Health Care Assessment

Emmanuela DeSanges-Sobia

                              Healthcare debates remain an especially important issue in the development of a country. The need for stabilization of healthcare continues to grow globally like an infectious tumor. Each country’s degree initiative when dealing with human rights is exposing the importance of human rights and why life expectancy rates rise when a country’s healthcare is stabilized and resources are affordable for everyone. The framework of the healthcare system of a country is an implemented social structure. Its institutions and systems ultimately say a lot about a country’s priorities and the country’s identity. Here the topic analysis of my research is maternal health care policies and demography. The unit of analysis is the United States compared to India.

Healthcare funding is set aside in a nation’s government budget and medical insurance is a vital expense in the lives of people. The fact that human life is not expendable in a society notes its conscientiousness’. The stratification of the moral aspect is then embedded, why do all things have to be protested in order to get attention. Women have yet to be given proper care. With puritan cultural beliefs was the United States was founded and as always blood is sacrificed, and the blood of those who sacrifice when they don’t have proper healthcare are the poor and the old. People die from illnesses that there are cures for because they don’t have the access to the resources in India and at times in the United States. This too harshly is the case for all nations that specifically need to make healthcare a priority.

                        During an observant and the birth era of westward expansionism for the United States Nathaniel Hawthorne (1850) an early American fiction writer famous fiction novel The Scarlet Letter would discuss moral dilemmas of adultery in a puritan society. The composer used education, health and nutrition, mind and physical state of the union. This negotiated a feeling of importance connecting women and the Americas the states. As for me, if the people are not healthy; nor is the state. It is a continuous fact that we are still at the set of the Gospel of Success stages here in the United States and abroad when dealing with Health care. As says the gospel of success there is an enormous and growing gap between the rich and the poor. The story is that one may become wealthy with enough hard work and determination, this Ideology was supported by Horatio Alger, a noted theorist. This idea of the Gospel of success still applies to today’s global discourse; it leaves out those who lack the personal funds to acquire the opportunity to do hard work and or mobile access to social services. In my discussion here we refer to what healthcare is. Shall only the rich and wealthy have access to healthcare? When looking at the social indicators of health and demography for these two traditionally different countries one must ask what is each countries place on the global discourse, Pierre Bourdieu’s Structures, Habitus, Practices (1974, 1980) asses a nation’s practices:

“Its conditions associated with a particular class of conditions of existence produce habits systems of durable, transposable dispositions, structured structures predisposed to function as structuring structures-.

The base reason why healthcare was formed is to provide medical services to people at an affordable rate and ensure medics were paid. A cost-effective way to provide health care coverage to all people is orchestrated. Each country’s form of government, socio-economic status, major religions, and major industries, even its cultural traditions help understand the consciences mode in which the healthcare structure is established. The governments of the United States and India are simply oddly at different development eras however there is a case and point regarding the importance of health care of the nation. They shadow each other as they perform similar functions securing the welfare and state of the procreative sector”.

United States form of Government

        The United States is bound by a set of bylaws named the constitution and comprises fifty states of one union. In the United States, the form of government is the federal traditional democratic roles of President, Vice President, Secretary, and treasurer along with the congressional and senate seats in addition to the judicial and federal state legislature, and the power of big business moguls. There is also the libertarian press system which keeps the country at an even quill. All these offices made for and by the people, allow a check and balance system. 

India’s form of Government

        During the sixteenth century, India through trading posts come under the subjections of European powers. European expansion in the name of conflict resolution amongst internal imperial powers in India infiltrated to end civil wars. Hence, implemented colonialism under the watch of Great Britain in the mid-1800s. As national military rebels failed to gain control of India from the British East India Company strict rules applied because of protest and the Crown of Britain directly governed India for almost another century. But after losing the first war, and suffering tremendously of poverty and instability in the early twentieth century educated barristers natives would form the Indian National Congress. Led by icon Mahatma Gandhi who is known for the quote, “be the change you wish to see in the world”. I may say it is evident that India saw its value as a prospective world economist.

        India’s people held national civil disobedience non-violent campaigns and were persistent as their forms of consciousness as a nation developed. As a result in 1950, India was granted its long yearned plight for independence. Thus India became a republic of states with new constitutions. Adapted from British rule, India has a parliamentary system of democracy where though the President is head of state; the government is governed by a Prime Minister. India comprises twenty-eight states and seven neighboring territories. There is a democratic government yet the central government exercises more power, children are sold because families cannot. The constitution is said to be the most exhaustive claiming India is a sovereign, socialist, secular democratic republic.

Although the United States and India differ immensely regarding the base structure of each country’s government each takes seriously their healthcare system. India is a developing country and the United States is an established one. As per the respected Oxford reference, Health laws consist of statutes and regulations, and judicial administrative decisions pertaining to the health of individuals and communities.  Raymond Williams in his (1959) article uses Marx’s ideology of a man-made superstructure which states that:

“Upon the several forms of property of a country, upon the social conditions of existence, a whole superstructure is reared of various and peculiarly shaped feelings, illusions, habits of thought, and conceptions of life. The whole class produces and shapes out of its material foundation and out of the corresponding social conditions. The individual unit to whom they flow through tradition and education may fancy that they constitute the true reasons for and premises of his conduct”. (Selected works 1. 272-3)

As Williams states there are various forms of approaching Marx’s theory of a determining base of a superstructure. For it depends on which class implements a structure within the nation, this then shows who benefits from the form of structure. The healthcare system to which a country is committed mirrors the country’s government. Health care development in a country addresses its legal and political superstructure which then corresponds with a country’s definite form of social consciousness and existence.

I do acknowledge that within each country there are provisions made to ensure health issues are taken seriously. That health services are administered confidentially and that resources are available for the wealthy class yet in the suburban area there are minimal resources. In order to prevent the spread of disease or high number mortality rates within the procreative sector of society; the expanse of health care professionals within each country work with human-rights organizations and professionals, in a respectful, constructive, and practical partnership. However, because of the high administrative cost of healthcare; especially for maternal health care, Millennium Goal 5 has stagnated. Common healthcare services which are supposed to be affordable have become too expensive for many already living within the poverty line to afford. 

United States Health Care origins

The origins of the healthcare system date back to the late 1920’s early 1930’s, during the era known as the roaring twenties. At some point during the mid-1920s in Dallas, Texas 1929 Baylor Medical Society born the First Insurance Plan. Hospitals had begun to perform medical surgeries and there were advances in science which consequently warrants that pharmacy medicine is advanced. For example, today we take for granted the groundbreaking discoveries of life expectancy changing medicines such as penicillin, and Insulin these discoveries changed and increased overall life expectancy rates.

“Throughout the 1920s, new technologies and new science led to the discovery of vitamins and to increasing knowledge of hormones and body chemistry. New drugs and new vaccines were released following research begun in the previous decade. Sulfa drugs became the first of the anti-bacterial wonder drugs saving thousands of lives from bacterial and viral infections. 

In 1920 Herbert McLean Evans discovered Vitamin E, and its anti-sterility properties, and Elmer V. McCollum discovered Vitamin D, its presence in cod liver, and its ability to prevent rickets, a skeletal disorder. Vitamins A, B, C, K, and various subtypes of each were also discovered during the 1920s.”

Therefore, to keep these medicines in stock and to continue funding medical research hospitals began to seek to service paying patients. Thus great middle-class American foundations formed the committee to stabilize medical costs; they created a national survey about medical spending. It became apparent that people could not afford to be ill because a week in the hospital was equivalent to a whole month’s pay, yet not everyone was ill at the same time. Medical expenses were concentrated on the healthy working-class, asking these people to join a pool to contribute to a social fund which created an insurance system that warranted their coverage if they were to get ill. Hospitals would be paid and there was medical coverage for all who did get sick. During this time the President of the United States was Franklin Delano Roosevelt, who sought to get the social security act passed along with national health insurance but his advisors told him otherwise. They advised President Roosevelt that state medical societies would rise up against him and block national health insurance and in turn derail the whole social security act. So President Roosevelt left national health insurance out of his initiatives. This worked out because patients were not the only ones suffering from medical bills, hospitals were too.

As the hospitals in the 1920s began to expand, building on new facilities took advantage of all the new technologies. Their hospital wards were full of patients who could not pay their bills, hospitals too could not pay their bills yet people were going to hospitals and getting well. The healthcare status of the country then improved yet economically strained hospitals still have to be paid so that these hospitals remain open. So the medical society in each state came up with a way to stay afloat, they collectively created the Blue Cross system. Which is actually the market-based policy practiced today.

It all started in Dallas Texas, when a former school teacher, a hospital superintendent brought his idea to the school board. Teachers were asked to join in and contribute a small amount weekly or monthly and hospitals would cover their medical needs for fourteen days each month this would be the first insurance plan. This plan proliferated and the blue cross-system was designed. It operated as a social insurance system; overall it was so that hospitals would get paid. Blue cross then began approaching large businesses, unions and implemented open-door policies. Over time the individuals who could afford a policy were granted one.

The government applied tax breaks, wage and the National War Labor Board monitored and regulated the efforts of organized labor during World War II, although the board would restrict wage increases and price controls it also encouraged the extension of many fringe benefits to American workers. These fringe benefits included private healthcare. Thus, developed is the system we have today, a system of private healthcare based on employment. Employers loved this arrangement, it created employee loyalties.   From the 1920s to the 1970s it worked, those left out were old and poor but in the 1960- 2000s, the government continue to develop Medicare and Medicaid. However, more than 50 years later. Private health care corps based on employment have overtaken the majority of Americans who are insured & getting healthcare from their jobs. Now post- Covid-19 pandemic the cost of providing healthcare is getting more expensive. The economy has been hit hard, unions are dwindling and employers are forced to relinquish employees, and those they keep employers provide minimal healthcare options.

The United States’ socio-economic status is tried as a developed country that competes globally. The economy changed and medical care is getting more expensive. Unlike the Model employers such as, General Motors which loaded its employees with good health insurance in the 1950s; half a century later model employers such as Wal-Mart today have not upheld these incentives for lifetime employees. They are competing with the global economy bottomless pit.

Schaffer H. Luke and Salmon Elizabeth, assess The Development of an Unequal social safety net: A case study of the Employer-based health insurance/noninsurance, (September 2009).

-The United States social safety net stretches thin the labor market inequalities rather than ameliorating them. They trace this theme with an important study of the United States determined superstructure of the healthcare institution. They discuss Habitus, in the United States of practicing the employer-based health insurance system. Employers became the dominant tax-preferred provider of health insurance in the United States without any federal legislative action. Understanding how this happened may reform efforts. This case study highlighted the two important factors; the first path is dependency, discussed by Skocpol (1992) and Pierson (2000). They argue that ambiguous divisions of power and pluralistic governance framework favor incremental processes of social policy formation in the United States. The second factor discussed is the divisions within the American workforce (Esping-Anderson, 1990). Divisions by race and sex have very often been left out or underserved by United States social welfare policy. Because of low-wage work, most are not covered by employer benefits, because they cannot contribute to the health insurance pool-.

The real foundation of the United States healthcare system is being shaken cracked. Employers cannot garnish enough profit to fund health care for their employees. While assessing I noticed that the United States Health care structure has approached a fork in the policy road. One policy leads the United States toward a Universal health plan with strong government involvement and the other policy supplements the already existing market-based health care choices and preserves the commercial health insurance industry. Maybe the single-paying system could work. That though the United States is opposed to a Socialist health care system, a consumer-driven health care shares components of the market-based system which allows patient choice that allots individual health saving accounts and increases cost-effective initiatives. These accounts are offered to employees as a means of increasing the cost-sharing of personal healthcare expenses. One must ask how much time will be wasted on Insurance driven bureaucracy; where doctors, insurance executive programs, lobbyists, and pharmacists profit but consumers don’t. Will the United States abandon earlier practices of pooling health care expenses across a wider community?

The Origins of India’s Health Care

The Indian health services maintain a separate agency within the Public Health Services. The infrastructure of India’s health care since the mid-twentieth century is traditional yet evolving into a shadow of the United States cash for the service insurance system. It is noted that in respect of all health indicators, the average figures for Tripura are better than the corresponding national average. India’s health care infrastructure is composed of the Ministry of Health and Welfare. The Bureau of health professions provides leadership in India as it is a developing nation. It uses the nation’s health personnel and resources; it administers training programs in the healthcare field. There is a shortage of doctors and it helps to instill access to health care facilities, services, and career centers.

The United States Socioeconomic status

“Preparing our nation to compete,” said President George W. Bush in his State of the Union message from January 31st, 2006, “is a goal that all of us share, we are seeing a shift in economical resources for the United States. The U.S. is now seeing new competitors like China and India, and this creates uncertainty”. The look space the United States has is that it holds in place a stable government. Agreeing, Richard H.K. Vietor How Countries Compete states that “there is an economic crisis in the United States. The “United States’ descent into deficits and debt despite high growth, low inflation, and outstanding improvements in productivity, the United States had developed massive fiscal trade deficits, with no savings to support them. The U.S has borrowed more and more from foreign savers, who consequently owned more U.S. assets and thus this has reached a major economic crisis. This then leaves the health of the nation in panic.

India socio-economic status

According to Vietor “India, a developing country needs to open up its doors; it lacks infrastructure and lack of foreign investments. India’s economic problems lie in the fiscal deficit. India has a fragmented democracy with ethnic and religious heterogeneity. The India debt to the GDP ratio needs to decline from its current level of 86%. Doing so may push growth to 9% annually and help moderate infrastructure while alleviating poverty”.

Traditional values of medicine in India

Unger Jean Pierre; Van Dessel Patrick; Sen. Kasturi, and DePaepe Pierre’s (May 2009) paper about International health policies and stagnating maternal mortality, ask “is there a causal link between weak healthcare practices and natural population growth rates”? They discuss progress towards Millennium Development Goal 5 on maternal health care. It appears to have stagnated in much of the global south. It is reported that 500,000 women die each year as a result of pregnancy or childbirth. They discuss the past fifteen years of international health policies.  That many countries are not making progress towards the efforts to reduce these deaths by ¾ by 2015. The demographic and health status of the maternal population is the question at hand regarding total fertility rate, crude birth rate, and crude death rates, natural growth rates, and maternal mortality rates in a country. Weak health systems, weak services, and low staffing levels and managerial weaknesses and lack of infrastructure and information cause this stagnation; then relates to the inability of some countries to meet two essential conditions. One is to develop access to healthcare for all people living within a nation. Every person must be capable of accessing essential comprehensive educational health services and healthcare. The second-all-nation states & government’s budget should be set to provide the not-for-profit sector with needed financial, medical, and technological support.

In the United, there are services set up for mothers and young children. There is free government-based insurance Medicaid; there is WIC which stands for women infants and children. It is federally funded health and nutritious supplemental program for pregnant women and their small children. This program provides educational materials for expectant mothers and child-friendly recipes.

The health status of the person in the United States is confidential, health insurance companies are not to share a piece of patient information with third-party members, common healthcare services are common but are not limited to routine physicals, including gynecology, immunizations, allergy injections, classes for quitting smoking, weight control and nutritional counseling, fitness test, message, and physical therapy, pharmacy services, and birth control counseling and psychological counseling. These are traditional day-to-day health issues in the United States. In the United States, a pregnant woman does not worry about ante-natal and postpartum care because there have been provisions implemented into the United States health care infrastructure to care for women and small children.

In India, women’s health is an important factor too. Yet, there are no provisions in the infrastructure of their health system for pregnant women. Women often receive minimal healthcare coverage. However, educating these mothers on how to provide for their offspring is a challenge. As diseases such as malaria and tuberculosis are prevalent in these societies and the morbidity rates are still high in India. There are various social groups and within the groups, age at marriage is an important factor in determining a woman’s health.

The social actor which contributes to the framework of improvement in health education and nutrition in Tripura reports the Indian National Fiscal health is “access to social medical resources. Service-2 was surveyed and 78% of the population reported the use of health services at the government or public institutions. This confirms that if nations are to see improvement in their national mortality rate, the structure of their health care services must improve.

  According to the Human Development Report (2000), the mean age at marriage in India is 22years old, childbearing age. The data within the report shows that the mean age at marriage has risen within the last years and most believe this is due to literacy enhancement. Tripura State is doing better than the national average; the national mean at the marriage of women now 22 years was higher than the national figure of 19 years. India’s public health society reports that pregnant women in Tripura, India as opposed to other states in India: “have a better chance of safe delivery because of healthcare developments and access to updated technologies. The question here is- Why do we question migration/ immigrants as they seek to find better health care opportunities? When all women want to get the chance of being supported and nurtured pre & post-natal.

Overall I deem that the healthcare status of a nation is its wealth. By addressing basic human needs such as clean and safe housing; access to healthcare and medicines for all citizens or inhabitants of the region; access to nutritious foods; equitable and quality education which lead to employable, knowledgeable man-power of the nation. I deem if we take Maslow’s law- and choose to apply it to ourselves and across the global communities, we will be a healthier human body.

Foster Care & the American Family

Emmanuela DeSanges-Sobia

Stability and Mentoring is the key to reaching a child

Triumphant stories of children who experience living in foster care are rare yet survival practices of these youth captivate the essence of human resistance. Very few succeed against all odds. Studies have been done to confirm that instability in foster care placements foster negative results. In order to overcome these challenges youth are in need of stability and positive role models, to serve as their mentors.

Foster care was intended to be short-term a temporary placement until children could return safely to their families or be adopted, but for more children, foster care has become a long term arrangement. According to the Federal Adoption and Foster Care Reporting System (AFCARS), in FY 2001 more than one-fourth of children in foster care had been in care for between two and five years; another 17% had been in foster care for more than five years. (Services, 2003)

The National Survey of Child and Adolescent Well-being Survey (NSCAW) have found that “placement stability over the first eighteen months of placement in care for adolescents is significantly related to permanency outcome”… (Wilson, March 17,2007)

In NSCAW, “Regardless of a child’s baseline risk for instability in this study, those children who failed to achieve placement stability were estimated to have 36% to 63% increased risk of behavioral problems compared with children who achieved any stability in foster care.” Wilson continues “the odds of a child being reunified with birth parents decline dramatically as length of stay (LOS) increases-children with behavioral problems have much lower reunification rates than Children without behavior problems.-Long (LOS) are associated with multiple placements. Almost half of children in care experience instability.” (Wilson, March 17,2007).

Why is stability important? It is important because it gives a sense of foundation. Stability fosters balance. Without emotional, mental and physical stability a child becomes dysfunctional. The Pew Commission on Children in Foster Care lends their expertise to express Foster Care Voices from the Inside. The forward of the report reads:

 “In the United States today, there are more than half a million children in foster care. The majority will remain in care for more than three years and live in at least three different foster homes. Some will stay much longer and be placed in seven more homes when tragedy strikes a child in foster care, the media and policy makers shine a spotlight on the Child Welfare Agency, Case Workers, parents, and foster parents. Sadly, that spotlight rarely illuminates some of the structural factors that limit the ability of a Child Welfare Agency to respond appropriately to the needs of children in their care. These include a financing structure that encourages over-reliance on foster care at the expense of services that might keep children safely out of foster care or move them more quickly to a safe, permanent home. Nor does the spotlight generally find the unsung heroes – the case-workers, foster parents who nurture and protect vulnerable children; the parents who overcome great odds and reunite safely with their children, and the children who show remarkable resilience in the face of profound and often prolonged difficulty.” (Gloria Hochman, Anndee Hochman, Jennifer Miller, 2005)

The Pew Commission on Children in Foster Care was formed in May of 2003, supported by a grant from the pew charitable trust of the Georgetown University Public Policy Institute. The Commission will develop practical, evidence-based recommendations to improve outcomes for children in foster care. (Gloria Hochman, Anndee Hochman, Jennifer Miller, 2005)

            According to Hoch man and Miller, the Commission expert analysis is done “by two prominent former members of Congress, Bill Frenzel (R-MN) and Bill Gray (D-PA), the Commission includes fourteen additional members who represent the range of stakeholders in Child Welfare including agency administrators, providers, state legislators, judges, foster youth, adoptive parents, and former foster youth”. They bring a wealth of experience to the table. The commission’s work is designed to improve the Child Welfare System. It’s distinguished for its work because its observation is of primary sources. The Foster Care Voices from the Inside report, examines the experiences of parents, adoptive parents, foster parents, and the children who experience living in foster care.

The Commission crafts recommendations in critical areas:

  • Improving federal funding mechanisms to help facilitate faster movement of children out of foster care and into safe, permanent home, and to help reduce the need for foster care;
  • Improving court oversight of child welfare cases to promote better and timelier decisions related to children’s safety, permanence, and well-being.

The report Commissions vow to concentrate on the cost of foster care. Hoch man and Miller reports, “We usually think of the cost of foster care in terms of dollars and fiscal implications. But those most involved with and affected by foster care-former foster care youth, parents and foster and adoptive parents- made it clear that the system exacts a daily price on their lives. In a six point thrust initiative the Commission vows to concentrate heavily on themes such as: the cost of insecurity, poor communication, inflexibility, the cost of not securing timely help, cost of professional burnout, and cost of stigma.

According to Chairman Frenzel, “improvements in federal financing and court oversight will enable states and communities to take steps necessary to improve outcomes for children in foster care”.

As the report reads, it is best that a foundation is created for the youth in care. Youth may search here and there everywhere, but if youth don’t get the support circle they fail to gain learn to trust. Youth and parents cannot champion these challenges of being separated. Parents who redeem their places in the lives of their children can attest to the importance of communication amongst all authorities involved. It’s alright to need help. It is alright to be need guidance. It is alright to fall yet it is up to each individual to get back up. It is up to the parent to spearhead the process of rehabilitation. If a parent fails to do so because of mental or emotional instability the child is primarily affected. However, when those who promise to provide a secure and caring environment for the youth in need fail to take their work seriously the youth suffer tremendously. The youth are on the track to face the biggest challenge of all trying to stay alive.

            In the Pew Commissions executive summary about Fostering the Future: Safety, Permanence and Well being for Children in Foster Care the Commission reports that there are; “Two issues are at the root of many of the problems that frustrate child welfare administrators, case workers, and judges as they seek to move children quickly from foster care to permanent homes or to avoid the need to place them in foster care in the first place. These issues are reforming federal welfare financing and strengthening court oversight of children in foster care.” (Gloria Hochman, Anndee Hochman, Jennifer Miller, 2005)

            A former foster care youth who worked with the Commission in finding resolve to issues facing foster care youth stated, “So, this is how it is in foster care, you always have to move from foster home to foster home and you don’t have any say in this and you are always having to adapt to new people and new kids and new schools. Sometimes you just feel like you are going crazy inside, and another thing, in foster care you are growing up not knowing that you can really be somebody. When I was in foster care, it didn’t seem like I had any choices for any future. All kids deserve families. They need a family, to have some-one, this is mother-they need a family so they can believe in themselves and grow up to be some-body. This is a big deal that people don’t realize. I wish every-one could understand.”

In correspondence to the six point thrust the guiding principles for the work of the Pew Commission’s executive summary- (Gloria Hochman, Anndee Hochman, Jennifer Miller, 2005)The preamble states that “all children must have safe, permanent families in which their physical, emotional, and social needs are met. When children are abused or neglected, these fundamental needs are not met. The recommendations of the Pew Commission focused on improving, the circumstances for children who are served by the child welfare system, whether in foster care or in their own homes. The Commission’s work was guided by the following principles:

  1. Firstly, children must be physically and emotionally safe and must be protected where ever they live. When children are removed from their homes. Public authorities have an obligation to ensure that they are safer in and out-of-home care.
  2. Secondly, children must have their needs met in a timely manner at every stage of public decision making about their futures.
  3. Thirdly, children must have continuity and consistency in care giving relationships, including healthy ties to siblings and extended family.
  4. Fourthly, children must have equal protection and care, including attention to meeting children’s needs in the context of their community and culture.
  5. Last yet not least, children and their families must have an informed voice in decisions that are made about their lives.

The New York City Administration for Children’s Services reports that youth in Foster Care are faced with many challenges and odds. According to New York City Administration for Children’s Services Preparing Youth for Adulthood manual (PYA), “It is nationally estimated that approximately, 20,000 youth per year leaving the foster care system are unprepared or marginally prepared to transition to adulthood.”

Mentors are in need because youth in foster care face unimaginable struggles which enable many to become productive members of society. The foster youth of America are in serious need of guidance and emotional support. Because permanent placement is rare many youth don’t get the chance to bond with caregivers. There is need for one to one mentoring programs to be implemented for the youth who need it. This idea is personally believed may decrease the number of unsuccessful discharged youth who enter mainstream society.

 Although there are many programs implemented such as Independent living skills which are funded by the state and implemented to provide youth with life skills training. Few youths take the available opportunity for upward mobility the rest fall through the cracks many youth fail to uphold the requirements to earn the stipend given let alone retain the programs initiative to guide the youths concerning the importance of education, health and hygiene care, maintaining a household and money management.

The proof such mentoring programs are necessary come from the New York City Adults and Children’s Services Preparing Youth for Adulthood (PYA) “which expresses that the New York City foster care system is home to some of the most vulnerable, and poorest young people.” Every day, these youths are faced with adversities such as, drug abuse, hunger, homelessness, gangs poor school performance, poverty, suicide, teenage pregnancies, unemployment, and violence.

Mentors who are consistent and will work within state bylaws to ensure a safety net for youths correspond with social workers, foster parents and educational personnel. Empowering foster care youth with wisdom, testimonies, networking and survival practices which coincide with the Preparing Youth for Adulthood six point thrust is a start in the journey of molding and shaping these youths. Concentrating on each individual youth and how each point best fits the youth at hand permits a foundation.

Youth are in need of permanent connection with caring adults, they need to develop the skills that will enable them to compete academically, mentally, and socially with youth who are raised with ongoing support from their guardians and loved ones. As the foster care youth learn from mentors the skills that will enable them to make healthy decisions they will be afforded great opportunities. These opportunities will allow these underserved youth to brew their education and personal development. In addition, youth will be encouraged to take increasing responsibility for their actions, their work and their life decisions.

 Mentoring reinforces each youth’s personal individual needs. Each youth’s needs may be met; youth will establish an ongoing network of support after aging out of foster care. Mentoring programs are to be designed to meet specific needs of America’s diverse foster care population. These mentoring programs should be designed to be successful and work towards positive outcomes despite all odds. This is one way to raise the percentage of youth ready to transition into adulthood.

My personal message to youth in foster care, In times of trouble or growth, seek out the experience of others on your team who have experience.  One of the greatest gifts of going through your personal journey is people who can serve as role models for us to follow.  “We do not want to become lazy, but to imitate those through faith and patience inherit what is promised” (BIBLE) Study and learn from people who are doing what you want to do. Your system of values will guide you as you are on your journey. But personal values are not created in a vacuum; they are formed in the context of community. “Let us not give up meeting together… but let us encourage one another.    

During research and due to personal relation to this topic one can attest that these trials and tribulations are hard to endure. Ones fervor for supporting youth in foster care comes from personal experience. As a youth in care there were many youth who fell through the cracks. Youth in foster care across the nation are in need of developing critical thinking, decision making and use of sound judgmental skills. These youth need people who are not afraid to shoulder the burden of helping a child in need. It is not a simple task. These youth need people who will give them constructive, instructive, criticism and honest feedback.


Gloria Hochman, Anndee Hochman, Jennifer Miller. (2005). The Pew Commission on Children in Foster Care. The Georgetown University Public Policy, Department Child Welfare. Washington D.C.: Commisioned by The Pew Report on Children in Foster Care.

Services, U. D. (2003, March). Youth and Famalies Childrens Bureau: Preliminary Estimates for FY 2001. Retrieved June 20, 2010, from Administration for Children and Families:

Wilson, D. (March 17,2007). Foster Care Out comes: Does Foster Care help or harm Childrens emotional and social development. CA Medical Consultants , 12~.

Case Analysis: Gun Control

Emmanuela DeSanges-Sobia

The Nature of Decision Making

The lack of restrictive access to private citizens purchasing guns used in massacres on civilians in American communities has brought light to the disparity between the existing access the general public has to guns and the original reasoning behind the 2nd Amendment. 

The 14th Amendment’s loopholes has issued unrestricted concerns for private individual access to gun ownership.   The Bill of Rights II Amendment in 1791 “A well-regulated militia, being necessary to the security of every state, the right to keep and bear arms, shall not be infringed. It was initially applied to the Federal Government. However, most recently it has been interpreted to grant the right of gun ownership to individuals for purposes that include self-defense. The actual condition of the United States Government- Recent Supreme Court Law evaluating Gun Law restrictions-  

The premier source of my analysis is an Amendment Review by Cornell School of law scholars.

Thus, the Supreme Court has revitalized the Second Amendment. The Court continued to strengthen the Second Amendment through the 2010 decision in McDonald v. City of Chicago (08-1521). The plaintiff in McDonald challenged the constitutionality of the Chicago handgun ban, which prohibited handgun possession by almost all private citizens. In a 5-4 decision, the Court, citing the intentions of the framers and ratifiers of the Fourteenth Amendment, held that the Second Amendment applies to the states through the incorporation doctrine. However, the Court did not have a majority on which clause of the Fourteenth Amendment incorporates the fundamental right to keep and bear arms for the purpose of self-defense. While Justice Alito and his supporters looked to the Due Process Clause, Justice Thomas in his concurrence stated that the Privileges and Immunities Clause should justify incorporation.

Recent case law suggests that courts are willing to, for example, uphold regulations which ban weapons on government property. US v Dorosan, 350 Fed. Appx. 874 (5th Cir. 2009) (upholding defendant’s conviction for bringing a handgun onto post office property); regulations which ban the illegal possession of a handgun as a juvenile, convicted felon.  US v Rene, 583 F.3d 8 (1st Cir. 2009) (holding that the Juvenile Delinquency Act ban of juvenile possession of handguns did not violate the Second Amendment); regulations which require a permit to carry concealed weapons. Kachalsky v County of Westchester, 701 F.3d 81 (2nd Cir. 2012) (holding that a New York law preventing individuals from obtaining a license to possess a concealed firearm in public for general purposes unless the individual showed proper cause did not violate the Second Amendment.) (Cornell University School of Law).

Let us start with what has happened over the past 48 hours. Perpetrator orders an assault rifle from a high-end NRA magazine without restriction. despite zealous religious beliefs, he was still able to access a weapon to kill and injure citizens. These horrific incidents question who is behind allowing these civil acts of terrorism. Is this acceptable? Congress needs to address these concerns, as they are representing the democratic republic. A republic which is suffering due to ineffective gun regulations and policies. Closing in on what the significant concerns are and who is paying the price for ineffective gun laws- Children and parents at places of worship, supermarkets, school, at movie theaters, mall, people at parties.

The American Government should apply effective gun control laws which are above and beyond other countries. Here is where we are globally in terms of gun violence. 

The pressures for legislators to put in place mandatory background check procedures need to come to fruition. The effective objectives-

⦁          Federal Government needs to issue strict policies on who can sell guns with federal license. This will reduce dealers as opposed to collectors and will subject both parties to conduct background checks and process applicants thoroughly before issuing a license for guns.

  • ⦁          Federal Bureau should continue expanding their manpower to train and hire personnel who are specifically trained to process background checks, 
  • implement technologies that require persons who own guns to use their fingerprints when a gun is in use.

⦁          Applicants to obtain guns cannot via corporations, entities or inherit them via trust.

⦁          The Department of Health and Human Services need to address regulations/policies for the FBI to assess applicants who have extensive manic or whatever violent criminal history. 

  • Or subjective mental health issues to prevent them from getting access to guns- its a safety concern.

⦁          Administration to put in place stricter regulations for reporting lost and stolen firearms. 

Expected ConsequencesPositives Less civil gun violence Stricter gun regulations Safer country Reframing regulatory standards pertaining to gun coNegatives NRA feeling lost of money. More Government over-sight Extremist testing Security of country
Gains and Losses for othersSafer Neighborhoods Thorough Background checksStricter Criminal Penalties Fewer Licenses issued NRA losses money
Self-ApprovalThis will allow many to be less fearful returning to work in the field. Sense of security, cleaning up neighborhoodsN/A
Social ApprovalApproval of families, communities in United States who have been affected by gun violence. Tourism boost for country’s economy Only those qualified through extensive FBI receive licensure to sell and own.NRA losing money Illegitimate gun sales off the internet Mental Health Assessments prevention for gun licensure. Accountability via expensive cost for lost stolen guns, firearms


Holzer, M. & Schwester, R.W., (March, 2011). Public Administration; An Introduction. M.E. Sharpe. ISBN: 978-0-7656-2120-7 ( pgs. 138-145)


Watch President Obama announce gun control initiatives at White House

Assessing the School to Prison Pipeline

Emmanuela DeSanges-Sobia

Race, class and gender have been a straightforward factor in the policing of schools, and how it affects minority students. This essay will examine the structural framework of school discipline, and the support needed to address the social needs of minority students. Why does the education system in America need to reframe school discipline, and implement social changes that reflect students’ academic, behavioral and personal challenges, in order to optimize their quality of life? It is to prevent the growth of the school to prison pipeline.

Regardless of the neighborhood which they come from, students enjoy learning new things. Human beings have an innate will to learn and explore. Schools should always have teachers who are appropriately trained to meet the academic needs of students. A productive learning environment entails safe and clean building infrastructure where schools are held, an administration which understands the service needs and culture of the population they are planning for, and teachers who are as stated above equipped to harken unto the plights of their pupil. Educators or teachers should understand the cultural, economic disadvantages and social challenges their students face. 

“What is education? Education is the social institution through which a society provides its citizens with important knowledge, including basic facts, job skills training, cultural norms and values. President and educational ambassador John Dewey believed in progressive education. He believed that education should serve as practical learning for students, and that students should be taught relevant skills to enhance their lives”. (Sociology,John J. Macionis; pg.537)

“The United States of America was among the first established civilizations in the new world to acknowledge the importance of educational institutions. The United States educational system instituted compulsory mass education, which is shaped and reflected by its influence of a democratic society. President Thomas Jefferson thought that the new nation would thrive as democratic principles implied that people should learn to read and understand what is going on in the world. However, crucial it is to have all people learn to read; girls and minority students as a whole were excluded from many academic privileges. Race, gender and class continue to be significant factors of exclusion for minorities”. (Sociology, John J. Macionis; pg. 537)

 Here in America, students are given formal instruction under the direction of “specially trained teachers”. A quote is placed on the specially trained teachers because many teachers lack the social and cultural training they need to appropriately guide or instruct students in impoverished neighborhoods. The impact that poverty has on a student with an economically disadvantaged education can be reflected in their attendance, behavior and attitudes. For starters, how can an educator work with a student who has not had a decent meal, who especially between grades 3-12 have confidence concerns due to abandonment, domestic violence,  neglect, or emotional maltreatment? A student who has not rested, is a student who is ill prepared to learn. 

When the above concept is coupled with the psychology behind Erik Erikson’s stages of development, students are prone to be critical of themselves.Common sociologist studies teach that, Erikson’s theory argues that adolescents compare themselves with others, and that most see a half empty glass as they seek to establish their personal identity derived from their family and social class standing. Therefore, concerns of an adolescent must be taken seriously as these concerns and how they’re handled mold them into adulthood. 

A teacher who moves from the suburbs or even one who comes from the urban area may be blindsided by the magnitude of assistance one student needs just to attend school on a regular basis, let alone complete homework tasks or find time to study. Many of these students are parentified at home; may lack proper nutrition; clean clothes to wear let alone a clean and decent place to sleep. Some young men opt to risk their rights to  an education because to them surviving the streets is key to succeeding at least short term, till gang violence or drugs overcome them, they risk it all just to provide for themselves and their families. 

 In New York State, Institute for Children Poverty and Homeless notes on their website that as late as 2011-2012 school year that “71,271 students were homeless. That means 6.9% of all students were homeless which was three times the nation’s rate amongst all states, these students 7 out 10 times were residing in shelters which are located in densely populated area. Which means they are attending schools that has reached its capta in enrollment. Graduation and retention rates are barely the nation’s 64% average hence, the educators are overwhelmed”.(

It is almost easy to say these teachers working with such students need additional training to be able to make these lesson plans incorporate or empathize with students personal struggles. These students lack self-esteem, in a sense self-esteem which is the foundational value of who a person believes they are, acknowledging their worth and values first begins at home. Most of these students may not have the positive feedback an individual needs from their parents to thrive and to acknowledge the importance of obtaining their education as a source of upward mobility. Education can become a valued equalizer amongst class, gender and race. 

The structural functioning analysis presented by John J.Macionis in his text Sociology, (Chapter 20- Education, pgs 521-537) discusses structural-functional analysis of education in America. At an academic institution students are given formal education which is essential to their place in society. Let’s look at role school plays in culture. The role schooling plays as a place to learn social skills,  which may be challenging, enjoyable and rewarding. Then discipline in schools and social control and how this affects a student’s long term development. John J. Macionis critical evaluation, states that structural-functioning analysis stresses the ways in which formal education supports the operation of a modern society. 

The following reading is found in Macionis’ text Sociology/John J. Macionis.-10th ed.(pgs. 521-537) “Structural-functional analysis looks at how formal education contributes to the operation of society. As the following analysis suggests, schooling does this in many ways- listed are his key concepts:

  • “Socialization: Technologically simple societies transmit their ways of life informally from parents to children. As societies develop complex technology, though, they turn to trained teachers to convey the specialized knowledge that adults will need for jobs and maintaining a household.
  • Cultural innovation: schooling creates and conveys culture, especially collegiate institutional research which may lead to discoveries in science or medicine. Which in turns strengthens environment biochemistry and findings improve life expectancy. 
  • Social integration: schools mold a diverse population into unified society. This integrative function is noted as important because the United States is a melting pot. This is one reason states enacted mandatory laws centuries ago as immigration increased- so that people understood the importance of education. 
  • Social placement: Schools identify and develop talent in students. Developing merit based systems to reward ability and effort regardless of race, social class or gender.” (Macionis, pg. 521)
  • John J. Macionis continues on to analyze the problems inherent in our educational system which ignores how schooling helps reproduce the class structure in each generation. By looking at the Social-conflict analysis these concerns are brought to light. The Social- conflict analysis is in contrast to the idea that schools provide a formula for upward mobility. Here Macionis argues that schools cause and perpetuate social inequality in several ways.( Macionis, pg. 522-524)
  • Social Control: Social-conflict-analysis suggests that schooling acts as means of social control, reinforcing acceptance of the status quo. Conflict theorist call these traits hidden curriculum, subtle presentations of political or cultural ideas in the classroom.
  • Standardized testing: A test strategically used to measure the academic ability of students in the United States. There is bias in the standardized testing as many minority students are not taught or know this society’s dominant culture.
  • School Tracking: Tracking is used to assign students to different types of educational programs such as gifted programs, college prep classes, general education, and vocational or technical training. Tracking supposedly helps schools appropriate instruction for students with different interests and aptitudes. However, educational critic Jonathan Kozol (1992) considers tracking one of the “savage inequalities” in our school system. Most students from privileged families tend to do well on standardized tests and get assigned to higher tracks, they’ll receive scholarships and other students do not get this privilege because they are not given the education opportunity. 
  • Inequality among Public schools: Given the racial imbalance of most urban areas compared to suburban areas- Funding for affluent areas offer better education value, the best teachers and opportunities. “

Schooling is not just about money. Macionis shares a classic report by a research group headed by James Coleman (1966) which is still truthful today- confirmed that predominantly minority schools suffer more problems, ranging from larger class sizes to inefficient libraries and few science labs. However, the Coleman  report suggests that although money may be provided it all boils down to the teachers, parents, and individual students’ drive for success. Rigid uniformity- meaning bureaucratic schools run by state funding generally ignore the cultural characteristics of local communities and the personal needs of their children ( Macionis, pg. 527).

However, the stipulations which hang over the doors of minority school districts is where the disparity lies, of course the students come in with baggage from their homes which pours into the school and this is from both sides of the fence. Students in a privileged neighborhood commit the same offenses on school property or grounds as under-privileged students and the consequences are far greater for the latter. For example, New York University Law students founded a project where students advocated for minority students who are given severe administrative suspensions at an alarming rate when compared to others. “NYU Law students founded SRP in 2007 to take on the “school-to-prison pipeline”—disciplinary policies that they felt were increasingly pushing at-risk students out of school and into the criminal justice system. Entirely student-run and staffed, SRP represents, at no charge, public school students facing long-term exclusion. The NYU-Student Representation Project Case Study reads that a student from Queens, New York; Naijab was given an unwarranted excessive suspension for a month in April of 2015”. However, through the effort and representation of SRP the student was represented in court and thus the charges were dropped and he was able to return to school. His collegiate dreams were not lost. Whereas many other students within the same school districts and those like it have not had the luck of being represented in court hence, they are sent through the school to prison pipeline.(

There are several sources of ambiguity causing disdain in our country’s educational system for students. For instance, adolescent minority students, especially from improvised neighborhoods attend underfunded schools. There are ambiguous concerns such as public schools neglecting to have the resources needed to implement counseling services, or meaningful educational formulas to address students with special needs (behavior, education or personal). In contrast to their counterpart students whose conduct reflect the same special needs (behavior, education or personal) students who are of different race and social class are given verbal warnings or counseling. Whereas, minority students are arrested on school grounds.  The unanticipated consequences of purposive social action to implement police presence on school grounds resulted in a vast number of minority students ciphering through what is known as the school to prison pipeline. 

There are facts which establish official municipal policy, the experiences of adolescents are not isolated incidents instead they are a part of a larger pattern and practice that exist within the New York City Public School Disciplinary system. Adolescent students from middle school to high school who become unruly are mis-handled by NYPD School Safety Division. 

The following is an excerpt, from the New York City Civil Liberty Union Court Records-  “United States District Court Eastern District of New York– plaintiffs are minor students -versus- defendants, City of New York; former Mayor Michael Bloomberg in his official capacity; former Police Commissioner Raymond Kelly in his official capacity; Assistant Chief James Secreto, in his official capacity; Sergeant Roslyn Downing-Lee, in her individual and official capacities; and School Safety Officers Kevin Mayes, and others whose names are withheld from the court documents hence, listed as Jane Doe, all in their individual and official capacities. Members of the NYPD School Safety Division engage in a pattern and practice of subjecting New York City public middle school and high school students to unlawful seizures and arrests by: (a) arresting students for minor violations of school rules that don’t constitute probable cause of criminal activity, and removing and holding those students off school grounds, often at police precincts; and (b) handcuffing students and detaining them in seclusion rooms in school buildings for minor violations of school rules that do not constitute probable cause of criminal activity. Students who are arrested are then removed from schools, typically in handcuffs, and held at police precincts, or transported to hospitals for emergency psychiatric evaluations in the absence of any legitimate cause for such evaluations. In addition, upon information and belief, a significant number of school children under the age of sixteen have been arrested at school for allegedly having committed non-criminal violations even though such arrests are prohibited by state law. During some of these removals officials use such excessive force injured students may require medical care or hospitalization.” 

Continued points discussed in court petition # 4-In recent years, New York City has drastically increased the deployment of law enforcement personnel to patrol its public school hallways. Since the adoption of a Memorandum of Understanding (MOU) transferring school safety responsibilities from the New York City Board of Education to the NYPD in 1998, the number of police personnel assigned to patrol New York City public schools has grown by 73 percent, even though school crime was declining prior to the 1998 transfer and student enrollment is at its lowest point since the past decade.

Point 5. The NYPD School Safety Division constitutes the 5 largest police force in the country, with more officers than the police departments in Washington, D.C., Detroit, Baltimore, Dallas, Phoenix, Boston, or Las Vegas. New york City deploys more School Safety Officers than guidance counselors: there are over 5,200 police personnel in public schools and there are only approximately 3,000 guidance counselors.  

Research demonstrates that law enforcement agencies frequently fail to account for the ways in which policing students in public schools differs from policing adults on street. A study commissioned by the U.S Department of Education found, “One of the most frequent and destructive mistakes many programs make is to fail to define [law enforcement’s] roles and responsibilities in detail before or even after- the officers take up their posts in schools. When programs fail to do this, problems often rampart in the beginning” (http://www.nyclu.org8/2016).   

In conclusion, whatever course of action taken by officials on school grounds to remove or handle unruly, frustrated students- the official should also think of the student need to be allotted their American Civil Liberty to an education. As Bolman and Deal discussed the two central issues concerning basic structural tensions, one being structural design: how to allocate work (differentiation) and how to coordinate diverse efforts after parceling out responsibilities ( integration). The division of labor-or- allocating task is the keystone of structure. (pg. 49) It is important for school officials to revise the concerns of the school to prison pipeline.

Every school should create a crisis team to address the needs of unruly students. Within the petition students’ grievances include plight for resolution. Request includes: a) Development of guidelines to ensure that school children are not unlawfully or inappropriately arrested; b) ensure that school administrators have an appropriate;role with respect to the maintenance of school safety, including by mandating compliance with state law requiring regular communication between building officials and police personnel; and c) implement improved training for members of the NYPD School safety Division with respect to the use of power to seize and arrest, and the use of force in the context of interactions with school children in New York City public middle schools and high schools.

The petition should also request specialized diversity training and behavior modification training for educators teaching at public schools. It is imperative that there are school social work behavior modification specialists available to assess and make appropriate diagnoses and or referrals. It is important that the New York City School system implement these specialized roles to get the important task of providing students from all social backgrounds race, gender, or class all respect due to obtaining a decent education. Why is it important to provide students across the board a wholesome educational experience? Because the students today are the administrators and educators of the generation to come. They are tomorrow’s America.


1-Macionis, John J. Sociology/John J. Macionis-10th ed. 

P. cm.

Includes bibliographical references and index. ISBN 0-13-184918-2 (alk.paper)

  1. Sociology. I. Title

HM586. M33 2005

Chapter 20, pages. 521-537

2- B.H., on Behalf of her minor daughter D.B.; V., The City of New York; Mayor Michael R.Bloomberg, in his official capacity., Dated 11th day of June 2010.  Vol.Amended Complaint 10 CV 0210 (RRM) (ALC)., New York City Civil Liberties Union.

3- Bolman, Lee G. Reframing organizations :artistry, choice, and leadership/ Lee G. Bolman, Terrence E. Deal. Fifth edition. Pgs. 47-50 
5. (


Faith, the various roots planted by seed of love, commitment, compassion and gratitude. Self worth, economic valuation. One seed at a time eventually sprouts good harvest. It is vital that one is capable of nurturing each seed at once and learn the art of balance.

What is mustard seed faith? It’s trusting that all will fall into place in due time. Its taking a few steps back and self evaluating. It is a roar, a song and dance when after all is said & done, the long nights, the fights, the health scares, the losses the grief you still have hope it will get better . It is all the other human intangibles. All the things I can’t explain yet have endured. Have molded me into the person I am today. My faith allowed me to develop patience. Having mustard seed faith is believing in a greater tomorrow.

I’ve come thus far because I had a small village of support. Just as I acknowledge there are scholars in need of a reason to have hope and believe in a greater good.

I encourage you too practice #Perseverance through flight or fight mode; making time for #Selfcare in-spite of being overwhelmed. I acknowledge #Compassion for others-stop and listen, share a kit-kat or donate a hat. Being teachable & practice #Humility we do not know everything nor will we ever become desensitized to another persons plight for advocacy or assistance. I am forever learning #teachable.

#Desfosterhope has mustard seed faith that those interested in ioining the conversation for effective change, & developing #SMARTGOALS for individuals & together as nation.

Fostering hope?

“A few months ago, I shared with you, & with some parents my journey as a foster youth . I was asked several questions regarding different experiences in foster care programs. Later I will provide some insight into my journey in foster care programs. Be mindful, this is my own experience.

“In quoting others, we cite ourselves.” — Julio Cortázar

As a youth in care- as a youth independent of care. Transitioning into adulthood and living this adult age having experienced care. The indefinite goal is to inspire youth living experiencing adversities and challenges. Learning from others, I take life one day at a time. ” Emmanuela DeSanges-Sobia


Destined to persevere inspite of circumstance.