| ANNOTATIONS
Vernellia R.
Randall, Racist Health Care: Reforming An Unjust Health Care
System To Meet The Needs Of African-Americans, Health
Matrix: Journal of Law-Medicine, vol. 3, pp. 127-194, Spring
1993.
This article provides a candid overview of how
African-Americans are treated in today's health care system.
African-Americans are sicker than European-Americans and are
dying at a significantly higher rate. This disparity has the
effect of precluding African-Americans from gaining full access
to the economic system. The reality is that decent health is a
precondition to getting the other attributes of life, such as
money, education, and know-how. When people are sick and poor,
they can not reach the level of health and economic well-being as
others.
The most objective measurement of health (death) clearly
indicates that African-Americans re sicker than
European-Americans. If African-Americans are sicker as a result
of disparate treatment in the health care system, then they are
the victims of unequal access to health care. Racism is the
result of this disparate treatment. Racism is both overt and
covert. Covert racism originates in the operation of established
and respected forces in society (termed institutional racism).
Institutional racism is a term that describes practices in the
U.S. nearly as old as the nation itself and comprises politics,
practices, and activities that injure an individual or group
based on race.
This article supports my overall conclusion about focused
advertising of unhealthy products. Focused advertising, which is
arguably a form of institutional racism, adversely affects the
health of many ethnic Americans. Those targeted ethnic groups, in
return, can not receive adequate health care to combat the evils
that the advertised products do to their health. This means that
as long as focused advertising is allowed to go on unregulated in
ethnic communities, those targeted groups can never truly gain
full access to the economic system. [Back]
15 U.S.C.A. §§ 1331,
1333, 1335 Chapter 36---Cigarette Labeling And Advertising.
Cigarettes are one of the most heavily advertised products in
ethnic communities.(1)Çards were
found to be highly concentrated in lower income and minority
areas, compared to few or none in the affluent areas. Nearly half
of the advertisements identified through the survey were in the
two poorest neighborhoods in the inner city. In addition, 54% of
the ads pictured Blacks compared to 25% that pictured whites.
Women in Leadership recommended that the District of Columbia
take new steps to control the proliferation of outdoor ads.
The organization also urged the business community and private
citizens to get involved to control advertising. Given the
disturbing statistics of focused advertising on minority
communities, I agree that more has to be done to control outdoor
advertising in such communities. [Back]
K. M. Cummings, Russell
Sciandra and James Lawrence, Tobacco Advertising in Retail
Stores, Department of Health and Human Services; Public
Health Reports 1991; 106, pp. 570-575. September, 1991.
The authors of this article conducted a survey of retail
stores in Buffalo, New York to assess the prevalence and type of
point-of-sale tobacco advertising. They chose tobacco because
cigarettes are one of the most heavily advertised consumer
products . The results were eye-opening. Two-thirds of the stores
displayed tobacco posters and 87 percent had promotional items
advertising tobacco products, primarily cigarettes. Very few
stores reported having displayed any antitobacco information.
Point of purchase advertising and promotion is an important
element in the overall sales campaigns of the tobacco industry.
Controlling such advertising is important for the industry
because ads and promotions are targeted to vulnerable
populations, that is the poor, teens, and minorities.
The authors stressed the importance of establishing guidelines
for responsible advertising of tobacco products in retail stores.
With heightened awareness of the ubiquity of tobacco advertising
in retail stores, the authors stress that citizen groups might be
organized to establish community standards encouraging retail
stores to adopt more responsible policies related to the
advertising and sale of tobacco products. Since cigarette smoking
is a preventable cause of death, the effects of focused
advertising is awesome. Something more must be done to eliminate
the effects of such advertising, especially in poor ethnic
communities. [Back]
Michael G. Lenett, Taking
A Bite Out Of Violent Crime, 20 U. Dayton L. Rev. 573, pp.
573-617, (1995).
This article stresses the impact that semiautomatic assault
weapons, and guns violence in general, has on the American
population. Such an article is important in this bibliography
because advertisements of guns are targeted toward ethnic
communities, and gun violence has a direct and adverse impact on
the health care system. The author of this article stresses that
gun violence is a multidimensional problem.
Semiautomatic assault weapons pose a multifaceted problem for
American society. Whether viewed from the criminological,
sociological, or epidemiological perspective, assault weapons
exacerbate violent crime, hinder law enforcement , burden the
public health care system, and disparately harm minorities and
the young.
Semiautomatic assault weapons pose a considerable public
health epidemic. Aside from the toll on human lives, the economic
and health care costs from gun violence are staggering. Moreover,
the effects of widespread access to assault weapons on youth and
minorities are devastating. The author concludes by emphasizing
that the assault weapons ban will lessen violent crime and
drug-related crime and will help ease the burden on the health
care system and on children and minorities. I agree with the
author's conclusions, however I think that his arguments can be
analogized to focused advertising of guns in general. The more we
do to eliminate the existence of guns, the more we do for our
ethnic communities and the health care system as a whole. [Back]
Robert J. Miller and
Maril Hazlett, The "Drunken Indian": Myth Distilled
Into Reality Through Federal Indian Alcohol Policy, 28 Ariz.
St. L.J. 223, pp. 223-298, (1996).
This article emphasizes the effects and reality of alcohol and
alcoholism in Native American communities. The authors point out
that according to the then most recent source, in terms of
mortality rates, those of the native population exceed those of
the general U.S. population for alcoholism by 332%. The Native
American population has become both targets and images used in
alcohol advertising. In the case of many tribes, alcohol
companies are also those most willing to sponsor cultural events
such as rodeos and parades.
The article cites another article that featured a thirteen
year old Native American girl in alcohol treatment. She described
how alcohol and alcohol advertising were a way of life from early
childhood. Another cited article described the 65th annual White
Mountain Apache Reservation Labor Day parade, where from the Bud
float, Budweiser mascots tossed fistfuls of miniature rolls of
lifesavers-style candy packaged to look like tiny beer cans to
excited children. The authors emphasize the need for the tribes
and other communities who are the target of such focused
advertising to take control of their communities. This involves
community participation and support. I agree that more must be
done to eliminate efforts by the alcohol industry to target the
most vulnerable populations. Focused advertising can have
detrimental and everlasting effects on the targeted communities.
[Back]
Thomas R. Burke, The
Economic Impact of Alcohol Abuse and Alcoholism, Department
of Health and Human Services; Public Health Reports 1988; 103,
pp. 564-568, November, 1988.
This article stresses the overall economic impact of alcohol
abuse and alcoholism in the United States. The author concludes
that the effects of alcohol abuse are as damaging to the nation's
economy as they are to our nation's health. He stresses the
impact of alcohol abuse on ethnic Americans. The figures are
distressful. Alcohol abuse contributes to the high health care
costs of minorities including, Blacks, Hispanics, and Native
Americans. Alcohol is one of the chief causes of illness and
death among those ethnic populations. Cirrhosis mortality rates
for Blacks are twice as high as the rates for whites.
In addition, alcohol-related illness and injury among American
Indians is three times the rate of the general population. He
concludes that if we could get a handle on the alcohol problem we
could, in addition to improving the health and quality of life
for millions of Americans, cut our expenditures for health care
dramatically.
Mr. Burke emphasizes the need to counter the impact of
alcoholic beverage advertising and promotion. The visibility of
the problem must be raised. I agree with his conclusions. Because
of the costs that are associated with alcohol abuse (for example
lost productivity and increased health care costs) there is a
need to reduce its negative effects. Since there is a direct
effort in this county to focus alcoholic beverage advertisements
to ethnic communities, there needs to be a direct effort by
Americans to counter this because the economic impact affects us
all. [Back]
Karen E. Meade, Breaking
Through The Tobacco Industry's Smoke Screen: State Lawsuits For
Reimbursement Of Medical Expenses, J. Legal Med. 17, pp.
113-141, (1996).
This article provides a candid overview of how some states are
trying to hold the tobacco industry responsible for medical
expenses incurred due to tobacco-related illness and disease. The
article explains how four states, Minnesota, Mississippi, West
Virginia, and Florida have filed suit against the tobacco
industry. Those states seek reimbursement for money paid through
state welfare programs to treat tobacco-related disease.
Often smokers are unable to cover the costs for treating their
smoking-related diseases and turn to their state welfare programs
for help. This has increased state welfare costs, burdening state
systems. States appear to be the better plaintiff because
individual plaintiffs have generally been barred from recovery
because juries find they assumed the risks of smoking. States
however can not assume those risks and have far more resources
than the typical tobacco-litigation plaintiff. In addition, the
fact the billions of taxpayer dollars are spent each year
treating tobacco-related illnesses my influence juries.
The author concludes that the tobacco industry must be held
liable for the harm caused by its products. I agree with the
article in that more must be done to help cover the escalating
cost of tobacco-related illness. Many ethnic communities are the
target of focused advertising of tobacco products. Those
communities are traditionally sicker and are thereby precluded
from attaining employment with adequate private insurance. As a
result, many members of ethnic communities are forced to turn to
the state welfare system for health care. Therefore, if focused
advertising is allowed to continue without regulation or
community resistance, state welfare systems are going to continue
to be burdened. Maybe losing a few lawsuits to the states will
make the tobacco industry reevaluate the current marketing and
advertising plans to ethnic communities. [Back]
Like San
Francisco, Los Angeles Sues To Get Health Care Money Back, 10
No. 8 Mealey's Litigation Report: Tobacco 17, (publication page
reference not available), August 15, 1996.
This report further explores the reality of suing the tobacco
industry to recoup health care costs, however, instead of the
state suing, here the individual counties are suing.. In its
69-page complaint, the county of Los Angeles contends that the
tobacco industry engaged in a conspiracy to conceal the harmful
health effects of smoking and made "patently false,
misleading, deceptive and fraudulent" statements on such
effects. In support of its argument, the county cited numerous
tobacco industry ads. Citing studies on tobacco use and
advertising , the county contends that the companies targeted
children and minorities with their advertisements and promotional
campaigns for cigarettes. The county put forth three causes of
action: breach of express warranty, unlawful, deceptive and
unfair business practices, and fraud and misrepresentation. The
county wants the tobacco industry to disgorge its profits and pay
unspecified restitution to the county for its health care
expenditures. This article further explores the impact focused
advertising can have on a community. Here, Los Angeles county
contends that the tobacco industry targeted minority and youth
populations. Hopefully the more negative attention the industry
receives about its marketing and advertising to ethnic
communities, the more likely it will change its focused
advertising campaigns. [Back]
Raymond E.
Gangarosa, Frank J. Vandall and Brian M. Willis, Suits By
Public Hospitals To Recover Expenditures For The Treatment
Of Disease, Injury And Disability Caused By Tobacco And Alcohol,
22 Fordham Urb. L.J. 81, pp. 81-139, (1994).
This article stresses the need to hold the tobacco and alcohol
industries responsible for health care costs, however in contrast
to the above articles, the authors contend that public hospitals
are the best plaintiffs in litigation and not the individual
states. Public hospitals are staggering under the massive burden
of illness caused by tobacco and alcohol. Public hospitals are
forced to absorb the treatment costs and risks for medically
indigent patients. Public hospitals are forced to subsidize
commerce of harmful products by absorbing the costs of the
products' health consequences. This contradicts the hospitals'
own interests in preventing disease, improving therapy and
treatment and competing with other hospitals.
According to a cited study by the CDC, Blacks, teenage girls
and people with a high school education or less continue to pick
up the habit of smoking or drinking. In addition, abusers of
alcohol and tobacco products are intensive users of health care
services, especially expensive emergency services. Patients
characteristically served by public hospitals are those living at
poverty level, without medical insurance, and having inadequate
social support. Minority and low-income populations are
comparatively heavy users of cigarettes and alcohol. These
populations are cited as more likely to use public hospitals.
Therefore, the authors emphasize that the preferred plaintiff
is the public hospital because it bears the costs of treating
disease and illness caused by alcohol and tobacco, but
experiences no economic benefit when a smoker or alcohol abuser
dies. Suits by public hospitals avoid the problem that a state
faces in the courts. When people die young from tobacco and
alcohol related disease, the Medicaid system is saved the cost of
treating them later. Early deaths do not save the public
hospitals anything. The arguments made in this article correspond
with the analogies I made in the above articles about the effects
of focused advertising. Moreover, I agree that the public
hospitals may be the preferred plaintiff in suits against the
alcohol and tobacco industry. [Back]
Jan Howard, An Overview
Of Prevention Research: Issues, Answers, and New Agendas,
Department Of Health and Human Services; Public Health Reports;
103, pp. 674-683, November 1988.
This article explores the effects of advertising on alcohol
consumption and the corresponding effort to utilize preventative
advertising campaigns to influence drinking behavior. The authors
specifically address how ethnic populations are affected by
advertising of alcohol--in particular Blacks and Hispanics. In
1988, Blacks composed about 12 percent of the U.S. population,
and Hispanics numbered more than 6 percent. Despite the sizes of
these two ethnic groups, relatively little research has focused
on their respective use and abuse of alcohol. In general, neither
the epidemiologic nor prevention efforts have addressed the wide
cultural diversity within the Black and Hispanic
populations.
Studies have revealed that Black men reported higher rates of
problem drinking than white men. Among Hispanic males, about 18
percent reported having one or more alcohol related problems.
Prevention strategies are discussed in the literature but not
from a research perspective. The authors point out that
prevention strategies should be designed with strong evaluation
components to determine what is effective and for whom. Careful
attention must be paid to the cultural values and social norms of
the target population. For example, among Hispanics, the
influence of the Catholic Church should be taken into
consideration. Likewise, religious beliefs and practices, the
family, and cultural heritage and pride play significant roles
among Blacks. I agree with the authors of this article in that
preventative efforts in the form of advertisements must be
tailored to the specific ethnic group in which is it suppose to
target. Hopefully, as the authors point out, more research will
be done on what can be done to effectively reach ethnic
population about alcohol prevention, and that the consorted
efforts of the alcohol industry in targeting these population
will be thwarted. [Back]
Mattew L. Miller, The
First Amendment And Legislative Bans Of Liquor And Cigarette Advertisements,
85 Colum. L. Rev. 632, pp. 632-655, (1985).
This article addresses the issue of whether liquor and
cigarette ads should be banned from the media. Proponents of such
bans, concerned about the effects of alcohol and cigarettes on
health and society, complain that the glamorous portrayal of
alcohol and cigarettes in advertising contributes to abuse. Those
opposing such bans fear that inroads on such ads will threaten
the economic base of the communications industry.
However, the author points out that the constitutionality of
such bans is often overlooked. The author argues that bans on the
advertising of potentially harmful substances such as liquor and
cigarettes are unconstitutional because they violate the First
Amendment rights of those who receive commercial messages. He
further argues that individual autonomy is infringed upon by
these advertising bans and asserts that the availability of
counter speech as a less restrictive alternative requires the
invalidation of nearly all such bans.
The author concludes the article by stating his belief that
all bans on advertising of liquor and cigarettes should be held
unconstitutional. He believes that such bans have only been
upheld in the District Courts because they have overlooked the
value of the First Amendment. He believes that counter speech is
the required less restrictive alternative. I can not say I agree
with Mr. Miller. I believe that it is up to the citizens to
determine what they want advertised in their respective
communities. If they do not want certain substances advertised or
want restrictions on those ads, then it is their right as free
thinking Americans to lobby for such bans. I think that
such bans in ethnic communities could help deter focused
advertising, and could help those communities reclaim their
citizens and help attain better health for their community. [Back]
Ahron Leichtman, The
Top Ten Ways To Attack The Tobacco Industry And Win The War Against
Smoking, 13 St. Louis U. Pub. L. Rev. 729, pp. 729-747,
(1994).
This article examines a strategy in which to attack the
tobacco industry's influx of advertising and promotions on the
American public. The article points out that smoking kills more
Americans each year than alcohol, cocaine, crack, heroin,
homicide, suicide, car accidents, fires, and AIDS combined
(citing a 1993 article in the JAMA). Tobacco is unlike any other
advertised product. The industry spent more than $12.6 million
per day (in 1993) using seductive imagery and high powered
advertising to associate glamour, athletics, success and sex
appeal with cigarettes. The author points out his belief that
this form of advertising is deceptive, false and
misleading.
The author sets out his plan for attacking the tobacco
industry. His suggestions include a requirement that newspaper
and magazines which accept tobacco ads to provide equal space for
anti-smoking groups to run pro-health messages. He also suggests
restricting the kind of tobacco ads and promotions that is
permitted by eliminating seductive imagery, the use of cartoon
characters and sponsorship of sporting events. He claims that the
only truthful images in cigarette ads would be showing dying
cowboys, yellow toothed teenagers, winded athletes, and cancer
patients; any other image lies. He points out that the industry
has continued to target children and people of color in its
advertising and promotional efforts.
I agree that more must be done to target the tobacco industry
in its shameless advertising. However, I do not think it is
economically feasible to require free counter ads to be placed in
magazines and newspapers. This could bankrupt many newspapers and
magazines because they would be required to give away for free
what they could be selling to a company for a profit.
I think that the best method of attack is challenging their
ads as deceptive, false, and misleading. I think that arguments
can be made to support this notion. In addition, I think that
banning the use of cartoon characters is well-founded. However, I
believe it is up to the effected communities and citizen groups
to start grass-roots movements to eliminate seductive and false
advertising. Community involvement and awareness appears to be
the best route to eliminating such advertising. [Back]
George White and Marc
Lacey, Liquor Industry Takes On Activists In Political Arena
Alcohol: Well-Funded Wholesalers Wield Power In Federal,
State Capitals. They Also Alter MarketingStrategies, L.A.
Times 1, (publication page numbers not available), December 15,
1992.
This article is the last of a two part series about liquor in
Los Angeles. This article focuses on the escalating conflict
about drinking's impact on the inner city. On the streets of
L.A., liquor stores are being blamed for drug dealing,
drunkenness, loitering and public urination. As the L.A.
residents struggle to shut down liquor stores, the National Beer
Wholesalers Association is trying to combat those groups. The
citizen groups are upset about the marketing of alcohol in the
inner city. Industry reps. acknowledge that they direct marketing
efforts at minority communities, but add that such promotions re
commonplace. The ethnic press is a major beneficiary of the
industry's outreach. Alcohol ads are second only to cosmetics and
hair products in Black-oriented publication, according to
"Marketing Booze to Blacks," as study be the Center for
Science in the Public Interest.
Although many financially strapped minority businesses and
organizations are more willing to snatch up the industry's
funding, others are beginning to question this flow of dollars.
Many community groups have sprung up to combat target
advertising. Numerous community and religious groups have banned
together to pressure the alcohol industry to eliminate alcohol
billboards and other ads and to dramatically reduce the sale
hours of liquor outlets. The article points out that around the
county, some companies have felt the impact of community
pressure.
I think that this article is the best of all the
"preventative measure" articles that I annotated. This
article stresses the need and the impact of community pressure on
industries that target their communities. Community involvement
is the best tactic for forcing focused advertising out of
affected communities, especially ethnic populations. When the
focused advertising is reduced or eliminated, then the affected
community has a chance to heal. In the case of harmful
substances, the targeted ethnic communities will have a chance to
catch up to the European-American communities in term of decent
health---which will allow those communities to better obtain the
economic necessities of life. [Back]
|
