Daily Archives: 9 March, 2010

Judge Orders New York to Move Mentally Ill Out of Adult Homes

accessibility, autonomy, class issues, disability activism, justice, mental health, policy

From the New York Times:

New York State must begin moving thousands of people with mental illness into their own apartments or small homes and out of large, institutional adult homes that keep them segregated from society, a federal judge ordered on Monday. The decision, by Judge Nicholas G. Garaufis of Federal District Court in Brooklyn, followed his ruling in September that the conditions at more than two dozen privately run adult homes in New York City violated the Americans With Disabilities Act by leaving approximately 4,300 mentally ill residents isolated in warehouselike conditions.

The remedial plan offered by Judge Garaufis, drawn from a proposal presented by advocates for the mentally ill that was backed by the Justice Department, calls on New York to develop at least 1,500 units of so-called supported housing a year for the next three years in New York City. That would give nearly all residents the opportunity to move out of adult homes.

The Americans with Disabilities Act gives PWDs the right to live in the least restrictive housing possible – in this case, moving from adult homes into independent supportive living units. This is a great development for those previously forced to live in the abusive conditions of the group homes.

This lawsuit was filed after a series of articles in the NY Times about the horrific and abusive conditions present in group homes for adults with mental disabilities. It is unclear whether these changes would have taken place had the newspaper not devoted the time and resources to their year-long investigation of these conditions and problems.

Recommended Reading for JD 2455264.5

recommended reading

Warning: Offsite links are not safe spaces. Articles and comments in the links may contain ableist, sexist, and other -ist language and ideas of varying intensity. Opinions expressed in the articles may not reflect the opinions held by the compiler of the post. I attempt to provide extra warnings for material like extreme violence/rape; however, your triggers/issues may vary, so please read with care.

Athena, Ivan and the Integral: Disability Blog Carnival Number 64: caught us with our pants down [submission deadline: March 31st]

The theme of our issue of the disability blog carnival is the following: breaking down stereotypes. We posed the following question: if you could break down one single stereotype, which would it be and why?

Trib Local: Disabled dancer reaches for dreams in ‘Prayer’

Lane has said she is not interested in hearing how inspiring and wonderful people think she is to do something like this despite being in a wheelchair.

Wheelchair Dancer: Do You Work?

Whether or not one is employed is a standard part of the social profile that new doctors seem to want to know — particularly in my case, since I don’t have a clear single diagnosis. “Work” for a doctor seems to serve as a bright line between genuinely disabled and neurotic, psychosomatizer. For far too many within the medical system, work serves as a talisman between a healthy coper and a drag on the medical and welfare systems.

Sunderland Echo: Wheelchair users face rail footbridge woe

Wheelchair users are facing a lengthy diversion if plans for a footbridge over a railway line go ahead. Network Rail wants to remove level crossings at Dawdon as part of a scheme to upgrade signals along the East Durham coast. Crossing the tracks on foot near Princess Road and at the town’s station would be stopped once footbridges are installed.[…]

Coun Bob Arthur, who represents the Dawdon ward on Durham County Council, said: “There is growing concern from people and they have been on to me about this because the bridge would not be suitable for wheelchairs and pushchairs.

NPR: Nine More Airports To Get Body Scanners

The Transportation Security Administration on Friday announced nine more U.S. airports that will receive body-scanning technology, as the U.S. heightens its effort to detect hidden explosives and contraband amid a threat highlighted by an attempted bombing on Christmas Day.

The Consumerist: New Airport Screening Machines To Launch Monday

These new “backscatter” type machines are different — and one would hope improved — from the existing “millimeter wave” types already being used in various spots around the country. Some of you might remember the story from a few weeks back of a millimeter wave machine in Denver being set off by an artificial breast.

BBC News: Women refuse to go through airport body scanners

Two women were stopped from boarding a plane at Manchester Airport after refusing to undergo a full body scan. The passengers were due to fly to Islamabad on 19 February when they were selected at random to go through the new scanning machine. […] The women were warned they were legally required to go through the scanner, after being chosen at random, or they would not be allowed to fly, an airport spokesman said.

Kelly Kleiman at Huffington Post: Full Body Scans Are a Feminist Issue

Surprisingly, a pair of otherwise civil-libertarian friends shrugged when they heard this rant. “I’m not with you on this one,” they said. They cited the impersonality and brevity and
disposability of the images. (I’m skeptical of the proposition that the government will
collect information and throw it away: since when?) They reduced me to inarticulate dudgeon, because I couldn’t imagine how they could fail to share a response I felt so viscerally.

And then I realized: they’re men. They haven’t spent their entire lives bracing themselves
against precisely the violation of being stripped naked by a stranger. As far back as grammar
school, it was accepted practice in my middle-class neighborhood for a boy to threaten to grab a girl walking home and strip her. I don’t know if this was ever actually done, but the mere threat was effective in keeping girls frightened and under control. And, as Susan Brownmiller established, the threat of rape-including the notion if not the actuality of nakedness-is the pervasive device by which men keep women in line.

Muslimah Media Watch: Naked Ambition: Airport Body Scanners Only Offensive to Muslim Women?

As much as having naked images of their bodies taken and viewed by strangers may be an upsetting idea to many Muslim women, why focus only on us? Or religious groups in general (The Jewish Daily Forward’s article claims that the airport scanners run “afoul of Jewish law.”)? The American Civil Liberties Union has issued a statement against the scanners that does not single out any specific religious group or gender. It seems likely many people would be equally offended by both the breach of personal privacy and the indignity of being constantly suspect while traveling or merely going about their business—why should the media assume that Muslim women are the only ones who will have ethical, ideological, or personal issues about the airport body scanners?

Black, Hispanic, Poor people wait longer for breast cancer treatment, experience more recurrences

accessibility, intersectionality, medical practice, poverty, race, , , , , , , , , , , , , , , , , , , , ,

In the USA, Black women have the highest mortality from breast cancer of any other group, despite the rate of diagnosis of breast cancer being highest in White women. Hispanic women have a lower breast cancer diagnosis incidence than either, but mortality rates are disproportionately high in Hispanic women also. Here are the CDC incidence and mortality statistics over time:

“Incidence rate” means how many women out of a given number get the disease each year. The graph below shows how many women out of 100,000 got breast cancer each year during the years 1975–2005. The year 2005 is the most recent year for which numbers have been reported. The breast cancer incidence rate is grouped by race and ethnicity.

For example, you can see that white women had the highest incidence rate for breast cancer. Black women had the second highest incidence of getting breast cancer, followed by American Indian/Alaska Native, Asian/Pacific Islander, and Hispanic women.

Breast ca incidence stats showing White women at highest risk

The graph below shows that in 2005, black women were more likely to die of breast cancer than any other group. White women had the second highest rate of deaths from breast cancer, followed by women who are American Indian/Alaska Native, Hispanic, and Asian/Pacific Islander.

Breast ca mortality stats showing Black women at greatest risk

A number of contributors to this disproportionate mortality have been proposed, including environmental toxin and pesticide exposure, more aggressive tumours, and later diagnosis. Most alarmingly, the mortality gap seems to be widening.

This week’s British Medical Journal (BMJ) has an important article today demonstrating one of the consequences of healthcare racism in the USA:

Impact of interval from breast conserving surgery to radiotherapy on local recurrence in older women with breast cancer: retrospective cohort analysis[1]

The researchers analysed national cancer records for 18,050 US women, aged 65 or older and otherwise non-disabled, who were diagnosed with early stage breast cancer during an eleven year period to 2002, and who received breast conserving surgery and radiotherapy, but not chemotherapy.

30% of the women in this study had to wait more than six weeks after their surgery before they could have radiotherapy. Delays greater than six weeks were associated with a modest but significant increase in local recurrence of the breast cancer.

The study also showed that there was a continuous relationship between radiotherapy delays and local recurrence; the sooner radiotherapy was started, the lower the risk of cancer recurrence, and this relationship was strong. This is concordant with previous studies.

So who was subject to these long, risky delays in treatment?

Sadly, the answer will not surprise you: Black women, Hispanic women, and poor women. Black women were almost 50% more likely to experience a longer than six week gap before radiotherapy treatment, and Hispanic women experienced a 30% increase in risk of delay.

The followup was only five years long in this study, and breast cancer tends to be a cancer that bides its time; the increase in risk (and in consequence mortality) may be greater, even much greater, with longer followup. In addition, as local recurrence risk tends to more common in younger women and this study focused on older women, the effect could be more pronounced in the total population of those with breast cancer. In addition, the study studied mostly White women, as Black women tend to get their cancers younger and have a decreased likelihood of receiving breast-conserving surgery and radiotherapy. In other words, this study was set up in a way that made it, in some ways, particularly difficult to find a significant difference in the effect they were looking at; the fact that they still found one means that the effect is likely to be really quite pronounced.

The accompanying BMJ editorial by Ruth H Jack and Lars Holmberg[2] goes on to suggest one possible model of healthcare delivery that might alleviate these delays:

One good example of how practices can be improved is the Rapid Response Radiotherapy programme in Ontario. This programme has drastically shortened waiting times for patients having palliative radiotherapy by restructuring the referral process so that many patients are treated on the same day as their consultation.9 Countries where disconnected systems are responsible for different aspects of treatment will find it more difficult to ensure that diagnosis, referral, and treatment are not subject to delay.

++++++++++++++++++++++++++++++++++++++++++

[1] Impact of interval from breast conserving surgery to radiotherapy on local recurrence in older women with breast cancer: retrospective cohort analysis
Rinaa S Punglia, Akiko M Saito, Bridget A Neville, Craig C Earle, Jane C Weeks.
BMJ 2010;340:c845; Published 2 March 2010,
doi:10.1136/bmj.c845

[2] Waiting times for radiotherapy after breast cancer
BMJ 2010;340:c1007
Published 2 March 2010,
doi:10.1136/bmj.c1007