A healthier future

I worked for over seven years to increase awareness of an important health condition that warrants everyone’s attention as 1 in 10 of us have it, and 1 in 3 of us are at high risk of developing the mostly preventable version — diabetes.

Every year as November approached, we would see and begin the preparations for Diabetes Awareness Month, and yet I would think to myself: “Every day is diabetes awareness day!” Thus my mixed feelings toward awareness days even as I knew that 1 in 5 people with diabetes don’t know they have it, and more than 8 in 10 individuals with prediabetes are unaware. This for a health condition that has the potential for significant improvement or control, and potential prevention — if we have the understanding of how to care for ourselves and manage our diabetes or prediabetes.

There are other kinds of awareness events, such as National Wear Red Day (on Feb. 4, this year), which raises attention to heart disease being the No. 1 killer of women, and all of February being American Heart Month; June being Alzheimer’s and Brain Awareness Month, and Sept. 5 to Sept. 11 being National Suicide Prevention Week. The calendar is now full with these kinds of awareness events and it’s difficult to register their existence, let alone keep track of them. Which has helped me now realize there actually can be a benefit to focusing much-needed attention, and has me wondering: As all of us are touched by one or more of these health issues, how do we support and amplify each other’s concerns so that we can all, together, contribute to building a healthier future?

Health equity means that everyone has a fair and just opportunity to be as healthy as possible. And we have long considered the United States to be the land of opportunity. Yet our current standing among developed countries as having the worst maternal mortality — where most maternal deaths are preventable — reminds us that we face a significant threat to the opportunity for all to thrive and contribute to this country’s future prosperity. There are many contributing factors for our current situation — some relate to individuals, many relate to our living conditions, and even more relate to systemic factors such as the availability of health insurance coverage, access to health care, bias that may be built into how things are done and more. Thankfully, more attention is being focused on helpful policy solutions that impact how care is provided in the clinical setting as well as the supports that can help all birthing people have healthy and positive perinatal experiences and contribute to community well-being.

This year April 11 through April 17 marked Black Maternal Health Week — I hope we will all be curious to learn why we should all care enough to be aware.

The wrong crib for this baby

by Jeff Rapsis

All politics is local — and our region’s inability to bring passenger rail back to Manchester, Nashua and the rest of the Merrimack Valley is a good example of that.

However, this old saying might offer the key to finally making progress, even as state lawmakers in Concord are maneuvering to ban using state money on the long-stalled project.

How? I think the issue is that in New Hampshire, as in most places in America, public transit projects such as this naturally fall to a state’s transportation department to plan and oversee.

But in the Granite State, a majority of residents feel they’ll see no real benefits from Manchester and Nashua joining Boston’s commuter rail network. Hence the opposition and inaction, even though civic officials in Manchester and Nashua, the state’s two largest cities, have pushed it for decades.

What to do? I think it’s time for leaders in the Merrimack Valley to recognize that the state DOT is simply the wrong crib for this baby. A majority of the state (and hence the Legislature, which funds the state DOT) will simply never be convinced to make the investment.

So instead, a group of civic leaders from Concord south to Nashua should band together and craft a plan to fund it on their own.

This would require the creation of an entity similar to a tax increment financing district, but on a larger scale. It might function like a regional planning agency, but with the power to propose and implement taxes or other funding mechanisms (subject to voter approval) to raise revenue for restarting and operating passenger rail.

It wouldn’t be easy. But the Merrimack Valley is the most heavily populated area of New Hampshire, home to 561,000 of the state’s 1.3 million residents. It boasts the state’s largest concentration of business activity.

Surely this area on its own could generate the estimated $300 million all-in investment needed to extend passenger rail north from Lowell, Mass., and the annual subsidy of about $13 million.

In return, we’d reap the benefits of improved access to Boston, the region’s economic hub.

And here’s an idea to start you thinking: Why not impose a $5 fee on anyone boarding a Boston Express Bus to Logan Airport, with the revenue earmarked for passenger rail?

Jeff Rapsis, a Bedford resident, is Associate Publisher and a co-founder of the Hippo.

Inquisitive minds

So often in our society, I hear how we crave opportunities for our children to explore, to tinker, and to figure out who they are in this world. We are all for our youth getting outside or into the kitchen or workshop to help make sense of what the world offers them.

What is often missing from this narrative is giving space for our kids to explore who they are and what they offer to the world. In fact, we can often find this downright threatening especially when it comes to exploring one’s race, sexual orientation, sex, gender and culture.

I see the fear of these types of examinations rippling throughout our entire public education system here in New Hampshire and our country as a whole. There are laws and policies being passed that dictate what a teacher can instruct on race, or what name a child can (or cannot) go by, and limit discussions around family structures. There are demands that parents must be notified of all that is being discussed in our K-12 schools with threats of lawsuits being made if those requirements are not met.

In Manchester, there is a lawsuit filed over chosen name practices within that district. We have HB2 in place, which white lawmakers adopted to limit discussions around race in our classrooms. In Mississippi, an administrator was terminated for reading a book titled “I Need a New Butt” to second-graders, and we cannot forget the recent legislation passed in Texas and Florida with really damaging practices put in place to further oppress LGBTQIA+ youth.

These are all motivated by fear but I’m not sure what the fear is about. Do we truly not believe our children are capable of learning more about themselves? To better understand the complexities and possibilities each of our identities hold? Is it that there is a belief that if they learned this information then they would be able to have better agency over their own bodies, their own lives, in a way that threatens the “norm”?

Our kids are beautiful and resilient humans. All trauma specialists talk about the need to build healthy resilience, which comes through conversation, connection and self-responsibility. Avoidance, unfortunately, does not get us there and stunts us against reaching our true potential.

I hope we can embrace and find the same level of fulfillment from self-exploration as we do exploration of the outside world. We can understand a lot from our children, and I believe they will be our greatest teachers in redeveloping our curiosity.

Saying goodbye

Fifteen years ago, as a new board member of the Animal Rescue League of NH, I pulled into the parking lot one day and met the sweetest beagle out for a walk. I went home and began negotiating with my husband, anxious for our 2-year-old son to have a canine companion to grow up with. He reminded me we were leaving on vacation. We agreed if the dog was still there when we got back, we could bring it home. The dog was adopted in the interim, but a few weeks later I received a call that he had been returned.

Potter and his sibling had both arrived at the shelter as strays. Their owner had been called but declined to pick them up. The shelter staff estimated Potter’s age as 1 at the time. When I saw Potter’s patience with our curious toddler, I knew he was meant for us. That patience never wavered with our son, nor with the next beagle I brought home, nor with the addition of a Brittany spaniel, and certainly never with our grandchildren.

This is not to say Potter didn’t have his quirks. UPS deliveries were a challenge as he assumed responsibility for judiciously guarding the front door from any drivers of brown trucks. A few years ago I noticed Potter no longer reacted to the sound of the UPS truck, and we soon realized he had gone completely deaf.

As he entered his senior years he slowed down remarkably, spending his days sleeping in his favorite chair, only rising (punctually) for his four meals a day. As one aging issue developed into another, Potter received his very own pill box so we could better manage his medications. We arranged our schedules to accommodate mealtimes and meds. He became increasingly anxious and restless, frequently pacing throughout the night, symptoms of doggie Alzheimer’s.

The past several months, we have struggled with when to let him go. At a recent vet visit, Potter became aggressive with the vet staff. I knew then that it was time, his pain and confusion causing atypical behavior for him. Potter did his job well, and the little boy who grew up with him is now a 17-year-old teenager. I will be forever grateful that he chose us all those years ago to be his forever home. His steadfast love and companionship made our family whole. He has more than held up his end of the deal and it is time to bid him farewell. May you rest in peace, our sweet boy.

High school diplomas outdated?

What does a high school diploma get you? Some might say that someone with a high school diploma will earn more money over their lifetime than someone who hasn’t earned a diploma. That may be true, but do you credit the diploma for the extra earnings? Does that diploma tell you anything about the specific skills that an individual would bring to the workplace? I believe that the high school diploma has largely outlived its usefulness and that the end game in high school should no longer be to simply earn a diploma.

What does a high school diploma tell you about someone? For example, if someone got a B in biology, can anyone tell me what that person knows and is able to do with what he or she learned in biology? How did they get the B? Did they get it because they got a B average on their tests? Was it because they passed their homework in on time? Did they regularly participate in class discussions? Did they do well on the final exam? Maybe they were nice to the teacher. Whatever they did, it translated into a B. Even if we assume that they did fairly well in their biology class, how much of what they were taught will they actually retain even two weeks after the exam?

And what are colleges supposed to translate from your grades in high school? Why is it that 40 percent of college freshmen need to take remedial courses in either math or language arts? Can we assume that their high school transcripts were interpreted by the admissions officers to be that these students actually had skills in those areas? Then how come they had to take remedial courses?

I believe the high school diploma’s usefulness is coming to an end, and that the new coin of the realm for high schools will be certifications and career credentials; something that will give confidence to anyone who has interest in someone holding one of these credentials that they have achieved the skills necessary to perform the associated tasks, be it a welder’s license, a massage therapist’s license, an associate’s degree in a specific field, etc. These credentials not only give someone confidence that you have the requisite skills but they immediately carry weight in the marketplace when seeking specific jobs.

Career-related credentials are coming soon to a high school near you and they will be a welcome improvement over the outdated notion of a diploma.

Fred Bramante is a past chairman and memtber of the New Hampshire State Board of Education. He speaks and consults on education redesign to regional, state and national organizations.

Finding connection

I recently found myself on a Zoom call with some medical school classmates I hadn’t spoken with in many years. While not a fan of school reunions, I found their enthusiasm infectious as we later considered how to encourage all 85 classmates from the Dartmouth Medical School class of 1997 to attend our upcoming reunion.

Later, I realized that over the last year, I had a few wonderful opportunities to reconnect with lost friends. There is the friend from San Diego who I have only seen once since my wedding 20 years ago; I spent two hours on the phone catching up. There is the friend from Pittsburgh who was my long-distance best friend in high school, back when pen-pals meant you wrote letters by hand and sent them through the (snail) mail. We lost touch until she emailed me. It turns out she has lived in New Hampshire longer than I have! There was joy in reconnecting with people who played significant roles in my becoming who I am today.

The universal need for social connection is well-documented, as are the benefits to physical health and mental and emotional well-being. Having social support networks is considered a social determinant of health — meaning part of the 80 percent of what contributes to our health outside of health care (which contributes at most only 20 percent). Not having social connection can have long-term negative health impacts. Social connection is not about the number of friends or contacts we have, or the number of groups we belong to. It’s about our subjective sense of connection, our feelings on the inside of being connected to others.

According to the Stanford Center for Compassion and Altruism Research and Education we can “give, share support and do acts of service and kindness for others” as compassion and volunteering create that helpful sense of connection and purpose. We should also prioritize taking care of ourselves, and asking for help when we need it. Oftentimes others in our lives would be happy to provide assistance.

On a population level, policy makers can promote awareness of the positive effects of social ties, being attentive to avoiding policies that have a negative effect on social connection, and prioritizing beneficial policies, interventions and programs that reduce social isolation and strengthen social networks and opportunities for connection.

In these challenging times of pandemic fatigue, climate disaster and what feels like the brink of world war, the words of Martin Luther King Jr. resonate for me: “Whatever affects one directly, affects all indirectly. I can never be what I ought to be until you are what you ought to be. This is the interrelated structure of reality.” In the words of a very successful marketing jingle from a while back, go ahead, “reach out and touch someone.” I’m pretty certain you’ll be glad you did.

Very like mine

Their kitchen is very like mine: a coffee maker, bowl of fruit, and a shelf of spices, under a window that looks outside. On their counter is a small TV or computer screen. Yes, it almost exactly mirrors my kitchen here in New Hampshire, but theirs is in an apartment building in Kyiv and one whole wall of their kitchen has been blown out from a Russian missile yesterday morning.

Their family is very like mine. Together today, we are three generations: my wife, our son and our daughter-in-law, and our two grandchildren. They are having breakfast at our house, stopping here on the way to Logan airport for a two-week vacation. I’ve been playing number games with my grandson and our granddaughter is learning to say “Aloha.” As a family, we look very much like them, but they, with their small children, are taking shelter in a subway station as the air raid sirens wail and the sounds of nearby shelling shakes the benches they are sitting on. I see joy and expectation in the face of my grandchildren and fear in the faces of that Ukrainian family. Mine knows where they are going. They have no idea where or when they will be safe.

Their neighborhood is very like mine. The houses are along a tree-lined street with cars parked outside. My neighbors are cleaning up after a snow storm, grumbling when the town snowplow deposits a plug of ice at the end of their newly cleared driveways. But the family outside Lviv is outside trying to halt a line of Russian tanks making its way through their otherwise quiet neighborhood.

Their neighbors are very like mine. Across my street lives a physician, next door is the owner of a construction company, further down is a retired school superintendent and a business executive, and beyond the owner of a tech company. Even in Covid times, we gather in one of our driveways to share a beverage in the evening and catch up on local news. But in Kharkiv, the neighbors gather to collect empty bottles — just like the ones we have — to make Molotov cocktails. And there, too, the counterparts of my neighbors — a physician, a builder, an executive, a retired superintendent, don makeshift uniforms and take rifles into their hands, many of which have never even held a weapon before. Why? Because their country means so much to them.

Empathy is the very human capacity to feel as another person might. The Russian invasion of Ukraine is like no other war in my experience. I do not read about it in a newspaper 24 hours later. Instead, it is broadcast live into my kitchen as it is happening and through those media relays from Ukrainian kitchens, families, neighbors and neighborhoods so very like mine, I am drawn deeply into their plight because it is now so possible to imagine what such a conflict would entail in my otherwise safe life.

They are fighting for democracy and their country. They are also fighting for us. We must help in any way we can.

Flowers for Father O’

Some years ago, I was on a business trip to South Korea, a guest of a university there that had invited me to give some lectures. The hospitality was gracious and generous and included several excursions to places of interest outside of Seoul. At the end of my third day, however, my host, Professor Hwang, advised me that on the next day not he but a colleague would be my guide, as he himself had a “duty” to fulfill.

When Professor Hwang did rejoin me two days later, I tried carefully and respectfully to inquire about the “duty” he had mentioned.Smiling kindly, he asked if I knew yesterday’s date. Of course,” I replied, and mentioned the number of the day in May. His smile grew broader as gently he reminded me it had been the birthday of the Buddha, and that, according to Korean tradition, at least once in a person’s life she or he should observe that sacred day by visiting and bringing flowers to that teacher who had been most influential in the formation of the student’s character. Professor Hwang had done just that. His story touched me deeply.

Three years later — by good fortune, also in the month of May — I was in Santa Barbara, a city to which my high school principal, Father Carroll O’Sullivan, had retired. He had been my mentor all through those long-ago days, but I had lost touch. He welcomed me warmly, graciously accepted the flowers, and as we had tea, I recounted my Korean experience as an explanation for my visit to him now. He was deeply touched. For a couple of hours, we reminisced on those times, and we ended our visit with a photograph being taken. “Father O,” as we all had called him that back then, died just a couple of months later. That photograph is now on my desk.

Yesterday’s Union Leader carried the worrisome news of a recent survey that revealed nearly half of the state’s teachers are seriously considering leaving their jobs. Such an eventuality, understandable given the unprecedented pressures today on their profession — pandemic-related accommodations, workload, fractious school board meetings, uncertainties in the face of legislation restricting what can and cannot be taught, overly officious regulators — would be terrible even to contemplate. And yet, who of us could not, given but a few moments of reflection, identify that one teacher who made such a welcome difference in our early lives?

Yes, this is the dead of winter and flowers are harder to come by and travel more difficult. But do we need to wait until May to contact that certain teacher and just say, “Thank you?”

Embrace the ‘mander

New Hampshire is in the process of its once a decade setting of electoral districts at all levels of government. The state and federal constitutions call for each district to be about the same size so that a vote in one district is equal to one vote in another district. This is the reason we take a census every 10 years.

Not surprisingly, this process of setting districts is a political one with the political parties jostling for position every decade. Each tries to tilt the map to its advantage. The result taken to the extreme is what political scientists call gerrymandering, where the driving force of redistricting is to ensure one party or the other is all but ensured of getting elected and the districts tend to stretch over long distances to get in one voting group or another. On the face of it, that seems pretty undemocratic.

But it’s not. Elections aren’t fair and never have been. Incumbents have huge advantages over challengers. Just like in life, those in power are likely to stay there. But it’s no conspiracy. We — the voters — elect them. Maybe you identify as a Republican but nothing stops you from voting for a Democratic candidate or vice versa. Nothing stops parties from running candidates that might appeal to voters that typically favor the other party.

And that may be why Gov. Chris Sununu signaled that he opposes the Republican state Senate plan that would take the current two districts and rejigger them so that one heavily favors Democrats and the other Republicans. As currently configured, Republicans actually have a good shot at taking both districts if they put up candidates that appeal to a wider electorate, candidates in the mold of Sununu himself.

And that’s the rub. Gerrymandering by its nature shifts candidates of the dominant party to the party base because the only race that counts is the one inside the party. In addition if you’re a party insider in Washington you’re not really looking for Sununu-type officials that might not vote the party line. This goes for both parties. Though the parties want to win, if given the choice, they are going to support less independent candidates.

The flip side is that heavily gerrymandered districts with their more fringy candidates can present an opportunity to the other party if they are willing to be a big tent and allow for candidates with broader views. Voters will listen and will vote for great candidates regardless of their party affiliation if they feel it’s in their interest. But you can’t expect people to vote for candidates who don’t share some of their values. To me the problem isn’t gerrymandering, it’s the parties’ unwillingness to really be competitive in every district. Now wouldn’t that be something.

Inspired for change

February has finally arrived and with it comes Black History Month. Having lived in New Hampshire for a significant portion of my life, I have only recently become aware of all the wonderful events happening across the state during this commemorative month. For those who, like me, wish to address racial injustice and to work for a more integrated nation, here are some things I’ll be doing to expand my commitment.

Attend a Black Heritage Trail of NH Tea Talk. This year’s series is being offered virtually with an in-person option with limited capacity on the subject of “Courage Conversations: Leaning in for Change.” For the 2022 Elinor Williams Hooker Tea Talks Series, BHTNH will work collectively to create a safe space for meaningful interchanges, grounded in history and lived experience between different segments of the Black, Indigenous, People of Color (BIPOC) community. We will also investigate the current issues that continue to create tension in the community. All talks are on Sundays from 2 to 3:30 p.m. and are free of charge. More information can be found at blackheritagetrailnh.org.

Address legislation impacting racial justice in New Hampshire. There are several bills in this year’s legislative session that will have an impact on how our state’s public education systems are able to practice their right to teach our students. The most promising, SB304, counters the harmful HB2 “divisive concepts” bill that has sent a chill throughout our state’s public institutions, especially K-12, in their efforts to address inclusion and equality especially around race. Passage means removing provisions concerning freedom from discrimination in public workplaces and education, and would clarify the authority of public schools and public employers concerning discrimination.

There are two additional bills that are looking to limit free speech and free expression in the classroom. HB1313 expands HB2 to include public higher education and limit the essence of higher education learning by promoting the omission and silencing conversation on important parts of our nation’s history as it relates to race and other protected identities. HB1255 seeks to ban New Hampshire public school teachers from promoting any “negative account or representation of the founding and history of the U.S.”

Explore my own biases and assumptions This is, for me, the most critical piece of this work. What is my vision for our society and what role will I play in helping to create this? I need to know that I am not free of racial biases and healing myself of these comes from self-responsibility, patience, love and mindfulness.

This work, of course, doesn’t end in February. This is a years-long journey and it will continue to require collective community to bring about the change.

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