds, who, along with their families, are at even greater risk for COVID-19. This vulnerable population of frontline workers are faced with a choice of going to work with inadequate PPE or placing food on their families’ table. In the United States, official recommendations seem to be ever changing, based more upon supply and test availability, than on science. We must rely on science and learn from the lessons of past pandemics or we will relive, even to a greater degree, the deaths and devastations experienced by our ancestors over 100 years ago.

Amend Pandemic Preparedness Legislation to Prioritize Diagnostic Test Development and Deployment

As the world becomes increasingly globalized, the propensity of pandemics, such as COVID-19, increases. The United States Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (PAHPAI) details the federal response to a health crisis including pandemics. The PAHPAI has hindered the nation’s response to COVID-19 due to its lack of emphasis on diagnostic testing (Burr 2019). Rapid testing is critical to slowing the spread of this disease. Ample testing will identify infected populations and will allow communities to take necessary precautions such as staying home and avoiding contact with others. Widespread shelter in place would not be necessary to control the spread of the virus, therefore reducing the economic impact of the pandemic. We propose Congress amends the PAHPAI to institute an improved testing response for future pandemics.

Demanding Better: A Case for Increased Funding and Involvement of State Medical Boards in Response to America’s Drug Abuse Crisis

ABSTRACT The federal response to the U.S. drug overdose epidemic has largely focused on supply-reduction efforts. Yet, this response has led to serious consequences for patients, prescribers and the public. Specifically, demand-reduction activities have been inadequately prioritized and pursued, and supply-reduction efforts targeted at the prescribers of controlled medications have resulted in reluctance to prescribe medically necessary controlled medications, thereby compromising access to treatment. Meanwhile, overdose death rates have remained tragically high as unabated demand has yielded shifts in the supply of substances of abuse. This article reviews federal responses to the opioid crisis, examining the allocation of federal funding as well as the U.S. Department of Justice’s enforcement actions against health care providers. The article then provides recommendations for how state medical boards can be better utilized in responding to the overdose epidemic. These recommendations include requiring that state medical boards be the primary investigators of questions relating to medical need, allocating federal funding to state medical boards, instituting continuing medical education requirements for controlled medication prescribers and expanding screenings for problematic substance use.