Is Getting too Little Sleep Making You Sick?

Published Fall 2012 in Broward Health Magazine

Do you wake up with morning headaches or have high blood pressure? Do you have difficulty with acid reflux? Has your child been diagnosed with attention deficit hyperactivity disorder (ADHD)? If so, Obstructive Sleep Apnea (OSA) may be to blame.

OSA is the most common sleep disorder. It begins with a blockage in the upper airway that interferes with breathing normally when asleep. The blockage leads to loud snoring, followed by silence, then choking or gasping for air, causing one to arouse momentarily from sleep or to wake up completely.

The most recognized symptoms are daytime sleepiness, fatigue, memory loss, mood swings, trouble concentrating and poor academic performance in children.

OSA is a serious condition, because quality sleep influences the regulation of body weight and metabolism, and insufficient sleep can lead to obesity and contribute to medical problems such as high blood pressure, diabetes and cancer. In fact, less than seven hours of sleep may alter hormone levels that regulate the appetite, which can lead to overeating. Furthering the problem is that OSA reduces daytime energy, which results in decreased physical activity and, ultimately, weight gain.

In addition to weight problems, OSA can increase the risk of Type 2 diabetes and is associated with insulin resistance and a rise in insulin secretion to maintain normal glucose tolerance.

Lack of sleep is also linked to more aggressive breast cancers and may raise the risk of cancer recurrence in older women. Data on over 400 breast cancer patients revealed women who averaged less than six hours of sleep a night before their diagnoses had more aggressive tumors than women who slept longer.

Adults aren’t the only ones who can suffer from OSA. In children, there has been an increased association between ADHD and sleep apnea. OSA can cause mild inattention or hyperactivity. Sleep disordered breathing may contribute to some mild ADHD-like symptoms, including decreased attention span and learning problems.

If you are exhibiting OSA symptoms, a simple overnight sleep study can be conducted to diagnose sleep apnea. A sleep study should also be considered before starting long-term drug treatment for ADHD.

Sleep studies can be performed at Broward Health Coral Springs or Broward Health Medical Center and involve monitoring breathing patterns, as well as brain wave activity to determine light or deep sleep, blood oxygen levels, heart rhythm, legmovements and snoring.

For more information about sleep disorders, visit BrowardHealth.org/sleep.

Melissa Brooks, MBA, RPSGT, CRT, is the clinical coordinator of the Sleep Disorders Center at Broward Health Coral Springs.

REFERENCES

Centers for Disease Control and Prevention (2012). Adult Obesity Facts. Retrieved August 28, 2012, from http://www.cdc.gov/obesity/data/adult.html

Chung, F., Yegneswaran, B., Liao, P., Chung, S., Vairavanathan, S., Islam, S., Khajehdehi, A., Shapiro C. (2008). STOP questionnaire. A tool to screen patients for obstructive sleep apnea. Anesthesiology, 108 (5), 812-21.

Institute of Medicine. Sleep disorders and sleep deprivation: An unmet public health problem. 2006. Washington, D.C.: National Academies Press;

Jean-Philippe Chaput*, Jean-Pierre Després*,†, Claude Bouchard‡ and Angelo Tremblay* Short Sleep Duration is Associated with Reduced Leptin Levels and Increased Adiposity: Results from the Québec Family Study. Obesity (2007) 15, 253–261; doi:10.1038/oby.2007.512

Kryger MH: Diagnosis and management of sleep apnea syndrome. Clin Cornerstone 2000; 2:39–47

Lack of Sleep Found to be a New Risk Factor for Aggressive Breast Cancers (2012). Retrieved August 28, 2012, from http://www.msnbc.msn.com/id/48802740/ns/local_news-peoria_il/

Pagel JF. Obstructive sleep apnea (OSA) in primary care: evidence-based practice. J Am Board Fam Med 2007; 20: 392–8.

Sushmita Pamidi, Kristen Wroblewski, Josiane Broussard, Andrew Day, Erin C. Hanlon, Varghese Abraham, and Esra Tasali. Obstructive Sleep Apnea in Young Lean Men: Impact on insulin sensitivity and secretion Diabetes Care published ahead of print August 21, 2012, doi:10.2337/dc12-0841

Walters AS; Silvestri R; Zucconi M; Chandrashekariah R; Konofal E. Review of the Possible Relationship and Hypothetical Links Between Attention Deficit Hyperactivity Disorder (ADHD) and the Sim- ple Sleep Related Movement Disorders, Parasomnias, Hypersomnias, and Circadian Rhythm Disorders. J Clin Sleep Med 2008;4(6):591-600.

76% Say It’s Jobs But Millennials Are By No Means Provincial

August 26, 2012

By Melissa Bynes Brooks

Millennial voters are at a crossroads laden with a series of economic, social, and cultural issues to consider as they contemplate whether to vote for President Obama or Mitt Romney on Election Day.

More than three-quarters (76%) say jobs and unemployment represent critical issues facing the country according to a 2012 Millennial Values Survey conducted jointly by Public Religion Research Institute and Georgetown University’s Berkley Center for Religion, Peace, and World Affairs. Even though young people have been impacted the most during the recession, they remain the most optimistic about the recovery of the economy which has added jobs in a slower than desired pace.

From April to July 2012, the number of employed youth 16 to 24 years old rose 2.1 million to 19.5 million, the U.S. Bureau of Labor Statistics reported in August. This year, the share of young people employed in July was 50.2 percent. The number of unemployed youth in July 2012 was 4.0 million, a slight decrease from 4.1 million a year ago. The youth unemployment rate was 17.1 percent in July 2012. The unemployment rate for young men was 17.9 percent, in July 2012, and the rate for women was 16.2 percent. The jobless rate for whites was 14.9 percent, compared with 28.6 percent for blacks, 14.4 percent for Asians, and 18.5 percent for Hispanics.

The impact of past events on present circumstances has never been more apparent. Approximately 7.5 million jobs were lost in the eighteen months from the beginning of 2008 through the middle of 2009. This period was fully shaped by the Bush economic agenda. The takeaway, this is the same agenda Mitt Romney and Paul Ryan are campaigning on. Romney-Ryan would like to reinstate the same tax cuts and deregulation policies that resulted in the economic crisis. Romney-Ryan would also cut spending on roads, highways, and other physical infrastructure which would lower output in ways similar to the effects of cuts in private capital investment.

Over the most recent 18 months of the Obama administration, approximately 2.8 million jobs have been added. The average monthly job loss before President Obama’s policies took effect was 417,000. Over the last year-and-a-half, the average monthly job gain has been 155,000. When Congress failed to pass the American Jobs Act, President Obama announced a new initiative called Summer Jobs+ in January 2012. The Federal government and private sector came together to commit to creating nearly 180,000 employment opportunities for low-income youth in the summer of 2012, with a goal of reaching 250,000 employment opportunities by the start of summer. At least 100,000 were for placements in paid jobs and internships.

A majority of Milennials report that education (54%) is another critical issue facing the nation.  President Obama signed an overhaul of the student loan program into law, increased funding for Pell Grants and allowed for direct student loans while preventing student loan interest rates from doubling. The American Recovery and Reinvestment Act invested heavily in education both as a way to provide jobs and lay the foundation for long-term prosperity. The Act provides $5 billion in competitive funds to spur innovation and chart ambitious reform to close the achievement gap and includes over $30 billion addressing college affordability and improving access to higher education.

Mitt Romney proposes tightening eligibility requirements for federal student financial aid and decreased funding for Pell grants. This may present a problem for lower income families by limiting their access to affordable higher education. He also opposes gainful employment regulations which help to prevent students from increasing their student debt while working towards degrees issued by sub-par schools. According to the Congressional Budget Office (CBO), Paul Ryan’s budget plan to cut federal spending for education such as loans or grants may lower productivity by reducing people skills.

Only 1-in-5 Milennials think social issues like abortion (22%) or same-sex marriage (22%) are critical issues. 53% think abortion should be legal, 43% do not, while 35% don’t know. One point of consideration is that the next president of the United States may have an opportunity to nominate a Supreme Court justice. This will be of particular interest for voters with concerns regarding women’s reproductive rights and the future of Roe v Wade. In 1973 the United States Supreme Court ruled that a right of privacy was protected by the Fourteenth Amendment under the Constitution and guaranteed a woman’s right to have an abortion under certain circumstances. Voters will determine whether to elect Obama- Biden who supports a woman’s right to choose or to elect Romney- Ryan, a team at odds on the issue. Romney opposes abortion with an exception for cases of rape, incest and risk to the mother’s life while Ryan objects to abortion in all circumstances except when the mother’s life is at risk. Paul Ryan, if he’s vice president, will literally be a heartbeat away from being the president so this makes his perspective relevant.

Access to affordable and preventive healthcare is important. Millennials broadly favored proposals that all Americans have insurance, that the government provides help for those unable to afford it, and supported a government health insurance plan to compete with private plans. A Pew Research Center poll taken via landlines and cellphones on September 22 through October 4, 2011 reflected that 56% of Millennials do not feel the government is doing enough for elderly Americans. They also feel more should be done to reduce the gap between the rich and the poor.

Millenials have an innate sense for tolerance and treating others fairly irrespective of class, race, gender, or sexual orientation and are more racially and ethnically diverse. Only 59% are white non-Hispanic. They are more open-minded than previous generations, suggests an analysis of studies by the Center for Information and Research on Civic Learning and Engagement, part of the University of Maryland’s School of Public Policy. They are also more inclined to support President Obama’s position of prosecutorial discretion when confronting illegal immigration and agree that the Defense of Marriage Act (DOMA) is unconstitutional. This generation is by no means provincial and there will be consequences, whatever the presidential choice.

Melissa Bynes Brooks is the editor of BrooksSleepReview.

Contact information: melissabynesbrooks@comcast.net

Follow on Twitter @Mlbbrooks

.

Medicare and Obamacare: The Numbers Square

August 19, 2012

By Melissa Bynes Brooks

Despite the massive media hype portraying President Obama as being fiscally irresponsible, he has improved the solvency of the Medicare Program for beneficiaries while saving tax payers billions of dollars. He has also invested in the American people by expanding health care coverage for millions who are uninsured. The Affordable Care Act (ACA) has been a contributing factor to the Medicare program’s sustainability and enhanced financial outlook, albeit for a period of 8 more years. The Medicare debate is currently front and center in the upcoming presidential election. A  PEW Research Center poll conducted among registered voters in April 2012 shows that 74 percent of Americans rank health care as the fourth most important issue to their vote.

Output has exceeded input in the Social Security and Medicare trust funds. In 2011, 36 percent of federal spending was for Medicare and Social Security. The trend for rising costs is expected to continue due to the aging population of the baby boom generation coupled with decreasing population numbers in subsequent generations. According to the U.S. Census Bureau, life expectancy  has increased and people 90 and older now comprise 4.7 percent of the older population of people that are age 65 and older. This has increased from 2.8 percent in 1980 and is projected to be 10 percent in 2050.

Medicare’s costs under the Trustees’ current-law assumptions rise from their current level of 3.7 percent of GDP to 6.0 percent in 2040 and 6.7 percent in 2085. If the Sustainable Growth Rate (SGR) restraint were overridden, Medicare costs would rise to 6.5 percent of GDP in 2040 and 7.8 percent in 2085. Under the full scenario, in which adherence to the ACA cost-saving measures also erodes, costs would rise to 7.0 percent of GDP in 2040 and 10.3 percent in 2085. The SGR system compares the accumulated amount of actual physician- related spending to a specified target level.

The Affordable Care Act decreases Medicare spending in the following ways:

  • It permanently reduces Medicare payment updates for most categories of providers by the increase in economy-wide multifactor productivity. “Multifactor productivity” is a measure of real output per combined unit of labor and capital, reflecting the contributions of all factors of production. There are reductions in the annual updates to Medicare’s payment rates for most services in the fee-for-service sector (other than physicians’ services) which will decrease Medicare spending by $415 billion. Physicians’ services are based on a fee schedule, which reflects the relative level of time and effort required for each service and its relative complexity. Relative factors per service are translated into dollar payment amounts through a conversion factor, which is updated each calendar year based on the SGR. Medicare payment rates for physician services are scheduled to be reduced by approximately 31 percent in 2013.
  • The ACA Reduces Medicare Advantage payment benchmarks and permanently extends the authority to adjust for coding intensity. A new mechanism for setting payment rates in the Medicare Advantage program will decrease Medicare spending by $156 billion. A Medicare Advantage Plan is a type of health plan offered by a private company that contracts with Medicare to provide all Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. Premium subsidy amounts will be calculated for low-income beneficiaries to help ensure that the premium subsidy in each Part D region, provides low-income beneficiaries with a sufficient choice of plans for which they would incur no premium liability.
  • The ACA Reduces Medicare Disproportionate Share Hospital (DSH) payments and refines imaging payments. DSH adjustment payments provide additional help to those hospitals that serve a significantly disproportionate number of low-income patients. States receive an annual DSH allotment to cover the costs of DSH hospitals that provide care which is not paid by other payers, such as Medicare, Medicaid, the Children’s Health Insurance Program (CHIP) or other health insurance. Federal Financial Participation (FFP) is limited and is not available for state DSH payments that are more than the hospital’s eligible uncompensated care cost. Unnecessary DSH spending will be decreased by $56 billion.

The estimated amount of deficit reduction from penalty payments and other effects on tax revenues under the ACA will be $5 billion.

Under Mitt Romney’s and Paul Ryan’s Medicare Plan, the CBO estimates that costs for senior citizens could increase by as much as $6,000.00 a year. Low-income beneficiaries who are not eligible for both Medicare and Medicaid would receive a medical savings account (MSA). This account will be used to pay premiums, co-pays, and other out-of-pocket costs. Low-income seniors would be offered the same range of plan options offered to other seniors. Whether they will be able to afford it is another issue since eligibility levels for low income beneficiaries are unspecified. Additionally, there are no price controls for out of pocket expenses for the coverage of essential benefits and unspecified prescription drug coverage. The specificities have not been clarified and senior citizens have expressed their concerns regarding the information provided or lack thereof.

“Our plan is very simple.  Which is, that for people 55 years of age and older there’s no change,” said Mitt Romney during an interview with ABC Green Bay affiliate, WBAY . “The only change I’d mention is we’d restore the $817 billion President Obama took out of the Medicare trust fund.  We’d restore it to Medicare.” 

I beg to differ. 

Mitt Romney’s plan to repeal Obamacare will be much more complicated. Several of the Medicare benefits and payments enacted by ACA will not be able to be retroactively adjusted. There are negotiated contracted payment rates and subsidized benefits in the Medicare Advantage program and the Part D prescription drug program. Likewise the Internal Revenue Service may not be able to collect revenues retroactively; relevant to provisions that have already been provided as new or increased tax benefits. If Mitt Romney repeals Obamacare, he will contribute to increasing federal budget deficits by $109 billion over the 2013–2022 periods. 

Clearly, Mitt Romney’s plan for healthcare is to transfer its ownership, finances, and accountability from the public sector to private enterprises. Read the fine print. The Romney- Ryan policies have the potential to fail to protect the poorest and most vulnerable citizens from social-economic injustices. Nothing happens by coincidence and efforts may be underway at this very moment, to promote their agenda by silencing the voices of those who will be impacted the most, with voter suppression laws. 

Melissa Bynes Brooks is the editor of BrooksSleepReview.

Contact information: melissabynesbrooks@comcast.net

Follow on Twitter @Mlbbrooks

 

“Obamacare: Win-Win for the Economy”

August 1, 2012

By Melissa Bynes Brooks

Theoretically, the cost of healthcare should decrease as the demand for products and services increase because the healthcare industry is the exception to the “basic economic” model of supply and demand. It is more complex. Health insurance costs are lower when larger groups of people are involved in the consumer pool thus increasing demand and lessening the costs of unhealthy or risky individuals with healthy or less risky individuals.

Despite looming promises of repeal by Republicans, the Affordable Care Act (ACA) is an essential component for cost containment and strengthening of the U.S. economy. This is especially true when 17 percent of the nation’s GDP is spent on health care with a GDP growth rate of only 1.5 percent.

Further analysis by the CBO, after the Supreme Court ruled that the ACA is constitutional, indicates that repealing the law would reduce direct spending by $890 billion and reduce revenues by $1 trillion between 2013 and 2022, adding $109 billion to federal budget deficits over that period. Additionally, an estimated 60 million nonelderly people would be uninsured.

Regulatory requirements have not eluded corporate leaders currently brainstorming and investing in new strategies and innovative technologies to position their companies for competition in a market place projected to expand health insurance coverage, to an estimated 14 million people by 2014, and 30 million people by the latter part of the coming decade.

Business mergers are forming between companies directly impacted by the ACA.

In early July, the first major health care sector merger occurred when health care giant WellPoint said it will buy Amerigroup, a managed health care company with 4.5 million customers of state sponsored health care programs, for $4.9 billion or $92 a share in cash.

“We believe that this combination will create an industry leader in the government sector serving Medicaid and Medicare enrollees,” said WellPoint CEO Angela Braly in a statement. Braly added that the merger, which focuses on Medicaid recipients like the poor and the elderly, is an opportunity to “position our companies for future growth as the health insurance industry changes and as we prepare for health insurance exchanges.”

Amerigroup shares increased 40 percent, to over $89.84 a share following news of the merger. WellPoint shares increased 3 percent, to $61.64 a share. Shares for both companies had decreased in value after the Supreme Court decision in June.

The ACA presents broad economies of scale for health information technology (HIT) companies specializing in the provision of secure platforms for accessing and sharing patient data through the installation of electronic health records (EHR), telemedicine, and mobile health applications. 88 percent of physicians said they would like their patients to track their health information and 40 percent of individuals said they would buy a personal health-monitoring device or pay for a monthly subscription to send health information to their providers.

Authentidate Holding Corp. provides secure web-based software applications and telehealth products and services that enable healthcare organizations to coordinate care for patients and enhance related administrative and clinical workflows.

Their alliance with hospitals, physicians, and consumers generated revenues for the quarter ending on March 31, 2012 of approximately $764,000, compared to $729,000 for the prior year period. Revenues were mostly from telehealth products and services. For the third quarter of fiscal year 2012, revenues increased approximately 16 percent compared to the second quarter of fiscal year 2012, due to higher telehealth revenues for the current period.

There are an estimated 5.9 billion mobile-cellular subscriptions. Mobile-broadband subscriptions have grown 45 percent annually over the last four years. PwC estimates the U.S. mHealth market opportunities will be $6.5 billion by 2017, for remote mobile-enabled services used to monitor symptoms and manage chronic conditions like high blood pressure and diabetes. Growth is expected to be driven in part by the ACA objectives of providing cost effective preventative care.

Administration of the U.S. health system alone accounts for 7 percent of total spending. ACA has established regulations to rein in costs. Health insurance providers are now required to decrease administrative costs. They must spend 80 to 85 percent of premium dollars on medical care and health care quality improvement or they will be required to provide rebates to their customers. This year an estimated nine million Americans may be eligible for rebates worth up to $1.4 billion.

There are reimbursement incentives for hospitals and healthcare providers busy implementing certified EHR technology to meet the Centers for Medicare & Medicaid Services’ (CMS) and Office of the National Coordinator’s (ONC) requirements for meaningful use by 2015. Health systems will see a decrease in their Medicare and Medicaid reimbursements if they are not able to demonstrate meaningful use relevant to e-prescribing, the electronic exchange of health information to improve quality care, and the submission of clinical quality and other measures.

Love it or hate it, the Affordable Care Act appears to be a win-win for the economy and healthcare industry stakeholders consisting of consumers, health systems, providers, and technology business enterprises.

“When you eliminate the impossible whatever remains however improbable must be the truth!”

-Sir Arthur Conan Doyle, Scottish author and creator of Sherlock Holmes.

Melissa Bynes Brooks is the editor of BrooksSleepReview.

Contact information: melissabynesbrooks@comcast.net

Follow on Twitter @Mlbbrooks

“Largest Mass Shooting in U.S. History: A Rational Call for Stricter Gun Control”

July 20, 2012

By Melissa Bynes Brooks

Recent gun violence in Chicago was not enough to commence debate on Capitol Hill for stricter gun control laws. Maybe the largest mass shooting ever in the United States on July 20, 2012, in Aurora, Colorado will. The massacre ended with a gunman killing 12 people and wounding 59 others during a midnight showing of ‘Dark Knight Rises.’

It was perfectly legal for James Holmes, the 24 year old suspect, to acquire all of the weapons he used in the massacre according to the state laws of Colorado. The gunman did not have a criminal record or history of mental disorder.  Aurora Police Chief, Dan Oates, said officers found an AR-15 assault rifle, a Remington 12-guage shotgun, a .40-caliber Glock handgun in the theater, and another identical handgun in the car.

While the suspect’s purchase may have been legal, serious proponents against gun violence are wondering, “Shouldn’t there be a meeting of the minds for developing some kind of “red flag” database system to alert law enforcement officials to (at least) multiple purchases of firearms?” In this case, all purchases were made within the last six months at Bass Pro Shops and Gander Mountain Guns.

Seriously, why would a 24 year old need a drum magazine capable of holding more than 100 rounds of ammunition if he’s not employed in law enforcement or on active duty in the military?

I don’t get it and I totally believe in the Second Amendment which gives all citizens the right to bear arms. I also believe that law abiding citizens, like me, who would not otherwise consider legally carrying a concealed weapon– are rethinking that option today because of inadequate gun control laws that are incapable of protecting them from gun violence.

But does this compound the problem?

These are the criteria for purchasing guns in the state of Colorado.

  • Colorado allows people to “possess a handgun in a dwelling, place of business, or automobile.” But they cannot “carry the weapon concealed while transporting it into your home, business, hotel room, etc.”
  • Colorado allows a person to carry a firearm in a vehicle, loaded or unloaded, if its use is for lawfully protecting that person’s property or another person’s property.
  • Concealed weapons permits can be obtained in the county in which a person lives.
  • Colorado prohibits gun registration.

At the end of the day and “yes, when the cameras are gone,” one can only hope that calls for stricter gun control laws will gain some traction. But the topic of gun control is such a politically polarizing issue. So, all bets are off and it is highly unlikely that we will see a healthy debate resulting in practical solutions among those advocating for stricter gun laws and those advocating for more gun rights.

Despite the cynicism, the call for action goes on.

Earlier this year in March, the Mayors Against Illegal Guns Coalition Co-Chairs which is a coalition of mayors advocating for stricter rules on gun sales and ownership, urged the U.S. Senate to reject bills that would override state laws on concealed, loaded guns.  New York City Mayor Michael R. Bloomberg and Boston Mayor Thomas M. Menino  joined  more than 625 mayors, police officers, prosecutors and domestic violence experts who oppose legislation introduced in the U.S. Senate that removes state rules for who can carry a concealed, loaded gun in public.

On Friday following the shooting in Aurora, Colorado, Mayor Bloomberg called on President Obama and Republican presidential candidate Mitt Romney to share with the American people what they would do to reduce gun violence. Stay tuned…

“Soothing words are nice, but maybe it’s time that the two people who want to be president of the United States stand up and tell us what they are going to do about it, because this is obviously a problem across the country,” Mayor Bloomberg said.

“I don’t think there’s any other developed country in the world that has remotely the problem we have,” Bloomberg said. “We have more guns than people in this country.”

So, let’s put the people’s interests before the special interests of the National Rifle Association (NRA). 

Melissa Bynes Brooks is the editor of BrooksSleepReview.

Contact information: melissabynesbrooks@comcast.net

Follow on Twitter @Mlbbrooks

 

 

 

Ten Ways to Stop the Violence in Chicago

July 8, 2012

By Melissa Bynes Brooks

Chicago is currently saturated in a wave of increased murders as a direct result of gun violence. There have been more than 1091 shooting incidents. This is an increase of 12 percent when compared to last year. And 260 murders have occurred, an increase of 37 percent since last year.

In an effort to fight crime, Chicago Superintendent Garry McCarthy uses a management philosophy based on the Bill Bratton approach . Bill Bratton was the Commissioner of the NYPD in the mid-1990s. The NYPD murder rate was cut in half during his tenure and his technique became a national model adopted in cities across the country.

His technique was the CompStat system, an organizational management tool for police departments to map and analyze crime statistics and hold commanders accountable while indicating how each district was performing. He also practiced the “broken windows” theory which instructed cops to crack down on minor offenses such as curfew violations and loud music underscoring- that the best way to fight crime is to fight the disorder that precedes it. Levels of bureaucracy were minimized thus eliminating middle managers and emphasizing the job of the beat cop.

Superintendent Garry McCarthy began applying the CompStat system in June 2011. While this strategy may have reduced crime in New York, results have been less than optimal in Chicago. Unfortunately, significant gun violence continues to be an issue and is directly attributed to youthful unorganized gangs.

These gang “cliques” or factions, some controlling no more than a block or two, have fueled much of the 37 percent rise in murders during the first six months of 2012, Superintendent McCarthy said.

 “They are the fracturing of the bigger gangs,” McCarthy said. “Pick the Gangster Disciples. That’s the biggest gang in the city. Now, there’s God knows how many factions of the GDs. Now, they have their own internal disputes between the cliques- and sometimes within the cliques.”

Superintendent McCarthy authorized a citywide gang audit to help officers recognize the fluid gang boundaries and affiliations. Completed in May, the audit shows that Chicago now has 59 active street gangs with 625 factions- up from 500 factions and 68 gangs in 2003.

Various strategies to dent crime have been implemented but to no avail. McCarthy touted a “wraparound” strategy designed to better connect residents in crime-ridden neighborhoods with social services, such as job placement, domestic violence counseling, camps for kids, and the like.

On June 11, the Violence Reduction Overtime Initiative  was announced. It was a new plan to pay officers overtime to work extra hours in troubled areas. The initiative was targeted at curbing the growing violence with officers directed to get out of their cars and be aggressive. By the end of that weekend, 35 people had been shot and 7 killed.

How can the senseless gun violence and murders be stopped?

Without a doubt, stricter gun laws are needed to prevent convicted felons and other prohibited persons from obtaining guns. Positive changes in the national economy and a calming of urban drug markets would also be helpful.

But in the meantime, here are ten measures with the potential to help decrease the violence as Chicago’s leaders ponder more aggressive crime fighting strategies and tactics- short of calling in the National Guard.

1. Maintain a continued partnership between the Chicago Police Department and Operation Ceasefire Illinois, an innovative violence prevention organization that applies public health principles in its approach to reduce the number of shootings and killings in communities with the highest rates of murder and poverty.

The two main elements of Ceasefire are (1) the direct attack on illicit firearms traffickers and (2) a set of intervention actions that can give gang members a strong deterrent to gun violence. Police can place strong and targeted enforcement pressure or harsh sanctions on gang members to discourage gun carrying. This is known as “lever pulling.” They can also spread the word among gang members about increased enforcement or all anticrime measures, known as “retailing.”

2. Ensure that Directed Police Patrols are dedicated to gun violence prevention, that they do not have to respond to 911 calls, and are trained in citizen interaction and gun seizures. Pedestrian and vehicle traffic are stopped as a blanketing effort or by targeting suspicious activity. Police work closely with citizens within the targeted communities to secure community support and address concerns. The officers on patrol are trained to treat citizens with respect and explain the reasons for the stop. 

3. Build Strategic Approaches to Community Safety Initiative (SACSI) which can reduce violent crime in targeted communities by as much as 50 percent.

Key elements of the SACSI strategy are:

  • Leadership by local U.S. Attorneys’ Offices within a collaborative, multiagency partnership.
  • Integration of researchers into planning and execution of intervention strategies.
  • Design and implementation of interventions that incorporate tactics proven to reduce illegal gun carrying and use.

4. Form Project Safe Neighborhoods (PSN) around five basic components. 

  • Partnerships: among law enforcement agencies, state and federal prosecutors, parole and probation agencies, and community groups– resulting in joint case reviews, chronic violent offender lists, offender notification meetings and directed police patrols in hot spots.
  • Strategic Planning: aimed at enforcement, prosecution, deterrence and prevention.
  • Training: more than 17,000 PSN members had received training by 2005.
  • Outreach: including “Hard Time for Gun Crime,” a nationwide public service announcement campaign.
  • Accountability: through various reporting mechanisms. 

5. Create federal, state, and local collaborations to offer advantages for local crime fighters facing high rates of gun violence. This includes agencies working across departmental lines in probation, parole, the Department of Family and Support Services (DFSS), the Federal Bureau of Alcohol, Tobacco and Firearms (ATF), Drug Enforcement Administration (DEA) and the Cook County District Attorney’s Office. 

6. Create conducive police-researcher partnerships that are vital for action research and intervention which works best when police set aside their reservations or “turf issues” and researchers are flexible and sensitive to law enforcement concerns and priorities. For example, social service workers could be dispatched to deal with the most at-risk youths on the streets to connect them with services and keep them out of trouble.

7. Use Problem-solving Policing crime analysis to locate concentrations of crime called “hot- analysis,” to help police identify high-crime areas, types of crime being committed, and other information that will help craft the most effective response.   

8. Focus on Deterrence-Targeting High-Risk Areas and Offenders in hot-spots of violent crime to convince gang members that just carrying an illegal gun or using it will result in a severe federal sentence without parole.

Remain focused on open-air drug markets which can create attractive targets for armed robbers; draw local youth into the drug trade as well as nonresident drive-through buyers; spur the creation of loose drug “crews” whose feuds can increase gun violence; and lead to the acquisition and use of firearms by dealers, buyers and some residents.

9. Increase involvement and honest communication from community leaders and organizations like the NAACP and National Urban League about personal responsibility and necessary changes needed in the physical and social environment while addressing the causes of violence. Implement mentoring programs that pairs a young person with an adult who can serve as a positive role model to guide the young person’s behavior.

10. Increase family education through social service agencies to prevent violence before it starts. Parents can receive training in child development and learn skills for talking with their kids and solving problems in nonviolent ways. Social-development strategies can teach children and adolescents to handle tough socio-economic situations and to resolve problems without using violence. 

Melissa Bynes Brooks is the editor of BrooksSleepReview.

Contact information: melissabynesbrooks@comcast.net

Follow on Twitter @Mlbbrooks

 

 

 

 

 

 

 

 

 

 

Brother’s Keeper: 6 Examples of Eric Holder Having Obama’s Back

June 23, 2012

By Melissa Bynes Brooks

It’s no secret U.S. Attorney General, Eric Holder, is in the line of fire of the Republican Party. They continue to lambast him at every opportunity, in the hopes of driving him out of office.

Evidence of this became more apparent in the Congressional hearings about Operation Fast and Furious which grew out of Project Gunrunner, set up by the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) to combat gun trafficking along the Southwest border in 2006.

For all intents and purposes, all parties involved agree that Operation Fast and Furious was a botched investigation which left much to be desired from the participating agencies. It was a gun trafficking investigation gone awry. It was mishandled, resulting in a threat to public safety and the 2010 border shooting that killed a U.S. border agent, Brian Terry.

Likewise, a 2010 review done by the Office of the Inspector General shows there was poor coordination, collaboration, and inadequate information sharing between ATF and other Department components, as well as the Mexican government in ATF’s overall management of Project Gunrunner.

ATF has since proposed to implement a revised Cartel Strategy for combating firearms trafficking, to increase its dissemination of intelligence information to its Mexican partners, to increase coordination with the Department of Homeland Security’s (DHS) Customs and Border Protection and Immigration and Customs Enforcement, and improve its coordination with the Drug Enforcement Administration (DEA).

Inquiries and investigations to hold people accountable and determine the root cause of the problems in order to prevent them from happening again is to be expected. Furthermore, Eric Holder has made necessary personnel changes in the Department’s leadership and has instituted policy changes to ensure better oversight of significant investigations. Nevertheless, Republicans continue in their quest to discover criminal activity on the part of Mr. Holder.

It won’t play.

President Obama has demonstrated that he is his brother’s keeper. He has pulled out all the stops to protect Eric Holder and his administration by asserting his Executive Privilege to withhold documents related to Operation Fast and Furious, deemed vital to national security interests.

Republicans were admittedly surprised. Conceivably, they got it twisted because in 2007, then Senator Obama opposed President George W. Bush’s assertion of Executive Privilege. White House Counsel Harriet Miers and White House Chief of Staff Joshua Bolten wouldn’t testify under oath or provide subpoenaed information about the firings of nine U.S. attorneys. The dispute led to the resignation of Attorney General Alberto Gonzales.

The House Oversight and Government Reform Committee, led by Chairman Darrell Issa (R) California, proceeded anyway with vote for a contempt citation against Eric Holder. The vote was lockstep within party lines. However, it was much ado about nothing in light of President Obama’s prior action.

Perhaps the prelude to the contempt citation really is a dictum of the anxiety Republicans have for Eric Holder in his role as President Obama’s keeper. Likely flashpoints involving Eric Holder come to mind.

There are six examples:

1 — A decision in 2009 to prosecute five men accused as co-conspirators in the Sept. 11 attacks in federal court in Manhattan despite criticism that holding such a trial presented greater risks than a military commission

2 — Support of President Obama’s initial desire to shut down Guantanamo Bay which was believed to drive recruitment for anti-American groups because of the mistreatment of prisoners. The alternative would have been to transfer its inmates to prisons in the United States.

3 — The 2010 challenge of the state of Arizona’s immigration law, S.B. 1070, in federal court as unconstitutional. The law attempted to establish Arizona’s own independent immigration policy and created new immigration crimes that were non- existent under federal law. The law also required police to verify citizenship when a person was believed to be undocumented and provided for their arrest. The private right of action against law enforcement officials failing to fully enforce the law was authorized.

4 — A notice to Congress in 2011, when he informed them of the Executive Branch’s determination that Section 3 of the Defense of Marriage Act (DOMA) is unconstitutional regarding the legal definition of marriage as being between one man and one woman when applied to same-sex couples who are legally married under state law. DOMA violated the equal protection component of the Fifth Amendment.

5 — An active commitment to fight voter discrimination and fraud across the country, while protecting the integrity of elections systems, and robustly defending Section five of the Voting Rights Act- which contains several special provisions applicable to jurisdictions showing evidence of ongoing violations or a history of interfering with the rights of minorities to vote.

6 — The recent filing on June 12, of a complaint against the State of Florida for violating Section 8 of the National Voter Registration Act (NVRA). The State continued to conduct a systematic purge of voters from its voter registration rolls within 90 days of an election for federal office. The complaint included Florida’s use of inaccurate and unreliable voter verification procedures.

While improving standard operating procedures is important, Congress could make better use of its time by working in a bipartisan way to improve the economy and pass the American Jobs Act, Dream Act, and an agreement to prevent the doubling of interest rates on federal student loans, on July 1.

Melissa Bynes Brooks is the editor of BrooksSleepReview.
Contact information: melissabynesbrooks@comcast.net
Follow on Twitter @Mlbbrooks

References

Bill Text 104th Congress (1995-1996). Retrieved June 22. 2012, from H.R.3396.ENR http://thomas.loc.gov/cgi-bin/query/z?c104:h.r.3396.enr:

Castillo, M. and Mears, B. (2012). Executive privilege: A rocky legal and political road in U.S. history. Retrieved, June 22, 2012, from http://articles.cnn.com/2012-06-20/politics/politics_executive-privilege-history_1_miers-and-bolten-executive-privilege-contempt-citation?_s=PM:POLITICS

Holder, E., U.S. Attorney General (2011). Defense of Marriage Act. Retrieved June 22, 2012 from, http://www.justice.gov/opa/pr/2011/February/11-ag-223.html

Holder, E., Attorney General Department of Justice (2012). Statement of Attorney General Eric Holder on the House Oversight and Government Reform Committee Vote. Retrieved June 22, 2012, from http://www.justice.gov/opa/pr/2012/June/12-ag-776.html

Justice News (2011). Assistant Attorney General Thomas E. Perez Speaks at the American Constitution Society. Retrieved June 22, 2012, from, http://www.justice.gov/crt/opa/pr/speeches/2011/crt-speech-111201.html

Justice News (2010). Citing Conflict with Federal Law, Department of Justice Challenges Arizona Immigration Law. Retrieved June 22, from http://www.justice.gov/opa/pr/2010/July/10-opa-776.html

Operation Fast and Furious (2012). House Oversight Committee Votes 23-17 to Hold Attorney General Holder in Contempt of Congress. Retrieved June 22, 2012, from http://issues.oversight.house.gov/fastandfurious/

Sage, A. (2011). Attorney General vows to close Guantanamo. Retrieved June 22, 2012, from http://www.reuters.com/article/2011/05/09/us-france-guantanamo-holder-idUSTRE74850M20110509

Savage, C. (2009). Holder Defends Decision to Use U.S. Court for 9/11 Trial. Retrieved June 22, 2012, from http://www.nytimes.com/2009/11/19/us/19detain.html?_r=1

U.S. Department of Justice FY 2013 Performance Budget (2012). Congressional Submission Office of the Inspector General. Retrieved June 22, 2012, from http://www.justice.gov/jmd/2013justification/pdf/fy13-oig-justification.pdf

U.S. Department of Justice (2012). Recent Activities of the voting Section. Retrieved June 22, 2012, from, http://www.justice.gov/crt/about/vot/whatsnew.php