A MAGAZINE FOR THE HELLER SCHOOL FOR SOCIAL POLICY AND MANAGEMENT
AT THE INTERSECTION OF RACE AND DISABILITY UNCOVERING THE DUAL DISPARITIES FACING MILLIONS OF AMERICANS
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Heller Magazine Published by the Heller School Office of Communications The Heller School for Social Policy and Management Brandeis University P.O. Box 549110, MS 035 Waltham, MA 02453-2728
Interim Dean Marty Wyngaarden Krauss, PhD’81 FROM THE EDITOR
Board of Overseers Chair Constance Kane, PhD’85 Alumni Association Board President Chrisann Newransky, MA SID’05
HELLER AT WORK VIDEOS: VISIT BIT.LY/HELLERATWORK TO SEE STUDENTS AND ALUMNI, LIKE MEGHA HEGDE, MA SID’14, MAKING A DIFFERENCE ON THE GROUND.
Heller Office of Communications Max Pearlstein ’01 Bethany Romano Alexandra Rubington Jack White
Thanks for opening this issue of Heller Magazine. If you like what you read here, I encourage you to visit heller.brandeis.edu and check out our new homepage, which places a greater emphasis on stories. You don’t have to wait until the next issue of the magazine to see how Heller people and projects are making an impact on critical social policy issues around the world. If you have story ideas for the website or our publications, including the new Heller Social Policy Impact Report — more info on that in the Heller News section — let me or Bethany Romano know (firstname.lastname@example.org or bromano@ brandeis.edu). We’d love to hear from you. Best, Max Pearlstein ’01 Editor
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Office of Communications © Brandeis University 2016 G063
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LETTER FROM THE DEAN
AT THE INTERSECTION OF RACE AND DISABILITY
ON THE GROUND: DENGUE CONTROL IN MEXICO
A DISTINCTIVE HISTORY IN HEALTH CARE
SOCIAL JUSTICE INSURRECTION
INCLUSIVE COMMUNITIES AND THE FUTURE OF ANTI-DISCRIMINATION FORENSICS
REMEMBERING STAN WALLACK
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LETTER FROM THE DEAN
Dear Friends, I’m writing this during an exciting time at Heller. The school continues to be a research powerhouse, fueled by our talented and committed research faculty and staff. Consider this magazine’s cover story, which showcases pioneering work by the Lurie Institute on the intersection between race and disability. On the educational side, our degree programs are thriving with continuous improvement in the curriculum and an engaged and passionate group of students from the U.S. and abroad. Every day, students and faculty feel a dynamism within the building. We try to convey that dynamism in our publications, including Heller Magazine and the Heller Social Policy Impact Report, that are skillfully produced by the Heller communications team. Besides reading about the Lurie Institute’s cutting-edge research, in this issue you’ll learn how our AACSB-accredited Master of Business Administration program emphasizes Corporate Social Responsibility, an area of immense interest to our students. You’ll also hear from Stuart Altman, who has been central to the school’s mission and success since the day he became dean in 1977. In an in-depth interview, he reflects on over four decades of leadership and progress in our evolving health care system. He has been at the table for virtually every significant reform and he is still at it! Anita Hill, recently named University Professor, Brandeis’ highest academic distinction, presents a fascinating analysis of the Supreme Court’s fair housing decision. The column is
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drawn from her standing-room-only lecture in celebration of her University Professorship. In the Heller News section, you will be introduced to some of our new leaders, new academic programs and new publications. We also share sad news about the death of Professor Stanley Wallack, the executive director of the Schneider Institutes for Health Policy, who passed away in October. The school has established the Stanley Wallack Distinguished Lecture Series to keep his remarkable career and pervasive influence at Heller a living memory for generations to come. Beyond the stories in this magazine, I also wanted to tell you that Deborah A. Stone has rejoined our faculty as Heller’s first Distinguished Visiting Professor. She will be here for three years (and maybe more!) and will teach in both the PhD and SID programs. In addition, our MBA program is welcoming its newest professor, Joel Cutcher-Gershenfeld. Faculty renewal is vital for any academic institution, and we have so much to be proud of with these new hires. They are both vibrant additions to our Heller community. Sincerely,
Marty Wyngaarden Krauss, PhD’81
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In her talk, Hill discussed the biases implicit in our society and how methods of fighting bias are developing and changing. She said, “If you think about how bias occurs, it’s not so much that people today have gotten more clever about hiding discrimination. I believe we’re dealing more with unconscious bias, decades of rank discrimination that never gets questioned. … The work of fighting discrimination is now being built on a body of research that helps us understand how bias is baked into our culture and our rules and policies.” This development, according to Hill, affords university researchers new opportunities to do work that responds to some of our most pressing social issues. You can read more about Hill’s thoughts on this issue in the Perspectives column on page 26. ANITA HILL APPOINTED FIRST FEMALE UNIVERSITY PROFESSOR AT BRANDEIS
INTRODUCING THE HELLER SOCIAL POLICY IMPACT REPORT
BY ALEXANDRA RUBINGTON
BY ALEXANDRA RUBINGTON
Anita Hill, professor of social policy, law and women’s studies, has earned the prestigious title of University Professor — only the seventh faculty member in Brandeis’ history to do so, and the first woman.
In October, the Heller Communications team launched its newest publication, the Heller Social Policy Impact Report. This magazine, which will be produced twice a year, compiles the research accomplishments of Heller faculty, researchers and students, including publications, grants, awards, presentations and public engagement. Research activities are listed by subject area — such as assets and inequalities; children, youth and families; and international development — so that readers can easily find those areas of Heller expertise that pique their interest. In addition, feature articles delve into greater depth about particular research projects and how they are effecting policy change both in the U.S. and abroad.
Hill arrived at Brandeis in 1998. She joined the faculty of the Heller School, where she continues to teach in the graduate and undergraduate programs. Her courses include “Race and the Law” and “Law and Social Justice: Gender Equity Policies and Litigation.” In March, the Brandeis Board of Trustees unanimously voted to recognize Hill with a promotion to University Professor. The title is awarded to scholars who have achieved exceptional scholarly or professional distinction within the academic community, whose work cuts across disciplinary boundaries, and whose appointment will enhance the reputation and prestige of the university. As part of a September gala celebrating her promotion, Hill delivered a lecture titled “Undoing ‘Generations of Rank Discrimination’: Inclusive Communities and the Future of Anti-Bias Forensics.” The talk’s title was inspired by the words of Justice Ruth Bader Ginsburg during the oral arguments of a recent U.S. Supreme Court decision regarding the 1968 Fair Housing Act. Justice Ginsburg said that the “grand goal” of the Fair Housing Act was to “undo generations of rank discrimination.”
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The Heller Social Policy Impact Report had its origins in Heller Highlights, the research newsletter initiated by former Heller Dean Lisa M. Lynch in 2009. In introducing the report, Interim Dean Marty W. Krauss, PhD’81, said, “Heller’s vibrant community of scholars share a passionate commitment to creating new knowledge
to solve seemingly intractable social problems.” Susan Parish, associate dean for research, said, “We are proud of the contributions our internationally recognized faculty, scientists and students have made to improve the policies that shape the lives of vulnerable people globally.” To read the Heller Social Policy Impact Report, visit bit.ly/impactfall15 or email hellercommunications@ brandeis.edu to request a hard copy. MEDICINE AND MANAGEMENT: HELLER INAUGURATES EXECUTIVE MBA PROGRAM FOR PHYSICIANS BY ALEXANDRA RUBINGTON
With health care reform putting medical care under the microscope, doctors have numerous demands on them, from offering an excellent patient experience to delivering high-quality care that results in positive clinical outcomes — all while keeping costs low. Meeting these goals requires that doctors have the expertise of a skilled manager as well as a skilled medical practitioner. The Heller School’s Executive MBA (EMBA) for Physicians program aims to prepare physicians for these new managerial roles. Designed for practicing physicians who are — or seek to be — in positions of management or leadership, this accelerated 16-month program integrates the student’s medical expertise with new knowledge in critical areas such as health policy and economics, operational systems management, high-performance leadership and health care innovation. Professor Jon Chilingerian, director of the EMBA for Physicians program, believes that the organization of medicine is becoming more challenging. “Safe, efficient, accountable, high-quality health care in the 21st century demands a very broad range of technical and analytical tools, as well as superb leadership skills that have become nearly impossible for self-taught physicians to learn on the job,” Chilingerian says. “In the most effective organizations, every physician has to become a leader, and every leader a collaborative team player. Educating physicians in the new science of medicine and management should become a significant ingredient in health care reform. We hope that our EMBA for Physicians program will contribute to that effort.”
SILLERMAN CENTER WELCOMES NEW DIRECTOR
Susan Eaton, formerly the research director for the Charles Hamilton Houston Institute for Race and Justice at Harvard Law School, was appointed director of the Sillerman Center for the Advancement of Philanthropy over the summer. Eaton arrived at the Heller School in September with a clear goal in mind. “My aspiration is for the Sillerman Center to be a bridge between the research centers and faculty members at Heller, as well as a bridge between Brandeis and members of the philanthropic community who are seeking guidance and knowledge to inform their grant making,” Eaton says. Founded in 2008, the Sillerman Center conducts, analyzes and disseminates research and best practices on what makes philanthropic giving effective in promoting social change and equity. In her new role, Eaton provides the strategic direction needed to raise the Sillerman Center’s national impact and profile while working with foundations and individuals to maximize the impact of their donations to social justice organizations. While at Harvard Law School, Eaton focused her research on the causes and cures for unequal opportunities for racial, ethnic and linguistic minorities in the United States. She is particularly concerned about the challenges of schooling and parenting in high-poverty, urban neighborhoods and has written extensively about immigrant integration practice and policy at the local level in the United States. “I greatly admire the research being conducted at Heller that addresses some of the most important social challenges of our time,” she says. “I look forward to working with students, faculty and staff as we bring this vital knowledge and on-the-ground experience to bear on social justice philanthropy.”
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AT THE INTERSECTION OF RACE AND DISABILITY UNCOVERING THE DUAL DISPARITIES FACING MILLIONS OF AMERICANS BY BETHANY ROMANO
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Timely diagnosis is an opportunity that should never be missed. Yet black and Latino kids are diagnosed with autism an average of two to three years later than white children — some of them aren’t diagnosed until they’re well into elementary school. —SUSAN PARISH
WINDOW OF OPPORTUNITY
The brain is a complex yet surprisingly adaptable organ. Its capacity for drastic structural and functional change — termed brain plasticity — is greatest early in life, when babies are starting to form memories, learn language and motor skills, and make emotional associations with their surroundings. This window of opportunity is the reason why early intervention services are so effective for infants and toddlers who are diagnosed early in life with disabilities or developmental delays. For children with autism spectrum disorder — the fastest-growing disability subgroup in the country — early diagnosis and early intervention services are crucial. Early diagnosis by a physician opens the door to a host of services when time is most precious. “Thanks to wonderful scientific advances, young children can now be reliably diagnosed with autism spectrum disorders at a young age,” says Susan Parish, director of the Lurie Institute for Disability Policy. “Timely diagnosis is an opportunity that should never be missed. Yet black and Latino kids are diagnosed with autism an average of two to three years later than white children — some of them aren’t diagnosed until they’re well into elementary school. And in fact, Latino children with severe autism spectrum disorders — which urgently require early intervention services — are being diagnosed much later than their white counterparts.” Parish’s data show no racial differences in when parents start to think that their child may not be achieving developmental milestones on time. However, when Latino parents take their child to the physician and express their concerns, the physicians too often tell them not to worry
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about it, that the child’s behavior is normal and that the child will outgrow it. “In this study, we controlled for a lot of things that might be expected to influence when children are referred for services,” says Parish. “These included income, parental education, access to care, severity of condition, family structure, and whether families lived in urban or rural locations. But even after controlling for all of these factors, the disparities persisted. These pervasive disparities suggest that racism may well explain at least part of what is happening.” The research team at the Lurie Institute is conducting pioneering research into the health of people with disabilities and has exposed an important trend. “The pattern, unfortunately, is clear, robust and consistent,” says Parish. “People with disabilities are highly disadvantaged because of their disability, and within that group, black, Latino and Asian people with disabilities are even more disadvantaged.” When black and Latino children are denied an early diagnosis or are not referred for important early intervention or specialty services, the resulting delay translates into much later access to services. “The doctor who provides the initial diagnosis is the gateway to specialized treatment,” says Parish. “You can’t get occupational therapy, speech therapy, physical therapy, sensory integration therapy, behavioral support, the list goes on — until the child has a diagnosis.” Parish and her team see this narrative play out across the lifespan for people with a variety of disabilities. Physicians,
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It’s infuriating to me that, in 2015, we still have children getting poor-quality health care services simply on the basis of their racial or ethnic identity. —SUSAN PARISH
who have diagnosing power, hold the key to a variety of services, which in turn are the gateway to specialty care and early intervention services. Yet children of racial and ethnic minority groups often have poorer-quality health care than their white counterparts.
Having a strong support network also seems to mitigate some of the barriers to health care experienced by these Asian-American immigrant families. Taking a closer look at the supports embedded in a child’s neighborhood may help explain these dual disparities.
NEIGHBORHOOD ENVIRONMENTS AND ACCESS TO CARE
Lurie Institute research has also found that when black and Latino kids with ASD live in safe and supportive neighborhoods, they’re more likely to receive high-quality care. Conversely, when they live in lower-quality neighborhoods, they are more likely to have physicians who don’t spend enough time with them, don’t listen carefully and aren’t attentive.
The same appears to be true for Asian-American families that have children with disabilities. The study, led by former Lurie Institute research associate and current CUNY Staten Island assistant professor Esther Son, focuses on the unique experience of Chinese and Vietnamese immigrant families in metro Boston. Lurie Institute research associate Leah Igdalsky ’14 has conducted a series of interviews with a sample of these families, documenting the barriers to high-quality health care they face, as well as factors that help them succeed. “There are a lot of things standing between these parents and a high-quality health care experience for their child,” says Igdalsky. “Race, culture, documentation status, language — all of these are barriers. But what seems to help is having a strong support network, and having a doctor who is either of their own heritage or who is culturally competent.” Igdalsky says that these parents appreciate doctors who spend enough time with them, accommodate language concerns, ask questions to make sure they understand and solicit parents’ questions in return. These behaviors are the product of cultural competency training and make a huge difference to families. “Disability crosses all age categories and all walks of life. Anyone in the medical field should be able to work with these populations,” adds Igdalsky.
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Residential segregation has long been documented as a driver of health inequities for people of all ages and backgrounds, but applying these concepts to health care for children with disabilities is a novel approach. “It’s important that we find an intermediary link between race and health care quality,” says Ilhom Akobirshoev, PhD’15, a postdoctoral fellow at the Lurie Institute. “Obviously you can’t change someone’s race to impact the health care they receive. So we are looking for things that we can change. Neighborhoods can change. From a policy perspective, we can design interventions to improve neighborhood safety and support systems.” What often gets missed in the conversation about health care quality is how it affects parents’ likelihood to take their child to the doctor as frequently. “If a parent takes his or her child to a doctor and the doctor doesn’t listen carefully or isn’t culturally competent, the likelihood that they’ll come back is much lower than if they have a good experience,” says Akobirshoev. “That means these kids are less likely to even get the same amount of care, even if it is at a lower quality.”
HEALTH LATER IN LIFE
Extensive research has shown that people with disabilities and their family caregivers routinely face poverty, underemployment, inadequate health care and educational disparities compared to their nondisabled peers. These inequities are well documented and persistent, so the inquiry often stops there. “A lot of researchers study access and quality of care,” says Parish. “Interestingly, almost no one has investigated actual health status disparities for people with intellectual disabilities.” So Parish and her team examined whether there are health disparities between white, Latino and black adults who have intellectual and developmental disabilities. It turns out that the disparities work both ways: black and Latino adults with intellectual and developmental disabilities have worse health than whites with the same conditions, and worse health than members of their respective racial or ethnic groups who don’t have such disabilities. “We know that the health of those with these disabilities tends to be quite poor, so we expected the data to show a disparity by disability status,” says Parish. “But I was stunned to see how strong the differences are between racial groups, even when combined with disability status. This study demonstrates that we should really be paying more attention to these intersecting identities of race, ethnicity and disability.” ROCKING THE BOAT
“It’s infuriating to me that, in 2015, we still have children getting poor-quality health care services simply on the basis of their racial or ethnic identity,” says Parish. “There is no credible excuse for these disparities, and everyone should be angry about them. We hope our research can support new policies and practices to end these disparities and give high-quality health care to every child, regardless of his or her race, ethnicity or disability status. Anything less is inadequate.” The mistake, says Parish, is that the disability field has long considered disability status in isolation — an identity unaffected by other things. They haven’t traditionally thought about race or ethnicity. Parish and her colleagues are among the first to break with that tradition — searching for ways to improve the situation of these vulnerable populations.
Perhaps part of the reason this group is so understudied is due to the misconception that this is a small number of people. In fact, nearly one out of every five adults in the United States has a disability, making it the largest minority group in the country. Of those 53 million adults, over 55 percent identify as Latino or black — more than 29 million people. That’s roughly the population of Venezuela. The dual disparities in health and health care experienced by people of color with disabilities are severe, persistent and expressed across the lifespan from diagnosis through adulthood. While Parish and her colleagues at the Lurie Institute are dedicated to contributing to this growing field of scientific literature, they recognize that these issues need to be part of a public debate about race, disability and equity. Parish says, “We’ve seen many policy proposals and statements from the surgeon general and other federal agencies that have argued that we have to address racial disparities. Yet we still have a terrible situation, and one that’s even worse for racial and ethnic minorities with disabilities. In fact, this is a population that is largely being ignored by public policy initiatives.” The results of the Lurie Institute’s research should make the issue much harder to ignore, especially since there are several key policy areas that Parish’s team has identified for reform, such as: improving the diversity and cultural competence of physicians; requiring basic medical school training in treating and diagnosing patients with disabilities; and improving local neighborhood support for families who have children with disabilities. These are all attainable goals — and they could make a huge difference for this population. “Just because a person has a disability doesn’t mean that other aspects of their identity don’t matter,” says Parish. “Fundamentally, these inequities are an enormous injustice. We won’t actually advance the nation’s health until we take seriously the situation of those children and adults of color who have disabilities.”
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ON THE GROUND
DENGUE CONTROL IN MEXICO
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DONALD SHEPARD AND A TEAM OF COLLEAGUES FROM THE INSTITUTE ON HEALTHCARE SYSTEMS HELP GOVERNMENT OFFICIALS UNDERSTAND THE TRUE COST OF THIS SPREADING DISEASE BY MAX PEARLSTEIN ’01
There is no vaccine available for dengue, a mosquito-borne virus that, according to the World Health Organization, infects an estimated 50 million to 100 million people per year and is a leading cause of hospitalization in Asian and Latin American countries. But that may soon change, says Donald Shepard, a health economist with the Institute on Healthcare Systems (IHS) at the Schneider Institutes for Health Policy, who has been studying the disease for 25 years. “Researchers have dreamed about a dengue vaccine for decades, and they’re now very close to achieving it,” he says. “The first vaccine has published encouraging results of effectiveness trials, and the manufacturer is applying for licensing.” If and when the vaccine does become available, one major barrier to its adoption, as a new product on the market, will be its high cost. The likelihood of a steep price tag poses a critical, complex economic question for countries whose populations are most affected by dengue to answer: What is the price of the vaccine versus the economic cost of not purchasing it? “It becomes a tough choice for countries, because it’s not just spare change to buy the vaccine, and we think that our economic studies can help countries look at those tradeoffs,” Shepard says. “Our research has contributed to the conversation among officials in Mexico, which has about 140,000 episodes of dengue annually. The country has been a world leader in adopting other vaccines and may be one of the first countries to license the vaccine.”
Mexico is just the latest dengue stop for Shepard. The World Bank first persuaded him in 1991 to co-lead a team studying the virus’ impact on low- and middle-income countries. Shepard has since traveled the world, spending time in Cambodia, Colombia, India, Malaysia, Panama, the Philippines, Puerto Rico, Singapore, Thailand and Venezuela, tracking the virus’ spread across hemispheres and assessing the financial burden it creates wherever it goes. GLOBAL SPREAD
For decades, there was no dengue in the Western Hemisphere. When the Panama Canal was built a century ago, it was necessary to control another illness transmitted by the same mosquito, yellow fever. Officials implemented a military operation that vigorously controlled the mosquitoes’ breeding grounds and got rid of not just yellow fever, but dengue in the process. “After that, public health officials got complacent,” Shepard says. “They said yellow fever is gone, and dengue is gone, and we don’t have to worry about them. And so they ignored it.” But while dengue was gone in Central and South America, it was still present in other parts of the world. “It’s like a forest fire,” Shepard says. “If you’ve got dry tinder and a spark, then it’s very easy to create a forest fire. The mosquito came back, and people who traveled to other parts of the world came back and carried dengue with them. It started to really spread in the 1970s.”
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MURAL SHOWING THE LIFE CYCLE OF THE MOSQUITO MOSQUITO-PROOF COVERS FOR WATER BARRELS
THAT TRANSMITS DENGUE
DONALD SHEPARD (TOP ROW, FAR LEFT) AND EDUARDO UNDURRAGA (TOP ROW, FAR RIGHT) WITH MEXICAN RESEARCH PARTNERS AND COMMUNITY MEMBERS INVOLVED WITH GREEN ROAD
The number of dengue cases has increased dramatically in the Western Hemisphere since its return four decades ago. Today, Brazil alone often reports over 1 million dengue cases a year. Those who are infected with dengue often develop a painful flu-like illness. In some cases, the infection will become severe with dangerous health complications,
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including plasma leaking, respiratory distress, significant bleeding or organ impairment and sometimes death. TRACKING THE ECONOMIC COST
Shepard, along with IHS colleagues Yara Halasa, MS’06/PhD candidate, Cynthia Tschampl, PhD’15, and Eduardo Undurraga, PhD’14 (who has since moved on to the Centers for Disease Control and Prevention), are
conducting a pair of important research projects in Mexico to inform officials responsible for developing policies to combat the virus. The first project examines the true economic cost and burden of dengue on a population basis. The IHS team partnered with colleagues from the National Institute of Public Health, the Ministry of Health and the Carlos Slim Foundation, a major nonprofit organization that works to improve the quality of life of vulnerable groups in Latin America. The researchers determined that the total economic burden of dengue in Mexico, including the cost of the illness, dengue disease surveillance and the implementation of control strategies, is about $170 million, or $1.56 per person. “This is an underestimate of the true cost, however, as dengue affects tourism, may generate health system congestion during outbreaks, and some people are affected by persistent symptoms, such as fatigue and headaches, for months following the infection,” Undurraga says. “By providing a better estimate of the cost of dengue, it helps the decision-makers understand the burden that governments, households and employers are facing,” adds Halasa. The results to date from their study were published earlier this year in the journal PLoS Neglected Tropical Diseases, and ongoing work is addressing further extensions. DETERMINING A BETTER APPROACH
Under the second project, IHS researchers are examining the cost-effectiveness of a promising program of vector control. Currently, the main method employed by the Mexican government to control dengue is vector control, where a truck drives through the streets spraying out pesticides. “It kills some adult mosquitoes, but mosquitoes reproduce very quickly,” Shepard says. “So while it kills some mosquitoes, very likely one to two weeks later new mosquitoes have hatched and the population is back to where it was.” The other challenge, Undurraga explains, is that mosquitoes prefer to live indoors, in places with no wind and where it is relatively dark. “You can imagine in an urban place like Mexico, try spraying in the streets — you’re not really effective,” Undurruga says. “Vector control does kill some mosquitoes, but it also kills a lot of other insects.”
Given the relative ineffectiveness of outdoor fogging, officials in the state of Guerrero — Acapulco is the region’s major city — are testing an alternative, potentially costeffective control strategy that’s focused on community education. Shepard and his team are currently conducting an economic evaluation of the program, called “Camino Verde,” or Green Road, which is coordinated by Professor Eva Harris from the University of California, Berkeley. The central concept is simple: By presenting local residents with evidence of dengue in their area and teaching them how to identify and remove mosquito breeding grounds, such as the large, uncovered water storage tanks that are frequently seen in Mexico’s poorest communities where there is no running water, you can greatly reduce the number of mosquitoes and, therefore, the potential for dengue. The results so far are promising: Dengue infections are down 30 percent. THE FUTURE COURSE OF A GLOBAL VIRUS
Shepard believes a combination of community education, vector control and a future vaccine could potentially lead to control, if not stoppage, of dengue transmission in Mexico. “But it will take resources to do that, and the hope is that our analysis will help countries make enlightened decisions. In places like Mexico, where there is a large burden, very likely those decisions are that the investment is worthwhile,” Shepard says. Halasa also points out that when we control dengue in Mexico, the impact is felt across international borders. “I think the situation in Mexico is something other countries in this region need to be watching, especially the U.S.,” she says. “Controlling dengue in Mexico has very good externalities for us. If you keep in mind the extensive movement of people and goods, reducing dengue in Mexico reduces the chance of having dengue here.” The key, Shepard adds, is that countries are aware of this growing issue. “With most infectious diseases there is a battle between public health and technology and the disease, and in most cases, public health is winning,” he says. “We have vaccines for both measles and polio, which were once major threats, for example, and so cases are much rarer. We’re hopeful that we’ll soon have a dengue vaccine that countries can afford, but until that happens, unfortunately, the number of dengue infections is only going up. It’s been getting worse over the last decade due to global warming, urbanization and other factors. It’s an increasing problem that demands attention.”
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A DISTINCTIVE HISTORY IN HEALTH CARE Stuart Altman, chairman of the state’s Health Policy Commission, talks about the ever-changing and innovative Massachusetts health care landscape BY MAX PEARLSTEIN ’01
Health economist Stuart Altman, the Sol C. Chaikin Professor of National Health Policy at Heller, has been a leader in both national and state health care since the early 1970s, when he played a key role in implementing Medicare during the Nixon administration. He has served on numerous government advisory boards, including Planning and Evaluation/Health at the U.S. Department of Health, Education and Welfare and the Prospective Payment Assessment Commission. In 1997, President Clinton appointed him to the National Bipartisan Commission on the Future of Medicare. He has long been one of the major voices on health care in Massachusetts. In 2012, then-Governor Deval Patrick named him the first chair of the newly created Health Policy Commission. Current Governor Charlie Baker has said that he plans to appoint Altman to a new, five-year term. Altman talked with Heller Magazine about the state of health care in Massachusetts and the challenges and opportunities that lie ahead.
HELLER MAGAZINE: What is happening right now in terms of health care in Massachusetts that people need to be aware of?
I think what’s most important to understand is that when it comes to health care, Massachusetts is the bellwether state. When you look at our medical schools, they are among the best in the country. We have arguably the best hospitals in the United States, and some would even say the world. That may sound a bit grandiose, but with Mass General, Brigham and Women’s, Beth Israel, Tufts and so on, it’s the truth. So, on the one side, we are the leaders on health care in America. We are also, on many levels, the most expensive health care system in the United States, which makes us the most expensive health care system in the world. We pay higher premiums as citizens of Massachusetts, and there are many other measures that put us, if not at the top of the list, then close to the top of the list.
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Massachusetts is the place that many of the leading policy people look to. If there’s going to be innovation — Massachusetts is often the first. We are the only state that made a commitment to work toward universal coverage for all our citizens. So, what Massachusetts does matters. With that said, when the Commonwealth passed its version of the Affordable Care Act in 2006, it said we’re going to deal with coverage first. But we will not be able to sustain this coverage if the cost of this coverage becomes too high — we must remember that much of this coverage expansion requires people to buy their own insurance. Also, government subsidies will become unaffordable. Therefore, we also need to develop programs that keep the growth in the cost of care in line with the growth in our state income. The same thing happened when the federal government passed the Affordable Care Act, or as we now call it, Obamacare. It, too, primarily focused on coverage, although it included a number of experiments in terms of trying to restructure the delivery system, but it also acknowledged that it needed to do more work on the cost side. Massachusetts passed a law soon after 2006 that required insurance companies to make available how much it would cost a potential patient for a particular procedure. Right now, it’s almost impossible for someone to figure out what it’s going to cost if you decide to go to Hospital A versus Hospital B, or go get your MRI done in a hospital versus having it done outside. Transparency has become a key issue, and we were one of the first to mandate that such information be made available. The state set up a whole series of activities designed to improve the delivery system and created a governmental
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So on many levels, what is going on here is extremely important for the citizens of Massachusetts, and, increasingly, it is the focus for those studying how to make the health system throughout the United States work more efficiently. —STUART ALTMAN activity to monitor how we spend our money and suggest ways to lower the cost growth — the Health Policy Commission. In 2012, Governor Deval Patrick asked me to become the chair of the commission. So I chair this 11-person commission that has many responsibilities designed to improve the delivery system, monitor how we spend our money and make recommendations on how to improve the efficiency of our system, including investing in community hospitals. So on many levels, what is going on here is extremely important for the citizens of Massachusetts, and, increasingly, it is the focus for those studying how to make the health system throughout the United States work more efficiently. You said the first step is to expand health insurance coverage, but then there’s the question of cost, which is where the Health Policy Commission comes in. You also said that Massachusetts is among the highest, if not the highest, in terms of insurance costs. Why?
ALTMAN: One of the aspects of the health care system in Massachusetts that separates us from every other state is that we, as citizens of this state, receive more of our care in big teaching hospitals. And teaching hospitals are the most expensive places to get health care. First, that’s where we train the next generation of health professionals, and that’s expensive. Second, big teaching hospitals are major sites for research. While the federal government or private companies fund much of the research, it’s also true that the hospitals subsidize this research. And some of those costs wind up being paid for by the patients who use their services. In addition, we have more specialists because of the amount of high-level activity that goes on here, and specialists generate higher costs.
Talk about the role that the Health Policy Commission has played since its creation in 2012. I know there have been some questions about the amount of power that the commission actually has in terms of enforcing the recommendations it makes.
ALTMAN: The commission is required to review any merger of hospitals or physician groups that are large enough to potentially impact the cost of care. The commission can review the merger and say, “Based on our assessment, this particular merger or acquisition is not likely to lead to an increase in costs or a reduction in quality or access,” and therefore the commission decides not to do a detailed review. Or it can look at a particular merger or acquisition and say, “This merger and acquisition has the potential to have a negative impact on costs of care, or an impact on quality or access,” and it will engage in what we call a full market review. After that review, if the commission finds there is a real possibility that this particular merger or acquisition could lead to an increase in costs, it is required to send its findings to the state’s attorney general.
Soon after the commission got started, Massachusetts’ major health care system, Partners HealthCare, announced that it planned to merge with a big community hospital, South Shore Hospital. So the commission looked at this potential merger and said, “Wow, this potentially has major implications for the state’s health system.” Partners is by far our largest system, it has upward of 6,000 physicians, it has, depending on how you count it, nine or 11 hospitals that are a part of its system, including Mass General, Brigham and Women’s and Newton-Wellesley, among others. There has been concern for a long time that Partners has used its bigness to extract higher rates. The attorney general at the time, Martha
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Coakley, had previously issued a report that showed how much more the Partners hospitals were receiving for similar kinds of patients than other hospitals in the state.
would Partners then be able to merge with South Shore and obtain extra power in the marketplace, it also could potentially merge with other hospitals.
So we did our report, using, where appropriate, outside consultants, actuaries, economists and health policy people. The report concluded that there is a strong likelihood that this merger would lead to higher costs in the area, and based on this finding asked the attorney general to further study the merger for possible anti-trust violations. After a careful review and long discussions with
In order to get the attorney general’s recommendation legally approved, it was necessary to have a state judge rule that this agreement with Partners and South Shore was in the public interest. After a careful review, the judge rejected the recommendation of the attorney general and cited the report of the Health Policy Commission as one of the main reasons for the rejection. During this time, Massachusetts transitioned to a new attorney general and a new CEO of Partners was appointed. Both decided not to pursue the merger. As a result of this very public two-year battle, the Health Policy Commission essentially became a household name within the state’s health care community. The case also has been cited in many national publications.
the parties involved with the merger, the attorney general recommended that the merger be allowed to go forward, but only after Partners made many significant changes in the way it would operate, and only after a set number of years. There was very strong opposition to the attorney general’s recommendation from other hospitals and physician groups in the state and even from several antitrust experts from around the country. Many felt that the required six and a half years would fly by very quickly, and not only
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So, the commission has become a very active place. It has a highquality staff approaching 50 people, and it is engaged in many other important activities, including investing in community hospital projects that are designed to improve the quality and efficiency of the state’s health care system. The activities of the commission, as well as other aspects of the 2012 law, are being studied by several other states. Connecticut recently passed a law that has some characteristics similar to what’s here in Massachusetts. California is looking into it. New York is looking into it. So, going back to your first question, Massachusetts is a potential model for what a state can do to improve a complicated health care system.
Are you proud of your work and the role that the Massachusetts Health Policy Commission plays?
was increased spending from newly insured individuals. Nevertheless, it is a warning sign for the future.
ALTMAN: Absolutely. Looking back, I wouldn’t have believed that the commission would be quite so central to the workings of the state’s health system. I am very proud of the work of our staff and the dedication and commitment of my fellow commissioners. We had a large group from the U.S. Justice Department visit the commission during the Partners/South Shore battle, and they said our report was the best report they had ever seen from an outside group in this area. So yes, I’m very proud.
When we exceed the goal, the questions the commission needs to ask are, “Why?” and “What can we do to change the trend?” So here’s where everything is sort of loose in the sense that the commission doesn’t have the power to require change. We can encourage it. We do have the authority, if a particular delivery system is spending beyond the goal, to require it to come up with a plan to slow its growth. If it refuses to undertake such an effort, we could fine it. We have not used that authority so far. So, looking into the future, the question will be, “What can we do if we exceed that goal?” Some are suggesting that maybe the Health Policy Commission should have more power. My current view is that we should wait and see if the existing forces in the marketplace and the existing authority of the commission is sufficient to keep state spending in line with growth in its income.
What’s on the horizon in terms of health care in Massachusetts that you’re paying attention to and that the Health Policy Commission is thinking about?
ALTMAN: Well, over the last couple of years, the growth in health care costs in the state has been quite minimal. And while this is also true throughout the country, our rate of growth has been lower than the national average. We want to keep this trend going, although it will not be easy. I should point out that one of the main responsibilities of the commission is to monitor the growth in health care spending. The 2012 law that created the Health Policy Commission stipulated that the growth in per capita health spending should not exceed the growth in the state’s gross domestic product, which is around 3.6 percent. If the system doesn’t meet that goal, the commission, along with a sister agency called CHIA — the Center for Health Information and Analysis — has to determine why health care costs are growing so rapidly and recommend changes in the system to slow that growth. This is a tall order, but we are working hard to meet our responsibilities.
Why does this area matter to you?
ALTMAN: Well, when you think about what separates a good society from a not-so-good society, a key component is whether it makes available high-quality health care to all its citizens at an amount that the society can afford. As someone who was trained in economics, I chose to become involved in studying our complex health system because of its importance in our society. It continues to fascinate me 45 years later.
Most states focus almost entirely on what they spend on Medicaid. That’s their state’s big spending category. In Massachusetts, the state recognizes that it has the responsibility to be concerned about all health care spending. Yes, this includes Medicaid, but it also includes what is spent for private insurance, out-of-pocket costs and even Medicare. As I said, over the last couple of years, the growth in health care spending has been quite moderate. Last year, we were under the goal. This year, we exceeded the goal, but it appears the main reason
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CHANGING CORPORATE BUSINESS PRACTICES FROM WITHIN BY BETHANY ROMANO
“Just think — if one huge retail company were to mandate that its suppliers re-design their packaging, huge forests could be saved,” says Michael Appell, MA’79, assistant director of the Heller MBA program in nonprofit management. “Walmart actually did this recently — they changed their packaging requirements, and that one edict by one corporation probably accomplished more than years of advocacy work by any given nonprofit. Corporations are enormously powerful.” Appell teaches the Heller MBA course “Managing the Triple Bottom Line,” which explores events like Walmart’s new packaging requirements — corporate decisions that prioritize social and environmental interests in conjunction with the financial bottom line. In other words: sustainability as a business practice. Commonly referred to as corporate social responsibility — or CSR — it is the idea that for-profit corporations can, and should, work toward social and environmental goals beyond strictly focusing on financial dimensions of the enterprise. Over the last 40 or 50 years, Appell explains, corporations have transitioned from a complete focus on profit to accepting some responsibility for a range of issues, including workplace diversity, community welfare, poverty and environmental health. Appell’s office is a growing library. His bookshelves are full, the floor littered with tote bags overflowing with yet more books. He gestures to the bags, saying, “This is the first of eight batches of CSR books I’ve collected over the years that I’m bringing in from home. When I first started teaching this topic in 2003, it was hard to find texts for students to consider. But CSR has become a cottage industry — hundreds of books have been printed. This field just exploded.”
With the rising tide of CSR initiatives across the globe has come a growing need for trained young professionals who can juggle and strategize among social, ethical and financial responsibilities. At the same time, more and more students currently entering MBA programs are acutely aware of these issues and committed to making a difference. CSR AT HELLER
“One dimension of the mission-driven work Heller students focus on in their careers is corporate social responsibility,” says Brenda Anderson, director of the Heller MBA program in nonprofit management. “At Heller, we weave this theme into numerous courses, such as ‘Managing the Triple Bottom Line.’ This training positions Heller MBA graduates to work in both traditional and more contemporary CSR roles.” Appell pushes his students to take a hard look at the contemporary trends that are evolving the traditional CSR approach. At the heart of every discussion is a central question: Are companies’ CSR initiatives having a true social or environmental impact, or are they merely investing in good corporate PR? To help find the answers, Appell regularly invites guest speakers to his class, giving students access to an in-person case study. “Last semester, I brought in a CSR executive from a high-profile accounting firm who was very transparent about his company’s corporate social responsibility activities. Each partner in the firm was invited to sit on the board of a nonprofit, and each department was given a modest budget to donate to charity. But the company gave no strategic guidance as to why they should engage in these activities, or what kinds of organizations they should support. It looked good on paper but was completely disconnected from the company’s activities and goals.”
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After the speaker left, the class erupted into a raucous debate. CSR in this case was perceived as a cost of doing business, not a way to shift societal or environmental standards. Appell notes that this example is specific to one firm, but it’s important for students to connect these concepts to actual companies. “Are these companies following through with what they say they believe? And if they are, what does that actually look like?” asks Appell. THE ALUMNA
“For me, CSR is more about doing the right thing as a corporate citizen. If you’re a corporation and you have a lot of employees that make up your community, you’re seen in a certain light,” says Miriam Hodesh, MBA’07, community investment consultant for Gulfstream Aerospace Corp. Committing to doing more might be considered Hodesh’s personal creed. When Hodesh started her MBA program at Heller, every student was asked to name a leader whom they admire. Hodesh took it upon herself to copy down each name, reach out to those individuals and ask for advice on behalf of her classmates. Hodesh was the commencement speaker for her MBA cohort in 2007. During her speech, she dutifully recited the advice and warm wishes those leaders had sent her, making a personalized statement to each of her fellow graduates. After graduating from Heller, Hodesh moved to Savannah, Ga., and took a job with the city’s anti-poverty initiative, where she worked for several years. “From there, I transitioned to working for Gulfstream, which builds the world’s most technologically advanced businessjet aircraft,” she laughs, acknowledging the huge shift from grassroots community work to an international corporation. “What I wanted was to work in a foundation, but there are no large philanthropies in Savannah. Gulfstream, however, is the largest private employer in Savannah and has a community investment and employee investment commitment.” After years of working to produce social change on a smaller scale, Hodesh was hungry to make a significant impact in her community. She was attracted to Gulfstream’s core value, integrity, which includes
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stewardship and having a positive influence in the communities where its employees work and live. Gulfstream actively encourages its employees to engage in volunteer work and aligns the company’s CSR goals and charitable giving with issues that matter to its employees. “We build airplanes at Gulfstream, yes,” acknowledges Hodesh. “But we also collaborate with nonprofits working to solve societal issues that face us all. We are not experts in the work of our grantees’ fields, but we need to be partners at the table. If an agency is looking for a board member with a specific skill set, we can help. Our grantees are invited to take free classes with in-house trainers who lead project management and leadership development classes. And we have helped convene Savannah nonprofits to collaborate and work together on big problems — like access to healthy food — that they can’t tackle alone.” As a Heller alumna and a professional in the field, Hodesh recognizes the importance of her company aligning its CSR department’s activities with the company’s broader values and goals. “It’s more than just cutting checks,” says Hodesh. “It’s important for Gulfstream as a big company to know what our employees — and by extension, the communities they live in — care about, and then reach out and say ‘We know this is a problem in the community, let’s see how we can tackle these issues together.’” THE STUDENT
What does it mean to make a difference in the world — and what are the rules? Nonprofit management students at Heller and elsewhere are often consumed with the ethical debates surrounding social justice work. From defining appropriate missions and methods to vetting staff and funding mechanisms, humanitarian careers are full of ethical questions. “Something I always think about, which a lot of Heller people say, is, ‘Don’t let perfect be the enemy of good,’” says Kalee Whitehouse, MPP/MBA’15. “I think of impact as a spectrum. If an organization’s CSR initiative only gives to charity, there’s only so much impact they can have, and they can only be so competitive. Companies that do more, and hold their employees responsible for doing more, are more effective and more competitive. To me, it’s compelling that running an ethical company has a
competitive advantage. Sometimes corporations use CSR as a glossing tool, but a lot of times it’s more than that.” Whitehouse took Appell’s course during her first semester at Heller, which she says put her on the path to pursuing CSR as a career. She is now the co-president of the Heller chapter of Net Impact, where she organizes CSR networking activities with like-minded changemakers in the Boston metro area. She also recently completed an internship for the CSR department at Cone Communications, a Boston PR firm. At Cone Communications, part of Whitehouse’s job included researching the social motivations that engage a younger workforce, so employers can respond to their desires. Modern consumers and employees are the driving force behind the current trend for companies to pursue a triple bottom line, says Whitehouse. “As employees, millennials want more company engagement, more diversity and inclusion in our places of employment. As consumers, we want ethically produced goods and services — and our desires make a difference in how companies are run.” LEADING THE CHARGE
The growth of ethical and effective CSR initiatives across corporate America has led to a niche job market for professionals with business training and a conceptual framework for advancing social justice. “The Heller MBA program,” notes Brenda Anderson, “is unique in that it provides traditional, rigorous MBA training, complemented by coursework in various social justice areas, to professionals who aspire to make a difference in the world.” “As the CSR field grows more sophisticated, our nonprofit management students are realizing that not every corporate job means ‘going over to the dark side,’” says Appell. “I’m hoping to open students’ eyes to career opportunities in CSR. They can make a real social impact from within powerful corporations that are embracing a triple bottomline approach.” The Heller MBA is training a new generation of professionals to leverage that power for good.
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INCLUSIVE COMMUNITIES AND THE FUTURE OF ANTI-DISCRIMINATION FORENSICS BY ANITA F. HILL
In 1939, having been denied the stage in Constitution Hall because of her race, internationally renowned contralto Marian Anderson delivered a stunning concert against the backdrop of the Lincoln Memorial. She sang to 75,000 people gathered in Washington and to America via NBC. According to a PBS essay on the event, Anderson was humbled by the size of the audience. Invoking community and group responsibility, she remarked, “We cannot live alone. And the thing that made this moment possible for you and for me has been brought about by many people whom we will never know.” Unfortunately, the sense of community that Anderson assembled was short-lived. When the concert ended, it’s fair to say that most of the people in the crowd returned to racially segregated neighborhoods that were the norm even in our nation’s capital. Three decades after Marian Anderson opened her concert with “My Country, ’Tis of Thee,” Congress responded to entrenched housing discrimination by passing the 1968 Fair Housing Act. The law directed the federal government to “affirmatively further” fair housing. Housing and Urban Development Secretary George Romney devised a plan to dismantle America’s segregated housing patterns, which he described as a “high-income white noose” around the black inner city. After much political resistance to the Romney plan, President Richard Nixon quashed the efforts even as he acknowledged that segregation would continue if the government did not act. By 1974, Justice Thurgood Marshall warned against the consequences of lax enforcement of integration policy in a landmark school desegregation case, Milliken v. Bradley. Milliken involved the question of whether federal courts could offer inter-district remedies to address school segregation occasioned by “white flight,” which, according to the plaintiffs, state and local policies had fostered. When the case came before the Supreme Court, it was 20 years into the bitter struggle in the North and the South to enforce the mandate of Brown v. Board of Education, which banned segregated school systems. Despite evidence PHOTO BY KEN SCHLES
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showing the systemic ways that government authorities were involved in the building of predominantly white suburban neighborhoods at the expense of largely minority urban Detroit, the Supreme Court refused to enforce a remedy that required suburban and urban school mergers. In his dissent, Justice Marshall wrote, “Today’s holding, I fear, is more a reflection of a perceived public mood that we have gone far enough in enforcing the Constitution’s guarantee of equal justice than it is a product of neutral principles of law. In the short run, it may seem to be the easier course to allow our great metropolitan areas to be divided up each into two cities — one white, the other black — but it is a course, I predict, our people will ultimately regret.” Though brought as an education case, Milliken had all the markings of a housing discrimination claim and serves as the best evidence of the systemic impact that past discrimination had on the racial environment, then and now. When faced with housing discrimination claims, courts tend to acknowledge that government, by offering seemingly neutral subsidies to whiter neighborhoods and largely neglecting primarily minority neighborhoods, has contributed to ongoing patterns of neighborhood racial and class isolation that impacts schools, transportation, jobs and community policing. This spring, almost three decades after Milliken and with limited progress integrating housing or schools, the court issued a housing discrimination decision that equal opportunity advocates hail as “an incredible victory … [which] moves us forward as a nation.” In Texas Department of Housing and Community Affairs v. The Inclusive Communities Project Inc., the court embraced a progressive approach to achieving what Justice Ruth Bader Ginsburg called the “grand goal” of the Fair Housing Act “to undo generations of rank discrimination.” The ruling opens the door for addressing institutional bias and implicit prejudice through something called the disparate impact theory and sanctions the theory’s application to claims of race, national origin, religion, gender, familial status and disability housing discrimination. Though not a new concept, the court was deeply divided, split five to four, with Justice Anthony Kennedy writing the court’s opinion and both Justices
Alito and Thomas penning dissents. The majority acknowledged that in order to end discrimination, civil rights laws must be authorized to disentangle present policies from past inequities, even though such policies fail to reference directly prohibited behavior. Within this framing lies a potential to reinvigorate the fight for equality in housing as well as in employment and education, areas that are already open to disparate impact proof. A few facts about the case: In the state of Texas, the Department of Housing and Community Affairs distributes low-income housing tax credits to developers who, in turn, construct affordable housing. However, according to the Inclusive Communities Project (ICP), a nonprofit group that assists low-income families in obtaining housing, the department and its officers allocate tax credits in a way that perpetuates segregated housing patterns, by assigning too many tax credits to housing in predominantly black inner-city areas and too few in predominantly white suburban neighborhoods. In the suit that worked its way to the Supreme Court, ICP attempted to prove the Fair Housing Act violation with statistical evidence. In response, the Texas Department of Housing argued that statistical proof of discriminatory impact was insufficient to establish a violation of the Fair Housing Act, and that ICP had to offer evidence that the department was intentionally biased in enacting the distribution policy. Exactly why the Supreme Court decided to hear the case is unclear. Typically, the court’s busy docket limits review only to those cases that present a novel question of law or to resolve a conflict among the lower courts. But 11 federal circuit courts that have been presented with the issue have applied the Fair Housing Act to public and private policies that unjustifiably perpetuate segregation, regardless of intent. Congressional endorsement of the theory was codified in the Civil Rights Act of 1991. And in 2013, the U.S. Department of Housing and Urban Development, the agency charged with administering the act, issued a regulation enshrining the principle. Furthermore, disparate impact theory is widely recognized by the highest courts in many other countries, including Canada, the United Kingdom, Australia and New Zealand, as well as in the European Court of Justice.
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But since the intent requirement was initially enshrined in the 1976 case of Washington v. Davis, American legal traditionalists have held to the idea that discrimination claims must be proven by direct proof of intent — that culpable individuals were motivated by some malevolent purpose in putting into place a discriminatory policy or practice. Neutral policies, the traditionalists argue, deserve to be treated as though they are bias free, even if a discriminatory effect is directly traceable to the policies. In the 1970s, the court hardened and further enshrined the intent doctrine in race and gender discrimination cases brought under the Constitution. For example, in Personnel Administrator of Massachusetts v. Feeney, the Supreme Court upheld a state law giving preference to veterans in state government employment, despite the fact that application of the policy meant that women were almost totally excluded from high-level civil service jobs. The court declared that no matter how much gender stratification resulted, the plaintiff Feeney had to show that the Commonwealth enacted the veterans’ preference “because of ” not merely “in spite of ” its adverse consequences to women. Feeney would have to offer some “smoking gun”— conclusive evidence, such as prejudiced statements by decision makers captured in the record or a sequence of biased behavior leading to the decision in issue found in legislative or administrative history, along with a past history of discriminatory conduct. Civil rights advocates’ argument that requiring proof of intent placed an insurmountable burden on challengers to face neutral policies, and that much of today’s discrimination is not intentional, fell on deaf ears. But since the Feeney decision, legal theorists have applied developing social science to analyze how discrimination works. With growing evidence of unconscious bias, there is ample reason to believe that many practices that have a discriminatory effect were not adopted because of bad motives. Compelling evidence that most individuals unknowingly rely on stereotypes about race, gender and sexuality, to name a few, in order to process information has convinced courts that unconscious bias can be built into institutional structures, practices and norms and upheld as tradition. This is especially true in complex institutional settings, such as housing councils, education boards or universities, when multiple parties are involved
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in decision-making processes. Requiring proof of intent sets an inappropriately high standard, and motivation may not even be relevant. The intent versus effect debate — what qualifies as proof of discrimination — is the backdrop for and the issue addressed in Texas Department of Housing and Community Affairs v. Inclusive Communities Project. The case came down to the court’s interpretation of whether three words found in the act — “otherwise make unavailable” — refers to the consequences of an action rather than the actor’s intent. For most of the nearly two-hour-long oral argument, the justices and two attorneys on each side pondered the meaning of that very brief phrase. Yet, early in the oral argument, Justice Ginsburg directed her colleagues’ and the parties’ attention beyond the three words to the social implications of the court’s construction of the Fair Housing Act. The generations of rank discrimination she referred to is well documented. Redlining, restrictive covenants in deeds, and outright refusal to sell or rent to people of color and religious minorities enshrined old biases in communities throughout the country. When one examines the history of housing discrimination, as the court did in the Inclusive Communities Project case, it’s hard to argue that “practices that are not intended to discriminate but in fact have a disproportionately adverse effect on minorities” are harmless. Through its reasoning, the Inclusive Communities court concluded that Congress deliberately sought to reach beyond intentional discrimination and combat rules and policies that had invidious discriminatory and often systemic effects. But disparate impact theory does have its critics. Indeed, Justice Samuel Alito’s dissent refers to “dire consequences” that could result from the onslaught of suits that may be filed against state and local entities under the theory. Some civil rights advocates argue that all of the attention given to the theory has detracted from efforts to study the ways that intentional invidious discrimination is proven. As well, they note that disparate impact claims do not result in damage awards, but only changes to policies — a point confirmed in the court’s opinion.
Through its reasoning, the Inclusive Communities court concluded that Congress deliberately sought to reach beyond intentional discrimination and combat rules and policies that had invidious discriminatory and often systemic effects. —ANITA F. HILL
And there is no guarantee that the Inclusive Communities Project will prevail at trial. As HUD itself recognized in its recent rulemaking, disparate-impact liability “does not mandate that affordable housing be located in neighborhoods with any particular characteristic.” Unfortunately, even if ICP prevails and affordable housing is built in more affluent suburbs, there is no guarantee that distressed inner city neighborhoods will improve. Nevertheless, even with its limitations, I believe Texas Department of Housing and Community Affairs v. The Inclusive Communities Project Inc. will enhance efforts to eliminate discrimination in housing. In 2011, I described many of the predatory, unfair and deceptive lending practices that contributed to the 2008 housing market collapse in my book “Reimagining Equality: Stories of Gender, Race and Finding Home.” Even though the country as a whole is recovering from that crisis, its impact continues. A recent report by Harvard’s Joint Center for Housing Studies found that “the foreclosure recovery varies unevenly by neighborhood race and ethnicity, reproducing patterns of neighborhood inequality.” And there is growing concern that despite the regulations put into place to curtail reckless loan practices, borrowers in communities of color are still underserved by
the mortgage market. If these conditions continue, housing advocates may be able to utilize the disparate impact theory as described in the Inclusive Communities decision to prove that banking practices are racially discriminatory and in violation of the Fair Housing Act. As well, the opinion’s progressive framing of the goal of civil rights laws and recognition of unconscious prejudice opens new pathways for proving and addressing other forms of discrimination. Neither the Inclusive Communities decision nor even the disparate impact theory will magically eliminate invidious discrimination, but they both are important legal tools with equally important potential for moving the country one step further toward equal opportunity for all.
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REMEMBERING STAN WALLACK Wallack, the founding executive director of the Schneider Institutes for Health Policy, passed away on Oct. 7. When he came to the Heller School in 1978, economist Stan Wallack had already played important roles on the national policy stage. He had previously served as an economic policy fellow at the Brookings Institution and as a policy analyst with federal agencies including the Department of Health, Education and Welfare and the Congressional Budget Office. “While in Washington, Stan was a driving force to reform our health care system,” recalls Stuart Altman, who recruited Wallack to become the founding director of Heller’s new health policy institute. “Stan was an important reason why Irving Schneider chose to provide endowment support for this new institute, which now carries his name,” Altman says. “It’s hard to imagine that we’d have the Schneider Institutes today without Stan.” During the next four decades, Wallack led the Schneider Institutes as it became what Heller Interim Dean Marty Krauss calls “one of the great health policy centers in the country.” In his own work, Wallack analyzed problems in the financing and delivery of health services, in hopes of finding innovative solutions. One of his first major accomplishments at Heller happened in the early 1980s, when he examined the uncontrolled, high costs associated with long-term medical care — a problem that particularly impacted America’s elderly population. Wallack developed the concept of the Social Health Maintenance Organization, or SHMO, which served as a precursor to the current Medicare Advantage Plans. Twenty years later, another of his research projects helped restructure how the federal government paid health care providers by linking incentives to achieving both financial savings and improved clinical outcomes. The project inspired the idea of accountable care organizations.
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Over the years, Wallack’s research interests diversified. “He became passionately interested in aging, mental health care, global health, and organization and management,” Altman says. “Stan’s intellect was eclectic, and, as a result, the Schneider Institutes had a broad-based focus on a wide range of issues.” In addition to his leadership at the Schneider Institutes, Wallack played a pivotal role on the academic side of Heller. “He was very much involved in ensuring the highest standards for his students,” says Altman. “Many have gone on to earn PhDs and become senior policy advisers in Massachusetts and around the country.” Some of his former students, like Michael Doonan, who now directs Heller’s Master of Public Policy program, ultimately became Wallack’s colleagues. “While incredibly accomplished in helping shape national health policy, Stan always took the time to mentor, prepare and inspire the next generation of health services researchers,” Doonan says. “He brought the Agency for Healthcare Research and Quality Training Program to Heller, provided research opportunities and mentorship, and was always generous with his time and access to his expanded network. In addition to his direct contributions, his impact will live on through his students.”
Michael W. Ames, PhD’15, is the new executive director/chief executive officer at Perkins in Lancaster, Mass. (email@example.com) Ashadudzaman Asad, MA SID’15, loves using the knowledge, network and spirit from Heller to work hard in transforming himself and to make the world a better place in a sustainable way. He is working as a manager for the Disaster Management and Climate Change Program of BRAC. He is more confident to face the challenges of climate change and alleviate poverty. He sends his thanks to the Heller community for imparting the confidence and sharing so many good things. (firstname.lastname@example.org)
well as her volunteer advocacy work in the Greater Boston dementia community at KatieBrandt.org. (Katherine.Brandt@mgh.harvard.edu) Jacqueline D. Braunthal, MMHS’84, is the principal and CEO of Health and Human Services Management Solutions LLC, a comprehensive care management practice and consulting firm in the Metro New York City area, including Southern Westchester and Southern Connecticut, serving seniors, their families, adults and children. In addition, her practice includes consulting areas such as sales and marketing, executive search, regulatory compliance and training. She says hello to Heller friends and welcomes new clients. (email@example.com)
Jessie Babcock, MBA’09, received the Office of the Secretary of Defense Medal for Exceptional Civilian Service in June 2015 for her three-year tenure as the country director for Argentina, Chile and Uruguay in the Department of Defense (DoD). Babcock recently transitioned to the Strategy Office in DoD, where she develops policies and strategies to enhance innovation in defense. She also recently completed a draft of her first novel, a young adult mystery and coming-of-age story, and is currently searching for a literary agent. (firstname.lastname@example.org) Katherine D. Brandt, MM’04, has accepted a position as the community resource specialist in the Frontotemporal Disorders Unit at Massachusetts General Hospital. This role will allow Brandt to work one-on-one with caregivers and families navigating life with a frontotemporal disorder, facilitate educational presentations to community partners, and plan events to raise awareness and funds to support clinical care and research. Learn more about Brandt’s new professional position as
Program for LGBTQ Students. She made two short films for Welcoming Schools, a Human Rights Campaign Foundation program for K-5 students. She also worked for eight years co-producing “At Home in Utopia” about radical Jewish immigrants in the Bronx in the 1920s. (ellenbrodskyfilms.com, ellenbrodsky@ comcast.net) Ariella Camera, MA SID’13, has successfully completed her Presidential Management Fellowship and is a public health adviser for Human Resources for Health and an agreement officer’s representative on USAID’s new flagship project HRH2030 with the Office of Health Systems, in the Global Health Bureau. (Ariella.Camera@gmail.com) Ellen F. Chayet, PhD’84, was promoted to professor of criminal justice at St. Thomas Aquinas College in Sparkill, N.Y. (email@example.com) David Chivo, MA/MMHS’96, is the associate vice president for the American Technion Society. He lives with his wife and two adolescent children in Mercer Island, Wash. (firstname.lastname@example.org)
Ellen Brodsky, MMHS’92, directed her first feature-length documentary film, “The Year We Thought About Love,” chronicling a year in the life of an LGBTQ youth theater troupe. After being shown at festivals worldwide, the film was picked up in August 2015 by New Day Films, which specializes in selling films to the educational market. After receiving her Heller degree, Brodsky ran a CDC-funded national training center on HIV prevention and worked for Massachusetts’ Safe Schools
Sarah Clark, MM’00, MBA’05, is the finance and administration officer at the Ruderman Family Foundation as of Sept. 8, 2015. Previously, she spent nine years at Gateways: Access to Jewish Education. (email@example.com) Brian Cohen, MA SID’06, recently started a job with the Freeland Foundation, a Bangkok-based group that combats wildlife trafficking, human slavery and illegal logging. In September 2015, he moved to Bangkok to head up efforts to grow the NGO. He would love to connect with any SID people living in Bangkok! (firstname.lastname@example.org)
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Luisa Stormer Deprez, PhD’95, retired as professor emerita of Sociology and Women and Gender Studies after 39 years of teaching at the University of Southern Maine (Portland). She resides in Portland and will continue the work she has been doing for decades, both statewide and nationally, focused on poverty, low-income women/mothers and higher education, and issues of social justice. She is also the Maine co-leader of the Scholars Strategy Network, a dynamic network of scholars from throughout the country working to improve public policy and strengthen democracy. (email@example.com) Charles H. Francis, MPP’10, began an exciting new role as director of policy at the Massachusetts Department of Housing and Community Development in June 2015. Reporting directly to the undersecretary, he focuses on developing and implementing a policy agenda aimed at increasing housing supply and serving vulnerable populations, as well as managing external stakeholder relationships, program-level policy concerns and oversight of legislative affairs. (firstname.lastname@example.org) Sheldon R. Gelman, PhD’73, has retired as professor emeritus and Schachne Dean Emeritus after 25 years at Yeshiva University in New York City. He served as Schachne Dean of the Wurzweiler School of Social Work for 21 years and 11 years as vice provost of the university. He is a member of the National Board of Case Management and a fellow of the New York Academy of Medicine. (email@example.com) Celeste Gregory, MA SID’10, was head of office in Ghor Province, Afghanistan, with Catholic Relief Services (CRS) for almost two years. She has transitioned to a special assignment as acting head of
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programming with the CRS Guinea program. In this new role, she will provide leadership in the management and growth of the CRS Guinea program portfolio. She will also provide technical support for staff and partners and ensure high program quality standards and compliance with donor reporting. (Celeste.Gregory@crs.org) Yan Huang, MS’08, graduated from the doctoral program in health behavior at Indiana UniversityBloomington School of Public Health in 2014. She recently became a tenure-track assistant professor at California State University Chico, Department of Health and Community Services. (firstname.lastname@example.org) Batya Hyman, PhD’93, began her new role as chair of the Department of Social Work at Salisbury University in July 2015. The department provides BASW and MSW programs to more than 500 students at five sites across Maryland and, through a partnership with the University of Maryland University College, to military personnel and their dependents across Europe. The department is in the forefront of designing alternative delivery models and is launching a new regional online MSW program this fall. (BXHYMAN@salisbury.edu) Marie Kearns, PhD’10, was recently promoted to manage Horizon House’s Philadelphia county Behavioral Health Services division. This fall semester, she also started as adjunct faculty at Temple School of Social Work. On Aug. 31, 2015, she celebrated a one-year
wedding anniversary with her spouse, Doris. Her twins are in their third year at college, Arielle for art and Alicia for premed. (email@example.com) Rienzzie Kern, MA SID’00, led Heifer International’s planning, monitoring and evaluation efforts for 14 years and is now leading the organization’s global efforts in state-of-the-art evaluation practice, cutting-edge research and actionable learning for evidence-based decision-making on program investments. Kern collaborates with academic institutions offering internships, fellowships and opportunities to members of faculty for research and publication. (Rienzzie.Kern@heifer.org) Alex Mkwamba, MS’10, is thankful for the full-tuition scholarship he received from Heller, which advanced his career in global health. He was then awarded the global health scholarship at Johns Hopkins, where he pursued an MPH degree (Epidemiology & Biostatistics). Armed with the unique combination of skills from two degrees, his first full-time job was as a consultant for the World Bank, conducting a rapid assessment in his home country of Zimbabwe, on whose basis the World Bank decided to expand resultsbased financing for health services in poor urban communities. From the World Bank, he joined MSF Doctors Without Borders, with whom he just completed his second mission. The first was in Mozambique and the second in South Africa, in a place that has been labeled the epicenter of the HIV and TB epidemic. He is glad to be serving the mission of his two scholarships and committing to his promise in the commencement speech he delivered in 2010. (firstname.lastname@example.org) Olajide Olagunju, MA COEX’06, started his second Brandeis-linked research project in Nigeria in 2008. This research, which is turning out to
be lifelong work, started with sponsorship from the Brandeis Sachar travel grant, Harvard research fellowship and Chevron consultancy. The research revolves around the management of Nigeria’s economy, beginning with current oil and gas conflict management. In August 2015, he was invited by the management of Nigeria’s oldest newspaper, Daily Times, to be their Thursday back-page columnist. His column, “Nigerian Narrative,” provides a critical opportunity to popularize his research findings and further share with policymakers thoughts for moving Nigeria forward and upward economically. Back and future editions of the column can be found by searching for “Jide Olagunju+Daily Times.” He writes, “I do hope this Brandeis/Heller seed helps Nigeria achieve its potential and vision to be in the league of 20 leading economies by 2020.” (email@example.com) Rebecca Pearl-Martinez, MA SID’01, is a research fellow and head of the Renewable Equity Project (REP) in 2015, an initiative to advance clean energy through a gender-diverse workforce. REP is part of the Center for International Environment and Resource Policy at the Fletcher School for International Law and Diplomacy at Tufts University. (Rebecca.Pearl_Martinez@tufts.edu) Anna Perlmutter, MBA’12, recently completed a three-month summer trip with her boyfriend on a 35-foot sailboat around the North-East loop from Cleveland, Ohio, through Quebec to Nova Scotia, down the East Coast to New York, and back to Cleveland. It was a challenging and exciting trip, complete with several up-close-andpersonal whale encounters! She is happy to be back safe and sound at home in Cleveland after these adventures, and she is looking forward to her third year as a PhD student in orga-
nizational behavior at Case Western Reserve University. Perlmutter’s trip blog is www.clevelandtocleveland.com. (firstname.lastname@example.org) Emily Pohl, MA SID’11, accepted a new position as program management advisor for Samaritan’s Purse. She recently moved back to the U.S. to assume the position and support teams worldwide. (email@example.com) Deborah A. Potter, PhD’07, was promoted to associate professor and awarded tenure at the University of Louisville, Department of Sociology in July 2015. Her article, “Situated Motives of Lay Participants in Community Collaboratives for Children’s Mental Health,” was published online in the journal Qualitative Health Research in February 2015. The same journal has accepted another article for which she was lead author. “Healthicization and Lay Knowledge About Eating Practices in Two African American Communities” will be published later this year. She also has been elected to serve a three-year term (2015-2018) on the Society for the Study of Social Problems’ Committee on Committees. (firstname.lastname@example.org) Alexander Scarlis, MPP’15, accepted a fiscal policy analyst position with the Massachusetts Executive Office for Administration and Finance. (email@example.com) Ibrahim Sebiyam, MA SID’11, was elected as an assembly man in Kpasenkpe Electoral Area in the West Mamprusi District of Ghana. He will be representing his people at the District Assembly under the local government administration. There was a soccer match between teams in his honor, where he donated three footballs to the teams. He champions the course of development and social justice issues in the area. (firstname.lastname@example.org)
Safia Trabelsi, MA COEX’10, just finished developing the Regional Action Plan (RAP) of Women Peace and Security for the Arab Region. She has been the expert at the League of Arab States for one year. Trabelsi is very pleased and eager that the first RAP in the Arab Region is ready to be implemented. (email@example.com) Emily Wilson-Hauger, MA SID’12, was recently hired as executive director of New Historic Thomas, a community revitalization/redevelopment nonprofit organization in Thomas, W.Va. (firstname.lastname@example.org) PUBLICATIONS/PRESENTATIONS
Qudratullah Ahmadi, MS’14; Homayoon Danesh, MS’14; Vasil Makharashvili, MS’15; Kathryn Mishkin, MA SID’15; Lovemore Mupfukura, MS’14; Hillary Teed, MBA/MS’15; and Margaret HuffRousselle, Heller adjunct senior lecturer, jointly published a paper titled “SWOT analysis of program design and implementation: a case study on the reduction of maternal mortality in Afghanistan” in the International Journal of Health Planning and Management 2015, and online in Wiley Online Library (wileyonlinelibrary. com) DOI: 10.1002/hpm.2288. (In same order as above: muhebabdal_ email@example.com, homayoon@ brandeis.edu, vmakharashvili@gmail. com, firstname.lastname@example.org, email@example.com, hjteed@ gmail.com and firstname.lastname@example.org) Caitlin Feuer, MPP/MBA’15, presented at the National Conference on Health and Domestic Violence in Washington, D.C., in March 2015. Her presentation, titled “Understanding barriers to safe and confidential health care: Where we are, where we hope to go, and how each of us can play a role in the policy-changing process,”
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was an extension of her MPP capstone from May 2014. Feuer presented to health care providers, domestic violence advocates, policymakers and researchers as part of a panel alongside nonprofit and hospital leaders from Boston and D.C. (email@example.com) Erika Kates, PhD’84, senior researcher at the Wellesley Centers for Women, was invited to participate with two other women scholars in a three-day colloquium, Gender Goes to Jail, held at St. Mary’s College of Maryland, March 23-25, 2015. It was the 15th annual colloquium the public honors college has held on gender issues involving collegewide involvement. On April 15, 2015, Kates held a symposium with Jennifer Musto, assistant professor of sociology and gender studies at Wellesley College, titled “Beyond the Carceral State for Women and Girls.” Its participants included policymakers, practitioners, researchers and justice-involved women. The event was the first funded by Wellesley College’s Program on Public Leadership and Action, whose purpose is helping faculty to enter the policy arena. (firstname.lastname@example.org) Diane Mahoney, PhD’89, was invited to be a visiting scholar to Alzheimer’s Scotland, where she participated in their national conference in June 2015 and met with persons with dementia, providers and researchers. She recently published “Family caregivers’ perspectives on dementia-related dressing difficulties at home: The preservation of self model” in Dementia 14, no. 4 (2015): 494-512 and “Prototype Development of a Responsive Emotive Sensing System (DRESS) to aid older persons with dementia to dress independently” in Gerontechnology 13, no. 3 (2015): 335-358. (email@example.com) Ashley C. Rondini, PhD’10, published two journal articles in the past six months: (1) “[Mis]Placing Race in
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Biomedical Clinical Context: Racial Categories, Medical Research and the Reproduction of Health Disparities” in Sociology Compass 9, no. 8 (2015): 704-717. (2) “Observations of Critical Consciousness Development in the Context of Service Learning” in Teaching Sociology 43, no. 2 (2015): 137-145. (firstname.lastname@example.org) Erika Smith, PhD’15, presented “Navigating the Transition from Foster Care While Pursuing Higher Education” at the 2015 National Conference on Students in Transition in Baltimore, Md., October 2015. (email@example.com) Aline P. Zoldbrod, MSW’71, PhD’78, published an article titled “Sexual Issues in Treating Trauma Survivors” in the March 2015 edition of Open Access in Current Sexual Health Reports. Download it at http://link. springer.com/ article/10.1007%2Fs11930-014-00346#page-1. It is being well received and she presented it for Psychiatry Grand Rounds at UMass Medical School last fall. She also presented a full day of discussion of women’s sexuality and trauma at the New England Society for the Study of Trauma and Dissociation in Boston in December. (firstname.lastname@example.org)
Insane in Petersburg, Va. (email@example.com) Prof. Richard Isralowitz, PhD’78, director of the Regional Alcohol & Drug Abuse Research (RADAR) Center at Ben-Gurion University’s Spitzer Department of Social Work, has received an award from the U.S. National Institutes of Health, National Institute on Drug Abuse (NIDA), International Program. Isralowitz received the award in recognition of “Contributions to Scientific Diplomacy Through Outstanding Efforts in International Collaborative Research on Drug Abuse and Addiction.” The RADAR Center was established at BGU in 1995. Since then, the center has promoted an international network of relations with experts and organizations addressing substance abuse prevention, treatment and policy issues through education, training workshops, research and publication. (firstname.lastname@example.org) BIRTHS/MARRIAGES
Calvin Harris, MPP’10, and Dea Watkins were married on May 9, 2015, in Haymarket, Va. The newlyweds
King Davis, PhD’72, recently received funding from the Andrew Mellon Foundation to support research that he and his colleagues are conducting to develop and field test a digital infrastructure for preserving and managing the historical public records from the Central Lunatic Asylum for Colored
currently reside in the Brookland neighborhood of Washington, D.C., with their puppy, Peace. Harris also accepted a position with the Bipartisan Policy Center (BPC) in September. As the senior manager of public affairs, he works with BPC’s policy experts to increase the visibility of regional,
state and local efforts to better inform the federal decision-making process. Prior to this role, Harris was a communications strategist with the Council on Foundations and SKDKnickerbocker and served as a speechwriter and press secretary for education advocate Michelle Rhee. (email@example.com) Summer Jackson, MA SID’13, married Luke Tarbi in her hometown of Sedona, Ariz., on April 18, 2015.
Ariella Camera, MA SID’13, and Kristen Pancio, MA SID’13, were bridesmaids, and Michael Galhouse, MA SID’13, attended. Jackson and Tarbi have moved back to the Cambridge, Mass., area, where Jackson has started a PhD in economic sociology at the MIT Sloan School of Management. (firstname.lastname@example.org)
Arina Chithavong Lester, MA SID’15, and Christopher R. Lester Jr. were married on Aug. 3, 2015, at Holy Trinity in Georgetown, Washington, D.C. They were blessed and thankful to have five Heller alumni in attendance: bridesmaid Alicia Tambe, MA SID’15; bridesmaid Wendy Gutierrez, MA SID’15; Kate Mishkin, MA SID’15; Melanie Allen, MA SID’15; and Gloria Namugaya, MA SID’15. The newlyweds currently reside in Washington, D.C., and are both enjoying their work in the field of international development. During her practicum, Lester worked as a consultant at ILO, the U.N. agency for international labor standards. She is currently working as the program accountability associate at the Fair Labor Association, an international nonprofit supporting the improvement of labor standards worldwide on the factory and agricultural level. (email@example.com)
Bernie McCann, PhD’11, married Fabio Alexandre Barros Marcondes on June 22, 2015. The two grooms enjoyed an intimate sunset beach wedding in Provincetown, Mass. (firstname.lastname@example.org)
Alex Lessin, MPP/MBA’14, married Sarah Marini on June 27, 2015, in Mattapoisett, Mass. He currently works for the city of Somerville. (email@example.com)
Daluwatte, MA SID’08; and Cecilia Emusu Ekayu, MA SID’09, and those who sent their best wishes. (firstname.lastname@example.org) Elizabeth Petheo, MA SID’06, received her MBA from MIT in 2014 and welcomed a son, Maximilian, in 2015. Petheo and her husband live in Washington, D.C., where she is a senior consultant. (email@example.com) Lynn Sanders, MPP’10, married Jim Morey on June 13, 2015, at Maple Hill Farm in Hallowell, Maine. The couple continues to live in Dorchester, Mass., with their cats Tuba and Jack. Sanders is currently the development coordinator and grant writer for Just-A-Start, a community development corporation in Cambridge, Mass. (firstname.lastname@example.org) Emily Wilson-Hauger, MA SID’12, and her husband, Matt Hauger, welcomed the birth of their daughter, Katherine Colleen, on March 7, 2015. (email@example.com)
Carolyn Musyimi, MA SID’08, married Francis Kamau Kang’ara on July 18, 2015, at the Riverside Assemblies of God in Methuen, Mass., followed by a reception at the Diburros in Haverhill, Mass. They are thankful to all alumni who joined them, including Chinedu Agbakwuru, MS’08, and his wife; Madris Njoka, MA SID’07, MA COEX’10; Shamila
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“WE NOW KNOW THAT FOR THE VAST MAJORITY, YOU ARE MUCH MORE LIKELY TO HARM PATIENTS THAN TO HELP THEM IF YOU PUT THEM ON LONG-TERM OPIOIDS.” ANDREW KOLODNY on NPR’s “On Point” in a discussion of the prescription opioid epidemic
“We now have a mountain of evidence showing that when women are included in the workplace, when they’re part of work groups, the decisions that are made are better — they’re more effective, they’re more efficient, and, in the long run, they benefit employers.” ANITA HILL in an interview with “Marketplace”
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“It’s only fair to say that these predictions [about Medicare], while they were wildly negative, did bring about a vast expansion of the health system. We expanded the delivery system to make sure they didn’t come true.” STUART ALTMAN in U.S. News & World Report on the 50th anniversary of Medicare
“IF NATIONS CAN COOPERATE ON TRADE AND DEVELOPMENT, THERE IS NO REASON THAT THEY CANNOT PARTICIPATE IN A GLOBAL DIALOGUE ON MINORITY RIGHTS THROUGH THE LENS OF THEIR RELIGIOUS, CULTURAL AND SOCIAL HERITAGES.” RAJESH SAMPATH in The Conversation on the similarities between
racial oppression in the U.S. and caste oppression in India
“It’s good that critics are countering the absurd idea that now is the time to raise interest rates. But the Fed is not the only possible game in town, and we need a much broader debate.” ROBERT KUTTNER in The Huffington Post on the potential for raising the Federal Reserve’s interest rates