MACA: Make America Competent Again

 

By David K. Shipler 

The first in an occasional series 

                Perhaps the word “again” should be put in quotes or parentheses or followed by a question mark, because while the United States has done a lot of things very well through its history, incompetence has also plagued governmental behavior in areas ranging from foreign affairs to poverty. A frequent hallmark of failure has been the unwillingness to apply what we know to what we do. Expertise does not get translated into policy.

                The most obvious recent example is the Covid-19 pandemic, where the Trump administration’s floundering cost lives and worsened economic hardship. But the gap between knowledge and practice inhibits problem-solving in many fields. If you add up all of society’s accumulated understanding about the causes of poverty, for example, or about the sources of conflict in one or another region of the world, and then compare that knowledge with the actions being taken, it looks as if knowledge gets filtered out through a fine sieve before it gets to the policy level.

The Vietnam War was such a case. The US government saw North Vietnam as a Chinese and Soviet proxy in the vanguard of communism, and therefore a threat to American security. But historians knew that Vietnam had resisted China for centuries. And so could any American soldier or diplomat in Saigon who bothered to notice how many streets were named for Vietnamese heroes in the long campaigns against Chinese occupation. It should have been no mystery to American policymakers that the war, for Hanoi, was the continuation of a long anti-colonialist struggle, not one fought to spread global communism.

The dilution of expertise in making policy can be seen in the Middle East, Russia, China, and other parts of the world. The same is true at home. Much is known about how to treat prisoners to reduce recidivism rates, how to prevent police from extracting false confessions, how to provide good defense attorneys for indigent defendants, how to curtail global warming, how to clean up air and water, how to make workplaces safer, how to reduce suicides (gun control), how to treat mental illness, and on and on.

Accumulated knowledge about poverty is not put to good use. We know how to alleviate housing problems in America; it’s a matter of money. We know how to eliminate malnutrition—also a matter of money. We know how to raise workers’ skills and make work pay enough to sustain a family. We know how to provide decent medical care. We know how to improve education. True, some of our abilities diminish along the more difficult part of the spectrum—we are confounded by child abuse, drug abuse, gang violence, racism, white supremacy, and harmful parenting. But we know how to ease many other hardships.

Why don’t we apply our knowledge? For at least two main reasons. One is the lack of will. We’re not good at playing the long game by paying for remedies that don’t show immediate results. We are stricken with impatience; deferred gratification is not our thing. We elect timid officials, not true leaders who dare to educate and inspire. Alarmist sound bites about higher taxes strike a chord. Blaming the victims is a professional pastime on the political right.

Another reason is widespread unawareness. In some quarters, experts are derided as elitist and disparaging. Research isn’t sufficiently shared among disciplines, so the silos of information don’t get blended and communicated to the general population. Specialists’ insights are often left hidden in obscure corners of the scientific or academic world. As a result, known lines of cause and effect are invisible.

An important illustration of the failing is the relationship between housing, malnutrition, brain development, and lifelong cognitive impairment that leads to learning disabilities and school dropouts. The chain reaction is well understood by experts but hardly at all by legislators who vote on housing subsidies, much less by the public at large.

It works this way: Take a low-income family way down on the waiting list for the inadequate government programs that reduce housing costs. On the open market, the family might pay 50 to 60 percent of monthly earnings for rent. That is not an optional expense. You have to pay the rent. You have to pay for electricity, heat, and phone. If you’re part of the vast majority of Americans who have to drive to get to work, you have to make the car payments and the insurance premiums. These are not choices. They cannot be squeezed. What can be squeezed is the part of the monthly budget for food.

And that is what many poor families confront. Research on low-income households has found a high correlation between a lack of housing subsidies and malnourished children.

Malnutrition impairs the immune system, making kids more susceptible to illness.

More seriously, decades of study by neuroscientists have shown that malnutrition during critical periods of brain development—notably the last two trimesters of a woman’s pregnancy and the first two or three years of a child’s life—can cause lifelong cognitive damage. The early deprivation can leave indelible marks even if it is followed by years of improved nutrition. Teenagers who suffered iron deficiency during periods of critical brain development score lower in math and written expression, motor function, spatial memory, and selective recall. They display more social problems, attention deficit, anxiety, and depression.

Facing such disabilities, they are candidates for the ranks of school dropouts, who earn less money, pay less in taxes, suffer more health problems, and encounter the criminal justice system at higher rates. Food insecurity now hits an estimated 27 percent of American adults without a high school diploma, compared with only 5 percent of college graduates.  

Obviously, not all cognitive deficits can be traced back to inadequate housing subsidies. But inadequate income can be felt indirectly as well. Childhood food allergies cannot be addressed without access to well-stocked grocery stores, which are sparse in poor neighborhoods that are often called “food deserts,” where 19 million Americans now live.

Nursing a child’s food intake cannot be done well without consistent adult supervision, often lacking when parents work odd hours for low wages and rely on neighbors or relatives as caregivers. New immigrants are sometimes fooled by advertising into thinking of American junk food—Coke and chips, for example—as nutritious. All this and more is witnessed by doctors and nutritionists in America’s malnutrition clinics. Yes, there are malnutrition clinics in the United States of America.

And the pandemic has only made the situation worse. With people out of work and schools closed, depriving kids of school lunches, a companion epidemic of food shortages has spread ominously. The incidence of households reporting inadequate food has risen from 10.5 percent in 2019 to estimates of 23 percent or more. Among families with children, rates are 27.5 to 29.5 percent, affecting over 13.9 million kids.

Do we not know the devastating brain damage being done to children? Yes, we know. That is, neuroscientists know, pediatricians know, some of us who have being paying attention know. If those who make policy knew, the idealist would say, we would spend more on housing. We would spend more on SNAP, formerly known as food stamps, which is underfunded and a perpetual target of Republicans. (Trump tightened the rules and reduced some benefits, which President Biden has reinstated.) If we were true to what we like to believe about ourselves, we would not be consigning millions of children to lifetime cognitive impairment.

When government fails, the society fails. That sets up a circular pattern, for alienated citizens tend to drift toward populist demagogues such as Trump, who devastated government agencies designed to render help. Republicans who cultivate distaste for government, and who deprive government of the tools necessary for effectiveness, reinforce the syndrome that will elevate the next Trump—on the backs of those who go hungry today. 

Next: Private efforts to Make America Competent