Matt Masiello, M.D., MPH

Category: Social Justice

  • Food Stamps, Poverty, and the Terribly Ignorant and Uncaring U.S. Politician

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    Poverty is increasing in America, with 17% of our citizens living in poverty, including 16 million of our children-our future. In several of our southern states, nearly 25% of the population lives in poverty. These states come close to Romania, considered an industrialized country, where their poverty rate is 25%. According to UNICEF, one American child in four is poor. When an educational minister from Finland, the country with the best educational system in the world, was asked what he could offer the United States as advice to enhance the educational status of the United States, his response was sobering – “nothing, there is too much poverty.”

    One shining light is the slow gains we have made in health care. For the first time in 37 years there are more Americans enrolled in a health care system. College students who will be buried in college loans now have affordable health care available to them. Our most vulnerable population now can enroll in a health care system with a pre-condition such as chronic illness; health promotion, wellness and disease prevention now are gaining some traction over the costly business of the latest and best technology, new and questionably safe medication; the unnecessary growth of some medical subspecialties and hospital surgical units, emergency rooms, and hospital executive office suites.

    So, what is our political response to this? Let’s randomly cut food stamps without offering a positive and sustainable alternative. The poor will work it out as the politicians go home to their comfortable homes and excellent health insurance, the best in the world in fact. And, this is their alternative; keep your food stamps, but let’s stop funding health care, even changes that have helped and will continue to help millions of our most needy.

    So, what should our response be as these politicians go home to their comfortable well- kept family and homes? Our educators and physicians, especially pediatricians, need to speak up. This, however, is a challenge and I will offer my opinion why in my next blog message on our ignorant and uncaring politicians.

  • The Poorest Example of Leadership

    20120517-163717.jpgNever before have I come so close to abandoning my right and privilege to vote. The level of disdain, frustration and sadness I and so many others have with our political system has now surpassed the same feelings many have for our educational and health systems.

    Why should the silent majority of Americans turn over one more dime to individuals, politicians, who cannot work together? This lack of leadership, now perceived by many to be at every level of government, is affecting Americans much deeper than our leaders can possibly realize. And I can only hope that it is simply not realizing the ramifications of partisan politics. If politicians were living in the reality of the majority of our citizens then this behavior is shameful. The political system is allowing for a pervasive sense of hopelessness, frustration and fear. Especially fear for those who are already at that point of no return with their health care bills; college tuition; mortgages and more.

    Sadly, It is really not a matter of trying to convince politicians to compromise at this critical point in our American history and that somehow all will be right. Compromise is an absolute must. The work will be in the recovery from this latest and worse political/civil debacle I have experienced in my lifetime. Americans are not losing faith in their politicians. It is lost.

    I make this as clear as possible- compromise, and make every effort to deliver this message to your democratic and republican congressional colleagues. This is the request, the demand. Though my desire to cast a vote may be in question I would offer and predict that if there is not compromise the reaction by citizens will make the popular tea party shenanigans look like the true definition of a “tea party.”

    Lead, give hope, do the right thing.

  • War No Longer an Option for Our Nation

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    “In the counsels of Government, we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the Military Industrial Complex. The potential for the disastrous rise of misplaced power exists, and will persist. We must never let the weight of this combination endanger our liberties or democratic processes.”
    – Dwight D. Eisenhower, 1961.

    “It’s a growth industry and we will get what we want.
    – Gen. David Petraeus, when asked recently about the need for the deployment of more troops to Afghanistan.

    As we came to the end of our walking-wheelchair trek from the Jefferson Memorial, Korean and Vietnam War memorials, to the World War II site, my 82-year-old mother offered a most surprising comment.

    “We Americans sure like our wars,” she said sadly.
    This from the wife of a WW II veteran who was awarded the Silver Star and a Purple Heart for his heroism.

    It was that simple comment that made me pause and reflect on where we were as a society, a country.

    I am also the sibling of a two-tour Vietnam War veteran who suffered through the aftermath of that conflict. Drugs, joblessness and life without a wife and children were his rewards.
    Thousands of our young have died, depriving us of a social force that may have brought us to a more peaceful, a more academically enlightened, and possibly a more environmentally friendly time decades later.

    Dwight Eisenhower said it best when he commented on the need for war to “prevent” communism, terrorism or world domination: “When people speak to you about a preventive war, you tell them to go and fight it. After my experience, I have come to hate war.”
    As thousands of our young soldiers have died in our current wars, many more thousands have returned with a multitude of war-related illnesses.

    And as we were underprepared to properly equip and protect our soldiers on the battlefield, so are we now so ill-prepared to care for these young Americans, their children and their wives upon the soldiers’ return to our communities.

    And again, another generation lost and a country missing out on what could have been – would have been – if these thousands of young men and women were here today, healthy and alive.
    The compromised physical and mental health of these soldiers will have an immeasurable toll on their families, our health-care system and our country for years to come.

    “The time not to become a father is 18 years before a war,” E.B. White said.
    A conservative number of 100,000 innocent Iraqi and Afghan men, women and children have died in these wars.

    An apology and a few thousand dollars are offered as payment for loss of home and life.
    For generations, the families of these innocent victims will hold us accountable for their sadness, misery and loss – a breeding ground for sustainable acts of terrorism.

    “And one of the things we should learn is you can’t fight and win a civil war with outside troops, and particularly not when the political structure in a country is dissolved. So it wasn’t the press that was the problem. The problem was that we were in the wrong place with the wrong tactics.”
    – Robert S. McNamara, secretary of defense during the Vietnam War.

    One in eight Americans and one in four children now rely on food stamps. We have more families and children living in poverty now than we did during the Lyndon Johnson war on poverty era.
    In this nation, a child is born into poverty every 33 seconds (Children’s Defense Fund, CDF).

    As we continue to experience the numbing greed of Wall Street, we have more children going to bed hungry than ever before.

    According to economist Jeffrey Sachs, “Wall Street takes more bonuses each year than the U.S. gives in all official development assistance.”

    Many of our community food pantries were finding it difficult to keep shelves stocked for this past Thanksgiving, and quite possibly will for the upcoming holidays and holy days.

    According to Marian Wright Edelman, president of CDF, we spend $60 billion per month on the war. It will take $105 billion over 10 years to provide maximum health-care reform for children. What is the child worth? Who are we?

    As our health system is fragmented and failing, our educational system is also suffering.
    The high school dropout rate is unacceptable by anyone’s standards.

    Our science and math scores are noncompetitive at the international level, and the ability of our students to obtain degrees once they enter college is surprisingly and sadly low.

    Our children still do not have the right to an education and health care as is the case in other modern, industrialized countries.

    Our young adults leave their educational environment thousands of dollars in debt before they have their first job offer.

    This is not the case in the great majority of other modern societies.

    We still abuse children by the hundreds of thousands, with one in 10 suffering some form of maltreatment. More than 10,000 children are known to have died from abuse and neglect from 2001 through 2007. The number could be much larger.

    Nations are staging special events to mark the 20th anniversary of the Convention on the Rights of the Child, which came to be on Nov. 20, 1989. It is the most widely ratified international human rights treaty. Every country in the world, with the exception of the United States and Somalia, has ratified it.
    Poverty breeds social unrest and violence. Though we need to be intelligently and morally responsive, militarily, to terrorism, the real war to win is that on poverty.

    Our military experts are now negotiating with the Taliban, realizing that they fight for food and money, regardless of who pays.

    According to Sachs, it will take one-tenth of one percent of the world’s gross national product to provide basic financial support to the world’s poor. And $35 billion, total, as compared to the $60 billion per month on the war effort, to significantly and positively alter the course of world poverty.
    When Gen. David Petraeus, the overall commander of U.S military forces in Iraq and Afghanistan, was asked recently about the need for more troops, his response was, “It’s a growth industry and we will get what we want.”

    Many Americans are now approaching that Vietnam mind-set of war weariness, and at a time when we are in a deep economic depression.

    There is discussion of a war surtax just as we are realizing the cost of overhauling of our health-care system, upgrading our educational system, and moving to cleaner, more-efficient energy sources.
    It is also the poverty, the hunger and the declining spirit of the masses.

    “The most successful war seldom pays for its losses,” Thomas Jefferson said.
    I believe this country has a “machine” as strong and powerful as our military machine of generals and war strategists.

    “Give peace a chance” should no longer be a cliché of the past. Today we are much better prepared to call upon and muster nations, economists, community planners, sociologists, educators, medical and public health professionals, and political peacemakers who can strategically infiltrate a society in conflict, or a country experiencing massive poverty, and reap significant gains with significantly less loss to life.

    It is time for a new world order – whether it be with the advice of a well-known Demo-crat, John Kennedy, “Mankind must put an end to war, or war will put an end to mankind,” or that advice of another distinguished soldier, Gen. Douglas MacArthur, when he courageously stated: “I believe that the entire effort of modern society should be concentrated on the endeavor to outlaw war as a method of the solution of problems between nations.”

    It is now that moment, in the history of our country, at this place in time, to speak out, peacefully protest, write and stir the spirit of this country.

    “May we never confuse honest dissent with disloyal subversion.”
    – Dwight D. Eisenhower.

    “War will exist until that distant day when the conscientious objector enjoys the same reputation and prestige that the warrior does today.”
    – John F. Kennedy.

    **As published in the Tribune-Democrat on December 06, 2009 12:42 pm

  • Why a blog?

    I look forward to sharing my experiences from the world of health. As a Board Certified Pediatrician and Public Health Professional, I view health from a more systematic perspective.I will begin to post about my current national and international work, overall health promotion, and issues that appear in the media.

    My current activities:

    • School-based bullying prevention-My team and I are responsible for the largest implementation of the Olweus Bullying Prevention program in the U.S. which was made possible through a private health foundation.
    • WHO Health Promoting Hospitals -I am a member of the WHO-HPH Governance Board and am working with a hospital in Italy regarding pediatric asthma.
    • Medical Home development at several hospitals throughout the country
    • Establishment of undergraduate Public Health Curricula

  • Bullying – yes, a lot of talk, but action

    When the media does get involved in an informed manner they are able to successfully make that statement to inform the public of where we are and where we should be regarding that “social issue.” Thomas Sowell, from the Hoover Institute based in Stamford, California and a frequent contributor to the Tribune Democrat national newspaper system did that for us in his April 25th piece on bullying, “A lot of talk about bullying, but little action.” In many ways he is correct. Politicians, alone or educators, alone, often have less then adequate results in any singular attempt to reduce bullying in our schools. What will work and what has been demonstrated to work is a public health approach to the issue. Bullying is a complex social epidemic. First, there should be no question that it is at epidemic proportions when upwards of 30% of our children are involved in bullying on any given school day. Also, the health and legal issues related to bullying adds another layer of activity to that epidemic. It costs all of us when that child is seen in the physician’s office or emergency room with a health issue, small or significant, related to bullying or when we can now document increased criminal activity in adulthood when a child becomes a bully in his youth.

    It is not only the politicians, media or educators that need to step up to the plate and act. Our managed care organizations and health care providers must appreciate the health consequences of bullying beyond that of the school based bullying event. Health care reform needs to involve all the players at many levels. The Academy of Pediatrics and similar national organizations must appreciate the “evidence” of evidence based programs. Though not having their origins in the United States these internationally recognized initiatives have been evaluated over the decades and to now hold these programs to another level of ill defined evaluation allows us never to get out of the gate to do something about the issue. Judges and lawyers need to imbed a “public health” foundation into their unfunded policy mandates and not just require, reprimand or punish the student or school. Monitored, evidence based programs need to be part of the equation.

    It is a complex issue requiring the theories and practices of public health science to implement that evidence based program with the highest of fidelity, monitor and evaluate the effort and, lastly, but most importantly, enable and empower those educators, politicians, health care providers, etc to sustain the initiative beyond the initial funding or programmatic activity.

    An example of this public health approach and the only such example in the United States is what has occurred in Pennsylvania. The Highmark Foundation, in partnership with their health care organization, Highmark, Inc, and in realizing the health and social consequences of school based bulling, developed a coalition of educators, public health professionals, program specialists and other key partners to strategically address the issue. This five year effort has resulted in the largest U.S. implementation and evaluation of an internationally recognized bullying prevention initiative. The $ 9 million dollars did not come from the government, CDC or some other nationally recognized organization, but from a regional foundation that wanted to develop that program to assist their clients. Along the way they developed a national model – – action, not talk. In this coalition driven initiative involving approximately 250,000 children, 400 schools and thousands of teachers, parents, school bus drivers, and lunch room monitors bullying rates have decreased along with increased adult and bystander involvement. We are now reporting out on these positive findings as well as demonstrating the cost benefit to the health care system, the educational system and society. Thus, the action taking place in western Pennsylvania resulted in a comprehensive public health initiative involving an evidence based program; a large population; program implementation with high fidelity; extensive monitoring and evaluation to the point of evaluating not only a decline in bullying rates but other behavioral and health enhancements as well as a cost benefit to many segments of our society. It is certainly a confirmed call to action.