Date: Sun, 25 Jul 2004 11:49:54 -0700 (PDT)
Subject: [HAB:] Social pathology as a public health issue


re: Fred, "The good of dialectical therapy" (0407.25)

Fred,

You've listed a range of issues that the social work
professions and the public health field live with.
Generally, what's needed, I believe, is an integration
of social services at several levels: 

---Integration at the nexus of the family: family
services, including crisis intervention, brief and
extended counseling, coordinated health care,
graduated foster care, graduated job training, special
education, and legal aid. In a phrase: comprehensive
care. I would propose a model of comprehensive care,
in terms of familty-targeted integration of social
services. Integration isn't measured by system
efficiency (or administrative integration, though
that's vital), but by family-centered appropriateness,
across kinds of family situations, i.e., with respect
to the *individuality* of family contexts. 
Effectiveness is measured in terms of
*appropriateness* of family outcomes:
individualization of services. This is expensive;
integrating family services implies the political
difficulties of budgetary cycles, creative leadership
in developing and shepherding coordination *durably*,
institutionalizing practices that work best for
specifiable kinds of family complexes, and so on. 

---Integration at the locus of the neighborhood:
Police as community support service over mere law
enforcement, working in tandem with  social services;
well-funded famlily courts, well-coordinated with
family services; coordination of employment
development services with social services and with
municipal economic development; and so on.

--- Integration at the locus of the municipality:
public health as a "global" (locally holistic) context
involving all dimensions of the community: cultural,
political, economic, housing, and infrastructural, but
specifically as a matter of the many dimensions of
public health in play simultaneously for the
lifeworld. I would advocate a public health model of
the public good. 

--- Integration across professions, at the university
level, in terms of holistic thinking about social
problems in terms of the lifeworld simultaneity of all
aspects of public health, political economics,
culture, geography, and individual differences. 

"Theory," as anthropological sciences understand it
(i.e., as conceptual work including, but much more
than, the scientific sense of theory, which is
empirical-analytical), pertains to the issues of
"horizontal" and "vertical" integration, modeling,
reconstructive inquiry, critical problem-solving,
evaluation, and further modeling. 

F> From a global perspective, [...there is] widespread
or folk sexism, racism, ageism, and classism. 

G: So, we have to come back from the heights of
anthropological generalization to target integrated
services effectively for individualized contexts or
sites. I call this a process of *site-ation":
appropriation of intervention as contextualization of
theory and practice *in the terms of* the site that
lives what "you", in turn, need to live *with* to
help. What's a good general model of the helping
professions that works (dwells well) across problem
complexes, adjusts well to cultural diversity, and is
replicable at, say, the level of the World Health
Organization? As important as anything, perhaps, is
one's embodied sense of communicative action or
rapport with the cultural geography of the
client---one's sense of site in sitation. 

F>  I  have always felt that one weakness in Habermas'
theory was the achievement of  autonomy or competency.
 I do not interact with many autonomous people who
could at least take an impartial look at their own
beliefs and reflectively assess how their beliefs
atttitudes, ideas, and behaviors which are  immoral. 

G: Yet, people widely share the *virtue* of what we
call autonomy, usually in senses of self-efficacy,
self-determination, productive well-being, etc. People
widely share the values of fairness, thoughtfulness,
and conscientiousness. We all have ideals. We all
believe that it's good that there be truth and
rightness. We all know that learning is important, and
we all come to appreciate in our own ways that
learning never ends. Ideal-typical modeling by social
theorists serves to conceptualize our valued
intuitions and foster an evolution of
conceptualization applicable to professional
development and social practice. 

F> ... humans are learning by imitation to practice
racism and sexism. If we claim that these beliefs, and
not other  macroeconomic processes, lead to increased
fitness and hence  reproduction, then your defense of
teleology might work,....

G: By "imitation," you're alluding to traditional
socialization. Education, broadly conceived (across
social services, workplace, and media, as well as
schooling), is the medicine that heals. I understand
teleology in a non-naturalistic sense of idealizing
social purposiveness, as is Habermas's project of
modernity. We want good lives for ourselves; that only
happens by deliberately aiming to make a good life, in
terms of what a good life is considered to feasibly
be. 

F> ... but population statistics indicate  that
fertility is decreasing or that child-bearing
strategies are optimizing by limiting reproduction. 

G: I don't follow your point. But I'm reminded of the
fact that European population is failing to grow like
the immigrant-rich U.S. population grows, and this is
an important factor in Europe's wariness of American
success in global competition. Just yesterday, I read
a fascinating article about how American success with
outsourcing in India was causing American Indians to
move back to India, while keeping strong ties to the
U.S. So, too, for Chinese-Americans, East
Asian-Americans, Latino-Americans (above all), and
Arab-Americans. American globalization has a
multi-ethnic character that Europe can't match, and it
drives the French and Germans nuts. 

Gary





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