How to Fight Racism: An Interview with Jemar Tisby

How to Fight Racism: An Interview with Jemar Tisby

Jemar Tisby generated a lot of necessary conversation about the intersection of race, social justice, and the global church in 2019 with his best-selling book, The Color of Compromise. With that book, he laid the historical foundation of racism in the church. In the last chapter of the book, Tisby shares practical tips for fighting racism. In his new book, How to Fight Racism, Tisby continues the conversation, but this time around he provides an actual framework that churches and Christian groups can use toward racial reconciliation.

“In a lot of ways, they [the books] pair together really well. Now, they can be read independently of each other. So, I don’t want folks to get scared if they didn’t read the first one. You can dive into the second. From my perspective, the second book is what I wanted to be the first book. I was really passionate about getting in there, getting involved in doing something about racism. But in conversations with publishers and advisors and things like that, it became apparent that we really needed to lay the groundwork for the problem of racism and white supremacy in this country. Especially as it relates to the church. And basically, diagnose the problem before we jumped to solutions,” said Tisby.

Tisby’s solution is built around a model he created called the ARC of Racial Justice. ARC is an acronym for awareness, relationships, and commitment. From Trayvon Martin through the Black Lives Matter Movement and even the tumultuous racial conflicts during the Trump presidency, many people have become more acutely aware of our country’s problems centered around race. But committing to developing relationships with people who may not have the same views as you do or are coming from a different cultural perspective and, in doing so, breaking down racist structures takes more of a plan for change.

“What I’m hoping for is that this sparks ideas for people to gather a group of folks around them and say, ‘Hey, let’s do something.’ And I am really looking forward to stories trickling in over the next year and two years or whatever, so that when we do the updated and revised version of How to Fight Racism, I can include stories from the field, so to speak,” Tisby said.

So, what about Critical Race Theory (CRT) as a way to combat racism? CRT argues that diversity training and changes in the laws are needed to combat structural obstacles created by white people that make for an unequal playing field in our society when it comes to people of color. Some people believe that CRT is a huge threat to the church. Tisby doesn’t see it that way. He says people who are dismissing it are using an old tactic — from tactics during the Civil War, when pro-slavery people used terms like “carpetbaggers” and “scallywags,” to the Jim Crow segregationists’ labels of “outside agitators,” to modern usages of Red Scare smears of “communists” and “Marxists.” Now, the label is “Critical Race Theory” proponents and is being used by people whom Tisby says want to defend a racist status quo.

“All of these things are about controlling the narrative. And what happens is, if I can use a label like Critical Race Theory, I can paint it as bad, slap you with it. Then I can put you in a box, put you on the shelf, and I don’t have to actually listen to what you’re saying about racism and white supremacy,” Tisby said. “What we have to do is not get distracted from the main issue, which is Christian nationalism. It has infected so many parts of the church in the U.S. and even beyond.”

Many white Christians don’t experience racism the same way as Black people and other people of color because the Christian nationalists are in their families, in their churches, and some cases, they’ve acclimated to that way of thinking. Tisby says it’s hard for them to see it as an urgent existential problem that the marginalized and oppressed people do. That said, he has noticed that the social justice marches and movements have had an impact. White women in particular, from a 30-something who teaches Bible study at a nursing home to 70-year-old women, have reached out to him via social media and seem catalyzed to start taking action.

“It might’ve had to do with the past year or two and what they saw, especially politically. White Christians are starting to realize, ‘Oh my, like these differences are real. They’re salient. They’re in my church. They’re in my family,’” Tisby said.

It’s no easy task to be as explicit as Tisby directs white Christians about calling out Christian nationalism and white supremacy in their ranks. We know how it’s infected historically and theologically what they do. He often praises Fannie Lou Hamer’s efforts, who became a nationally known civil rights activist after seeing a presentation about voting rights at her church. Tisby admires how she always connected her activism to her faith. With that in mind, what should Black Christian activists be doing now?

“We are going to have to protect our peace. We are living in perilous times right now. And I find myself even just scrolling through Twitter or social media and whatnot, that I’ve got to take breaks because the flood of negative news, the flood of anti-Blackness, all of that stuff is too much to handle all at once. So, we will have to cultivate communities that affirm our dignity, that affirm our being made in the image of God. You got to go out and seek it and find it.”

He Saw That It Was Good: An Interview with Sho Baraka

He Saw That It Was Good: An Interview with Sho Baraka

As our world becomes more divided and we seek to reconcile with ourselves and our neighbors we know we need God more than ever. But how can we hear and follow God in the midst of our fractured reality in ways that are faithful and life-giving? UrbanFaith sat down with the artist, activist, and creative Sho Baraka to talk about his new book He Saw That It Was Good, which helps us think through some of the most pressing questions of our world to see the beauty and purpose of God’s creation expressed in our lives. The full interview is above and the excerpts below have been edited for clarity and length.

 

 

 

Allen

Hello UrbanFaith. We have with us one of our very own gems of our generation, as I like to say, an artist and activist. He’s a historian. He’s an author now, and that is Mr. Sho Baraka. With his book, He Saw That It Was Good. And we’re going to be able to talk with him about this book, what it was that he’s thinking, and how he’s thinking through these things, because I just feel like he’s got wisdom to drop for us today. So Sho, good to have you. 

My first question for you is one of the ones that people ask all the time, I know you as an artist. A lot of people have encountered you in that space. What made you decide to write down your thoughts in this book and continue to integrate your art in this form?

 

Sho

I think ever since I recognized that I was a creative, I think I’ve always wanted to write. As a young child, I wanted to write novels, short stories. But like my own experience, as I got older, I got introduced to hip hop and poetry from the Harlem Renaissance. And my desire for art kind of moved towards poems and music. And so I pursued more hip hop than I did writing and poetry. But I got to a place where I felt like there were there were some things that music couldn’t really quite communicate. And when we got around 2016, the political landscape started to get real divisive. People were shouting at each other, friends became disintegrated. And I said, you know, music is great, music has this place of disarming people and communicating things in ways that are really helpful to society, getting us to reimagine our world. But I feel like, I need to communicate a very straightforward, more poignant message, and also exercise these muscles that I’ve always wanted to exercise. And so in 2016, is when I really [started] to process through. All right, I think I want to write a book. The question was, what type of book?

And a lot of people wanted me to write a book about race. Because I talked about race a lot. A lot of people wanted me to write a book about politics, because I wrote about politics sometimes. But the reality of it is I’m no expert in either one of those arenas. And so what I wanted to do was say: well, what is my personal, ethical, and theological approach to work? Creativity in telling stories, which is informed by race, which is informed by politics, which is informed by our personal experiences, and therefore I can talk about race, I can talk about politics, I can talk about creativity. But ultimately, I want to show how all of those things affect how we work, and how we and how we create and tell stories in this book.

 

Allen

I love it. You mentioned  how you’re bringing in so many different things. You talk about race here, you speak, you do poetry, you do short stories in here. You’re bringing in history, you’re talking about creativity and theology. And I would say that that makes this a true theological work because us understanding God and ourselves is multiplicity, right?  And so I wonder why do you think that’s important that you’re able to bring together all those different pieces of yourself? In order to share a message why is it important that we do that kind of work? 

Sho

Yeah, I think you hit on it. I think oftentimes in theological posture in America, we’ve separated. Really, we’ve created a bifurcation of the body and spirit. You know, like there’s there’s ways to fake it and there’s ways to be. And I think Jesus very much so, the Bible very much so teaches us how to be comprehensive in our beings.

[It’s okay] to weep. Jesus is very emotional with people, he has these wonderful physical relationships with people, but he also is very didactic and theoretical and philosophical. And oftentimes, we feel that we can only exist in one or two spaces. The gist, I believe, and I think this book is arguing as well, is historically, the black Christian posture has done a great job of doing both. Because you can’t separate the spiritual element, like the theory or the up in the air aspect of like, we know that Jesus is real, we know God is real. We know we believe [even when] we can’t quite feel him in that sense. But there’s also this physical aspect of: we need liberation. There’s a physical, there’s a physical desire we have, we’re on this plantation, you know, I mean, we’re asking the Lord to be rescued. But at the same time, we know that…there’s a here and now need, and then there’s a future glory that we’re going to see as well. 

And Christian faith in the black tradition has always been tethered to justice. So it’s always been tethered to this physical aspect of redeeming the world that has been broken, as well as this intellectual, inner introspective. Kind of how do I how do I wrestle with my own existential experiences, if you will. And to jump to the end of the book and kind of steal some of its glory, I talked about one of my favorite people, George Washington Carver. And that I think he had this wonderful mysticism, and I don’t want to say mysticism to scare people away from…the true and the actual, but there is a bit of mysticism about our faith. And we see that throughout the scriptures. But George Washington Carver had this physical felt God, let me relationship with God, that I think we often look at is weird to have, well, he knew nature. He knew the plants he knew. He knew that because he knew God years and his relationship with God and formed his work and his relationship. So much so that he spoke to plants. Yeah. And people who said, “It’s crazy.” And so for me, what I say is there’s this aspect of us, coming into this full, comprehensive understanding of what the gospel is. It’s not just this intellectual understanding, it’s the physical body, it’s how do we get connected with our bodies, and in the sense of that, how that impacts our communities and the things we make and create. 

 

Allen

So last question for you. And this is one of those easy takeaways, what is it that people can do?  What is it that we should do now in order to live into our vocation to make a difference? How can we approach finding our next is a better way to say it?

 

Sho

Yeah, that’s a good one of the things I this is, you know, this is not gospel, but this is just my own personal observation. I think when we think about the word calling, I think, oftentimes, we just think about what am I good at? What what’s my skills, and let me go pursue that. And I, you know, that can be very romantic and poetic, but often think that also has its problems. I think the way we should view calling is, where’s their need? And where has God led me to fulfill this particular need? Because we see that throughout Scripture, we see Moses being called to a problem. And Moses is like, well, I don’t know if you got the right guy. And God is like, No, I’ve got the right person, I just need you to go do it. And but the reality is, is Moses does have the skill sets he was born into, I mean, he was raised in the palace, you know, he knows the laws, he knows the culture. And so to send Moses back is the most wise actions you can do. And so Moses can say he’s like, but this is not what I want to do. Oftentimes, we got to get past what we want to do in order to really see great change in our society.

I hope that we start seeing vocation apart from something we just do, but it’s a part of actually creating and cultivating society. So oftentimes, you will think of artists and creatives of people who actually create culture. But the reality is, is every vocation participates in the building up of a culture of a society. And the more we wake up every day, seeing that we have this canvas, and we can paint this beautiful image of God without work, then the more intentional we’ll be about the work, we, we choose how we work every day, and how we, you know, view other people’s work. And so don’t just work at a place just to get a check.

But if that is you, if you are in a place in your life, where you only when you have to work just to provide Yeah, a lot of us are in that situation, then figure out how do you do that for the glory of God, you know, me? Because I know some people don’t have the luxury of picking a path and picking a career. Some people just have to pay bills. Yeah. But understand even in that, that’s, that’s important. That’s just that’s God glorifying, like your work doesn’t have to be tied to some sort of social good in order to be transformative. And if you’re working at the drive thru, well, the way that you come to work and the environment, you try to create the way you interact with the customers creates culture. It creates an environment. And so I look at chick fil a, the one thing you will know about chick fil a is when you go into chick fil a people don’t be foul. They don’t be smiling, they will say My pleasure, you’re going to get a wonderful experience. I don’t know if that person can have a moment. They can have the worst day ever. They can be mad, but they don’t least fake it. Yeah.

They’ve created a culture and an environment. And I think a lot of chick fil A’s business is because of that. Yeah. what you can expect from the environment. Imagine if we all had that posture where I work, I’m going to work even if I don’t like the job to create an environment of my pleasure. And that’s that’s kind of like the way we should view our vocation. So those are a few things I think that we can do.  

William Pannell wrote ‘The Coming Race Wars?’ nearly 30 years ago. It still resonates today

William Pannell wrote ‘The Coming Race Wars?’ nearly 30 years ago. It still resonates today

(RNS) — In his book, “The Coming Race Wars?,” theologian William Pannell foresees the poor and disenfranchised engaging in violent urban uprisings and revolts across the world similar to the 1992 Los Angeles riots. It will only be a matter of time, he writes, “before some cop blows it again in his or her treatment of a Black person, probably a Black man.”

Police brutality, racist and discriminatory lending practices, lack of well-paying jobs could push Black people and other marginalized communities to revolt, Pannell predicts. And the evangelical church — with all its influence, resources and its supply of missionaries across the world — is ill-equipped to address social issues at home, he argues.

Pannell, professor emeritus of preaching at Fuller Seminary, pushes back against the notion that Jesus is all people need to make it.

“I really do believe that people — all people — need Jesus,” Pannell writes. “But to make it in society, white Christians realize they need a lot more than salvation. They may expect Black people to be content with salvation in Christ. But that is not enough for the white Christians themselves.”

While the debate has been “between those committed to evangelism and those committed to justice,” Pannell writes that “what we should be striving for is a spirituality that will inform both evangelism and social transformation.”

Pannell wrote “The Coming Race Wars?” nearly 30 years ago.

“The interesting thing about this book is that it sounds so contemporary, even though it’s about 30 years old,” Pannell, 92, told Religion News Service. “Why is that? What is there about this book that makes it so painfully contemporary after so long a time?”

The book was first published in 1993, in the wake of the 1992 uprising that erupted in Los Angeles after a jury acquitted four LAPD officers in the beating of Rodney King. Now, in the wake of 2020’s racial justice uprisings after the killing of George Floyd, Pannell has released an updated version.

“The Coming Race Wars: A Cry for Justice, from Civil Rights to Black Lives Matter” was published in June, and features a new introduction by Jemar Tisby, author of the book “The Color of Compromise: The Truth About the American Church’s Complicity in Racism,” and an afterword that Pannell began writing before COVID-19 struck the nation and prior to the police killing of Floyd that sparked protests across the country against police brutality and in support for Black Lives Matter.

In the afterword, Pannell explains that he essentially began writing it nearly 30 years ago, when Rodney King called for an end to the riots, publicly asking on television: “Can we all get along?”

“The question of the Black man from Los Angeles loomed large thirty years ago and it still throbs with meaning,” Pannell writes.

Pannell, in the new epilogue, seeks to answer the Rev. Martin Luther King Jr.’s question, “Where do we go from here?” But the meaning of “here” is something Pannell grapples with.

He underscores the death of King and recalls the crowd leaving the March on Washington “wondering about the future.” He highlights Billy Graham’s 1970 “The Unfinished Dream” speech in front of a predominantly white crowd and how his “power and prestige legitimated the marriage of God and country.” Pannell documents Graham laying the foundation for evangelical support for conservative agendas. After his death and the “evangelical movement shattered along ideological lines,” he asks, “What’s next?”

Pannell brings readers back into the present, to the Black Lives Matter protests and to former President Donald Trump’s speech at Mount Rushmore where he “drove the dagger of division deeper into America’s heartland,” and asks again, “Where do we go from here?”

“The here, unfortunately, is pretty much what it was 30 years ago,” Pannell told RNS.

To Edward Gilbreath, vice president of strategic partnerships at Christianity Today, the expanded and new version of Pannell’s book serves as a historical reflection but “also as a statement on how far we haven’t come.”

“Dr. Pannell was not afraid to speak the truth to power in evangelical circles at that time. He was very much engaged and a part of the predominantly white evangelical community,” said Gilbreath, who in 2019 helped spearhead Pannell’s updated book when he was an executive editor at InterVarsity Press.

“This gave him a very intimate perspective in terms of being trusted and someone who is not just criticizing for criticism’s sake, but he really cared about the church and wanted to see real change because he loved the church,” Gilbreath added.

With this version of the book, Gilbreath said he hopes to introduce Pannell to a new generation, those who may know about evangelist Tom Skinner “but have not heard the name William Pannell.”

Anthea Butler, associate professor of religious studies and Africana studies at the University of Pennsylvania, said it’s crucial to contextualize how the original book was published at a time when L.A. was reckoning with the aftermath of what’s been described as one of the worst race riots in American history.

“It was important to talk about the ways in which evangelicals hadn’t paid attention to race,” said Butler, author of “White Evangelical Racism: The Politics of Morality in America.” “He was already working on that book when the L.A. riots happened.” Butler dedicated her book to Pannell.

Butler juxtaposes “The Coming Race Wars?” with Pannell’s 1968 book, “My Friend, the Enemy,” where he seeks to explain how white people, including those Pannell knew and loved, could “at once be both friend and foe.” In it, he centers his experience as an evangelical Black man among Christians who seldom challenged white supremacy.

“That book was trying to address back in 1968 the same kind of issues that he was addressing in 1993, and here we are in 2021 with the updated version, and evangelicals still haven’t gotten it yet,” Butler said.

Pannell recognizes that a majority of evangelicals supported Trump and his administration. “It has become clear that this segment of the church is deeply divided and segregated not only by theology but by political ideology,” he writes.

The race wars may still be coming, Pannell writes, but he also highlights how the “command of the risen Christ to his followers was that they go into all the world and make disciples of the nations. Not build churches; not make converts. Make disciples.”

“It seems fairly clear today that we have far more churches and Christians than we have disciples,” Pannell writes.

In his afterword, Pannell poses the question: “What, after all, does it mean to be the people of God today?

“Moving forward from here will require a greater investment in discipleship, a deeper commitment to beloved community, and a reliance on the power of the Holy Spirit,” Pannell writes. “In other words, we’ll need to be the church.”

 

Hundreds arrested at Capitol while protesting for voting rights, minimum wage

Hundreds arrested at Capitol while protesting for voting rights, minimum wage

The Rev. William Barber, center, flanked by the Rev. Liz Theoharis, left, and the Rev. Jesse Jackson, right, speaks during a Poor People’s Campaign demonstration in Washington, Monday, Aug. 2, 2021. RNS photo by Jack Jenkins

WASHINGTON (RNS) — As police escorted a demonstrator in a wheelchair away from the chanting throng descending on the Capitol Monday (Aug. 2), fellow protesters turned to watch the person go. The group paused for a moment, then altered their call.

They screamed in unison: “Thank you! We love you!”

The lone protester nodded, fist raised. The crowd erupted in applause.

It was a moment that played out again and again over the course of the afternoon. According to Capitol police, more than 200 faith-led demonstrators were arrested while praying, singing and protesting in the street, hoping to draw attention to voting rights and a slate of other issues participants argued impact the poor and low-wage workers.

The sprawling demonstration was organized by the Poor People’s Campaign, an advocacy group led by the Rev. William Barber II and the Rev. Liz Theoharis that tends to support left-leaning policies. Monday’s action on the Hill constituted one of the largest mass-arrest nonviolent protests at the Capitol in recent memory and attracted an array of prominent voices, including civil rights icon the Rev. Jesse Jackson and Luci Baines Johnson, the daughter of late President Lyndon B. Johnson.

At a rally near the Capitol immediately before the march, leaders laid out what they insisted were interconnected issues driving their protest, which centered on voting rights, immigration reform, a $15 an hour federal minimum wage and eliminating the Senate filibuster that has stymied passage of related federal legislation.

“Filibuster is a sin!” Barber declared. “Making essential workers work during a pandemic — and risk their lives to save this country — and then not give them a living wage is sin.”

The event also featured music. Singers led the crowd in belting: “Somebody’s hurting my brother, and it’s gone on far too long. And we won’t be silent anymore!” The singers changed the lyrics as the song progressed, inserting lines such as “Somebody’s stealing our wages!” and “Somebody’s blocking our voting rights!”

The song echoes the sweeping, evolving agenda articulated by a variety of faith leaders across the country in recent months, particularly those who operate within religious communities of color.

The Poor People’s Campaign took a leading role in propelling that agenda this summer in the wake of Republican-led efforts to pass state-level elections bills many activists decry as restrictive. Indeed, Monday’s march follows what organizers called a “season” of similar demonstrations organized by the PPC over the past two months in Washington, Arizona and most recently Texas, where activists mimicked the 1965 civil rights march from Selma to Montgomery, Alabama. The group walked 27 miles from Georgetown to Austin, Texas, in late July to oppose voting restrictions.

Texas pastor the Rev. Frederick Haynes III, who joined the Texas march and has vigorously opposed state elections bills, was among the speakers at the Washington rally.

Activists are arrested during a Poor People’s Campaign demonstration in Washington, Monday, Aug. 2, 2021. RNS photo by Jack Jenkins

“President Biden, Democrats and Republicans, the culture will put it like this: If you come for us and we didn’t send for you, you don’t want this smoke,” said the Progressive National Baptist, whose denominational convention is happening this week. “You don’t want this smoke because we are fighting for the soul of this nation.”

The activists’ efforts have hit roadblocks with some Democrats at the national level, particularly Sen. Joe Manchin of West Virginia and Krysten Sinema of Arizona. Both opposed efforts to pass minimum wage increases and eliminate the filibuster this year — in Manchin’s case, despite a meeting with Barber and low-wage workers.  The Poor People’s Campaign has since targeted bothlawmakers with protests.

Barber was quick to harangue members of both parties during the rally, accusing some Democrats of heaping praise on late civil rights icon Rep. John Lewis but failing to support his vision for voting rights.

“Some Democrats told us: ‘If y’all organize, don’t connect wages to voting rights,'” Barber said. “I’m too old to play that.”

He added: “The same people suppressing the votes suppress your wages, won’t fix your utility grids, suppress your health care, cut public education, block living wages — you’ve got to make the connection.”

Barber also offered his own adaptation of the Scripture passage from Isaiah 10:1-3:

“Woe unto you hypocrites who pay attention to all of Robert’s Rules (of order), all the made up rules of the Senate and the House, but you filibuster justice. And filibuster mercy. And you filibuster faithfully.”

Barber was briefly joined at the rally by Sen. Raphael Warnock, himself a prominent Georgia pastor. However, Barber explained Warnock would not speak because the campaign generally does not let politicians address their protests. Warnock is a champion of the For the People Act, a federal voting rights legislation Barber and others praised but Manchin opposed.

The Rev. Rev. Liz Theoharis, center left, and the Rev. William Barber lead a Poor People’s Campaign demonstration march in Washington, Monday, Aug. 2, 2021. RNS photo by Jack Jenkins

Among the clergy milling about the crowd — which also included many red-shirted members of the labor union Unite Here! — were the Rev. Patrick Messer, a United Church of Christ pastor who just left a church in Nebraska, and the Rev. Deana Oliva, a Unitarian Universalist minister from Kentucky.

Asked what spurred them to be part of the protest, Oliva was aghast at the thought of not participating — “Where else would we be?” — and Messer pointed to Jesus.

“I’m here because in Jesus’ first sermon he said the spirit is upon me to bring good news to the poor, and to bring deliverance to the captive,” Messer said. “We’re here to bring a $15 minimum wage to all workers, restore the Voting Rights Act of 1965 and pass all the provisions of the For the People Act and end the filibuster.”

The daughter of President Lyndon B. Johnson — who signed the Voting Rights Act into law — also addressed the crowd at the event. Luci Baines Johnson noted she could not speak for her father, but insisted he would have wanted her to be with activists “in the fight for social justice and voting rights.” After voicing support for the For the People Act and the John Lewis Act, another voting rights bill, she invoked Scripture while calling for bipartisanship.

“In the 1960s, Democrats and Republicans stood up together for social justice,” she said. “It was the right thing then, and it’s the right thing now. Now more than ever before, we need to — in the words of Isaiah — come and reason together to get a more just America for everybody.”

The Rev. Jesse Jackson also addressed the crowd, bemoaning what he called a nation “in crisis” and voicing a willingness to go to jail for the cause.

The Rev. Jesse Jackson, center, speaks during a Poor People’s Campaign demonstration in Washington, Monday, Aug. 2, 2021. RNS photo by Jack Jenkins

He led the group in a call-and-response chant: “I am! Somebody! I may be poor! But I am! Somebody! I may be unemployed! But I am! Somebody! I may not have health care! But I am! Somebody! Respect me! Protect me! Elect me! I am! God’s child!”

Others who delivered either speeches or prayers at the event included prominent Muslim American activist Linda Sarsour, National Council of Churches President Jim Winkler, Simple Way founder Shane Claiborne, activist and former chairman of the San Carlos Apache Tribe Wendsler Nosie and several low-wage workers or people impacted by poverty.

After the speeches, the activists massed into a column and marched toward the Capitol, with clergy walking alongside low-wage workers and those impacted by poverty. Tensions briefly flared with police when they insisted demonstrators stay on the sidewalk for one stretch of their march. Protesters initially refused, walking past police before a wave of new officers arrived and corralled the group off the street.

Demonstrators took to the street a short time later after processing past the Supreme Court toward the Hart Senate building. One column of protesters stayed on the sidewalk, but a separate group — including Barber, Theoharis, Jackson and what appeared to be Messer and Oliva — positioned themselves in the middle of the road, refusing to move. Some briefly requested entry to the Hart building at Barber’s urging, but police rebuffed them, and they returned to the street.

As demonstrators sang and chanted (“What do we want? Voting rights! When do we want them? Now!”), officers began arresting those in the road one by one, carefully leading them away. Cheers rose up as Theoharis, Barber and Jackson were arrested, and they were followed by hundreds more: clergy of multiple faiths, low-wage workers, young activists and elderly people in walkers or wheelchairs were all among those arrested.

When each one arrived at the area where other arrestees were waiting to be processed, shouts and applause rang out.

It remains to be seen how lawmakers will react to the growing protest movement. Sen. Sherrod Brown of Ohio was spotted walking quickly past the protest. When demonstrators shouted for the end of the filibuster, he quickly replied, “I agree with you,” a reference to his public willingness to end the filibuster if Republicans continue to use it to block liberal legislation.

The mixture of religious and labor demonstrators appeared to be clear in their cause on Monday and dedicated to convincing Congress to support it. They sang many songs, but one favorite seemed to be aimed directly at lawmakers: It simply asked, over and over, “Which side are you on?”

 

Hospitals, Insurers Invest Big Dollars to Tackle Patients’ Social Needs

Hospitals, Insurers Invest Big Dollars to Tackle Patients’ Social Needs

PHILADELPHIA — When doctors at a primary care clinic here noticed many of its poorest patients were failing to show up for appointments, they hoped giving out free rides would help.

But the one-time complimentary ride didn’t reduce these patients’ 36% no-show rate at the University of Pennsylvania Health System clinics.

“I was super surprised it did not have any effect,” said Dr. Krisda Chaiyachati, the Penn researcher who led the 2018 study of 786 Medicaid patients.

Many of the patients did not take advantage of the ride because they were either saving it for a more important medical appointment or preferred their regular travel method, such as catching a ride from a friend, a subsequent study found.

It was not the first time that efforts by a health care provider to address patients’ social needs — such as food, housing and transportation — failed to work.

In the past decade, dozens of studies funded by state and federal governments, private hospitals, insurers and philanthropic organizations have looked into whether addressing patients’ social needs improves health and lowers medical costs.

But so far it’s unclear which of these strategies, focused on so-called social determinants of health, are most effective or feasible, according to several recent academic reports by experts at Columbia, Duke and the University of California-San Francisco that evaluated existing research.

And even when such interventions show promising results, they usually serve only a small number of patients. Another challenge is that several studies did not go on long enough to detect an impact, or they did not evaluate health outcomes or health costs.

“We are probably at a peak of inflated expectations, and it is incumbent on us to find the innovations that really work,” said Dr. Laura Gottlieb, director of the UCSF Social Interventions Research and Evaluation Network. “Yes, there’s a lot of hype, and not all of these interventions will have staying power.”

With health care providers and insurers eager to find ways to lower costs, the limited success of social-need interventions has done little to slow the surge of pilot programs — fueled by billions of private and government dollars.

Paying for Health, Not Just Health Care

Across the country, both public and private health insurance programs are launching large initiatives aimed at improving health by helping patients with unmet social needs. One of the biggest efforts kicks off next year in North Carolina, which is spending $650 million over five years to test the effect of giving Medicaid enrollees assistance with housing, food and transportation.

California is redesigning its Medicaid program, which covers nearly 14 million residents, to dramatically increase social services to enrollees.

These moves mark a major turning point for Medicaid, which, since its inception in 1965, largely has prohibited government spending on most nonmedical services. To get around this, states have in recent years sought waivers from the federal government and pushed private Medicaid health plans to address enrollees’ social needs.

The move to address social needs is gaining steam nationally because, after nearly a dozen years focused on expanding insurance under the Affordable Care Act, many experts and policymakers agree that simply increasing access to health care is not nearly enough to improve patients’ health.

That’s because people don’t just need access to doctors, hospitals and drugs to be healthy, they also need healthy homes, healthy food, adequate transportation and education, a steady income, safe neighborhoods and a home life free from domestic violence — things hospitals and doctors can’t provide, but that in the long run are as meaningful as an antibiotic or an annual physical.

Researchers have known for decades that social problems such as unstable housing and lack of access to healthy foods can significantly affect a patient’s health, but efforts by the health industry to take on these challenges didn’t really take off until 2010 with the passage of the ACA. The law spurred changes in how insurers pay health providers — moving them away from receiving a set fee for each service to payments based on value and patient outcomes.

As a result, hospitals now have a financial incentive to help patients with nonclinical problems — such as housing and food insecurity — that can affect health.

Temple University Health System in Philadelphia launched a two-year program last year to help 25 homeless Medicaid patients who frequently use its emergency room and other ERs in the city by providing them free housing, and caseworkers to help them access other health and social services. It helps them furnish their apartments, connects them to healthy delivered meals and assists with applications for income assistance such as Social Security.

To qualify, participants had to have used the ER at least four times in the previous year and had at least $10,000 in medical claims that year.

Temple has seen promising results when comparing patients’ experiences before the study to the first five months they were all housed. In that time, the participants’ average number of monthly ER visits fell 75% and inpatient hospital admissions dropped 79%.

At the same time, their use of outpatient services jumped by 50% — an indication that patients are seeking more appropriate and lower-cost settings for care.

Living Life as ‘Normal People Do’

One participant is Rita Stewart, 53, who now lives in a one-bedroom apartment in Philadelphia’s Squirrel Hill neighborhood, home to many college students and young families.

“Everyone knows everyone,” Stewart said excitedly from her second-floor walk-up. It’s “a very calm area, clean environment. And I really like it.”

Before joining the Temple program in July and getting housing assistance, Stewart was living in a substance abuse recovery home. She had spent a few years bouncing among friends’ homes and other recovery centers. Once she slept in the city bus terminal.

In 2019, Stewart had visited the Temple ER four times for various health concerns, including anxiety, a heart condition and flu.

Stewart meets with her caseworkers at least once a week for help scheduling doctor appointments, arranging group counseling sessions and managing household needs.

“It’s a blessing,” she said from her apartment with its small kitchen and comfy couch.

“I have peace of mind that I am able to walk into my own place, leave when I want to, sleep when I want to,” Stewart said. “I love my privacy. I just look around and just wow. I am grateful.”

Stewart has sometimes worked as a nursing assistant and has gotten her health care through Medicaid for years. She still deals with depression, she said, but having her own home has improved her mood. And the program has helped keep her out of the hospital.

“This is a chance for me to take care of myself better,” she said.

Her housing assistance help is set to end next year when the Temple program ends, but administrators said they hope to find all the participants permanent housing and jobs.

“Hopefully that will work out and I can just live my life like normal people do and take care of my priorities and take care of my bills and things that a normal person would do,” Stewart said.

“Housing is the second-most impactful social determinant of health after food security,” said Steven Carson, a senior vice president at Temple University Health System. “Our goal is to help them bring meaningful and lasting health improvement to their lives.”

Success Doesn’t Come Cheap

Temple is helping pay for the program; other funding comes from two Medicaid health plans, a state grant and a Pittsburgh-based foundation. A nonprofit human services organization helps operate the program.

Program organizers hope the positive results will attract additional financing so they can expand to help many more homeless patients.

The effort is expensive. The “Housing Smart” program cost $700,000 to help 25 people for one year, or $28,000 per person. To put this in perspective, a single ER visit can cost a couple of thousands of dollars. And “frequent flyer” patients can tally up many times that in ER visits and follow-up care.

If Temple wants to help dozens more patients with housing, it will need tens of millions of dollars more per year.

Still, Temple officials said they expect the effort will save money over the long run by reducing expensive hospital visits — but they don’t yet have the data to prove that.

The Temple program was partly inspired by a similar housing effort started at two Duke University clinics in Durham, North Carolina. That program, launched in 2016, has served 45 patients with unstable housing and has reduced their ER use. But it’s been unable to grow because housing funding remains limited. And without data showing the intervention saves on health care costs, the organizers have been unable to attract more financing.

Often there is a need to demonstrate an overall reduction in health care spending to attract Medicaid funding.

“We know homelessness is bad for your health, but we are in the early stages of knowing how to address it,” said Dr. Seth Berkowitz, a researcher at the University of North Carolina-Chapel Hill.

Results Remain to Be Seen

“We need to pay for health not just health care,” said Elena Marks, CEO of the Houston-based Episcopal Health Foundation, which provides grants to community clinics and organizations to help address the social needs of vulnerable populations.

The nationwide push to spend more on social services is driven first by the recognition that social and economic forces have a greater impact on health than do clinical services like doctor visits, Marks said. A second factor is that the U.S. spends far less on social services per capita compared with other large, industrialized nations.

“This is a new and emerging field,” Marks said when reviewing the evaluations of the many social determinants of health studies. “The evidence is weak for some, mixed for some, and strong for a few areas.”

But despite incomplete evidence, Marks said, the status quo isn’t working either: Americans generally have poorer health than their counterparts in other industrialized countries with more robust social services.

“At some point we keep paying you more and more, Mr. Hospital, and people keep getting less and less. So, let’s go look for some other solutions” Marks said.

The covid-19 pandemic has shined further light on the inequities in access to health services and sparked interest in Medicaid programs to address social issues. Over half of states are implementing or expanding Medicaid programs that address social needs, according to a KFF study in October 2020. (The KHN newsroom is an editorially independent program of KFF.)

The Medicaid interventions are not intense in many states: Often they involve simply screening patients for social needs problems or referring them to another agency for help. Only two states — Arizona and Oregon — require their Medicaid health plans to directly invest money into pilot programs to address the social problems that screening reveals, according to a survey by consulting firm Manatt.

The Centers for Medicare & Medicaid Services, which is funding a growing number of efforts to help Medicaid patients with social needs, said it “remains committed” to helping states meet enrollees’ social challenges including education, employment and housing.

On Jan. 7, CMS officials under the Trump administration sent guidance to states to accelerate these interventions. In May, under President Joe Biden, a CMS spokesperson told KHN: “Evidence indicates that some social interventions targeted at Medicaid and CHIP beneficiaries can result in improved health outcomes and significant savings to the health care sector.”

The agency cited a 2017 survey of 17 state Medicaid directors in which most reported they recognized the importance of social determinants of health. The directors also noted barriers to address them, such as cost and sustainability.

In Philadelphia, Temple officials now face the challenge of finding new financing to keep their housing program going.

“We are trying to find the magic sauce to keep this program running,” said Patrick Vulgamore, project manager for Temple’s Center for Population Health.

Sojourner Ahebee, health equity fellow at WHYY’s health and science show, “The Pulse,” contributed to this report.

This story is part of a partnership that includes WHYY, NPR and KHN.

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Slave-built infrastructure still creates wealth in US, suggesting reparations should cover past harms and current value of slavery

Slave-built infrastructure still creates wealth in US, suggesting reparations should cover past harms and current value of slavery

The Port of Savannah used to export cotton picked by enslaved laborers and brought from Alabama to Georgia on slave-built railways. Cotton is still a top product processed through this port. Joe Sohm/Visions of America/Universal Images Group via Getty Images
Joshua F.J. Inwood, Penn State and Anna Livia Brand, University of California, Berkeley

American cities from Atlanta to New York City still use buildings, roads, ports and rail lines built by enslaved people.

The fact that centuries-old relics of slavery still support the economy of the United States suggests that reparations for slavery would need to go beyond government payments to the ancestors of enslaved people to account for profit-generating, slave-built infrastructure.

Debates about compensating Black Americans for slavery began soon after the Civil War, in the 1860s, with promises of “40 acres and a mule.” A national conversation about reparations has reignited in recent decades. The definition of reparations varies, but most advocates envision it as a two-part reckoning that acknowledges the role slavery played in building the country and directs resources to the communities impacted by slavery.

Through our geographic and urban planning scholarship, we document the contemporary infrastructure created by enslaved Black workers. Our study of what we call the “landscape of race” shows how the globally dominant economy of the United States traces directly back to slavery.

Looking again at railroads

While difficult to calculate, scholars estimate that much of the physical infrastructure built before 1860 in the American South was built with enslaved labor.

Railways were particularly critical infrastructure. According to “The American South,” an in-depth history of the region, railroads “offered solutions to the geographic barriers that segmented the South,” including swamps, mountains and rivers. For inland planters needing to get goods to port, trains were “the elemental precondition to better times.”

Our archival research on Montgomery, Alabama, shows that enslaved workers built and maintained the Montgomery Eufaula Railroad. This 81-mile-long railroad, begun in 1859, connected Montgomery to the Central Georgia Line, which served both Alabama’s fertile cotton-growing region – cotton picked by enslaved hands – and the textile mills of Georgia.

Sepia-toned lithograph of six Black men and women in sunhats and overalls in a cotton field
Picking cotton outside Savannah, Ga., in 1867. Library of Congress

The Eufala Railroad also gave Alabama commercial access to the Port of Savannah. Savannah was a key cotton and rice trading port, and slavery was integral to the growth of the city.

Today, Savannah’s deep-water port remains one of the busiest container ports in the U.S. Among its top exports: cotton.

The Eufala Railroad closed in the 1970s. But the company that funded its construction – Lehman Durr & Co., a prominent Southern cotton brokerage – existed well into the 20th century.

Examining court affidavits and city records located in the Montgomery city archive, we learned the Montgomery Eufaula Railroad Company received US$1.8 million in loans from Lehman Durr & Co. The main backers of Lehman Durr & Co. went on to found Lehman Brothers bank, one of Wall Street’s largest investment banks until it collapsed in 2008, in the U.S. financial crisis.

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Slave-built railroads also gave rise to Georgia’s largest city, Atlanta. In the 1830s, Atlanta was the terminus of a rail line that extended into the Midwest.

Some of these same rail lines still drive Georgia’s economy. According to a 2013 state report, railways that went through Georgia in 2012 carried over US$198 billion in agricultural products and raw materials needed for U.S. industry and manufacturing.

Black and white image of an old train depot
The 1872 Vicksburg & Brunswick Depot, a passenger and freight station in Eufala, served the Eufala and Georgia Central rail lines, among others. Library of Congress

Rethinking reparations

Savannah, Atlanta and Montgomery all show how, far from being an artifact of history, as some critics of reparations suggest, slavery has a tangible presence in the American economy.

And not just in the South. Wall Street, in New York City, is associated with the trading of stocks. But in the 18th century, enslaved people were bought and sold there. Even after New York closed its slave markets, local businesses sold and shipped cotton grown in the slaveholding South.

Black-and-white lithograph of a wide street lined with large buildings
Wall Street around 1850. New York Public Library

Geographic research like ours could inform thinking on monetary reparations by helping to calculate the ongoing financial value of slavery.

Like scholarship drawing the connection between slavery and modern mass incarceration, however, our work also suggests that direct payments to indviduals cannot truly account for the modern legacy of slavery. It points toward a broader concept of reparations that reflects how slavery is built into the American landscape, still generating wealth.

Such reparations might include government investments in aspects of American life where Black people face disparities.

Last year the city council in Asheville, North Carolina, voted for “reparations in the form of community investment.” Priorities could include efforts to increase access to affordable housing and boost minority business ownership. Asheville will also explore strategies to close the racial gap in health care.

It is very difficult, perhaps impossible, to calculate the total contemporary economic impact of slavery. But we see recognizing that enslaved men, women and children built many of the cities, rail lines and ports that fuel the American economy as a necessary part of any such accounting.The Conversation

Joshua F.J. Inwood, Associate Professor of Geography Senior Research Associate in the Rock Ethics Institute, Penn State and Anna Livia Brand, Assistant Professor, University of California, Berkeley

This article is republished from The Conversation under a Creative Commons license. Read the original article.