Realtors Want Housing For All

By | Homelessness, The Race to End Homelessness | 2 Comments

How do you experience homelessness? I wrote several months ago about the preferred terminology for homelessness; that “people experiencing homelessness” is a better phrase than “homeless people,” because it reminds us that homelessness is a condition – hopefully a temporary one – and not a defining characteristic. After further consideration, I think the phrase applies to all of us – even those of us who are lucky enough to have our own beds and roofs and keys to the front door. I have never experienced homelessness, but my experience with homelessness – meeting people who have lost their homes and their families and their health due to lack of affordable housing – makes me want to end this issue. I know many social workers, case managers, and shelter employees that are passionate about ending homelessness because they (we) interact with individuals experiencing homelessness every day. Sometimes I think we exist in a nonprofit bubble, believing that our peers in other lines of work cannot understand the realities of homelessness, or the importance of ending it. This is inaccurate.

For Cindy Eich, experiencing homelessness didn’t involve seeing a family member lose housing or encountering someone panhandling. As an Illinois Realtor, she started seeing not only people without homes, but homes without people. In 2011, Eich remembers “we were showing properties that were foreclosures and it was obvious that families had lived in those homes.” Motivated by the empty dwellings she saw, especially those that used to have children in them, Eich created Realtors Against Homelessness in 2011 and has since held multiple fundraisers in her community, the last of which raised $25,000.

This week in Florida, the state’s largest professional association – realtors – gathered at a conference to discuss how they could help end homelessness. As Florida hosts the third largest number of individuals experiencing homelessness, this is a crucial issues facing the state. The group has advocated for Florida legislation that supports individuals experiencing homelessness and provides more funding for rentals and home ownership.

In an era when politicians, business owners and plenty of private citizens attack and berate individuals for being homeless, it is refreshing and promising that this professional organization supports ending homelessness and is working to make that happen. People experiencing homeless are not a likely group to utilize the services of a realtor, so there is an obvious disconnect between realtors making a financial profit and helping this population. Their commitment to doing so demonstrates how important a home really is – the professionals who dedicate their careers to knowing the details of housing see how important having your own place can be, and want every person to have this as an option.

Our professional lives connect to homelessness in ways that aren’t always obvious. For one realtor, selling a foreclosed house was her experience with homelessness. For others, it may be serving homeless clients or treating homeless patients. Our experiences with homelessness are wide ranging, but until we see the end off this social issue, it will impact us all.

 

Hashtag: #EndingHomelessness

By | Homelessness, The Race to End Homelessness | 2 Comments

You won’t find out what I’ve done today by checking my facebook statuses. I’m comfortable with social media, but I try not to get too comfortable. No “woke up, ate eggs, went to work, looks like it might rain” information from me. I’m on the quieter side – both in real life and when it comes to posting what I’m thinking about, which is perhaps why I struggle when I see my friends and colleagues use their twitter feeds as a platform for social advocacy.

As #Bringbackourgirls, the hashtag protesting the kidnapping of more than two hundred girls in Nigeria, exploded this past week, I wondered if I should be tweeting the same thing. I read up on this travesty, and felt outraged at this human rights violation, but I struggled to connect how my tweeting – even with a hashtag used by hundreds of thousands of other users – might lead to justice half a world away.

This week, Twitter made an announcement that really connected the dots for me, and showed how a platform made up of 140 characters can make a difference online and off. The microblogging giant announced plans to open and operate a tech center for individuals experiencing homelessness in the San Francisco area. Computers are increasingly relevant to the job market, both in finding available job opportunities and in possessing basic computer skills, but poverty creates a “digital divide,” and people from lower income backgrounds have less access to computers as they grow up, making the internet a scary place.  The space, called the Twitter Neighborhood Nest, will be open to individuals as well as families, with tech skills offered to any age group. For adults, this will include computer literacy as well as job searching skills.

Twitter is the place for the newest information, where the news is splayed across your screen in tiny snippets. So it is perhaps somewhat surprising that the platform for all things instant is partnering with a service organization that is more than a century old. Compass Family Services will work with Twitter to create the new technology center, as the nonprofit currently coordinates services for more than 3,500 individuals experiencing or on the brink of homelessness.

This partnership is an excellent move, one that gives The Twitter Neighborhood Nest a strong foundation. This seems to be much more than a one-time donation or a publicity move, because Twitter has sought input from people who know the demographic they hope to serve. Partnerships – especially the unlikely ones – are the key to having enough knowledge and resources to overcome the digital divide and overcome homelessness.

 

No Need for Spring Cleaning

By | Homelessness, The Race to End Homelessness | 6 Comments

I used to save everything. Clothes I’d never wear, old schoolwork, books I’d read already. I was a pack rat, and this continued right up until I had to move to college. And then move to Baltimore. Now, as I start my next apartment search in the city, I’ve already begun inspecting my belongings with a critical eye. The idea of hauling everything I own – even to the next neighborhood – makes me cringe.

Because things cost money, we obviously equate possessions with wealth. But clutter doesn’t make me feel wealthy, it makes me feel tired and overwhelmed. My most important possession isn’t my best item of clothing, my favorite photo album, or even my wallet – it’s the fact that I have somewhere safe to keep these things so that I don’t have to keep them on my person every moment of the day. If I wear one dress to work, I don’t worry that the rest of my closet will be empty when I come home. When I take a shower, I don’t worry that anyone will grab my credit card.

Experiencing homelessness not only leaves an individual without shelter, it leaves their things without any place to stay. Certainly, learning to minimize our dependency on “stuff” is an important lesson, but what if that comes down to deciding to carry my winter coat all July, or to hope to come by a new coat next October?

When I read about a Texas couple who went on a 21-day trip across Europe but packed nothing (just passports, no clothes, no dental floss), I was intrigued by the story, but not exactly sure what they were trying to prove. Twenty-one days is a long time without your favorite sweatshirt, but both of these travelers knew their possessions would be waiting for them upon their return home. Living freely is one thing, but it takes a significant level of privilege to leave one’s things behind and trust they will all be there when you’re ready for them.

In Florida, the example of the winter coat might not be as relevant, but if a person carries their belongings with them everyday all over the city, they are probably important to them. That’s why it is so concerning that a new Florida rule will strip homeless people of their possessions if they leave them for 24 hours. After that, the individuals can pay a fee to get them back, or lose them to the Ft. Lauderdale police.

It is true that many people experiencing homelessness have storage units, or have friends and family who can keep their things for them, but even these individuals may have to go several days without access to their belongings, and must choose what to keep on their person. If you had to leave behind your physical house, closet, bookshelves, and photo albums, what might you take with you? Maybe something to remind you of a happier time, or an appliance that represents the hope that you will one day again have your own place. Maybe you’re very practical, and you take clothes to keep yourself warm and soap to keep yourself clean. You probably take your photo ID and some money.

No matter what you have, it probably isn’t something you want lost or ruined. In Hawaii, one man doesn’t care what possessions they are; if they belong to a homeless person, he’s going to destroy them – with a sledgehammer. Tom Brower, a Hawaii state representative, travels his district and destroys the shopping carts people experiencing homelessness use to transport their belongings.  He does it, he says, because homeless people “disgust” him. (But apparently people roaming around wielding sledgehammers is not cause for concern.)

While Brower is busy with a sledgehammer, several cities have begun to offer storage units for people without housing. Portland and Washington D.C. are among the latest to provide some refuge for the stuff that is important to its homeless populations. These differing approaches show which cities are committed to good ideas and ending homelessness – and which need to throw away not belongings, but their current policies.

Perspective of the Poet

By | Homelessness, The Race to End Homelessness | 6 Comments

April is National Poetry Month. If poetry is the kind of thing you associate with Dr. Seuss or college kids at a coffee shop open mic, you are missing out. I’m no poet myself, but as a consumer I find that one of the most important elements of any artistic pursuit – poetry or otherwise – is the perspective of the artist. 

I invite you to absorb these pieces crafted by individuals experiencing homelessness, as they can explain their situation in a way no one else can. Starting with an untitled piece by Scott Abbott, which speaks about a day of homelessness in ways I hadn’t considered before:

Ankles and shoes, ankles and shoes,
Submerged beneath the financial news,
A coin may be flipped, a coin may be tossed,
A soul self serving, a breakfast of frost,
Memory fragments, drew down the curtain,
Breath still exhaled, reasons uncertain,
Herds of strangers with familiar laces,
Test acoustics of a concrete matrix,
Intruding upon a homeless muse,
Left with the vision of ankles and shoes.

To me, this poem’s imagery reminded me that too often, passerbys don’t make eye contact with people sitting or living outside, only leaving them to see our ankles and shoes as we walk away.

This next poem, an excerpt from “Dark Waters,” is only one of many from a collection by James Allison. Homeless for two years, Allison lived and wrote in his truck until a friend offered him housing. Once stably housed, Allison compiled his works and had his collection published.

Tired of false hope and false promises
and a future that is anything but secure
I am ready to leap into the dark waters
and take my chances
in what could be my only hope
of survival

He is currently housed, employed, and in good health.

I’m not the only one who has been impressed with the work of an individual experiencing homelessness. Three years ago, during Poetry Month 2011, Shalla Monteiro befriended a man living in a pile of garbage in Brazil. The poet, Raimundo Arruda Sobrinho, had been homeless for nearly thirty-five years, but he wrote poetry every day. Impressed by his writing, she started a facebook page to help get his poetry collection published.

The page attracted many fans of Raimundo’s work, including a man who already knew him – his brother. After losing touch for more than fifty years, Raimundo’s brother contacted Monteiro through her page and reconnected with his sibling.

Now Raimundo lives with his brother- and is working on publishing his work. You can get regular updates on his writing process via his facebook page and see his story – and some of his work – here:

April may be ending soon, but I invite you to read poems written by people with all perspectives – if you love poems, you can find something great. Even if you think you hate poetry, this form of writing is the one in which some people communicate best. This is your opportunity to hear them.

Homelessness, Have You Heard of it?

By | Homelessness, The Race to End Homelessness | 2 Comments

Do you know the kinship you feel when someone mentions your favorite obscure band, or makes a reference to a movie you thought you were the only person to have ever seen? That feeling that someone else stumbled onto this awesome music/movie/media on their own, and now you can discuss it? Sometimes that’s how I feel about the issue of homelessness.

I realize that’s an odd thing to say, since I work in homeless services and read articles on homelessness and even write about what I’m learning, reading, and thinking here in The Race to End Homelessness. I just mean that outside of those dedicated circles, it seems as though homelessness is an issue people are uncomfortable discussing. Telling people about my job at parties will often send them heading for the snack table, or at least grasping for a subject change.

That’s why I was surprised when I read the United Nations April 2014 report that criticizes the United States for several often discussed controversial policies – Guantanamo Bay, NSA surveillance… and one less publicized issue – the poor treatment and criminalizing of Americans experiencing homelessness. It wasn’t just that the content of the report that stunned me, (although the findings are quite astounding) but rather that the issue of homelessness is finally a talking point at an international level.

Of course it would be preferable if this were an issue the U.S. could address domestically and not be embarrassingly criticized on an international stage, but as long as criminalizing those without a home is a problem that persists in the United States, it deserves worldwide attention. If the United Nations committee on Human Rights calls a practice, “cruel, inhuman, and degrading treatment,” will we see change in the way cities treat homeless individuals? Approaching homelessness as a crime has been consistently demonstrated not to work, illustrated most recently by James Boyd, shot multiple times for camping in the mountains of Albuquerque, and Jerome Murdough, imprisoned for sleeping in a New York City stairwell and then left to roast in a 100+ degree jail cell. Even so, many cities and policies seem determined to prove that homelessness is wrong via arrests, fines and other punishments. Instead of sticking a homeless person with legal charges or bail that will keep them stuck in poverty, the UN report recommends state and local governments “ensure close cooperation between all relevant stakeholders … to intensify efforts to find solutions for the homeless in accordance with human rights standards.”

It is my hope that the United Nations recommendations will not be the last international look at the treatment of those experiencing homelessness. We need this issue in the news, in the UN committee reports, and on the minds of government leaders and individual people. Criminalizing homelessness is an issue that threatens the lives of hundreds of thousands of vulnerable American people, and it is too important to have it be an obscure issue we are uncomfortable discussing.

An Immodest Proposal: A Better Bet for Warren Buffett

By | An Immodest Proposal, ChangeEngine | 7 Comments

The trouble with poverty is that there’s no money in it. Unlike, say, NCAA basketball – a business worth almost a billion dollars a year. And though Warren Buffett’s cash was safe long before UConn cut down the nets on Monday, the world’s fourth richest man was willing to shell out a billion dollars of his own should any of us have come up with a perfect tournament bracket. Shabazz Napier, the transcendent point guard who led UConn to victory and helped make the school, its sponsors and the NCAA hundreds of millions of dollars, struggled during his time there to afford food. In the United States, one in six people and a quarter of all children go hungry, and almost 50 million Americans live in poverty. Globally, hunger kills more than three million children a year and over a billion people live on less than a dollar a day.

So here’s an immodest proposal: why not make poverty pay? Or, to put it more precisely, why not give eradicating poverty some clear market value? If Buffett is willing to reward a lucky guess with an astonishing fortune, how about a billion bucks for the person who alleviates the wretched conditions of the most unfortunate? Why is that not a bet worth making?


As it stands today, the fight against poverty is driven by charity and goodwill. Any kind of profit motive is considered unseemly. Helping the poor is a testament to how much you care, in which effort and good intentions are applauded no matter the result. It’s where scoundrels go for redemption and goodie two-shoes go for a spit-shine ethical polish. If we fail, no-one loses, other than the poor of course. It’s not as if anyone’s going to lose a billion dollars over it, or a shot at a billion dollars.

There’s no doubt that anti-poverty crusades are noble, Buffett’s own efforts included. But while we’ve made gains in reducing global poverty (largely due to China’s industrialization), this system on the whole doesn’t work very well. How could it? It’s based on the kindness of people’s hearts, and kindness doesn’t pay the bills or get me a shiny new iPad. That’s not a condemnation; it’s just a fact.

The profit motive is one of the most powerful forces known to human history. It drives capitalism, moves mountains, and conjures fierce competition, economies of scale, creative destruction, iconoclastic visionaries and innovative ideas. Some would say it’s the cause of poverty in the first place (including Buffett’s own son) but good luck extirpating it. Instead, why not try to harness it?


So how would this work? Well, pick a metric. Any metric. Malnutrition, household income, a solid roof over a child’s head – whatever suits your fancy, or a billionaire like Warren Buffett’s. That metric now equals revenue – this much poverty reduced equals this much money, like a bounty for the death of a rogue gunslinger or a unit price. Appoint an auditor to impartially determine whether gains have been made. Pool the money from as many billionaires and corporate behemoths (and governments) as necessary to create the payout fund. Announce, award, repeat.

Before this starts to seem implausible, consider the precedents. The Google Lunar X Prize will award $20 million to the first team to land a robotic spacecraft on the surface of the moon. We’ve spoken in this space before of the need for a moon-shot for justice, “a space race for social change.” Well, what’s more worthwhile? To put one small unmanned drone on the moon or take a giant leap forward out of poverty for all mankind?

Only that space race can unleash the energy and ambition we need to radically impact poverty. Whether it’s cheap, sustainable generators for the developing world, a farming system, or a jobs scheme, the prospect of riches would attract the best and brightest and encourage the most effective and efficient solutions so as to maximize profits. Entrepreneurs could take on venture capital in anticipation of reaping great rewards. “Social return on investment” would finally have real meaning rather than a fuzzy feel-good vagueness. Anti-misery magnates and transformative tycoons would take greater risks and try bigger ideas. Wheat would separate from chaff.

As one participant at the Ashoka Globalizer on Economic Inclusion said: “wouldn’t it be great if ‘billionaire’ was re-defined to mean someone who had improved 1 billion lives?” Yes, but wouldn’t it be even better – and a greater incentive for greater solutions – if that person could make a billion dollars from improving those billion lives? It seems odd that the rewards for helping to rid the world of the scourge of poverty should be dwarfed by the proceeds from creating the Shake Weight or the ShamWow!.

The Nobel Peace Prize cash award won by Muhammad Yunus was about a million dollars for a lifetime of battling poverty. Warren Buffett makes more than that in an hour. The Hult Prize gets closer: “the annual competition aims to identify and launch the most compelling social business ideas—start-up enterprises that tackle grave issues faced by billions of people. Winners receive USD 1 million in seed capital…” But that’s still chump change. And for the most part we get this: “By taking part in Activities, students can earn points on their way to become an Anti-Poverty Crusader. We will share the hard work of the winning school via our website, email database and social media. In addition, your school will receive a framed copy of one of the photos featured in the Make Poverty History photo exhibition.” Hardly a Lamborghini and a solid gold jet, or the cover of Forbes magazine.


Think of all the anti-poverty start-ups that might emerge if kids knew those points could be profits. Better yet, think what a person living in poverty might do if we weighted the rewards even more greatly for the poor to create those businesses and ideas themselves. There’s nothing to be lost with this model – the risk is entirely on the entrepreneurs and their backers; no results, no payout. Sticking with the current system is far more of a risk. The poor will continue to rely on the largesse of the rich and languish in the back of our minds as a guilty afterthought. Selfishness will run rampant and charity will continue to be seen as a speeding ticket or a piddling penance on the way to acquiring sybaritic fortunes.

Solving poverty is currently a hobby of the wealthy, let’s make it an industry for the innovator. Let’s make it everyone’s business, and whether or not it’s our problem, let’s make it our profit, until there’s nothing left to gain. Let Warren Buffett bet us all that we can’t eradicate poverty and have him pay out for our million and billion-dollar ideas. On reflection, the wealthiest might consider this quite a modest proposal. Because the only other solution for the poor masses gorging on the air promise-crammed and told for centuries to eat cake might just be to eat the rich.


Smokescreen

By | Health, The Global Is Local | One Comment

America still smokes.

Just under 20 percent of us are regular cigarette smokers, although there is a lot of variation by gender and race (higher among men, lower among Asian Americans, for instance).

This is not a post about the evils of tobacco, the high health care costs associated with it, or even the socioeconomic patterns common to most addictive drugs that are so frustrating for public health workers.

Instead, one might look at this post as a reflection on the entrepreneurial spirit and technologically cutting edge strategies of tobacco companies, and the policies that are growing to address new growth in the industry.

This is a second golden era for tobacco users. It’s almost as though the 1950’s have taken a ride with Marty McFly and arrived in a world where pipes, chewing tobacco, and cigarettes might be frowned upon, but e-cigarettes, “smokeless” tobacco, and hookah lounges are embraced by hipsters, Fed Hill club goers, and baseball audiences alike. Despite the smoking bans enacted around the country (and locally in 2007), the broad range of new tobacco products on the market are also a dream come true for today’s youth. While my peers were limited to a traditional variety of options – basically cigarettes, maybe cloves for the cautious, maybe cigars for the adventuresome – middle and high school-age kids these days have a veritable smorgasbord of options including lots of fruity flavors. Paradise! According to the CDC, there’s been a big uptick in use of those little cigars – often with delicious flavoring – by the tween and teen set, since they can be bought individually with lower taxes and more flavors than cigarettes, and with fewer regulations and less oversight.

For the grownups as well as the kids, the e-cigarette is a non-smoking-friendly smokers option, as is the smokeless tobacco pouch, which doesn’t require all the spitting and blackened teeth of the bygone age of chewing tobacco.

Finally, perhaps the least bizarre on my earlier list is the hookah lounge, a long-standing, and, in many places around the world, culturally-important method of tobacco consumption. While I was in Public Health school, some colleagues and professors were conducting research into the potential harms associated with hookah use, as the popularity of these lounges is still relatively new. Their conclusions as well as well as those of the CDC are that there is significant risk for hookah users, particularly in the context of the hookah lounge, due to the length of use during a single session among other factors.

Interestingly, Baltimore County is considering a bill to sharply curb the hours of operation of local lounges, not because of tobacco-related health concerns, but because of several violent incidents that have taken place in or outside some establishments.

Regardless of the decision about this regulation, or any other local policy choices about tobacco use, the underlying fact is that tobacco remains a legal substance, used by a substantial minority of Americans. On the other hand, it is also an addictive and dangerous substance that causes a multitude of health effects, as well as correlating with negative socioeconomic indicators. Maryland, and Baltimore in particular, suffer from astonishingly high disparities in health between racial and economic groups. Tobacco related health problems, such as chronic lung conditions, are high on that list of disease disparities, and should be considered very seriously when policymakers choose how to regulate tobacco products, as well as how to allocate funding for cessation and harm reduction strategies.

Are You A Soul Food Junkie?

By | ChangeEngine | 5 Comments
What are you doing this Sunday? I have the good fortune to be moderating a terrific panel on food justice with a city councilman, a celebrated urban farmer, a vegan soul goddess, a champion in the war against hunger, and the city’s food access mastermind. The panel will follow a screening of Byron Hurt’s documentary, Soul Food Junkies, which is a truly lyrical and profound exploration of the role of food in African-American life and its complex power to both sustain and destroy.

Come join us for a great opportunity to learn more about Baltimore’s struggle for greater food justice.
The event is at 2pm on Sunday, April 6th at the Lewis Museum (corner of Pratt and President streets). Did we mention that it’s completely FREE!!! See the museum’s website for more information, or register for the event on Facebook.
Hope to see you there!

Zoning Laws Outlaw Peanut Butter

By | Homelessness, The Race to End Homelessness | 6 Comments

I have a friend who raves about the fried peanut butter and jelly you can order at Rocket to Venus in Hampden. I’m sure she’ll get me to try it one day, but I have a hard time believing they have improved on my life-long favorite sandwich.

Because they are cheap, easily assembled and, (in my opinion), delicious, PB & Js are the favorite sandwich of volunteer groups passing out food to homeless people. If you don’t share my personal tastes, peanut butter and jelly could get boring. While everyone deserves variety, sometimes food is food, and when you’re hungry, a solid sandwich can be a big help.

Notice I said “when you’re hungry,” not “when you’re experiencing homelessness.” Most groups that pass out food in public places don’t care if the recipients are homeless, because they know that hunger affects people even after they get housing. That is why volunteers in Raleigh, North Carolina were so surprised last summer when they were told they could not pass out hot breakfast to the line of individuals that has come to expect their presence on weekday mornings. The group, called Love Wins Ministries, arrives weekly with breakfast sandwiches and a vat off coffee, but in August 2013 they were stopped by Raleigh police and threatened with arrest before they could serve.

Raleigh is not the only city letting its hungry residents stay that way. You may remember the less-than- hospitable town of Columbia, South Carolina that was working this winter to outlaw homelessness. As of February 15th, the area has taken further steps to alienate its already marginalized population, by requiring that any group planning to distribute obtain a permit (costing around $120) to serve meals in any public park or open space. This discourages volunteer groups that are not run by a registered nonprofit from providing food. In Rockford, Illinois, both food and shelter have been interrupted at Apostolic Pentecostal Church. Last week, church officials were informed they would be acting outside the law if they continued to use the empty church building as a shelter and warming station for homeless individuals.

Law enforcement in each of these cities and towns cite zoning or permit regulations as the reason for the recent interruptions, but there has to be a way to have a city that can feed its homeless population without it being deemed a fire hazard or an illegal act. Homelessness won’t end with a peanut butter and jelly sandwich, but if we can’t even serve this simple snack, what hope is there for a large scale, system change to end homelessness? These jurisdictions must find a way to prioritize human needs, and work with groups that are trying to help, not against their efforts.

Hélder Câmara, a 1980’s Brazilian Archbishop once explained, “When I give food to the poor, they call me a saint. When I ask why they are poor, they call me a communist.” Today, feeding the poor might earn him handcuffs, not sainthood. As neither a saint nor a communist myself, I still think it is important to ask why so many cities demand people living in poverty navigate legal hurdles in order to obtain a warm bed or a snack – and I wonder how we can improve upon this practice. 

Our Beliefs, Our Health

By | Health, The Global Is Local | One Comment

Monday’s issue of JAMA Internal Medicine included results of a survey about American’s perceptions about health interventions and medical practices. Half of all Americans, according to JAMA, believe in one or more medical conspiracy theories, such as the autism/vaccination connection and deliberate, CIA sponsored, HIV infection of African Americans.

These beliefs are powerful and real examples of the challenges faced by public health workers around the globe as well as here in Baltimore. Beliefs are incredibly hard to shake free once they have taken hold, and no preponderance of evidence will be sufficient to do so, unless a number of other factors come into play as well. This is one of the primary reasons that public health experts emphasize the importance of community involvement in interventions, in building trust and relationships among the families and networks that are targeted for the intervention, and supporting the growth and learning that leads to change.

The Health Belief Model, Wkimedia Commons

A study published in the late 90’s illustrates an example right here in Baltimore, in that case of the perceptions of the benefits of preventative oral health care. Beliefs are often tied to communities, including communities of geography, race, ethnicity, economic status, and gender. Those who are most likely to refuse vaccination, for instance, are likely to be well educated and well-to-do.

The implications for Baltimore are substantial, and tied to our burden of disease. Public health efforts to address the HIV rate among young black gay men, or the rate of narcotic use, or even more socioeconomic health factors such as poverty and nutrition can only succeed if the perceptions of healthy behavior are also addressed.

As all of us who have ever tried to argue with deeply held beliefs will attest, however, people who believe things believe they are true. This is true for all of us. Imagine someone well-meaning and intelligent coming up to you and saying: “Listen, I know you BELIEVE that this gravity thing is a force that pulls you downward, but this is merely a perception that is reinforced by your community. If you listen to this well reasoned argument, then you will be free from this inaccurate belief and thus free to enjoy the benefits of weightlessness, ease of motion, decreased back pain, and splinters in your socks.”

ChangeEngine is a group of public health advocates, whether through advocating for thoughtful design and public planning, creative solutions to aging, the importance of art, the awareness of racial, gender, and socioeconomic divisions. We encourage thoughtful and creative solutions to Baltimore’s challenges, and we challenge our readers to do the same. We must also encourage our ChangeEngine community members to consider and advocate for creative and thoughtful approaches that acknowledge and respect the burdens that belief can impose on community. We must respect that often the greatest barrier to changing ourselves IS ourselves. We need reflect no further than the New Year’s resolutions scattered upon the gym floor to appreciate that this is true.

My suspicion is that Baltimore – or whichever community you live in –  reflects the beliefs reported in the JAMA survey. If you have evidence that either supports or contradicts this suspicion, I encourage you to share in our comments sections and on social media. What are our beliefs about how we got to this time and place? What community legends prevent your neighbors from seeking care? What is the consensus among your colleagues about food, health, or wealth? We must first identify the biases of our community before we can leverage that knowledge to effect transformational change.