Tuesday, July 26, 2011

New Government Housing

The following pictures are of a new government housing project that has just been built. Orange Grove looks brand new. The houses are painted, the lawns are green, all the windows and doors are intact. This is what Roger Williams, R V Taylor and Josephine Allen looked like when they were built a few decades ago. The houses are built with cheap materials, as they are meant to be transitional living for families in need. But when talking to families in these projects, you quickly realize that this is not temporary housing. Generation after generation will live in these housing units, and because poor resources and lack of up-keep are commonplace, the new houses of Orange Grove will slowly begin to rot, become invested with bugs and consumed by molds. Lawns will dry-up, and windows and doors will be broken and boarded-up. Eventually, these housing units will deemed uninhabitable and the project will be shut down like Josephine Allen, displacing hundreds of families.

Orange Grove Housing in Mobile, located next to the highway:

Monday, July 25, 2011

Sleep In-Home Surveys and Chatting with a Mom

Our last couple of weeks was filled with conducting surveys at sites, doing mop-up, and administering in-home sleep surveys. I was assigned to school sites mostly. We had to recruit in a ghost town, Van Lee Circle. Almost every housing unit looked like the following pictures.

I also administered my first sleep surveys during the last couple weeks. The study was designed to look at sleeping problems and habits of MYS participants, ages 14 to 15. The survey takes about 45 minutes to administer and we ask the participants a series of questions about their sleep habits, nightmares, depression, substance abuse, and chaos in the home environment. This data will then be matched to the MYS data to see if any attitudes, experiences and behaviors may predict or be associated with poor sleep outcomes. In theory it sounds like a fascinating study but it was extremely difficult to read and very repetitive. The kids also only received five dollars, which they were not too excited about. Our goal was to administer 150 surveys throughout the summer, which doesn't sound like a lot but it was very difficult to reach.

My partner and I headed to R V Taylor to recruit and administer sleep surveys. We finally found a girl that had time to take it. We usually split up reading the in-home surveys, so the partner not reading doesn't get too bored. My partner began reading the survey and I started chatting with the participant's mother, Charlotte. Charlotte had lived in R V Taylor since she was a small girl. She had a hard life with men and drugs. She never actually said this to me but kept saying that the "devil had tempted her to do some bad things in her life". Her boyfriend had a lot of trouble with drugs, so assumed she was mixed up in it as well. However, when she became pregnant at around 16 (she couldn't quite remember), she knew she had to change her life. She found God. We talked a lot about her church community and how the father of her child decided to move in with her. They were going to make a life for themselves. She had four children with this man and they are still living together.

She was extremely proud of the fact that her man (not sure if they were married or not) had stuck with her through all her pregnancies. She felt very blessed that God had given her such a reliable partner. I chose this word "reliable" carefully because she was not referring to having a loving partner, she was happy with him because he had stuck around. She then said how blessed she was to have her four children and that she was happy not to be having anymore because she was grandma now. A little infant was resting on her chest the whole time we were having this conversation; it was her baby granddaughter. Her daughter had unexpectedly become pregnant.

Two very interesting conversation stemmed from this. First, we discussed birth control, and then we discussed men's lack of involvement in family planning and how the burden lay entirely on the woman. Charlotte got pregnant young and she was not in denial about her girls becoming sexually active at an early age. While she tried to tell them to wait, she knew how the neighborhood worked and that this is what young people did. She brought her 15 year-old daughter to the doctor to get her on birth control. Many of the girls in the community had trouble complying with taking a pill everyday, so the doctor was promoting the birth control patch. Charlotte was so upset talking about how much trouble her daughter had with this form of birth control. It was constantly falling off and her daughter sometimes forgot to change it. However, Charlotte did not know what to do about this. She did not go back to the doctor to try and get another form. She just accepted the patch as the only form of birth control for her daughter. Low and behold, her daughter got pregnant and her beautiful granddaughter was born.

I was so disheartened by this story. Here was a woman that had done everything right for her daughter. She had accessed family planning services for her daughter and the system had failed her. I was also upset with this physician. I was trained in family planning education, and the fact that Charlotte had heard that the patch was her daughter's only option was very upsetting. Later, my partner and I speculated that this could be because it is a cheap form of birth control and something it alleviates the burden of taking a pill everyday. But more options should have been shared with Charlotte and her daughter.

Charlotte then turned her focus to her 14 year-old daughter that we were surveying. She asked me about birth control options for her. I told her about all the options I could think of and referred her to Planned Parenthood's website that explains all these options. I stressed that there were options and what works for one person, doesn't necessarily work for another. She was so happy to have someone talk to her frankly about birth control and she thanked me for not judging her. I told her I would never judge a mother that advocated for the health of her daughters and that I wished more mothers were involved with their daughters' lives.

Our conversation then took a turn to male involvement in birth control. She explained that men just refused to wear condoms and that was the way it was. I had heard this from many other mothers. She said she was glad she was done with pregnancy; she had gotten her tubes tided. I asked her if she had asked her partner if he would get a vasectomy because it is a simpler procedure. She just laughed at me. She said, "Honey, that's what white men do. They have their little ladies tellin' them what to do and they do it. A black man wouldn't be caught dead doin' that." I asked her why she thought that was, and she said because black men never stay put. They may leave their woman and they need to be able to have kids with their new woman.

Again, this was hard for me process. This culture of hypermasculinity astounds me! It was very similar to what I heard in India. Being "male" is very much connected to potency or the ability to have many children. I just wonder how this gets taught to young men in the community. Why don't they fear getting someone pregnant? Why don't they want to use condoms? Why don't their mothers, who are very involved in their daughters' sexual health, have these conversations with their sons? In India, a male troupe set-out to do puppet street performances targeted to men. They wanted to tap into masculinity, by claiming that the "manly" thing to do is to take care of their family and this means protecting their women and children from diseases by wearing condoms. I am very curious how condom use and negotiation is discussed in these neighborhoods. According to the women I talked to, condom negotiation appears to be nonexistent. They simply say that boys refuse to wear them, so the girls must take birth control. But what does this mean for sexually transmitted infections, such as HIV. Every kid we surveyed said they were scared of AIDS... but how do they protect themselves from HIV, if they are not using barrier methods? It is a very scary reality!

I learned a lot from Charlotte and it made me more curious about this masculine culture surrounding pregnancy. It is a reality that is so different from how I grew-up, a practice and mindset that I had equated with cultures outside of the United States. Again, I was surprised to find it here in the United States. However, it is also uniquely American, a culture of teen pregnancy complicated by a cyclical pattern of adolescent pregnancy that is rooted in poverty, historical racism and strict binary gender dynamics.

Consequences of Residential Mobility

I would like to get back to an issue that was highlighted with the brawl that broke-out at R V Taylor, discussed in an earlier post. It was a fight that began at the Boys and Girls Club, when a kid from a different neighborhood entered R V Taylor turf. After this happened, we discussed in class how residential mobility can have devastating consequences for young people. This will soon become a reality for hundreds of young people living in Josephine Allen, when they shutdown the housing project. Families will be relocated to already overcrowded housing projects, like R V Taylor and Roger Williams. While constant residential mobility adds stress, anxiety, feelings of isolation, and school and social disconnect, increased vulnerability to violence is a harsh reality that many of these young people will also face.

Contrary to popular belief that "turf wars" are exclusively connected to gangs, it is a much more complicated issue in these neighborhoods. Most kids bond together with other kids in their neighborhood, regardless of gang affiliation. When they move, they loose the protection that comes from their friends and are more vulnerable to social exclusion, bullying and getting beaten-up by kids in their new neighborhoods. The MYS data also shows that high neighborhood mobility is associated with carrying weapons and negative attitudes toward their current neighborhood. So why do most planned mobility studies claim that residential mobility from low income families is a good thing?

First, most residential mobility studies are artificially created to move low income families into higher income neighborhoods. These studies demonstrate short-term benefits for children, as they are exposed to better schools and safer neighborhood environments. The problem is that this is not the reality for most low income families. They are not choosing to leave their homes for better neighborhoods, which is known as the "pull effect". In most cases, they are forced out of their homes because they can no longer afford the rent, or their homes are unsafe, or housing projects are being shutdown. This is described as the "push effect"; families are essentially being pushed or forced to move because of external factors, they are not choosing to leave. Residential mobility studies focus on the "pull factor", the idea that if circumstances are right (support mechanisms are in place), poor families would choose to live to higher income neighborhoods, and thus, have a better quality of life. However, these studies do not examine the "push factor". In reality, most families are forced to leave their homes and find homes in other poor neighborhoods.

Our professor conducted an adult survey of MYS participants' caregivers for several years. In this survey, about 40% of caregivers said that if their forced to move in the next week, they would look for places in West Mobile (middle to upper income neighborhoods). However, looking at their past moves, many of the respondents had moved to low income neighborhoods within a couple miles of their current homes. The majority of families would move into friends or relatives homes or get advice from friends about where to look for a new residents after being forced to move. Again, the "push" factor is the reality of residential mobility, very few families choose to move because they acquire the financial means and resources to live in higher income neighborhood. The fact that caregiver respondents desired to live in richer West Mobile neighborhoods also highlights a trend we see in the MYS data. It is the idea that people wish or desire better things in their future but they do not have intermediate steps in place to acquire these dreams. For instance, many of the caregivers lack the financial resources to afford homes in West Mobile because they are unemployed but they still desire this in their future.

Most policy makers are oblivious to harmful behavioral consequences of low income families constantly moving and they examine residential mobility as choice. They believe that if families are given the opportunity to move to better neighborhoods, they will, and their kids will benefit from this move. While this may be true for some low income families, what is the point of developing housing programs around this premise, when this is not the reality of how people move when they are living in low income neighborhoods? Where are the studies that inform policy about the "push" factor, rather then the "pull" factor?

Again, actually going into these neighborhoods and talking to folks about how and why they are constantly moving is a good place to start.

Thursday, July 14, 2011

The 9th Ward in New Orleans

I have traveled to New Orleans three weekends during my time here in Mobile. The drive is an easy 2 hours and the city is so vibrant, with incredible jazz. But as many of you know, the devastating effects of Katrina still linger in almost every neighborhood. And the 9th Ward, is still littered in vacant, damaged houses. Many of us noticed how strictly similar Mobile and Prichard neighborhoods looked to the 9th Ward. Instead of gutted water damaged homes, Mobile and Prichard homes are burned and boarded up. But unlike the 9th Ward, many residents still live among these burned and abandoned homes in Mobile and Prichard. While the 9th Ward is beginning to rebuild and some families are moving back. It is still pretty desolate. We just couldn't believe how similar these home devastated my natural disaster looked to the homes in the neighborhoods we were working in.

Here are some comparison photos of the two areas to exemplify what we saw:

Home in Prichard (still being lived in):

Vacant Home in 9th Ward:

Apartment in Van Lee Circle, Mobile:

Apartment in 9th Ward:

Vacant Home in Prichard:

Vacant Home in 9th Ward:

This is a community garden in the 9th Ward. I have yet to come across a community garden in Mobile or Prichard. Our professor said that some mixed-income and middle class neighborhoods in Mobile have gardens but no low income or Section 8 housing neighborhoods have these urban farming projects.

This is a picture of Brad Pitt and Angelina Jolie's 9th Ward Rebuilding Project Homes. Check-out the sweet solar paneling on the roofs. We saw a ton of people living in the area but wondered how very poor families that were displaced afforded these new-age, modern homes.

This is a home that someone turned into a giant chalkboard. People write down what they hope to do before they die. It was so fun to read and we all added our hopes for the future.

Returning to R V Taylor Public Housing

During our first week of training, we visited R V Taylor Public Housing. The brick one-level housing units are set-up in a circular pattern in a giant field of dead grass and dirt. No housing unit has a distinct yard, the only outside area designated to each house is a cement porch outside each door, covered by the extended roof. All the windows and doors have metal bars over them. In the back of each unit, there is usually two poles connected by a clothes line. The clean cloths blow in the dusty, hot breeze. There is not a shade tree in sight. We were told to go out in this neighborhood and just walk around, talking to whoever we saw outside.

I remember being so nervous. It was pretty easy to talk to the older residents out on their porches but I was very awkward in conversation, always fishing for things to say. I was so surprised at how all the children and even some adults addressed me as "ma'am". It was especially unsettling when people older than me addressed me as "ma'am". I made a very conscious effort to call everyone older than me "sir" and "ma'am", and thanking them for taking the time for talking to me. We saw a boy dressed from head to toe in royal blue, a visual sign of affiliation to the Crips. I was hyper vigilant of my surroundings, looking around for any signs of danger. But mostly we found mothers, grandmothers and their children. We went to a playground and raced children through the trash covered ground. Broken beer bottles littered the periphery of the playground and many of the children were running around barefoot. And this was my first experience in one of the projects we would be working in.

In week 6 of this internship, I returned to R V Taylor. I freely went up to houses, not hesitating at the doors, practicing what to say or preparing myself for the smells that would come when the door was opened. I had smelled everything from marijuana to mold to rotting dog, so nothing phased me anymore. I reminded whoever answered the door to have the participants come to the Boys and Girls Club for their survey and quickly moved on to the next house. The broken car and house windows, the boarded up windows, the head nods from groups of men congregating outside were all familiar sights now. I no longer felt afraid in the neighborhoods and dealing with uncomfortable situations was just second nature.

With this familiarity came positive and negative feelings. I am happy that I feel more comfortable interacting with people that live so differently from how I was raised. I love being able to chat about anything, not just focus on discussing the survey and justifying my presence in their neighborhoods. But I also feel like I am loosing sight of the reality of violence that exists in these neighborhoods, as well as the extremely terrible living conditions. I guess it is a hardening effect that is beginning to set in. I would not be able to handle this position everyday, without distancing myself from the reality of these young people's lives. I use to try to see how the young people were answering the survey questions (I know the IRB would have a fit about this) and when an answer was put down that alluded to a terrible trauma in their life, I dwelled on it. But you just can't do this for every kid. The more and more kids I saw putting down these answers, the more hopeless I felt. I know I can not save all these young people from the reality of violence, drugs, and engaging in high risk behaviors, and I know that this is not why I am in these neighborhoods... but it is really hard not to get attached and want to directly help them.

We had a very successful survey site at the R V Taylor Boys and Girls Club. We had mastered catching scammers and we didn't have too many "parents" claiming they had 6 kids to sign-up that were miraculously all born in the same year (oh yes, this happened a lot). But after we packed up one day, a huge fight broke-out over a kid who was from Josephine Allen and was on R V turf. One of our interns that was recruiting talked to a mother and her daughter about it. They both had black eyes. Apparently, their cousin had gotten caught up in the giant brawl and they had tried to pull him out of it. It sounded like there were over 30 people beating each other spurred by this kid being in the wrong neighborhood. No one was killed and no one was arrested.

See the news coverage of this at the following link: http://www.fox10tv.com/dpp/news/crime/around-100-teens-fight-in-neighborhood

This event spurred a very interesting discussion about the violent repercussions of youth being moved out of their neighborhoods. As I mentioned in a previous post, Josephine Allen will be shut down soon, and the families will be relocated to other projects in the area. This means brawls over turf will become more frequent. This is just another negative consequence of the high residential mobility of youth in this population. I will continue this discussion in my next post.

While I realize that I can not directly help the young people I have met. I hope studies like the MYS will influence responsible programming that truly addressed the experiences of this population. Utilizing MYS for future programming and policy in high poverty areas is how I identify the impact I am making in these communities. And on a more humanistic level, just being here is important. Being present in neighborhoods that are feared, isolated and forgotten. Not giving voice to these young people but listening to the voices they already have and encouraging them to use them to share their experiences. This is why I am here.

Tuesday, July 5, 2011

Pictures of Prichard

I took the following pictures while recruiting in Prichard for another survey site at Whitley Elementary.

This picture is of partially burned house that we had on our recruitment list. The family and previous survey participants are long gone. The mangled house was surrounded by occupied homes. I can't get over how aesthetically displeasing these houses are amongst all the occupied houses in the neighborhood. It was the first time that I had recruited at a burned home. We see them all the time but I have never had the address of a burnt house on my recruitment list.

Here is another example of a vacant home that is not burned. This is a very common sight and several of the addresses we recruit at get a failure code for being vacant.

Here are some examples of occupied houses in Prichard.

Dowtown Prichard is now a ghost town of boarded up buildings and barred stores. Here are some pictures of the main street.

Here are some positive messages on billboards in the area. The HIV/STD rate is extremely high in Prichard, so efforts for public health campaigns constantly include public service announcements, such as the one below. My partner and I were also inspired by the billboard from this Prichard mother, celebrating the successes of her children. It is also very interesting how idolized these few success stories are in the community, when they are not the reality for so many young people living in Prichard.

The Boys and Girls Club in Roger Williams Public Housing

This is Roger Williams Public Housing, which is located in Mobile. We spent about two weeks recruiting and surveying kids here. We got very close to many of the kids at the Boys and Girls Club, where we administered the survey. Roger Williams is one of the most crowded housing projects in Mobile and has a very high crime rate. The housing units were similar to Happy Hills but were brick with about four housing units per building. Many of the families from Happy Hills will relocate to Roger Williams after they shutdown Happy Hills in the next year. I have no idea how more families can fit into these congested, old brick buildings without building more units. No one seems to know.

During recruitment, several interns passed by a recent murder scene that took place in one of the units. Everyone in the neighborhood kept talking about how the heat made young people do crazy things. It is interesting how aggression and crime are constantly connected to the extreme summer heat. However, I see some truth to this. The heat is extremely uncomfortable, and as a result, you constantly feel irritable. This is a picture of the crime scene:

Before we begin the survey each day, we drop-off reminder cards at the houses of every kid signed-up to take the survey that day. While dropping off reminders our first day, we saw a freshly burned house off the main street. I am surprised how desensitized I am to burned houses now. They are everywhere and the community just continues about their daily business around these burned plots.

While we drop-off reminders, mothers usually say that their kids are already waiting at the survey site. Kids are scheduled for a specific day and time slot during recruitment to help us plan for the amount kids we will be surveying each day. However, most of the time kids come the first couple of days in the morning. Once the word gets out, every kid and their mother is at the site trying to take the survey. We have a very "elaborate" system to see if the kid is who we surveyed in previous years and to make sure kids are not taking it multiple times in the summer. We have a master list of all the previous participants or newly consented participants, with their birthdate, street address and a column that contains the date that the young person took the survey. If this column is filled with a date, the youth is not surveyed. If they say a completely false birthdate, they can not take the survey. And if they are not on the list, they need to bring a parent to the site to consent them as a new participant.

We now take a day to process the consent paperwork, so we can cross-check the kid with school records. We are catching so many kids that "don't exist" this way. Either they have recently moved and are not in the records or they are fabricated because they want to take the survey again under an alias. While some kids may have dropped-out of school, we are able to look back at school records for several years and can usually find them. Additionally, the kids that recently moved are not ideal participants because they can not accurately answer the school connectivity and neighborhood violence questions for Mobile and Prichard area.

The moral of the story is that this is not an exact science, the IRB would never let us use photo IDs to help identify kids that are suppose to be de-identified, and forcing families to produce birth certificates is completely unreasonable. However, we did have a mother bring her children's report cards to prove who they were. So birthdates and middle names are our best defense against scammers. Here we are at the check-in table:

Imagine the perfect adolescent survey... kids are in desks facing forward, spaced apart from one another to ensure confidentiality. The room is completely quite except for the clear voice of the survey administrator reading each question. The room is a comfortable temperature with no other distractions, which facilitates complete participant concentration on the survey. Now imagine the exact opposite scenario and you have the survey environment in Roger Williams. Kids are at crowded tables lining the edge of the gym, where loud pick-up games of basketball are being played amongst young children screaming and running around. Survey participants are laughing about the questions, looking over at each other's answers because they are so crowded at the tables, while the survey administrator battles to be heard over the gym chaos, and constantly reminds the participants to keep their comments to themselves and eyes on their own surveys. This is the reality of the Mobile Youth Survey (MYS), and clearly this has a negative effect on how young people answer the questions. However, the alternative is missing this population all together. MYS goes were the young people are... neighborhoods the few researchers dare to enter.

We had so much fun playing with kids at the Boys and Girls Club, when we were not administering surveys. Here are a couple pictures of hanging-out with the kids:

I will end this post by sharing an inspiring piece composed by a six year old. One of our interns asked this girl what she would do if she were president. He wrote down her words displayed in the following picture (click on picture to enlarge):

The optimism, passion and resiliency of these children is inspiring. I am truly a better person because of the time I have shared with these children. It is a gift they have given to me that I will carry and cherish throughout my life.