<br>

Analytic note: Although there is strong rationale to believe that health care financing changes will promote collaboration between LHDs and LBHAs, one respondent explicitly stated that such funding could have the opposite effect and hinder collaboration. As this respondent said, “… the money sometimes gets people to create moats and walls that will happen. It's sometimes easier to collaborate when there's no money at stake at all.” (Respondent 7)

Full Citation: Interview with Respondent 7.

<br>

Analytic note: A potentially useful tool to help LHDs integrate mental health into their scope of practice: Lando and colleagues developed a logic model to integrate mental health into physical health promotion initiatives which includes steps such as “define public health role in mental health” and “integrate mental health into public health program efforts.”

Full Citation: Lando J, Williams SM, Williams B, Sturgis S. A logic model for the integration of mental health into chronic disease prevention and health promotion. Prev Chronic Dis. 2006:3(2):A61.

<br>

Source excerpt: “And, yes, we could have said, we don't really – we're not invested in [mental health], but I think as public health our goal has been to plan, prevent and protect… So when you look at it from that perspective and then you look at the social determinacy of health and other things that play into chronic illness, it just was a natural progression for us to want to take that up and lead that charge.” (Respondent 17)

Full Citation: Interview with Respondent 17.

<br>

Analytic note: This sentiment is reinforced by this quote from a respondent: “Here at the public health district, we would say that mental health certainly is a public health problem, but we aren’t technically in the business of delivering direct mental health services.” (Respondent 6)

Full Citation: Interview with Respondent 6.

<br>

Analytic note: Although many respondents alluded to the idea that the field of public health is currently embracing the notion that mental health is a public health issue, some respondents expressed that many staff within their LHD still view mental health as something that is beyond the scope of public health practice.

In one instance, a LHD official identified stigma towards people with mental illness as a major barrier to her co-workers’ viewing mental health as a public health issue As this respondent stated, “I think there’s that stigma. Unfortunately, there’s a horrible stigma with behavioral health clients. They’re ‘those people.’ And that’s just to me a cultural thing and perhaps when you have those entrenched staff persons, they don’t kind-of get it. And it takes more of an effort to get the staff persons that have been here many years to buy into it [and see that] it’s all people that reside in this community. And most of the people that reside in this community are ill in many different ways.” (Respondent 21)

Full Citation: Interview with Respondent 21.

<br>

Analytic note: A recent study provides the first empirical evidence that LHD engagement in population mental health activities improves population mental health outcomes. Chen and colleagues found that LHD provision of mental health preventive care (OR=0.76, 95% CI=0.63, 0.92) and mental health promotion activities (OR=0.77, 95% CI=0.62, 0.94) were significantly associated with lower rates of preventable hospitalizations for individuals with ambulatory care–sensitive conditions and coexisting mental disorders.

Full Citation: Chen, J., Bloodworth, R., Novak, P., Le Cook, B., Goldman, H. H., Rendall, M. S., ... & Reynolds, C. F. (2018). Reducing Preventable Hospitalization and Disparity: Association With Local Health Department Mental Health Promotion Activities. American journal of preventive medicine, 54(1), 103-112.

<br>

Analytic Note: For readers who might like to see the exact language of each civil rights statute, we provide links to, respectively, the Civil Rights Act of 1968 (of which the fair housing act was a component, starting on p. 12 of the document) and the Civil Rights Act of 1964, of which equal employment was a component, starting on p. 253 of the document)

Full Citations: 82 Stat. 81 (1968); 78 Stat. 241 (1964)

https://legcounsel.house.gov/Comps/Civil%20Rights%20Act%20Of%201968.pdf <br> Permanent link: https://perma.cc/S773-ERU2 <br>

https://www.gpo.gov/fdsys/pkg/STATUTE-78/pdf/STATUTE-78-Pg241.pdf <br> Permanent link: https://perma.cc/8U9F-ADRM <br>

<br>

Analytic Note:

We cite two primary documents in this section: a New York Times article and a government document showing official HUD correspondence. Both sources show the political and legal obstacles facing HUD officials who sought a broader GCE enforcement strategy. More specifically, both sources discuss how local zoning laws constrained possible plans to integrate urban and suburban communities.

Data Sources: Shipler (New York Times, 1970): http://www.nytimes.com/1970/05/17/archives/us-aide-attacks-suburban-zoning-denies-lack-of-funds-bars.html <br> Permanent link: https://perma.cc/KL3T-FUFJ <br>

HUD Papers (23 Jan. 1970): https://data.qdr.syr.edu/file.xhtml?fileId=15261

<br>

Analytic Note: The archival government documents cited in these highlighted sections offer further historical evidence of HUD’s initial attempts to incorporate an aggressive GCE-based enforcement structure for fair housing (although they eventually proved unsuccessful).

Data Sources:

https://data.qdr.syr.edu/file.xhtml?fileId=15262

https://data.qdr.syr.edu/file.xhtml?fileId=15264

https://data.qdr.syr.edu/file.xhtml?fileId=15265

<br>

Analytic Note: Here we cite a primary government document collected at the National Archives. It provides evidence that HUD initially sought a broad, GCE approach to fair housing enforcement that would include substantive integration of entire communities.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=15263

Full Citation: Romney to Sloane, Dec. 9,RG207,REL 6-2, box 68, folder “Sept. 9–Dec. 31 1969,” p. 1, U.S. Department of Housing and Urban Development Papers, National Archives, College Park, Md. (hereafter HUD Papers).

<br>

Analytic Note: We cited several primary governmental sources to supplement secondary sources with respect to Reagan’s later attempts to dismantle the GCE-based “disparate impact” standard for proving employment discrimination. Weakening disparate impact doctrine was a way to weaken equal employent enforcement more generally, which is consistent with our broader claims about GCE enforcement and civil rights policy success.

Full Citations: R. Stryker interview with Mark Rosenblum, Washington, D.C., June 4, 2008.

U.S. Department of Education (1987); U.S. Commission on Civil Rights (1987); U.S. Congress (1985a; 1985b); U.S. Commission on Civil Rights (1987)

<br>

Analytic Note: Another convention in historical-comparative research is to first consider whether other theories/arguments can explain comparative outcomes across selected cases. A set of alternative explanatory factors emphasized by prior theories are typically constructed as respective qualitative-binary "variables" which are either "present" or "absent" in each case. Secondary and/or primary qualitative data can be cited to establish scholarly consensus about whether these alternative factors were present or absent in each case. In our study (summarized in Table 1), we considered four existing explanations for civil rights policy outcomes: 1) formal enforcement power; 2) bureaucratic infrastructure; 3) policy entrepreneurship; and 4) white resistance.

We concluded that while each of these factors were important, none alone could explain our observed hierarchy of COMPARATIVE outcomes across all three cases. For example, strong enforcement powers were present in voting rights but absent in both equal employment and fair housing policy. Nonetheless, equal employment was substantially more successful than fair housing and; thus the "strong enforcement powers" argument alone cannot adequately explain civil rights success. After doing this for each alternative explanation, it sets the stage for our own theoretical argument about civil rights policy outcomes that we claim CAN explain outcomes across all three cases. Specifically, we claim that the degree to which each civil rights policy incorporated a "group-centered enforcement" (GCE) structure can explain our observed outcomes across all three cases.

<br>

Analytic Note: This section comprises the bulk of our qualitative comparisons among the three civil rights laws and their early enforcement trajectories. Key qualitative-comparative findings are summarized in Table 3 and are based on a combination of primary and secondary data. Specific examples follow in subsequent notes.

<br>

Analytic Note: This section begins our formal empirical-qualitative analysis of comparative civil rights outcomes. Our guiding “GCE” theoretical framework outlined above FIRST explores the extent to which civil rights law incorporates GCE principles both in terms of ORIGINAL STATUTORY LANGUAGE. Thus, this section compares the formal statutory language AS ORIGINALLY ENACTED of voting rights, equal employment, and fair housing law.

<br>

Source Excerpt: The weight of the legislative history and an analysis of the basic purposes of the Act indicate that the enactment in each of these cases constitutes a "voting qualification or prerequisite to voting, or standard, practice, or procedure with respect to voting" within the meaning of § 5. No. 25 involves a change from district to at-large voting for county supervisors. The right to vote can be affected by a dilution of voting power, as well as by an absolute prohibition on casting a ballot. See Reynolds v. Sims, 377 U. S. 633, 377 U. S. 555 (1964). Voters who are members of a racial minority might well be in the majority in one district, but in a decided minority in the county as a whole. This type of change could therefore nullify their ability to elect the candidate of their choice, just as would prohibiting some of them from voting.

Analytic Note: Because the expansiveness (vs. narrowness) of legal doctrine on defining and proving unlawful discrimination is a core feature of our GCE framework, court rulings, and Supreme Court rulings in particular, were an invaluable source of qualitative data. In this highlighted passage, we note that the Supreme Court’s 1969 Allen v. State Board of Education decision EXPANDED the legal defintion of voting rights to include not only the right to register and cast a ballot, but also for racial minority groups to not have their votes “diluted” by other changes to state electoral procedures. This provides qualitative-empirical evidence that voting rights enforcement incorporated an aggressive GCE approach that contributed significantly to the overall success of voting rights law.

Full Citation: Allen v. State Board of Education 393 U.S. 544 (1969)

https://supreme.justia.com/cases/federal/us/393/544/case.html <br> Permanent link: https://perma.cc/3HB7-LPLQ <br>

<br>

Analytic Note: The highlighted citations are examples of qualitative sources cited to establish a set of introductory facts or events that provide a “hook” for the paper’s analytic objectives. In this case, we begin with a citation to a 2013 Supreme Court ruling that weakened the 1965 Voting Rights Act; we coupled this with a quotation in the New York Time Magazine from a civil rights activist decrying the decision. Thus the “hook”: by legally narrowing the Voting Rights Act, civil rights advocates feared that the law’s impact on minority rights were under assault in ways that presumably would not have been the case had the Supreme Court ruled otherwise. Moreover, because this is a comparative study, we added a citation to another Supreme Court ruling in a separate area of civil rights law (housing) that expanded the legal scope of housing discrimination in ways that, again citing the New York Times, might render equal housing at least somewhat more effective. In sum, these concise introductory citations from qualitative sources set the stage for the paper’s basic question: how and to what extent do changes in formal legal doctrines impact the opportunities and life chances of minority groups?

Full Citations: Shelby County v. Holder (2013); Rutenberg (New York Times Magazine 2015); Texas Dept. of Housing v. Inclusive Communities (2015); New York Times (Editorial Board 2015)

<br>

Analytic Note: Each of the above are citations to secondary sources used to establish comparative differences between equal employment and fair housing enforcement; they show in part that the EEOC more successfully established elements of GCE enforcement than did HUD.

Full Citation: Johnson (2011); Schwemm 1988; Schwemm and Taren (2010); Seicshnaydre (2013)

<br>

Source Excerpt: The objective of Congress in the enactment of Title VII is plain from the language of the statute. It was to achieve equality of employment opportunities and remove barriers that have operated in the past to favor an identifiable group of white employees over other employees. Under the Act, practices, procedures, or tests neutral on their face, and even neutral in terms of intent, cannot be maintained if they operate to "freeze" the status quo of prior discriminatory employment practices...good intent or absence of discriminatory intent does not redeem employment procedures or testing mechanisms that operate as "built-in headwinds" for minority groups and are unrelated to measuring job capability.

Analytic Note: This is another example of a Supreme Court ruling be used as primary-qualitative data. Recall that the EEOC attempted to expand the legal definition of employment discrimination to cover not only intentional acts of discrimination, but also practices that unintentionally have a statistically disparate "impact" on minority groups. In the Griggs case cited here, the Supreme Court explicitly endorsed the EEOC's position thus providing equal employment law with a major GCE-based resource that it would have lacked had the Supreme Court ruled otherwise.

Full Citation: Griggs v. Duke Power Co. 401 U.S. 424 (1971)

https://supreme.justia.com/cases/federal/us/401/424/case.html <br> Permanent link: https://perma.cc/9F7K-8JNF <br>

<br>

Analytic Note: Here, we cite two primary government documents (a Supreme Court ruling and EEOC interpretive guidelines) to demonstrate that Title VII in the late 1970s was expanded to allow and encourage employers to take "affirmative action" to increase minority employment opportunities. Affirmative action as a substantive remedy for systematic discrimination is one component of a GCE-based enforcement structure, one that takes a more proactive and aggressive approach to remedying employment discrimination.

Full Citations: United Steelworkers v. Weber 443 U.S. 193 (1979); EEOC Affirmative Action Guidelines (44 Fed. Reg. 11997 [1979])

https://supreme.justia.com/cases/federal/us/443/193/case.html <br> Permanent link: https://perma.cc/7EM3-BGTK <br>

http://cdn.loc.gov/service/ll/fedreg/fr044/fr044043/fr044043.pdf <br> Permanent link: https://perma.cc/2AQV-GQ9P <br>

<br>

Analytic Note: Grofman (1992) is among the most comprehensive analyses of the Voting Rights Act’s early positive impact on black voting in the South. We made heavy use of it because it provided solid evidence for our theoretical claim that the Voting Rights Act was so successful because it incorporated an aggressive GCE enforcement structure. We supplement this with another secondary source (Light 2010) and a primary-government document (U.S. Commission on Civil Rights 1970)

Full Citations: Grofman et. al. (1992); Light (2010); U.S. Commission on Civil Rights (1970)

<br>

Analytic Note: Here we cited data obtained from retrospective in-depth interviews with equal employment legal experts to buttress and provide further evidence for several of the key claims and conclusions we make in this section.

Full Citations: Robin Stryker interview with Al Golub (2005); Robin Stryker interview with Mark Rosenblum (2008)

<br>

Analytic Note: Historical-comparative research often uses qualitative data initially in the paper's theoretical front end/literature review to set up the study's comparative design. This section of our paper cites a variety of mostly secondary sources to establish a set of civil rights outcomes across several cases that sets the stage for the study's formal comparative analysis to follow in later sections. In other words, qualitative data plays an important role in the study's front AND back ends.

<br>

Analytic Note: This empirical-analytic section on equal employment opportunity again uses a combination of secondary and primary qualitative data to construct our narrative about Title VII's limited success in expanding equal employment opportunities. In this highlighted section, we citied the EEOC's early testing guidelines published in the Federal Register. This document was chosen in part because it provides empirical evidence for our theoretical claim that the EEOC, despite lacking formal enforcement powers, nonetheless used it's legal-interpretive authority in an attempt to LEGALLY EXPAND the definition of unlawful employment discrimination, a key component of our GCE framework developed in the paper's front end.

Full Citation: EEOC Testing Guidelines (35 Fed. Reg. 1970 [Aug. 1], p. 12333).

http://cdn.loc.gov/service/ll/fedreg/fr035/fr035149/fr035149.pdf <br> Permanent link: https://perma.cc/V6FC-CYEH <br>

<br>

Analytic Note: Table 2 summarizes the statutory language of voting rights, equal employment, and fair housing law. We rely largely on secondary sources to establish scholarly consensus on what each law said, what prohibited/allowed, how each law was to be enforced, etc. However, we also cited primary-government documents to supplement secondary sources (see next comment).

<br> This is an Annotation for Transparent Inquiry project, published by the Qualitative Data Repository.

<br/>

<font>The Data Overview discusses project context, data generation and analysis, and logic of annotation.</font> </br/>

Please cite as:

Ramírez Stege, Alyssa M.; Yarris, Kristin Elizabeth. 2018. "Data for: Culture in la clínica: Evaluating the utility of the Cultural Formulation Interview (CFI) in a Mexican outpatient setting". Qualitative Data Repository. https://doi.org/10.5064/F6ICDLGP

Additional documentation can be found on QDR.

Learn more about ATI here.

<br>

Analytic Note: In addition to the examples from two providers given in the published article, here I offer an example from another Provider, Maribel, taken from her Post interview. The two providers presented in the article, Maria and Rufino, both have additional training outside of Psychiatry. In Maria’s case, she is trained as both a General Practitioner and in Public Health; in Rufino’s, he has graduate training in the humanities – History and Philosophy.

In the article, we argue that this broad training (beyond biological/clinical medicine) gives these two providers a more complicated understanding of the ways in which mental illness is associated with social/cultural/contextual factors in patients’ lives and an understanding of the humanistic side of medical/psychiatric practice (e.g. Maria and Rufino are empathetic to their patients’ life concerns). On the other hand, Maribel is trained purely in medical psychiatry, and her view of mental illness reflects the biomedical model, whereby mental illness results from neurochemical imbalances and brain pathology. Thus, the example below offers a counterpoint to the Rufino and Maria examples given in the published article. Given her narrow scope of training, as the extract below shows, Maribel views the CFI as basically irrelevant to her diagnostic process and clinical practice, since, in her view, culture has essentially no bearing on the course or treatment of mental illness. In an inverse way to the examples in the published article, then, the example below also supports our argument, which is that provider training shapes the utility of the CFI.

Source excerpt:

AR: Este- ¿Cómo crees que influye la entrevista de formulación cultural al diagnóstico diferencial y/o final a la que vas a llegar? ¿O a la que ya llegaste?

PR: Pues ahí sí la verdad no mucho porque es como un poco independiente de lo que.

AR: Mm mm.

PR: Lo que [ellos tienen].

AR: Ya. ¿De qué manera es como independiente? Para tí.

PR: Pues- por lo regular no- no tenemos tanto a [contar a] la cultura para las enfermedades. Si bien que si hay síndromes culturales en las clasificaciones, como que en pues- esquizofrenia y eso como es más universal no depende tanto de la cultura. Entonces- ya el diagnóstico pues no cambia ¿no? más bien vemos que tenemos que reforzar a lo mejor pero el diagnóstico no cambiaría.

AR: Entonces influiría otras cosas.

PR: Ah huh, sí. En como el paciente [exactamente ve a la enfermedad] porque en el diagnóstico pues, no. Ya.

Source excerpt translation:

AR: How do you think the Cultural Formulation Interview influenced the differential or final diagnosis at which you are going to arrive or at which you have already arrived?

PR: Well there the truth is not that much because it’s a little independent of...

AR: Hmm mm.

PR: What they have.

AR: In what way is it independent? For you.

PR: Well, normally- we don’t have to take into account culture in [mental] illnesses. It is true that there are cultural syndromes in the classifications, but like in schizophrenia and these things they are more universal and don’t depend much on culture. So then the diagnosis doesn’t change, right? Instead we see what we need to reinforce, but the diagnosis doesn’t change.

AR: So it might influence other things.

PR: Yeah, that’s right. Like in how the patient exactly sees their illness. But the diagnosis, well, no [it is not influenced].

Full Citation: POS PR8 PX 10, (Note: “PR” is Provider Maribel and “AR” is Researcher).

<br>

Analytic Note: We had many examples of social support arise in our interviews with providers (psychiatrists and residents in psychiatry). These comments came out particularly in the “post” interviews, which were conducted with providers and patients separately at the conclusion of every CFI interview. Space limitations in the published article meant we only included two brief interview extracts as examples of social support. Below is an extension of the interview extract with Provider Juan included in the published article. This longer excerpt from the Post interview with Juan illustrates further the argument made in the article, that is, that one of the key ways the CFI is useful is in eliciting information about the patients’ social support. Juan was one of a number of providers who pointed this out, and yet his comments below expand this point to reference the broader cultural relevance of the family in psychiatric care in Mexico. The quote in the published article from Juan was embedded in an exchange with the interviewer that touches on several related points, which are illustrated in the longer extract below.

Specifically, Juan discusses his views of the importance of the family in conceptualizing culture in Mexican clinical settings, a point that is central to our findings about the utility of applying the CFI in this clinical context. He also discusses the influence of culture and family on the course of mental illness and the importance of including the family in mental health treatment.

Source Excerpt:

AR: Ok, perfecto. ¿Hubo algunas preguntas que cree que fueron más útiles?<br> PR: La-la concepción que tiene la familia sobre ellos o los amigos sobre la enfermedad, yo creo que es algo muy importante que ellos den su punto de vista de lo que los demás piensan porque él sabe lo que tiene y cómo se siente, este- a lo mejor no te lo sabe explicar de una manera muy adecuada pero la familia es importante saber qué es lo que- cómo lo perciben a él- cómo él se siente que se percibe- que lo perciben<br> AR: ¿Y por qué crees que a lo mejor es importante tener como esa información?

PR: Porque podemos ayudar a la psicoeducación con los demás familiares, ¿no? Que entiendan que lo que le pasa a él pues es una enfermedad que puede mejorar, que puede controlarse pero que- que no es- no es algo que con el tiempo se va a ir quitando ¿no? Al revés, con el tiempo, si no toma un tratamiento no va a mejorar<br> AR: Perfecto. Este, ¿hubo alguna pregunta que no fue muy útil, que a lo mejor cambiaría?<br> PR: Mmm, yo creo que la parte final que cuál serían como sus expectativas ¿no? A lo mejor este saber específicamente qué es lo que espera de su- de esta enfermedad, ¿no? En que- cómo puede concluir ¿no? O si va a involucrarse con otras enfermedades<br> AR: Entonces este, esa sería una pregunta que a lo mejor incluiría a eso y como sus expectativas<br> PR: Mhm<br> AR: ¿Hay otra pregunta que incluiría para mejor capturar el rol o papel que juega su origen o cultura en su enfermedad o tratamiento?

PR: Por nuestra cultura y desarrollo es bien importante la familia en México ¿no? Entonces tenemos que hacer mucha hincapié en qué es lo que piensa la familia y cómo vive la familia con un-un-un-una persona que tiene una enfermedad<br> AR: Entonces no nada más enfocarnos como en el individuo pero como más en su contexto social.<br> PR: En su contexto social, así es.<br> AR: ¿Algo más?<br> PR: Nada más, yo creo que todo muy bien

Source excerpt translation:

AR: Ok, perfect. Were there any questions that you thought were more useful [in the CFI]?<br> PR: The conception that the family or their friends has about them [the patients] and about the illness, I think that is something very important that they give their point of view about what others think because he knows what he has and how it feels, maybe he doesn’t know how to explain it to you in the best way but it is important to know how the family perceives him [the patient] how he feels about how they perceive him.

AR: And why do you think it is important to have this information?

PR: Because we can help with the psycho-education of family members, right? So that they understand what it is that is happening to him [the patient], it is an illness that can improve, that can be controlled, but- it is not something that is going to go away with time, right? Just the opposite, with time, if he doesn’t follow a treatment, it is not going to get better.<br> AR: Perfect. Um, was there a question that was not very useful, that you would change?<br> PR: Hmm, I think that the last part about what would be their expectations, no? Maybe it would be better to know specifically what is what they expect of their illness, no? About how it might end, no? Or whether it might be related to other illnesses.

AR: So, that would be a questions that you would include, about their expectations<br> PR: Hmhm<br> AR: Is there any other question that you would include to better address the role that culture or origen plays in their illness or treatment?

PR: For our culture and development in Mexico, the family very important, no? So we have to put a lot of emphasis in what the family thinks and how the family manages to live with a- a- a- person that has a [mental] illness.

AR: Meaning, not just focus on the individual, but more in their social context.

PR: In their social context, that’s right.<br> AR: Anything else?

PR: Nothing else, I think that everything’s very good.

Full Citation: Post interview, Provider 4, Patient 5 (POS PR4 PX5) (Note: “AR” is Researcher; “PR” is Provider Juan).

<br>

Analytic note: Question 8 (“Q 8”) of the CFI is explicitly related to culture, as it asks patients how their “background or identity” has influenced their “presenting problem”. Across our observations of the CFI interviews, this was the question that most frequently was misunderstood, or not understood at all, by patients, with providers also struggling to explain the meaning of the question to their patients during the CFI interview. As a result, patient responses to Q 8 were limited or, at times, nonexistent. At times, patients understood this question as an inquiry into their family relationships, and thus would elaborate upon aspects of their family lives they feel are relevant to their illness experience.

The two interactions we offer in the published article are thorough and do illustrate the general ways that providers and patients responded to question 8 of the CFI. Nonetheless, I am offering another example of a patient response to CFI Q 8 here, which illustrates the difficulty patients had in understanding and responding to this CFI question. This was a significant finding across many of our CFI interviews, but we were forced to cut some of these additional examples from the published manuscript due to space limitations. In the extract below, the patient’s presenting “problem” was “nervios” (nerves, a cultural idiom of distress in Mexico), and the provider – following the CFI instructions, uses her “nervios” as the problem of focus in framing Q 8. The provider also uses some of the prompts attached to the CFI in instructions to interviewers provided in the instrument. In reformulating the question, this provider attempts to frame CFI Q 8 in their (the provider’s) own words, in a way that they (the provider) think will facilitate the patient’s understanding of the question. Despite the provider’s reformulation/customization of the question, the patient flatly fails to comprehend the intention or meaning of CFI Q 8.

Source excerpt:

PR: ¿Mhm? A veces aspectos que se refieren a nuestro origen, este, del lugar donde nacimos, a nuestra identidad- a la identidad de una persona, pueden mejorar o empeorar sus nervios. Por origen o identidad me refiero, por ejemplo eh- al lugar donde usted pertenece, este, el lenguaje que usted habla, eh de donde es usted, su familia, este la raza, este, el hecho de que usted es mujer, este, algunas personas la orientación sexual, la fe o la religión, este, esto se lo menciono, es importante para las preguntas que vienen. Para usted, ¿cuáles son los aspectos más importantes de su identidad o de su origen?<br> PX: ¿Cómo? No lo entiendo

Source excerpt translation:

PR: Hmm? Sometimes aspects related to our origin, the place where we were born, our identity- the identity of a person, can help or worsen your nervios. By origin or identity, I’m referring, for example, to the place that you belong to, the language that you speak, where you are from, your family, race, um- the fact that you are a woman, um- for some people, their sexual orientation, faith or religion, um- I mention this to you because it’s important for the following questions. For you, what are the most important aspects of your identity or origin?

Patient: What? I don’t understand.

Full Citation: CFI Interview, Patient (“PX”) 8, Provider (“PR”) 6 (EFC PX8 PR6).

<br>

Analytic note: This section of the results describes the clinical implications of the CFI and is well-supported with the quotes and analysis we provide in the original published article. Nonetheless, below I present an additional exchange to both further demonstrate the clinical implications of the CFI, and to expand the discussion presented in the article. The extract below, from a Post interview with Provider Maria, describes what the Provider found useful in the CFI interview, but also moves into a set of broader reflections about the overall clinical implications of the instrument. This extract thus illustrates arguments we make in the article about the utility of the CFI in enhancing provider empathy towards patients’ lived experience, about the ways the CFI offers access to information about the broader cultural context and background of patients, and about how this information opens new insights for providers about the clinical relevance of culture for their patients’ future course of psychiatric treatment. Specifically, as we see at the end of the exchange below, this Provider arrives at a differential diagnosis for this particular patient due to their experience with the CFI interview.

Source excerpt:

EN: Aha. ¿Y qué impacto tuvo la Entrevista de Formulación Cultural sobre el contenido y la calidad de la información que obtuviste?

PR: Pues más que nada este, es como que adentrarte un poquito más al contexto del paciente. Ya te ayuda para ver en qué situación en particular el paciente se encuentra y que son las cosas que le están afectando que a veces no tomamos en cuenta porque son preguntas que no hacemos de manera rutinaria y pues no, no nos damos cuenta de lo que el paciente pues está viviendo.

EN: Bueno. ¿Y amm, que impacto tuvo la EFC, la entrevista sobre tu relación con el paciente? ¿Crees?

PR: Pues si es bueno porque ya le preguntas cosas más personales y se, se fomenta más la empatía con el paciente y que el paciente tenga, te tenga un poquito más de confianza y también tu pues te haces, haces una, la relación médico-paciente es un poquito más estrecha porque ya sabes más cosas de él

EN: Ok. ¿Y cómo crees que influya la entrevista amm al diagnóstico diferencial y/o final a la que llegaras? Al diagnóstico.

PR: Pues si nos ayuda porque aumenta la cantidad de preguntas y, y ya pude observar otros síntomas que no había observado porque no se los había preguntado. Entonces sí,creo que ya puedo este, aumentar otro diagnostico en ella.

EN: Ok. ¿Y, y siguiendo en este tema, este que impacto crees que tendrá la entrevista sobre el plan de tratamiento? ¿Hay un cambio del plan de tratamiento? ¿O hay un impacto?

PR: Bueno por ejemplo en ella este aparte de namas la teníamos con este coeficiente intelectual limítrofe pero ya, bueno como ya la había visto y con otras, como en las citas anteriores no la vi porque ya no estaba aquí pero ahora yo creo que si tiene algo de, de un transtorno mixto ansioso-depresivo entonces pues como ya tengo otro diagnostico pero las preguntas me ayudaron a llegar a eso este pos le tengo que iniciar un antidepresivo.

EN: Ok. ¿Y que fue de más ayuda sobre la inclusión de la entrevista amm en la evaluación clínica? ¿Qué ayuda más?

PR: Mmm, de que es lo que ella cree que tiene, osea.

EN: Ahh.

PR: Si. Este, que es lo que cree que le está pasando y amm (.) y lo que empeora su problema, los factores que expresan la pregunta número siete entonces ahí pude ver de qué pues si tiene, si tiene un, tiene un componente ansioso lo que ella su, su patología.

Source excerpt translation:

EN: Ah ha. And what impact did the Cultural Formulation Interview have on the content and quality of the information you obtained?

PR: Well, more than anything, it’s like you get to go a little more inside the context of the patient. It helps you to see what particular situation the patient is in, and what are the things that are affecting the patient, since sometimes we don’t pay attention to [these things] because we don’t ask these types of questions on a routine basis and so we don’t notice what the patient is living [through].

EN: Good. And, what impact did the CFI, the interview, have on your relationship with the patient, do you think?

PR: Well it’s good because you ask [the patient] more personal questions and it- it creates more empathy with the patient and [makes] the patient have- have a little more trust in you. Also, well, you make- you form a doctor-patient relationship that is a little tighter because you know more things about [the patient].

EN: Ok. And how do you think the interview influenced the differential or final diagnosis that you arrived at?

PR: Well, it does help because it enhances the quantity of questions and I could observe other symptoms that I hadn’t observed because I hadn’t asked about them. So, yes, I think that now I can enhance her [the patient’s] diagnosis.

EN: Ok. And, continuing with this topic, what impact do you think the interview with have on your treatment plan? Is there a change in the treatment plan? Or, will there be an impact?

PR: Well, for example, with her [the patient], besides the fact that we have with her this borderline IQ, but since I have seen her in prior visits, I didn’t see it because I wasn’t here, but now I think that, yes, she has something like a depressive-anxiety disorder. So, well, I have another diagnosis but the questions helped me to arrive at that- so, well, I have to start her on an antidepressant.

EN: Ok. And what was most helpful about including the interview in your clinical evaluation? What helped the most?

PR: Hmm, about what it is that she thinks she has, I mean.

EN: Ahh.

PR: Yeah. What is it that she thinks is happening to her and what makes her problem worse, those things that question number seven get at, there I could see that yeah, she has- she has an anxiety component to her pathology.

Full Citation: Post interview Provider 1, Patient 1 (POS PR1 PX1), (Note: EN is interviewer/researcher, PR is Provider).

<br>

Analytic Note: The discussions regarding 'individualism' reflected several social and cultural aspects of the community. Within the focus groups issues of class differences, family 'cliques', and trust surfaced as the rationale for a lack of collective action among community members. Both long time members of the community and those new to the area identified a cultural predisposition as individualistic.

<br>

Source Excerpt: "Fazer algo que chame atenção - uma campanha ou mutirão na praia e distribuir cartezes, panfletos, etc. As pessoas gostam as coisas que chame atenção. Assim eles dariam mais importância.

Source Excerpt Translation: "Do something that draws attention - a campaign or collaborative volunteer effort and distribute posters, brochures, etc. People like things that draw a lot of attention. this would give them (TAMAR) more importance."

<br>

Analytic Note: The focus group schedule was developed with consideration of the data from the questionnaires. The goal was to derive more in-depth understanding of participation within particular groups and generate a discussion among members about community participation more broadly, as well as participation in sea turtle conservation.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=15308

<br>

Analytic Note: The primary forms of community engagement employed by the research base in Sítio do Conde include informational presentations with schools and local fishers’ groups, public release of sea turtle hatchlings on local beaches, and the distribution of informational posters, magazines and other materials to local restaurants and hotels. The attached table presents information compiled from reporting documents representing the number of activities and participants over a five-year period from 2008 to 2012. For example, staff conducted or organized 36 school presentations for approximately 2511 primary and secondary local school children. More people were reached through the release of hatchlings or rehabilitated sea turtles on the beach, with over 10,000 people participating in these events. However, it is important to note that these occur primarily throughout the reproductive season, also the tourist season, meaning that participants in this type of activity are more likely to be tourists than local residents. In comparison to the national data, activities conducted by the research base in Sítio do Conde represent 4% of all participants nationally.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=15311

<br>

Analytic Note: In delving into the issue of 'more presence' by TAMAR in the community, focus group participants wanted the conservation project and staff to be more integrated into the community. It is important to note here that the main project staff, the biologists, are usually from another part of the country and not locals to state or even the region. They often don't share many cultural similarities, have different accents, are accustom to different food, climate and way of life. Although the project does hire local staff to assist in monitoring sea turtle nests on the beach and with other tasks, these staff are not involved in decision-making. In fact, decision-making for the research base often comes from the headquarters and is out of control of the staff biologists. In addition, the staff biologists are tasked with facilitating community activities with little to no training, time, or interest. Therefore the relationship with the community fluctuates over time with staff changes. It is important to keep in mind how dynamic socio-ecological systems are and the influence this has on conservation at the community level.

<br>

Source Excerpt:

P1: União<br/> P2: Participação<br/> P1: União<br/> P2: É isso.<br/> P1: Todo mundo unido...todo mundo pensando na mesma manera...pode conseguir tudo isso aqui..entendeu? Conseguindo não tirar lixo e outras coisas..<br/> Entrevistadora: Cada pessoa tem que fazer sua parte?<br/> P1: Exactamente...não uma pessoa pensando de seu jeito e pensando do outro.. <br/> ...<br/> P3: A união faz a força..<br/>

Source Excerpt Translation:

P1: Unity<br/> P2: Participation<br/> P1: Unity<br/> P2: That's it.<br/> P1: Everyone united....everyone thinking in the same way...you can accomplish all of this here...understand? Such as not throwing trash and other things...<br/> Facilitator: Each person has to do their own part?<br/> P1: Exactly...not one person thinking one way and another in another way<br/> ....<br/> P3: Unity provides strength.

Analytic Note: This excerpt presents a portion of a 2 minute and 33 second dialogue about the importance of unity in the fishers association and in relation to sea turtle conservation. While there were about 3 people who were the main contributors to this discussion, as the facilitator I did ask it there was agreement among the other participants, to which the response was a strong "sim" or yes. This was echoed in 2 other groups and noted as a strong motivation for them to participate in a group, to feel a part of something, share experiences, and work collectively.

<br>

Data Source: Study Site: https://data.qdr.syr.edu/file.xhtml?fileId=15310

<br>

Analytic Note: A number of factors were considered in determining what aspects were more relevant, including the number of times a code appeared in a focus group, the amount of time or length of comments related to the topic, as well as the number of groups mentioning these issues. However, this was not a purely quantitative assessment of absence or presence, with a focus on what and how people were discussing an issue in addition to how often. The quantitative aspects of the codes was left out of this manuscript because it detracts from the over all findings, especially with a small sample size for the focus groups.

<br>

Source Excerpt:

P1: Tem homens participando bastante porque hacen artesanato muito bonito, muito bem feito. Mas tambem sao um pouco de….<br/> P2: É um pouco de machismo.<br/> P1: É.<br/> P2: Tem um pouco de…<br/> P3: É orgullo<br/> P1: Mas tem...eu sei que tem grandes talentos.<br/> P2: Se hacen luminarias..<br/> P1: É muito difícil para os homens…é bem difícil né? Collective – É<br/> P2: o machismo <br/>

Source Excerpt Translation:

P1: There are men that participate a lot because they make very beautiful handicrafts and art, very well made. But also they are a little…<br/> P2: It’s machismo a little.<br/> P1: Yep.<br/> P2: They have a little..<br/> P3: It’s pride.<br/> P1: But they have..I know that they have great talent.<br/> P2: They make lamps…<br/> P1: It is very difficult for the men…it is really difficult, isn’t it?<br/> Collective – It is.<br/> P2: ..the machismo…

Analytic Note: In this discussion among focus group participants from the local artisan's group, which was made up entirely of women, the group discusses the lack of men in their group. It is common for men in the area to make different types of handicrafts., such as the lamps mentioned as well as woodcarvings, paintings, and weavings. However, they felt that 'machismo' and pride kept them from participating in a group of all women. In another focus group of all women the issue of machismo also arose when discussing men's participation with the youth group activities. Often the group hosts gatherings where food is served and asks families to volunteer to help cook and serve. This responsibility always falls to the women, as men don't see cooking and serving food as "men's work, reinforcing local gender roles. There are many men who own restaurants in the area and cook or serve food in this context, this adds an additional gender dimension between paid and un-paid work. This excerpt also illustrates how cultural norms lead to gender segregated networks.

<br>

Analytic Note: According to the Colônia de Pescadores Z-31 (fishers’ association) in Sítio do Conde, in 2011 there were roughly 450 associated fishers from the surrounding communities; however, this does not include those that fish for recreation or in times of need to feed their families. Women are more likely to participate in subsistence fishing and not be regular members of the association. This was evident through interviews, not included in this manuscript, conducted with women fishers. These interviews also revealed that women didn't see the association as addressing their needs and concerns, as they are more often involved in near shore or mangrove fishing (marisquera), than open water fishing (pesca). Furthermore, fishers without a legal form of identification cannot register to participate with the fishers association, which was later mentioned in a focus group as a barrier to participation - especially for older and/or lower income men and women.

<br>

Analytic Note: Projecto TAMAR is a federally sponsored conservation monitoring program in Brazil. TAMAR is meant to represent the word for sea turtle in Portuguese, tataruga marinha (TA-taruga MAR-inha). The project monitors sea turtle populations along the entire coastline of Brazil, managing 22 research stations in 9 states. More information can be found on their webpage, provided here.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=15312

http://www.tamar.org.br/ <br> Permanent link: https://perma.cc/ZB79-HHZ5 <br>

</a> <br> This is an Annotation for Transparent Inquiry project, published by the Qualitative Data Repository.

<br/>

<font>The Data Overview discusses project context, data generation and analysis, and logic of annotation.</font>

<br/> Please cite as:

Rinkus, Marisa A.. 2018. "Data for: “Ninguém me chama” - “Nobody asked me”: Gendered patterns of participation in sea turtle conservation in Northeast Brazil". Qualitative Data Repository. https://doi.org/10.5064/F6SGXPOS.

Learn more about ATI here.

<br>

Data Sources: Images of community activities

https://data.qdr.syr.edu/file.xhtml?fileId=15314

https://data.qdr.syr.edu/file.xhtml?fileId=15315

https://data.qdr.syr.edu/file.xhtml?fileId=15316

https://data.qdr.syr.edu/file.xhtml?fileId=15305

https://data.qdr.syr.edu/file.xhtml?fileId=15306

<br>

Source Excerpt: "Hoje em dia a maior participação são das mulheres, antes a concentração maior era dos homens. A nova Lei do Estatuto estabelece que a tem que ter a liderança mais de mulheres. El assim estão incluindo mais mulheres na diretoria da Colônia." Research assistant focus group notes

Analytic Note: While there is a sense among the focus group participants from the fishers association that there is more participation by women than men, there were only 2 women participants (one was a member of the governing committee) at the focus group. In addition, the data from the household questionnaire and my observations indicate that participation by women was still in the minority in comparison to men. The governing committee is made up of 18 people and with the new law will need to be 9 men and 9 women. This will be a drastic change for the organization as in 2011 there was only one woman participating on the committee.

Source Translation: "Today the majority of the participation is from women, before the majority was from men. A new State Law was established to have more women in leadership. He (the President of the fishers association) is including more women in the governing committee."

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Source Excerpt: 3.5) Você já participou de alguma atividade do TAMAR (palestra, soltura, etc.)? Sim [ ] Não [ ]

3.6a) (SE NÃO) Por que não? Nunca foi chamado [ ] Não sabia que podia participar [ ] Outro [ ]

3.6b) (SE SIM) Qual ou quais atividades?

(a) Você participaria novamente? Sim [ ] Não [ ]

(b) Você vê algum beneficio ou vantagem para você participar destas atividades? Sim [ ] Não [ ] (SE SIM) Qual?

(c) Você vê alguma desvantagem ou prejuízo para você o trabalho que o TAMAR realiza aqui? Sim [ ] Não [ ] (SE SIM) Qual?

3.7) Em sua opinião, quais outras atividades deveriam ou poderiam ser realizadas pelo TAMAR neste povoado?

Source Excerpt Translation: 3.5) Have you participated in a TAMAR activity (presentation, hatchling release, etc.)? Yes [ ] No [ ]

3.6a) [IF NO] Why not? Never invited [ ] Didn't know I could participate [ ] Other [ ]

3.6b) [IF YES] Which activities?

(a) Would you participate again?

(b) Do you see any benefit or advantage for you to participate in these activities? What are they?

(c) Do you see any disadvantage or prejudice for you to participate in these activities? What are they?

3.7) In your opinion, what other activities should or could be carried out by TAMAR in this town?

Analytic Note: Although portions of the instrument used were adapted from the Social Capital Assessment Tool (SOCAT) used by the World Bank, section 3 'Nature and Conservation Programs' was developed by the author for the purpose of this study. These questions pertain to sea turtle conservation more specifically and local environmental concerns. The development of these questions and the refinement of the SOCAT was informed by semi-structured interviews conducted with local leaders and pilot testing of early drafts with research assistants and their families. This excerpt includes some of these questions, mainly the open ended questions. However the closed-ended questions included here benefited greatly from the semi-structured interviews and pilot testing to create the response categories, as some were initially open ended. The full questionnaire is included here in Portuguese as well.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=15309

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Analytic Note: This Skype interview occurred on June 26, 2015. The conversation with an international rule of law professional based in Kabul who worked with the Ministry of Justice and other state and international actors regarding potential state regulations of the non-state justice sector. Our discussion focused primarily on the history of state attempts to regulate non-state justice in the post-Taliban era and the future prospects of regulation.

Full citation: Author Skype interview with international rule-of-law professional in Afghanistan, 2015.

<br>

Analytic Note: All interviews were conducted on the basis of strict anonymity, which interviewees viewed as an essential precondition to a more expansive and forthright interview. At the same time, recognizing that anonymity also raises concerns regarding sourcing in no instance has a claim been accepted based on an anonymous interview that has not been collaborated by another functionally independent source.

These interviews, both of which focused on US efforts to engage with non-state justice, were conducted on February 9 and February 12, 2014 respectively in Kabul. Both participants worked directly with the programs in question and confirmed the existence of this dynamic based on their work outside Kabul.

<br>

Analytic Note: While USAID produced regular reports, evaluations, and other program-related materials, State Department programs were more opaque. Reports were not published with the same regularity and when they were they were far less likely to be made publicly available. Fortunately, these program have been subject to contemporary oversight from sources such as SIGAR that help facilitate process tracing based research.

<br> This is an Annotation for Transparent Inquiry project, published by the Qualitative Data Repository. Please cite as:

Hamilton, Melissa. 2018. "Replication Data for Debating Algorithmic Fairness". Qualitative Data Repository. QDR Main Collection. https://doi.org/10.5064/F6JOQXNF

Additional documentation can be found on QDR.

Learn more about ATI here.

<br>

Analytic Note: The SPSS output files supporting the separate analyses referred to herein are available in the linked file.

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=11299

<br>

Analytic Note: The SPSS output files supporting the separate analyses referred to herein are available in the linked file.

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=11299

<br>

Analytic Note: The SPSS output files supporting the separate analyses referred to herein are available in the linked file.

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=11299

<br>

Analytic Note: Graphs of recidivists and of non-recidivists by decile and race may visually provide context for the mean score differences. The top graph shows the proportion of recidivists for each race that were classified in each decile bin. The lower graph does the same amongst the non-recidivists. These visually depict that both recidivist and non-recidivist blacks were more likely to be classified among the top four decile scores, which would increase their total mean scores comparatively.

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6763

<br>

Analytic Note: COMPAS shows significant differences in mean decile scores for Hispanics versus non-Hispanics as well (Hamilton, forthcoming 2018).

Source Excerpt: “All four comparisons of mean decile score differences between groups are statistically significant at the level of p=.005 or below. Mean scores for recidivist and non-recidivist Hispanics are substantially lower than non-Hispanics. Practical differences exist as well. Mean scores for Hispanics exhibit much less variance between the recidivists and non-recidivists in both scales, being approximately one decile apart. The means for the non-Hispanics are at least two deciles apart, thus signifying greater mean score differences that distinguish non-Hispanic recidivists from non-recidivists in scoring to a greater degree. Overall, the metrics in Figure 7 signify a failure in balances for the positive and negative classes and thus again indicate algorithmic unfairness and disparate impact of COMPAS scoring based on Hispanic ethnicity.”

Full Source Citation: Melissa Hamilton, The Biased Algorithm: Disparate Impact for Hispanics, AM. CRIM. L. REV. (working paper, forthcoming 2018), https://ssrn.com/abstract=3251763

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6759

<br>

Analytic Note: The following excerpt from a data scientist further explains how the balance equations serve fairness.

Source Excerpt: “A second goal focuses on the people who constitute positive instances (even if the algorithm can only imperfectly recognize them): the average score received by people constituting positive instances should be the same in each group. We could think of this as balance for the positive class, since a violation of it would mean that people constituting positive instances in one group receive consistently lower probability estimates than people constituting positive instances in another group. In our initial criminal justice example, for instance, one of the concerns raised was that white defendants who went on to commit future crimes were assigned risk scores corresponding to lower probability estimates in aggregate; this is a violation of the condition here. There is a completely analogous property with respect to negative instances, which we could call balance for the negative class. These balance conditions can be viewed as generalizations of the notions that both groups should have equal false negative and false positive rates.”

Full Source Citation: Jon Kleinberg et al., Inherent Trade-Offs in the Fair Determination of Risk Scores, Conf. on Innovations in Theoretical Computer Science 2 (2017), https://arxiv.org/abs/1609.05807 (emphasis in original).

Permanent link: https://perma.cc/J4RD-C6QY

<br>

Analytic Note: COMPAS shows test bias for Hispanics as well (Hamilton, forthcoming 2018).

Source Excerpt: “Model 1 indicates that Hispanics are significantly less likely to engage in any act of recidivism. Model 2 supports the overall utility of COMPAS for the groups combined in that the odds of general recidivism increases 32% for every one unit increase in COMPAS decile score. In Models 3 and 4, when adding the decile score, Hispanic ethnicity is no longer statistically significant. While the odds are less for Hispanics in Model 3, such that there is evidence of overprediction for them, it is not statistically significant (p=.380). However, the interaction term in Model 4 is statistically significant (p=.015). This means that Hispanic ethnicity significantly moderates the relationship between COMPAS decile score and general recidivism. As the interaction term is below one, the regression slope is less steep for Hispanics, revealing that as the COMPAS score increases, it has weaker influence on predicting recidivism for Hispanics. In other words, COMPAS does not predict as strongly for Hispanics and thus is not as valid a predictor for that group. Further, unequal slopes reflect differential test prediction and thus present as disparate impact.”

Full Source Citation: Melissa Hamilton, The Biased Algorithm: Disparate Impact for Hispanics, AM. CRIM. L. REV. (working paper, forthcoming 2019), https://ssrn.com/abstract=3251763

Permanent link: https://perma.cc/993U-Z5UF

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6764

<br>

Analytic Note: Flores et al. (2016) published results of what is purported to show no test bias for blacks using the same dataset for COMPAS general recidivism. This might appear to be inconsistent with what is presented here where in Model 3 the variable of black was statistically significant at p = .037. However, to attain a statistically nonsignificant result for blacks in their Model 3, Flores et al. added gender and age variables as controls. As shown in the data source, controlling for gender or age by itself would still have left the black variable with statistical significance in their Model 3’s at p < .1. While generally in a dataset this large, this would not have been deemed to be statistically significant, perhaps it was too close for comfort. By controlling for both female and age, the authors then could more strongly report no statistical significance as the black variable in the larger model with the two demographic controls had a p = .191. It is noted that the gold standard for test bias using the hierarchical regression model approach does not generally suggest adding controls other than those related to the predictor tool.

Full Source Citation: Anthony W. Flores et al., False Positives, False Negatives, and False Analyses, 80 FED. PROBATION 38, 41 (2016).

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6753

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6754

<br>

Analytic Note: Another way to look at calibration is what has been referred to as well-calibration (Source Excerpt). Also known as differential prediction, it looks to whether expected rates of recidivism are the same as observed recidivism rates in action, and that this is the case irrespective of group membership. Expected rates are generated from logistic regression models whereas observed rates are the actual recidivism statistics. We can show these differences by plotting expected rates of recidivism against the observed rates at every COMPAS decile score (with expected versus observed referred to herein as “E/O”). In the data file, we plotted a single expected rate line computed using Model 2 statistics from Table 1 in the paper. The single expected rate line represents the expected recidivism rate at each decile score, regardless of group. Two lines of observed rates of recidivism are presented (one for blacks and the other for whites) at each decile. Notice the inequalities at several decile scores. The results are consistent with Model 3 in Table 1, whereby controlling for decile score, blacks still had a higher recidivism rate than whites. Hence, this particular measure indicates inequalities, though here favoring blacks in that the plots show underprediction.

Source Excerpt: “This definition extends the previous one stating that, for any predicted probability score S, subjects in both protected and unprotected groups should not only have an equal probability to truly belong to the positive class, but this probability should be equal to S. That is, if the predicted probability score is s, the probability of both male and female applicants to truly belong to the positive class should be s.”

Full Source Citation: Sahil Verma & Julia Rubin, Fairness Definitions Explained, FairWare ’18 conference 2 (2018), http://www.ece.ubc.ca/~mjulia/publications/Fairness_Definitions_Explained_2018.pdf

Permanent link: https://perma.cc/Q87U-APQN

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6751

<br>

Analytic Note: Basically, a regression analysis is a statistical method to evaluate the relationship between one or more predictors with a response (outcome) variable (Backman & Paternoster, 1997). An interaction term refers to the product of two predictor variables (here, test and group) to determine whether the effect on the outcome of either predictor is moderated by the presence of the other (i.e., changes its strength or direction of influence) (Jaccard, 2001).

Full Source Citation: RONET D. BACHMAN & RAYMOND PATERNOSTER, STATISTICS FOR CRIMINOLOGY AND CRIMINAL JUSTICE 675 (1997).

Full Source Citation: JAMES JACCARD, INTERACTION EFFECTS IN LOGISTIC REGRESSION 12 (2001).

<br>

Analytic Note: Northpointe characterizes these differences as “slightly lower” or “slightly higher,” which serves to mask attention to statistical tests for significance (Source Excerpt 1). Perhaps it was simply taking advantage of ProPublica’s first neglect here as in an explanatory document released along with the Machine Bias piece it also characterized a PPV differential of 4% as meaning one group designated at high risk was “did recidivate slightly more often” (Source Excerpt 2).

Source Excerpt 1: “The results actually indicate that in comparison with whites a slightly lower percentage of blacks were “Labeled Higher Risk, But Didn't Re-Offend” (37% vs. 41%). The results also show that in comparison with whites, only a slightly higher percentage of blacks were “Labeled Lower Risk, Yet Did Re-Offend” (35% vs. 29%). Thus we conclude that the General Recidivism Risk Scale exhibits predictive parity for blacks and whites. This result refutes PP's claim of racial bias.”

Source Excerpt 2: “However, black defendants who scored higher did recidivate slightly more often than white defendants (63 percent vs. 59 percent).”

Full Source Citation: Jeff Larson et al., How We Analyzed the COMPAS Recidivism Algorithm, PROPUBLICA (May 23, 2016), https://www.propublica.org/article/how-we-analyzed-the-compas-recidivism-algorithm

Permanent link: https://perma.cc/SAN7-YLGG

<br>

Analytic Note: Northpointe has previously shown sensitivity to critical reviews by independent auditors. The following is an excerpt from a response to a review of COMPAS by Skeem & Louden (2007).

Source Excerpt: “We acknowledge at the outset that most of the evidence for the reliability and validity of COMPAS is found in the results of in-house research studies conducted by Northpointe across a variety of jurisdictions and states. We know that critics may discount this research. However, much of our in-house research is conducted for state agencies. In many cases, competent research divisions within those agencies scrutinize the methods and results very closely. These state-sponsored studies are often subjected to a more thorough vetting than that provided by the editors of peer-reviewed journals since internal research staff has full access to the data and can replicate our analyses, initiate new queries, and require additional verification analyses. We recognize from a scientific standpoint that independent research evidence and peer-review for the reliability and validity of COMPAS will bolster its standing in the marketplace. Thus, we encourage our clients to form collaborative relationships with independent researchers to pursue independent research opportunities and conduct well-designed validation studies.”

Full Source Citation: Tim Brennan et al., A Response to “Assessment of Evidence on the Quality of the Correctional Offender Management Profiling for Alternative Sanctions (COMPAS)” (Skeem & Louden, 2007) (2009), http://www.northpointeinc.com/files/whitepapers/Response_to_Skeem_Louden_Final_071509.pdf

Permanent link: https://perma.cc/AD2V-P46Q

Full Source Citation: Jennifer L. Skeem & Jennifer Eno Louden, Assessment of evidence on the quality of the Correctional Offender Management Profiling for Alternative Sanctions (COMPAS) (2007), https://www.researchgate.net/publication/268327001

<br>

Analytic Note: The source explains the concept of a biased tool.

Source Excerpt: “Because the prediction vendor seeks to maximize predictive accuracy, it may (intentionally or otherwise) bias the predictions to unfairly favor certain groups or individuals. The use of machine learning to maximize utility is especially concerning because of its reliance on historical datasets that mirror societal biases, and its tendency to automate decision making.”

Full Source Citation: David Madras et al., Learning Adversarially Fair and Transferable Representations 1 (2018), arxiv.org/abs/1802.06309

Permanent link: https://perma.cc/GER2-QNPX

<br>

Analytic Note: Northpointe represents that COMPAS uses “unbiased scoring rules” (Source Excerpt 1, with references to Angwin and to PP therein referring to the ProPublica report). This representation serves to ignore many voices which claim otherwise in that the variables within the risk tool carry bias from other actors. For example, when the tool places heavy emphasis on criminal history it may simply replicate biased decisions by police officers (Source Excerpt 2). Moreover, Northpointe is likely aware of this probability that the COMPAS predictors will recycle such biases. The ProPublica document credits Tim Brennan, the developer of COMPAS and one of the authors of Northpointe’s document responding to ProPublica, conceding the need to include racially-tinged predictors to improve tool accuracy (Source Excerpt 3). Further, the 2017 COMPAS Practitioner’s Guide discusses the reasons that a recidivism risk tool may contain racial effects (Source Excerpt 4).

Source Excerpt 1: “Results of our analyses indicate that as the mean difference in scores between a low-scoring group and a high-scoring group is increased, the base rates diverge and higher false positive rates and lower false negative rates are obtained for the high-scoring group. This is the same pattern of results reported by Angwin et al. This pattern does not show evidence of bias, but rather is a natural consequence of using unbiased scoring rules for groups that happen to have different distributions of scores. These results help to explain the effects of the relatively higher risk scores and higher base rates of blacks on the false positive and false negative rates in the PP study.”

Source Excerpt 2: “Pretrial detention reform that addresses the injustice of people being jailed because of their poverty is urgently needed, but substituting risk assessment instruments for money bail is not the answer. Biased policing practices in communities of color result in racial disparities in the data risk assessment tools rely on, making Black and Brown people look riskier than White people. Pretrial detention reform must include solutions that will reduce the disproportionate incarceration of people of color, not worsen it.”

Full Source Citation: The Leadership Conference, Press Release, More than 100 Civil Rights, Digital Justice, and Community-Based Organizations Raise Concerns About Pretrial Risk Assessment (July 30, 2018), https://civilrights.org/more-than-100-civil-rights-digital-justice-and-community-based-organizations-raise-concerns-about-pretrial-risk-assessment/

Permanent link: http://perma.cc/3DVR-BPCA

Source Excerpt 3: “Brennan said it is difficult to construct a score that doesn’t include items that can be correlated with race — such as poverty, joblessness and social marginalization. ‘If those are omitted from your risk assessment, accuracy goes down,’ he said.”

Source Excerpt 4: “Risk scales may exhibit race and gender effects because race and gender are correlated with the outcomes that risk scales are designed to predict. . . . Disadvantage in the domains of employment, education, and housing stems from structural inequalities in our society. Constructs within these domains correlate with criminal behavior. In some respects many of the widely accepted criminogenic needs are indirect measures of disadvantage. Risk scale scores use inputs (prior arrest, age at first arrest) and predict outcomes (arrests) that are impacted by intense police practices in some geographical areas . . . . These effects are at the heart of methodological controversies in criminology related to risk assessment and racial bias that have emerged in different contexts over the years.”

Full Source Citation: equivant, Practitioner’s Guide to COMPAS Core (Dec. 19, 2017), http://equivant.volarisgroup.com/assets/img/content/Practitioners_Guide_COMPASCore_121917.pdf

Permanent link: https://perma.cc/U3QR-KV3R

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6749

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Analytic Note: The company’s argument here attempts to blame base rate differences for why blacks would have a higher false positive rate (FPR=1-specificity), as the fuller excerpt indicates below (Source Excerpt 1). Yet this characterization is not entirely supported by the study cited. Leeflang et al. (2013) found that in some studies specificity decreased as prevalence increased and sensitivity at times increased as prevalence increased. However, Leeflang et al. are clear that the base rate is not necessarily the causative factor (Source Excerpt 2). Leeflang et al. identify theoretical reasons that there are such relationships—as indicated in the table contained in the attachment. A further problem is the implication by Northpointe that a higher base rate is only associated with a higher FPR. A prior publication by Leeflang and two authors (2009) finds that this is not always the case, whereby at least some studies have shown that the FPR instead decreases with a higher base rate (Source Excerpt 3). Singh, a widely-cited expert in the field of recidivism risk assessment, confirms these variations (Source Excerpt 4).

Source Excerpt 1: “It is unrealistic to expect equal Model Error trade-offs at a particular cut point in two samples that have different risk score distributions and base rates of recidivism. Although Sensitivity and Specificity do not depend on the base rate of recidivism, because they are calculated separately on recidivists and non-recidivists, the trade-offs between Sensitivity and Specificity can be impacted by the base rate. Leeflang, Rutjes, Reitsma, Hooft, and Bossuyt (2013), using data from 23 meta-analyses to assess the effect of base rate (prevalence) on Sensitivity and Specificity, found that Specificity decreased as disease base rate increased. In other words the false positive rate increased with increasing base rate. Differences in the base rates of blacks and whites for general recidivism (0.51 vs. 0.39) and violent recidivism (0.14 vs. 0.09) in the PP samples strongly affected the Sensitivity and Specificity tradeoffs observed in the PP study.”

Source Excerpt 2: “We do not and cannot claim that changes in prevalence cause differences in sensitivity and specificity. Because sensitivity is estimated in people with the disease of interest and specificity in people without the disease of interest, changing the relative number of people with and without the disease of interest should not introduce systematic differences. Therefore, the effects that we found may be generated by other mechanisms that affect both prevalence and accuracy, as we described earlier.”

Full Source Citation: Mariska Leeflang et al., Variation of a Test’s Sensitivity and Specificity with Disease Prevalence, 185 CMAJ E537, 3539-40 (2013), https://doi.org/10.1503/cmaj.121286

Source Excerpt 3: “A number of studies have shown that a test’s sensitivity and specificity may vary with disease prevalence. These effects are not specific; higher prevalence does not systematically lead to either higher or lower sensitivity and specificity.”

Full Source Citation: Mariska M.G. Leeflang et al., Diagnostic Test Accuracy May Vary with Prevalence, 62 J. CLINICAL EPIDEMIOLOGY 5, 5 (2009). https://doi.org/10.1016/j.jclinepi.2008.04.007

Source Excerpt 4: “If a risk assessment instrument is reasonably accurate at discriminating between violent and non-violent groups, sensitivity tends to increase (and specificity decrease) as base rate increases, although there is no exact functional relationship between prevalence and either performance indicator.”

Full Source Citation: Jay P. Singh, Predictive Validity Performance Indicators in Violence Risk Assessment: A Methodological Primer, 31 BEHAV. SCI. & L. 8, 9-10 (2013). https://doi.org/10.1002/bsl.2052

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Analytic Note: The passage below reflects inconsistency on the term “performance” as applied to this context. Notice that Northpointe variously uses performance to mean equal AUCs, equal PPV/NPVs, but gives a broader interpretation as well to include a non-exhaustive list of other factors that cannot be statistically calculated.

Source Excerpt: “The performance of the risk scale depends on its intrinsic accuracy as well as external factors such as base rate and user preferences about the costs of errors, benefits of treatment, selection ratio, and other criteria. The fact that the accuracy of the risk scale is the same for blacks and whites is critical. If the AUCs were not the same for blacks and whites, then the performance of the risk scales would not be similar for blacks and whites. Performance refers to the positive and negative predictive values and their complements that take into account the base rates for blacks and whites.”

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Analytic Note: Yet Northpointe impliedly concedes that COMPAS may be biased against, or at least not functioning as intended with, whites. See the quote below where GRRS refers to the general recidivism risk scale. There, the company acknowledges that the algorithm is performing as expected for blacks in terms of the normed distribution of scores expecting 10% within each decile. The visual table comparing blacks and whites in risk distributions are from Northpointe’s document. While not expressly admitted by Northpointe, this constitutes evidence that COMPAS does not perform equally on blacks and whites by Northpointe’s own norms.

Source Excerpt: “We reproduce the bar plots to point out that the decile scores of blacks have a better distribution in comparison with whites. The bar plots show that the GRRS decile scores of blacks are well-aligned with the norm group that is used in Broward County (close to 10% fall into each decile score level). The GRRS decile score distribution of white defendants on the other hand is shifted much lower relative to the norm.”

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6755

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Analytic Note: The document contradicts itself as to whether the AUC is a measure of accuracy. Compare Excerpt 1 to Source Excerpts 2 and 3. Plus, Source Excerpt 1 acknowledges the AUC is computed from sensitivity and specificity. These reflections contradict its position against the value of FPR/FNR statistics.

Source Excerpt 1: “A risk scale exhibits accuracy equity if it can discriminate recidivists and non-recidivists equally well for two different groups such as blacks and whites. The most well-developed and widely used measure of discriminative ability is the area under the receiver operating characteristic (ROC) curve (AUC). The ROC curve is a plot of Sensitivity (tpr) and Specificity (tnr) for all possible cut points of a risk scale. The AUC is a summary measure of discriminative ability (diagnostic accuracy) across all the thresholds of the risk scale. The AUC is interpreted as the probability that a randomly selected recidivist will have a higher risk score than a randomly selected non-recidivist.”

Source Excerpt 2: “Accuracy refers to how accurately the risk scale discriminates between non-recidivists and recidivists. The AUC is a rank-based measure of discriminative ability not a measure of accuracy.”

Source Excerpt 3: “When we talk of accuracy what we really mean is discrimination—the ability of a risk scale to discriminate between recidivists and non-recidivists. The AUC is a rank-based measure, not a measure of accuracy. Technically, accuracy refers to measures that take into account both calibration and discrimination.”

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Analytic Note: Northpointe emphasizes that “accuracy equity” is about the aspect of discrimination (Source Excerpt 1). Discrimination determines how well a tool differentiates recidivists from non-recidivists. The contention that FPR/FNRs are inappropriate, though, strategically ignores that sensitivity (1-FNR) and specificity (1-FPR) are high and low discrimination indices, respectively (Singh, 2013) (Source Excerpt 2).

Source Excerpt 1: “A risk scale exhibits accuracy equity if it can discriminate recidivists and non-recidivists equally well for two different groups such as blacks and whites.”

Source Excerpt 2: “Sensitivity is a high risk discrimination index representing the proportion of violent individuals who were judged to be at high risk, whereas specificity is a low risk discrimination index representing the proportion of non-violent individuals who were judged to be at low risk . . . . Sensitivity and specificity are calculated using information available in a 2x2 contingency table, which organizes assessment and outcome information into counts of true positives (TPs), false positives (FPs), true negatives (TNs), and false negatives (FNs) at a single cut-off threshold . . . . TPs are individuals judged to be at high risk who went on to commit a violent act, TNs are individuals judged to be at low risk who did not go on to commit a violent act, FPs are individuals judged to be at high risk who did not go onto commit a violent act, and FNs are individuals judged to be at low risk who went on to commit a violent act. These four values can be computed using any software package that provides cross-tabulations between dichotomous variables.”

Full Source Citation: Jay P. Singh, Predictive Validity Performance Indicators in Violence Risk Assessment: A Methodological Primer, 31 BEHAV. SCI. & L. 8, 9 (2013).

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Analytic Note: The selection of the PPV/NPVs hurts Northpointe’s ability to promote COMPAS’ predictive accuracy for other protected groups. The author in another article (Hamilton, forthcoming 2018) using the same Broward County dataset shows that the PPV is significantly lower for Hispanics versus non-Hispanics at cutpoint 5 (56% and 63%, respectively). Northpointe has argued that cutpoint 5 is artificially low. Thus, using a higher cutpoint with COMPAS definitions combining low and medium risk and then differentiating high risk (cutpoint 8), the PPV disparities were greater between blacks and whites (57% and 75%, respectively). The differences at both cutpoints were statistically significant at p<.01, thus indicating differential prediction. This excerpt further discusses that significant ethnic differences also existed for true positive rates (1-FNR).

Source Excerpt: “In Figure 8, five of the eight comparisons are statistically significant, again confirming differential validity and differential prediction. With respect to the True Positive Rate, the tool is significantly better at discriminating the recidivists from the non-recidivists for non-Hispanics at both cutpoints. Indeed, the general recidivism TPRs for non-Hispanics are approximately 50% and 120% better than for Hispanics. The low TPRs for Hispanics are actually quite poor from quantitative and qualitative perspectives. For example, at the higher cutpoint (low/medium versus high) the TPR is only 14%, meaning the test is wrong at least eight out of ten times for Hispanics.”

Full Source Citation: Melissa Hamilton, The Biased Algorithm: Disparate Impact for Hispanics, 56 AM. CRIM. L. REV. (working paper, forthcoming 2018), Hamilton, Melissa, The Biased Algorithm: Evidence of Disparate Impact on Hispanics (October 5, 2018). 56 AM. CRIM L. REV. Forthcoming. https://ssrn.com/abstract=3251763

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6761

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Analytic Note: Northpointe attempts to provide support for distinguishing “Model Errors” from “Target Population Errors” by referring to an article by Linn (Source Excerpt 1). Yet this attribution takes Linn’s article out of context. Linn’s conclusion shows that the article was merely a suggestion about how to teach contingency tables to graduate students in a fresh way so that they more fully understand the differences between FPR/FNRs and PPV/NPVs (Source Excerpt 2).

Source Excerpt 1: “Linn (2004) discusses the difference between Model Errors (fpr and fnr from the ROC method) and Target Population Errors (complements of predictive values). Referring to the Model Errors, Linn (2004) noted that ‘these statistics do not assess the accuracy of the diagnostic test in a clinically useful way, i.e., in a way that can be used by patients and physicians. Clinicians and patients relate to the sequelae of the clinical test results and do not know, at the time of performing the test, who has the disease and who does not (otherwise the test would not be performed). What is of interest to both physicians and patients is how many of the positively diagnosed patients, in fact, do not have the disease and how often a person with the disease is not diagnosed by the test.’”

Source Excerpt 2: “This manuscript focuses on an approach to teaching the main characteristics of a diagnostic test, the PPV and NPV, when it is applied in the general population, in a situation such as screening for cancer. “The manuscript does not deal with validation of a test through repeated testing. As has been mentioned above, most textbooks present both the sensitivity and specificity or the PPV or NPV in a single table. Moreover, some would prefer, pedagogically, to begin with a simpler one 2X2 table and then proceed on to a more conceptually correct - but perhaps more complex - two 2X2 table presentation. It is suggested using a two-table presentation for advanced students, or including a transition from a one-table to a two-table presentation even if one begins teaching using a simple one table. Eventually, using two tables to describe diagnostic test characteristics is, in our experience, pedagogically and conceptually more acceptable to students. “Using the two tables and the derived equations demonstrates clearly the use of Bayes’ Theorem, test characteristics (the sensitivity and specificity) and the prevalence to calculate PPV. It is more obvious that the analyses are done in two stages, for two different populations: the selected study population and the target population. This approach makes it easier to discuss and define two different types of false negative rates and false positive rates in the two populations.”

Full Source Citation: Shai Linn, A New Conceptual Approach Teaching the Interpretation of Clinical Tests, 12 J. STATISTICS EDUC. (2004), http://ww2.amstat.org/publications/jse/v12n3/linn.html

Permanent link: https://perma.cc/945L-A85U

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Analytic Note: It can be difficult to prove a negative, but searches for “target population error” along with “model error” or “risk assessment” yielded a handful of returns on Google Scholar, which are generally not relevant to the subject here.

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6766

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Analytic Note: This is not the only time that Northpointe has attempted to mediate the results of a scientific article that expresses negative information about COMPAS’ abilities. A recently released article (Dressel & Farid, 2018) contends its study shows that people with little criminal justice experience responding to an online survey could predict recidivism given a few facts as well as COMPAS (the abstract is in Source Excerpt 1). Northpointe (rebranded as lower case equivant) responded critically and, as with ProPublica, with a posting on its website (Source Excerpt 2).

Source Excerpt 1: “Algorithms for predicting recidivism are commonly used to assess a criminal defendant’s likelihood of committing a crime. These predictions are used in pretrial, parole, and sentencing decisions. Proponents of these systems argue that big data and advanced machine learning make these analyses more accurate and less biased than humans. We show, however, that the widely used commercial risk assessment software COMPAS is no more accurate or fair than predictions made by people with little or no criminal justice expertise. We further show that a simple linear predictor provided with only two features is nearly equivalent to COMPAS with its 137 features.”

Full Source Citation: Julia Dressel & Hany Farid, The Accuracy, Fairness, and Limits of Predicting Recidivism, 4 SCI. ADVANCES (forthcoming 2018), https://doi.org/10.1126/sciadv.aao5580

Source Excerpt 2: “The cursory review of the article indicates serious errors related to misidentification of the COMPAS risk model and a lack of an external/independent validation sample. . . . equivant will be requesting the data used in the referenced study as well as peer review results documented by external sources. Our Research division will review the data upon receipt. It is critical to ensure the appropriate methods, fair comparisons, and conclusions were made as the article is given wide circulation online.”

Full Source Citation: equivant, Official Response to Science Advances, EQUIVANT (Jan. 17, 2018), http://www.equivant.com/blog/official-response-to-science-advances

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6752

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Analytic Note: A marketing brochure provides screen shots of the COMPAS Core tool, including its risk assessment scales.

Full Source Citation: equivant, COMPAS Core, www.northpointeinc .com/files/downloads/Risk-Needs-Assessment.pdf.

Permanent link: https://perma.cc/J9Z7-6EG3

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Analytic Note: This is a simplistic visual of the input process for a risk assessment tool.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6815

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Analytic Note: ProPublica’s description of its mission may help explain its interest in the topic of risk assessment in criminal justice decisions.

Source Excerpt: “ProPublica is an independent, nonprofit newsroom that produces investigative journalism with moral force. We dig deep into important issues, shining a light on abuses of power and betrayals of public trust — and we stick with those issues as long as it takes to hold power to account. “With a team of more than 75 dedicated journalists, ProPublica covers a range of topics including government and politics, business, criminal justice, the environment, education, health care, immigration, and technology. We focus on stories with the potential to spur real-world impact. Among other positive changes, our reporting has contributed to the passage of new laws; reversals of harmful policies and practices; and accountability for leaders at local, state and national levels.”

Full Source Citation: ProPublica, https://www.propublica.org/about/

Permanent link: https://perma.cc/D75X-H8S4

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Analytic Note: This is a simplistic visual of the tool development process.

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6765

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Analytic Note: Northpointe representatives describe the COMPAS system in sophisticated terms.

Full Source Citation: Tim Brennan & William Dieterich, Correctional Offender Management Profiles for Alternative Sanctions (COMPAS), in HANDBOOK OF RECIDIVISM RISK/NEEDS ASSESSMENT TOOLS 49, 64 (Jay P. Singh et al. eds., 2018).

Link to Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=6760

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Analytic Note: The groups met on July 30, 2018 at the Leadership Conference, described as “The nation’s premier civil and human rights coalition.” The press release issued at the conclusion of the meeting exemplifies the general concerns about risk assessment tools used in a pretrial setting.

Source Excerpt: “These tools use data to forecast an individual’s likelihood of appearance at future court dates and/or risk of re-arrest. While many jurisdictions claim that these tools are a necessary part of an effort to end money bail and create a fairer pretrial system, the signers, representing millions of people impacted by mass incarceration, urge jurisdictions to reconsider their use of these tools, and to center transparency and accountability to the communities judged by the tools. “In the statement, the groups underscore that risk assessment tools are not a panacea to reforming our unjust and broken bail systems, and that, in fact, these tools can worsen racial disparities and allow further incarceration. The groups urge jurisdictions to not embed risk assessment tools in pretrial decisionmaking, but instead reform their systems to significantly reduce arrests, end money bail, severely restrict pretrial detention, implement robust due process protections, preserve the presumption of innocence, and eliminate racial inequity.”

Full Source Citation: The Leadership Conference, Press Release, More than 100 Civil Rights, Digital Justice, and Community-Based Organizations Raise Concerns About Pretrial Risk Assessment (July 30, 2018), https://civilrights.org/more-than-100-civil-rights-digital-justice-and-community-based-organizations-raise-concerns-about-pretrial-risk-assessment/

Permanent link: https://perma.cc/3DVR-BPCA

</a> <br>

Annotation 1

The Data Overview discusses project context, data generation and analysis, and logic of annotation.

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Annotation 3

Analytic Note:

Type: Conceptual Transparency

Restating the Claim: The term fact and its distinction from the term evidence are central in this paper. However, the term fact has a dual and conflicting meaning that requires clarification.

Analytic Commentary: The historians’ usage of facts as evidentiary raw material conflicts with another, broader usage of fact as an empirical finding so well tested and corroborated that it is widely viewed as a fact. (as in evolution is a fact) German distinguishes these connotations by referring to the former as Fakten (facts) and the latter as Tatsachen (matters of fact). In a rich chapter on the history of facts, David Wotton points out that our “understanding of facts is Janus-faced: at one moment, we regard them as things, reality itself; [i.e. raw material for selecting evidence] at the next, they are true beliefs, statements about reality. In so far as facts are real, they are not true of false; insofar as they are statements, they are.” (Wootton 2015, 255) I use the term in sense of facts, not matters of fact.

Full Citation: Wootton, David. 2015. The Invention of Science: A New History of the Scientific Revolution. Harper Collins.

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Annotation 16

Analytic Note:

Type: Epistemological Transparency

Restating the Claim: The conclusion raises the objection that Browning’s superior description to Goldhagen might be an artifact of their disciplinary backgrounds as historians and political scientists and thus ultimately simply reflect two incommensurate epistemologies. I offer here additional evidence to rebut this constructivist objection.

Source Note: The historian Ingrid Gilcher-Holtey raised this constructivist objection the most explicitly. Responding to the earlier, largely negative reviews of Goldhagen, she points out that his critics overlook his distinctly different approach. She characterizes the prior debate as having been defined by a intentionalist or structuralist perspective. (Shandely 1998, 8) Goldhagen, by contrast, puts forth an anthropological perspective drawing from cultural sociology. This perspective seeks “to apprehend the everyday thinking and habitual behavior of groups and individuals. How do basic ideological patterns, worldviews, and images or the world get carried over into schemes of through and behavior that shape collective and individual conduct? To answer this, the social relevance of ideas is what should be analyzed.” (106) Gilcher-Holtey then contends that the critics failure to apprehend this perspective is what led their critic of his work. “If one reads Goldhagen’s study from this angel, then his controversial causal attribution exposes an innovative inquiry, and his these compel confrontation with heretofore insufficiently explored dimension needed to explain how the murder of the Jews was implemented and accepted: that of mental disposition.” (107)

Analytic Commentary: Gilcher-Holtey’s constructivist positions is problematic for a number ofreasons. It does not address the empirical flaws in Goldhagen’s analysis and particularly the cross-level inference and temporal lumping problems that such a perspective implies and that are discussed in the article. Furthermore, Goldhagen did not employ this line of defense thus casting doubt of Gilcher-Holtey’s defense. If anything, Goldhagen gives every indication that he wanted this work to engage with the existing historical Holocaust literature rather than some broader political science work on genocides or cultural anthropology. Before publishing his book, he published a review critical of Browning’earlier book. (Goldhagen 1992) And he presents his book as an improvement of Browning’ analysis, citing him cited twenty times. Goldhagen’s books was criticized not just by historians but also by social scientist whose critiques were similar to those made by historians. I could not identify any anthropologists or cultural sociologists reviewing his work. According to J-Stor, Hitler’s Willing Executioner was reviewed in five political science journals. Four of those reviews were negative (Goldberg 1997, Finkelstein 1997, Monroe 1997, Stern 1996), while one, written by his dissertation committee member (Goldhagen 1996, 604) Stanley Hoffman (1996), was positive. Drawing on a wider sample, Istvan Deák counted 3 positive reviews, three mixed ones, and 15 critical ones. (296)

Full Citations:

• Deák, István. 1997. “Holocaust Views: The Goldhagen Controversy in Retrospect.”Central European History 30(2): 295–307.
• Finkelstein, Norman G. 1997. “Daniel Jonah Goldhagen’s Crazy Thesis: A Critique of Hitler’s Willing Executioners.”New Left Review (224): 39–88.
• Gilcher-Holtey, Ingrid. 1998. “The Mentality of Perpetrators.” In Unwilling Germans? The Goldhagen Debate, ed. Robert R. Shandley. Minneapolis: University of Minnesota Press: 105-07.
• Goldberg, David J. 1997. “Review of Hitler’s Willing Executioners: Ordinary Germans and the Holocaust.”International Affairs 73(2): 375–77
• Goldhagen, Daniel Jonah. 1992. “The Evil of Banality.”New Republic 207(3/4): 49–52.

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Annotation 15

Analytic Note:

Type: Analytical Transparency

Restating the Claim: I stated that historians determine their confidence in such cross-level inferences by casting a wide evidentiary net to increase the probability of finding counter-evidence, and by evaluating the inferential leverage of supporting evidence in light of competing hypothesis. Birn critiques various of Goldhagen’s cross-level inferences because he fails to cast his evidentiary net widely and overlooks alternative interpretation. I provide an illustration for this analytical transparency issue.

Source Note: Birn critiques Goldhagen’s analysis of force labor camp in Lublin and Lipowa. (Birn 1997, 204-05) Goldhagen claims that the Lublin Labor camps provides a crucial case because German exceptionally cruel treatment of Jews defied the economic logic of extracting the maximum of useful free labor from them. He takes his defiance of this economic logic as evidence for how powerfully their eliminationist anti-Semitism motivated their behavior. Goldhagen thus makes here first a descriptive cross-level inference from the cruel conduct of Jews by individual Lublin work camp guards for the entire staff of the camps and ordinary Germans more broadly. To validate such a cross-level inference, he would have had to convince other historians that he did not overlook some readily available counter-evidence and that this descriptive inference is not under challenged by other possible interpretations of the same evidence. Birn points out that he fails to do so on several accounts. First, he does not review any of the other works on the Lublin and Lipowa camps. Second, he overlooks that by 1941 Hitler had decided on the Final Solution and that work camps served the same purpose as concentration camps, namely the extermination of Jews. As far as the Jews were concerned, the economic logic of keeping camp inmates alive to maximize their work output no longer applied. Third, Christian Wirth was the commander of the Lipowa camp and known for his excessive cruelty towards Jews. Goldhagen overlooks that Wirth was also engaged in the earlier euthanasia program direct against Germans thus underscoring that his social pathologies were not just confined to Jews. Fourth, Goldhagen omits evidence that some guards at Lipowa felt uncomfortable by the treatment of Jews. (Birn 1997, 204-05)

Analytic Commentary: Goldhagen’s backgrounding of all this information and its alternative interpretation diminishes the confidence in Goldhagen’s cross-level inferences from individuals to the entire camps and the ordinary Germans. Birn raises very similar criticism of his treatment of the death marshes and the various police battalions.

Full Citations: Birn, Ruth Bettina. 1997. “Revising the Holocaust.”The Historical Journal40(01): 195–215.

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Annotation 14

Analytic Note:

Type: Data Access

Restating the Claim: The text points out that Browning devotes his chapters to discreet points in time and geographic locations while Goldhagen lumps them together. I provide here he evidence to substantiate this point more fully.

Source Note: Figures 2 and 3 provide a visualization of the two authors lumping and splitting. These two figures are based on Figure 3 discussed in the text. They are a slight modification by making individual chapters, rather than pieces of evidence, the unit of analysis. Chapters are important organizing elements in the overall analysis and therefore form meaningful proxies that help visualize how author re-structures time and space. I calibrate location in terms of countries being analyzed and time in terms of either individual years or slightly longer time periods. I consider chapters as lumping time or space if they combine evidence from three or more locations or time periods without taking into consideration their geographic or historical particularities. That is, I only consider evidence as lumped when the author treats it as uniform despite potentially important spatial or temporal confounders. To facilitate the reading of these time and space rosters, I identify all “lumping chapters” by making the borders of their boxes bold. I also vary the sizes of the country and time boxes depending on how frequently they are referenced.

Analytic Commentary: The large sizes of the Poland and 1942 boxes indicate that Goldhagen and Browning both focus on almost identical time periods and geographic areas. Goldhagen, though, lumps time and space slightly more than Browning. Seven of Goldhagen’s sixteen chapters bring together evidence from different locations and time periods without giving consideration to their historical or geographic particularities. Many of these chapters have a more theoretical or conceptual focus in which Goldhagen treats evidence as uniform even though it takes place during war years, pre-war years or even pre-Nazi years, or is located in Poland and Germany. By contrast, Browning is an extremely fine-grained splitter, even by historians’ standards. Each chapter focuses on a particular location in Poland and a specific set of months during 1942 and 1943. By splitting his evidence, he pays close attention to the historical and geographic particularities of his evidence.

Full Citations:

• Browning, Christopher R. 1993. Ordinary Men. Reserve Police Battalion 101 and the Final Solution in Poland. Harper Collins.
• Goldhagen, Daniel Jonah. 1996. Hitler’s Willing Executioners. Ordinary Germans and the Holocaust. New York: Knopf.

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Annotation 16

Analytic Note:

Type: Conceptual Transparency

Restating the Claim: Critics mostly focus on Goldhagen’s temporal lumping. This requires a quick conceptual clarification because the events for time periods also coincided with different geographic locations.

Analytic Commentary: His critics emphasize temporal lumping even though his lumping of war-time and pre-war events means that he also lumps events that occurred in Germany and Poland. It therefore is impossible to observe temporal and geographic lumping separately. The critics are correct, however, in emphasizing the temporal lumping because the difference between the war and pre-war context is far more significant than the difference of events taking place in Germany and Poland. It could even be argued that, given the focus is on Germans in Poland, any geographic differences between Germany and Poland are minimal. More recent work on the Holocaust has emphasized the significant geographic variation in the killing of Jews which reflected different levels of cooperation of local populations and governments. (King 2012, 427-29)

Full Citations: King, Charles. 2012. “Can There Be a Political Science of the Holocaust?”Perspectives on Politics 10(02): 423–41

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Annotation 12

Analytic Note:

Type: Knowledge Production

Restating the Claim: Goldhagen responded to a number of his critics but those replies did not engage the key criticisms raised.

Source Note: Fritz Stern wrote a review in Foreign Affairs to which Goldhagen replies. Stern made pointed out that Goldhagen’s analysis is ahistorical and he mis-interpreted evidence. He writes “To say it at once: the book has some merit, especially in the middle section, which depicts three specific aspects of the Holocaust, and it has one overriding defect: it is in its essence unhistorical. It is unhistorical in positing that one (simplistically depicted) strain of the past, German antisemitism, explains processes that the author strips of their proper historical context; it is unhistorical in over and over again presenting suppositions as "incontestable" certainty.” (Stern 1996, 129) I discussed Stern’s concerns about Goldhagen’s misinterpretation of the evidence in an earlier ATI. Stern concludes his review with a summary of Goldhagen’s public reception. In this context, he indicates that the forthcoming German copy of his books moderate the points made in the English versions. Goldhagen’s reply start with a lengthy denial that he German translation departed from the English original. (Goldhagen 1997) It then devotes the rest to retelling the very positive response he received from the Germany public and how this somehow disproves the allegations raised against him by historians.Similarly, Ruth Bettina Birn provides the most detailed empirical assessment of Goldhagen’s argument. (1997) Birn had knowledge of the primary sources Goldhagen used, and, according to Goldhagen’s acknowledgements reviewed them the same that he did. She uses her intimate archival knowledge to point out a long series of factual errors in his analysis. Goldhagen replies with a 46-page article entitled “The Fictions of Ruth Bettina Birn”. (Goldhagen 1997) He writes “she presents an altogether, grossly distorted account of the book which she then uses as the basis on which to attack it. Her piece consists of an unremitting attack not upon what my actually says, but upon her fictional positions that she falsely presents as mine.” (120) He then lists those alleged distortions and offers his rebuttal. Birn’s allegedly first distortion is to accuse him of being ahistorical, a point that comes up with virtually every critic of his work. He rebuts it by belabor a quote in which she changed “Germans” to “German” and “were” to “is”. It is never quite clear how those changes make his analysis more historical. But, he then pivots to his favorable public reception as evidence that his critics must be wrong. And it continues in vain for thirty more pages.

Analytic Commentary: Goldhagen engagements with his critics mirrors his engagement with facts as he is in both instances unwilling to fairly engaged and rebut challenges to his central thesis. It underscores in both instances a very strong confirmation bias. He also leverages his favorable public reception to substitute scholarly engagement with public popularity contest.

Full Citations:

• Birn, Ruth Bettina. 1997. “Revising the Holocaust.”The Historical Journal40(01): 195–215.
• Goldhagen, Daniel Jonah. 1997. “Germans vs. the Critics.”Foreign Affairs 76(1): 163-67.
• Goldhagen, Daniel Jonah. 1997. “The Fictions of Ruth Bettina Birn.”German Politics and Society: 119–165.
• Stern, Fritz. 1996. “The Goldhagen Controversy: One Nation, One People, One Theory?”Foreign Affairs 75(6): 128-38.

<br>

Annotation 11

Analytic Note:

Type: Analytical Transparency

Restating the Claim: Critics have accused Goldhagen of systematically leaving out contextual information containing evidence that would confound his descriptive inferences.

Source Note: I provide two illustrations from Goldhagen’s analysis. First example: Both Browning and Goldhagen draw heavily on the testimony provided by Commander Hartwig Gnade, who led one company in Police Battalion 101. Browning cites him on nineteen different and Goldhagen on nine different pages. Gnade drew their attention because his treatment of Jews was particularly cruel. He regularly went beyond following orders to “just” shoot Jews and delighted in humiliating them first and on occasion also bludgeoned them to death. His cruelty is relevant because it permits possible inferences not just about the willingness about also the wantonness with which ordinary Germans killed Jews. Browning is cautious about drawing too many inferences from Gnade’s cruelty because the testimony describes Gnade as a Nazi by conviction, thus unlikely to be representative of ordinary Germans, and as suffering from a serious drinking problem. Goldhagen, by contrast, omits these two details and therefore makes Gnade appear as an ordinary German whose gruesome actions must therefore speak of the willingness of regular Germans’ anti-Semitism that he argued dominated German culture. (Browning 1993, 82 Goldhagen 1996, 228) Goldhagen, in short, selects out the confounding effects of Gnade’s political ideology and alcoholism.Second example: Browning and Goldhagen also report a particularly gruesome mass killing that occurred in Bialystok, Poland. Bialystok had a large Jewish population that a Police Battalion began to round up in the summer of 1941 and marched them to the town square. It then ordered 700 Jews into the local synagogue and set it on fire. The German police officers then watched and shot whoever tried to escape as the Jews painfully died inside the burning synagogue. Browning and Goldhagen agree on the chilling details of this massacre. Goldhagen, however, omits the fact that the perpetrators were drunk and that the commanding officers subsequently tried to cover up the burning down of the synagogue and were reprimanded by their superiors. (Browning 1993, 12-24, Goldhagen 1996, 188-91; Pohl 1997, 26-27; Birn 1996, 200) In light of the moral depravity of such an atrocity, it might seem pointless to quibble over perpetrators’ sobriety and whether or not they deviated from military protocol. But when the particulars of this event become the evidentiary basis for drawing conclusions about the broader willingness of Germans, these details matter. In leaving them out, Goldhagen can more readily present these actions as acceptable and commonplace actions of ordinary Germans. He boldly uses his rendition of the Bialystok massacre to infer “the men of this police battalion ... became instantaneous Weltanschauungskrieger, or ideological warriors. [...] The manner in which they rounded up Jews, the wanton beatings and killings, the turning of streets of Bialystok into corpse- and blood-bestrewn pathways, and their own improvised solution of a cleansing conflagration are indeed acts of Weltanschauungskrieger - more specifically, of anti-Semitic warriors.” (Goldhagen 1996, 190-91)

Analytic Commentary: In both these example, the omitted contextual information contains partial counter-evidence that weakens the validity of his descriptive inferences.

Full Citations:

• Birn, Ruth Bettina. 1997. “Revising the Holocaust.”The Historical Journal40(01): 195–215
• Browning, Christopher R. 1993. Ordinary Men. Reserve Police Battalion 101 and the Final Solution in Poland. Harper Collins.
• Goldhagen, Daniel Jonah. 1996. Hitler’s Willing Executioners. Ordinary Germans and the Holocaust. New York: Knopf.
• Pohl, Dieter. 1997. “Die Holocaust-Forschung Und Goldhagens Thesen.”Vierteljahrshefte Für Zeitgeschichte 45(1): 1–48.

<br>

Annotation 10

Analytic Note:

Type: Production Transparency

Restating the Claim: Critics pointed out that Goldhagen mis-cites texts.

Source: Fritz Stern pointed out two such mis-citations. Goldhagen for example used an article by Fritz Stern that discusses Thomas Mann to support his claim of Germany’s eliminationist anti-Semitism. Goldhagen wrote "Thomas Mann, who had already long been an outstanding opponent of Nazism, could nevertheless find some common ground with the Nazis ... 'it is no great misfortune that... the Jewish presence in the judiciary has been ended. The dominant cultural cognitive model of Jews and the eliminationist mindset that it spawned was dominant in Germany." After citing this passage, Fritz Stern comments: “A note indicates that he [Goldhagen] takes the citation from an essay of mine in which I quoted passages from Mann’s journal. I consider Mann, married to Katia Pringsheim, the daughter of a prominent Jewish family, perhaps the best example of the ambiguity and complexity of German antisemitism, and I cited this passage, written in the early months of the regime, precisely because of its fascinating vacillation of tone and meaning. The very next- indeed, inseparable - sentence, which Goldhagen omits, suggests Mann's own distaste at his thoughts, which he characterizes as ‘secret, disquieting, intense,’ but the passage concludes with his musing that the process of historical change, just recently initiated by the Nazis, had in it ‘nonetheless things that are revoltingly malevolent, base, un-German in the highest sense. But I am beginning to suspect that their process could well be of that kind that has two sides. Another example: he mentions the late Israeli scholar Uriel Tal's comment on liberal dis appointment with Jews in the late nineteenth century but omits that Tal observed in the same context: "Political and racial antisemitism during this period [the Second Reich] failed to exert any appreciable public influence,whatever effectiveness it had was limited to short intervals and restricted regions." (Stern 1996, 130)

Analytic Commentary: Fritz Stern’s passage is self-explanatory. Goldhagen’s reply to Stern does not respond to those mis-citations. (1997)

Full Citations:

• Goldhagen, Jonah Daniel. 1997. “Germans vs. the Critics.”Foreign Affairs 76(1): 163–67.
• Stern, Fritz. 1996. “The Goldhagen Controversy: One Nation, One People, One Theory?”Foreign Affairs 75(6): 128-38.

<br>

Annotation 9

Analytic Note:

Type: Conceptual Transparency

Stating the Claim: I would like to point to additional conceptual problems in Goldhagen’s analysis to which main text did not allude.

Analytic Commentary: The goal of concepts is to standardize observations and thus assure consistent “measurements” or interpretation of facts. Goldhagen undermines this objective by using different language when he applies his concepts to the empirical evidence and when he uses concepts at the end of chapters to sum up his findings. The concluding sections of his chapters are noteworthy for two rhetorical qualities that distinguish Goldhagen from Browning. (Birn 1997, 199-200; Browning 1993, 207; Pohl 1997 25-26, 29) These concluding sections use particularly vivid or“hot” language that is missing in earlier sections where he describes those actions and thus in in closer dialogue with the particularities of his evidence that might not support such vivid and gory conclusions. By contrast, Browning avoids such bold inferences about perpetrators’willingness. He describes one event after another in the central chapters of his book and offers his inferences about perpetrators’ willingness only in the final chapter. He prefers much cooler language that forgoes highlighting the gory details and he constantly qualifies his analysis with possible objections. Browning thus offers a much higher ratio between the pieces of evidence and the number of descriptive inferences and also treats confirming and disconfirming evidence in a more even-handedly.

Full Citations:

• Birn, Ruth Bettina. 1997. “Revising the Holocaust.”The Historical Journal40(01): 195–215.
• Browning, Christopher R. 1993. Ordinary Men. Reserve Police Battalion 101 and the Final Solution in Poland. HarperCollins.
• Pohl, Dieter. 1997. “Die Holocaust-Forschung und Goldhagens Thesen.”Vierteljahrshefte für Zeitgeschichte 45(1): 1–48.

<br>

Annotation 8

Analytic Note:

Type: Data Access

Restating the Claim: The text claims that Goldhagen and Browning’s evitentiary sources are sufficiently similar that they cannot account for the differences in their descriptive inferences. To substantiate this claim, I briefly review their accounts of their sources.

Source Note: Both Goldhagen and Browning acknowledge that humans don’t usually document their private thoughts thus making it rare to find relevant documentary material. (Browning 1993, 36-39) Governmental archives were not particularly helpful for this purpose because they contained mostly information related to the logistical and administrative aspects of the Holocaust, not the mindset of the perpetrators. Two potential sources, that could have provided pertinent evidence, were accounts by Jewish survivors or personal notes by the perpetrators themselves. Neither of these sources existed thus making the discovery relevant facts challenging. (For the literature on survivors, see Pohl 1997, 1-14) This changed in the early 1980s when scholars became aware of the trial records that Germany’s Central Agency for the Prosecution of Nazi Crimes had generated in 1960s when it investigated the murderous activities of the Order Police deployed in Eastern Europe.(Browning 1993, 36. And personal communication) The Order Police consisted of German units carrying out non-military security operations behind the actual frontline where regular military units did the actual fighting. From mid-1941 onwards, one responsibility of these units was to carry out the Final Solution. They were given the task of rounding up Jews, deporting them to the concentration camps, or, in many instances, killing them directly. The Central Office for the Prosecution of Nazi Crimes investigated these activities and generated an enormous amount of information. This information is exceptional because its interrogators tried to reconstruct the activities of these military units in unusual detail. The investigators of Police Battalion 101 were particularly thorough and persistent, generating 7800 pages of detailed and rich testimony. (Goldhagen 1996, 598-99) The testimony of Police Battalion 101 provides the central factual basis for both Browning and Goldhagen

Analytic Commentary: Browning and Goldhagen’s accounts about their sources support my claim that they make inferences from evidence that was sufficiently similar. It therefore is reasonable to conclude that differences in their inferences were the result of their varying interpretations rather than differences in evidence consulted.

Full Citations:

• Browning, Christopher R. 1993. Ordinary Men. Reserve Police Battalion 101 and the Final Solution in Poland. Harper Collins
• Goldhagen, Daniel Jonah. 1996. Hitler’s Willing Executioners. Ordinary Germans and the Holocaust. New York: Knopf
• Pohl, Dieter. 1997. “Die Holocaust-Forschung Und Goldhagens Thesen.”Vierteljahrshefte Für Zeitgeschichte 45(1): 1–48

<br>

Annotation 7

Analytic Note:

Type: Production of Knowledge

Restating the Claim: I described earlier my data generation as a form of meta-analysis that uses the points raised in the debate over Goldhagen’s work as its evidentiary basis for evaluating their respective descriptions. This require attention to how this debate could have shaped the evidence and hence the validity of my inferences.

Analytical Note: The debate surrounding Goldhagen’s work was a very public and as such entangled with economic considerations (promoting the book), moral concerns (Germany’s grappling with its Nazi past), professional turf battles (the political scientist Goldhagen’s trespassing on the territory or historians). (Shandley 1998, 1-30) Thus, there is no denying that my evidence was produced in this context and thus could have been potentially biased it by it. I tried to address these potential biasing effects in the following ways. First, I weighted the evidence coming from peer-reviewed academic journals far more highly than that published in newspapers. These journals typically are subject to a double-blind peer review process and thus filter out the potentially more biasing factors that were apparent in the public debates. Second, Goldhagen responded to many of his critics in a number of very detailed articles. I read those articles closely in order to potentially eliminate biased or inadequately substantiated critics of his work. (Goldhagen (1996, 1997a, 1997b, 1998)

Full Citations:

• Goldhagen, Daniel Jonah. 1996. “Motives, Causes, and Alibis.”New Republic, December 23: 37–45.
• Goldhagen, Daniel Jonah. 1997a. “Germans vs. the Critics.”Foreign Affairs 76(1): 163–67.
• Goldhagen, Daniel Jonah. 1997b. “The Fictions of Ruth Bettina Birn.”German Politics and Society: 119–165.
• Goldhagen, Daniel Jonah. 1998. “The Failure of the Critics.” In Unwilling Germans? The Goldhagen Debate, ed. Robert R. Shandley. Minneapolis: University of Minnesota Press.
• Shandley, Robert R. 1998. “Introduction.” In Unwilling Germans? The Goldhagen Debate, ed. Robert R. Shandley. Minneapolis: University of Minnesota Press

<br>

Annotation 6

Analytic Note:

Type: Knowledge Production

Restating the Claim: Section 1.2 of the paper raised the epistemological question about the theory-laden descriptions and hence whether its underlying facts have sufficient epistemological autonomy to serve as empirical benchmarks for evaluating description. Section 1.2 and the conclusion show that descriptions vary in their theory-ladeness and that the epistemological problem is not a severe as constructivists imply. This broad discussion about the theory-laden nature of analysis applies to the Goldhagen debate additional and interesting ways. Its public nature brought out broader sociological factors that potentially shaped either Goldhagen’s own analysis or that of its critics. It thus illustrates that, it is not just theoretical foreknowledge, but also broader sociological and personal factors, that shape analysis. This broader sociological foreknowledge thus goes beyond the structuring effects that theoretical foreknowledge and its epistemological underpinnings might have, I briefly review here some of these factors to make their potential impact as transparent as possible. Source: I encountered three sociological factors. Andrei Markovits (1997) noted that many German reviews dwelled on the biographical details of Goldhagen and his initial American reviewers. The reviewers pointed out that Goldhagen is Jewish and that his father was a Romanian Holocaust survivor. (A fact shared by Goldhagen in his acknowledgements) They also pointed out that many positive reviews came from American journalists who were Jewish. Markovits infers from this pattern a latent anti-Semitism and anti-Americanism among Germans. He attributes those sentiments to an unwillingness by Germans to accept Goldhagen’s premise of Germany’s eliminationist anti-Semitism. Werner Bergman (1998) discusses the interesting and complex interactions between the scholarly and journalist discussions and their very different modes of intellectual engagement. He points out that scholarly debates defer to expert judgments and are guided specific guidelines of empirical validation. Journalistic accounts, by contrast, are driven by novelty, controversy, personalization, and stimulating public debate. (133) He argues that Goldhagen and his publisher were playing a media game, aimed at attracting publicity, while historians were playing a scholarly game, and were resentful of the media game. (141-43) Goldhagen and his publicists were emphasizing the book’s moral message that highlighted in new ways the brutality with which Germans killed and downplayed the shortcomings of his deterministic explanation. They accentuated this point further by pointing out that earlier historians had downplayed this brutality and thus insinuated they were morally compromised. (Deák 1997, 298) István Deák also speculated the professionally jealousy maybe played a role “for the violent professional critique. Historical works seldom become bestsellers, and it is even less common for historians to become public figures. As Josef Joffe put it, ‘one can imagine the resentment of scholars who have worked hard for decades on the history of the Third Reich without getting anything like the attention given to Goldhagen.’” (Deák, 297)

Analytic Commentary: These various sociological factors may have influenced the judgments of various reviewers. But these effects are almost impossible to empirically substantiate which is why they are usually not considered in scholarly discussions. I have no way to verify them, but I am reasonably confident that they did not play any role in my assessments. But given they could and given my Swiss-Austrian ancestry, it still might be helpful to make them transparent.

Full Citations:

• Bergman, Werner. 1998. “Im falschen System. Die Goldhagen Debatte in Wissenschaft Und Öffentlichkeit.” In Geschichtwissenschaft Und Öffentlichkeit. Der Streit Um Daniel Goldhagen, ed. Johannes Heil and Rainer Erb. Frankfurt: S. Fischer: 131-47.
• Deák, István. 1997. “Holocaust Views: The Goldhagen Controversy in Retrospect.”Central European History 30(2): 295–307.
• Markovits, Andrei. 1998. “Discomposure in History’s Final Resting Place.” In Unwilling Germans? The Goldhagen Debate, ed. Robert R. Shandley. Minneapolis: University of Minnesota Press.

<br>

Annotation 5

Analytic Note:

Type: Analytical transparency

Restating the Claim: The text discusses in very general terms four criteria for evaluating the validity of cross-level inferences. This ATI provides a concrete illustration of those four criteria.

Analytic Commentary: Let me provide a concrete illustration of these four criteria for evaluating cross-level inferences.

Let us assume that the piece of evidence involves an official birth certificate from which a scholar tries to draw different inferences. Drawing an inference from the certificate about the person’s place of birth is straight forward because it does not involve any cross-level inferences. The inference consequently is so self-explanatory that no interpretation is required. However, the effort to draw a cross-sectional inference from the same certificate about the socio-economic status of the person’s family would be problematic without additional evidence as well as a more detailed interpretation. Such an inference could be judged in the following ways. First, the magnitude of the upscaling is relatively modest and thus limits possible confounding factors. Second, the certificate now offers only circumstantial evidence and needs to be cross-corroborated by additional pieces of evidence that could increase the confidence such a cross-sectional inference. The scholar might look whether the birth certificate states the parents’ vocations or the name of the hospital. The hospital’s name would generate clues about what sort of clients that hospital typically served. If the hospital was a private clinic, this might suggest a higher socio-economic status than if it was a public hospital. Third, the explicitness of the reasoning process linking the hospital’s name with the family’s hypothesized socio-economic status would influence the confidence in such an inference. Finally, such an interpretation would also have to be defended against other possible interpretations of the same evidence. So, the inference that a private clinic suggests high socio-economic status would have to be defended against the possibility that such a clinic also provided free health care to under-privileged mothers.

<br>

Annotation 4

Analytic Note:

Type: Production transparency

Restating the Claim: The text discusses the importance of fact checking for establishing the validity of descriptive inferences. However, it does not provide any specific guidelines for how to check facts. This ATI elaborate on the difficulties for establishing such guidelines.

Analytic Commentary: Fact check relates to how facts are translated into evidence and relates to production transparency. It is difficult to establish a priori clear fact checking guidelines for four reasons. First, fact checking poses the initial challenge of which of the numerous pieces of evidence to fact check. Political scientists, probably should follow the example of media checking site of focusing on statements that meet a certain significant threshold. (Graves: 87-11) Second, factual accuracy is context specific. Getting the month of an election date wrong probably is less consequential than the month of a diplomatic cable in the lead up to W.W. I. Fact checking guides thus usually propose slightly different criteria for different subject matters. (Borel) This dilemma is wonderfully illustrated in a fact checking exchange between an overly diligent fact checker and writer trying to tell a story. (D’Agata & Fingan, 2012) Third, factual errors are inescapable and requiring a judgment of whether they are random or systematic. In historical description, the systematic nature cannot be inferred from frequencies but must be judged in terms of the probative value a single piece of evidence has for a specific inference. Fourth, fact checking is difficult and time consuming, especially when page numbers are missing. It requires intimate knowledge of sources that are frequently not readily accessible and oftentimes idiosyncratically organized. (Trachtenberg 2014, 15)

Full Citations:

• Borel, Brooke. 2016. The Chicago Guide to Fact-Checking. University of Chicago Press.
• D’Agata, John, and Jim Fingan. 2012. The Lifespan of a Fact. New York: W.W. Norton.
• Graves, Lucas. 2016. Deciding What’s True: The Rise of Political Fact-Checking in American Journalism. Columbia University Press.
• Trachtenberg, Marc. 2015. “Transparency in Practice: Using Written Sources.”Qualitative and Multi-Method Research Newsletter 13(1): 13–17

<br>

Annotation 2

Analytic Note:

Type: Analytical Transparency

Restating the Claim: The text makes the broad point that evidence becomes more theory-laden as the theory and testing methods, that are used analyze a particular subject matter, advance with time.

Source: Economics arguably is the theoretically most formalized social science and thus frequently is used to illustrate the theory-laden nature of evidence. However, Mary Morgan shows that we can observe some variations over time in how theory-laden economics has been. She takes the example of development economics during the 1950s and 1960s when it was established as a subfield within economics. The existing economic models were all based on Western, established market economies and thus proved of limited use to explain the emerging, post-colonial economies. Nor did the newly independent countries have the administrative capacity to generate the economic data sets required for standard econometric techniques. She describes how early development economists responded to those constraints by conducting field research in those emerging economies.

Analytic Commentary: The work produced by those early development economists was far less theory laden than that of their counter-parts studying established economies. This difference in the theory-ladeness of supports the broader claim that scholarship becomes more theory-laden as the theories and the testing techniques advance.

Full Citation: Morgan, Mary S. 2011. “Seeking Parts, Looking for Wholes.” In Histories of Scientific Observation, ed. Lorraine Daston and Elizabeth Lunbeck. University of Chicago Press: 303-25.

</a> <br> This is an Annotation for Transparent Inquiry project, published by the Qualitative Data Repository.

<br/>

<font>The Data Overview discusses project context, data generation and analysis, and logic of annotation.</font>

<br/> Please cite as:

Kreuzer, Markus. 2018. "Data for: The structure of description: Evaluating historical description and its role in theorizing". Qualitative Data Repository. https://doi.org/10.5064/F6OAEIDA.

Learn more about ATI here.

<br> This is an Annotation for Transparent Inquiry project, published by the Qualitative Data Repository.

<br>

<font>The Data Overview discusses project context, data generation and analysis, and logic of annotation.</font>

<br> Please cite as:

Musgrave, Paul. 2018. "Data for: Defending hierarchy from the Moon to the Indian Ocean: Symbolic capital and political dominance in early modern China and the Cold War". Qualitative Data Repository. https://doi.org/10.5064/F6NNOI5C . QDR Main Collection.

Learn more about ATI here.

<br>

Analytic note: Surprisingly little summing-up work exists to justify the frequently made claims that Apollo mattered for technological spinoffs. NASA frequently makes claims about the spillover effects of the space programs; see NASA Spillover Handout PR.pdf for one example. But on closer examination many of these claims simply don’t add up to something justifying billions of dollars. The NASA handout, summarizing the agency’s claims, lists (among others) “Moon Boots”, heart monitors, and spinoffs from flight suits. Additional claims are made at https://spinoff.nasa.gov/ .

The fact that NASA spends so much effort in trying to persuade the public of the spinoffs from Apollo is, in its own way, evidence that such spinoffs are hard to find. Even the common ha-ha response we’ve received from readers and audiences that “well, at least we got Tang from the Moon mission” is wrong; Tang was invented in 1957. http://blogs.discovermagazine.com/vintagespace/2017/07/26/no-nasa-didnt-invent-tang/#.WlparVS7_OQ

The evidence for Apollo spillovers becomes even scarcer when one applies counterfactual reasoning. For something to count as an Apollo spinoff, it must not only have been generated for the Apollo program, but similar technology must have been unlikely to have otherwise been generated in the absence of Apollo. In general, there do not seem to have been many of these sorts of benefits. A 1977 report by the Comptroller General of the United States disputes exaggerated NASA claims of spillover effects generally; GAO Report.pdf .

The biggest evidence for the lack of hard evidence in NASA’s preferred direction is that space advocates frequently fall back on intangible benefits—often, as in the Freakonomics quorum linked in the footnote, to inspiration or long-term benefits from extra-planetary colonization. We don’t deny these benefits, but we do suggest that the absence of hard, dollars-and-cents benefits means that the commonplace economic/R&D interpretation of why the US designed a manned space program is not even wrong.

Incidentally, even if there were massive spinoffs, the evidence from the JFK administration’s decision-making in the relevant timeframe suggests that there was no expectation of such; indeed, the evidence suggests that they would have gone ahead and done it for the prestige reasons alone. See the evidence throughout the rest of this paper and the appendix.

Data Sources: https://data.qdr.syr.edu/file.xhtml?fileId=2596

https://data.qdr.syr.edu/file.xhtml?fileId=2597

<br>

Data source: https://data.qdr.syr.edu/file.xhtml?fileId=2595

<br>

Analytic note: We have given Wiesner authorial credit, although the task force included Kenneth Belieu, Trevor Gardner, Donald F. Hornig, Edwin H. Land, Max Lehrer, Edward M. Purcell, Bruno B. Rossi, and Harry J. Watters.

Data source: https://data.qdr.syr.edu/file.xhtml?fileId=2600

Full citation: Wiesner, Jerome. 1961. “Space Frontiers”. Reprinted in New Frontiers of the Kennedy Administration: The Texts of the Task Force Reports Prepared for the President. Washington, Public Affairs Press. Available via HeinOnline. Note that Section 4, Military Space Programs, is published separately as FRUS 1961-1963 XXV Document 356 at https://history.state.gov/historicaldocuments/frus1961-63v25/d356

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Data source: https://data.qdr.syr.edu/file.xhtml?fileId=2592

Full citation: “Expenditure Outlook”, December 26, 1961, David E. Bell Files, Box 14, File “Executive Branch Memoranda,’ John F. Kennedy Presidential Library.

<br>

Source excerpt: (Stine, 2009, Summary) “In 2008 dollars, the cumulative cost of the Manhattan project over 5 fiscal years was approximately $22 billion; of the Apollo program over 14 fiscal years, approximately $98 billion; of post-oil shock energy R&D efforts over 35 fiscal years, $118 billion. A measure of the nation’s commitments to the programs is their relative shares of the federal outlays during the years of peak funding: for the Manhattan program, the peak year funding was 1% of federal outlays; for the Apollo program, 2.2%; and for energy technology R&D programs, 0.5%. Another measure of the commitment is their relative shares of the nation’s gross domestic product (GDP) during the peak years of funding: for the Manhattan project and the Apollo program, the peak year funding reached 0.4% of GDP, and for the energy technology R&D programs, 0.1%.”

Data source: https://data.qdr.syr.edu/file.xhtml?fileId=2599

<br>

Analytic note: This is a gloss on Logdson’s analysis of the 20 April 1961 memorandum from Kennedy to LBJ, which is self-explanatory. Online: https://www.jfklibrary.org/Asset-Viewer/fz9Rxczs_UmFjbYk_Siy0Q.aspx

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=2594

<br>

Source excerpt (p. 36 of the Sprague Committee report): “The United States has had, and continues to have, over-all superiority in science and technology. Nevertheless, since the launching of Sputnik I there has been considerable evidence that the average man in most countries believes that Soviet capability continues to grow relative to that of the United States and that the Soviet Union leads in certain important apsects of space technology. Short of some now unforeseeable and revolutionary scientific breakthrough, it will be extremely difficult to re-establish the degree of American technological prestige and pre-eminence relative to that of the USSR which existed prior to October 1957. The Committee feels that, since throughout the world the status of the nation’s science is increasingly taken as a measure of its power and dynamism, two things are indispensable psychologically: (1) that the U.S. maintain a continuing stream of scientific and technological achievements; and (2) that these achievements be more effectively communicated to the world than has been the case in the past.”

Data source: https://data.qdr.syr.edu/file.xhtml?fileId=2598

<br>

Analytic Note: This is the same document as referenced in FN 107 and the previous annotation

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=2593

Full Citation: “A Comparison of US and USSR Capabilities in Space,” 1 January 1960, CIA-RDP80B01676R004000110002-6.

<br>

Source excerpt: The opening page of the memorandum is telling; note that “the ICBM program itself was not considered”—this is a study of relative scientific prestige.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=2593

Full Citation: “A Comparison of US and USSR Capabilities in Space,” 1 January 1960, CIA-RDP80B01676R004000110002-6.

<br>

Analytic note: Our purpose in choosing these examples was to find instances of the voyages being used uncritically as authoritative examples of exploration as a marker of expansive great-power status.

Source excerpt: Smith and Davies (2012), 141: “Indeed, Cheng Ho’s expeditions did expand China’s influence, and brought back a world of knowledge to the Ming Dynasty—this is not in doubt. But it was expensive. Had the Chinese continued on their course, it is quite likely that they would have avoided centuries of humiliating occupation by European powers. China, the ‘world leader in science and technology in the early fifteenth century, was soon left at the doorstep of history.’ Had the ruling Ming court known the outcome of being ‘the discovered’, how might they have thought differently about the cost? Cheng Ho’s voyages were a positive development for China, but for whatever reason, they stopped.”

Source excerpt: Zuber (2011), 1: “History teaches us that great civilizations explore and dare not cease exploration. As a case in point in the early to mid 1400’s China had arguably the greatest navy on Earth under the command of Zheng He. During the Ming Dynasty Chinese expeditions established trade routes in the Indian Ocean to Arabia and Africa, until the voyages were canceled and the fleet was burned, in part to save money. … World history may have been very different had da Gama’s handful of ships encountered Zheng He’s fleet of over 250 large junks. But the Chinese stayed home and their influence waned, while the nations of Western Europe went on to dominate world affairs.”

Data Sources:

Zuber 2011: https://data.qdr.syr.edu/file.xhtml?fileId=2601

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Analytic note: The meeting minutes referenced here are conspicuous for not mentioning any urgent need for a booster capable of sustaining military (non-NASA) men-in-space programs, and even the limited recognition of such programs’ potential value pointed only to an orbital capacity which would not have required a Saturn-class booster.

Source excerpt (FRUS XXV 367): “It was pointed out that there is a probable role for military men in space as well as for men in space for scientific and other purposes. The advantage of having men in a space vehicle is the opportunity to use judgment and to adapt to unprogrammed or unexpected conditions. To some extent this advantage is offset by the increased vulnerability of man and the substantial weight and additional equipment which needs to be given over to the problem of survivability. However, many of the problems of vulnerability also exist as regards advancing electronic systems or films in space vehicles. Reference was made to the Dina Soar as a manned military space project. It was pointed out that this needs to be given further careful examination, to ascertain the military reasons for the space flight reentry capability. Further on the military space side, it was pointed out that there is need of a capability to maintain complex electrical equipment of at least 5000 pounds in space for extended periods of time. Little value was given to the use of space vehicles for bombardment purposes. On this aspect of military use of space, some question was raised as to whether there was significant military importance to this competence and as to whether very large payloads in space were needed for defense. It was emphasized, however, that the R & D program should be maintained to make certain that we had the competence to meet all military space requirements. At this time, there is only one manned Lunar flight program, and that is under NASA management.”

Full citation: Summary Minutes of the Meeting of the National Aeronautics and Space Council, FRUSVol. XXV, Document 367, Online: https://history.state.gov/historicaldocuments/frus1961-63v25/d367

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Analytic note: We suspect that the prominence of the Zheng He/treasure fleet voyages in the Western literature have led authors to overlook the longer history of Chinese trade and exploration before those fleets. However, Needham’s exhaustive recounting of the relations between China and the areas to which the fleets visited makes clear that, aside from a quirk of timing, the voyages had almost nothing in common with the European voyages of discovery to which they are often and lazily compared.

Source excerpt: (Needham, 1972, 488): “There had, of course, been semi-governmental trading intercourse with the south seas for a thousand years already … In _987 the Song court had sent eight palace officials in four fleets to the countries of the south seas (South-east Asia and probably India) to purchase drugs, ivory, rhinoceros horns, pearls, etc…the Yuan government had also sent many missions abroad beginning in +1279 and the fleet of fourteen great ships which carried Marco Polo homeward, reaching Ormuz in +1294, will, of course, be remembered….Facts such as these make it clear that there was nothing essentially new in principle in the voyages of Cheng Ho. The scale and scope of the operations were what was unprecedented.”

Source excerpt: (Needham, 1972, 494-6): “But Chinese relations with East Africa were far older than the day of Cheng Ho. … descriptions of this part of the world (Azania, al-Zanj) can be found in Chinese literature as early as about +860…How many Chinese merchants and sailors actually themselves visited these waters between the +8th and the +14th centuries we have no means of telling. Apart from texts such as those just mentioned there is only the mute evidence of Chinese objects scattered up and down the coast. And these are many indeed, so many that it is rather hard to believe they all came there through the hands of intermediate traffickers….an Arabic source [records] the presence of Chinese merchants on the shores of +12th-century East Africa.”

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Analytic note: A constant refrain from reviewers and others has been that the Apollo project must have had significant military spillovers. But the divorce of the military and the Saturn program happened during the Eisenhower administration—the Defense Department attempted to cancel Saturn on the grounds that it lacked a clear military purpose. The booster is the most obvious channel for spillovers, but there seems little evidence of direct or nonsubstitutable spillovers via that channel.

Source excerpt: “In a memorandum to Johnson dated 9 June 1959, York rebuffed an ARPA request for additional funds. ‘In the Saturn case,’ York said, ‘I consider that there are other more urgent cases requiring support from the limited amount…[ellipses in original]which remains uncommitted.’ York’s reasoning apparently stemmed from a position taken by other Eisenhower Administration advisors that the requirements of the Department of Defense for launching military communications satellites would be achieved more effectively by relying on existing ICBM boosters. Saturn had always been touted as the military’s booster for such missions, so it did not seem to be needed any more….York felt that Saturn was simply too big for any military mission, and that included men in space. Big boosters of the Saturn class should be NASA’s responsibility, he reasoned, because there was no urgent military application and because of York’s own reading of the Space Act of 1958 and his understanding of Eisenhower’s views on the matter.”

Full citation: Bilstein, Roger E. 1996. Stages to Saturn: A Technological History of the Apollo/Saturn Launch Vehicles. NASA SP-42606. NASA History Office: National Aeronautics and Space Administration.

Analytic Note: Citation inadvertently omitted. This is from Sheehan (2007) p. 8.

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Source excerpt: “It is generally assumed by the American citizen that our vast expenditures of money and technical talent in the national space program are primarily designed to meet the overriding needs of our military security. The fact is, however, that the sense of excitement and creativity has moved away from the missile field to the other components of the list, and that missiles, long before they are in condition for us to depend upon them, are slowly being delegated to the category of routine management.”

Full citation: Wiesner, Jerome. 1961. “Space Frontiers”. Reprinted in New Frontiers of the Kennedy Administration: The Texts of the Task Force Reports Prepared for the President. Washington, Public Affairs Press. Available via HeinOnline. Note that Section 4, Military Space Programs, is published separately as FRUS 1961-1963 XXV Document 356 at https://history.state.gov/historicaldocuments/frus1961-63v25/d356

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Source excerpt: (Muir-Harmony 2014, p. 36) “Tracing public diplomacy space programming from the late 1950s through the early 1970s, this dissertation reveals an evolution in the methods and mechanisms utilized by US government officials to capitalize on space accomplishments. In the late 1950s and early 1960s, USIA and State Department officials looked to the space program to demonstrate American technological, scientific, and economic superiority on the world stage. Although they incorporated inclusive elements in their rhetoric and programming, the emphasis of this material was rooted in ideas of progress and American national power. But, by the end of the decade, public diplomats’ approach to space programming had shifted notably. No longer were space feats employed to primarily highlight American prestige and power; instead the emphasis of programming portrayed space exploration as a global accomplishment, undertaken ‘for all mankind,’ as part of an effort to establish American influence without the look of hegemony."

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Source excerpt: (Muir-Harmony 2014, p. 211) “Reactions to the World's Fair exhibit, in addition to the other moon rock exhibits that the United States mounted around the world varied, but interest in the rocks was widespread in the late 1960s and early 1970s. By the end of 1970, more than 41 million people attended moon rock exhibits in over one hundred countries. The USIA suggested that these exhibits "brought some of the experience of [the lunar landing] to the home ground of millions." 3 Newspapers, journals, and millions of exhibit goers offered both complimentary and critical commentary on the displays, the rocks, the significance of the Apollo program, and the massive resources that the United States utilized to bring the rocks back to earth.”

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Analytic note: An excellent transcription of the full conversation, with footnotes and other interpretive information, can be found in Coleman, David, Timothy Naftali and Philip Zelikow (eds) The Presidential Recordings of John F. Kennedy: The Winds of Change, November 8-30, 1962 (Volume V), pp. 409-449. Kennedy discusses the matter in several additional passages that mirror the tenor here. We provide additional snippets from this tape transcript.

Source excerpt (Coleman et al, eds, p. 435):

President Kennedy: Yeah, the only thing is, I would certainly not favor spending 6 or 7 billion dollars to find out about space, no matter how—on the schedule we’re doing. I’d spell it out over a five-, ten-year period. But we can spend it on—But why are we spending $7 million on getting fresh water from salt water when we’re spending $7 billion to find out about space? … And the second point is that the fact that the Soviet Union has made this a test of the systems. So that’s why we’re doing it.”

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Source excerpt: “Dramatic achievements in space, therefore, symbolize the technological power and organizing capacity of a nation. It is for reasons such as these that major achievements in space contribute to national prestige. Major successes, such as orbiting a man as the Soviets have just done, lend national prestige even though the scientific, commercial, or military value of the undertaking may be by ordinary standards be marginal or economically unjustified. This nation needs to make a positive decision to pursue space projects aimed at enhancing national prestige. Our attainments are a major element in the international competition between the Soviet system and our own. The non-military, non-commercial, non-scientific but ‘civilian’ projects such as lunar- and planetary exploration are, in this sense, part of the battle along the fluid front of the cold war. Such undertakings may affect our military strength only indirectly if at all, but they have an increasing effect upon our national posture.” (p. 8 of cited memorandum)

Full citation: Webb, James E., and Robert McNamara, “Recommendations for Our National Space Program: Changes, Policies, Goals”, 8 May 1961, online reproduction of files from John F. Kennedy Library, https://research.archives.gov/id/193859.

This can be more directly accessed online via the JFK Library site: https://www.jfklibrary.org/Asset-Viewer/Archives/JFKPOF-030-019.aspx

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Analytic note: In budget talks regarding the FY1964 budget, for instance, Kennedy acquiesced to higher NASA spending despite his desire to pare down overall expenditures.

Source excerpt: DILLON: One thing, Mr. President, that’s … I think important. Looking at this, it’s one of the big areas, and this is this NASA program where for us to cut back anything you’d have to slow up the date of the landing on the moon. I asked Dave what that meant and he said that meant ’67. Now … well, I … we’ve always had this commitment to be there by the end of the—

PRESIDENT KENNEDY: No, we really felt that ’67 … We said the end of the—

DILLON: End of the decade.

PRESIDENT KENNEDY: Yeah. I think we probably should not…I think we…currently there may be some things we’re doing in space which are superfluous or just supportive but not vital. But I don’t think we ought to…I’d rather unbalance my budget and all the rest, and—

DILLON: You want us to get there by ’67? Unclear exchange between Dillon and President Kennedy

PRESIDENT KENNEDY: --not have the commitment. Then if we could justify it, we could make a mistake and we’d be penny-wise and [pound-foolish].

Full citation: Zelikow, Philip, and Timothy Naftali (eds), John F. Kennedy: The Great Crises: The Presidential Recordings, Vol II: September-October 21, 1962, p. 348

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Analytic note: These discussion notes are framed as point-by-point responses to Kennedy's memo to Johnson.

Source excerpt:

1. “Do we have a chance of beating the Soviets?”

a.<br> “By putting a laboratory in space?” There is no chance of beating the Soviets in putting a multi-manned laboratory in space since flights already accomplished by the Russians have demonstrated that they have this capability. The U.S. program must include the development of a multi-manned orbiting laboratory as soon as possible since it is essential for the accomplishment of the more difficult flights to the moon.

b.<br> “Or by a trip around the moon?” With a determined effort of the United States, there is a chance to beat the Russians in accomplishing a manned circumnavigation of the moon. The Russians have not as yet demonstrated either the booster capability or the technology required for returning a man from a flight around the moon. The state of their booster technology and other technology required for such a difficult mission is not accurately known. With an accelerated program, it is not unreasonable for the U.S. to attempt a manned circumlunar flight by 1966.

c.<br> “Or by a rocket to land on the moon?” On September 12, 1959, the Russians crash-landed a small package on the moon. This package did not transmit any information from the surface of the moon. The NASA program currently includes impacting instruments on the moon in such a way that they may survive the impact and transmit scientific information back to earth. The first flight in this program is scheduled for January 1962. Close-up television pictures will be obtained of the surface of the moon, as the spacecraft descends to the moon. In August 1963 the current NASA program also includes a soft landing of instruments on the moon. Several flights in succeeding months are included in this program to insure the possibility of success. The Russians can accomplish this mission now if they choose.

d.<br> “Or by a rocket to go to the moon and back with a man?” There is a chance for the U.S. to be the first to land a man on the moon and return him to earth if a determined national effort is made. The development of a large chemical rocket booster, the spacecraft for landing and return, and major developments in advanced technology are required to accomplish this most difficult mission. The Russians initiated their earth orbiting program probably as early as 1954 as evidenced by their flight of a dog in November 1957. In the earth orbiting competition the United States was attempting to accomplish in less than three years what the Russians had worked on for seven years. It is doubtful that the Russians have a very great head start on the U.S. in the effort required for a manned lunar landing. Because of the distinct superiority of U.S. industrial capacity, engineering, and scientific know-how, we believe that with the necessary national effort, the U.S. may be able to overcome the lead that the Russians might have up to now. A possible target date for the earliest attempt for a manned lunar landing is 1967, with an accelerated U.S. effort.

e.<br> “Is there any other space program which promises dramatic results in which we could win?”

(1)<br> The current NASA program provides the possibility of returning a sample of the material from the moon surface to the earth in 1964. An experiment of this kind would have dramatic value and may or may not be a part of the Russian program. The Russians could carry out such an experiment in the same time period or earlier if they choose.

(2)<br> The lead the U.S has taken in developing communications satellites should be exploited to the fullest. Although not as dramatic as manned flight, the direct benefits to the people throughout the world in the long term are clear. U.S. national prestige will be enhanced by successful completion of this program. The current program will provide for the flight of an active communications satellite in mid-1962. The experiment will enable live television pictures to be transmitted across the Atlantic. The continuing program will lead to the establishment of worldwide operational communications systems.

(3)<br> The U.S. lead established in our successful meteorological experiments with the Tiros satellites, should be maintained with a vigorous continuing program. The whole world will benefit from improved weather forecasting with the possibility of avoiding the disastrous effects of major weather disturbances such as typhoons, hurricanes and tornadoes.

Full citation: Dryden Notes, 22 April 1961, in FRUS 1961-1963, Volume XXV, Doc. 362, Online: https://history.state.gov/historicaldocuments/frus1961-63v25/d362

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Source excerpt: “Following up on our conversation of the other evening, I would like to elaborate on the questions posed by the Russian Venus shot and our relative positions in the general fields of space exploration and science. The most significant factor, as we have said many times, is that the Soviets have developed a rocket as part of their ballistic missile program with considerably more thrust or lifting power than anything we have available. We know that the Soviet booster can put payloads of the order of several tons (the most recent one was announced to be seven tons) in a low orbit, while the best we can do at the present time, using our latest combination rocket Atlas-Agena, is approximately 5,000 pounds. This combination was used to launch the recent Samos shot. These figures indicate that the Soviets have approximately a three-to-one advantage in weight-lifting capability at this time. This corresponds roughly to the difference we believe to exist in the payload capability of the USSR vs. U.S. ballistic missiles.”

Full citation: Jerome Wiesner to Kennedy, 20 February 1961, in Foreign Relations of the United States [FRUS] 1961-63, Volume XXV, Document 386.

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Analytic note: The document in question is a Kennedy campaign transition document, but evidence abounds of criticism by both LBJ and JFK of the Eisenhower position. LBJ had, as Senate Majority Leader, scored the Eisenhower dismissal of Sputnik within weeks of the Soviet triumph.

Source excerpt: “With the launching of Sputniks I and II, and with the information at hand of Russia’s strength, our supremacy and even our equality has been challenged. We must meet this challenge quickly and effectively in all of its aspects. …It is not necessary to hold these hearings to determine that we have lost an important battle in technology. That has been demonstrated by the satellites that are whistling above our heads. But to me, and I think to every other American, a lost battle is not a defeat. It is, instead, a challenge, a call for America to respond with the best that is within them.”—Lyndon Johnson

Full citation (for Johnson statement): “Inquiry into Satellite and Missile Programs, Part 1.” 25 November 1957. Subcommittee Investigating Preparedness; Committee on Armed Services. Senate. HRG-1957-SAS-0015. Pp 2-3.

Full citation (for Kennedy memo): “Briefing Paper on Space,” Papers of John F. Kennedy. Pre-Presidential Papers. Presidential Campaign Files, 1960. Issues. Position and Briefing Papers, 1960. Briefing Papers: Social Security, space, tax, unemployment, Veterans’ affairs, water pollution. https://www.jfklibrary.org/Asset-Viewer/Archives/JFKCAMP1960-0993-020.aspx.

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Source excerpt: “3. A second essential feature of the Soviet outlook in the current period is its high confidence in the growth of the USSRʼs power and influence. Looking back to the weak and perilous position in which the new Communist regime found itself in 1917, remembering all the internal and external trials it has survived, and considering its growth in relative economic and military power over the last 20 years, the Soviet leaders are encouraged in their doctrinaire expectations about communismʼs inevitable triumph. That it was a Communist rocket which first ventured into space symbolizes for them that they are marching in the vanguard of history. They think they see a response to their doctrines and influence in the revolutionary turmoils of Asia, Africa, and Latin America. They expect to associate the peoples emerging from colonialism and backwardness with their own cause, mobilizing them against an ever more constricted world position of the Western states. The relative internal stability of the latter at present they see as only a transient phase.”

Full citation: CIA, National Intelligence Estimate NIE 11-4-60, “Main Trends in Soviet Capabilities and Policies, 1960-1965,” FRUS 1961-1963, Volume V, “Soviet Union”, Document 1, Online: https://history.state.gov/historicaldocuments/frus1961-63v05/d1

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Source excerpt: “Military Supremacy. On the question, ‘All things considered, which country do you think is ahead in total military strength at the present time—the U.S. or the U.S.S.R.?” Russia is ahead in all four countries as follows: Britain 56% to 15%; France 43% to 12%; Italy 29% to 22%; and West Germany 38% to 26%. From 8 to 20% volunteered the answer that the two countries were about equal…

Space Race. Earlier surveys have indicated that Soviet space achievements have been related to estimates of Soviet military strength. In the new survey the Soviet Union increases its lead in space developments as follows: Britain 78% to 7%; France 80% to 2%; Italy 62% to 11%; and West Germany 67% to 12%.”

Full citation: Donald M. Wilson to President Kennedy, October 19, 1961, https://www.jfklibrary.org/Asset-Viewer/Archives/JFKPOF-091-002.aspx.

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Source excerpt: "Memorandum for: The President

Attached is a resume of a Public Opinion Survey on Western European public confidence int he United States. Also attached is the full survey.

Because of the obvious political combustibility of the survye, other copies are only going to the Secretary of State and CIA (who paid half the bill).

Full Citation: Donald M. Wilson to President Kennedy, October 19, 1961, https://www.jfklibrary.org/Asset-Viewer/Archives/JFKPOF-091-002.aspx

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Source excerpt “The general tenor of comment almost everywhere is to acclaim the first manned space flight as 1) a great event in human history, 2) a tremendous scientific and technical achievement, and 3) a triumph for the USSR that would have many repercussions in the cold war. Commend tended to acclaim the Soviet achievement generally as an epochal landmark in mankind’s progress, and to move from congratulations to considering its significance in the East-West confrontation. The Soviet feat is generally held to have increased and consolidated the Soviet lead in space, and to increase Soviet military, political, and propaganda leverage. Many observers indicated uneasiness about how the USSR will use its ‘advantage,’ and emphasized the need to strengthen efforts for peace and disarmament. It was often assumed that the U.S. is on the verge of putting a man in space, but expectations that the U.S. will soon equal or outdistance Soviet space achievements seem fainter and less confident than they were in immediate post-Sputnik comment.”

Full Citation: United States Information Agency Office of Research and Analysis, “Initial World Reaction to Soviet ‘Man in Space’”, 21 April 1961. JFK Presidential Library.

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Source excerpt: “So let us begin anew--remembering on both sides that civility is not a sign of weakness, and sincerity is always subject to proof. Let us never negotiate out of fear. But let us never fear to negotiate. Let both sides explore what problems unite us instead of belaboring those problems which divide us. Let both sides, for the first time, formulate serious and precise proposals for the inspection and control of arms--and bring the absolute power to destroy other nations under the absolute control of all nations. Let both sides seek to invoke the wonders of science instead of its terrors. Together let us explore the stars, conquer the deserts, eradicate disease, tap the ocean depths and encourage the arts and commerce.”

Full Citation: John F. Kennedy: "Inaugural Address," January 20, 1961. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ws/?pid=8032

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Source excerpt “Science and education were at the heart of the project to build modern states in the Third World, not least since thirty-four of the new chief executives had themselves been trained at universities in the former metropolis.” Westad, Global Cold War, 93.

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Source excerpt: “The US and the USSR space programs are generally assessed as competitive efforts, and there is notable concern regarding the need to limit the dangers seen in this rivalry. Soviet successes in space have produced a major revision in the image of the USSR and to some degree of the Soviet system, and lent greatly enhanced credibility to Soviet propaganda claims. The USSR, by appearing to have spectacularly overtaken the US in a field in which the US was very generally assumed to be first by a wide margin, is now able to present itself as fully comparable to the US and able to challenge it in any field it chooses -- perhaps the most striking aspect of the propaganda impact of space developments. Although most opinion still considers the US as probably leading in general scientific and technical accomplishments, the USSR is viewed in most quarters as leading in space science. The expectation is, however, that, for the foreseeable future, leadership will see-saw.”

Full Citation: U.S. Information Agency, Office of Research and Analysis, "Impact of U.S. and Soviet Space Programs on World Opinion," 7 July 1959, U.S. President¹s Committee on Information Activities Abroad (Sprague Committee) Records, 1959-1961, Box 6, A83-10, Dwight D. Eisenhower Library, Abilene, Kansas. Online: https://history.nasa.gov/sputnik/july59.html

<br> Source excerpt: (Sheehan 2007, 28-29) For Korelev, the head of the Soviet space programme, the purpose of space launches was the scientific exploration of the solar system, leading in time to the permanent presence of human beings in space and on other bodies. For Khrushchev however, it was simply a propaganda tool, with no significant value in itself. In the years 1958 to 1961, the United States launched 56 satellites, while the Soviet Union only launched 12. Unlike the American launches, few of the Soviet missions produced significant gains in scientific knowledge. For Khrushchev, space research for its own sake was of no interest, and follow-up missions were invariably cancelled because they might appear repetitious, even though they would have been scientifically important in confirming and developing knowledge. Instead, Korolev was forced to conform his space launch schedule to Khrushchev’s diplomatic agenda.”

<br> Source excerpt: (Fursenko and Naftali 2007, 152) “The public reaction in the United States and throughout the world, where Sputnik was hailed in all languages, was intoxicating for Khrushchev. The Soviets were now touted as being ahead in rocket science, something they had only dreamed of before. If that were not enough to please Khrushchev, because of Sputnik, the Americans were second-guessing themselves, complaining about their own weaknesses. The initial reporting on Sputnik in Pravda had been restrained. But after watching the excitement abroad, the Kremlin decided to give the achievement banner treatment in the October 6 edition.”

<br> Source excerpt: (Westad 92) “Because of the global distribution of power and because of the Cold War ideological division, there were two hegemonic models of development on offer when the new states were being created. One, symbolized by the United States, promised intensive urban-based growth in both the private and the public sectors, the import of advanced consumer products, and the latest technology through joining a global capitalist market, and an alliance with the world’s most powerful state. The other, that of the Soviet world, offered politically induced growth through a centralized plan and mass mobilization, with an emphasis on heavy industry, massive infrastructural projects, and the collectivization of agriculture, independent of international markets. The US model was tainted by the association of US capitalism with the capitalism of the colonial oppressors. The Soviet model suffered from the image of the Soviet Union as the ‘secondary’ superpower and from what was often seen as second-rate Soviet products and technology. Both, however, offered a road to high modernity through education, science, and technological progress.”

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Analytic note: One interesting measurement of this comes from the way American textbooks presented the Soviet economic system as a fierce rival. Since the Cold War was fought in part over rival economic systems’ performance, this provides an interesting clue about an enduring elite belief in the US that the Soviet system could sustain a long rivalry.

Source excerpt: “The most successful principles [intro] textbooks in the 1960-1980 period were so confident of the superior prospects for Soviet growth relative to the US that they persisted in their forecasts even though the relative size of US-Soviet output stayed at 2:1 for more than 20 years in McConnell’s textbook and 12 years in Samuelson’s. This overconfidence did not characterize less successful textbooks, even those whose authors shared Samuelson’s political views.” (Levy and Peart, 124)

Full citation: Levy, David M. and Sandra J. Peart. 2011. “Soviet Growth and American Textbooks: An Endogenous Past.” Journal of Economic Behavior and Organization. 78:110-125.

<br> Analytic note: The reference to the “over the horizon” threat is an oblique reference to the Timurid empire. Some sources raise the possibility of the treasure fleet as an expedition to combat Timurlane but quickly dismiss it, not least because the expeditions continued long after Timurlane was known to have died. Cham (1988, 257) bluntly declares that “The Ming court had little understanding of Timur’s rise and vast ambitions” before the treasure fleets, although Timur had entered into a tributary relationship under Hongwu (Cham 1988, 258-9); his ambitions extended to proposing an invasion of China and its conversion to Islam (Cham 1988, 259), but “news of this did not reach Nanking until March 1405” by the time the court learned of this plan “Timur had already died … and the invasion had been canceled” (Cham 1988 259).

<br> Analytic note: The death of the Yongle emperor and his succession by the Hongxi emperor forms the basis for this claim. The Xuande emperor’s temporary resurrection with the seventh fleet complicates our assessment here. However, we do not believe that the seventh fleet had to be undertaken for the same reasons as the first, or even the first several. Alternative explanations for the seventh fleet point to the notion that the data-generating process had shifted. We judge that the subsequent hostility of the Confucian scholar-bureaucrats to the fleets implies that (besides their accurate assessment of the waste involved in the fleets) their objection was to the way the treasure fleet/tributary system promoted the imperial throne and its eunuch allies against the regular scholar-officials. Such conflict was a mainstay of the structure of the Ming Constitution, reaching perhaps its apex under the Wanli emperor but present already in the Hongwu emperor’s abolition of the office of ‘prime minister’ (chief scholar-official) in 1380. Cham 1988 is probably the best single overview in the sources cited.

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Analytic notes: The secondary sources on which we rely disagree starkly on this point. Cham (cited in footnote) states: “The voyages brought back to China not only all sorts of exotics, but huge quantities of more mundane products, above all spices. The economic impact of these expeditions is difficult to assess, largely because they were organized and paid for by eunuch agencies, which left no accounts of the total costs, despite objections from conscientious scholar-officials. And while the Ming court had acquired great quantities of treasure and exotic luxuries from these expeditions, they were seen only by the emperor and his court; they rarely entered the marketplace.” By contrast, T’ien Ju-kang argues that so much pepper entered the Ming lands that it led to the spice no longer being a commodity: “In China, the change in the value of pepper from being a precious commodity to one in common use came about as the result of Cheng Ho’s voyages” (187) and records that pepper and sapanwood from the voyages were used in lieu of payment for officials and soldiers (188-89). T’ien argues that the infusions of pepper from the treasure fleets led to a glut of pepper: “By the end of the reign of the Yung Lo Emperor…the store of pepper in the imperial granaries had swollen to such proportions that it was no longer to possible to dispose of it” (190-191).

The disagreement seems vast, but both stories are consonant with the notion that the treasure-fleet voyages did not reflect an economic logic. Even a far-sighted monopolist should have wanted to import only to the profit-maximizing point. Given that private trade in pepper continued after the Zheng He voyages (T’ien 1982) but on a much smaller scale, the treasure fleet voyages could not have reflected a mercantile logic.

Full citation: T’ien Ju-kang. 1982. “Cheng Ho’s Voyages and the Distribution of Pepper in China.” The Journal of the Royal Asiatic Society of Great Britain and Ireland 2:186-197.

<br>

Source excerpt: [A presentation accompanying a portrait of the giraffe/qilin] “Respectfully I consider that Your Majesty succeeded to the Emperor T’ai-tsu’s [another name for the Hongwu emperor] Grand Heritage and that Your virtue transforms (the world?) and causes the Three Luminaries to follow their regular course and the officials (?) to perform their duty. Consequently a Tsou-yu has appeared, Wonderful Ears are produced, Sweet Dew has descended, the Yellow River has been Clear and Savoury Springs have gushed forth. All the creatures that spell good fortune arrive. In the 9th month of the year chia-wu of the Yung-lo period (1414) a ch’i-lin (giraffe) came from the country of Begnal and was formally presented as tribute to the Court. The ministers and the people all gathered to gaze at it and their joy knows no end. I, Your servant, have heard that, when a Sage possesses the virtue of the utmost benevolence so that he illuminates the darkest places, then a ch’i-lin appears. This shows that Your Majesty’s virtue equals that of Heaven; its merciful blessings have spread far and wide so that its harmonious vapors have emanated a ch’i-lin, as an endless [sic] bliss to the state for a myriad myriad [intentional duplication] years.”

Full citation: Duyvendak, J.J.L. 1939. “The True Dates of the Chinese Maritime Expeditions in the Early Fifteenth Century”, T’oung Pao 34(5): 402-403.

<br>

Analytic note: Here, we depart from Needham, who recognizes the use of force (1972, p. 489) but who downplays it in the service of a depiction of the meaning of the voyages as ultimately pacific: “the Chinese, calm and pacific, unencumbered by a heritage of enmities; generous (up to a point, menacing no man’s livelihood; tolerant, if more than a shade patronizing; in panoply of arms, yet conquering no colonies and setting up no strongholds”—all contrasted with the altogether (in his telling) more dastardly Portuguese. That fits with Needham’s generally Sinophilic outlook but not, in this case, with the facts (on Needham and the fascinating story of Science and Civilization in China, see Winchester, Simon. 2008. The Man Who Loved China. New York, NY: Harper, 2008.).

Finlay (1991) portrays the voyages as far more militaristic, and this seems to fit with the scale and—especially in the early voyages—willingness to employ force.

Source excerpt: (Finlay, 1991, 9): “Certainly the impression made by Zheng He’s troops was forceful and lasting, as was conveyed by the people of Calicut telling da Gama’s men about the helmets, spears, and bombards of their mysterious predecessors. When Zheng He’s 26,000 troops marched off his ships and built their fortified warehouses, it surely inclined their hosts to consider that a client relationship with the Ming emperor was an offer that they could not refuse. … Zheng He’s soldiers destroyed ten pirate ships and killed several thousand followers of Chen Zuyi, the Fujianese pirate-chiefatin of Palembang….In 1411, on the third expedition, Vira Alakasvara, the de facto monarch of Ceylon, attacked a contingent of Zheng He’s forces with (it is alleged) 50,000 troops...Zheng He broke out of the ambush, invaded the capital city with 2,000 men, captured the king and his court, and then spent six days fighting his way back to this ships.”

<br>

Analytic note: Finlay (2008) does an excellent job of situating the Hongwu approach to governance and legitimacy within the dynastic successions antecedent to his rise from peasant to emperor, and explains the bargain struck between Hongwu and the scholar-officials as a restorationist bargain that legitimated his overthrow of the Mongol yoke in exchange for Confucian endorsement.

Source excerpt: “Instead of regarding the tribute system as a matter of ritual and formality, Hongwu treated it as a bureaucratic structure of management, an administrative instrument of foreign policy. For the first time, tribute relations took on a truly systematic character, transformed from ceremonies and tacit accords into a set of regulations spelling out actions and obligations down to the smallest detail, such as which foods were to be served to tribute envoys and which to their servants. Perhaps to assert the legitimacy of his new dynasty, Hongwu took the unprecedented step of dispatching envoys to invite states into a tribute relationship with the Ming court….He believed his radical measures would cauterize the wound inflicted on the Chinese moral and political order by Mongol influence and alien exchange.” (Finlay, 2008, 334)

<br>

Analytic note: Purists will note that we have elided two developments that are more widely separated in time than the sentence may imply. Our point here is analytic, not chronological; the renaming of the Prince of Yan’s fief to “Beijing” and the consolidation of Beijing as primary capital were separated by 17 years (the former in 1403, the latter in 1420). Cham identifies both of these as part of the legitimation process of the new Yongle reign and the effacement of the Jianwen emperor in favor of the soi-disant restoration of the Hongwu constitution.

Source excerpt: “[Zhu Di] then named the remaining months of [1402] by an artificial extension of the reign title of Taizu as the thirty-fifth year of Hongwu, thereby explicitly denying Jianwen’s legitimate status, and proclaimed the inauguration of the reign of Yongle (Everlasting Happiness) for the following year. In January 1403 he changed the name of his fief [heretofore Beiping] to Beijing (Peking), elevating it to capital status, and sent his eldest son Zhu Gaochi…to proceed there to assume charge while he stayed in Nanjing to work on the transition of government and did not return to Peking until March 1409…In October 1420, after much deliberation and years of preparation and rebuilding, he decreed the formal transfer of the capital to Peking in the following year but retained Nanjing as the secondary capital. This was the year that formally marks the end of the turbulent phase of the accession of the Prince of Yan and inaugurates a new era for the Ming dynasty….”(Cham, 2007, 93-94)

<br> Source excerpt: “The most violent action taken by the new emperor was the wanton execution of the former officials of Jianwen who had refused to give their allegiance, including Huang Zicheng, Qi Tai, Fang Xiaoru, and several hundred others. The purge was necessary not only because he needed to eliminate opposition to his new authority but also to justify his earlier claims that the mission of his campaign was to punish the ‘nefarious ministers’ who had misguided the emperor. In due course, the purge was extended to involve tens of thousands of innocent people, who were executed, incarcerated, or banished; the new emperor proved himself as ruthless as the founder in conducting wide-ranging, bloody purges.” (Cham, 2007, 94)

<br>

Analytic note: The early Ming dynasty, and especially the Yongle period, were even more exciting than we have made them seem. Writers almost universally remark upon the energy of Yongle in contrast to Jianwen and subsequent emperors, which we read as corroborative evidence for political unrest in context.

Source excerpt: “Under the Yung-lo emperor the forceful manner of the founding emperor continued to be evident in the measures taken to secure the empire’s northern frontiers and to extend its political hegemony. This was displayed in the several major campaigns against the Mongol hordes, in the restructuring of the Great Wall line of defense, in the restoration of tributary relations with Japan and Korea, in the annexation of Annam, and in the eunuch Cheng Ho’s expeditions through the South Seas and the Indian Ocean to Africa and the Persian Gulf.” (Cham, 1988, 183).

<br>

Analytic note: We mean “serious attempts” in the sense that it appears that no subsequent emperor rebuilt the treasure fleets or even maintained a naval industrial basis capable of doing so (on the scale of the industrial base, see Needham 1972 479-480; on its demise, 484, 526-7). However, it does appear that in the late fifteenth century, the influential palace eunuch Wang Zhi did float the idea of rebuilding the treasure fleets. In response, a high scholar-official destroyed the archives to prevent a recurrence of the fleets.

There appears to be a slight discrepancy here with the fact that the records of the shipyards survived, however, since Needham (1972, 582) records that “in +1533 a full-dress history of Cheng Ho’s shipyards was written. This was the Lung Chiang Chhuan Chhang Chih already mentioned (Record of the Shipbuilding Yards on the Dragon River), near Nanking, by Li Chao-Hsiang…The fourth chapter describes the yards, giving plans and then there follow specifications and dimensions of materials, tabulated with costs in ounces of silver, and details the number of shipwrights and workmen required for each particular job.” Needham notes in a footnote (1972, p. 525d) that this view is disputed and that Liu Daxia may have only hidden, not destroyed, the records—and that Wang Zhi may have wanted to repeat the invasion of Vietnam by the Yongle emperor rather than the naval expeditions.

Whether the records were destroyed altogether or whether only the local copies of the records (e.g., those in Beijing at the Ministry of War) were destroyed or hidden, however, does not bear on the absence of recurrences of the treasure fleet. And one suspects that had Wang Zhi been genuinely serious about the attempt, the mere disappearance of records would not have posed a problem.

Source excerpt: “About 1477, the eunuch Wang Zhi, the Inspector of the Frontiers, requested the records of Zheng He’s voyages, apparently with the intention of reasserting Chinese authority in the seas of Asia. In response, Liu Daxia, a high official in the Ministry of War, destroyed the archives of the expeditions because of his conviction that the Chinese preoccupation with the world outside China was damaging to the empire. AS he told his superior, “The expeditions [of Zheng He] to the Western Ocean wasted tens of myriads of money and grain, and moreover the people who met their deaths [because of them] may be counted in the myriads. Although he returned with wonderful things, what benefit was it to the state? This was merely an action of bad government of which ministers should severely disapprove.”

Citation: Finlay, 1991, 12.

<br>

Analytic note: The Hongxi emperor died after less than a year on the throne, which we think qualifies as ‘unexpected’.

<br>

Source excerpt: “In China the critics [of overseas exploration] had always been far more numerous and determined. The Confucian bureaucracy, with its country landlord basis, was always liable to look askance at any intercourse with foreign countries. These countries were of no interest in themselves and could offer nothing but unnecessary luxuries. But according to the classical Confucian motif of scholarly austerity, to which in the national ethos the imperial court itself was theoretically bound, unnecessary luxuries were deeply wrong. … The champion of retrenchment and economy was Hsia Yuan-Chi, who had financed the expeditions at the beginning. Imprisoned under the Yung-Lo emperor, he was immediately released by Jen Tsung [Hongxi] upon his accession in the summer of +1424 and urged that fleet movements should be stopped immediately.”

Citation: Needham 1971, 524-25

<br>

Analytic note: We rely on Needham’s chronology here. Note that Needham uses a slightly idiosyncratic dating system, with AD/CE represented by “+”.

Source excerpt: “The seven expeditions from China extended progressively westwards. The first (+1405 to +1407) visited Champa (Indo-China), Java, and Sumatra, going the other way as far as Ceylon and Calicut on the west coast of India. The second (+1407 to +1409), under another commander, Cheng Ho [Zheng He] being absent, visited Siam and added Cochin to its Indian ports of call. On the third the fleet went to all the usual places in the East Indies….and became involved in affairs both distressing and comic on the island of Ceylon (+1409 to +1411). At this time a third able leader, the eunuch Hou Hsien, was joined to Chen Ho and Wang Ching-Hung. India was left behind by the fourth expedition in +1413 to +1415…some squadrons visited all the East Indies again, others (based on Ceylon) explored Bengal, the Maldive Islands, and reached the Persian sultanate of Ormuz. … Between [1417] and +1419 while its Pacific squadrons went as far as Java, Ryukyu, and Brunei, its Indian ones ploughed the seas from Ormuz to Aden, visiting Mogadishu in Somaliland, Malindi north of Mombasa, and other places on the Zanguebar coast. … The sixth expedition covered the same ground as before (+1421 to +1422)…the following monarch, Hzuan Tsung [Xuande], was left to preside over the last and perhaps the most dazzling of the Grand Treasure-Ship Fleets. It left in +1431 and before it returned in +1433 its commanders, with their 27,550 officers and men, had established relations with more than twenty realms and sultanates fro Java through the Nicobar Islands to Mecca [!] in the north and the coast of al-Zanj (East Africa) in the south.”

Citation: Needham 1971, 489-490.

<br>

Analytic note: We refer to Chinese monarchs by their personal name (Zhu Di, Zhu Gaochi, etc) on first reference but then by their regnal names throughout—not just out of respect for dynastic custom but to avoid the problem that otherwise every emperor would be “Zhu”. Whenever possible, we use the full version (“the Yongle emperor”) in preference to “Yongle” to reflect the fact that these are not personal names. We avoid other titles (e.g., “Prince of Yan” for Zhu Di before assuming the throne) to avoid confusion. We follow contemporary transliteration practice; researchers may also find the Yongle emperor referred to as Yung-lo, for instance.

<br>

Analytic note: The final document referred to in this sentence is a Kennedy administration directive by McGeorge Bundy (3 February 1961) in which “the free world” is used in policy guidance, a point we find telling about the ubiquity and taken-for-grantedness about the use of this concept.

Full Citation: National Security Action Memorandum 3, Bunkering of Free World Ships Under Communist Chinese Charter, Papers of John F. Kennedy. Presidential Papers, National Security Files, JFKNSF-328-004. Online: https://www.jfklibrary.org/Asset-Viewer/Archives/JFKNSF-328-004.aspx

<br>

Source excerpt: the Portuguese Foreign Minister’s declaration: “The Portuguese Foreign Minister, accompanied by Ambassador Pereira, called on the Secretary following intimations given Ambassador Stevenson in New York that he would welcome an invitation. Franco Nogueira said he wished to come directly to the matter on his mind. He had jotted down a few points on the plane coming from New [Page 963]York so that he would not forget. He was sure the Secretary said he was aware of the “misunderstanding” of the last few days. The Secretary said he was aware of the démarche made by Mr. Fragoso and of the shaking repercussions it had caused in Washington. Franco Nogueira said he was referring to this. He wished to make a matter of record that both he and Portugal had the highest respect and consideration for the President not only as the leader of the Free World but also as a person and an individual. He was not saying this just because of this misunderstanding. He hoped Ambassador Elbrick had reported previous conversations in Lisbon in which he had said the same thing. He has always had such views. The Secretary could ask Burke Elbrick to confirm this. He was not trying to patch matters up or to flatter the President. Franco Nogueira said “let me put a question to you. Do you think it in our interest to offend the President or to offend the United States? Surely not! If this was done it must have been done inadvertently”.

Full Citation: FRUS Volume XIII, Western Europe and Canada, Document 354, (“Memorandum of Conversation”, 2 August 1963) Online: https://history.state.gov/historicaldocuments/frus1961-63v13/d354

<br>

Analytic note: We found Khong’s ideas here to be well-crafted but lacked the space to engage them in the original article. Khong proposes that the United States, like the traditional portrait of the Chinese “tributary system”, serves as “the chief patron of a system of client states” (p. 2). In particular, he argues that the United States, also like China, seeks recognition by its tributaries and emulation of its domestic system by those tributaries. We think that this analogy could be interrogated more if we envision imperial systems as incorporating elements of “international” systems within themselves, but the larger point is to draw on the idea that the U.S. repertoire had parallels in the Chinese system during the eras in which we were also interested.

Source excerpt: “America has more in common with China than is generally recognized. In this article, I employ the idea of the tributary system—most often associated with China’s international relations from antiquity—to interpret how America relates to the rest of the world (ROW). I argue tha the United States has instituted the most successful tributary system the world has ever seen. … Through an equally impressive array of international institutions and organizations, many of which it created, the United States transmits and imposes its values and its preferred rules of the game on the international system.” (Khong 2013, 1-2)

<br>

Analytic note: We sought quotidian examples of “leader of the Free World” being employed as arguments for or against a given idea. (We were surprised that there seemed to be no academic article making the point that LotFW was a rhetorical trope that could be cited as having force of its own.” However, in our search, we also found Secretary of Defense Robert McNamara using the term in an ExCo meeting during the height of the Cuban Missile Crisis. Excerpts from the documents cited follow.

Source excerpt: McNamara comments during the Cuban Missile Crisis: “Secretary McNamara listed the disadvantages of the blockade route as follows:

1. It would take a long time to achieve the objective of eliminating strategic missiles from Cuba.
2. It would result in serious political trouble in the United States.
3. The world position of the United States might appear to be weakening.

1. It would cause us the least trouble with our allies.
2. It avoids any surprise air attack on Cuba, which is contrary to our tradition.
3. It is the only military course of action compatible with our position as a leader of the free world.
4. It avoids a sudden military move which might provoke a response from the USSR which could result in escalating actions leading to general war.”

Full Citation: FRUS Volume XI, Document 34 (“Minutes of the 505th Meeting of the National Security Council”). Online: https://history.state.gov/historicaldocuments/frus1961-63v11/d34

<br>

Analytic note: We worded this sentence precisely to distinguish between those who see the cessation of the treasure-fleet voyages as a cause of Chinese decline (as in the first paragraph) and those who see it as evidence of Chinese decline.

Source excerpt: Zakaria (2012), 64 [note misprint in original citation]: “Just as China chose to turn away from the outside world, Europe was venturing abroad, and it was Europe’s naval expeditions that allowed it to energize itself and spread its power and influence across the globe. If China had kept its navy afloat, would the course of modern history have been different? Probably not. China’s decision to turn inward was not simply one bad strategic call. It was an expression of a civilization’s stagnation.”

<br>

Analytic note: In our reading on the subject, we’ve tended to find that advocates of manned space exploration display an unusual fondness for this example. This clause is more or less all that remains of that finding, but it does seem noteworthy to us. Often, these invocations of the Ming example rest on oversimplified versions of the case—one of the reasons we go to some trouble to present our interpretation of the evidence in the empirical section. We present here one example of this: a Washington Post opinion section written in the aftermath of the space shuttle Columbia explosion in 2003.

Source excerpt: “Great and vital nations almost always seem to need to look outward and to push their geographical, intellectual and spiritual boundaries to remain dynamic. In the past, they have exercised this impulse through foreign trade, warfare and territorial expansion. But to continue exercising these imperatives on our own terra firma has its perils. After all, this is no longer the era of Zheng's wooden-hulled sailing ships quaintly plying the seas to trade porcelain and silk for spices and exotic hardwoods. … However, with our technological ability to penetrate space, we are given a providential alternative way to compete, explore, expand and keep our faith in the idea of progress. To contemporary America, and especially our youth, space has become the equivalent of Zheng's voyages. And we would do well to remember that when China turned inward in the 15th century, it took several centuries for it to begin to recover its sense of expansive confidence, creative energy and pride.”

Full citation: Schell, Orville. 2003. “A Ming Emperor Would Have Grounded the Shuttle. Bad Idea.” The Washington Post 2 March. Online: https://www.washingtonpost.com/archive/opinions/2003/03/02/a-ming-emperor-would-have-grounded-the-shuttle-bad-idea/7daa3b5e-2677-464b-a865-ddd62b6cba65/?utm_term=.ae609cac2482 Last accessed: 10 January 2018.

<br>

Analytic note: We chose to date this at the Nixon administration’s announcement of its decision to proceed with the development of the space shuttle (formally, the Space Transportation System).

The decision heralded a self-evident shift from grandeur to reliability; as the statement issued in President Nixon’s name noted, “This system … will revolutionize transportation into near space by routinizing it.” Indeed, the very arguments used to bolster the administration’s decision serve as a negative proof of the lack of economic spinoffs of the Apollo project. The statement continued that the switch to the shuttle “will go a long way toward delivering the rich benefits of practical space utilization and the valuable spin-offs from space efforts”, in contrast with the “special effort and staggering expense” of the Moon missions. Nixon pledged that “by sharply reducing costs in dollars and preparation time” the new space shuttle would “achieve a real working presence in space”.

Unlike Kennedy, who spoke of the sacrifice of the space effort, Nixon highlighted that “this major new national enterprise will engage the best efforts of thousands of highly skilled workers and hundreds of contractor firms over the next several years. … [R]obust activity in the aerospace industry is healthy for everyone—not just in jobs and income, but in the extension of our capabilities in every direction.”

Source excerpt: “The new year 1972 is a year of conclusion for America's current series of manned flights to the moon. Much is expected from the two remaining Apollo missions--in fact, their scientific results should exceed the return from all the earlier flights together. Thus they will place a fitting capstone on this vastly successful undertaking. But they also bring us to an important decision point--a point of assessing what our space horizons are as Apollo ends, and of determining where we go from here.”

Full citation: Richard Nixon: "Statement Announcing Decision To Proceed With Development of the Space Shuttle," January 5, 1972. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ws/?pid=3574.

<br>

Analytic note: This phrase has become familiar from repetition, but it is a specific policy pledge embedded in a special State of the Union address by President Kennedy. Reading the 25 May 1961 “Special Message to the Congress on Urgent National Needs” brings out several of the claims we make in greater detail below, including Kennedy’s positioning of the Cold War struggle for the hearts and souls of “the whole southern half of the globe—Asia, Latin America, Africa, and the Middle East—the lands of the rising people” and—through the document’s very length and exhaustiveness—the totalizing nature of the Cold War struggle and its intermingling of international and domestic politics in the United States and throughout the world.

Although “Space” comes last in the document, the text makes clear that we are to regard this as a question of pride of place. Kennedy argues that “if we are to win the battle that is now going on around the world between freedom and tyranny, the dramatic achievements in space which occurred in recent weeks should have made clear to us all, as did the Sputnik in 1957, the impact of this adventure on the minds of men everywhere, who are attempting to make a determination of which road they should take.” This positions the speech in a Cold War setting and privileges the political nature of the struggle over economic, bureaucratic, or militaristic interpretations. Moreover, Kennedy is clear that unmanned exploration and scientific purposes, such as the satellites for communication and weather observation, come second to manned Moon missions: “We propose additional funds for other engine development and for unmanned explorations—explorations which are particularly important for one purpose which this nation will never overlook: the survival of the man who first makes this daring flight.”

Source excerpt: “I believe that this nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to the earth. No single space project in this period will be more impressive to mankind, or more important for the long-range exploration of space; and none will be so difficult or expensive to accomplish. We propose to accelerate the development of the appropriate lunar space craft. We propose to develop alternate liquid and solid fuel boosters, much larger than any now being developed, until certain which is superior. We propose additional funds for other engine development and for unmanned explorations--explorations which are particularly important for one purpose which this nation will never overlook: the survival of the man who first makes this daring flight. But in a very real sense, it will not be one man going to the moon--if we make this judgment affirmatively, it will be an entire nation. For all of us must work to put him there.”

Full citation: John F. Kennedy: "Special Message to the Congress on Urgent National Needs," May 25, 1961. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ws/?pid=8151.

<br>

Analytical note: Information on agricultural production is provided in the German Colonial Atlas (Deutsches Kolonial-Lexikon; Schnee 1920), an extensive collection of data brought together by generations of German colonizers from the start of German imperialist endeavours in the 1880s until 1914. The encyclopedia was mostly completed before the beginning of the first World War, but could not be published until 1920. Its three volumes comprise articles on diverse colonial subjects from all over the colonies, classified from A to Z. Furthermore, there are 208 black/white/grey figures as well as 37 ones in color. Besides that, the encyclopedia includes maps on every colony, especially 11 different maps on German East-Africa.

Link: The Kolonial-Lexikon has been digitized by the Goethe University Frankfurt and the University of Applied Science Dresden. It can be found here: http://www.ub.bildarchiv-dkg.uni-frankfurt.de/Bildprojekt/Lexikon/Standardframeseite.php

Full Citation: Heinrich Schnee, former governor of German East-Africa, German Colonial Atlas (Deutsches Kolonial-Lexikon; Schnee), 1920.

<br>

Analytic Note: Following the descriptive analysis, the statistical analysis was carried out using RBrul Johnson, 2009, http://www.danielezrajohnson.com/rbrul.html . RBrul functions similarly to an R-package but replaces the usual command-line interface with a series of y/n options and prompts. Rbrul compiles mixed-effects logistic regression models utilising the same packages and formulas as the longhand command-line method but exhibits a number of differences in its model calculation and presentation. For instance, as a default, RBrul presents the factor level contrasts using a sum to zero calculation which means that the different categories within a factor group are compared to the overall mean. This is in contrast to the default comparison style within the command-line method where the model selects a category within each factor as the baseline against which all the other categories are compared. For example, if the factor is age, Rbrul will compare each of the categories: old, middle and young, against the overall mean (or proportion in this case as it is a binary variable). In the command-line default, rather than comparing old, middle and young against the overall proportion rate, the model would select one category e.g. old and then compare middle and young against the old proportion rate. Rbrul therefore uses the same method of presentation (i.e. sum to zero), and factor weights making it directly comparable with the traditional Variable Rule (Varbrul) analyses used in the field. Further, as it runs through R, it is capable of using more recent developments in statistical modelling (modelling mixed effects, modelling interactions) not available using older Varbrul type analyses.

The most recent version of RBrul (not available at time of original analysis) uses a graphical (Shiny) interface. This version enables users to drag and drop variables into the model (see file: RBrul model potential predictors.JPG and RBrul model predictors selected.JPG). An added benefit of the new version is that it calculates the p-values associated with particular variables as the model is compiled online. These can then be used to inform whether or not factors are entered into the model i.e. stepping up. This is in contrast to the kitchen sink approach where all potential factors are added and the model compiled through stepping down (see file: RBrul model basics potential predictors.JPG). Indeed, Johnson (2017) notes that building models manually with the help of p-values is statistically more respectable and should allow for a deeper understanding of your data."

Data Sources:

Model basics https://data.qdr.syr.edu/file.xhtml?fileId=2514

Model potential predictors https://data.qdr.syr.edu/file.xhtml?fileId=2515

Model predictors selected https://data.qdr.syr.edu/file.xhtml?fileId=2516

<br>

Analytic Note: Previous studies of glottal replacement have employed a number of different coding schema including following phonetic environment and word position (see references on page 12). As Tagliamonte (2006:123) notes about coding schema: There is more than one way to cut a pie. The coding schema eventually employed a five way split that accounted for both syllabic position and following phonetic environment. However, initially a much more elaborated coding schema was used; Unstoppable glottal original coding coding.pdf provides a breakdown of all 20 contexts and includes examples from the data. The sound files provided offer an opportunity to hear the variation across the five final different linguistic contexts.

Data Sources:

List of Extracts: https://data.qdr.syr.edu/file.xhtml?fileId=2504

Original Coding: https://data.qdr.syr.edu/file.xhtml?fileId=2505

Extract 1a https://data.qdr.syr.edu/file.xhtml?fileId=3999

Extract 1b https://data.qdr.syr.edu/file.xhtml?fileId=4000

Extract 2a https://data.qdr.syr.edu/file.xhtml?fileId=4001

Extract 2b https://data.qdr.syr.edu/file.xhtml?fileId=4002

Extract 3a https://data.qdr.syr.edu/file.xhtml?fileId=4003

Extract 3b https://data.qdr.syr.edu/file.xhtml?fileId=4004

Extract 4a https://data.qdr.syr.edu/file.xhtml?fileId=4005

Extract 4b https://data.qdr.syr.edu/file.xhtml?fileId=4006

Extract 5a https://data.qdr.syr.edu/file.xhtml?fileId=4007

Extract 5b https://data.qdr.syr.edu/file.xhtml?fileId=4008

Extract 5c https://data.qdr.syr.edu/file.xhtml?fileId=4009

<br>

Analytic Note: The file linked below contains details on the project.

Data Sources: https://data.qdr.syr.edu/file.xhtml?fileId=4016

<br>

Source Excerpt: По-прежнему руководители решают возникающие проблемы с помощью налаженных связей и без особого труда откупаются от проверяющих. Однако сегодня происходит определенная переоценка подобного риска ведущими участниками рынка – риск начинает восприниматься все более болезненно. Причина не только в возможных потерях вследствие наложения штрафов и конфискации товара и не только в лучном спокойствии предпринимателя («заплати налоги и спи спокойно»). Дело в том, что снижение такого рода рисков необходимо для повышения общей стабильности деятельности и успешного продвижение брэнда компании. Возможные сбои в случае селективных проверок ставят под угрозу и стратегию развития, и репутацию бизнеса. А для ведущих игроков подобные риски становятся крайне нежелательными. (Radaev 2002, p. 44)

Source Excerpt Translation: Directors [of firms] still resolve problems with the help of established connections and buy off inspectors without much trouble. However, today a definitive reevaluation of risk is occurring among leading players in the market—risk is beginning to be perceived as more painful. The reason is not only possible losses as a consequence of fines and confiscation of goods and not only the entrepreneur’s peace of mind (“pay your taxes and sleep calmly”). The fact of the matter is that reducing certain types of risks is necessary in order to increase the general stability of activity and the successful promotion of a company’s brand. Possible complications in the case of selective inspections put at risk both the development strategy and the reputation of the business. And for leading players such risks are becoming extremely undesirable. (Radaev 2002, p. 44)

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=2802

Full Citation: Radaev, Vadim. 2002. Institutsionalnaya Dinamika Rynkov i Formirovanie Novych Konseptsii Kontrolya [Institutional Market Dynamics and the Formation of New Concepts of Control]. Higher School of Economics working paper.

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Analytic Note: This quote by Potanin, himself a powerful oligarch, should be placed in context. I include it because it nicely offers a glimpse of the logic shared by many Russian businesspeople in the early 2000s, as attested to in the interviews in Radaev (2002) cited throughout the article. Whether Potanin was sincere or whether such statements were just lip service is a valid question. But corporate governance ratings of Potanin’s companies – and those of a number of other oligarchs – improved dramatically during the late 1990s and early 2000s. See, for example, the ratings for Norilsk Nikel in Table 1 on p. 78 of Markus (2008). Such investments in corporate governance reforms appear to indicate that a substantial shift in oligarchs’ approach to business occurred during the period in question.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=2657

Full Citation: Potanin, Vladimir. 2003. “Corporate Governance: “Russian Model” in Progress.” Journal on Foreign Affairs and International Relations. Available at http://eng.globalaffairs.ru/number/n_1724

Full Citation (Supplementary Source): Markus, Stanislav. 2008. “Corporate governance as political insurance: firm-level institutional creation in emerging markets and beyond.” Socio-Economic Review 6: 69-98

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Analytic Note: The claim that evaluations of the commercial courts improved marginally while evaluations of police remained unchanged and evaluations of regulators and inspectors fell between 2000 and 2007 is based on Table 2 (Таблица 2) on p. 222 of Yakovlev (2008). The table shows the difference between the percent of respondents who approve of a given institution and the percent of respondents who disapprove of a given institution. The first row of the table provides assessments for regulators and inspectors at the oblast or city level (чиновники областной и городской администраций, различных инспекций), the second row for police (милиция), and the bottom row for the commercial courts (арбитражный суд). The columns are divided between the industrial sector (промышленность) and the service sector (услуги). The balance of positive and negative assessments of regulators and inspectors falls from -14.2 to -24.1 among industrial firms and -20.9 to -36.9 for service firms.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=2666

Full Citation: Yakovlev, Andrei. 2008. Pravo i Pravoprimenenie v Rossii Glazami Biznesa: Chto Izmenilos za Sem Let [Law and Law Enforcement in Russia through the Eyes of Business: What Changed in the Last Seven Years]. In Pravoprimenenie: Teoriya i Praktika, ed. Yury Tikhomirov. Moscow: Formula Prava, 214– 39.

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Analytic Note: In earlier versions of the article, and in other studies (see p. 55 in Jordan Gans-Morse, Property Rights in Post-Soviet Russia: Violence, Corruption, and Demand for Law, Cambridge University Press, 2017), I included additional sources in support of the claim that criminal rackets control around 10-20 percent of the private security market. In seeking to reduce word count as the article went through the review process, I removed some of these. The two sources that I cite in the article, Khodorych (2002) and Volkov (2002), give the estimate that criminal rackets by the early 2000s controlled only around 10% of the market (see the excerpts below). I am including here an excerpt from Taylor (2007) which points to the upper range of the estimates indicating that the police controlled 70% of the market and the FSB 10%; this implies that 20% of the market remained in the hands of criminal organizations.

Source Excerpt (Source 1): Как бы то ни было, деньги на российском охранном рынке крутятся немалые. Сначала их делили ВО, ЧОПы и криминальные структуры, которые в начале 90-х контролировали до 80% рынка (занимались так называемым крышеванием). Теперь же, когда доля криминальной и нелегальной охраны не превышает 10% (оценка Сергея Минаева, гендиректора Специальной информационной службы), основная битва, как уже сказано, развернулась между частными структурами и вневедомственной охраной (ВО). (Khodorych, 2002)

Source Excerpt Translation (Source 1): However that may be, a large amount of money is being made in the Russian private security market. At first this money was divided among the VO [the extra-departmental security division of the Ministry of Internal Affairs], PSAs [private security agencies], and criminal organizations, which at the beginning of the 90s controlled up to 80% of the market (offering so-called “roofing” [slang term for the protection of a racket]). Now, when the share of criminal and illegal protection is no more than 10% (the assessment of Sergey Minaev, the General Director of the Special Information Service), the main battle, as has already been said, unfolds between the private [security] organizations and the extra-departmental security division [of the Ministry of Internal Affairs]. (Khodorych, 2002)

Source Excerpt (Source 2): Purely criminal arrangements lack long-term stability. After their heyday in 1991-95, criminal “roofs” began to dwindle away or evolve under the triple pressures of capitalization, competition, and law enforcement. According to expert estimates, in 1998 in Petersburg only 10 percent of all “roofs” were purely criminal. A respondent who, at some stage in his career, had been involved in private protection as a member of an organized criminal group in Novosibirsk pointed out that purely criminal “roofs” were being driven out of legal business and superseded by informal police protection. (Volkov 2002, 169-70)

Source Excerpt (Supplementary Source): One of the most common forms of enrichment for power ministry personnel is the provision of protection (a “roof,” or krysha in Russian parlance) to businesses of all sizes. In the immediate post-Soviet period state law-enforcement agencies proved unable to protect the property rights of newly-legal stores and companies, so mafia groups filled this void by running protection rackets. Over time, however, much of this activity was taken over by state agencies – not as part of their legal responsibilities, but on a for-hire basis. One Russian crime journalist estimated that if in the early 1990s 70 percent of roofs were criminal, ten years later 70 percent were provided by the police, and another 10 percent by the FSB. Large enterprises were more likely to have a FSB roof. Medium and large enterprises usually hire a former officer from the FSB or the MVD to serve as the “vice president” for security, who manages the firm’s relations with the law enforcement authorities. (Taylor 2007, pp. 44-45)

Data Sources: https://data.qdr.syr.edu/file.xhtml?fileId=2655 https://data.qdr.syr.edu/file.xhtml?fileId=2665

Note: Taylor’s monograph is available online for free at http://insct.syr.edu/wp-content/uploads/2015/10/Taylor_Russia_Power_Ministries_2007.pdf

Full Citation (Source 1): Khodorych, Aleksey, “Posledniy dovod zashchity (The defense’s last argument),” Den’gi, April 17, 2002

Full Citation (Source 2): Volkov, Vadim. 2002. Violent Entrepreneurs: The Use of Force in the making of Russian Capitalism. Ithaca, NY: Cornell University Press

Full Citation (Supplementary Source): Taylor, Brian. 2007. Russia’s Power Ministries: Coercion and Commerce. Syracuse, NY: Institute for National Security and Counterterrorism, Syracuse University

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Analytic Note: The claim that murders resulting from business conflicts in the Central Federal District fell from over 200 in 1997 to around 30 in 2005 is based on data from the top line of the table under Figure 1 (Рис. 1) at the top of p. 87 in Matveeva (2007). These statistics are in the row labeled все (all); the rows above are labeled нераскыт and раскрыт (unsolved and solved). Matveeva also discusses these statistics on p. 86 in the passage cited below.

Source Excerpt: В то же время наметилась тенденция снижения уровня тяжкого насилия в сфере предпринимательских отношений. За рассматриваемый период времени количество расследованных убийств предпринимателей сократилось с 217 в 1997 до 33 – в 2005 году или в 6,6 раза.

Source Excerpt Translation: At this same time, a trend was seen of a declining level of violence in the sphere of entrepreneurial relations. For the period of time examined, the quantity of investigated murders of entrepreneurs fell from 217 in 1997 to 33 in 2005, a 6.6-fold decrease.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=2658

Full Citation: Matveeva, N. 2007. “Kriminologicheskiy analiz sostoyaniya zashchishchennosti predprinimatelei ot tyazhkogo nasiliya v Tsentralnom Federalnom okruge [Criminological analysis of the entrepreneurs’ degree of protection from harmful violence in the Central Federal District].” In Kriminalnaya ekonimika i organizovannaya prestupnost [The criminal economy and organized crime], ed. A. Dolgova. Moscow: The Russian Criminological Association and the Nizhgovorod Academy of the MVD

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Analytic Note: The claim that between 1994 and 2010 annual cases in Russia increased from around 200,000 to over one million is based on the second row of the table in VAS (2011) with bolded letters on p. 1 and p. 4 of the data source, i.e., the row with the label Рассмотрено дел в 1 инстанции (Cases heard in the courts of first instance). The exact figure for 1994 is 208,081 cases and for 2010 is 1,197,103 cases. I rely on this category instead of the first row with bolded letters with the label Поступило заявлений, исковых заявлений (Claims filed) to remain consistent with earlier works that cite these caseload data (see, e.g., Table 1 in Kathryn Hendley, “Temporal and Regional Patterns of Commercial Litigation in Post-Soviet Russia,” Post-Soviet Geography and Economics, 1998, 39, 7, pp. 379-398; Table 1 in Kathryn Hendley, “Suing the State in Russia,” Post-Soviet Affairs, 2002, 18, 2, pp. 122-147). Strictly speaking, these statistics refer to all cases filed, including cases filed by state agencies against firms, rather than specifically to cases filed by firms (cases filed by individuals, as opposed to firms, are handled in an entirely different system, the courts of general jurisdiction rather than in the commercial courts). For a discussion of this issue in greater detail, see pp. 69-70 in Jordan Gans-Morse, Property Rights in Post-Soviet Russia: Violence, Corruption, and Demand for Law, Cambridge University Press, 2017. Most importantly, even when considering only cases filed by firms, the comparison of 200,000 cases in 1994 to more than one million cases in 2010 remains accurate.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=2663

Full Citation: Vysshyi Arbitrazhnyi Sud (VAS). 2011. Osnovnye Pokazateli Raboty Arbitrazhniykh Sudov RF [Basic Indicators of the Work of the Commercial Courts of the RF]. Vysshyi arbitrazhnyi sud [Supreme Arbitrazh Court] in Moscow.

<br> This is an Annotation for Transparent Inquiry project, published by the Qualitative Data Repository.

<br>

<font>The Data Overview discusses project context, data generation and analysis, and logic of annotation.</font>

<br> Please cite as:

O'Mahoney, Joseph. 2018. "Data for: Making the real: Rhetorical adduction and the Bangladesh Liberation War". Qualitative Data Repository. https://doi.org/10.5064/F6M2H9VQ

Learn more about ATI here.

<br>

Analytic Note: This is a telegram of 11 January 1972 from Christopher Ewart-Biggs, Minister of the UK Embassy in Paris, France, to the FCO in London, from folder 37/1023 of the Foreign and Commonwealth Office's Archives at Kew, UK. The telegram describes a conversation Ewart-Biggs had with Henri Froment-Meurice, the Director of Asian Affairs at the French Foreign Ministry about recognition of Bangladesh.

The excerpt reveals that control of territory and the presence of Indian troops were both potential barriers to recognition for France. Froment-Meurice points to the consent of the Dacca government as a reason to dismiss the presence of Indian troops as a problem. He maintains that this consent means that “it was not a Prague situation”, presumably referring to the invasion and occupation of Czechoslovakia by the USSR in 1968, 3 years earlier. An interesting wrinkle here is that Froment-Meurice does not think that “the questions of recognition and withdrawal should not be too formally tied together”. Without any other elaboration, it seems probable that he means that actual withdrawal should not be formally, i.e. publicly, held to be a sine qua non for French recognition.

Source Excerpt: The main considerations, which Froment-Meurice had obviously included in the paper he has drafted for the minister were: (1) Control of the territory. The Bangladesh authorities were establishing their control over the territory and this would be strengthened by the arrival of Mujib. With the help of the Indian Army, there was less disorder than might have been expected. (II) The Indian Presence. The Indian forces were there with the consent of the Dacca government: it was not a Prague situation. The Indians had already withdrawn some troops and said that they would not stay longer than the Bangladesh government wanted. It was up to the Indians and the Bangladesh government to arrange the timing of the withdrawal between them. But the questions of recognition and withdrawal should not be too formally tied together.

Data Source: https://data.qdr.syr.edu/file.xhtml?fileId=2543

Full Citation: Christopher Ewart-Biggs, Minister of the UK Embassy in Paris, a telegram from Ewart-Biggs to the FCO in London, 11 January 1972. Folder 37/1023 of the Foreign and Commonwealth Office's Archives at Kew, UK.

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Source Excerpt:

"We are both soldiers who occupied your neighborhood for 14 months...

We acknowledge our part in the deaths and injuries of your loved ones as we tell Americans what we were trained to do and carried out in the name of “god and country”. The soldier in video said that your husband shouldn’t have brought your children to battle, but we are acknowledging our responsibility for bringing the battle to your neighborhood, and to your family. We did unto you what we would not want done to us."

Full Citation: Courage to Resist, ‘Letter of reconciliation and responsibility to the Iraqi People’, Courage to Resist (2010), available at: http://www.couragetoresist.org/news/838-letter-of-reconciliation-and-responsibility-to-the-iraqi-people.html (defunct; archived version here).

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Analytic Note: The Collateral Murder web site consists of: An overview page with three embedded videos. This contains both a longer and a shorter, edited, version of the Apache footage and a video of a US soldier, Ethan McCord speaking at a peace conference:https://collateralmurder.wikileaks.org/

A page containing download links for videos and associated transcripts: https://collateralmurder.wikileaks.org/en/download.html A page containing a set of stills taken from the video: https://collateralmurder.wikileaks.org/en/stills.html A page containing a timeline of events depicted in the video:https://collateralmurder.wikileaks.org/en/timeline.html A page containing a transcript of the video: https://collateralmurder.wikileaks.org/en/transcript.html A page containing further resources, including US military rules of engagement for the time of the incident, news sources from the time of the incident, photos and captions relating to the two Reuters employees who were killed, and 'New Iraqi Material' which consists of subsequently added details concerning the children injured in the attack and their father who was killed: https://collateralmurder.wikileaks.org/en/resources.html

There are two further webpages, one containing details of how to support WikiLeaks and one containing contact details:

https://wikileaks.ch/support.html (defunct; archived copy here)

https://collateralmurder.wikileaks.org/en/contact.html

<br> This is an Annotation for Transparent Inquiry project, published by the Qualitative Data Repository.

<br>

<font>The Data Overview discusses project context, data generation and analysis, and logic of annotation.</font> </br/>

Please cite as:

Tidy, Joanna. 2018. "Data for: Visual regimes and the politics of war experience: Rewriting war ‘from above’ in WikiLeaks’ ‘Collateral Murder’". Qualitative Data Repository. https://doi.org/10.5064/F643DB5O

Learn more about ATI here.

<br> This is an Annotation for Transparent Inquiry project, published by the Qualitative Data Repository.

<br>

<font>The Data Overview discusses project context, data generation and analysis, and logic of annotation.</font>

<br> Please cite as:

Moorlock, Greg. 2018. "Data for: An empirically informed analysis of the ethical issues surrounding split liver transplantation in the United Kingdom". Qualitative Data Repository. https://doi.org/10.5064/F66QRSDR

Learn more about ATI here.

<br> This is an Annotation for Transparent Inquiry project, published by the Qualitative Data Repository.

<br>

<font>The Data Overview discusses project context, data generation and analysis, and logic of annotation.</font>

<br> Please cite as:

Arrey, Agnes Ebotabe. 2018. "Data for: Perceptions of stigma and discrimination in health care settings towards Sub-saharan African migrant women living with hiv/aids in Belgium: A qualitative study". Qualitative Data Repository. https://doi.org/10.5064/F6CNZC8J

Learn more about ATI here.

<br>

Analytic note: Stigma and discrimination of people living with HIV/AIDS is a global phenomenon. This article is devoted to the responses of people living with HIV and describes their experience of living with a long term chronic illness. It contains a number of studies detailing findings from research in social sciences recently conducted in France, Australia, Canada, the United Kingdom and the French Caribbean, i.e. in countries where HAART have been widely available for about ten years. This paper gives ways in which people live with and manage their chronic illness, in this case living with HIV, is similar across some of the studies and countries represented in this paper. The findings also illustrate the ways in which gender, socio-economic status, and race influence access to and uptake of antiretroviral therapy. The study further highlights the persistence of stigma and discrimination of persons especially from marginalized groups, living with HIV/AIDS. This article is relevant to support our claim of persistent stigma and discrimination of HIV-infected persons in all settings, including healthcare settings.

Source excerpt: Overall, what these studies indicate is that since the advent of highly active antiretroviral therapy in 1996, people are increasingly able to live with HIV as a chronic illness; many people are able to lead lives in which they work and play, have sex, and reproduce. However, research also reveals that stigma and discrimination continue to be present in the lives of many living with HIV, especially those already marginalized by gender, race and socio-economic status. Stigma and the associated shame appear to amplify the complexities of living with HIV. As the number of people living with HIV grows, policy makers and health care professionals need to develop tailored programs of support and care to meet their complex needs and requirements. Social research comparing living with HIV with living other chronic diseases would be useful in this regard, as would studies addressing issues related to the ageing of the population of people living with HIV. Research to inform such programs of support and care are sorely needed, especially in developing countries burdened by the largest numbers of people living with HIV.

Full Citation: Kippax, S. C., Aggleton, P., Moatti, J. P. & Delfraissy, J. F. (2007) Living with HIV: recent research from France and the French Caribbean (VESPA study), Australia, Canada and the United Kingdom. AIDS 21 (Supplement 1), S1–S3. doi: 10.1097/01.aids.0000255078.01234.71

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Analytic note: HIV-positive persons are ‘labelled’ in the community as well as in medical institutions. Persons with HIV perceive ‘HIV/AIDS labelling’ as discrediting, stigmatizing and discriminatory. Most HIV persons avoid using the word ‘HIV or AIDS’. They refer to being ‘sick or ill’. HIV-related metaphorical terms and phrases reported in this study are often used regardless of the presence of a person living with HIV/AIDS (PLWH). Some direct insults and other ‘concealed’ terms are often used to discuss the PLWH in their presence but without their knowledge. The following source excerpts are from raw data.

Source excerpt: “When we meet at the clinic (AIDS clinic) “juju house” (nickname for clinic), nobody greets or talks to the others. We pretend not to recognize anyone but back in town people will know who attended the clinic.”

Another participant explained that in her African community, HIV/AIDS is coded in their dialect and simply referred to as the “4 lettered word”, meaning AIDS, during conversations involving someone living with HIV/AIDS.

Full Citation: Arrey, A. E, Bilsen, J. Lacor, P. Deschepper, R. “It’s my secret”: Fear of disclosure among sub-Saharan African Migrant Women Living with HIV/AIDS in Belgium. PLOS One. 2015 Mar 17; 10(3). DOI:10.1371/journal.pone.0119653

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Analytic note: The question of the origin of HIV has much been debated and many hypotheses to support one or another school of thought have been presented since the beginning of the HIV epidemic. This article disputes the claim promoted by Western scientists that the AIDS epidemic started in Africa, making it an African disease and thus, an African problem. It discusses Western perceptions of the scale and mode of transmission that is influenced by racism and not science. The authors of this book chapter stresses on the fact that it is not the origin of AIDS that matters but the concerted efforts to deal with and contain the epidemic. Reference to this chapter relates to the perception that HIV and AIDS is an African disease even among medical personnel. Today there still exist some elements of truth in the critique of AIDS as an African disease as is seen in our study and in previous studies.

Source excerpt: Western scientists have promoted the hypothesis that the AIDS epidemic began in Africa, arguing that AIDS had existed for many years in an African “lost tribe” or that a retrovirus crossed the species barrier from monkey to man. The scientific evidence in support of this hypothesis has included AIDS-like cases from Africa that predated the epidemic in the West, seroepidemiological evidence for an early African infection, and the isolation of retroviruses from African monkeys considered similar to the hulas immunodeficiency virus. Yet when the scientific literature supporting an African origin is explained, it is found to be contradictory, insubstantial or unsound, whilst the possibility that AIDS was introduced to Africa from the West has not been seriously investigated. The belief that the AIDS epidemic started in Africa has also distorted Western perceptions of the scale and mode of spread of the epidemic in Africa, and it would seem that much of the research into AIDS and Africa has been influenced by racism and not science.

Full Citation: Harrison-Chirimuuta, R. & Chirimuuta, R. (1997) AIDS and Africa: a case of racisim vs science? In Bond, G. C., Krensike, J., Susser, I. & Vincent, J. (eds) AIDS and Africa and the Carribbean. Westview Press. http://www.virusmyth.com/aids/hiv/rcafrica.htm

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Analytic note: The HIV epidemic remains a major public health problem in the EU, though the number of HIV infections has ceased to increase. Heterosexually-transmitted HIV infection accounts for the second largest number of people with HIV in Europe. A considerable proportion of these HIV cases are among migrants, largely from sub-Saharan Africa. This article describes the epidemiology of HIV and AIDS among migrants in 27 European Union (EU) countries, plus Norway and Iceland from 1999 to 2006. The article indicates that migrants from sub-Saharan Africa represent a high proportion of HIV and AIDS in the EU. The main mode of transmission in this group is through heterosexual transmission. Its conclusion gives a base for our study.

Source excerpt: Migrant populations, largely Sub-Saharan Africans, represented a considerable and growing proportion of both AIDS cases and HIV infections reported in the 27 EU countries, Norway and Iceland during 1999–2006. The drop in AIDS cases observed in native populations is seen only in migrants from Western countries, while in migrants from other geographical origins increases are seen. The contribution of migrants to the AIDS and HIV epidemics is notably higher among female reports, in particular for women from SSA. Closely linked to the high burden of HIV infection in women from SSA is the high proportion of migrants from SSA among MTCH HIV reports. Although the largest proportion of migrants is, by far, among heterosexually acquired HIV and AIDS reports, a significant percentage of diagnoses in MSM are also migrants, largely from Western Europe and Latin-America and North-Africa and Middle East. A higher proportion of migrants developed TB as their initial ADC compared with natives; people from SSA and Eastern Europe had the highest prevalence of TB, closely followed by people from Southeast Asia.

Full Citation: Del, A. J., Likatavicius, G., Perez-Cachafeiro, S., Hernando, V., Gonzalez, C., Jarrin, I. et al. (2011) The epidemiology of HIV and AIDS reports in migrants in the 27 European Union countries, Norway and Iceland: 1999–2006. European Journal of Public Health 21(5), 620–626. https://doi.org/10.1093/eurpub/ckq150

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Analytic note: Healthcare providers are known to be a vital source of stigma and discrimination, which impacts the lives of persons living with HIV and AIDS. This study examines rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India. It uses a cross-sectional research method. In correlation with previous studies in SSA and Jordan, the study finds high stigma and discrimination among doctors, nurses and other auxiliary medical staff towards people living with HIV and AIDS in India. This article reiterates that the high rates of stigma and discrimination among healthcare providers in these urban Indian healthcare settings appear to be driven primarily by negative feelings towards PLHIV, lack of experience, as well as misconceptions and fear of casual transmission. This article is very relevant with regards to the aim of our study, for it confirms the existent stigma and discrimination among health care providers in healthcare settings in resource-rich as well as resource-limited regions.

Source excerpt: Unfortunately, health professionals are often named as one of the most important sources of stigma for PLHIV. In sub-Saharan Africa, studies have documented discriminatory practices, including patient neglect, provision of differential treatment based on HIV status, denial of care, breach of confidentiality, isolation and verbal abuse by healthcare staff. High rates of refusal of care have also been reported among nurses in Jordan and stigma and discrimination have been documented in some healthcare settings in India also.

Full Citation: Ekstrand, M. L., Ramakrishna, J., Bharat, S. & Heylen, E. (2013) Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions. Journal of the International AIDS Society 16(3) (Supplement 2), 18717. doi: 10.7448/IAS.16.3.18717.

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Analytic note: AIDS-related stigma and discrimination remains a pervasive problem in health care institutions worldwide. Previous studies have demonstrated that AIDS-related stigma is a common phenomenon worldwide that occurs in a variety of contexts, including the family, community, workplace, and health care settings. This article discusses the effectiveness of a stigma-reduction intervention, with the goals of reducing discriminatory practices and improving quality of care for people living with HIV/AIDS in India. A mixed-method research is used and the study findings highlight issues peculiar to the health care sector in limited-resource settings. Strikingly, these findings mirrored in our study, done in a resource-rich context, confirm that HIV/AIDS-related stigma and discrimination in healthcare settings persist, despite progress made with various stigma-reduction interventions.

Source excerpt: The health care setting is a particularly conspicuous context for HIV/AIDS-related stigma and discrimination. In this context people living with HIV or AIDS (PLWHA) often discover their status, and it is where people living with HIV have the potential to gather information about how to care for themselves and prevent transmission to others, as well as get treatment and care. Because of stigma, there have been various reports of HIV positive people receiving inferior care or being denied care altogether (Ogden & Nyblade, 2005). For example, health care workers are influenced by the attitudes of the greater society, and prevailing negative attitudes can result in discrimination. In India, a country with an estimated HIV/AIDS. While AIDS-related stigma in health facilities has become better understood over the years, it is only recently that responses are moving beyond documenting negative experiences to implementing interventions. The findings reported on in this paper highlight that stigmatizing attitudes and discriminatory behaviors towards people living with HIV/AIDS are big challenges in hospitals in India, and that there are particular issues in this limited resource setting that are often not taken into account in global discussions about HIV-related stigma in the health care sector.

Full Citation: Mahendra, V. S., Gilborn, L., Bharat, S., Mudoi, R., Gupta, I., George, B. et al. (2007) Understanding and measuring AIDS-related stigma in health care settings: a developing country perspective. SAHARA Journal 4(2), 616–625. https://doi.org/10.1080/17290376.2007.9724883

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Analytic note: This article uses questionnaires to investigate the existence of discriminatory practices in the health sector that affect the health and well-being of people living with HIV/AIDS in Nigeria, the readiness of health workers and institutions to treat people living with HIV/AIDS and examine factors that may contribute to discriminatory practices. The author suggests that a majority of healthcare professionals are involve in discriminatory and stigmatizing attitudes and behaviors. Many of the healthcare professionals breach confidentiality and demonstrate unethical behavior. Though this study was conducted in Nigeria, it is relevant to the focus of our paper. The author recognizes the fact that a qualitative research is needed to understand the root causes of discrimination and stigmatization of people living with HIV/AIDS and what incites people, including healthcare professionals, to discriminate.

Source excerpt: The study suggests that a significant number of health-care professionals engage in discriminatory and unethical behavior. Some professionals reported giving confidential information to other people (family members and unrelated individuals) without the patient's consent. Despite these discriminatory attitudes, an optimistic finding is that most health-care professionals expressed an interest in additional information and suggested education and counselling as a way to address discriminatory behaviors by their colleagues.

Full Citation: Letamo, G. (2005) The discriminatory attitudes of health workers against people living with HIV. PLoS Medicine 2(8), e261. https://doi.org/10.1371/journal.pmed.0020261

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Analytic Note (Source 1): Stigma is still perceived as a major limiting factor in HIV/AIDS prevention and care. HIV/AIDS stigma and discrimination continue to influence people living with and affected by HIV disease as well as their health care providers, wherever they live. This review article discusses HIV/AIDS stigma, the impact of AIDS stigma and how healthcare providers can help to manage HIV/AIDS stigma in South Africa. In defining stigma, authors look into different definitions of stigma by various authors and make particular allusion to Goffman’s definition of stigma as ‘an attribute that is deeply discrediting within a particular social interaction’, as a ‘spoiled social identity’ and ‘a deviation from the attributes considered normal and acceptable by society. On the impact of AIDS stigma, the article gives an insight into the fear of, and the stigma associated with, HIV were significantly related to the HIV-affected person’s decision to not seek timely healthcare services. This article provided a base for our study.

Analytic Note (Source 2): According to the late Jonathan Mann, the former WHO Head of Global Program on AIDS recognized stigma, discrimination, blame, and denial as potentially the most difficult aspects of HIV/AIDS to address. This article summarizes the key contributions of the Horizons stigma research portfolio to describing the drivers of stigma, identifying effective interventions and approaches for reducing stigma in different settings, and improving methods for measuring stigma. Horizons developed and implemented a wide range of activities in collaboration with numerous local and international partners in Africa, Asia, and Latin America. This article is cited to corroborate the existence of stigma and discrimination in different settings including healthcare.

Analytic Note (Source 3): This article reflects on the progress over the last 30 years with respect to older and more emergent forms of education concerning HIV and AIDS. This education includes treatment education, HIV prevention education, and education to encourage positive and supportive community response. The article emphasizes on the careful analysis of different forms of HIV-related education, the consequences, effects and identifying specific effectivity of HIV-related education in order to achieve positive outcomes. The article also discusses new ways of seeing and understanding the need to support processes that “think” ahead of the epidemic. This article does not discuss HIV educational strategies that may reduce stigma and discrimination in healthcare settings in the globalized world. However, this article is relevant, though not the basis of our research, because it highlights the difficulty to provide HIV education to stigmatized and discriminated groups after more than 30 years since the start of the epidemic. Giving the negative social responses to HIV and AIDS, education is vital in contributing to a positive response. Individual and community empowerment are the necessary mechanisms by which social inclusion can be promoted.

Source Excerpt (Source 1): Other researchers have reported that health care personnel knew very little about the potential for HIV contamination in the workplace. In Kuwait, some family doctors knew less than they should have about HIV and looked upon AIDS patients negatively, even in the third decade of the AIDS pandemic. Similarly, AIDS stigma and discrimination continue to influence people living with and affected by HIV disease as well as their health care providers, particularly in southern Africa where the burden of AIDS is so significant. Stigma is perceived as a major limiting factor in primary and secondary HIV/AIDS prevention and care. Similar to the findings of Adebajo, Bamgbala and Oyediran (2003) in Nigeria, the results in Kuwait showed that nurses and laboratory technicians also had negative attitudes toward AIDS patients. Health care workers’ poor attitudes and inadequate care in these anecdotal reports could be related to stigma. This argument was reaffirmed in our study.

Source Excerpt (Source 2): Horizons and partners recognized from the outset that to improve the environment for people with HIV in health-care settings, it was important for management and health providers to acknowledge that stigma exists in their facilities. They found that a participatory approach that included ongoing sharing of data about levels and types of stigma in institutions helped build staff and management support for stigma-reduction activities

Source Excerpt (Source 3): “As we approach the 30th anniversary of the date on which AIDS was first identified, it is salutary to reflect on progress made in tackling the epidemic. This is especially so in relation to education and HIV, a field that is laden with possibilities but one that has in many ways eluded its potential. Despite these difficulties, education in a variety of forms holds the potential to arrest and turn back the three epidemics (Mann, 1987) to which HIV has given rise: (a) the epidemic of AIDS, which has caused untold harm through serious illness and death; (b) the epidemic of HIV, in many ways silent, unseen, and often unknown; and (c) the epidemic of fear, shame and denial that has led people living with HIV to be stigmatized, ostracized, discriminated against, and denied their human rights”.

Full Citation (Source 1): Holzemer, W. L. & Uys, L. R. (2004) Managing AIDS stigma. SAHARA Journal 1(3), 165–174. doi/pdf/10.1080/17290376.2004.9724839

Full Citation (Source 2): Pulerwitz, J., Michaelis, A., Weiss, E., Brown, L. & Mahendra, V. (2010) Reducing HIV-related stigma: lessons learned from Horizons research and programs. Public Health Reports 125(2), 272–281. doi: 10.1177/003335491012500218

Full Citation (Source 3): Aggleton, P., Yankah, E. & Crewe, M. (2011) Education and HIV/AIDS-30 years on. AIDS Education and Prevention 23(6), 495–507DOI: 10.1521/aeap.2011.23.6.495

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Analytic Note (Source 1): Most African cultures influence health and well-being.The authors use focus group discussions to explains migrant people’s understandings and experiences of healthcare services in the UK and in their home country. Access to, and use of, biomedical, alternative, and traditional sources of treatment were also discussed. The authors argue that patient-doctor relationships can be heavily influenced by the perceived legitimacy of different forms of medical knowledge, communication and treatments and by culturally influenced ideas regarding health, wellbeing and agency among African migrants. Our findings confirms the influence of culture on health.

Analytic Note (Source 2): The process and patterns of HIV disclosure differ in different settings. This article reviews literature that underscores the need for a careful review of the evidence on disclosure, an examination of individual motivations and experiences around disclosure, an assessment of the role of health workers, and a better understanding of the societal determinants and consequences of disclosure in diverse settings.

Analytic Note (Source 3): HIV status disclosure is vital to public health as a preventive measure to reduce and prevent HIV transmission and eventually enhance treatment.This article describes the role of health-care workers in Central and Nairobi provinces in Kenya in facilitating disclosure in the contexts of voluntary counselling and testing and provider-initiated testing and counselling and includes a discussion on how participants perceive and experience disclosure as a result. This article is relevant to our study because it focuses on disclosure, which was found to be a major concern in our study.

Source Excerpt (Source 1): This is of considerable significance in the case of HIV, since it affects a disproportionate number of black African migrants in relation to the white population of the UK, and requires adherence to carefully monitored and individualized anti-retroviral treatment regimens in order to help prevent the development of drug resistant strains and ultimately, death. At the same time, delays in getting affordable and consistent sources of ART to many parts of Africa have meant that historically, relatively few people from affected countries have been able to rely upon such forms of biomedicine and have been placed in situations in which it is arguably entirely rational to seek out alternative forms of treatments. Indeed, such treatments are often integral to African cosmologies which regard many types of ill health as having environmental or spiritual, rather than purely biomedical aetiologies, and many of which have been found to be effective in peoples’ own or shared experiences via the provision of physical and/or psychological relief.

Source Excerpt (Source 2): A main goal of this review was to assess the extent to which health facilities and health workers facilitated disclosure. We found that health worker facilitation of disclosure was limited by the potential for discrimination at health facilities, the limited counselling abilities of many health workers, and health workers’ own fears and concerns regarding HIV. The relatively high frequencies of health workers disclosing people's HIV status without their consent and the low levels of partner disclosure, particularly in less developed countries, testify to the difficult balance between encouraging disclosure and keeping HIV status confidential. Health workers on the front lines need support as they negotiate these complicated situations.

Source Excerpt (Source 3): The quote below from a Central Province woman demonstrates some of the problems that arise from obligatory disclosure: “First, I didn’t want people to know I am HIV positive. But what I really did not like was being told to disclose to someone before being started on ARVs. I was told I have to tell someone I am HIV positive. It was a painful decision, but I ended up telling my aunt ... she was very shocked. I went to her house and told her I wanted to see her on some private issue. We went to her bedroom and I told her I was tested HIV positive and they needed someone who knows about my status as a guarantor at the clinic before I am started on treatment. She was shocked and was quiet for some time. I told her that I was not going to disclose to her but the clinic required that I disclose to someone and go with the person to the clinic before I was started on ARVs. She still kept quiet, and then I asked her if she would agree to come with me to the clinic. She did not talk and I left. But a few minutes after arriving at my home, my aunt came to my house and told me she had accepted to come with me to the clinic”.

Full Citation (Source 1): Thomas, F., Aggleton, P. & Anderson, J. (2010) 'Experts', 'partners' and 'fools': exploring agency in HIV treatment seeking among African migrants in London. Social Science & Medicine 70(5), 736–743. https://doi.org/10.1016/j.socscimed.2009.10.063

Full Citation (Source 2): Obermeyer, C. M., Baijal, P. & Pegurri, E. (2011) Facilitating HIV disclosure across diverse settings: a review. American Journal of Public Health 101(6), 1011–1023. doi: 10.2105/AJPH.2010.300102

Full Citation (Source 3): Moyer, E., Igonya, E. K., Both, R., Cherutich, P. & Hardon, A. (2013) The duty to disclose in Kenyan health facilities: a qualitative investigation of HIV disclosure in everyday practice. SAHARA Journal 10 (Supplement 1), S60–S72. http://dx.doi.org/10.1080/02664763.2012.755339

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Analytic Note: It is evident in literature that healthcare workers perpetrate discrimination towards people living with HIV and AIDS. This paper uses questionnaires to examine the extent to which people living with HIV in London reported being discriminated against because of their infection. It also identifies factors associated with reporting HIV-related discrimination. This report asserts that discrimination by healthcare providers working with the National Health Services in London towards living with HIV persist. This article is relevant to our paper as it highlights the existence of HIV-related stigma and discrimination in healthcare settings.

Source Excerpt: In a diverse sample of people living with HIV surveyed in London in 2004 or 2005, nearly a third said they had been discriminated against because of their HIV infection. Of those who reported HIV-related discrimination, almost a half said this had involved a health care worker including dentists, general practitioners (ie primary care physicians) and hospital staff outside the HIV clinic. Overall, one-in-seven people living with HIV in our survey said they had been discriminated against by a health care worker because of their HIV status. While a number of studies in the USA and Australia have documented discrimination against HIV-infected people by health care staff.

Full Citation: Elford, J., Ibrahim, F., Bukutu, C. & Anderson, J. (2008) HIV-related discrimination reported by people living with HIV in London, UK. AIDS Behavior 12(2), 255–264. http://dx.doi.org/10.1007/s10461-007-9344-2

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Analytic Note: The cultural background and ethnicity of a person may engender prejudice and discrimination. Although HIV/AIDS as a disease can be considered a biomedical concept that is universally applicable, HIV/AIDS is always experienced in a particular socio-cultural context. The disease is experienced and interpreted differently by individuals within their particular cultural background. This article explores the cultural context of HIV positive women's perceptions of stigma in health care settings in Western Cape, South Africa using qualitative focus group discussions methods. Only the abstract of this article was consulted due to limited access to this article. Consistent with results of previous studies, and confirmed by the findings of our study, the abstract highlights the need to consider cultural context in delivering care to women living with HIV/AIDS in order to reduce HIV/AIDS-related stigma and discrimination in health care settings.

Source Excerpt: We explored the cultural context of HIV positive women's perceptions of stigma in health care settings in Western Cape, South Africa. We conducted seven focus groups with women living with HIV/AIDS in Gugulethu and Khayelitsha. We used deductive/inductive approaches to identify themes. Fifty-one women participated, with ages ranging from 18 to 47. Using the PEN-3 model as a guide, we detected these emergent themes: expectation of care (perceptions), care delivery protocols (enablers), and physical environment (nurturers). We recommend that the cultural context in which care is delivered to women living with HIV/AIDS be considered in efforts to reduce and eliminate HIV/AIDS-related stigma in health care settings

Full Citation: Okoror, T. A., Belue, R., Zungu, N., Adam, A. M. & Airhihenbuwa, C. O. (2014) HIV positive women's perceptions of stigma in health care settings in Western Cape, South Africa. Health Care Women International 35(1), 27–49. https://doi.org/10.1080/07399332.2012.736566

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Analytic Note: This is a qualitative study on the experiences of sub-Saharan African (SSA) migrant women living and aging with HIV/AIDS in Belgium. The author demonstrates that a majority of sub-Saharan African migrant women living with HIV/AIDS in Belgium refused to participate in this study because of fear of disclosing their HIV/AIDS status. Despite significant advances in treatment and care, HIV/AIDS remains life-threatening and life-changing, and new challenges continue to arise for HIV/AIDS women and SSA migrant women in particular throughout their lives. The high rate of refusal highlights the extent to which most HIV-infected women still want to keep their HIV positive status secret. Most of the women who refused to be interviewed informed the care providers that they did not want to discuss their illness out of the medical realm. However, some were willing to be interviewed if it was a European conducting the study. Most believed that by participating, their identities would be disclosed to members of the diaspora, and family and friends in their home countries. These reasons further depict the mistrust and confidentiality concerns present among the SSA communities.

Source Excerpt: Of the 116 patients invited to participate in the study 44 agreed to be interviewed and/or observed.

The main reasons why participants want to keep their HIV positive diagnosis secret are: fear of stigma and discrimination, shame, fear of disrupting relationships, rejection, violence and abandonment. Concerns about confidentiality and distrust of other SSA migrants living in Belgium as well as their compatriots in Africa was also evoked as fueling the determination to hide their HIV status.

Full Citation: Arrey, A.E. (2016): Experiences of sub-Saharan African Migrant Women Living and Aging with HIV in Belgium: an ethnographic study. VUBPRESS, Brussels University Press

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Analytic Note (Source 1): Qualitative research aims to address questions concerned with developing an understanding of the meaning and experience in human lives and social environment. Qualitative data are a source of grounded data with rich description and explanation of processes in identifiable local contexts. This book is relevant to our research as it addresses the need of qualitative researchers to share the explicit methods they use to collect, analyze and interpret data. Qualitative researchers need methods that are credible, dependable and replicable.

Analytic Note (Source 2): This is a book review on qualitative research methods. The book review offers an overview of what qualitative research is about. The author of this review is one of the authors of the book “In-depth Interviewing: Researching People” relevant in the use of in-depth interviewing employed in our larger study.

Source Excerpt (Source 1): Analytically, some points are notable. First, ethnographic methods tend toward the descriptive. The analysis task is to reach across multiple data sources (recordings, artifacts and dairies) and to condense them with somewhat less concern for the conceptual or theoretical meaning of these observations. Of course, in deciding what to leave in, what to highlight, what to report first and last, what to interconnect, and what main ideas are important, analytic choices are being made continuously. Social anthropologist are interested in the behavioral regularities in everyday situations language use, artifacts, rituals, relationships. These regularities are often expressed as “patterns” or “languages” or “rules”, and they are meant to provide the inferential keys to culture or society under study. As Van Maanen (1979) put it, the prime analytic task is to “uncover and explicate the ways in which people in particular (work) settings come to understand, account for, take action and otherwise manage their day to day situation.” This “uncovering” and “explicating” is typically based on successive observations and interviews, which are reviewed analytically to guide the next move in the field. (Page 20)

Source Excerpt (Source 2): In summary, this is a useful book for the beginner public health researcher who wants to learn about how to use qualitative research, be better informed about reading qualitative articles, or a better reviewer of qualitative grant applications. I also recommend it as a textbook for students studying research methods

Full Citation (Source 1): Miles, M. J. & Huberman, A. M. (1994) Qualitative Data Analysis: An Expanded Source Book, 2nd edition. Sage Publications, Thousand Oaks, CA.

Full Citation (Source 2): Minichiello, V. (2006) Book reviews: qualitative research methods. Australian and New Zealand Journal of Public Health 30(2), 190–196.

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Analytic Note (Source 1): In qualitative research, the researcher systematically watches people and events to find out about behaviors and interactions in natural settings. It epitomizes the idea of the researcher as the research instrument. It involves "going into the field"--describing and analyzing what has been seen. In health care settings this method has been insightful and illuminating, but it is not without pitfalls for an unprepared researcher. Our research used observational methods as one of the data collection methods. Observations were conducted allowing the researcher to interact socially with the participants in order to observe and understand them.

Analytic Note (Source 2): As qualitative methods are experiencing increasing popularity in consumer research, methods are being introduced from other disciplines, particularly anthropology and sociology. Ethnography has received attention as a promising consumer research method, although it has yet to achieve mainstream status within the discipline. The aim of this type of research is to see the world through the eyes of the members of the culture being examined. This paper discusses the compatibility of ethnography with the grounded theory method of theory induction as employed in sociology, anthropology and other disciplines. In examining stigma and discrimination, we looked into the culture (ethnography) of the study participants for a better understanding (grounded theory) of how stigma and discrimination is perceived by this group to generate patterns..

Source Excerpt (Source 1): The term "observational methods" seems to be a source of some confusion in medical research circles. Qualitative observational studies are very different from the category of observational studies (non-experimental research designs) used in epidemiology, nor are they like the clinical observation of a patient. Observational methods used in social science involve the systematic, detailed observation of behavior and talk: watching and recording what people do and say. Goffman neatly captured this distinct research method with his recommendation that, in order to learn about a social group, one should "submit oneself in the company of the members to the daily round of petty contingencies to which they are subject."' Thus, observational methods can involve asking questions and analyzing documents, but the primary focus on observation makes it distinct from a qualitative research interview (see the next paper in this series) or history taking during patient consultation. Another crucial point about qualitative observation is that it takes place in natural settings not experimental ones; hence, this type of work is often described as "naturalistic research."

Source Excerpt (Source 2): Ethnography can provide in-depth understandings of the ways in which consumers buy and use specific items, while also providing insights into consumption in general. The grounded theory method can generate substantive theories of behavior, thus supplying a means of extending or validating existing consumer behavior theories. It is suggested here that these two methods combined may produce a level of detail and interpretation that is unavailable from other methodologies. Further applications of the combination of ethnography and grounded theory, beyond the limited forays outlined here, are required to further explore the compatibility of these methods and to assess the potential of the combined approach.

Full Citation (Source 1): Mays, N. & Pope, C. (1995) Qualitative research: observational methods in health care settings. British Medical Journal 311(6998), 182–184. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2550229/pdf/bmj00601-0048.pdf

Full Citation (Source 2): Pettigrew, S. F. (2000) Ethnography and grounded theory: a happy marriage? Advances in Consumer Research 27, 256–260. http://acrwebsite.org/volumes/8400/volumes/v27/NA-27

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Analytic Note: In Belgium, HIV is concentrated among two main groups namely: predominately heterosexual Sub- Saharan African migrants and men having sex with men (MSM). Epidemiological surveillance of HIV infection and AIDS has been ongoing since 1985 and is based on the registration of new HIV diagnoses and new cases of AIDS by the Scientific Institute of Public Health. Since 2006, this surveillance is reinforced by collecting data from HIV infected patients in medical follow-up in Belgium: the Belgian HIV cohort. This report is important to our research because it provides the official 2015 epidemiological situation of HIV/AIDS among heterosexuals in Belgium.

Source Excerpt: La transmission par contact hétérosexuel est principalement rapportée par des personnes d’Afrique subsaharienne. Parmi les personnes hétérosexuelles diagnostiquées en 2015, 45 % (N=148) sont de nationalités africaines subsahariennes, 32 % (N=105) de nationalité belge, 14 % (N=47) de nationalités européennes et 9 % (N=30) d’autres nationalités. Les femmes représentaient en 2015, 74 % des diagnostics posés chez des hétérosexuels d’Afrique subsaharienne et 54 % chez des hétérosexuels de nationalité belge.

Source Excerpt Translation: Heterosexual contact transmission is mainly reported by people in sub-Saharan Africa. Of the heterosexual persons diagnosed in 2015, 45% (N = 148) are of sub-Saharan African nationality, 32% (N = 105) of Belgian nationality, 14% (N = 47) of European nationalities and 9% (N = 30) other nationalities. In 2015, women accounted for 74% of diagnoses among heterosexuals in sub-Saharan Africa and 54% among heterosexuals of Belgian nationality. (Google free translation).

Full Citation: Sasse, A., Van Beckhoven, D. & Verbrugge, R. (2015) Epidemiology of AIDS and HIV infection in Belgium. Scientific Institute of Public Health, Brussels, Belgium. URL: https://www.wiv-isp.be/pages/en-home.aspx accessed on 25-01-2016.

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Analytic Note: Globally, health disparities may result in experiences of discrimination, especially among vulnerable groups. This article examines through a cross-sectional study whether foreign-born persons are more likely to report discrimination in healthcare than U.S.-born persons in the same race/ethnic group, whether the immigration effect varies by race/ethnicity, and whether the immigration effect is "explained" by socio-demographic factors. This article highlights that migrants were more likely to report discrimination than U.S.-born persons adjusting for race/ethnicity. It concludes by proposing that immigration status should be included in studies of healthcare disparities because birth is a key determinant of discrimination experiences. Information in the abstract supplements information on discrimination in healthcare settings, the focus of our paper. The full paper is not accessible because of the copyright clause. However, the abstract gives an inside insight of the perception of discrimination in healthcare settings.

Source Excerpt: U.S. healthcare disparities may be in part the result of differential experiences of discrimination in health care. Previous research about discrimination has focused on race/ethnicity. Because immigrants are clustered in certain racial and ethnic groups, failure to consider immigration status could distort race/ethnicity effects. We examined whether foreign-born persons are more likely to report discrimination in healthcare than U.S.-born persons in the same race/ethnic group, whether the immigration effect varies by race/ethnicity, and whether the immigration effect is "explained" by sociodemographic factors. Seven percent of blacks and Latinos and 4% of Asians reported healthcare discrimination within the past 5 years. Immigrants were more likely to report discrimination than U.S.-born persons adjusting for race/ethnicity. For Asians, only the foreign-born were more likely than whites to report discrimination. For Latinos, increased perceptions of discrimination were attributable to sociodemographic factors for the U.S.-born but not for the foreign-born. Speaking a language other than English at home increased discrimination reports regardless of birthplace; private insurance was protective for the U.S.-born only. Immigration status should be included in studies of healthcare disparities because nativity is a key determinant of discrimination experiences for Asians and Latinos.

Full Citation: Lauderdale, D. S., Wen, M., Jacobs, E. A. & Kandula, N. R. (2006) Immigrant perceptions of discrimination in health care: the California Health Interview Survey 2003. Medical Care 44(10), 914–920. doi: 10.1097/01.mlr.0000220829.87073.f7

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Analytic Note (Source 1): The face of HIV in Western Europe is changing, as it mirrors the predominantly heterosexual pattern of the disease in sub-Saharan Africa (SSA). Sub-Saharan African migrants are disproportionately affected by HIV in Western Europe and wherever they live. This article discusses the barriers to HIV testing for black Africans living in the UK and the Netherlands. The authors identify access to testing and care, fear of death and disease and fear of stigma and discrimination in the community as cultural, social and structural barriers to testing for HIV. In addition, the lack of political will, restrictive immigration policies and the absence of African representation in decision-making processes as important factors preventing black Africans from testing. This study contributed in formulating the basis of our research.

Analytic Note (Source 2): Migration and HIV are often linked in literature. This report discusses monitoring migrant health, migrant-friendly health services, policy and legal frameworks on migrant health and partnerships, networks and multi-country frameworks. In the report, it addresses the HIV vulnerabilities of migrant population in western industrialized countries. This report is cited to support the relationship between HIV and migration.

Source Excerpt (Source 1): Across Western Europe, the face of the HIV epidemic is changing, reflecting patterns of disease in sub-Saharan Africa (SSA). Although the predominant mode of transmission within Western Europe is sex between men, countries have seen increases in new HIV diagnoses among heterosexuals originating from countries with generalized epidemics. In 2005 in the European Union (EU), nearly half (46%) of heterosexually acquired HIV infection was diagnosed among immigrants, primarily from SSA, and most infections were acquired outside the EU. Late diagnosis (diagnosis with an AIDS-defining illness or a CD4 count of <200 cells/μL) is common among migrants in Western Europe. The associated impact on individual morbidity and mortality means that migrant black Africans continue to be disproportionately affected. In this paper we discuss the barriers to HIV testing for sub-Saharan migrants, with particular emphasis on the experience in the UK and the Netherlands.

Source Excerpt (Source 2): Migrants from countries with generalised HIV epidemics who live in the EU are disproportionately affected by HIV. In 2010, 27 116 newly diagnosed cases of HIV infection were reported by 28 (of the 30 total) countries of the EU/EEA. In 2010 in the EU/EEA, the predominant mode of transmission for HIV infection was MSM (38 per cent of the reported cases), followed by heterosexual contact. In total, around 35 per cent of the new heterosexual HIV diagnoses in the EU were diagnosed in individuals originating from countries with generalised epidemics, primarily sub-Saharan Africa, ranging from very low levels in the eastern parts of the EU to approximately 60 per cent in Belgium, Sweden, and the United Kingdom. These percentages are most likely to be an underestimate of the true figures. Although migrants from countries with generalised HIV epidemics represent many of the HIV cases in the EU, more than 60 per cent of heterosexuals from generalised epidemic countries present at a stage in their illness when they are already in need of antiretroviral therapy, with a CD4 count of less than 350 copies/mL.

Full Citation (Source 1): Fakoya, I., Reynolds, R., Caswell, G. and Shiripinda, I. (2008), Barriers to HIV testing for migrant black Africans in Western Europe. HIV Medicine, 9: 23–25. doi:10.1111/j.1468-1293.2008.00587.x

Full Citation (Source 2): ECDC (2012) Responses to HIV and Migration in Western Industrialized Countries: Current Challenges, Promising Practices, Future Directions. European Centre for Disease Control, Stockholm. URL: http://www.ecdc.europa.eu/en/publications/publications/hiv-migration-meeting-report.pdf accessed on 11-02-2013.

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Analytic Note: For some reasons migrants, especially from resource-limited regions, have increased vulnerability to infectious diseases and face multiple barriers to healthcare. The article explores the views of new migrants around barriers, accessibility, and acceptability of screening for HIV, tuberculosis, hepatitis B, and hepatitis C in the UK, a resource-rich setting similar to the setting (Belgium) in our study. Similar to our study, this paper confirms the vulnerability of migrants, especially from sub-Saharan Africa to infectious diseases including HIV and AIDS. Moreover, barriers that discourage uptake of screening include disease-related stigma present in their own communities and services being perceived as non-migrant friendly are also present in our study. Most migrants are likely to be disproportionately affected by these barriers, with implications for health status, as reiterated in our study.

Source Excerpt: In the past decade the UK in particular has received a sizeable and increasing number of new migrants, which has had important implications for public health services. Infectious diseases are believed to be the key health issue for new migrants from high-prevalence countries, with asylum seekers and refugees considered to be particularly affected. Migrants bear the largest burden of infectious disease in the UK; approximately 70% of newly diagnosed UK tuberculosis (TB) and 60% of new HIV cases are in migrants, with comparable trends expected for hepatitis B and C. London now has the highest tuberculosis rate among all capital cities in western Europe. Numerous factors contribute to the vulnerability of new migrants to infectious diseases, with migrants - and ethnic minorities more broadly - known to face barriers to healthcare, which may result in delays to screening and diagnosis. Tackling infectious diseases may raise specific issues, including stigma and fear of discrimination. New migrants may be particularly affected in terms of their ability to access and benefit from screening programmes for infectious disease as they attempt to navigate a new health system.

Full Citation: Seedat, F., Hargreaves, S. & Friedland, J. S. (2014) Engaging new migrants in infectious disease screening: a qualitative semi-structured interview study of UK migrant community health-care leads. PLoS One 9(10), e108261. https://doi.org/10.1371/journal.pone.0108261

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Analytic Note: Literature documents poor relationship between drug users and therapeutic staff. This article examines consumer projects introduced in three Australian drug treatment services. The title of the article ‘We are people too’ depicts the vulnerability of this group of persons, similar to the group (migrant women with HIV/AIDS) in our study.

Source Excerpt: For service users, the opportunity to have ‘a voice’ began to disrupt the routine objectification or dehumanization that consistently, if unintentionally, characterize the treatment experience. Having a voice, it seemed, was synonymous with being human, with having ones’ ‘humanness’ recognized. We contend that not only did the introduction of consumer participation appear to empower service users and enhance the therapeutic alliance, it may have also improved service quality and health outcomes.

Full Citation: Rance, J., & Treloar, C. (2014) ‘We are people too’: consumer participation and the potential transformation of therapeutic relations within drug treatment. International Journal of Drug Policy https://doi.org/10.1016/j.drugpo.2014.05.002

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Analytic Note: Men having sex with men (MSM) is a vulnerable group, especially when these persons are HIV- positive. This review article assesses MSM comfort in accessing health services and willingness to participate in HIV prevention research in Kisumu, Kenya-an area of high HIV prevalence. This study uses mixed-methods comprising of interviews and surveys. It is relevant to our study which also studied a vulnerable group of migrant women with HIV/AIDS.

Source Excerpt: The only factor in our analysis associated with these men was a report of feeling people were staring at them. In a similar vein, the main barrier to participating in HIV research was having their personal information made available to others in the community. Receiving education that could help prevent HIV infection was the main motivator to taking part in an HIV research study. That a large proportion of MSM in Kisumu had some discomfort (62.7%) when seeking services at a public hospital agrees with reports of MSM from other areas of Africa. Among MSM in South Africa, all reported witnessing or experiencing homophobia from health care workers. Among MSM in Malawi, Namibia, and Botswana, there was an association between fear of health care services and ever having experienced discrimination. Homophobia and provider stigma were noted as barriers to obtaining condoms, lubricants, HIV testing, and HIV treatment in a global MSM health and rights study.

Full Citation: Okall, D. O., Ondenge, K., Nyambura, M., Otieno, F. O., Hardnett, F., Turner, K. et al. (2014) Men who have sex with men in Kisumu, Kenya: comfort in accessing health services and willingness to participate in HIV prevention studies. Journal of Homosexuality 61(12), 1712–1726. doi: 10.1080/00918369.2014.951261

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Analytic Note (Source 1): All women are at risk of acquiring HIV but black women have higher rates of HIV. The authors discuss the effect of gender-sensitive and culturally relevant HIV prevention film messages using behavioural interventions on HIV prevention behaviour changes among women resident in Boston. Contrarily to our study, the authors avoided asking if participants were HIV positive. The authors focused on HIV prevention interventions. A similarity with our study is the unwillingness to participate in HIV research for fear of disclosure, stigma and breach of confidentiality.

Analytic Note (Source 2): Most HIV persons perceive participating in HIV research as confirming HIV positive status. This qualitative study expands current knowledge of stigma and discrimination related to participation in HIV vaccine research in sub-Saharan Africa. It explores the perception of stigma and discrimination as a barrier to participation in HIV vaccine research in Kenya. This paper is relevant to our study because many women with HIV who were invited to participate in our study refused participation on grounds that their HIV status will be disclosed. Fear of the negative effects of HIV positive status hampers participation in HIV research.

Analytic Note (Source 3): This toolkit discusses and illustrates that to disclose HIV positive status is an obligation under the Canadian criminal law since 1990s. This article reveals that since 2012, people living with HIV in Canada have a legal duty to disclose their HIV status before having sex.

Source Excerpt (Source 1): The participants were not asked if they were living with HIV, because stigma related to disclosure has often decreased willingness to participate in studies such as this, and the focus of this study was on primary prevention.

Data Source (Source 1): DeMarco_2009

Source Excerpt (Source 2): Four prominent stigma-related barriers to participation emerged among all respondent groups, across both centers: (1) volunteers are often assumed by family and community members to be HIV positive because of their participation in vaccine research; (2) HIV-related stigma is perceived as pervasive and damaging in the communities where volunteers live, thus they fear consequent stigma if people believe them to be HIV positive; (3) potential volunteers fear being tested for HIV, a prerequisite for participation, because of possible disclosure of HIV status in communities with high perceived HIV-related stigma; and (4) volunteers must carefully manage information about their participation because of misperceptions and assumptions about vaccine research volunteers. HIV-related stigma and discrimination influence people's decisions to join HIV-vaccine related research.

Data Source (Source 2): Nyblade_2011

Source Excerpt (Source 3): This guide is useful for lawyers, advocates, researchers and persons living with HIV and AIDS. Criminalization of HIV non-disclosure also exist in Belgium as in many other European countries, making this toolkit important to our paper.

Full Citation (Source 1): DeMarco, R. F., Kendricks, M., Dolmo, Y., Looby, S. E. & Rinne, K. (2009) The effect of prevention messages and self-efficacy skill building with inner-city women at risk for HIV infection. Journal of the Association of Nurses in AIDS Care 20(4), 283–292.. DOI: 10.1016/j.jana.2009.02.007

Full Citation (Source 2): Nyblade, L., Singh, S., Ashburn, K., Brady, L. & Olenja, J. (2011) ‘Once I begin to participate, people will run away from me’: understanding stigma as a barrier to HIV vaccine research participation in Kenya. Vaccine 29(48), 8924–-8928. DOI: 10.1016/j.vaccine.2011.09.067

Full Citation (Source 3): Canadian HIV/AIDS Legal Network, (2014) Criminal Law and HIV Non-Disclosure in Canada. URL: www.aidslaw.ca/criminallaw accessed on 24-04-2015.

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Analytic Note: Positive HIV diagnosis has not impeded the desire of women and men living with HIV to have children. This article describes the experiences of conceiving and having children following an HIV diagnosis of women and men living with HIV in Iringa, Tanzania. Despite the existing stigma and discrimination, this study like in previous studies, and our study, supports the fact that childbearing desires of women and men living with HIV/AIDS are shaped by personal, social and institutional factors.

Source excerpt: The lived experience of having children after an HIV diagnosis is situated within this sociocultural and institutional context, where parenthood often defines one’s sense of self and one’s social position. Because of the stigma associated with being HIV-positive, weighing biomedical and social risks can be particularly challenging for those women and men who have children following an HIV diagnosis. The social risk of being ostracized for not having children or for not reaching a socially desirable family size may override any real or perceived biomedical risks

Full Citation: Saleem, H. T., Surkan, P. J., Kerrigan, D. & Kennedy, C. E. (2015) Childbearing experiences following an HIV diagnosis in Iringa, Tanzania. Qualitative Health Research https://doi.org/10.1177/1049732315605273

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Analytic Note (Source 1): Stigma and discrimination in healthcare remains a pervasive problem. This review paper argues that stigma has a far more insidious influence, going well beyond the individual and potentially impacting on all sectors of society. As in our study, this article underlines how stigma undermines a person's identity and capacity to cope with the disease at an individual level.

Analytic Note (Source 2): The study examines internalized AIDS stigmas among people living with HIV/AIDS in Cape Town, South Africa. It demonstrates that discrimination experiences are common and internalized AIDS stigmas were prevalent among people living with HIV/AIDS. Our article confirms the persistence of social stigmas and discrimination and internalized stigma.

Analytic Note (Source 3): HIV/AIDS has evolved but stigma and discrimination persists. This article measures the frequency of discrimination and assesses its correlates among people living with HIV in France. The survey uses data from a national representative survey, the ANRS-Vespa2 study, conducted in France in 2011 among 3022 male and female HIV-positive patients followed at hospitals. The most striking finding relates to women from sub-Saharan Africa reporting the highest levels of discrimination, whereas heterosexual non-African men reporting the lowest. In this study, HIV-related stigma and gender intertwine. We cited this article because it demonstrates that people living with HIV are exposed to stigma not only because of their HIV-positive status but also because they are blacks or belong to a minority population in France, as is the case in Belgium and most European Union countries.

Source Excerpt (Source 1): Discrimination has significant impacts on diagnosis and treatment. For the individual it can delay diagnosis and therefore also delay entry into treatment and adoption of a healthy lifestyle. There is no motivation to be tested, as the person sees no benefit when the diagnosis of HV is seen as equivalent to death, and they are likely to experience discrimination.

Source Excerpt (Source 2): Discrimination experiences were common and internalized AIDS stigmas were prevalent among people living with HIV/AIDS in Cape Town.

Source Excerpt (Source 3): Since the advent of AIDS, discrimination has remained at the core of the experience of people living with HIV (PLHIV). PLHIV who belong to minority groups are exposed to discrimination not only on the grounds of their HIV infection but also because of rejecting attitudes towards drug users, homosexuals and black people.

Full Citation (Source 1): Skinner, D. & Mfecane, S. (2004) Stigma, discrimination and the implications for people living with HIV/AIDS in South Africa. SAHARA Journal 1(3), 157–164. DOI: 10.1080/17290376.2004.9724838

Full Citation (Source 2): Simbayi, L. C., Kalichman, S., Strebel, A., Cloete, A., Henda, N. & Mqeketo, A. (2007) Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Social Science & Medicine 64(9), 1823–1831. DOI:10.1016/j.socscimed.2007.01.006

Full Citation (Source 3): Marsicano, E., Dray-Spira, R., Lert, F., Aubriere, C., Spire, B. & Hamelin, C. (2014) Multiple discriminations experienced by people living with HIV in France: results from the ANRS-Vespa2 study. AIDS Care 26 (Supplement 1), S97–S106. DOI: 10.1080/09540121.2014.907385

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Analytic Note (Source 1): This article discusses HIV prevention programs as HIV is now a preventable disease. With intervention programs that focus on identifying and targeting high risk groups, based on evidence of knowing the HIV epidemic, new HIV transmission can be prevented. This article was selected because it depicts HIV as a preventable disease through efficient and sustainable prevention intervention programs that include a combination of behavioural as well as biomedical intervention programs. It was not selected for any specific intervention program but to support the fact that HIV is a preventable disease since it emerged more than 30 years ago.

Analytic Note (Source 2): This study discusses gender-sensitive and culturally relevant HIV prevention film messages combined with self-efficacy and skill building exercises on self-reported safe sex behaviours, intentions, attitudes, and self-advocacy over time. The findings show that, HIV is preventable through a combination of interventions. Despite the short duration of the intervention, participants self-reported significantly more use of safe sex behaviours and being prepared for sexual intimacy after the intervention. The article is relevant to our study because the preventive messages it purports could be encouraged among women at risk of HIV.

Analytic Note (Source 3): This article discusses early AIDS epidemiology and surveillance, AIDS as a metaphor for emerging infections and a new global health, the globalization of science, research and practice, response and the future of AIDS. This article is relevant because it supports our claim that HIV is a preventable disease.

Analytic Note (Source 4): This article upholds that though HIV is a preventable disease, but the challenging social environment makes prevention difficult.

Source Excerpt (Source 1): Millions of people would not be newly infected each year if that were not the case. Our challenge now is to start doing more prevention, better. We must also ensure that the situation improves each year as researchers develop more effective interventions, programme evaluators learn about what works best, where, and for whom, and managers learn how to deliver services more efficiently. Although we still hope that a magic bullet will one day be discovered, we must now start designing and implementing prevention programmes that can succeed without one.

Source Excerpt (Source 2): The purpose of this study was to examine the effect of gender-sensitive and culturally relevant HIV prevention film messages combined with self-efficacy and skill building exercises on self-reported safe sex behaviours, intentions, attitudes, and self-advocacy over time. A sample of 131 women of mixed ethnicity from inner-city Boston who were living in transitional housing participated in a 4-week pre/post measurement design. Results showed that, despite the short duration of the intervention, participants self-reported significantly more use of safe sex behaviours and being prepared for sexual intimacy after the intervention. The study validated use of an approach originally intended for African American women with other women at risk for HIV.

Source Excerpt (Source 3): Although the end of the epidemic is not yet in sight and many challenges remain, the response has been remarkable and global health has changed for the better.

Source Excerpt (Source 4): Evidence from the study showed that prevailing HIV prevention paradigms reinforce the difficulties faced by young women in their sexual lives. This research adds to calls for alternative and wider approaches to HIV prevention, underpinned by gender empowerment.

Full Citation (Source 1): Bertozzi, S. M., Laga, M., Bautista-Arredondo, S. & Coutinho, A. (2008) Making HIV prevention programmes work. The Lancet 372(9641), 831–844. DOI:10.1016/S0140-6736(08)60889-2

Full Citation (Source 2): DeMarco, R. F., Kendricks, M., Dolmo, Y., Looby, S. E. & Rinne, K. (2009) The effect of prevention messages and self-efficacy skill building with inner-city women at risk for HIV infection. Journal of the Association of Nurses in AIDS Care 20(4), 283–292.. DOI: 10.1016/j.jana.2009.02.007

Full Citation (Source 3): De Cock, K. M., Jaffe, H. W., & Curran, J. W. (2011). Reflections on 30 Years of AIDS. Emerging Infectious Diseases, 17(6), 1044–1048. http://doi.org/10.3201/eid1706.100184

Full Citation (Source 4): Conn, C. (2013) Young African women must have empowering and receptive social environments for HIV prevention. AIDS Care 25(3), 273–280. https://doi.org/10.1080/09540121.2012.712659

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Analytic Note: This article is about shouldering stigma emanating from health problems. This article discusses burn-out syndrome in rich healthcare systems and brain-drain in poor countries.The author posits that the burden of disease can be reduced by appropriate treatment and other measures but that it is not reduced by transferring responsibility to the persons who are suffering from a disease to the responsibility of someone else. This article is relevant as a citation in our study to demonstrate how the consequences of health problems are often left to the individual to shoulder as in the case of HIV/AIDS-related stigma and discrimination.

Source Excerpt: The introduction of the idea of self-reliance goes against this arrangement and places the responsibility after individual. Should individuals fail to look after themselves the responsibility falls on society as a whole, i.e. to the government that is supposed to represents it. For many, particularly the healthy and the strong in the country previously relying on interdependence the principle of self-reliance is attractive because it liberates them from the myriad of obligations that interdependency implies. Thus, they accept the notion and promote it. The problem resides in the fact that governments in countries in which the members of the population until now coped by relying on one another usually do not have the resources and perhaps not even the intention to help its citizens deal with their problems. Another sin of many administrators and

Full Citation: Sartorius, N. (2009) Illnesses of the health system. Psychiatria Danubina 21(4), 444–445.

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Analytic Note: This article discusses cultural beliefs surrounding mental illness, and how experiences of stigma impact relationship with family and help-seeking behaviours among black and minority communities in the UK. This qualitative study asserts that stigma is communicated by the medical staff, community members or through the family. Although the focus of this article is on mental illness, its reference is pertinent because HIV/AIDS-related stigma and discrimination can also affects the mental health of an individual. Moreover, some HIV/AIDS persons may suffer from a mental disorder such as anxiety, depression and chronic stress at one point in their HIV/AIDS trajectory. Additionally, some of our study participants experienced one or more mental disorders.

Source Excerpt: Participants identified inequalities in diagnosis, particularly psychosis, and treatment. These experiences echo previous research particularly relating to higher rates of diagnoses of psychosis among black and minority ethnic groups as well as compulsory admission (Boast & Chesterman, 1995; Davies et al 1996; Dunn & Fahy 1990; McGovern & Cope 1991; Singh et al 1998. This finding that external stigma compromises the trust of ethnic minorities demonstrates how experiences of stigma impact on help-seeking behaviours and treatment. Ultimately, stigma from authorities or medical services can lead to the underutilisation of the medical system by ethnic minorities (Burgess et al 2008; Gary 2005).

Full Citation: Shefer, G., Rose, D., Nellums, L., Thornicroft, G., Henderson, C. & Evans-Lacko, S. (2013) 'Our community is the worst': the influence of cultural beliefs on stigma, relationships with family and help-seeking in three ethnic communities in London. International Journal of Social Psychiatry 59(6), 535–544. DOI: 10.1177/0020764012443759

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Analytic note: This article assesses the experience of stigma and discrimination on the psychological and health behaviour of people living with HIV/AIDS in Arba Minch, Ethiopia. It suggests that stigma and discrimination has an implication on care and support behaviour among people living with HIV/AIDS in a resource-limited area. Although conducted in a resource-limited area, this paper is relevant to our research because it reports on the progress made in alleviating stigma and discrimination among individual and the community. Notwithstanding the changes from an overt to a more concealed type, the problem remains pertinent in the lives of people living with HIV/AIDS in resource-limited as well as resource-rich regions. The looming concealed nature of present day stigma and discrimination not only affects the psychological wellbeing but also physical health, whereby individuals refuse to disclose their status, seek timely medical treatment and increase the possibility of non-adherence to antiretroviral therapy.

Source excerpt: Fear of being identified as having HIV or AIDS may discourage a person from getting tested, from accessing medical services and medications, and from disclosing their HIV status to family and friends. This might be mainly due to the fact that higher perceived susceptibility and perceived severity to stigma and discrimination leads to decreased motivation, which in turn results in reduced performance and productivity

Full Citation: Alemu, T., Biadgilign, S., Deribe, K., & Escudero, H. R. (2013). Experience of stigma and discrimination and the implications for healthcare seeking behavior among people living with HIV/AIDS in resource-limited setting. Sahara J, 10(1), 1–7. http://doi.org/10.1080/17290376.2013.806645

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Analytic Note: Ebola has recently been included in the list of diseases with stigmatizing and discriminatory attitudes and behaviors tied to it. This article reviews literature that discusses the similarities and differences between HIV/AIDS and Ebola virus disease in the community as well as in healthcare settings. The authors also discuss how lessons learnt from HIV/AIDS-related stigma can be applied to Ebola disease and ensuing stigma. The article highlights similar stigmatizing attitudes and behaviors directed towards persons with HIV/AIDS and Ebola, and the life-threatening nature of both diseases. In both cases, stigma and discrimination is propagated by misinformation and myths on mode of transmission and affected persons. They differ in the mortality. Ebola has a shorter life span than HIV/AIDS. In addition, Ebola patients don’t suffer from potential criminal persecution in case of Ebola transmission due to non-disclosure. This article is relevant to our research because it confirms stigma as a disruptive factor in the quality of life of persons with HIV/AIDS and Ebola survivors.

Source Excerpt: Stigmatizing attitudes and behaviours, including patient blaming and neglect, refusal/denial of care, and irrational and inappropriate fear of contagion directed toward impacted populations have not only devastated familial, social, and economic relationships and infrastructures but they have also interfered and created colossal barriers to access, prevention, and treatment . More specifically, HIV/AIDS-related stigma has led to avoidance of healthcare, reduced adherence to antiretroviral medications, increased HIV symptomatology, and emergence of mental health pathologies including depression. Stigma in the context of EVD is equally disconcerting as it also originates from structural inadequacies, including poverty, lack of education, and political conflict. These factors combined with cultural practices subsequently influence attitudes, beliefs, and behaviors with respect to disease transmission. During the 2000 and 2001 EVD epidemics in Uganda for example, harassment, rejection, and abandonment of individuals with EVD were common occurrences. Those in contact with EVD patients were also victimized with some being prevented from returning to their homes and communities, and their properties destroyed. Children were also not spared. There are reports of children orphaned by EVD who remain sero-negative but have not been taken up for care by families and communities out of fear of contagion.

Full Citation: Davtyan, M., Brown, B., & Folayan, M. O. (2014). Addressing Ebola-related Stigma: Lessons Learned from HIV/AIDS. Global Health Action, 7, 10.3402/gha.v7.26058. http://doi.org/10.3402/gha.v7.26058

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Analytic Note: Stigma has been perceived as accompanying certain diseases for which society associates behavioral norms to these disease. Stigma is an obstacle to the positive development of physical as well as mental health. This article reviews and describes anti-stigma activities in 14 European countries (including Belgium) regardless of language used to publish the article or if the article had been previously published. This article indicates that there is a lack of adequate support against stigma and discrimination of mental illness. The anti-stigma and discrimination activities in these countries are not part of long-term programs to fight mental health stigma and discrimination. This article is useful because it highlights the fact that mental illness remains a stigmatized disease despite treatment of the disease, just like HIV. The paper is relevant because some HIV/AIDS patients may suffer from a mental illness as a result of their HIV infection.

Source Excerpt: Stigma of a disease often indicates that the persons who suffer from that disease are dangerous, likely to infect or otherwise harm others, that they are incurable, and that they are of little or no value to society. The discovery of a treatment that cures the disease changes such perceptions and signals that it is worth investing in treatment because it will return the sick individuals to useful roles in society. It also signals that persons affected by the disease have not become valueless because they have the illness.

Full Citation: Beldie, A., den Boer, J. A., Brain, C., Constant, E., Figueira, M. L., Filipcic, I. et al. (2012) Fighting stigma of mental illness in midsize European countries. Social Psychiatry and Psychiatric Epidemiology 47 (Supplement 1), 1–38. https://doi.org/10.1007/s00127-012-0491-z

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Analytic Note: This article highlights the existence of stigma among persons living with type 2 diabetes, especially as it can sometimes be considered a disease of lifestyle, just like HIV. The authors conducted a qualitative study consisting of interviews and informed on a literature review with the aim of exploring the social experiences of Australian adults living with type 2 Diabetes, with a particular (but concealed) focus on the perception and experience of diabetes-related stigma. Thematic analysis using an inductive approach was used to analyse data. The study finds evidence of feelings or experiences of stigma among a majority of study participants and concludes that type two diabetes is a stigmatizing disease. This confirms the perception of stigma of life-style chronic diseases including HIV.

Source Excerpt: A total of 21 (84%) participants indicated that they believed T2DM was stigmatized, or reported evidence of stigmatization. Specific themes about the experience of stigma were feeling blamed by others for causing their own condition, being subject to negative stereotyping, being discriminated against or having restricted opportunities in life. Other themes focused on sources of stigma, which included the media, healthcare professionals, friends, family and colleagues. Themes relating to the consequences of this stigma were also evident, including participants’ unwillingness to disclose their condition to others and psychological distress. Participants believed that people with type 1 diabetes do not experience similar stigmatization. “I think the stigma is that it's a lifestyle disease. That somehow you've been lazy and you've allowed this to happen to yourself. I think to me that must come through very strongly, that's the judgment that I think that is made. (#19; woman, 54 years)”

Full Citation: Browne, J. L., Ventura, A., Mosely, K. & Speight, J. (2013) 'I call it the blame and shame disease': a qualitative study about perceptions of social stigma surrounding type 2 diabetes. BMJ Open 3(11), 1–10. BMJ Open 2013;3:e003384. doi: 10.1136/bmjopen-2013-003384

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Analytic Note: There has always been an undeniable relationship between stigma and discrimination and health. This article reviews the development of international research on the relationship between discrimination and health. This author identifies from reviewed articles some key findings that might guide practical and programmatic responses to human suffering and health challenges caused by stigma and discrimination. We used this article to confirm the interconnection between stigma, discrimination and health

Source Excerpt: In examining stigma and the HIV issue, we gave even greater emphasis to the emergence and evolution of stigma in specific contexts of culture and power. For this reason, stigma is not a free-floating social phenomenon; the historically determined nexus between cultural formulations and systems of power and domination is crucial. We argued that the period in which a stigma appears and the form it takes are always influenced by historical circumstances. Understanding this historical context and its consequences for affected individuals and communities can help us develop better approaches for combating this phenomenon and reducing its effects. This framework focuses on how stigma is used by individuals, communities and the state to produce and reproduce structures of social inequality. It also pushes us to examine the political economy of stigmatization and its links to social exclusion and how historically constructed forms of stigma are strategically deployed to produce and reproduce social inequalities.

Full Citation: Parker, R. (2012). Stigma, prejudice and discrimination in global public health. Cadernos de Saúde Pública, 28(1), 164-169. https://dx.doi.org/10.1590/S0102-311X2012000100017

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Analytic Note: Stigma and discrimination are social processes, characterized by cross-cultural diversity and complexity. This article offers a new framework, from that of Goffman, by which to understand HIV and AIDS-related stigma and its effects. It highlights the manner in which stigma feeds upon, strengthens and reproduces existing inequalities of class, race, gender and sexuality. This article forms a solid basis of our research.

Source Excerpt: This sociological emphasis on the structural dimensions of discrimination is particularly useful in helping us think more sensibly about HIV and AIDS-related stigmatization and discrimination. To move beyond the limitations of current thinking in this area, we need to reframe our understandings of stigmatization and discrimination to conceptualize them as social processes that can only be understood in relation to broader notions of power and domination. In our view, stigma plays a key role in producing and reproducing relations of power and control. It causes some groups to be devalued and others to feel that they are superior in some way. Ultimately, therefore, stigma is linked to the workings of social inequality and to properly understand issues of stigmatization and discrimination, whether in relation to HIV and AIDS or any other issue, requires us to think more broadly about how some individuals and groups come to be socially excluded, and about the forces that create and reinforce exclusion in different settings.

Full Citation: Parker, R. & Aggleton, P. (2003) HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Social Science & Medicine 57(1), 13–24. https://doi.org/10.1016/S0277-9536(02)00304-0